Commissioning for integration: exploring the dynamics of the “subsidy tables” approach in Dutch social care delivery

Abstract

PurposeThe objective of this paper is to develop a redesigned commissioning process for social care services that fosters integrated care, encourages collaboration and balances professional expertise with client engagement.Design/methodology/approachThis study employs a two-pronged approach: a case study of a municipality’s use of subsidy tables and a literature scoping review on integrated care research.FindingsThe paper introduces a new framework for the study of the new “subsidy tables.” A well-defined and extensive consultation process involving both social care providers (suppliers), the Service Triad, and client representation adds to the existing research on supplier consultation, and on how to define the outcomes for clients via client engagement.Research limitations/implicationsWhile aspects are clearly relevant to the Netherlands, the design of the commissioning process of social care has international relevance as well: finding definitions, formulating outcomes and incentives, designing a more collaborative instead of competitive process, stakeholder engagement and consultation.Practical implicationsSeveral Dutch municipalities started using the “subsidy tables” method for commissioning integrated social care. This paper offers clear improvements that benefit the commissioners, the social care providers and their clients.Social implicationsImproving the commissioning process of integrated social care will lead to better fitting care for people who need social care.Originality/valueThis paper is one of the first to do a thorough analysis of the “subsidy tables” method for commissioning integrated social care.