Results Based Accountability

1. Results Based Accountability Charlotte Drury WLGA

2. Results Based Accountability • Purpose of Workshop: • Provide an overview of the RBA framework • Show how RBA can help to plan and deliver outcome based services • Give some examples of practice in Wales

3. Results Based Accountability A disciplined way of embedding outcome based decision making into planning, delivery and accountability for partnerships and projects. RBA increasingly popular in UK and elsewhere . . . • Embeds performance management into planning and delivery • Helps turn talk quickly into actions • Explains both collaborative and service accountability and how they fit back together RBA included in CYP Plan and HSCWB Guidance

4. www.cartoonstock.com

5. The Importance of Language All these new words are very elitist, and I don’t think there’s a place for it. [By...] using language that a fair proportion of the community won’t understand you’ve already set yourselves apart before you’ve even started.’ Interview transcript - Royal Town Planning Institute research into the language of regeneration, 2001

6. The Importance of LanguageToo many terms. Too few definitions. Too little discipline Benchmark Outcome Result Indicator Goal Modifiers Measurable Core Urgent Qualitative Priority Programmatic Targeted Performance Incremental Strategic Systemic Aim Objective Milestone Target Impact Measure

7. RBA Common Language Tools

8. Two Types of Accountability Performance Accountability – the responsibility of a project, programme or service system for specific results for its “customers” (e.g. drug cessation programme accountable for “customer results”) Population Accountability – collective or collaborative responsibility for the well being of populations (e.g. Local Service Board accountable for all people in L.A. Area)

9. Why This Matters: Responsibility English National Indicator Set: Outcome 4: Healthy & Successful Adults (Population Accountability) NI131: Timeliness of social care assessment (Performance Accountability)

10. Why This Matters: Responsibility CYP Plan Outcome Measures Framework: Priority 3.2:Every child and young person is safe and protected from abuse, victimisation and exploitation (Population Accountability) Outcome Measure: % of initial Social Services assessments carried out within 7 working days (Performance Accountability)

11. Keeping Accountability Straight Population Outcome A condition of well-being for a population (or sub-pop) stated in plain language People in Wrexham live in a safe community Children in Walesare born healthy Population Population Indicator Measurable information which helps quantify achievement of population outcome Crime rate in Wrexham Rate of low birth weight babies in Wales Performance Measure Measurable information which helps quantify if a service etc works • How much did we do? • How well did we do it? • Is anyone better off? Performance

12. Population and Performance Accountability CONDITION OF WELL-BEING A Flying Start for Children in Cardiff POPULATION INDICATORS % low birth weight % breast fed at 6 months % fully immunised % assessed ready for school End Contribution Parenting Project PERFORMANCE MEASURES % parents attending gaining better coping skills % parents who use techniques learnt after 6 months Children in Cardiff WHOLE POPULATION Means Courtesy of David Burnby & Associates

13. Outcome, Indicator or Performance Measure? Outcome Indicator P.Measure Outcome Indicator Indicator P.Measure ? Indicator If the question is “How are we doing as a community on education attainment?” If the question is “How good is XYZ school at raising educational attainment?” P.Measure People in the community are safe Crime Rate Average Police Response Time People living in safe, stable affordable housing First time entrants to Criminal Justice System % of low birthweight babies % of LAC reviews carried out on time Achievement of 5 A*-C grades at GCSE

14. From Ends to Means in 7 QuestionsPopulation Accountability • What is the quality of life condition we want for the selected population in our community?

15. Population Outcomes A condition of well being for a population or sub population stated in plain language. A Population (or sub) + A Place + A Condition of Well Being

16. From Ends to Means in 7 QuestionsPopulation Accountability • What is the quality of life condition we want for the selected population in our community? • What would this look like if we could see it? • How can we measure these conditions? • How are we doing on the most important of these measures? (Baselines and the story behind them)

17. Baselines 3 years if nothing changes – OK? Today % Teen pregnancy WHY? Target for 3 years from now Time

18. From Ends to Means in 7 QuestionsPopulation Accountability • Who are the partners that have a role to play in doing better? • What works to do better, including no cost/low cost ideas and off the wall ideas? • What do we propose to do? Action – what, how, who, when, how much!

19. 1. Condition of Well Being Children in Powys are safe 2. What does this look like? Safe at home, from crime & bullying etc DD1 3. How can we measure these conditions? % young people victims of crime 4. How are we doing? Baselines & stories 5. Which partners? Police, YOTs, schools, families etc 6. What works to do better? DD2 Best ideas, new ideas etc 7. What are we going to do? Action plan and budget – by when and how?

