How can you make better decisions in #complexity?

What is one thing you’d like to offer to adult social care commissioners to help them decide their approach?

How can you make better decisions in #complexity?

How do we ensure a better #future for citizens, communities – and ourselves?

How can we encourage #innovation in an over-pressurised and partly broken system?


Adult social care #commissioning is a fantastic space to explore these issues, as we’ve been doing for the last few weeks on an interesting project, and for years before that!

Commissioning in adult social care means shaping a complex system to get better outcomes for people with learning disabilities, physical disabilities or physical or mental health issues.

It can be as narrow (but challenging) as ‘procuring organisations to provide homecare’, and as wide and messy as ‘shaping a community where everyone can thrive’.

As a commissioner, you have varying levels of power, authority, capability, respect, and understanding in your organisation.

…you have to constantly respond to crises (most of them caused by ‘austerity’): a provider of care collapsing; problems recruiting and retaining workforce because they’re paid less than Amazon; 30% of carers off sick with COVID; an urgent need for particular specialist mental health services (say).

…and you have to work in a place, with all its complexities:

– do the chief executives of the council and the hospital trust get along, or can they not be trusted to be in the same room together?

– do our providers trust us, or are they still hurting because we clumsily tried to reduce their fees three years ago?

– do the community organisations agree with our ideas about ‘coproduction’, or do they see it as foisting the costs of care on to them?


What we’re doing is trying to produce a tool to help people doing this messy, complex job to assess their context, and:

1- put together a commissioning development plan to get more ability to influence the system of health and care in their place (or, even, the system of wellbeing)

2- decide which of twelve ‘commissioning approaches’ fits their place and their needs best


We’ve been running this as a #workoutloud process – so if you fancy diving in and contributing, you’re welcome! There’s an open Mural board and an open meeting on Wednesday 20 April at 2:30pm (links below).

Or you can give us a quick comment here:

What is one thing you’d like to offer to adult social care commissioners to help them decide their approach?


As well as the slides (scroll to the bottom), the draft working documents are on a Mural board for comment, at https://app.mural.co/t/redquadrant9812/m/redquadrant9812/1644015309200/e20e0564cb7277f742c6f3923f2cc0d6e90ca20e?sender=benjamintaylor2777

Mural Board

And there’s a final meeting of our open group for anybody who wants to comment on Wednesday 20th 2:30-3:45pm which you are welcome to attend – registration needed at https://us06web.zoom.us/meeting/register/tZYld-CtrDMtH9RG2dYFmpqKoLqPbBZz82eU


About this work:

The Public Service Transformation Academy has been commissioned by the LGA (the Care and Health Improvement Programme, jointly run with DHSC and ADASS) to produce a tool for adult social care commissioners to go through strategic options appraisal – i.e. to assess their place and decide the best approach to commissioning.


The slides in PDF:

One thought on “How can you make better decisions in #complexity?

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s