How can RBA work for you?

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

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

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
QUANTITY QUALITY
EFFORT
How much How well
INPUT
service did did we
Cause
we deliver? deliver it?
OUTPUT
EFFECT
How much What quality of
change/effect change/effect
did we produce? did we Effect
produce?

7. Enter title
QUANTITY QUALITY
How much did we do? How well did we do it?
EFFORT
LEAST Also Very
Important
important
Is anyone better off?
EFFECT
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  help@wcva.org.uk