Transcript Applying Outcome Thinking

Outcome based
commissioning
Mark Napier, The Centre for Public Innovation
[email protected]
www.publicinnovation.org.uk
The new direction of travel
“For too long the focus has been on measuring
inputs and processes that are remote to patients.”
Delivering outcomes will be “the most important
and fundamental issue of all.”
Andrew Lansley, 2 July 2010
New NTA business plan, “will seek to reposition
the treatment system to focus on sustained
recovery, and demonstrate transparent
outcomes.”
First principles
What are outcomes?
Specific changes in behaviour, condition and/or
satisfaction which demonstrate gains, results or
impacts for service users and carers.
So: outcomes describe what happens to the client,
not what we do.
Allied concepts
Performance Targets:
SMART…and link to the outcomes
About customer achievement not provider activity
Milestones:
Crucial and verifiable steps to success
Measure client behaviour not provider
activity
Describe the pathway to success
Key Concepts
Commissioners
An end state or vision in a given
area. In Outcome Based approach
this statement is in the domain of
the Commissioner.
OUTCOME
PERFORMANCE
Specific changes in behaviour,
condition that define project
/service achievement. Defined by
the providers.
TARGET
MILESTONES
A verifiable, critical point in a
project that participants must reach
to ensure that a project is on course
to achieve its performance target.
Providers
Putting this into practice: 1
Outcome based counselling, advice and information
programme for prisoners.
Outcome
PDUs will become abstinent and will learn
a range of skills to enable them to sustain
abstinence.
Performance
target
15 PDUs will complete the programme drug free
and remain drug free at six months follow up
Putting this into practice: 2
No
Milestone
Learn of Tier 3 and present
250
Complete initial TOP setting care plan goals
226
Engage in service, describe risk factors
associated with overdose.
91
73
164
Identify three relapse triggers and describe
coping strategies to deal with these.
Demonstrate significant progress
at TOPS reviews.
80
132
88
Care planned discharge.
Make initial contact with
relapse prevention.
%
67
51
16
58
31
What are the implications?
• Accurate performance management:
what impact are your providers having on clients? Is their
engagement actually making a difference to client’s lives?
• Outcome based specifications:
Specifications based on what providers will achieve not what
they will do.
• Efficiency savings:
Enables commissioners to ensure that they are not
“warehousing” clients in treatment for extended periods of
time. Client move-on produces savings.
• Payment by results:
providers paid by outcomes achieved.
Measuring outcomes
Outcomes can be measured using a basket of
indicators:
• Self-reported data – client
• Programme staff data – reports, assessments,
observations…
• Peer reported data – other service users, family
members, carers, advocates, friends…
• Other external professionals assessment data –
teachers, health visitors etc….
• Empirical data - counting things
• Formal third party validation and evaluation
Questions?
E: [email protected]
W: www.publicinnovation.org.uk
T: 020 7922 7823
Twitter: @cpiorg