Quality Assurance: Creating meaningful, measurable change and improving quality (creating savings)
- Russell Henderson
- 3 days ago
- 4 min read
Latest analysis by CIPFA indicates councils are spending around 78% of their main budgets (council tax + general funds income) on adult & children’s social care combined in 2024/25. Staggaring isnt it?
The Local Government Act 1999 - Best Value Duty requires that councils must secure continuous improvement in the economy, efficiency and effectiveness of services and as part of that, performance management and contract management. The failure to manage the performance of contracts, costs, or outcomes properly is a breach of Best Value.
Dynamic Purchasing Systems (DPS), Spot purchasing and deliberate efforts to commission in complexity including the use of Small/medium Enterprises (SME) have contributed effectively to limit the impact of provider failure, leverage fee negotiation and improve choice, satisfying key legislation (Care Act 2014, Children Act 1989 & Children Act 2004)
Commissioning and contract management resources are typically seen as finite, fixed recourses, creating structural challenge. When capacity is insufficient to provide sufficient across contracts the risks that performance issues, quality concerns, or financial instability need naming. It perhaps seems pessimistic, but Edsel Murphy's Law rings true 'The one thing we can guarantee, is that anything that can go wrong, will go wrong'.
Identifying/naming these risks is the first step in influencing proportionate/risk-based monitoring. Next, self-assess our confidence in data (our own data/provider data) - what is the evidence for this - is this a historical myth of bad data, or an area that's known.
Ask stakeholders, do they understand the process of Contract and Quality management - is it consistently applied, are Commissioning and Contracts teams actively involved in supporting the continuous cycle of improvement of provider services.
In 2025 I held a lessons-learned session for providers who had been involved in forensic level Quality Assurance process - involving site visits, interviews and 2500 documents assessed across three providers.
What stood out, was the integrity and ownership from the provider side. Too often relationships can become oppositional and defensive - the enemy of progress. This work ultimately triggered a wider piece of work, including a co-developed, refined QA process to reduce unnecessary demands on providers and improve both the intelligence gathered and turning this into - what next....
So how does this relate to our elusive savings?
The short answer is that effective Quality Assurance and contract management have a significant function as cost-control mechanisms. Positive (effective) relationships with providers enable quicker placements, negotiation on costs / fulfilled request for transparency.
Quality-led assurance enables savings in three ways:
(1) Cost avoidance.
Early identification of quality issues, governance weakness, or financial fragility prevents escalation into provider failure, emergency placements, or service failure. These events carry significant costs: Unplanned spot purchasing at higher rates, legal challenge, reputational damage, regulatory intervention, judicial review, fines, disruption for the person receiving care and the management time consumed by crisis response. Avoiding just one major failure offsets the cost of QA /Contract monitoring officer many times over.
(2) Fee and contract negotiation.
Where commissioners have confidence in evidence—provider performance data, outcome measures, service-user experience, and compliance—they are better positioned to assess uplifts, and redirect spend toward what demonstrably works. Weak assurance leads to defensive contracting and price inflation; strong assurance supports value-based decisions.
(3) A driver of Continuous Improvement culture
Reduces demand pressure and the churn of repeat searches for placements. Collaborative QA improves service stability, workforce practice, and outcomes, which in turn reduces complaints, re-referrals, placement breakdowns, safeguarding escalations, and repeat interventions. These are real savings, even where they do not always present neatly as budget-line reductions.
The 2025 lessons-learned session reinforced this. Providers engaged positively when QA was experienced as rigorous but fair, forensic but human. That engagement translated into ownership, faster improvement, and reduced resistance—conditions essential for long-term value.
Conclusion
The conclusion - Councils cannot afford not to invest in proportionate, risk-based Quality Assurance and contract management. In a system where nearly four-fifths of core budgets are consumed by social care, failure to grip quality and performance is not neutral—it actively drives cost, risk, and exposure.
Effective QA does not just protect vulnerable adults and children at risk, it protects budgets, reputations, and statutory compliance—while creating the conditions for sustainable savings and long-term Best Value.
Start with an assessment of QA/Contract management function, talk to your experienced officers; 'what will add capacity, where it is needed', 'where are savings to be found', 'what data is unreliable', 'is there data 'gaming' in provider returns'. Next, prepare a proposal for bolting on fixed-term addittional resource that captures 'actual' savings and postive outcomes (contract errors, successful negotiations, quick placements, quality improvements). Cite risks of reputational/ judicial review.
Quality Assurance Lessons learned session: Output
👥 What came through clearly
A strong theme was how Quality Assurance is delivered:
- When QA feels punitive, people retreat
- When QA feels collaborative, people engage, reflect, and improve
⚠️ Why this matters
QA delivered with curiosity, empathy, and respect:
- Strengthens relationships rather than straining them
- Reduces defensiveness and encourages openness
- Helps everyone move in the same direction
🛠 Practical priorities identified
- Create time and space for shared learning between providers
- Reduce unnecessary information requests
- Set clear expectations of the process at the very outset
- Consider why organisations work the way they do, not simply how - what is the organisations root and story
💬 Feedback from the session
“The QA experience has been in-depth and thorough, and this has been a positive experience.”
“It’s been a chance to look at positives, not just areas for development.”
"Including the voice of the child/young person brought a different perspective.”
"It’s felt supportive throughout.”
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