Managing Disputes and Challenge in ABI Commissioning Relationships
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Disputes between providers and commissioners can arise in acquired brain injury services due to cost pressures, differing risk tolerance or disagreement about outcomes. How these challenges are handled has a direct impact on service stability, safeguarding and long-term relationships.
This article explores how ABI providers can manage disputes constructively. It should be read alongside Quality, Safety & Governance and Working With Commissioners, ICBs & Neuro-Rehabilitation Partners.
Why disputes arise in ABI commissioning
Complex needs, high costs and variable recovery trajectories increase the likelihood of challenge.
Commissioner and inspector expectations
Expectation 1: Professional conduct. Commissioners expect evidence-led, respectful challenge.
Expectation 2: Risk transparency. CQC expects providers to escalate safeguarding risks clearly.
Operational example 1: Disputed support reduction
A provider used outcome data and risk assessment to challenge a proposed reduction.
Using evidence to support challenge
Objective evidence strengthens credibility during disagreement.
Operational example 2: Independent clinical input
External clinical opinion supported continued support needs.
Knowing when to escalate
Formal escalation routes should be used proportionately.
Operational example 3: Formal review meeting
A structured review resolved disagreement without contract damage.
Evidencing professional dispute management
Providers should evidence:
- Risk assessments
- Outcome reports
- Formal correspondence records
Why this protects long-term relationships
Constructive challenge builds respect and trust over time.
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