Issues in commissioning

"If you always do what you always did, you will always get what you always got...."

The concept of a Psychologically Informed Environment, and the principles behind it, raise some interesting issues and challenges for commissioners, as well as for providers of services.

For example, two papers  in the Library (Johnson 2013a, 2013b) on "complex needs"  argue that smarter, more "psychologically informed" commissioning lies at the very heart of the way we can now begin to address "complex needs", at locality level.


A growing area of concern

But we are not alone in raising such questions. There has been, in recent years, a huge advance in the confidence of homelessness services in particular; we do know how to improve services. The PIEs framework itself has, hopefully, played some useful role in expressing and advancing this.

But even a long term and concerted attempt to encourage system change at locality level, such as the Big Lottery's Fulfilling Lives Complex Needs programme, seems to have revealed the

In consequence, there is a growing body of opinion that the deeper problems of homelessness are systemic; and widespread 'whole systems' change may be needed to talk these advances any further. It is even argued, quite convincingly, that the entire edifice of commissioning for discrete services with, clear quantifiable outcomes is fundamentally mis-conceived; and is now part of the problem.  The business-like approach known as the New Public Management may, it is suggested, have proved to be 'penny wise, pound foolish'.


Some help in practical solutions

Nevertheless, we do see many examples of constructive, enlightened commissioning.  In  Five Top Tips for Commissioners, Victoria Aseervatham, Rough Sleeping Services commissioner for London's Westminster, suggests a range of ways, and introduces some of her inspirational resources, for effective commissioning.  (We also have an article, "More for Less?" by Peter Cockersell formerly of St Mungos - one of the co-authors of the 2012 operational guidance - which aims to address issues of increased efficiency via introduction of  PIEs.) 

The "Recurring themes" paper in the Library area also offers an overview, in brief, "headline" terms, of many of the underlying themes in practical operation that were found in the CLG/NMHDU good practice examples*.  The paper aims to indicate how 'psychologically informed' commissioning can create the business environment within which individuals services can then work. 

Finally, with the introduction in 2017 of the Pizazz for self assessment and self development of service, we saw the first attempts to provide a more specific and practical tool for development of PIEs within services. We can suggest that commissioners might want to encourage the use of this 'distance travelled' measure, rather than the highly simplistic, sometimes positively un-helpful stipulation that services they commission should 'be a PIE'.

The introduction in 2021 of the software version, the PIE Abacus, brings with it the potential for taking this service-level PIE framework to a new, locality-level.  It remains to be seen how far this ambition is achievable; and a further round of pilots of the software in this use will be needed.


*   NB: this paper was originally in preparation for the 2010 CLG/NMHDU guidance, but was completed too late to meet the deadlines (and it has been re-worked somewhat since then). Since this document did not appear in the original CLG/NMHDU guidance, and there has been no feedback or debate, it is presented here purely to stimulate discussion on how useful these ideas may be.

Further background reading/listening/viewing

PIElink pages

Can commissioning help to encourage PIEs? HERE

Whole systems evaluation : HERE

The PIE Abacus - an on-line Pizazz : HERE


Library items

Do 'complex needs' need 'complex needs services'? : HERE 

More for Less? Using PIEs and recovery to improve efficiency in supported housing : HERE 

Recurring themes ( in practice and commissioning)  : HERE 

Five top tips for CommissionersHERE

A Whole New World; funding and commissioning for complexity : HERE

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