Skip to main content

Outcomes Matter: Effective commissioning in domiciliary care

The concept of outcome-based commissioning has been a feature of the adult social care landscape for some time, as a method of delivering personalised services based on need. A recent LGiU survey has shown that over 70% of local government respondents regard outcomebased commissioning as ‘very important’ to the future of adult social care.

But what do we mean by commissioning? The renewed interest in in-house provision shown by some local authorities could be held to imply a move away from standard commissioning models. We would argue however that ‘commissioning’ describes the strategic process of designing services and choosing delivery agents, rather than proscribing a particular form of provision. As such, it remains intrinsic to the system, irrespective of the choice of service provider. Most definitions describe a cyclical process, where possible involving carers, care workers and service users through consultation and coproduction, and including the following steps:

  • assessing the needs of a population
  • setting service priorities and goals
  • securing services from providers to meet those needs
  • monitoring and evaluating outcomes.