The last few years have seen a plethora of reports about the lack of appropriate placements for children in care and the dire outcomes that have followed.
These include children and young being placed far from loved-ones and social networks, or in unsuitable, and sometimes unlawful, accommodation, and enduring multiple placement breakdowns. Those with the most complex needs have often being the worst affected.
These have been accompanied by concerns about councils facing spiralling costs for such placements and some - particularly large - providers making excessive profits by taking advantage of the shortage of provision and authorities' lack of choice.
Regional commissioning plan
To tackle these issues, the Department for Education (DfE) has accepted the Independent Review of Children’s Social Care’s recommendation to regionalise placement commissioning, through the establishment of regional care co-operatives (RCCs).RCCs – of which there would be 20 following implementation – would take over their member councils’ responsibilities for placing children in care, and would be complemented by a national body supporting councils with forecasting demand and the procurement of care from providers.
This function - recommended by the Competition and Markets Authority in its report last year on the children’s social care market - may be folded into RCCs over time, the DfE suggested in its recently published draft strategy for the sector.
Providing greater scale than councils
RCCs are designed to overcome the challenge of individual councils being too small – and having too few children – to be able to meaningfully shape the services providers offer and ensure that they meet need and are value for money.The DfE said that, by operating at much greater scale than councils, RCCs, supported by the national body, would be much better able to forecast need, and commission sufficient placements, in the right places, to meet it.
It would also be much easier to share learning, good practice and information about the cost and quality of providers between 20 RCCs, compared with 152 councils, improving the quality of commissioning.
This would reduce excess profit making and improve outcomes for children by making it more likely that they would be in a placement that meets their needs, said the DfE.
Co-operatives to face Ofsted checks
In time, RCCs would be inspected by Ofsted, to hold them to account for providing sufficient, high-quality placements.As with the rest of their reforms, the DfE is not rushing ahead with implementation, but plans to establish two pathfinder RCCs next year.
But the department is clear that this is the way forward, with the pathfinders designed to shape how RCCs are implemented, not whether.
So what does the evidence say about their prospects?
Mixed history
Councils working together across regions to commission care placements is nothing new. However, several reports have found issues with these approaches.
A 2015 study by Oxford Brookes University for the DfE identified 35 consortia or partnerships involved in commissioning care placements, encompassing the majority of councils. Most operated framework agreements, which defined service specifications and prices for providers who signed up.
The report found that, while consortia had generated savings for member authorities, both commissioners and providers acknowledged there was considerable scope for improvement. Procurement and monitoring activities were seen as particularly “bureaucratic and wasteful”.
Earlier call to require regional commissioning
A year later, Sir Martin Narey’s independent review of residential care for the DfE found councils could be obtaining “significantly greater savings” through consortia-based commissioning.Foreshadowing the care review's recommendations last year, Narey recommended the department require councils “to come together into large consortia for the purpose of obtaining significant discounts from private and voluntary sector providers”.
On the back of this, the department funded two projects, both in London, through its innovation programme, to test the benefits of regional commissioning.
However, an evaluation of one of these projects found that fewer providers than expected had made bids to join its proposed framework agreement, and those that had had offered prices higher than the market rates. Several providers reported that their preference was to offer placements to councils through unplanned spot purchases, where they could set their own fees.
“The findings highlight a tension between the interests of local authorities in securing in-borough, suitable and more cost effective placements, and the business interests of independent placement providers,” found the overarching evaluation of the second round of innovation programme funding, published in 2020.
Lack of provider sign-up
More recently, a 2022 study by What Works for Children’s Social Care found that, while most councils were part of a regional or sub-regional commissioning framework, several said these did not help them secure local placements or reduce reliance on spot purchasing. As with the innovation programme project, the key issue was lack of provider sign-up.And in its report on social care last year, the CMA found that councils “can struggle to collaborate successfully due to risk aversion, budgetary constraints, differences in governance, and difficulties aligning priorities and sharing costs”. It concluded this was unlikely to change without action by central government.
