As details of the approaches to be taken by the payment by results drug and alcohol recovery pilots are being developed, supporting material has today been published.
The pilots, which began in April with the launch of a co-design group, are the result of a commitment in the cross Government Drug strategy that was launched last December. The new approach looks to further incentivise providers to support adults with drug or alcohol dependency to recover.
This approach is innovative. Previous Department of Health approaches have largely focused on payment for activity and outputs but, under these pilots, providers are no longer paid simply on activity, providers are now rewarded for the outcomes achieved for the individual.
The aim is to test whether such an approach can help more people to break the cycle of dependence and achieve long-term recovery, with recovery having an impact not only for the individual, but also for their families and communities too.
Select a section
The eight local areas selected to pilot the new approach were announced on 8 April 2011:
- Bracknell Forest
- London Borough of Enfield
Updates on the progress of the pilots as they develop will be published. You can read the news stories to date in the news section below
The pilot bids
Following a request for initial expressions of interest in December 2010 through an ‘invitation to participate’, 29 applications were received.
Of these, 16 were shortlisted. Representatives from these shortlisted areas were invited to a workshop to talk through the remit of the pilots in more detail ahead of submitting a fuller, second stage application.
Full applications were received from 12 areas and 8 of these were of high enough quality and had suitably innovative approaches to be taken forward.
The documents that formed the winning bids are available at the links below.
A co-design approach
The detail of the approaches are currently being developed in partnership between the pilot areas and central Government through a co-design group. Central government have developed a framework within which the pilot areas are developing their individual models.
Input is also being sought from experts from the broader recovery sector during this initial co-design period.
The pilots will focus on delivery within the following four high-level outcomes:
- free of drug(s) of dependence
- reduced re-offending or continued non-offending
- in employment
- improved health and well-being
The first challenge for the co-design approach is to agree a more detailed definition of these outcomes, and draft outcome definitions were published earlier this month.
The pilots will use the same definition for each of the outcomes, but weighting of payments for each outcome will be set locally, allowing areas to reflect their different circumstances and focus on specific outcomes.
Governance of the pilots
The pilot areas are being supported by a cross-government team with representatives from the Department of Health and from the:**
- Department of Work and Pensions
- Ministry of Justice
- Home Office
- National Treatment Agency for Substance Misuse
The project is also being overseen centrally by an Officials Steering Group and supported by a Co-design Group, see below for more information on these. Papers and minutes of the meetings of these groups are available.
Officials Steering Group
A national Steering Group comprising senior officials from cross-government departments was established to oversee and guide the pilots.
The membership comprises:
- Deputy Director of Drugs and Alcohol, Department of Health - Chair
- Deputy Director Reducing Re-Offending, Ministry of Justice
- Deputy Director, Reducing Re-Offending, Home Office
- Deputy Director, Labour Market Inclusion Division, Department for Work and Pensions
- Chief Executive, National Treatment Agency
The Co-Design group supports the pilot areas in developing the outcome domains and providing advice on cross-cutting issues. The terms of reference and membership are available below.
Originally this group was constituted as a National Expert Group in January 2011, on a time-limited basis, to support the project up to the selection of the pilot sites in April 2011. It was tasked with advising the Steering Group on the development of the outcome domains.
Membership was invited from payment by results experts from relevant Government Departments, together with those representing expertise in each of the outcome domains. This included clinical, academic and employment experts among others.
Following selection of the pilot sites, the Expert Group was reconstituted and re-named the Co-Design Group. This was done to include representatives from all the pilot sites in the group and to reflect the new focus of designing the detail in partnership.
- Governance documents (published after September 2011)
- Governance documents (published before August 2011)
The pilots programme will be subject to rigorous independent evaluation. A selection decision is expected to be made by the end of August, with a view to appointing an evaluation team to start in October.
The applications have been submitted to scientific peer review and review by lay assessors. An independent commissioning panel comprising leading academic experts and a patient and public involvement in research representative will meet to consider the applications and make recommendations to the Department of Health.
Observers from the Department of Health, the Department for Work and Pensions, the Home Office and the Ministry of Justice will also be in attendance.
This follows the issuing of an invitation to tender for the evaluation by the Department, which closed last month.
The Drug Strategy
The Drug Strategy, published December 2010, set out a vision for a locally-led recovery-orientated drug system with the aim of not only supporting people to tackle their dependency, but helping them to recover and rebuild their lives.
It recognised that an individual’s dependence on drugs and alcohol cannot be tackled in isolation and sought to put the individual at the heart of any recovery system by commissioning a range of services at the local level to provide tailored packages of care and support.
The Department of Health jointly leads on the recovery strand of the Strategy with the Department for Work and Pensions and the Ministry of Justice.
The drugs recovery team is keen to hear from any local areas that are independently adopting a payment by results approach. The team is particularly interested to hear about the model you have adopted, its impact and any best practice examples.
Recent drugs recovery news
- 28 April 2011: Recovery Service providers encouraged to take part in Payment by Results (PbR) (opens new window)
- 27 April 2011: Payment by results - provider event, Quarry House, Leeds (opens new window)
- 8 April 2011: Payment by Results pilot sites announced (opens new window)
- 18 February 2011: Payment by Results update: 16 local areas selected as potential pilot sites (opens new window)
- 24 January 2011: Payment by Results update (opens new window)
- 20 December 2010: Piloting Payment by Results for Drugs Recovery: Invitation to Participate (opens new window)
- Home Office Drug Strategy 2010 (opens new window)