Evaluation of the payment by results drugs recovery pilot programme

In the early 2010s, the Department of Health and Social Care, the National Treatment Agency, and a number of other Government Departments developed pilots that rewarded and incentivised providers that supported individuals to recover from their drug and alcohol dependence.

The aim of the pilots was to focus on a holistic approach to long-term recovery for the individuals and their families and communities. The main outcomes sought were freedom from drugs of dependence, reduced offending, and improved health and wellbeing.

PIRU was asked to provide advice on how the pilots could be evaluated and the outcomes measured.

The PIRU team analysed the documentation on the Payment by Result (PbR) Drugs Recovery pilots, attended two co-design meetings in late May and July 2011, and monitored the web forum set up by DH to communicate with the pilot sites, PIRU was unable to contribute to shaping the outcome measures to be used in any future evaluation since these were selected by Ministers and their officials and the detailed work on the outcome measures was well-advanced by the time PIRU became involved. PIU provided its advice based on team members’ experience from working on other evaluations involving PbR and payment for performance.

Some of the key issues the evaluation team would need to consider were difficulties comparing pilot sites with one another or with control areas because of the lack of randomisation and the different ways local pilot sites implemented the PbR scheme (in terms of outcomes monitored, level of payments for outcomes achieved, etc). The commissioning of advice on the best methods of evaluation had come too late in the process to exert any influence on the design of the PbR pilots.