Improving strategic commissioning information

Are we really doing the strategic bit?

NRCCI (2009) SWIA (2011) Audit Scotland (2012)

All identified important areas for improvement in terms of how councils plan and commission services for children

Key areas of weakness in information about local needs, effectiveness of services and determining the actual cost of internal and external services

How much do different services cost? Are services matched to individual

need?Are services effective? Value for

money?Are ‘expensive’ services ever worth it?Do early interventions work? Do ‘intensive’ or ‘therapeutic’ services

work?Are we measuring the right outcomes?

Knowns, Unknowns and Known Unknowns

◦ Robust information about:

◦ the needs profiles and characteristics of LAC

◦ trends and frequency of need◦ the full costs of services - £££ and

resources◦ outcomes achieved for particular groups

of LAC by different services◦ outcomes for children and performance of

services over time◦ care pathways and impact of timing of

interventions and combination of services

Weak information about the needs profiles of LAC – local and national recording

Reliance on administrative data Care pathways not being tracked Inconsistent outcomes

specification and measurement What works? What’s best value? Inconsistent costing methodologies

and preconceptions about cost & value

Lack of longitudinal information

Based on more than a decade of research by the Centre for Child and Family Research (CCFR) at Loughborough University

Calculates costs from the ‘bottom up’ Individual costs based on the actual care history

of each child Relates costs to children’s needs Uses longitudinal data to track costs incurred

throughout care pathways of children Presents results for any child, group of children or

type of placement by any time period Analyses costs by outcomes

What goes in:

◦ Unit costs of social care staff time based on 8 case management processes:

• Real data, using national statistical returns and local collection, re child placements and care pathways:• Child need categories• Placements and service types• Activities and events undertaken to support the child

1. Decide child needs to be looked after

2. Care planning 3. Maintaining the placement4. Leaving care/ return home

5. Find a subsequent placement6. Review7. Legal processes8. Transition to leaving care

services

In addition to administrative & CLAS data:◦ Reliable information about the psycho-social

wellbeing of LAC – SDQ scores◦ Categories of need for LAC eg. emotional and

behavioural difficulties; mental health support, Record of Need, offender, school exclusion, disability.

◦ Categorisation of service or placement type eg. specialist foster care, mainstream foster care, therapeutic service etc

• Quality data in --- quality data out• <6 months - unit costs of services• <1 year -output reports highlight ‘outliers’ • 3-5 years – progress data• Longitudinal data takes time (!) • ‘see the future’ – development of costed care

pathways for LAC with different needs• Identification of the drivers of high cost• ‘what if?’ analyses – comparison of relative

value of different services – estimation of potential cost/benefit

Proof of concept pilot across small group of LAs Initial scoping work by Loughborough – 1 month Loughborough academics map social care process

information – 3-6 months LAs agree additional data collection to support

Cost Calculator Development of Cost Calculator specifically

tailored for Scotland and for the in participating councils

Develop knowledge and support amongst stakeholders