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CAPITAL CONCERNS Payment by Results

CAPITAL CONCERNS Payment by Results. Marcus Roberts Director of Policy and Membership, DrugScope. ‘A radical programme of public service reform’. ‘localising power and funding’ ( remove ring fences and promote personal budgets) ‘cutting burdens and regulations on frontline staff’

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CAPITAL CONCERNS Payment by Results

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  1. CAPITAL CONCERNSPayment by Results Marcus Roberts Director of Policy and Membership, DrugScope

  2. ‘A radical programme of public service reform’ • ‘localising power and funding’ (remove ring fences and promote personal budgets) • ‘cutting burdens and regulations on frontline staff’ • ‘increasing diversity of provision in public services through further use of payment by results, removing barriers to greater independent provision, and supporting communities, citizens and volunteers to play a bigger role in shaping and providing services’ • ‘improve transparency, efficiency and accountability’ ‘Reform’ – SPENDING REVIEW 2010

  3. What is (and isn’t) it • Paying for results is not always Payment by Results • Payment by Results is not always paying for results • There are a number of Payment by Results schemes (‘family resemblance’) • The Drug Treatment PbR scheme is arguably the most radical (other nominees include Peterborough Social Bond Pilot)

  4. The end(s) in view • Free of drug/s of dependence • Reduced offending or continued non-offending • Employment(sustained employment or full-time education – rate of people moving off benefits) • Health and well-being (‘to reflect stakeholder feedback on the need to ensure harm reduction gains are maintained and to reflect more holistic progress towards recovery’)

  5. Where we’re at • Selection of pilot sites ‘co-design’ • Pilots start in October (with consideration of national roll out pencilled in for 2014-15) • Specifying outcomes (including interim measures) and working out tariffs and payments • Development of LASARS (Local Area Single Assessment and Referral Services) • Sorting out the evaluation (does PbR support the drug strategy, public health policy objectives and provide value for money) • No extra cash …

  6. Some issues • Outcomes reflect reality of recovery • Risk of perverse incentives (cherry picking and parking) • NHS standards and regulatory frameworks • Methods for assessing results with minimal bureaucracy • Service user role in negotiating outcomes (families) • What’s the role for VCS (especially smaller and local) • Incentivising co-operation and responding to local environments

  7. Is it relevant (if I’m not in Enfield)? • A multitude of schemes • Prospect of national roll-out in three years • ‘It’s already happening where we are …’ • Payment by Results is setting a standard for other commissioners • New element in Pooled Treatment Budget formula to ‘incentivise local systems to become more recovery focused’ – rewarding partnerships for successful completions (applied in 2012-13 allocations based on outcomes for 2011-12) ONE POT, ONE PURPOSE (Feb 2011)

  8. Contact Details E-mail: marcusr@drugscope.org.uk Tel: 0207 940 7520 E-mail: marcusr@drugscope.org.uk Website: www.drugscope.org.uk

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