The subject of incentivisation often arises in relation to Individual Service Funds, with the perceived wisdom often being that ISF provider organisations need financial incentives to deliver this model of personalised support. With this in mind, I recently took a poll of Individual Service Fund providers in England to ask them what they wanted in terms of a reward for working differently to more traditionally commissioned and contracted support services.

As indicated by the poll, organisations’ preferences highlight a clear priority around achieving wider recognition for the quality of their support over purely financial incentives (although a fair ISF management fee was considered relatively important).

Recognising and effectively utilising these preferred incentives for providers can significantly influence the success of ISFs in an area, fostering conditions where quality, personalisation, and outcomes-driven approaches can thrive. This article aims to distil these insights, offering commissioners strategies to shape and enhance their local provider marketplace.

Here’s a breakdown of the poll results:

1. Recognition as a local outcomes-based & personalised support champion (5.25): Being acknowledged in council contracts for excellence in delivering personalised care can enhance the organisation’s reputation and help to position itself as a leader in personalisation and outcomes-focused support.

2. Priority listing for new referrals (5.0): Securing a spot on a list of providers recommended first to citizens by commissioning bodies, brokerage services, or ‘Dynamic Purchasing Systems’ and frameworks will help ISF providers improve their visibility but also the likelihood of being chosen by citizens.

 3. Wider public promotion (4.31): Receiving promotion from the council and social work teams directly to citizens and families locally can boost an organisation’s profile and connect it more directly with the community.

4. Banded ISF Management Fee (3.75): A management fee that adjusts based on the bespoke needs of citizens acknowledges the varying degrees of effort and resources that may be required to provide people with the right support.

5. Flat Rate ISF Management Fee (3.69): A consistent management fee provides financial stability and simplifies budgeting for organisations. However, it ranks slightly lower, indicating a preference for a more nuanced approach to funding.

6. Enhanced Hourly Rate for Support (3.25): Receiving a higher hourly rate for the support provided.

7. Mission driven (2.5): A notable portion of organisations emphasise their commitment to delivering ISFs as a reflection of their values, rather than for any external rewards. This intrinsic motivation underscores that many organisations are values driven and have an ethical foundation for their work.

8. Share of Budget Underspend (2.38): Gaining a share of any budget underspend at the year’s end is seen as the least attractive reward. While this may be financially beneficial, it may not directly relate to the quality of service delivery or the organisation’s mission and may also create conflicts of interest.

Implications

For organisations navigating the ISF landscape, understanding these preferences is vital. Recognition and visibility emerge as top motivators, suggesting that efforts to enhance organisational reputation and public awareness can significantly impact success in ISF delivery. Financial incentives, while important, vary in appeal, indicating the need for a balanced approach that considers both the financial health of the organisation and its commitment to high-quality, personalised care.

Conclusion

For Local Authority Commissioners, using the insights from this poll of ISF provider preferences offers an opportunity to strategically shape the provider market and enhance the quality and range of personalised support options that are available to citizens via ISFs. By aligning commissioning approaches with these reward systems, commissioners can not only incentivise high-quality service delivery but also shape a provider marketplace that fully embraces the principles of creative outcomes-based care. As the adult social care provider marketplace continues to evolve, such approaches will be crucial in meeting the diverse needs of citizens while ensuring sustainable, best value and high-quality care & support delivery.

Considerations for Commissioners

 Understanding and integrating these provider preferences into commissioning strategies can help local authorities cultivate a provider marketplace that is both competitive and aligned with the goals of personalisation and outcomes-based care. Commissioners should:

• Develop recognition approaches that highlight great providers and reward excellence in personalised approaches and outcomes.
• Refine internal referral and purchasing systems to help prioritise providers demonstrating this high-quality care.
• Offer public promotion of high-performing providers, increasing their visibility and accessibility to the community (for example, on care directory websites).
• Consider innovative funding structures, such as banded management fees, to better align financial incentives with the complexity of ISF management support and brokering that is provided.
• Foster an environment where mission-driven providers can thrive, recognising their contributions and ethos of personalised care.

Chris Watson
Chris Watson is the founder of Self Directed Futures and the Chair of SDS Network England. With extensive experience in strategic commissioning and change management, Chris advocates for innovative, community-led approaches to adult social care.