Sainsbury Centre for Mental Health

Commissioning
day and vocational services

Day and vocational services are central to supporting people with mental health problems.

Now is the opportune time for services to live up to their potential to help people gain employment and fully participate in their communities. Too many are failing to do this. Money and other resources are tied up in services that, although valuable to some who still use them, are not meeting the needs of the diverse populations that they serve and the growing number of people who have different aspirations.

Many of the current services need to change and this is a complex process. A comprehensive re-design of services is required, sometimes by transferring them to voluntary sector providers or by supporting them to develop independently as social firms.

Health and social care commissioners hold the key to this process and should lead the way. They need to give service users and carers an equal say in the design of new services and their contribution to any service changes should lead to more choice and better quality.

Key recommendations for commissioning success

• Continued and committed Director level input from all parties
• Service user involvement from the outset and throughout
• A collaborative commissioning approach with all providers
• Support from the existing NHS Trust provider - finance, estates, human resources
• Extensive formal and informal consultation
• Dedicated, experienced project management throughout the process
• Access to a range of relevant expertise - eg. re-commissioning, contractual issues, communications advice

About Time: Commissioning to transform day and vocational services

About Time provides a step-by-step guide to managing this change. It includes information on:

• What to include in a joint strategic needs assessment for employment
• How to develop new service specifications in line with evidence-based practice in the field and local population needs
• Suggestions for the on-going monitoring, development and evaluation of day and vocational services.

Download the summary of About Time (249 KB)

Key Performance Indicators for employment services

Evidence-based employment services for people with mental health problems are central to the 'social inclusion' agenda and to most users' hopes for recovery. Assisting services to develop and monitoring quality and outcomes requires a set of performance indicators which specify the key elements of good practice.

We are developing a set of indicators in partnership with several other organisations. They will be based on information gathered by local services.

The pilots are in progress. More information and the manual for the pilots are available here. The results will be published and launched later in 2008.

Other work on commissioning

Developing Day Services

The National Social Inclusion Programme has launched a framework and guidelines for mental health day services.

The Day Services Outcomes Framework has been developed to help commissioners and providers to monitor, evaluate and measure the effectiveness of mental health day services.

The guidelines on how to identify good socially inclusive practice in mental health day services were developed to bring some objective criteria to the identification of services offering examples of good practice.

DWP Commissioning Strategy

Read our response to the DWP Commissioning Strategy (February 2008). It lays out changes to the way in which the Department for Work and Pensions delivers employment support to its customers. The Department will take the responses into account when finalising the strategy.

Commissioning Framework for Health and Wellbeing

We responded to the Government's Commissioning Framework for Health and Wellbeing consultation in May 2007.

The Commissioning Framework presents a positive vision of public services working together for health and wellbeing. But it does not include enough detail of how to achieve its goals. The Government needs to invest in the skills and knowledge of commissioners across the country.

Download our response to the consultation (Word, 124 KB)