5.5 Commissioning for Quality

The Care Act 2014 puts emphasis on greater integration of services provided by the Local Authority and its relevant partners to:

  • Create a service market of diverse and quality services; 
  • Foster continuous improvements in the quality and effectiveness of provider services; and
  • Foster a workforce whose members are able to ensure the delivery of high quality services.

Quality services are those that place the health and welfare of people who use services as paramount and deliver positive outcomes. These are evidenced in the characteristics of the service through policy, procedures, standards, and structures for overseeing and maintaining service delivery to the requirements set by the Regulator (CQC) and/or by robust contract monitoring. In some instances, a Local Authority may not contract with a provider; neither may the provider be subject to the CQC inspection regime. Providers, who fall under this category, will still need to maintain health and safety standards and where it delivers care and support through regulated activity, it should still have quality and safeguarding measures in place. Click here for more information on regulated activity.

Commissioners should set out clear expectations of providers within contracts and monitor compliance. Commissioners have a responsibility to ensure that commissioned services:

  • Know about and adhere to relevant provider registration requirements and guidance. 
  • Meet the CQC, legal or contract standards. 
  • Ensure that all documents such as service specifications, invitations to tender, service contracts and service-level agreements adhere to safeguarding principles and standards.

Effective and strong commissioning under Commissioning for Better Outcomes  supports prevention strategies and sets out the key criteria commissioners are seeking from providers to evidence their commitment to delivering high quality, safe services. The domains stress that services should be:

  • Person-centred and outcomes-focused 
  • Inclusive 
  • Well-led 
  • Promote a sustainable and diverse market place.

Standards developed by health organisations, for example National Institute for Health Excellence, offers guidance to improve the quality of health and care services.

Additionally Safeguarding Adults: The Role of Health Services provides helpful advice for NHS commissioners to identify quality services.