When you are establishing the outcomes for your programme, you may draw on a number of sources:
- Needs assessment. What does research show about the needs of your target client group? For example, if one of the main needs is a higher rate of vaccination among the children in your client group, that will help you in designing the outcomes of you programme. Third sector organisations (TSOs) can be extremely helpful in helping you understand these needs [see practical examples on ‘Engaging with TSOs’]. The first of the Government’s principles of good commissioning is to engage with the third sector to ensure a good understanding of the needs of users and other communities. You should draw on their advocacy role (speaking for the groups they represent) and on their specialist knowledge (of the barriers faced by, difficulties for, and capabilities of, the groups they represent);
- National political drive. If the government introduces a new policy and delegates the delivery of it to you, you will probably find that the policy comes with national outcomes attached. You may need to break these down into outcomes to be achieved at a local level, in terms of their scale and/or relevance;
- Legislation. Similar to the national political drive but, because this is legislation, it is set by Parliament, not government;
- Local political drive. In the same way as national politicians, local councillors (and their equivalents in NHS Boards) may set outcomes for a programme;
- The need to make savings. At this point, it is important to recognise the impact that a drive to create economy and efficiency might have on effectiveness. In particular, it could lead to fewer outcomes or outcomes that have less impact. We provide further guidance under Value for money;
- Proposals from TSOs. You should have ongoing dialogue with the TSOs in your area, before, during and after any particular commissioning process. They will be well-placed to advise on outcomes, particular those TSOs that have a significant advocacy role. This can be the case particularly in relation to hard-to-reach people and issues;
- When deciding on outcomes, you should focus on ‘sustainable commissioning’. This means taking full account of economic, social and environmental impacts earlier in the cycle. The London Borough of Camden Sustainable Commissioning Model is an example of this.