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Payment for Success – How to shift power from Whitehall to public service customers

Alan Downey, Paul Kirby, and Neil Sherlock, KPMG
 
Conclusion
 
This paper has tried to outline the need for a consistent and radically applied approach to payment for success across the UK public sector. It has suggested an integrated solution – allocating funding to 3 distinct customers, implementing a progressively more challenging regime of PBR and giving providers almost total freedom to deliver what the customers are requiring. It has be done in a holistic and systematic way – to cherry pick bits and pieces of the agenda will leave us the same current public sector reform frustrations listed in this paper. It will not be easy to implement Payment for Success and the radical change required will present many risks and create a lot of turbulence. 
 
But given the need to make major financial savings and empower public service providers to find and deliver the solutions, it seems urgent to get on with it. The alternative is too ugly and unnecessary to consider – the default path of old-fashioned crude cutting. This will be the politically hard, managerially easy route whi ch we have seen before in public services. It is the default route in times of spending restraint. There is a managerially hard, politically easier route, which is set out in this Payment for Success strategy. This needs strong political leadership to put it in place, but it will shift decision-making about solving the fiscal problem from Whitehall to the millions of people who produce and consume public services. They then can find the best way to protect what matters most in those services, not just in the short-term but sustainably over the next decade and beyond.
 

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