I can only speak for the public health weight management industry here, however colleagues have reported the same issue in other fields, so I hope this blog is useful.
One of the most significant issues as a commissioner is that providers are naturally presenting the best view of themselves when preparing a tender to provide services. In our field (behaviour change and weight management), there is currently no repository where you can see all of the contracts that providers are delivering and whether they have hit the targets they set out to.
In chatting with other providers and commissioners over the years, I have been told about some of the claims made by providers about what they will be able to deliver. There are few opportunities during a procurement process that allow fact-checking of claims made. You are assuming providers can deliver what they say they can.
Unfortunately, the industry seems to have evolved towards higher and higher numbers for less money. It is understandable to expect to see this with economies of scale or a mature digital market. However, this industry benefits from neither and therefore the ever increasing numbers that are claimed in tender proposals are often not genuinely achievable.
As a provider to the public, it is true to say that it is tricky to predict how the public will react to the services you provide or say exactly how the referral pathways in a specific area will perform. However, it may be considered controversial to say, but there are providers who systematically inflate their offer in order to win a contract and then deliver much fewer numbers. By this point, it is very tricky to change provider, having spent tens of thousands of pounds and 6 – 12 (or more) months procuring a service, there is little will to go back to the markets.
PHE have tried in the past to publish the results of providers across the country to support commissioners when making decisions. However, this was unsuccessful. In the meantime, there is something you can do as a commissioner to satisfy yourself that the providers can deliver what they say they will. Get references.
When we tender for a contract we provide the contact details of all of the commissioners that we are currently working with and suggest that the commissioners call them for an informal chat about some key questions they should satisfy themselves of before they go into a long term contract:
We actively want commissioners to call their counterparts in areas we are delivering because they should have a good idea of what they are getting themselves into. We do ‘partner’ with commissioners because we believe they are a valuable resource in helping agree the course of the contract. We don’t tender with disingenuous numbers. We always react to the needs of the population, often creating new programmes to accommodate. We always focus on supporting people holistically and focus on giving each person we work with a quality experience. And we want commissioners to know that – but can you believe me when I write it in a tender or here in this blog? I wouldn’t believe this source! I would check before jumping in!
The take away from this is to ask providers to submit a reference for ALL of their contracts they have delivered in the past 5 years. The ones they no longer deliver are the most important ones – why do they no longer deliver them? Choose a few and call them up. You would not make a huge decision about spending huge sums of your own money without looking into the history first, so don’t do it when buying services on behalf of the public.
If any commissioners are thinking about procuring behaviour change and weight management service and are interested in speaking to our commissioners about our performance, please get in touch with them:
Gloucester – email@example.com
Brighton and Hove – firstname.lastname@example.org
Hertfordshire – email@example.com
Bedfordshire – firstname.lastname@example.org
I am happy to informally chat through any of the content of this blog or the others in this commissioning series so please feel free to get in touch any time.