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Outcomes Focussed Practice;

the Paradigm shift in Public Services

Rob Hutchinson, CBE

April 2007

Based on Results Based Accountability www.resultsaccountability.com

(Mark Friedman ) www.trafford.com

www.raguide.org

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Every Child Matters – what is it about?

• Response to Laming enquiry into the death of Victoria Climbie – lack of accountability and no sharing of information

• Improving outcomes for ALL children, and narrowing the gap between those who do well and those who do not

• Strengthening the links between well being and educational attainment

• Improving and integrating universal services• Strong focus on families and parenting• Earlier interventions and effective protection• More specialist help to promote opportunity and prevent

problems• Reconfiguring services around the child and family

Every Child Matters HM Treasury, 2003

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Children’s Trusts as Catalysts for Local Change

• Children and young people at the centre, within communities

• Integrated people – staff trained with a common core, multi-disciplinary teams, co-location and a lead professional

• Integrated processes – information sharing and common assessment

• Integrated systems – planning and commissioning with pooled resources

• Inter-agency governance – director of children’s services and lead member for children’s services

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Children & Young People

Lead

ersh

ip a

t eve

ry

leve

l

Sh

are

d V

isio

nInvolvem

ent of children

& young people

Children’s Trusts involve…

Source: DfES

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Outcomes Accountability

is made up of two parts:

Service Effectivenessabout the well-being of

CLIENT POPULATIONSFor Programmes – Agencies – and Service Systems

Community Wellbeingabout the well-being of

WHOLE POPULATIONSFor Communities – Cities – Counties – States - Nations

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Outcomes Accountability

COMMON LANGUAGE

COMMON SENSE

COMMON GROUND

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THE LANGUAGE TRAP

Too many terms. Too few definitions. Too little discipline

Benchmark

Target

Indicator Goal

Result

Objective

Outcome

Measure

Modifiers Measurable Core Urgent Qualitative Priority Programmatic Targeted Performance Incremental Strategic Systemic

Lewis Carroll Center for Language Disorders

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DEFINITIONS

RESULT or OUTCOME

INDICATOR or BENCHMARK

PERFORMANCE MEASURE

Children born healthy, Children succeeding in school, Safe communities, Clean Environment, Prosperous Economy

Rate of low-birthweight babies, crime rate, air quality index, unemployment rate

1. How much did we do? 2. How well did we do it? 3. Is anyone better off?

A condition of well-being for children, adults, families or communities.

A measure which helps quantify the achievement of a result.

A measure of how well a programme, agency or service system is working.

Three types:

= Customer Results

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From Ends to MeansFrom Talk to Action

ENDS

MEANS

RESULT or OUTCOME

INDICATOR or BENCHMARK

PERFORMANCE MEASURE

Customer result = EndsService delivery = Means

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1. Safe Community

2. Crime Rate

3. Average Police response time

4. A community without graffiti

5. % of surveyed buildings without graffiti

6. People have living wage jobs and income

7. % of people with living wage jobs and income

8. % of participants in job training who get living wage jobs

IS IT A RESULT, INDICATOR OR PERFORMANCE MEASURE?

RESULT

INDICATOR

PERF. MEASURE

RESULT

INDICATOR

RESULT

INDICATOR

PERF. MEASURE

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POPULATIONACCOUNTABILITY

For Communities

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Results for All Residentsof the Nation, County, City or Neighbourhood

● A Prosperous Economy

● A Clean Environment

● Healthy and Safe Communities

● Children Ready for and Succeeding in School

● Parents and Other Adults Healthy and Self-Sufficient

● Older People Living with Dignity in Setting of Their Own Choice

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Outcomes

• 5 Outcomes: (Supported by parents, carers and families)* Stay safe* Be healthy* Enjoy and achieve* Make a positive contribution* Achieve economic well being

• Portsmouth 8: Children and Young People should grow up -

* Having an active say in any development

* Healthy

* Emotionally secure and confident

* Having succeeded as far as they can at school

* Having facilities and opportunities to play safely

* Having stayed out of trouble

* Living in a safe place

* Having the opportunity to succeed in their dreams

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MEANS not ENDS

1. COLLABORATION

2. SYSTEMS REFORM

3. SERVICE INTEGRATION

4. DEVOLUTION

5. FUNDING POOLS

To Improving Results In Themselves

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The Matter of Baselines

H

M OK?

L

O

O Point to Point Turning the Curve

History Forecast

Baselines have two parts: history and forecast

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Rebound

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Performance Measures Against the Portsmouth 8

I ndicator Portsmouth National/ local data

source

Teenage conceptions 1998 1999 2000 2001

54.3 53.0 39.1 47.7

England 47.0 45.3 43.8 42.3 Wards in 1999 Charles Dickens 121.7 Fratton 76.6 Paulsgrove 71.2

ONS (number/ 1000 concep-tions in population under 18 years)

I nfant mortality 1998 1999 2000 2001

8.9 5.4 6.8 8.8

England and Wales 5.7 5.8 5.6 5.5

ONS (number per 1000 live births)

Breastfeeding rates 2002 2001 2000 1999 1998

at birth 80.9% 70.7 69.7 69.5 66

For 3 month period Apr-J un03, 20% mothers were breastfeeding af ter 2 weeks and 13% when baby was 6 weeks old

PHT – percent mums breastfeeding their baby

Baseline

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• Agree the Results/Outcomes you want

• Decide how to measure whether you have achieved them

• Draw up the data/facts/figures

• Create Community Boards

• Find new partners

• Agree priorities

• Build up the 1%

• Think from the child’s viewpoint and engage young people

• Develop Champions

• Aim for Tipping Point

Practical Steps to Change Children’s Lives

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DfES Toolkit

Turning the Curve Toolkit:

– http://www.everychildmatters.gov.uk/resources-and-practice/EP00201/

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Performance Accountability

For Services

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HowMuchdid we do?

( # )

HowWell

did we do it?

( % )

Quantity Quality

Programme Performance Measures

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How much did we do?

Programme Performance Measures

How welldid we do it?

Is anyonebetter off?

Quantity Quality

Effe

ct

Effo

rt

# %

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How much did we do?

Not All Performance Measures Are Created Equal

How well did we do it?

Is anyone better off?

LeastImportant

Quantity Quality

Effe

ct

E

ffort 2nd Most

Important

3rd MostImportant Most

Important

Least

Most

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How much did we do?

Drug/Alcohol Treatment Programme

How well did we do it?

Is anyone better off?

Number ofpersonstreated

Percent ofstaff withtraining/

qualification

Number of clientsoff alcohol & drugs - at discharge - 12 months after discharge

Percent of clientsoff alcohol & drugs - at discharge - 12 months after exit

Quantity Quality

Effe

ct

E

ffort

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How much did we do?

Separating the Wheat from the Chaff

How well did we do it?

Is anyone better off?

# Clients/customers served

# Activities (by type of activity)

% Common measurese.g. client staff ratio, workload ratio, staffturnover rate, staff morale, % staff fully trained, % clients seen in their own language,worker safety, unit cost

% Skills / Knowledge (e.g. parenting skills)

#

% Attitude / Opinion (e.g. toward drugs)

#

% Behaviour (e.g.school attendance)

#

% Circumstance (e.g. working, in stable housing)

#

% Activity-specific measures

e.g. % timely, % clients completing activity, % correct and complete, % meeting standard

Point in Time vs. Point to Point

Improvement

Types of Measures Found in Each Quadrant