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Were we wrong to talk about outcomes?

Steven Marwick talking about outcomes …

ESS loves outcomes and we are not giving them up without a fight.  But there are some problems with the way we use the word.  And that matters because it’s getting in the way of public service improvement.

We’ve got the verb wrong

The postie delivers the mail.  The midwife delivers the baby.  No one delivers an outcome.

In fact we deliver activities that enable the people we work with to achieve outcomes.  So at most the verb should be “achieve”.

But in relation to strategic outcomes, the most appropriate word is contribute since no single activity or organisation can achieve those outcomes on their own.

Am I just being pedantic?  Why does the verb matter?

Well because …

Outcomes are not targets

Did I mention ESS loves outcomes?  We love them because they focus attention on the difference we want to make rather than just activities or money.  Outcomes help us critically question whether we are doing the right thing to bring about the change people want.  Outcomes provide a route map for measurement and learning.

But they are not targets.  We should hold them lightly. We should change them if we discover, as we work, that they are not right.  We should measure “what works, who for and why – or why not?” not simply how many reduced loneliness we have “delivered”.

And another thing …

You can’t commission an outcome

If you can’t deliver an outcome you certainly can’t commission one.  “I’d like a new laptop and some increased wellbeing please”  Nonsense! Outcome-focused commissioning is crucial, don’t get me wrong.  But it’s the service you commission not the outcomes.  That means commissioning a service that has the best possible chance of achieving positive outcomes for a particular client group. 

Less performance more learning

Another reason why words matter is because they drive culture.  And we seem to have a public service culture where performance and accountability trumps learning almost every time.  This means we know if services have been delivered but not whether these are the right services, delivered in the right way to the right people to achieve the outcomes people want.  The performance culture means we know a great deal about what’s going wrong and far too little about how to put it right.    

Public sector activity is driven by performance measures (and by budgets).  That’s a problem because we do what we are measured on.  So measures, rather than a focus on making the system work for people, is driving what we do.

What would happen if we had no national statistics?  No local authority league tables?  No HEAT targets.  Would we be any worse off?  I wonder.

Imagine instead if public services were only driven by local need and desired outcomes.  And then we only measured whether and how we achieved those outcomes and for who, and what we have learned, then I suggest we’d be much further forward with Christie.

Most importantly where are the people?

Outcomes matter to people.  We all want to be happier, healthier, smarter, sexier (or is that just me?).  Anyway, when we write our outcomes we should include the “who” in the outcome.  For example “care experienced young people have more positive life chances”.  That way we know who we intend to make a difference with and for, and who we should ask for feedback from when measuring the outcome.

Indeed the people the outcomes are for should really be involved in writing them in the first place.  And people should be at the heart of measuring the outcomes approach.  They – not (just) the stats – tell us whether activities are making a difference and why.  That in turn means that the outcomes approach requires a rich tapestry of evidence – research, practitioner experience, lived-experience evidence; a mix of stats and stories. 

So don’t ditch outcomes.  Let’s use them properly. And the third sector can help.  We don’t have all the answers and we need to learn as well.  But the more the third sector’s experience is used to feed in, contribute, even lead public service reform the better chance we have of truly achieving outcomes.  And then we’ll all love them.

What do you think?  Would you like to get involved in this debate?  Please