Title
Contents
Acknowledgements 7
The Authors 8
Abbreviations 9
Summary 10
1. Introduction 16
1.1 Background to the research 16
1.1.1 Recent developments in Welfare to Work support for people with health conditions 16
1.1.2 Key aspects of outcome-based contracting in PL Pathways 17
1.1.3 The need for research on outcome-based contracting in PL Pathways 18
1.2 Research aims and questions 19
1.3 Summary of research design 19
1.4 Report content 20
2. The prime provider organisations 22
2.1 Prime Provider, Area 1 22
2.1.1 Organisation background 22
2.1.2 PL Pathways organisation structures and staffing issues 23
2.1.3 Client services 23
2.2 Prime Provider 2, Area 2 24
2.2.1 Organisation background 24
2.2.2 PL Pathways organisation structures and staffing issues 24
2.2.3 Client services 25
2.3 Prime Provider 3, Area 3 25
2.3.1 Organisation background 25
2.3.2 PL Pathways organisation structures and staffing issues 25
2.3.3 Client services 26
2.4 Prime Provider 4, Area 4 26
2.4.1 Organisation background 26
2.4.2 PL Pathways organisation structures and staffing issues 27
2.4.3 Client services 27
2.5 The prime providers compared 27
3. The management of PL Pathways contracts 32
3.1 Performance monitoring of prime providers 32
3.1.1 The division of responsibilities 32
3.1.2 The use of outcome-based targets 33
3.1.3 Use of Management Information 34
3.1.4 Contract Reviews, Quality Assessment and Development Plans 36
3.1.5 Provider Engagement Meetings 37
3.1.6 Monitoring customer experience 37
3.2 Performance monitoring of the supply chain 39
3.2.1 Division of responsibilities 39
3.2.2 Monitoring arrangements 40
3.2.3 The use of client feedback 41
3.3 Key relationships in contract management 42
3.3.1 The relationship between providers and CMs 42
3.3.2 The relationship between CMs and TPPMs 43
3.3.3 The relationship between providers and Jobcentre Plus 44
3.3.4 The relationship between different providers 46
4. Influence of outcome-based contracting on provider operations 48
4.1 The business case for entering into an OBC 48
4.1.1 Financial viability 49
4.1.2 Length of contract 51
4.2 OBC and service delivery 51
4.2.1 Views of partner providers 53
4.3 OBC and service administration 53
4.4 OBC and service innovation 54
4.4.1 Efficiency measures 55
5. The influence of outcome-based contracting on front-line work with PL Pathways clients 58
5.1 Client barriers to work and views on clients who are easier and harder to work with 58
5.1.1 Barriers to work 58
5.1.2 Classification systems 59
5.2 Key skills and the adequacy of training for front-line staff 60
5.3 The use of targets and other approaches in the supervision and monitoring of front-line staff 61
5.3.1 Use of targets 61
5.3.2 Management support and case reviews 63
5.3.3 Observation 63
5.3.4 Peer support 64
5.4 Targets and front-line adviser working practices: the duration and intensity of adviser contact with clients 64
5.4.1 Caseloads and client contact 64
5.4.2 Creaming practices 65
5.4.3 Parking practices 67
6. Conclusions and policy implications 70
6.1 Main themes in stakeholder reflections on PL Pathways services and outcome-based contracting 70
6.1.1 What was working well? 70
6.1.2 What was not working well? 71
6.2 Discussion and policy implications 73
6.2.1 The division of labour across prime providers and the supply chain 73
6.2.2 The adequacy of resources 74
6.2.3 Improving administrative processes 74
6.2.4 Exploring other approaches to outcome-based contracting 75
Appendix. Topic guides 78
Qualitative study exploring the influence of outcome based contracting in Provider-led Pathways to Work 79
Key informant topic guide 79
Final Contract Manager Topic Guide 84
Final Third Party Provision Manager Topic Guide 93
Prime Provider Topic Guide 102
Provider Adviser Topic Guide 111
Subcontractor/partner Topic Guide 119
References 128
Table 2.1 Prime providers compared 30
Figure 1.1 Iterative research design 20