Service providers are being urged to become early adopters of Payment by Results (PbR) models for drugs recovery.
More than 65 drug treatment and recovery service providers attended the Department of Health (DH) in Leeds on Wednesday 27 April to hear about the emerging models of PbR following the recent announcement of eight pilot sites.
The highlight of the event was a networking opportunity enabling the pilot areas to showcase their emerging work, and encouraging providers to market their services to commissioners interested in PbR.
Chris Heffer, DH Deputy Director for Alcohol and Drugs, said the goal of the project was to free-up providers to use their expertise and develop innovative approaches. The pilots are currently in a co-design phase, working out with officials the detail of how each will operate locally when they commence in October.
Although each pilot area will be responsible for designing their own system, national definitions for the agreed outcomes will be published shortly, while an invitation to tender will also go out for the independent evaluation of the project.
A variety of speakers at the event acknowledged the range of challenges ahead. These included whether to start with a complex or simple model; how to avoid the risk of 'perverse incentives' and 'cherry-picking' clients; the importance of minimising bureaucracy; ensuring all providers have equal opportunities to compete; delivering more outcomes without increased funding; and ensuring the needs of the whole population were addressed within a local system
Colin Bradbury, Head of Delivery for the NTA, said it was important that all providers were able to contribute to the process of designing the PbR model. He acknowledged that sub-contracting would be crucial to achieving recovery outcomes, and urged providers to be flexible in setting up new relationships.
Marcus Roberts, Director of Policy for DrugScope, said members of his organisation were aware of the need to adapt, but they shared anxieties and concerns.
Describing the process as "entering uncharted territory" and "breathtakingly radical," he said the test of the pilots would be how well they engaged new providers (from the private as well as voluntary sector) and delivered a strong focus on social integration, through jobs, housing and family relationships.
Karen Biggs, Chief Executive of Phoenix Futures, described how her organisation had developed its own version of PbR for adult residential services. She highlighted the importance of measuring outcomes in any system that would have a major impact on the treatment and recovery marketplace.
Nic Adamson, Partnership Manager for Worcestershire DAAT, set out a local approach to commissioning drug recovery services. Worcestershire has a PbR contract with CRI, and is measuring its success against a set of milestones benchmarked against an evidence-base that includes the Substance Misuse Skills Consortium Resource Hub.
Emily Bolton of Social Finance, the organisation behind the social impact bond scheme that is helping Peterborough Prison reduce reoffending, showed how social investment could apply to PbR for substance misuse. She said the model could fund infrastructure for smaller local providers, and help introduce an integrated measurement system for gauging results.
Presentations from the event are now available.