We received questions about:
• what kinds of organisations can fill the role of regional commissioner
• the role of Aboriginal Community Controlled Organisations (ACCOs)
• the things government, providers and communities need to do to make this approach more common.
The role of a regional commissioner could be filled by many different organisations, but there are a few key features that make regional commissioners effective:
- strong relationships with the community and service providers
- high levels of trust within the community
- a degree of impartiality to enable them to work with a broad range of organisations and people.
In many communities across Australia, these organisations already exist: they could be Primary Health Networks (PHNs), ACCOs or backbone organisations. There are a range of issues that need to be considered and managed in these processes, including conflicts of interest and impartiality given existing funding flows. The right fit in one location, may not be the same in another.
In terms of embedding collaborative commissioning into practice, it’s important to note that this approach is already happening across Australia, particularly in the health sector. The work ahead involves building on these foundations and broadening the practice. In its interim report on Delivering Quality Care for Effectively the Productivity Commission outlined several key steps the government can take to embed collaborative commissioning, including removing barriers to pooling funding, making funding more flexible and ensuring regional commissioners are sufficiently resourced to undertake comprehensive governance. Some additional steps that will support collaborative commissioning include:
- moving to long-term (5 or more years) and flexible funding cycles
- implement shared governance models
- support outcomes-focused reporting and relational ways of working and contracting.
Service providers need to shift from a competitive mindset to one of collaboration. The current purchaser-provider model encourages competition, but collaborative commissioning encourages collaboration and integration. This does, however, require a different way of working and sufficient time and resources to build relationships.
Many communities already have existing governance structures that can be leveraged to support collaborative commissioning and are already actively engaged in consultation and co-design of services. Communities should be supported to build capacity when required, in a way that matches the local context.