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 OutputsTopicOutcomes  Care planning and assessment driven by defining a fixed service response to needs identified through assessment. Care Planning and Assessm ent  Assessment driven by defining what outcomes a service user would like to achieve.  Care Plan determined by provider and service user reaching agreement.

Potential distinctions between a traditional output based system and a system managed by outcomes OutputsTopicOutcomes  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. Contracts and Funding  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 OutputsTopicOutcomes  Carers employed on a basis of so much per hour Carers Employ ment  Carers are employed as salaried staff with outcomes based bonuses.  Carers are discouraged from performing additional tasks.  Seen as a job that requires limited range of skills 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.

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? Exercise