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Payment by Results

Getting the right outcomes for payment by results

Not only do outcomes therefore have to be accurate and realistic but commissioners need to consider that providers will quite reasonably de-prioritise work which is not governed by an outcome.

Alcohol/Drugs/Gambling

Drug treatment helps recovery but is not enough on its own

Measuring drug recovery is problematic, to say the least. Recovery from drug dependence is, like desistance from crime, rarely a linear process and typically includes lapse and relapse over many years. Different people choose different recovery goals: some people remain abstinent from all substances for life; others continue to use occasionally; or replace drug dependence with a reliance on alcohol.

Payment by Results

Payment by results – the devil really is in the detail

PbR is simple in theory…

Payment by results is quite a straightforward concept. Its chief attraction lies in its ability to incentivise providers to deliver exactly what a commissioner wants. For example, any PbR contract concerned with reducing reoffending should ensure that organisations receive the biggest payments when they succeed in getting prolific offenders to give up crime. This saves the commissioner – the Ministry of Justice – and the country money and is to the benefit of everyone in society.
However, getting the contract right in practice is proving rather more challenging – indeed, I’ve yet to go to a PbR event where at least one speaker hasn’t said: “The devil is in the detail.”

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