Outcomes Focused Commissioning

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Outcomes Focused Commissioning
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We believe that you should no longer ask the
question Is an outcomes approach appropriate
for commissioning and contracting in the social
sector? and ask instead Which of the various
outcomes models is the best fit and how should it
be implemented?
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• The Worcestershire Supporting People Team has
  adopted an outcomes-focused approach to
  commissioning
• Outcome-focused contract
• Outcome-review process
• Outcome-focused procurement
• Outcome-focused strategic planning
• Recognition that service user involvement is
  integral to a good outcomes-focused approach

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• Why?
• Termination of interim contract (no longer fit
  for purpose)
• The need to re-contract with providers that had
  come through the review process
• Need to develop a new contract to replace the
  interim contract
• Changing the focus of the contract specifications
  towards outcomes meant that more effective and
  objective judgements could be made about the type
  of service that needed to be commissioned. This
  then allowed for a more thorough evaluation of
  performance post-procurement.

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• The Drivers for Change
• There was a need to evidence the wider value of
  the Supporting People Programme in achieving a
  range of strategic targets for all stakeholders.
• There was a need to improve the business
  relationship between commissioner and provider.
• There was a need to develop a regional approach
  to the delivery of the Supporting People
  Programme.

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• The Aim
• To have a range of services that are
• Good value for money
• Empowering individuals and improving quality of
  life
• Strategically important
• Also CLG wanted authorities to evidence the
  contributions of Supporting People to national
  and local objectives.

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Outcomes focused commissioning is not about re
designing everything you do. Its about
questioning how you do things and then using
outcomes to create a joined up way of
commissioning services for vulnerable people
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Outcomes-focused thinking Outcomes thinking
shifts our focus from ourselves and our
organisation to the clients perspective and to
understanding what success will mean from that
vantage point.
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The Commissioner becomes an investor rather
than a purchaser The Commissioner facilitates a
relationship between providers and clients that
can identify, monitor and evaluate outcomes
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• An outcomes-focused approach was made possible
  because a number of achievements. These gave a
  baseline and allowed us to act with confidence.
• Every service had been reviewed to a high
  standard
• A 5 year strategy, annual business plan and a
  clear commissioning strategy
• A strong culture of performance monitoring
• TRUST between team and providers
• Strong Culture of Service User Involvement

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• There are a number of outcomes methods that can
  be used to adopt an outcomes focus but we
  recognised that initially during early stage of
  adopting this approach a logic chain method
  offered a number of benefits.
• It allows providers, frontline staff, service
  users, commissioners etc to see at a glance the
  gaols of the program
• It depicts the flow of activity needed to produce
  good outcomes
• It promotes greater stakeholder involvement
• It allows for effective evaluation of the program
• It displays the interrelationship of longer term
  strategic aims and shorter term objectives.

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• The logic chain model focuses on six connecting
  elements of outcomes
• INPUTS
• PROCESSES ACTIVITIES
• OUTPUTS
• EARLY OUTCOMES ( Service user)
• INTERMEDIATE OUTCOMES (Service provider)
• LATE OUTCOMES (Strategic)

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• INPUTS
• These are established by the Supporting People
  Team
• Because of the factors identified that have made
  outcomes focused contracting possible only three
  Input are needed.
• PRICE
• 2) CAPACITY
• 3) ELIGIBILITY

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• PRICE
• Specifying Price has meant a move away from cost.
• Not being able to establish price has been a
  major barrier to previous attempts to move
  towards an outcomes focus.
• Price per hour is the amount per hour of direct
  support that the Supporting People Programme can
  afford to pay. It includes all relevant costs.
• In order to establish price the Supporting People
  Team, in partnership with providers through the
  VFM groups, have created a price identifier.
  This will give an expected price per hour.

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Strategic Outcomes

• These reflect the strategic aims of the
  Supporting People programme and are in the 5 year
  strategy
• Preventing homelessness and repeat homelessness
• Preventing people from offending and re-offending
• Prevent or limit longer term need for people to
  access Adult Social Care Services
• Prevent or limit need for people to access
  Primary Health Care
• Prevent or limit social exclusion

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• Service Level outcomes
• 5 outcomes identified by CLG (communities and
  local government)
• Economic Wellbeing
• Being Healthy
• Safety Security
• Social Civic Partnership
• Enjoying Achieving

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• Service User Level Outcome
• Identified by providers and service users
• Measured using outputs
• Range of Service user level outcomes sit under
  each service level outcome
• Direct measurement of what is being achieved
  through support planning
• List of service user outcomes in contract
  linked to support plan

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• Output
• An output is the end point produced by a given
  activity or process
• It is measured in numbers e.g. number of service
  users who were supported to .
• Links to an outcomes or several outcomes

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At the moment there is a risk that the component
parts of commissioning e.g procurement, service
development, service review,strategic review,
user involvement, contracting, contract
monitoring, contract negotiations, tendering,
performance monitoring, all become fragmented.
An outcomes focus draws all these parts
together to reinforce the cyclical nature of
commissioning. Stakeholders have a common aim and
a shared responsibility. What action you take
at any point in the chain becomes more obvious.
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• Outcome focused procurement allows us to be more
  streamlined and person centred by identifying
  available resources specifying outcomes and using
  those to seek a provider.
• Using the outcomes process to identify gaps
• To link the meeting of individual needs with
  achieving local, regional or national targets
• To ensure that the views of service users really
  impacts on service delivery and service
  availability
• Reduces inputs and promotes creativity

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The experiences of the Worcestershire Supporting
People team over the last year show that it is
possible to implement an effective holistic
approach to outcome-focused practice in a social
care setting. All of the tools, approaches and
knowledge are readily available. If you would
like to know more about the work being undertaken
on outcome-focused commissioning in
Worcestershire, please fell free to talk to us.
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Emma MatthewsSupporting People Contract
Officerematthews2_at_worcestershire.gov.uk01905
728820 / 21www.worcestershire.gov.uk/supportingp
eople