The rough guide to results based accountability

How can RBA work for you?

1. The rough guide to ‘Results Based Accountability’ Bryan Collis WCVA  www.wcva.org.uk  0800 2888 329  [email protected]

2. What is RBA? Getting from talk to action Also called Outcomes Based Accountability Three parts Strategic planning based on outcomes or impact POPULATION ACCOUNTABILITY Measuring performance of services that contribute PERFORMANCE ACCOUNTABILITY Commissioning services that contribute to outcomes RESULTS BASED COMMISSIONING Making it fit together

3. 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

4. Populations All People in Cardiff WHOLE POPULATION OUTCOME: People in Cardiff are Healthy INDICATOR Obesity Rate People attending active lifestyle programme Contribution Means End PERFORMANCE MEASURE % People attending losing weight

5. 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

6. Performance EFFECT 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? EFFORT OUTPUT INPUT Cause Effect QUANTITY QUALITY

7. Enter title QUANTITY QUALITY EFFORT EFFECT How much did we do? How well did we do it? Is anyone better off? LEAST important Also Very Important MOST important

8. 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.

9. 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

10. 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

11. 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

12. 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?

13. 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’.

14. 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.

15. 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.

16. Thank You Diolch yn fawr Bryan Collis WCVA  www.wcva.org.uk  0800 2888 329  [email protected]