Overcoming challenges in collaborative commissioning

Overview

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CPD’s briefing note explores the main barriers to collaborative commissioning and ways of overcoming them to design services that truly meet community needs.

This briefing note was provided to the Productivity Commission’s inquiry into Delivering quality care more efficiently.

Download the briefing note

CPD’s briefing note Overcoming challenges in collaborative commissioning pinpoints the main barriers to adopting this approach, and explores ways to overcome them to design services that truly meet community needs.

Download the briefing note [PDF]

What is collaborative commissioning?

Collaborative commissioning is the process of bringing together funders (government agencies) and service providers to collectively identify and respond to a population’s needs. This approach to commissioning social services promotes local autonomy and accountability, fosters coordination and cooperation between actors across sectors, and leverages partnership with communities to improve outcomes for people.

What are the key elements of collaborative commissioning?

Collaborative commissioning approaches share some key elements:

  • People- and place-centred: Services are designed around the needs, strengths, and aspirations of people and communities, prioritising local knowledge and lived experience in decision-making. 
  • Shared vision, goals, and outcomes: Communities, service users, and delivery partners co-create a shared vision, goals, and outcomes that guide all planning and decision-making. Funding is sometimes tied to these co-designed outcomes. 
  • Strategic resourcing: Flexible funding models are used to ensure resources are aligned with mutually-agreed goals across services and systems and service offerings can be scaled up or down based on community need. 
  • Joint governance: Cross-sector partners share power, decision-making, accountability, and data and cooperatively consider performance through joint governance. 
  • Trust-based collaboration: Care delivery relies on long-term, respectful relationships between actors centred on people’s needs and shared goals, not organisational boundaries. 
  • Continuous learning and adaptation: Data, community feedback, and practitioner experience are used to iterate and improve design and delivery over time, building workforce capability. 

What are the core barriers to this approach?

Collaborative commissioning is held back by entrenched system dynamics, policies and mindsets of our political leadership, public services, care providers, and communities. The briefing note identifies three main barriers:

  • Marketisation: The practice of distributing government resources on a competitive market impairs collaborative commissioning. This marketisation approach manifests in various systems as demand-side funding, one-on-one appointment-based service models, competition between providers, limited government stewardship, and restrictive centralised procurement rules. 
  • Short-term thinking and funding: A focus on achieving easily measured results over a short timeframe. This is the product of political leadership, electoral expectations, and media environments which demand concrete deliverables in short time frames. 
  • Risk aversion and rigid accountability: In the public service, this manifests as reporting structures where accountability flows from low level public servants up the organisational hierarchy to the minister responsible for that portfolio. Sectors that contract out service delivery often use rigid contracts with largely punitive measures to keep providers in line. These structures are designed to minimise risk as much as possible, which has the effect of stifling innovation and impairing outcomes. 

What do we suggest?

Successfully scaling collaborative commissioning and its key elements will require capability and culture change among the public service, service providers, and communities. Examples might include: 

  • Where appropriate for the sector, employing a combination of government and non-government service provision so that government agencies better understand the complexities of service delivery 
  • Immersing commissioning agency staff in the communities for which they commission, such as by co-locating government staff in communities or hosting events where providers take government staff through the community 
  • Regular interdisciplinary spaces for shared learning and information exchange 
  • Providing community members with similar professional development resources to practitioners 
  • Funding dedicated to building and maintaining partnerships 

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