The 2nd Commandment of payment by results: Thy outcomes shall be few
Most payment by results pilot schemes are targeted at entrenched social problems. These problems – troubled families, long term unemployment, re-offending and drug dependency – are complex by nature. They require a coordinated response which addresses a wide range of issues. PbR funded interventions are a natural commissioning approach to tackle complex problems. However, PbR schemes quickly run into trouble when the outcomes themselves become complex.