SSRG Conference

New Outcome Framework

18th April 2007

Presentation by David Burnham and Nick Miller

Previous Episodes

1, 1980s Efficiency2, 1990s Assessment/gate keeping3, 1997 – 2006 PAF PIs(and from 2002 ‘partnerships’)4, 2007 >>>>>> Outcomes??

Old Framework

•National Standards•High level PAF PI’s and self report, inspection evidence and BRM judgement•Focus on quantitative PI’s, some parts of our business, certain activities •‘Performance’ became almost a separate activity from operations•Clear game elements – we all got better at the game •Immense effort to get where we are…will inertia prevent embracing something new?

Old Framework

PAF & Star Rating judgement has:•Sharpened us up•Focussed activity •Policies have been ’delivered’ in assessment process timeliness, home care versus residential care, Delayed Transfers etc...•Created in social care a national community of effort in place of services which varied considerably

No one has ‘celebrated’ these achievements but we should

New Framework

• Real focus on outcomes for citizens• This pattern potentially has meaning to people. Is

here the Golden Thread of meaning? citizen, staff, activity, evidence, descriptors, outcome, judgement

• Potentially a real influence on improving services • Transparency of scoring and judgement• Real engagement between CSCI & ADSS & broader

set of partners. Ownership across the sector?• Influence other Inspectorates and Public Services?

New Framework

• CSCI set ‘outcome domains’ for CASSRs to demonstrate achievement against OHOCOS outcomes

• More focussed ‘descriptor’ set for each domain • 06/07 judgement to be made using this

framework…• …although data formally collected for 06/07 from

CASSRs not radically different from 05/06

New Framework

• …so framework in place – precise content needs to be derived…

• …and thinking about what ‘evidence’ means

• Do we replace one set of quantitative PIs with a set of ‘outcome’ PIs? Or do we move to considering how to really demonstrate the differences our services make to people?

Questions

• …If outcome domains are the heart the new PAF, the descriptors are the blood pumping through the heart.

• PIs, any other information and any new national measures are only important insofar as they demonstrate achievement against the descriptor.

• The predominance of PI’s therefore subsides.• If CASSR’s own local evidence is more robust for a

particular descriptor than relevant national measure will the BRM consider it?

• If the BRM accepts “local” evidence do we need national evidence measures at all?

Questions

•if a growing amount of evidence is local does that jeopardise national comparison? (No because IC will collect activity data)

•potential for a finely engineered policy management from the centre, by identifying stringent standards for descriptors.

•Where do Key Thresholds sit with this?

•Will the inertia of the familiar keep us thinking about PIs rather than finding relevant local evidence?

•and what about performance partnership with health?

Future development?

Descriptor development continues…

Will ‘standards’ be identified for descriptors?

Some PI collections continue, where PIs can be used as evidence against descriptors (i.e. 4.1a – evidence is PAF PI D55)

Should PI names and numbers be disbanded? (PIs become evidence against descriptors and have no “special” status)

Future development?

Establish, say, 2 national “evidence measures” for each Domain with objectives and targets for national comparative purposes?Require each LA to devise own evidence compendium in discussion with local CSCI?Should we identify nationally agreed:

Standards for what constitutes evidence?

Menu of survey/citizen perception questions and other ‘survey standards’?

Pattern of planned and achieved outcome intelligence required from SU databases?

What we have done

• ADSS regions engaged in developing measures from a ragged ‘long list’

• Regions used Outcome Domain ‘descriptors’ in this work as soon as they became available

• Once proposals made today – they’re considered by PCG on April 10th and the technical work required can be completed…(But for clear ‘runners’ work can start now).

• …new measures for 08/09 announced by September 30th

The work done • Considerable enthusiasm in most regions for this work –

appreciation that this is a difficult task • Some talk of ‘killer’ PIs, but not much evidence that they can be

devised • Regions have reported proposals in (more or less) the same format.• Only one region submitted specific set of separate comments • All 7 outcome domains ‘covered’ for discussion today• Some have proposed two or three measures per domain, a couple

have commented positively on all on the long list. • There will of course be ‘overlap’ between measures for various

domains – especially where surveys are proposed

• Repeat the caveat – not all the measures will make it – some few will appear in the 08/09 set, some will be the subject of further work, some will inform your local response to devising evidence.