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The Ten Commandments of Payment by Results

It’s getting increasingly difficult to have a productive debate about payment by results. For many people, PbR is merely shorthand for the privatisation or even a backdoor way of funneling public funds into multinational companies. For others, it is a potentially exciting approach to commissioning public services which can drive innovation and improved performance. But whether you love PbR or hate it, the main reason why it’s difficult to have a meaningful discussion is the lack of any evidence base. This post is my take on 10 critical success factors for PbR.

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PbR is everywhere

There are payment by results initiatives across a wide range of government departments including:

  • The Department of Health
  • The Department of  Communities and Local Government
  • The Department of Health
  • The Ministry of Justice
  • The Department of Welfare and Pensions
  • The Department for Education

The UK  Border Agency and the Greater London Authority have also commissioned substantial services via a PbR mechanism.

However, despite all this activity, it’s getting increasingly difficult to have a productive debate about payment by results.

For many people, PbR is merely shorthand for the privatisation of public services or even a backdoor way of funneling public funds into multinational companies.

For others, it is a potentially exciting approach to commissioning public services which can drive innovation and improved performance.

Lack of an evidence base

But whether you love PbR or hate it, the main reason why it’s difficult to have a meaningful discussion is the lack of any evidence base.

It is a very new model of commissioning and we just don’t know yet in what circumstances it is likely to be effective – or counter-productive.

However, there is a steady stream of interim findings from the Work Programme (seen as proof that PbR doesn’t work) and a number of pilots in the criminal justice and substance misuse fields.

I’ve been following the development of PbR in the UK very closely and have developed my list of 10 critical success factors which should shape the development of payment by results schemes.

I’m quietly confident that these “10 Commandments of PbR” will be proved wrong over time, but I think it’s worth sharing them now if only to try and stimulate a more interesting level of debate.

I’ll be dedicating a blog post to each of these 10 over the next few weeks and hope that some of you will use the comments section below to critique them and come up with alternative critical success factors yourselves.

 

infograph 10 commandments

 

I’ll be publishing the posts twice a week on Tuesdays and Thursdays.

The next post will look at the First Commandment of PbR:

“Thou shalt commission for a single purpose”

 

Browse my comprehensive resource pack on Payment by Results.

Check out my Marmite Infographic for simple explanation of key PbR jargon.

 

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The main message from the literature is that commissioners need to be proactive in ensuring that PbR providers deliver a good quality service — particularly when service users include vulnerable groups

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When outcomes are the basis for payment, it is important that the provider receiving the payments is responsible for achieving the outcomes. Targets should not be unduly influenced by external factors (such as the state of the economy for Work Programme type schemes) or by the work of other agencies who are not receiving payment from the contract.

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commissioners are urged to consider whether potential providers have sufficient financial resources to bid for a contract which requires considerable initial investment and where payments are delayed until the achievement of outcome measures has been verified.

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