The belated final evaluation of the drug and alcohol PbR recovery pilots found they were expensive, delayed treatment entry & had fewer treatment completions.
The researchers come to the very fair conclusion that PbR is not a straightforward guarantee of improving performance in drug and alcohol recovery. Although previous studies have shown that PbR can drive some limited improvements in quality, this study unambiguously found that: “the introduction of payment for outcomes had a significant, negative impact on successful treatment completion.”
PbR schemes now account for at least £15 billion of public spending in the UK including the Work Programme, the new private probation contracts and numerous homelessness and substance misuse schemes. Despite extensive negative media coverage, neither the Cabinet Office nor the Treasury currently monitors how PbR is operating across government.
A proper assessment will have to wait until we have more details but these figures do suggest that Payment by Results may be a more successful approach when savings are shared between government and providers with an explicit understanding that providers will reinvest their success payments rather than merely pass them on to shareholders.
I just got back from an interesting roundtable discussion on payment by results and re-offending convened by IPPR. I cam away with two main thoughts. Is there really no alternative to the MoJ’s cumbersome cohort approach to calculating PbR? And who is going to provide on the ground leadership for the rehabilitation revolution in a centrally commissioned model with a much reduced probation service?
00000This is the third in a series of posts about the five principles of PbR commissioning set out in a recent Audit Commission report. Principle 3: A well-designed payment and reward structure The Audit Commission helpfully encourages commissioners to consider a wide range of PbR reward structures with an emphasis on schemes where only some of the funding is dependent on results. It points out that many small providers are unlikely to be to carry the …