21. The RBA Commissioning Journey – From Talk to Action ENDS (POPULATION ACCOUNTABILITY) Drawing the BASELINE (and the CURVE TO TURN) DESIRED OUTCOME The STORY BEHIND THE BASELINE Choosing the INDICATORS Choosing the PARTNERS REVIEW The ACTION PLAN Deciding WHAT WORKS Contributory Relationship COMMISSIONING MEANS (PERFORMANCE ACCOUNTABILITY) PERFORMANCE MEASURES How Much? How Well? Better Off? (CLIENT OUTCOMES)

22. Risks • Less money – fewer grants – more competitive • Everyone likely to be hit - some more than others • Less stability = more difficult to retain and develop good people • Ultimately the price falls on people who need these services

23. Opportunities • Agencies which speak a common language best placed improve services & save money • Greater clarity of expectations • Being able to demonstrate impact of well-founded programmes • Able establish clear link between service results and population well being • Opportunity to use flexibility of 3rd Sector

24. Performance Accountability - for projects/services with a defined customer)

25. Two Types of Accountability Performance Accountability – the responsibility of a project, programme or service system for specific results for its “customers” (e.g. drug cessation programme accountable for “customer results”) Population Accountability – collective or collaborative responsibility for the well being of populations (e.g. Local Service Board accountable for all people in L.A. Area)

26. Keeping Accountability Straight Population Outcome A condition of well-being for a population (or sub-pop) stated in plain language Older people in Flintshire live in a safe community Older people in Gwent live independent lives Population Crime rate in Flintshire Population Indicator Measurable information which helps quantify achievement of population outcome Number of hospital admissions due to falls Performance Measure Measurable information which helps quantify if a service etc works • How much did we do? • How well did we do it? • Is anyone better off? Performance

27. Performance Measures Quantity Quality or How much did we do? # How well did we do it? % Effort or Is anyone better off as a result? Effect % #

28. Performance Measures Types of Performance Measure How much did we do? How well did we do it? (#) Customers served (#) Activities (%) Common measures (e.g. % staff fully trained) (%) Activity specific (e.g. % on time, % fully completed Is anyone better off as a result? (%) Skills or Knowledge (e.g. qualification) (%) Attitude or Opinion (e.g. towards school) (%) Behaviour (e.g. attendance) (%) Circumstance (e.g. in work)

29. Performance Measures Substance Misuse Service How much did we do? How well did we do it? # young people seen # 1-to-1 sessions % staff with higher qualification % 1st appointments within 2 weeks of referral Is anyone better off as a result? % people using service who are off drugs/reduced use at end of 12 week intervention % people using the service who are off drugs/reduced use 6 weeks after end of intervention

30. Performance Measures Education How much did we do? How well did we do it? # of additional learning courses # young people on courses % sessions delivered to schedule % young people completing course Is anyone better off as a result? % young people on additional learning courses gaining 1 or more GCSEs % young people on additional learning course with improved general attendance

31. Performance Measures Youth Outreach Service How much did we do? How well did we do it? # outreach bus sessions # contacts % sessions delivered to schedule % young people writing action plan Is anyone better off as a result? % young people accessing appropriate training as a result of contact with youth outreach % young people reporting increased healthy behaviour

32. Turning Case Management Data into Performance Measures Possible service performance measure of “Is Anyone Better Off”? (Lower Right) An aggregate of the difference the service has made to individuals! • % service users showing “significant” or “partial” positive change (60%)

33. Population Outcome Contributed to – “High Achievement for Young People” 1. Customer Population Young people on ed. support programme 2. Is anyone better off? LR % Key Stage passes DD1 3. Are we delivering services well? UR % sessions delivered on scheduled date 4. How are we doing? Baselines & stories 5. Which partners? Schools, families, peers etc 6. What works to do better? DD2 Mentoring, alternative curriculum 7. What are we going to do? Action plan and budget

34. Fitting Population Accountability and Performance Accountability Together

35. PERFORMANCE ACCOUNTABILITY Ante-Natal Smoking Project Fitting it all Together POPULATION ACCOUNTABILITY Outcome = Healthy children Indicator = % low birth weight Contributory Relationship Alignmentof measures How much? # sessions # service users How well? % sessions to schedule % satisfied Appropriateresponsibility Is anyone better off? # service users stopping while pregnant % service users stopping while pregnant Customer Result

