Can smarter commissioning help encourage PIEs?

Commissioning - a systemic role?

We don't perhaps make as clear a distinction as we might between commissioning and procurement.

That is, procurement is a contract setting and compliance monitoring process, that aims to see that the services contracted to provide a service are providing exactly what they were contracted to do.

By contrast, commissioning is the process of thinking through, with all concerned, how to get the maximum value out of all services, working together. Any specific budget that commissioners may hold is there not just to plug any obvious gaps, but to attempts to align all services to maximise the effectiveness of the whole.

Commissioning, in other words, is systemic. The parts you can procure are only a part of the whole. It's about making the whole system work - or can and should be.


Would smarter commissioning help?

Probably the biggest mistake that commissioners can (and do) make is to stipulate that the services they will commission should 'be' a PIE - and often without much thought as to what that might mean. This is not merely a misunderstanding; it can even be positively damaging.

Firstly, being a PIE is inevitably a complex and multi-faceted thing. In PIEs 2, we identify five main themes; and each of these is then honed with a number of other more specific practice elements. Any working services is going to be further advanced in some areas than in others; and not all may be relevant. Services working with this framework must make their own decisions as to what is right for them.

Working as a PIE is therefore simply not an 'either/or' thing. Success in a PIE is always a matter of degree. As we have said, if it was an Olympic sport, it would be a long jump, not a high jump. But if sport is for health and not for prizes, its about services achieving a '(team) personal best....

Secondly, 'being' a PIE is also a continuous process of being informed.  To stipulate that services must 'be' a PIE is at best to ignore the importance of the on-going process of discussion and learning. But at worst, it will invite mere lip service - an approach 'implemented' or imposed upon a service and a team, solely in order to win contracts. . 

Thirdly, insisting a services should 'be' a PIE might just work, if there was somewhere a list of the things you supposedly 'must do, in order to 'be' a PIE. Even though that too would inevitably tend to encourage tick box adherence; which is another reason why there isn't such a list.  Even the many examples we can give here should be seen as just a menu from which services can choose what suits them best. But its that constantly choosing and revising that makes for a PIE.

But more seriously still: real development as a PIE always come from the ground up, not 'from above'.  Just as tightly specified 'outcomes' simply tie the hands of services for those with complex needs, overly prescriptive procurement contracting can often end up dis-empowering staff for creativity and responsiveness. It is clear that funding and contracted service specification can hugely assist or can seriously distract from the on-going and continuous development of PIEs within services.  We need the commissioning process itself to be psychologically informed.  

But also, there is a process that can help.

PIEs 2.0, systems and sector engagement

The Pizazz process now provides a practical instrument for services to use, to assess and to further their development as PIEs. It doesn't tell them what to do; but it points them towards the parts of the PIEs 2 framework that may shed most light; and then takes them through a process of discussion, to see where they can make progress.

Until recently, much of the focus on development of PIEs lay in identifying the key features and encouraging development of PIEs. This had been focussed on the work being done within services 'at the coalface'. Wider government and local funders' efforts have been in the background. But with the publication of the expanded PIEs 2.0 framework, this is changing.

PIEs 2 encourages recognition of those services that are actively engaged with identifying and tackling gaps and barriers to their service users' progress and prospects. It looks at addressing such issues not solely in individual casework, but in wider forums where the coherence or fragmentation of the systems and pathways can be addressed.

The self assessment framework, the Pizazz, set out to allow for and encourage this; and therefore explicitly makes a place for such 'sector engagement', in addition, that is, to the keyworker's brokerage of gaps and barriers with individual users.

Using - and learning with - the Pizazz

As part of the general organisational ethos of Learning and Enquiry,  services are encouraged to assess how far they are able to to engage in this wider 'sector engagement', and what helps and hinders.

It's for all these reasons that we have developed the Pizazz, both in the Pizazz on paper, and in the on-line version (the PIE Abacus), to measure 'distance travelled', and to work with staff's own views of what they can improve. This is why we say that being a PIE is best seen as a journey, not a destination.


On 23rd November 2021, as part of the PIElink community of practice lunchtime forums, Season Three (HERE), we had a discussion on the role of commissioning (and perhaps any other form of funding) in promoting PIEs.




Further background reading/listening/viewing

PIElink pages


In principle

A PIE of pathways : HERE

Pathways, systems and system coherence : HERE

'Joined up thinking' : HERE

The New Public Management approach : HERE

Whole systems evaluation and the public health paradigm : HERE

The Inner Game of PIE : HERE

PIEs 'from the ground up' (the book) : HERE


In practice

Navigators and system brokers : HERE

A single framework : HERE

PIEs 1, 2 - and 3? : HERE

Service users' PIE assessments : HERE

Partially PIE'd? : HERE

Evaluation by outcomes : HERE

PIEs accreditation? : HERE

The PIE Abacus - an on-line Pizazz (summary) : HERE

Customising the PIE framework with the Abacus : HERE


Library items.

Joy McKeith: Enabling Help : HERE

Lankelly Chase: Behaving like a system: HERE

Victoria Aseervatham: Top Tips for commissioners : HERE

Alex Smith and Ray Middleton : navigators and system change brokers : HERE 

Robin Johnson: Key learning from the history of the Care Programme Approach : HERE

Robin Johnson : Do 'complex needs' need 'complex needs services'? Part One : HERE

Robin Johnson: Do 'complex needs' need 'complex needs services'? Part Two  : HERE

Zack Ahmed on Participatory appraisal in Tower Hamlets: HERE

Paul Hoggett:  Conflict and ambivalence in public services: HERE

Lipsky (Wikipedia age) on street level bureaucrats: HERE