These are tough times, not only for the third sector, but for all who care about our public services. Too often services are commissioned based on price, rather than effectiveness. Too often cuts to services bite the hardest to reach with the most severity. This cannot go on. What we set out to do in this report is to find a way to improve the operation of the state, without simply throwing more money that is not there – while at the same time holding the concept of dignified, humane care at our core.