The outcome delivery toolkit: a third sector win?

1. PST 2020 seminar series The outcome delivery toolkit: a third sector win? Joy Dobbs & Francesca Cignola, NCVO

2. Outline • Third sector win – the right question? • Third sector growth in public service delivery • Measuring Outcomes • context • challenges • some existing approaches • current projects • Quality Measurement Framework project • Camden outcome-based commissioning model • Where next?

3. NCVO & its Public Service Delivery Network A free network for anyone interested in third sector commissioning and public service delivery issues Over 1500 members from the public and voluntary sector www.ncvo-vol.org.uk/psdnetwork

4. A third sector win - the wrong question? more a win for service users and taxpayers third sector providers not automatically better than other sectors exist to provide benefits to users & society third sector have range of roles identifying need lobbying providers public service delivery

5. A growing role for the sector in psd Total government spending&statutory income to sector,2000/01 – 2006/07(2000/01 = 100) Source : The State and the Voluntary Sector, NCVO, Sep 2009

6. Local and central government are main source of statutory funding for the VCS Is there figure showing % of charities income that comes from central Gov, over last 3 yrs? Dave’s Fig 5 (showing that it’s nevertheless only small % of Gov depts spend) Statutory funding to the voluntary sector by ‘tier’ of government, 2004/5 – 2006/07 (£ billions) Source : The State and the Voluntary Sector, NCVO, Sep 2009

7. Statutory funding by sub-sector, 2006/07(% of each sub-sector’s income) Source : The State and the Voluntary Sector, NCVO, Sep 2009

8. New ways of working • Outcome focus • Procurement • Individual budgets

9. Responding to changing times value/impact/outcomes Public Administration Select Report need evidence to demonstrate what we can offer procurement and commissioning sector needs better understanding of rules and principles also need commissioners/funders to focus on right things individual budgets flexible and enterprising ensuring and monitoring quality and outcomes

10. Measuring outcomes : context • move towards outcome-based commissioning and monitoring in public service delivery • move towards contracts rather than grants • limited progress in practice • more talked about than practised, variation • requires cultural shift • plethora of tools but often process-oriented • need for more consistent & robust approaches • is compulsion essential to overcome barriers?

11. Measuring outcomes : challenges • Strategic challenge • defining desired outcomes - be clear and specific (even if can’t measure them) • Measurement challenges • identifying outcome indicators • balance depth of information with practicality of collecting it • attribution and baselines • conceptual model e.g. whose assessment • people adapt to difficult circumstances

12. Measuring outcomes : some approaches • Communities : Outcome Based Accountability • Organisations • National Outcomes Programme (CES) • Social Return on Investment (nef) • Social accounting & audit (various) • Services • Outcomes Star (Triangle Consulting) • NPC well-being tool for children • Substance project reporting system

13. Measuring outcomes : developments • Quality Measurement Framework project • Camden Outcome-Based Commissioning Framework

14. QMF project • adult social care • care homes detailed observation/assessment • daycare self-completion • pre-school education • compare detailed measures and regulatory lower burden indicators • volume & characteristics of services by third sector

15. Uses of QMF adult social care measure • Validated approach to establishing outcomes for care home residents & day-care users - basis for outcome-based commissioning & monitoring • Relationship between regulator assessments and resident experiences – support tand influence regulation using outcomes • Provide national measures of quality – to allow outcomes-related quality adjustment of National Accounts

16. Older adults : needs and outcomes

17. Camden Outcome-Based Commissioning framework • Commissioning Devising OB commissioning & procurement processes / tender documents / guidance • Contract monitoring/performance management Developing and embedding appropriate outcome measurement, capture and reporting mechanisms • Culture Change • Piloted on • Adult Social Care mental health services • Supporting People [SP] programme

18. Commissioner & service user priorities Community strategy & Corporate priorities National outcome frameworks OBC Framework

19. What next - Changing times • spending cuts • long term outcomes vs short term savings • policy environment • How to ensure consistent outcome monitoring in a more fragmented “personalised” market

20. Further information/contact • Websites www.ncvo-vol.org.uk/publicservicedelivery/ www.statistics.gov.uk/qmf www.pssru.ac.uk • Email: joy.dobbs@ncvo-vol.org.uk francesca.cignola@ncvo-vol.org.uk miia.chambers@camden.gov.uk

21. Additional slides

22. Conceptual base for measurement • 9 domainse.g. personal care; control over daily living • outcome gain= Q x CfB on each domain • Q : what current service delivers quality /outcome achieved /current level of needs • CfB: what service could deliver difference between need level in absence of services (how reliant) and ‘perfect’ service • add across domains using preference-based weighting

23. Example: Personal care • I feel clean and presentable • I do not feel as clean and presentable as I would like • I do not feel at all clean and presentable and have poor personal hygiene

25. 1.2 Community level outcomes (example tender doc for SP service) Sustainable Growth Strong Economy Connected Community Safe and Vibrant Efficient & Responsive Camden Sustainable Community Strategy objectives • Promote environmental sustainability • Create a sustainable social infrastructure • Improve housing opportunities to meet residents’ needs • Make Camden a better location for business • Maximise education and training opportunities for young people • Increase access to skills and employment • Promote active citizenship and social cohesion • Improve the life chances and life choices of our children and young people • Improve the range of support available to help people maintain independence • Support people to lead healthier lives • Reduce crime and • the fear of crime • Make Camden • Town a better place to • live, work and visit • Enhance the • attractiveness of the • borough • Promote Camden • as the cultural centre • of London in the run up to the Olympics and • Paralympics • Improve our focus • on customers and • citizens • Deliver the better • and cheaper • programme and instil a • culture of efficiency • Develop a high • performing workforce • Provide effective • and enabling support • services Camden Corporate Plan Improvement Priorities 4 - Participate in chosen training and/or education, incl. achieving qualifications 5 - Participate in chosen leisure / cultural / faith / informal learning activities 7 - Establish contact with external service / family / friends 8 -Better manage physical health 9 - Better manage mental health 10 - Better manage substance misuse 11 - Better manage independent living as a result of assistive technology / aids and adaptations 12 -Maintain accommodation and avoid eviction 15 -Greater choice and/or involvement at service level and within the wider community 1 - Maximise income, including receipt of the right benefits 2- Reduce overall debt 3 - Obtain paid work / participate in paid work 6 - Participate in chosen work / voluntary / unpaid work activities 13 -Comply with statutory orders and processes (re offending behaviour) 14 - Better manage self harm, avoid causing harm to others, minimise harm / risk of harm from others Intermediate- level SP outcomes Service-level activity