IPC
OUTCOMES WORKSHOP : DAY 1
IPC Model of an Outcome Based
Approach
Outcome-based contracting
For us outcome-based contracting means…
…putting in place a set of arrangements whereby a
service is defined by, and paid for, on the basis of a set
of agreed outcomes.
Outcome based contracting means shifting…
…the basis on which services are purchased and
resources allocated from units of service provision
(hours, days or weeks) to meet pre-defined needs,
to…
…what do we need to do to ensure that the outcomes
service users’ desire can be met.
What is Outcome Based Care?
 It’s a service…….
• Which gives choice and is flexible enough to
meet service users needs
• Which enables the service user to have a say in
how they wish to receive their care.
• Which helps service users identify
outcomes/goals, will improve/maintain and
support individuals to live at home.
• Which aims to improve independence through
enablement.
Care UK
This means…
 Rather than assessing peoples’ disabilities,
assessing what issues and problems are faced and
what outcomes are desired.
 Being more innovative in terms of how those desired
outcomes can be met.
 Providing flexible, person centred services.
This requires…….
 Developing an assessment process that looks at
need in terms of what issues and problems are faced
and what outcomes are desired / are achievable.
 Commissioners developing an improved knowledge
of what outcomes might be achievable.
 Providers developing a greater repertoire of how
outcomes might be delivered.
 Changing the basis on which we employ staff and
widening the basis of skills.
 Giving organisations who provide services
incentives for doing better than the agreed
outcomes, and disincentives if they don’t.
A Framework for developing an Outcome
Based Approach
e.g. culture
e.g. care planning
e.g. Agreeing the
service delivery
arrangements
Potential distinctions between a traditional
output based system and a system managed
by outcomes
Outputs
Care planning and
assessment driven by
defining a fixed service
response to needs
identified through
assessment.
Topic
Outcomes
Care
Assessment driven by
Planning
defining what outcomes a
and
service user would like to
Assessm
achieve.
ent
Care Plan determined by
provider and service user
reaching agreement.
Potential distinctions between a traditional
output based system and a system managed
by outcomes
Outputs
 Where a block contract is set
up for the purchase of
service it tends to be for
some many hours.
 This time is then allocated as
needed to each individual
service user.
 There are no incentives for
good performance.
Topic
Contracts
and
Funding
Outcomes
 A block contract for outcomes
prescribes the overall
outcomes the agency aspires to
reach and the rationale as to
why they are appropriate.
 Payment may be made on three
different levels; a block
proportion to deliver a service,
a proportion based on the
achievement of outcomes for
individuals and incentives if
better outcomes are achieved
and the local authority saves
money as a result.
Potential distinctions between a traditional
output based system and a system managed
by outcomes
Outputs
Carers employed on a
basis of so much per
hour
Carers are discouraged
from performing
additional tasks.
Seen as a job that
requires limited range
of skills
Topic
Outcomes
Carers
Employ
ment
Carers are employed as
salaried staff with
outcomes based
bonuses.
Carer
Skills
Care agencies employ a
wider diversity of staff
and a better qualified
workforce, on the basis
of carers expected to
deliver outcomes with a
‘do what it takes’
approach.
Benefits of an outcome-based approach
 Focus: It makes the LA & provider focus on exactly
what they need to support the SU to achieve and
why, rather than volume of service provided.
 Motivation: Achieving outcomes can be both
collectively and individually more motivating than
providing an amount of service.
 Quality: It can have a beneficial approach to both
raising the quality of the service and for enhancing
working relationships.
Exercise
Read through the example and discuss the following
questions:
 How is this different from your current
arrangements?
 What changes would you need to make?
 What issues might you face?