All you need to know about PbR:
Here you can find over 150 posts tracking every major development in payment by results since 2011. You can see where PbR has succeeded and, more frequently, where it has failed across a wide range of sectors: offending, welfare, employment, substance misuse… If you’re looking for something in particular, try the search box below:
The idea is that by commissioning outcomes rather than outputs, commissioners allow provider to work in any way they see fit, safe in the knowledge that if the outcomes are not achieved, they do not have to make payment. But do PbR schemes achieve better outcomes?
The rationale for PbR This is the second post in a blog series looking at the lessons I’ve learned from a recent review of the payment by results literature and it focuses on understanding the different rationales for the PbR approach to commissioning. [button-blue url=”http://www.russellwebster.com/Lessons%20from%20the%20Payment%20by%20Results%20literature%20Russell%20Webster%202016.pdf” target=”_self” position=”left”]You can download the full literature review here[/button-blue] [divider] One of the main things which became clear to me from reviewing the literature was that commissioners used the PbR approach for
The association of many PbR schemes with very robust cost-cutting and/or the privatisation of previously public markets has caused considerable controversy and confusion which has enabled researchers working from the same data to reach opposing conclusions about the same initiative.
There have been concerns about the pace of change, about the danger of fragmentation and about IT systems. The MoJ has emphasised the importance of the voluntary sector in the CRC partnerships; however, they have been concerns about lack of clarity for that sector about what their role will be.
There’s no free lunch. Yet across the country, advocates of Pay for Success (PFS), or Social Impact Bonds (SIBs), serve up this alternative private financing model as a cost-free, risk-free silver bullet to support critical, yet underfunded, public services.
The pilot was widely claimed to have been set up to stimulate innovation, although it was based on a previous model already developed by St Giles trust. Nevertheless, the SIB funding was found to be flexible and allowed staff to use a personalised budget approach to resolve issues for individual service users as well as incentivising engagement.
However, if the offender population in Peterborough is typical of local prisons, these results are promising although they do not reach the 10% target figure which would release the full PbR payment (the number of reconviction events would need to be 148 per 100 offenders rather than the current 155).
IPPR put forward the same rationale that was advanced to establish the Troubled Families programme; that the current response to people with complex needs is still largely reactive and uncoordinated, mainly consisting of expensive crisis services rather than preventative work.