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Children’s Services Understanding Cost and Outcomes

Children’s Services Understanding Cost and Outcomes. Improving strategic commissioning information. Are we really doing the strategic bit?. Strategic Commissioning. Not according to. NRCCI (2009) SWIA (2011) Audit Scotland (2012)

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Children’s Services Understanding Cost and Outcomes

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  1. Children’s ServicesUnderstanding Cost and Outcomes Improving strategic commissioning information

  2. Are we really doing the strategic bit? Strategic Commissioning

  3. Not according to.... • NRCCI (2009) • SWIA (2011) • Audit Scotland (2012) • All identified important areas for improvement in terms of how councils plan and commission services for children • Key areas of weakness in information about local needs, effectiveness of services and determining the actual cost of internal and external services

  4. Knowns, Unknowns and Known Unknowns • How much do different services cost? • Are services matched to individual need? • Are services effective? Value for money? • Are ‘expensive’ services ever worth it? • Do early interventions work? • Do ‘intensive’ or ‘therapeutic’ services work? • Are we measuring the right outcomes?

  5. Do we have the right tools?

  6. Effective Strategic Commissioning Requires... • Robust information about: • the needs profiles and characteristics of LAC • trends and frequency of need • the full costs of services - £££ and resources • outcomes achieved for particular groups of LAC by different services • outcomes for children and performance of services over time • care pathways and impact of timing of interventions and combination of services

  7. Strategic Commissioning - Challenges • Weak information about the needs profiles of LAC – local and national recording • Reliance on administrative data • Care pathways not being tracked • Inconsistent outcomes specification and measurement • What works? What’s best value? • Inconsistent costing methodologies and preconceptions about cost & value • Lack of longitudinal information

  8. Loughborough Cost Calculator • Based on more than a decade of research by the Centre for Child and Family Research (CCFR) at Loughborough University • Calculates costs from the ‘bottom up’ • Individual costs based on the actual care history of each child • Relates costs to children’s needs • Uses longitudinal data to track costs incurred throughout care pathways of children • Presents results for any child, group of children or type of placement by any time period • Analyses costs by outcomes

  9. The Cost Calculator • What goes in: • Unit costs of social care staff time based on 8 case management processes: • Real data, using national statistical returns and local collection, re child placements and care pathways: • Child need categories • Placements and service types • Activities and events undertaken to support the child 1. Decide child needs to be looked after 2. Care planning 3. Maintaining the placement 4. Leaving care/ return home 5. Find a subsequent placement 6. Review 7. Legal processes 8. Transition to leaving care services

  10. The Cost Calculator • In addition to administrative & CLAS data: • Reliable information about the psycho-social wellbeing of LAC – SDQ scores • Categories of need for LAC eg. emotional and behavioural difficulties; mental health support, Record of Need, offender, school exclusion, disability. • Categorisation of service or placement type eg. specialist foster care, mainstream foster care, therapeutic service etc

  11. The Cost Calculator – what comes out? • Quality data in --- quality data out • <6 months - unit costs of services • <1 year -output reports highlight ‘outliers’ • 3-5 years – progress data • Longitudinal data takes time (!) • ‘see the future’ – development of costed care pathways for LAC with different needs • Identification of the drivers of high cost • ‘what if?’ analyses – comparison of relative value of different services – estimation of potential cost/benefit

  12. Next Steps... • Proof of concept pilot across small group of LAs • Initial scoping work by Loughborough – 1 month • Loughborough academics map social care process information – 3-6 months • LAs agree additional data collection to support Cost Calculator • Development of Cost Calculator specifically tailored for Scotland and for the in participating councils • Develop knowledge and support amongst stakeholders

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