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.
