1. Introduction
• What is commissioning concerned with
London Joint Improvement Partnership
London Joint Improvement Partnership
Outcomes – a commissioner’s perspective
• Quality – what does it mean
11th November 2009
• Commissioning for outcomes
Natasha Cooper, Strategic Commissioning • Quality outcomes
Development Manager
• Your commissioner needs you
Commissioning Levels Commissioning for Quality
• Individual • Customer satisfaction
London Joint Improvement Partnership
London Joint Improvement Partnership
– Diversification, individualised – PROMs, choice & control, dignity
– personal budgets/personal health budgets,
• Outputs
• Locality – Technical merits
– Community of interest
– Local services to meet specific area needs • Outcomes
– Opportunities for joint commissioning – Clearly defined
• Strategic • Sustainability
– JSNA – Cost effective
– Capacity building and market development – Achieving outcomes
– Partnerships
Outcome based services Commissioning for outcomes
London Joint Improvement Partnership
London Joint Improvement Partnership
What are outcomes? • Outcomes are about results for people
“The impact or end result of services (or • Start with the end result and then work backwards
interventions) on a person’s life” (SCIE 2007)
• People should be able to choose the outcomes
Outcome focused services aim to achieve goals, aspirations or priorities of
individual clients • Commissioners are investing rather than funding or
purchasing
No longer enough to measure quality and success by outputs
• Providers should have autonomy and are expected to
innovate

2. Outputs vs Outcomes Changing the focus
Quantity Quality Quantity Quality
London Joint Improvement Partnership
London Joint Improvement Partnership
How much did we do? How well did we do it?
How much How well
2nd Most
Least
Effort
Effort
did we do? did we do it?
Important
Important
Is anyone better off?
Is anyone
better off? 3rd Most
Effect
Most
Effect
# % Important
Important
27 28
Ron Hutchinson CBE Ron Hutchinson CBE
Commissioning for outcomes Providers who do quality outcomes
How much did we do? How well did we do it?
• Whole system approach
London Joint Improvement Partnership
London Joint Improvement Partnership
# Clients/customers % Common workload ratio, staff
e.g. client staff ratio,
measures • Services with systematic assurance
turnover rate, staff morale, % staff fully
served trained, % clients seen in their own language,
worker safety, unit cost
– Comparators, accreditation
– Independently assessed
# Activities (by type % Activity-specific
– Customer led
of activity) measures
e.g. % timely, % clients completing activity,
% correct and complete, % meeting standard • Evidence of being responsive
Is anyone better off?
# % Skills / Knowledge • Organisational learning
(e.g. parenting skills)
# Point in Time % Attitude / Opinion
(e.g. toward drugs)
vs. Point to Point
# Improvement % Behaviour • Workforce issues
(e.g.school attendance)
– Training
# % Circumstance – Recruitment/retention
(e.g. working, in stable housing)
Ron Hutchinson CBE
London Joint Improvement Partnership
commissioner