Greater Manchester Centre for Voluntary Organisation

Evidence based commissioning: a risk to voluntary sector assets?

There is a growth in demand for evidence of impact from funders across the board. Will this create unintended consequences? GMCVO's Policy and Partnerships Officer, Beth Sharratt explores the issue.

An implication of cuts in public spending is likely to lead to only those deemed being in the most need (or highest risk) being eligible to access some services that we have become accustomed to seeing as part of a universal offer. As well as the reduction in the number of people accessing support – the services themselves are under intense scrutiny as those holding the purse strings are looking to see what interventions are effective, and in theory, should provide greatest value for money for the taxpayer.

In order to establish effectiveness, commissioners are looking at the evidence base behind each of the services on offer. Originating in the medical world, the evidence-based approach seeks to avoid a ‘one size fits all’ model so that services can be commissioned based on specific needs. Recognised evidence includes randomised control trials, academic studies and recognition by professional bodies, including NICE (National Institute for Clinical Excellence).
This is not something that is likely to change any time soon. Currently, we are seeing more commissioners and grant funders ask for detail around an organisation's evidence base, and Jon Cruddas MP, the Labour Party’s Policy Review lead, has also spoken of the importance of evidence based interventions in their approach to public service delivery.

For voluntary organisations wishing to access public funding, this poses a complex challenge.

In the current operating environment, voluntary organisations can (crudely) identify as having one or both of two roles:

  1. Non-profit contracting: The first is that of a provider of services in the marketplace. In this instance, organisations should expect to compete on a level playing field with organisations in the private and public sectors.
  2. Asset rich community-rooted delivery: This role is something different, unique and arguably fundamental to being within the ‘voluntary’ sector.

Whilst many organisations may see this second option as a clear fit, believing themselves to be rooted in communities, it is important to challenge our own assumptions. Robust organisations will need to demonstrate they are in possession of clear ‘assets’. These are not necessarily financial/physical, eg a community building or a sizable endowment but can be less tangible - the goodwill of volunteers, having links into and in depth knowledge of a particular community, having the ability to access and draw in a variety of funding from different sources (note the distinction from a healthy bank balance).

Importantly, when it comes to delivery in areas where there is much public statutory service delivery, such as mental health, social care or criminal justice, for example, the great asset many voluntary organisations are in possession of is the trust of the individuals they are working with. Without the stigma of being ‘the social’ or being seen to have the power to sanction, eg take away children; the relationship they are able to build has a solid foundation.

In relation to non-profit contracting, when tendering to deliver an established intervention the evidence base challenge needn’t be a significant consideration, as the intervention/s will have been the choice of the commissioner. However, if tendering on an outcomes basis, organisations will need to build and present a more detailed case. Generally, larger voluntary organisations capable of delivering at scale will have sufficient experience and expertise, or access to these, to support and strengthen their bid. When tendering to deliver public services, sound procurement processes with integration of the Social Value Act etc should recognise the value of all bidders and score tenders accordingly.

In relation to asset rich community-rooted delivery, building an evidence base around these intangible assets is, at the very least, tricky. Smaller organisations are unlikely to have the resources to carry out or invest in long term academic research, and wouldn’t dream of carrying out a randomised control trial in order to demonstrate their value. This kind of activity requires a different approach.

A co-ordinated, strategic approach is required across sectors recognising;

  • The varying roles of individuals, organisations and institutions in making a difference to people's lives;
  • That there is a complex set of interdependencies and relationships between all of these elements, a community ecosystem if you will, and that no single element should be looked at in isolation;
  • What is recognised as an evidence base should be proportionate and appropriate to the service/intervention being delivered. Whilst is principle there is little argument against an organisation being asked to demonstrate its delivery is effective - when it comes to evidencing, there is no ‘one size fits all’ approach. General services helping people with many needs (as is the case for many voluntary organisations), cannot be measured in the same way as targeted services with clear outcomes, eg a smoking cessation service.

Public agencies need to be empowered to provide small scale investment into asset-rich organisations that form a vital part of the local ecosystem within their community. At the same time, voluntary organisations must be clear in articulating how and why they exist and bring about benefit for their service users and in part, create the conditions for that enable evidence based interventions to be successful.

Whatever web is woven through the complex and multiple factors influencing the life of a vulnerable individual or family, we can be sure of one thing, there is no ‘quick fix’ or ‘magic bullet’ that will set people unfaltering onto the ‘right track’. People’s behaviour changes and lives improve when a sustained period of stability allows that individual or family to flourish, and no one intervention, evidence based or not, can guarantee to provide this.

If decommissioning a service in favour of an evidence based approach results in a change of provider, this could risk the loss of assets within the community. As voluntary organisations, we know the impact we can have in bringing about positive change. It’s up to us to make it clear to commissioners what they will lose should they fail to see the whole picture.

August 2013