Performance Measurement in Social Care: A Comparison of Efficiency Measurement Methods

Clarkson, Paul

doi:10.1017/s1474746406003174

Cited by 8 publications

(4 citation statements)

References 41 publications

(38 reference statements)

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“…Finally, there was also many examples of how soft forms of sanctioning took place through social accountability measures like discussion in cases of conflict or indications of poor performance. The frequent use of social accountability measures, particularly in information-gathering, likely reflects the high information costs associated with monitoring a complex service like nursing home care (Hefetz, Warner, and Vigoda-Gadot 2014;Hefetz and Warner 2007;Clarkson and Challis 2006;Hart, Shleifer, and Vishny 1997). In this sense, the findings support previous research indicating that collaborative practices might be more efficient for achieving accountability than hierarchical or market-based, particularly in services where outcomes are hard to measure like social services (Amirkhanyan, Kim, and Lambright 2012;Amirkhanyan 2009).…”

Section: Discussionsupporting

confidence: 78%

Contracting out welfare services: how are private contractors held accountable?

Blomqvist

Winblad

2020

Public Management Review

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A challenge for governments contracting out public services is holding accountable contractors who fail to meet agreed-upon standards. In social services, contract monitoring is complicated by the fact that contracts tend to be incomplete and performance hard to assess. In this study, we examine how local governments in Sweden hold private contractors accountable in nursing home care. The main finding is that a mixture of accountability mechanisms was used, but that social accountability was seen as most effective. Marketaccountability measures like contract termination and financial sanctions could not be applied as local governments lacked the capacity to enforce them

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Section: Discussionsupporting

confidence: 78%

Contracting out welfare services: how are private contractors held accountable?

Blomqvist

Winblad

2020

Public Management Review

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“…Secondly, the challenges involved in measuring service level outcomes are many and have been noted elsewhere. 59,60 Thirdly, the measurement and responsiveness of some outcomes may have been affected by the fact they were national performance measures. 58,59,61 Fourthly, it is not possible to measure every aspect of agency arrangements for the management and delivery of services.…”

Section: Discussionmentioning

confidence: 99%

Exploring patterns of care coordination within services for older people

Chester

Hughes

Sutcliffe

et al. 2015

International Journal of Care Coordination

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Introduction: Supporting frail older people at home is an international policy objective. This article explored variations in care coordination arrangements and their relationship with service level outcomes using England as a case study. Method: Survey data and routinely generated data collected in 2006 from 119 local authorities responsible for social care were combined. Using cluster analysis, distinct groups were identified with regard to forms of care coordination. Results: Considerable variation was evident both within and between different types of care coordination, reflecting implementation guidance. Links with service level outcomes were weak, the most notable being the provision of intensive home care, a component of intensive care management. Discussion: Thus this study, using agency level data, confirmed the variability in care coordination arrangements and the relative absence of intensive care management, central to shifting the balance of care from residential and nursing provision to care at home.

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“…Those measures which simply indicate the achievement of central government policy priorities at the local level (for example the numbers receiving direct payments) have shown substantial improvement. Others, such as 'the cost of intensive social care', an efficiency measure (Clarkson and Challis, 2006); have shown little or no reported improvement over time. Similarly, performance on the key threshold indicators (measures on which councils must have performed well to obtain a good summary rating) has, on the whole, improved whilst that on some other measures has not, giving some credence to the view that where performance is not measured (or in this case, an aspect of it is not stressed to as great a degree) then it will not be given the same priority by local officers reporting the data (see Ridgway, 1956 for an early example of this issue).…”

Section: Discussionmentioning

confidence: 99%

Has social care performance in England improved? An analysis of performance ratings across social services organisations

et al. 2009

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Performance measurement in the English public sector has been implemented in a top-down manner. The mechanics of this regime (centralised targets, public reporting of performance data and the use of rewards and penalties) are driven by central government and are intended to hold agencies to account for their performance and regulate their behaviour. This paper examines whether the operation of such a regime has resulted in the improved performance of social care organisations. Comparable data from Northern Ireland Health and Social Services Trusts, where performance measurement processes are less centrally driven and rewards and penalties are less contingent on ratings, are used to investigate the potential impact of different performance regimes. Indicators of admissions to residential care and delayed discharges from hospital are used to signal progress in the meeting of social care objectives in the two countries.We find that in England social care organisations have broadly improved their performance over time in composite ('star') ratings and with generally higher ratings across individual indicators, with noteworthy improvement across key threshold indicators (measures which councils must perform well on to obtain a good summary rating). The comparative analysis highlights the differences across the two countries with an improvement in performance over time in England and a fairly static picture in Northern Ireland. These improvements may reflect a host of factors other than the incentives created by centralised targets and measures. Our data show, for example, that external characteristics of English councils predominantly influence their being reported as 'poor performers'.Evidence suggests that the rate of performance improvement reflects the incentives inherent in the English performance system. An incentive structure that promotes the 3 achievement of specific targets may have influenced the behaviour of local managers responsible for performance in this sector. However, further information from local organisations is required to more fully explicate all the relevant factors that may have a bearing on reported performance. The evidence reported here does, however, point to the beneficial effects (at least for the regulator) of centrally set measures. It is uncertain whether more recent moves away from this target regime in England, towards the development of local indicators and 'individual incentive' regulation, will likewise offer the appropriate inducements for performance improvement.

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Performance Measurement in Social Care: A Comparison of Efficiency Measurement Methods

Cited by 8 publications

References 41 publications

Contracting out welfare services: how are private contractors held accountable?

Contracting out welfare services: how are private contractors held accountable?

Exploring patterns of care coordination within services for older people

Has social care performance in England improved? An analysis of performance ratings across social services organisations

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