SSRG Conference New Outcome Framework

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SSRG Conference New Outcome Framework
Presentation by David Burnham and Nick Miller

• 18th April 2007

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Previous Episodes

• 1, 1980s Efficiency
• 2, 1990s Assessment/gate keeping
• 3, 1997 2006 PAF PIs
• (and from 2002 partnerships)
• 4, 2007 gtgtgtgtgtgt Outcomes??

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Old Framework

• National Standards
• High level PAF PIs and self report, inspection
  evidence and BRM judgement
• Focus on quantitative PIs, some parts of our
  business, certain activities
• Performance became almost a separate activity
  from operations
• Clear game elements we all got better at the
  game
• Immense effort to get where we arewill inertia
  prevent embracing something new?

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Old Framework

• PAF Star Rating judgement has
• Sharpened us up
• Focussed activity
• Policies have been delivered in assessment
  process timeliness, home care versus residential
  care, Delayed Transfers etc...
• Created in social care a national community of
  effort in place of services which varied
  considerably
• No one has celebrated these achievements but we
  should

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New Framework

• Real focus on outcomes for citizens
• This pattern potentially has meaning to people.
  Is here the Golden Thread of meaning? citizen,
  staff, activity, evidence, descriptors, outcome,
  judgement
• Potentially a real influence on improving
  services
• Transparency of scoring and judgement
• Real engagement between CSCI ADSS broader set
  of partners. Ownership across the sector?
• Influence other Inspectorates and Public
  Services?

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New Framework

• CSCI set outcome domains for CASSRs to
  demonstrate achievement against OHOCOS outcomes
• More focussed descriptor set for each domain
• 06/07 judgement to be made using this framework
• although data formally collected for 06/07 from
  CASSRs not radically different from 05/06

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New Framework

• so framework in place precise content needs to
  be derived
• and thinking about what evidence means
• Do we replace one set of quantitative PIs with a
  set of outcome PIs? Or do we move to
  considering how to really demonstrate the
  differences our services make to people?

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Questions

• If outcome domains are the heart the new PAF,
  the descriptors are the blood pumping through the
  heart.
• PIs, any other information and any new national
  measures are only important insofar as they
  demonstrate achievement against the descriptor.
• The predominance of PIs therefore subsides.
• If CASSRs own local evidence is more robust for
  a particular descriptor than relevant national
  measure will the BRM consider it?
• If the BRM accepts local evidence do we need
  national evidence measures at all?

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Questions

• if a growing amount of evidence is local does
  that jeopardise national comparison? (No because
  IC will collect activity data)
• potential for a finely engineered policy
  management from the centre, by identifying
  stringent standards for descriptors.
• Where do Key Thresholds sit with this?
• Will the inertia of the familiar keep us thinking
  about PIs rather than finding relevant local
  evidence?
• and what about performance partnership with
  health?

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Future development?

• Descriptor development continues
• Will standards be identified for descriptors?
• Some PI collections continue, where PIs can be
  used as evidence against descriptors (i.e. 4.1a
  evidence is PAF PI D55)
• Should PI names and numbers be disbanded? (PIs
  become evidence against descriptors and have no
  special status)

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Future development?

• Establish, say, 2 national evidence measures
  for each Domain with objectives and targets for
  national comparative purposes?
• Require each LA to devise own evidence compendium
  in discussion with local CSCI?
• Should we identify nationally agreed
• Standards for what constitutes evidence?
• Menu of survey/citizen perception questions and
  other survey standards?
• Pattern of planned and achieved outcome
  intelligence required from SU databases?

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What we have done

• ADSS regions engaged in developing measures from
  a ragged long list
• Regions used Outcome Domain descriptors in this
  work as soon as they became available
• Once proposals made today theyre considered by
  PCG on April 10th and the technical work required
  can be completed(But for clear runners work
  can start now).
• new measures for 08/09 announced by September
  30th

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The work done

• Considerable enthusiasm in most regions for this
  work appreciation that this is a difficult task
  
• Some talk of killer PIs, but not much evidence
  that they can be devised
• Regions have reported proposals in (more or less)
  the same format.
• Only one region submitted specific set of
  separate comments
• All 7 outcome domains covered for discussion
  today
• Some have proposed two or three measures per
  domain, a couple have commented positively on all
  on the long list.
• There will of course be overlap between
  measures for various domains especially where
  surveys are proposed
• Repeat the caveat not all the measures will
  make it some few will appear in the 08/09 set,
  some will be the subject of further work, some
  will inform your local response to devising
  evidence.