The rough guide to results based accountability

The rough guide to ‘Results Based Accountability’

Bryan Collis

WCVA

www.wcva.org.uk 0800 2888 329 help@wcva.org.uk

What is RBA?

• Getting from talk to action• Also called Outcomes Based Accountability• Three parts

– Strategic planning based on outcomes or impactPOPULATION ACCOUNTABILITY

– Measuring performance of services that contributePERFORMANCE ACCOUNTABILITY

– Commissioning services that contribute to outcomesRESULTS BASED COMMISSIONING

• Making it fit together

Populations

• Population – All people in Cardiff• Outcome – People in Cardiff are healthy• Indicator – Percentage of people who are obese• Baseline – Statistics are available – 54% of those 16+• Story behind this – The rate is increasing• Partners – Health, Education, Youth, Leisure, Voluntary

Sector, Food outlets, Food industry, Advertising• What works? – Obesity pathway• Action plan - Healthy lifestyle groups, food labeling, etc

Populations

All People in CardiffWHOLE POPULATION

OUTCOME: People in Cardiff

are Healthy

INDICATORObesity Rate

People attending active lifestyle

programme

Contribution

Means

End

PERFORMANCE MEASURE

% People attending losing weight

Turn the curve!

• What is the desired change in the indicator.• Use this to measure success and decide what works.• Use a ‘simple’ abbreviated report to show what is

happening (in your pack)• Think about ‘no cost’ and ‘low cost’ actions as well as ‘off

the wall’ ones to stimulate creativity

PerformanceE

FF

EC

T

How much service did we deliver?

How well did we

deliver it?

How much change/effect

did we produce?

What quality of change/effect

did we produce?

EF

FO

RT

OU

TP

UT

INP

UT

Cause

Effect

QUANTITY QUALITY

Enter title

QUANTITY QUALITY

EF

FO

RT

EF

FE

CT

How much did we do? How well did we do it?

Is anyone better off?

LEASTimportant

Also Very Important

MOSTimportant

Commissioning

• You can purchase services.• You can purchase service quality• You cannot purchase customer outcomes.

• But, you can purchase a contract relationship that maximizes good customer outcomes.

Commissioning

• The most important performance measures– 3 to 5 quality and outcome measures.

• Set up a Continuous Improvement Process– Review meetings concentrate on these measures with a report

similar to the population accountability report using a similar set of questions.

• Performance Partnership between commissioner and service provider– Ask what can the commissioner can do to help

Commissioning

• As a service provider you will have a report card for each contract/service/beneficiary group.

• The most important performance measures– 3 to 5 quality and outcome measures.

• Set up a Continuous Improvement Process– Review meetings concentrate on these measures with a report

similar to the population accountability report using a similar set of questions.

• Performance Partnership between commissioner and service provider– Ask what can the commissioner can do to help

Does it work?

Strengths• Focuses on people, outcomes and change• Can cope with equalities issues• Separates out who is responsible for what• Includes partnership ideas and co-design / co-delivery

Does it work?

Weaknesses• Children’s services in England have implemented OBA

over last 3 years – mixed experience– Courage to stop counting what you have always counted– Needs to be part of a change agenda – not just an add on– Organisational inertia and vested interests

• Needs the right indicators– What if your service doesn’t link to the indicators chosen– What if the indicators are not linked directly to the outcome?

• All examples are people based – what about infrastructure bodies?

Does it work?

Weaknesses• It is based on the dominance of numbers over stories

and the presumed independence of numbers.• Of critical importance are

– The story behind the baseline– The trend and the curve to turn.

And these may be decided behind closed doors by ‘experts’.

Does it work?

Opportunities• Involvement in the partnership discussions about what

the outcomes look like and which indicators should be used.

• Changing relationship between commissioner and provider.

Does it work?

Threats• Outcomes and indicators may be imposed nationally.• If your service cannot demonstrate its contribution to

achieving the outcome(s), then funding may be threatened.

• Service user voice may be reduced – customer is just that – not automatically a citizen.

Thank YouDiolch yn fawr

Bryan Collis

WCVA

www.wcva.org.uk 0800 2888 329 help@wcva.org.uk