36. Presenting Your Contribution Outcome(s) to which you most directly contribute Indicators Population Accountability Story behind the curves to turn Partners with a role to play Actions – what its going to take to turn the curve Your role – as part of the larger strategy Your programme & what it delivers Performance measures Performance Accountability Story behind the curves to turn Partners with a role to play Actions – what its going to take to turn the curve

37. How it all fits together Community Strategy Outcome = Prosperous City Economic Strategy Indicator = % unemployed CYP Plan Outcome = Children Live Free From Poverty Flying Start Indicator = % children living in workless households Project = Maintained Childcare % parents helped to access work, education or training Outcomes & contributions align – indicators/measures make sense – appropriate accountability – what matters is outcomes not plans and process

39. POPULATION Children aged 0-3yrs 11 months with an eligible post code, resident in one of the eight Cardiff Flying Start catchment areas. Population Scorecard OUTCOME Flying Start Children are Healthy & Thriving • Headline Indicators (Bellwethers) • % FS Children assessed, scoring >2 deviations below their chronological age on the ‘Schedule of Growing Skills Assessment at 2yrs (21-29 mths) & at 3yrs (33-41 mths) • % FS Children fully immunised to schedule at 47 mths • % FS Families who respond to questionnaire, reporting that FS has helped THEIR CHILD ‘a lot or more’ • DATA DEVELOPMENT AGENDA • % FS Children completing primary immunisations • % FS Children with a BMI below the 91st percentile and above the 2nd percentile at 36 months • % FS Children scoring >2 deviations below their chronological age on the ‘hearing & language skills SOGS Assessment ‘ when aged (a) between 21-29 mths & (b) 33-41 mths HOW ARE WE DOING?

40. HOW ARE WE DOING (Con’t)? • STORY BEHIND THE BASELINE • Children who had their 1st SOGS II assessment at 3 yrs were born in 2006/7, prior to the initiation of the FS Programme. These are children that would have had very limited exposure to FS interventions. In comparison the children who had their 1st SOGS at 2yrs were born in 2007/8 & would have had greater exposure to FS interventions. The trend line indicates that children having greater exposure to FS are more likely to be developing normally. Initial analysis needs to be treated with caution, as we need to be certain that SOGS assessment are being applied consistently SOGS scores shows marked developmental variations across catchments, with some children in particular catchments scoring lower than average on particular skills sets. • Schools are telling us that FS children are entering nursery classes with good language & communication skills, are settling quickly and are more independent that their non FS peers. • The introduction of mandatory training for all FS practitioners on supporting and developing childrens language & communication is possibly having an impact on practice. Childcare settings are also being encouraged to take up and apply the ‘Learning Language & Loving It’ training and we think that this is starting to improve practice. • Parents are reporting that FS is helping their children to be more confident and sociable and that they are learning more, but more could be done to support parents in developing their childrens language skills; relationships and managing behavioural issues. • Immunisation data suggests that parents are good at taking their children for Primary Course & Booster immunisations but that it drops below 50% for the final MMR & HIB catch up immunisations. PARTNERS WHO CAN HELP US FS Service Managers & Teams; FS Catchment Schools; Early Years Forum; Childcare Settings; Childcare Workforce Development Team; Parents; GP Practices • WHAT ARE WE DOING & WHAT IS OUR RESOURCE • Develop a referral pathway for children with additional needs • Explore development of ANCo role for FS childcare settings • Interrogate SOGS & Parental questionnaire data to establish trend lines & what might help parents more • Develop a standardised induction process for all FS staff, which includes compulsory training on language development and behaviour management strategies.

41. How Are We Doing?

44. How Can RBA Help Us? • Planning & performance management framework to deliver on collaborative duties • Planning & performance management framework for funded projects (e.g. Cymorth) • Organise and explain how population and performance levels fit together e.g. CYP Plan and Cymorth projects • Make sense of multitude of partnerships and plans – what matters is results not processes! • The future – less money, less small specific grants, more emphasis on outcomes and collaboration

45. Implementing Results Based Accountability Leadership at a senior level Championship by a senior project manager and from champions at different organisational levels Ownership of a commitment to recognising success as better outcomes, not outputs Partnership and multi-agency working. RBA is hard to implement where partnerships are not invested in

47. Resources • Mark Friedman Trying Hard Is Not Good Enough (Trafford Publishing, 2005) • www.raguide.org – website including implementation guide and examples • www.resultsaccountability.com – website including papers on Results Accountability and links to other resources

48. Results Based AccountabilityCharlotte Drury Questions?