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Outcomes Focussed Practice; the Paradigm shift in Public Services Rob Hutchinson, CBE April 2007 Based on Results Based Accountability (Mark Friedman ) 1 www.resultsaccountability.com www.trafford.com www.raguide.org Every Child Matters – what is it about? • Response to Laming enquiry into the death of Victoria Climbie – lack of accountability and no sharing of information • Improving outcomes for ALL children, and narrowing the gap between those who do well and those who do not • Strengthening the links between well being and educational attainment • Improving and integrating universal services • Strong focus on families and parenting • Earlier interventions and effective protection • More specialist help to promote opportunity and prevent problems • Reconfiguring services around the child and family 2 Every Child Matters HM Treasury, 2003 Children’s Trusts as Catalysts for Local Change • Children and young people at the centre, within communities • Integrated people – staff trained with a common core, multi-disciplinary teams, co-location and a lead professional • Integrated processes – information sharing and common assessment • Integrated systems – planning and commissioning with pooled resources • Inter-agency governance – director of children’s services and lead member for children’s services 3 Children’s Trusts involve… Shared Vision Children & Young People Source: DfES 4 Outcomes Accountability is made up of two parts: Community Wellbeing about the well-being of WHOLE POPULATIONS For Communities – Cities – Counties – States - Nations Service Effectiveness about the well-being of CLIENT POPULATIONS For Programmes – Agencies – and Service Systems 5 Outcomes Accountability COMMON LANGUAGE COMMON SENSE COMMON GROUND 6 THE LANGUAGE TRAP Too many terms. Too few definitions. Too little discipline Benchmark Outcome Result Modifiers Indicator Measurable Core Urgent Qualitative Priority Programmatic Targeted Performance Incremental Strategic Systemic Objective Measure Target Lewis Carroll Center for Language Disorders 7 Goal DEFINITIONS RESULT or OUTCOME A condition of well-being for children, adults, families or communities. Children born healthy, Children succeeding in school, Safe communities, Clean Environment, Prosperous Economy INDICATOR or BENCHMARK A measure which helps quantify the achievement of a result. Rate of low-birthweight babies, crime rate, air quality index, unemployment rate PERFORMANCE MEASURE A measure of how well a programme, agency or service system is working. Three types: 8 1. How much did we do? 2. How well did we do it? 3. Is anyone better off? = Customer Results From Ends to Means From Talk to Action RESULT or OUTCOME ENDS INDICATOR or BENCHMARK PERFORMANCE MEASURE Customer result = Ends Service delivery = Means 9 MEANS IS IT A RESULT, INDICATOR OR PERFORMANCE MEASURE? RESULT 1. Safe Community INDICATOR 2. Crime Rate PERF. MEASURE 3. Average Police response time RESULT INDICATOR 4. A community without graffiti 5. % of surveyed buildings without graffiti RESULT 6. People have living wage jobs and income INDICATOR 7. % of people with living wage jobs and income PERF. MEASURE 8. % of participants in job training who get living wage jobs 10 POPULATION ACCOUNTABILITY For Communities 11 Results for All Residents of the Nation, County, City or Neighbourhood ● A Prosperous Economy ● A Clean Environment ● Healthy and Safe Communities ● Children Ready for and Succeeding in School ● Parents and Other Adults Healthy and Self-Sufficient ● Older People Living with Dignity in Setting of Their Own Choice 12 Outcomes • 5 Outcomes: (Supported by parents, carers and families) * Stay safe * Be healthy * Enjoy and achieve * Make a positive contribution * Achieve economic well being • Portsmouth 8: Children and Young People should grow up - * Having an active say in any development * Healthy * Emotionally secure and confident * Having succeeded as far as they can at school * Having facilities and opportunities to play safely * Having stayed out of trouble * Living in a safe place * Having the opportunity to succeed in their dreams 13 MEANS not ENDS To Improving Results In Themselves 1. COLLABORATION 2. SYSTEMS REFORM 3. SERVICE INTEGRATION 4. DEVOLUTION 5. FUNDING POOLS 14 The Matter of Baselines H M OK? L O O Point to Point History Turning the Curve Forecast Baselines have two parts: history and forecast 15 Rebound 16 Performance Measures Against the Portsmouth 8 Baseline Indicator Teenage conceptions 1998 1999 2000 2001 Infant mortality 1998 1999 2000 2001 Breastfeeding rates 2002 2001 2000 1999 1998 17 Portsmouth 54.3 53.0 39.1 47.7 8.9 5.4 6.8 8.8 at birth 80.9% 70.7 69.7 69.5 66 National/local data source England 47.0 45.3 43.8 42.3 Wards in 1999 Charles Dickens 121.7 Fratton 76.6 Paulsgrove 71.2 England and Wales 5.7 5.8 5.6 5.5 For 3 month period Apr-Jun03, 20% mothers were breastfeeding after 2 weeks and 13% when baby was 6 weeks old ONS (number/ 1000 conceptions in population under 18 years) ONS (number per 1000 live births) PHT – percent mums breastfeeding their baby Practical Steps to Change Children’s Lives • Agree the Results/Outcomes you want • Decide how to measure whether you have achieved them • Draw up the data/facts/figures • Create Community Boards • Find new partners • Agree priorities • Build up the 1% • Think from the child’s viewpoint and engage young people • Develop Champions • Aim for Tipping Point 18 DfES Toolkit Turning the Curve Toolkit: – http://www.everychildmatters.gov.uk/resourcesand-practice/EP00201/ 19 Performance Accountability For Services 20 Programme Performance Measures 21 Quantity Quality How Much How Well did we do? did we do it? (#) (%) Effect Effort Programme Performance Measures 22 Quantity Quality How much did we do? How well did we do it? Is anyone better off? # % Effort Not All Performance Measures Are Created Equal Quantity Quality How much did we do? How well did we do it? Least 2nd Most Important Important Effect Is anyone better off? 23 3rd Most Important Most Important Effort Drug/Alcohol Treatment Programme Quantity Quality How much did we do? How well did we do it? Number of persons treated Percent of staff with training/ qualification Effect Is anyone better off? Number of clients Percent of clients off alcohol & off alcohol & drugs drugs - at discharge - 12 months after discharge 24 - at discharge - 12 months after exit Separating the Wheat from the Chaff Types of Measures Found in Each Quadrant How much did we do? How well did we do it? # Clients/customers served % Common measures # Activities (by type of activity) % Activity-specific measures e.g. client staff ratio, workload ratio, staff turnover rate, staff morale, % staff fully trained, % clients seen in their own language, worker safety, unit cost e.g. % timely, % clients completing activity, % correct and complete, % meeting standard Is anyone better off? % Skills / Knowledge # # # # 25 (e.g. parenting skills) Point in Time vs. Point to Point Improvement % Attitude / Opinion (e.g. toward drugs) % Behaviour (e.g.school attendance) % Circumstance (e.g. working, in stable housing)