Commissioning for Outcomes 27 th and 28 th September 2011. Commissioning: Evidence-Informed & Outcomes Focused. 09.30Coffee and Registration 10.00Welcome and Introduction – Claire Lightowler (IRISS) and Dee Fraser (CCPS) 10.15Introduction to the day
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Commissioning for Outcomes
27th and 28th September 2011
09.30Coffee and Registration
10.00Welcome and Introduction – Claire Lightowler (IRISS) and Dee Fraser (CCPS)
10.15Introduction to the day
10.20Commissioning: context and framework
10.40Commissioning for outcomes
11.45Using evidence to deliver change in commissioning: tools and case studies
2.15Evaluating outcomes & group discussion
3.00 Feedback and reflection
Commissioning for OutcomesGlasgow & EdinburghLiz Cairncross & Juliet Bligh27th and 28th September 2011
We work for better health, social care, education, housing and welfare with the public, private and voluntary sectors
A range of projects on commissioning for national, regional and local government:
Commissioning: context and framework
Public bodies should have local commissioning strategies and/or service plans which establish strategic and individual needs and determine what type of service should be put in place to meet those needs and deliver the intended outcomes.
Procurement of Care and Support Services, Scottish Government, 2010
Role of commissioning
“Commissioning at both the strategic and the individual level, is an important tool in helping to achieve improvements.
Getting it right can transform people’s lives giving more flexibility, independence and choice as well as quality and value for money.
Getting it wrong can lead to uncertainty, lack of continuity, undermining the potential for people to be part of the solution – sometimes being shoe-horned into provision, just because it is there.”
Commissioning for Personalisation, 2009
Joint commissioning model for public care (SWIA)
Commissioning for Outcomes – An IPC Perspective
“Outcomes are specific changes in behaviour, condition and satisfaction for the people that are served by a project or a service.
These gains are generally signal improvements or ‘human gains’ that have been brought about by the service/intervention.”
Centre for Public Innovation
“...shift the focus from activities to results, from how a programme operates to the good it accomplishes.”
Plantz and Greenaway
Our particular interest is in moving the focus of service purchase from buying by outputs –days, hours, treatments - and onto purchasing by a set of agreed outcomes.
For IPC outcome based purchasing means…
…putting in place a set of arrangements whereby a service is defined by, and paid for, on the basis of a set of agreed outcomes rather than the volume or way in which it is delivered.
Using evidence to deliver change in commissioning: case studies and tools
‘Taking a systematic approach to collecting
and analysing evidence throughout the
commissioning process. By evidence we
mean research, local data and evaluations.’
http://www.esds.ac.uk/government/resources/themeguides.asp - includes: Guide to data sources for Scotland
Developing an approach to outcome based contracting
It makes the authority focus on exactly what they want the provider to achieve and why, rather than volume of service provided.
Achieving outcomes can be both collectively and individually more motivating than providing an amount of service.
It can have a beneficial approach to both raising the quality of the service and for enhancing working relationships.
Recent evaluation of an approach by major UK care
Developing an outcomes based specification
“Outcomes-focused services … aim to achieve the aspirations, goals and priorities identified by service users – in contrast to services whose content and/or forms of delivery are standardised or are determined solely by those who deliver them.”
Social Care Institute for Excellence, 2007
Hartlepool case study
Early engagement on principles of outcomes based contract.
Starting with a ‘clean slate’.
Care management ‘buy in’.
A service that can:
Support the on-going care and support needs of its residents and reduce the likelihood of admission to long term care.
Be prepared to pilot the approach.
Outcomes based contract no good without outcome care/support planning.
Plan time for transition from traditional practice but ............... be prepared to take the plunge.
Be sure to have all the ‘right’ people on board.
Communication is key – care managers, provider mangers, care staff and service user!
Train and re-train all staff.
Culture change doesn’t happen overnight.
It might be hard but is worth doing.
Contracting for outcomes is not a way of saving money.
Agree the desired outcomes.
Describe why these outcomes are desirable.
Define other required parameters, e.g. timescales, limitations or boundaries of service, estimate of funding available etc.
Decide what methods will be used to deliver outcomes and determine what evidence is there that the methods will achieve them.
Describe measures for monitoring.
Determine what resources required
Write action plan.