Outcomes-based contracts in the UK public sector
A major innovation in public sector commissioning in recent years is the recourse of the state to so called ‘Outcomes-based Contracts’ particularly Payment by Results (PbR) in the UK. A PbR contract contains three elements, a commissioner, a service provider and an outcomes metric. The outcomes metrics is designed, in theory, to align the incentive structures of the commissioner and the service delivery agency so as to achieve efficient results. Thus, PbR is theorised to allow public commissioners to pay a provider of services on the basis of specified outcomes achieved rather than the inputs or outputs delivered. A related innovation is that of Social Impact Bonds (SIBs). SIBs are distinguished from PbR contracts in that they supposedly allow financiers to contribute to the social innovation process by providing working capital. The return on the SIB is calculated using PbR methodology. Compared to a PbR contract, the SIB contract seeks to align the incentive structures, not only of commissioners and providers, but also financiers through an appropriate metrics-based payments scheme. PbR and SIBs have been referred to as key tools for delivering change. In this chapter we set out the theoretical and practical challenges arising from the development and application of PbR and SIBs and consider the evidence of their efficacy or otherwise.