A critical insight into practitioners’ lived experience of payment by results in the alcohol and drug treatment sector

an article by Helena Gosling (Liverpool John Moores University, England) published in Critical Social Policy Volume 38 Issue 2 (May 2018)

Abstract

Since former Chancellor George Osborne described reducing public spending as ‘the great national challenge of our generation’ (Her Majesty’s Treasury, 2010: 12) the UK Government have demonstrated a profound interest in Payment by Results (PbR) as a mechanism to improve service quality, value for money and innovation (Audit Commission, 2012).

Although PbR is not a new initiative, it has been rebranded and sold as a vehicle that can steer ongoing strategies for reform, particularly in the field of criminal justice and drug/alcohol treatment (Her Majesty’s Government, 2010; Ministry of Justice 2013).

Despite such assertions, the initiative has become synonymous with budget cuts (Community Links, 2015), the privatisation of public services (Policy Exchange, 2013) and controversy.

Drawing upon the findings of a focus group with staff who work in a Therapeutic Community, this article highlights the lived experience of practitioners as PbR takes hold of the alcohol and drug treatment sector. The findings suggest that outcome-orientated incentives, such as PbR, hold the potential to transform welfare-orientated sectors into a financial, market-focused milieu.

Full text (PDF 18pp)

It is certainly worth reading the whole of Helena Gosling’s paper. She did not manage to change my initial reaction to the abstract. Payment by Results will work only so long as you have clients who are willing to work with you and are likely to provide you with a good result within the statistical period which is normally only a year.

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