What Are You Tolerating as a Commissioner That Needs to Stop

Because what we tolerate quietly shapes outcomes loudly.

Commissioners are rarely short of responsibility, but they are often short of space to pause, reflect and ask a harder question:

What am I currently tolerating that is actively undermining impact for children and families?

Most commissioners I work with already know where things aren’t right.
What’s missing isn’t insight, it’s a safe, structured way to surface it, scrutinise it, and act on it without blame.

This article offers a practical diagnostic to support scrutiny‑safe conversations; with yourself, with providers, and across systems.

The Reality Commissioners Are Navigating

Commissioning rarely happens in ideal conditions.

More often, commissioners are asked to commission, or recommission, services knowing they cannot fully meet the needs of the communities they are meant to serve.

This can include:

• Services struggling to meet cultural, ethnic or language needs
• Limited specialist support for children affected by domestic abuse or complex trauma
• Provision that works in theory but not in day‑to‑day practice

When this happens, commissioners are often forced into tolerating risk rather than resolving it. Over time, tolerance becomes normalised and normalisation becomes harm.

Common Areas commissioners End Up Tolerating

Across local authorities and systems, similar patterns keep showing up:

1. High waiting lists that quietly grow

Waiting lists are often framed as a “system pressure” that is responding to more complex needs. Early help is not arriving earlier enough especially for children and young people that are affected by trauma and mental ill health.

Tolerance statement to notice:

“It’s happening everywhere, there’s nothing we can do about the waiting list right now.”

2. Staff turnover that destabilises delivery

High turnover affects more than continuity it erodes trust, relationships and the fidelity of trauma‑informed practice.

Tolerance statement to notice:

“At least the service is still running, we are holding a waiting list.”

3. Activity‑based accountability over long‑term impact

Commissioners are often supplied with outputs rather than outcomes:

• Number of referrals received
• Number of sessions delivered
• Numbers of children reached

But activity is not the same as change.

Tolerance statement to notice:

“We’re meeting KPIs”

4. Poor or weak impact data

When impact data:

• Is inconsistent
• Isn’t disaggregated
• Doesn’t demonstrate evidence‑based practice

…it becomes reassuring data rather than useful data.

Tolerance statement to notice:

“It’s the best data we can get at the moment.”

5. Learning that stays siloed

Key insights from delivery often fail to travel:

• Between providers
• Between commissioning and practice
• Between services working with the same families

This limits learning and repeats mistakes.

Tolerance statement to notice:

“We can’t share this data as this is data that is collected for the organisation to use”

6. A disconnect between commissioning and implementation

Commissioners may lead on commissioning services or training, yet feel disconnected from:

• The realities of the pressures faced by the frontline practitioners
• Understanding the barriers for implementation
• Service managers and strategic plans

As a result, the focus subtly shifts to commissioning activity rather than implementation impact.

Tolerance statement to notice:

“Our role is to commission it, we don’t oversee the delivery”

A Diagnostic Checklist for Commissioning Decisions in Local Authorities

Use this checklist as a self‑reflection tool, a team discussion starter, or a provider dialogue framework.

Take the Health Check Now! 📋