Ethical commissioning

Ethical commissioning

The Bill requires both the Scottish Government and the newly created care boards to create a strategic plan setting out their vision, objectives and budgets for those services they are responsible for delivering as part of the National Care Service. The Scottish Government and care boards must also develop an ethical commissioning strategy for care delivery which will inform their approach to planning and obtaining goods and services as part of the National Care Service. Ethical commissioning strategies should set out “arrangements for providing services and how those arrangements have been designed to ensure they best reflect the NCS principles”. To support ethical commissioning and procurement of social care services, the Scottish Government is proposing to create a National Commissioning and Procurement Structure of Standards and Processes, to be developed “together with people with lived experience”. If you agree with these proposals in the Bill select the thumbs up button If you agree with these proposals in the National Care Service Bill click the thumbs up button (👍) in the rating section below. If you disagree with these proposals click the thumbs down button (👎) in the rating section below. If you are unsure about the proposals and feel you need to know more about them click the question mark button (❓) in the rating section below. If you have any additional comments about this proposal please provide them in the comment section below.

Points

A national commissioning and procurement structure needs to recognise the experience of those currently managing procurement - mostly parents/relatives acting on behalf of those in receipt of care packages. The flexibility to devolve responsibility and funding to those closest to the person in need is important. They will operate in accordance with best practice and bring local knowledge to the procurement process.

Will any of this give us (unpaid carers) the resources and support that we need. I think not. It does not require a national commissioning structure, just common sense.

It is a very vague statement. What exactly is entailed by ethical commissioning needs spelled out!

Training needs to be provided for Ministers and Care Boards into what ethical looks like and what person centred care looks like. Also training into how to commission effectively. The Bill needs to put in this stipulation and provision.

Like it, but need to follow through on their promises. Everyone in the group happy with this approach.

It is hard to know what ethical commissioning is. Is Scottish Government saying that it does not happen now ? If it is to be replaced by a human rights based, inclusive and genuinely person centred alternative, this might be good. This could be led by citizens and carers with government support.

All in favour of ethical commissioning. But…. Why can’t this be delivered currently by local authorities/ collaboration amongst councils to the same ethical standards?

Not sure there is enough information around this issued to make an informed decision.

Again, how would this be done and who would decide the budget for the area and how the funding would work? How would the NCS avoid the post code lottery from happening all over again?

I truly welcome this. The present neoliberal management of social care has done exceptional harm to service users. We need a system which meets the ethics of social work and the rights of their clients to live a 'full life' of equal participative citizenship.

Does ethical commissioning apply only to NCS commissioned services or those services commissioned by individuals directly with providers? Whilst ethical commissioning should include good staff pay and conditions, it should also address quality of care provided and be fair to providers- paying a decent fee to cover costs and avoiding the use of penalties which can threaten sustainability. Ethical commissioning should also encourage diversity, competition and improvement and, ultimately, choice. Whether that requires centralisation or can be implemented through the current arrangements, is not clear from the information seen.

I believe there is a focus of government effort on creating strategies, or frameworks, which are very long winded documents, but very little effort in considering how it will be implemented. It is drafted and ‘thrown over fence’ for local authorities or quasi new boards to deal with, without consideration or planning for what is involved.

We are presuming the process of determining what services are needed have been looked at i.e. collating data etc, especially in such a diverse population and geographical areas. Regarding the tendering process, this needs to be determined by quality and not purely financially driven. Experience by some on the board who have worked in social work suggest procurement needs to be flexible to ensure quality and value for money can be sought locally, rather than from large corporate businesses who are more able to reduce prices but not always deliver quality.

The Scottish Government must base services in communities and offer both formal and informal support, with a focus on relationship-based practice, building consistent and trusting relationships with individuals, families, and communities. The Scottish Government must ensure services represent all placement types and are inclusive of people who are adopted and who may experience adoption breakdown. Evidence taken from The Bairns Supper report.

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