This paper aims to give an insight into the process behind Payment by Results (PbR) by looking at the detail involved in the pilot areas for Recovery PbR for drug services. Questions asked include how PbR could work in practice, the national outcomes by which providers will be measured, the Co‐design process and a brief comparison to PbR in alcohol and mental health. An illustrative case study from one of the PbR pilots is included to provide further detail.
The paper was written by a member of the Co‐design group for the PbR pilots and used first‐hand anecdotal knowledge of the process and a former government civil servant with first‐hand experience of PbR in development. The minutes of previous co‐design and steering group meetings were referred to for further details and the NTA was consulted to ensure factual accuracy. The approach was to provide a factual breakdown of PbR and let readers come to their own conclusions about the topic. PbR is still in early stages and it would be inappropriate to pre‐judge the success at this stage.
A number of discussion points centered around the differences between the pilot areas, i.e. whether they were a prime provider or multiple provider model, whether they are including tier 4 (residential rehab), and if pilots are choosing to include an employment outcome. As mentioned before, it is too early to pre‐judge the success of PbR and the pilots – the paper aims to provide information for the reader, who may draw their own conclusions.
This is a substantial paper looking at PbR from the perspective of the pilot areas – a lot of the information is as up‐to‐date as possible in terms of where pilots are in their development. It is a valuable starting point for anyone who wants to understand PbR and its wider implications. It also provides practical information for commissioners and providers who are interested in what PbR will look like in practice.
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