How commissioning works
How a bespoke support package is mobilised
From referral to first session, a commissioned package goes through seven stages. Knowing what happens at each — and what a provider needs from you at each — is the difference between a package that mobilises cleanly and one that stalls.
In short
- Seven stages: refer, assess, design, mobilise, deliver, report, review.
- Most delay happens between assess and design, and it is usually missing information.
- Design is where hours, ratio, skill mix, management, reporting and price are settled together.
- A package that skips design tends to become an argument later.
- Review is part of mobilisation, not an afterthought — the exit is designed at the start.
The seven stages
The same sequence applies whether the package is a single piece of contact work or a complex 2:1 arrangement. What changes is how long each stage takes.
1. Refer
You provide: the situation, current information, known risks, the support you think is required, the location and the outcomes you need.
We do: acknowledge and begin screening.
What speeds this up: a referral that states outcomes and specific risk rather than a general description. See what information is needed for a complex support referral.
What slows it down: "high risk" with no detail; no stated outcome; no location; no indication of hours.
2. Assess
We do: screen the referral against our current service scope and operating boundaries, and assess whether we can deliver it safely and appropriately — including whether the practitioners required are available in that area.
Three questions: is it within scope; can it be staffed there; is the proposed model safe.
Possible outcomes: we can deliver as described; we can deliver with a different model and will explain why; or we cannot deliver it and will say so.
3. Design
The stage most often skipped, and the one that determines whether the rest works.
Settled here, together:
- Support model — what the support actually does
- Staffing ratio, and whether it varies across the week
- Hours and coverage pattern
- Practitioner requirements and skill mix
- Management arrangement — what sits with us, what stays with you
- Outcomes and how they will be measured
- Reporting format and frequency
- Review points and what would trigger change
- Price
These interact. Changing the ratio changes the price and the practitioner requirement. Changing the reporting changes the management requirement. Settling them together produces a coherent package rather than a set of separately negotiated items.
You receive: a proposal setting out the above, including the practitioner and supervision arrangements that would apply.
4. Mobilise
We do: build the team, brief practitioners, put the support plan and risk assessment in place, and prepare for delivery.
Specifically: allocate practitioners against needs, risk, continuity and geography; produce the support plan and a risk assessment specific to the package; set the rota including contingency cover; brief practitioners on the plan, risks and reporting standard; and confirm escalation routes and contacts.
What we need from you: confirmation to proceed, funding position, the named contact who can make decisions, and any records agreed through a secure route.
Timescale: we will confirm feasibility and mobilisation requirements following referral review. It depends on the ratio, the practitioner skills required and availability in that specific area — which is why we do not quote a standard figure before reading the referral.
5. Deliver
We do: provide and manage the commissioned support, with records kept from the first session.
Within the scope of the contract and our current regulatory position, that includes practitioner allocation, rota and contingency cover, support planning, risk assessment, safeguarding processes, practitioner supervision, daily records, incident management and commissioner communication.
You have: a named contact throughout.
6. Report
You receive: the agreed evidence at the agreed frequency — daily or weekly or monthly as set at design stage — plus incident reports as they occur.
Reporting is structured around the outcomes agreed at design, not around hours delivered. See what good commissioner reporting should include.
7. Review
Together we look at: risk, progress against outcomes, whether the model is still right, and whether the package should continue as is, step down, change shape or end.
Review points are set at design stage rather than arranged when something goes wrong. Where a package should reduce or end, we say so.
What causes delay
| Cause | Stage | Avoided by |
|---|---|---|
| Referral lacks outcomes or specific risk | Assess | Using a referral checklist |
| No location given | Assess | Town or partial postcode at referral |
| Funding not confirmed | Mobilise | Saying so up front so nobody plans around a date that cannot hold |
| No named decision-maker | Design / mobilise | Naming someone who can authorise between meetings |
| Scope disagreement surfacing late | Mobilise | Settling management arrangement at design |
| Practitioner availability in that area | Mobilise | Flexibility on start date, or earlier referral |
| Records needed but no secure route agreed | Mobilise | Agreeing the method early |
Questions we are asked
How long does mobilisation take?
We will confirm feasibility and mobilisation requirements following referral review. It depends on the ratio, the practitioner skills required and availability in that specific area. We do not publish a standard timescale because it would not be reliable for your package.
Can we skip the design stage for something urgent?
Design can be compressed but not skipped. Even in urgent situations the ratio, hours, escalation routes and reporting need to be agreed before the first session. Packages that start without that tend to become disputes.
What if we need to change the package after it starts?
That is expected. Review points are set at design stage, and change can also be triggered between them if circumstances shift. Ratios, hours and skill mix are all revisable — the package is not fixed for its lifetime.
Do you charge for the assessment and design stages?
Screening and the proposal are part of responding to a referral. Where a piece of commissioned assessment work is required in its own right, that is a separate service with its own scope and price.
What if you cannot deliver what we have asked for?
We tell you at the assess stage, and try to be specific about why — scope, regulatory position, or practitioner availability. Where a different model would work, we explain what and why.