Individual Outcomes: Getting Back to What Matters

There is an increasing emphasis on outcomes in public services in the UK. Whilst the considerable improvement potential of the approach is emerging, it is also apparent that there are different understandings and interpretations of outcomes at play in both policy and practice terms. There is also a significant challenge at all levels in the system in making the shift from focusing on ‘outputs’ to ‘outcomes’. Emma Miller locates the new focus on outcomes in community care in its recent policy context and considers key barriers to implementation. She explores understandings of outcomes from the perspectives of service stakeholders ranging from service users and carers to policy-makers, and emphasises the need for a common perspective. Two core outcomes paradigms are currently at play: the improving and the proving agendas. The improving agenda involves putting the person at the centre with a change management agenda which focuses on culture, practice and flexible approaches to communication. The proving agenda, more consistent with managerialism, centres on evaluating and evidencing improvement, leaning towards measurement and standardisation, and has a focus on tools. It is essential to strike the right balance between these approaches. She concludes positively on the progress and potential of outcomes, whilst sounding a cautionary note about the need for the improvement agenda to remain paramount.