Throwing the baby out with the bathwater…
When embarking on any new and untried policy, strategy or system one must be mindful to strike the right balance between maintaining the things that are successful already whilst changing the things that are not.
In the Lincolnshire Drug and Alcohol PbR pilot it would be fair to say that we have made several radical changes to how services are delivered within the county. From April 2012 people with drug or alcohol problems in Lincolnshire have been able to choose which one of two providers will help them get the support they feel they need.
For many years people were able to access only one main ‘pathway’ into substance misuse services. Our two main providers of substance misuse services worked together in a traditional tiered system albeit achieving notable success. Their dedication and hard word for example placed the partnership into the top quartile nationally on targets such as successful exits and Hep B vaccinations received.
Yet despite these achievements, in Lincolnshire, as with the other 7 PbR pilot sites we are now focussing on the measurable outcomes that individual people with drug or alcohol problems can achieve and rewarding providers accordingly.
In addition to the PbR outcomes, we felt the need to ensure the success we had already achieved as a partnership was not lost. We are therefore also rewarding our providers in the first year based on the achievement of existing system wide performance targets. These so called ‘quality’ measures such as wait times, Hepatitis B vaccination rates and engagement targets will also hopefully ensure that the opportunities for gaming are reduced.
As we introduce a new system that has service user choice, provider competition and recovery at its core we have also made steps to ensure that in Lincolnshire we don’t ‘throw the baby out with the bathwater’.