Transcript Slide 1

CAPITAL CONCERNS
Payment by Results
Marcus Roberts
Director of Policy and Membership,
DrugScope
‘A radical programme of public service
reform’
o ‘localising power and funding’ (remove ring fences and
promote personal budgets)
o ‘cutting burdens and regulations on frontline staff’
o ‘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’
o ‘improve transparency, efficiency and accountability’
‘Reform’ – SPENDING REVIEW 2010
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)
The end(s) in view
o Free of drug/s of dependence
o Reduced offending or continued non-offending
o Employment (sustained employment or full-time
education – rate of people moving off benefits)
o 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’)
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 …
Some issues
o Outcomes reflect reality of recovery
o Risk of perverse incentives (cherry picking and
parking)
o NHS standards and regulatory frameworks
o Methods for assessing results with minimal
bureaucracy
o Service user role in negotiating outcomes (families)
o What’s the role for VCS (especially smaller and local)
o Incentivising co-operation and responding to local
environments
Is it relevant (if I’m not in Enfield)?
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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)
Contact Details
E-mail: [email protected]
Tel: 0207 940 7520
E-mail: [email protected]
Website: www.drugscope.org.uk