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General overview

Stage of development: Complete

Policy sector: Employment and training

Date outcomes contract signed: May 2020

Start date of service provision: Apr 2020

Anticipated completion date: Jul 2024

Capital raised (minimum): GBP 300k (USD 372.21k)

Max potential outcome payment: GBP 2.07m

Service users: 3k+ individuals

Intervention

Individual Placement Support aimed at getting people with mental health issues back or into competitively paid employment

Target population

People with enduring and severe mental health issues

Location

Country

  • United Kingdom

Service delivery locations

  • Tower Hamlets

Involved organisations

Configuration of contracting parties:

  • Managed: Outcome payer holds contract with Mental Health and Employment Partnership limited (led by intermediary)

Commissioners/outcome payers

Service Providers

Investors

Intermediary organisations

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Outcome metrics

  • Metric 1: Individual engages with IPS programme and completes vocational profile
  • Metric 2: Individual gains competitive employment and starts Job
  • Metric 3: Individual sustains Job at less than 16 hours a week < 16 hours per week
  • Metric 4: Individual sustains Job at more than 16 hours per week

Results

This project started delivering services in April 2020 and will finish in July 2024. Data was last updated in March 2024. These are interim results.

Outcome achievements

Overall target is based on the high case scenario defined in the Life Chances Fund Final Award Offer or Variation Agreements.

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The intermediary organisation's comment on this graph:

'The metrics selected are in line with the IPS Grow key performance indicator framework, which was developed in collaboration with high fidelity UK IPS services. The metrics chosen represent a balance between achieving the 'key' outcome: entry into work, with a proxy measure for the quality of the outcome: how long the job is sustained. Although we would ideally like to track longer-term sustainments, over the course of MHEP, we have learnt that evidencing sustainment outcomes can be a challenge for providers. Often individuals will lose touch with the service after they secure employment, and obtaining evidence that they are still in work many weeks or months after the last needed support touch point can be challenging and administratively burdensome.

As well as achieving the specified outcomes in each project, conversations with providers and commissioners have suggested that the SIB strucuture may have helped move provider/commissioner relationships beyond 'compliance' toward collaborative problem solving to achieve better outcomes for service users.'

Outcome payments

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The intermediary organisation's comment on this graph:

'In this project, MHEP receives outcomes payments for each outcome achieved. The Local Authority receives a block payment from MHEP to deliver the service as well as outcomes payments worth up to 5% of the contract value, which are passed on to the provider, beyond a contract minimum threshold. A few key adaptations over the life of contract allowed us to navigate COVID and other challenges: (1) we minimised the requirements for achieving outcome payments during the pandemic to support the service to adapt (and then moved back to original tariffs in 2021), and (2) we integrated additional targets based on the providers performance over the life of contract to provide appropriate 'stretch' where the contract targets had become less achievable.

Three main lessons for us delivering this project have been: 1. performance management based on strong, trusting relationships and accurate, accessible operational data can help diagnose and solve issues and drive up performance; 2. strong relationships between providers and commissioners can facilitate necessary adaptation over the life of the contract to e.g. respond to shifting economic context or accommodate new/changed referral pathways into the service. and 3. financial caps can disincentivise over-performance and make it harder to make up for underperformance early in the contract.'

Linked resource by project's intermediary organisation:

https://golab.bsg.ox.ac.uk/documents/MHEP_full_report.pdf

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