Phase 1 - Define

1.6 Progress conversations with outcomes payers

As you’re preparing your case for your initial meetings with the commissioners, think about the following:

  • A compelling explanation of the social challenge, your intervention, and what makes it different
  • The reasons you are in the best position to deliver this intervention, perhaps in partnership with other providers
  • Examples of other local authorities that have done something similar

Bear in mind why the commissioner might be interested in participating in a SIB. Brookings (2015) lists:

  • Opportunity for future savings from financing a preventative programme
  • Only needing to pay if the programme is successful
  • Finding it exciting to be part of an innovative financial model
  • Wanting to scale up an intervention with demonstrated effectiveness
  • Being frustrated by the silos, politics, and procurement issues created by traditional funding and seeking a way to collaborate with other commissioners and private investors to break these down

Masterclass : How to engage your commissioner

Contributed by Dr Chih Hoong Sin, Director, OPM

Providers often underestimate how much work goes in to securing a commissioner, especially in provider-led SIBs. They tend to focus their efforts on modelling, whereas actually the technical piece of SIB development is the easy one. The relational piece is the hard one and must come first. If you have not got full support from all the right people within the commissioner – or if there are fundamental things you haven't unblocked – you could waste a huge amount of energy, time and potentially advisory fees building technical models that will not be used. Indeed, between the 'in principle' award and signing the contract for a SIB, between a third and a half of commissioners tend to drop out.

So how can you increase the chances of your commissioner following through? You need to be aware that even though it may be appropriate to begin your conversations with a contact that you know within a commissioner, stakeholders from other departments will need to be involved with any commissioning decision. You need to be making sure that your contact is involving all the right colleagues:

  • SIBs don't always have to be about savings (see point 5 below), but we acknowledge that this can be the primary motivator behind commissioner's engagement. So, make sure that you have a conversation with your contact about saving against specific budgets. Specifically, your contact needs to ask himself or herself: "if we see these outcomes achieved, which departments and which budgets would that have implications for?" Budgets are siloed and each department typically only has sight of their own budget, so they may not have done this piece of work. You can encourage him or her to think this through, by brain-storming together where the authority might feel the benefits of your outcomes, and even drawing a map together. Your contact can then work out which colleagues may need to be involved.

  • Don’t assume that “warm noises” from your contact mean that a deal is likely; there may well be blockages within different parts of the commissioner’s internal decision-making process, which may not be communicated to you as a provider. You need to ask your contact some key questions, to check levels of commitment of the various departments. Here are 5 questions to ask your contact within a commissioning organisation to check whether you have support from the whole team.

    • Have you involved your procurement colleagues?

    • Have you involved your legal and finance colleagues?

    • Does the board have direct line of sight on this project?

    • The board sponsor may sign even if his or her heart is not in it, e.g. to show they are pursuing innovation.

    • Is this a procurement-led or commissioning-led authority?

    • Most commissioners will say that they are commissioning-led, but when you dig, you might find that they are procurement-led.

    • Has the authority thought about the whole range of strategic rationales for commissioning the intervention? It's not all about departmental savings: your programme could create economic benefits to society, reduce pressure on certain services or increase individual or community wellbeing generally

 

Here’s how delivery organisations who’ve gone through the process of engaging with commissioners describe the challenges:

Leaving their comfort zone:

Our biggest challenge was trying to push commissioners to do something different and leave their comfort zone. They will view you with suspicion from a procurement standpoint, because of the high-risk perception of a SIB, and won’t trust your intentions and motivations. They also didn’t want to speak with the investment community, as they don’t trust them.

Fear of complexity:

You will need to contend with the fear that it’s too long to develop, far too complicated, far too risky.  A grant programme doesn’t have the same level of rigour.

Lack of understanding:

Commissioners have been doing the same thing for a very long time.  This requires a huge change in accountability, practice and service.  After a year of low-key conversations, some still believe that social investors will pay for the whole project.

Loss of control:

Some of the local authorities we engaged with at the beginning enthusiastically supported our work; others were concerned that the SIB activities would cut across, and perhaps even undermine, services that they directly commission. Our job was to work considerately with all local authority partners within whose areas SIB service users were to be found and, in time, we feel that the support and understanding of our work was recognised and appreciated by all.

 

And here are some ways providers have approached the challenges:

Start preparing early:

A SIB is usually a very different way of financing for the commissioner.  You may need to prepare considerably in advance of beginning the process, to change mindsets and behaviour.

Resolve their challenges in advance:

This is a government department, and you’ve all worked with the government so you have your insights. Think about what makes this most challenging for them and try to solve that problem for them.

Appeal to a focus on impact and learning:

The SIB has been a steep learning curve for Thames Reach, but also for the commissioners, and we appreciate the spirit of partnership in which the SIB has been developed and progress measured. One of the attractions of the SIB was the agreement with the commissioners that they would not focus on outputs and the detailed interrogation of budgets but instead concentrate on verifying outcomes and sharing and disseminating learning.

Engage multiple partners:

Get as many people as possible involved and excited. Partnering up can enable a greater reach and be more attractive for investors and commissioners too.

Build trust and confidence

If possible, work with the senior commissioners to give their teams permission to work in a different way. Find the stakeholder that they trust - and this is not always the investor; perhaps it’s GOLab, because they are seen as independent?  Find role models who have done this before, to de-risk it for the commissioners.

Provide resources and ‘playbooks’:

A big barrier is that the resources for learning about the process are theoretical.  Try to find practical papers and resources that walk commissioners through what they need to do.

Next: 1.7 Model scenarios to price outcomes