Thursday, 2 February 2012

Did the intervention have the desired impact?

Tucked away in this week's Sunday Times were some notes from an interview with Health Secretary, Andrew Lansley.  In the interview he is reported to have said, "An interesting case in point is knee surgery.  The data has now come back demonstrating half of knee surgery doesn't substantially change the outcome for patients: their mobility isn't improved that much, nor their pain."  In other words someone asked the common sense question: 'did the intervention make, as a minimum, the desired impact; was it value for money?' This should also be at the centre of any outcomes based commissioning and procurement.

I'm sure you have been asking
past customers of potential service providers this sort of question as part of your supplier appraisal process. If previous clients could look back and recognise a positive impact, that's helpful in providing reassurance for the future.  It should also be part of looking forward, 'will the proposed approach, at a minimum, have the desired impact?'  I say 'at a minimum' as there will, hopefully, be additional benefits.

I hear you saying 'of course we do that'.  You will therefore be surprised that I recently uncovered evidence of one organisation believing it was not permissible to take into consideration bidders past experience.  Let me be clear, this was not just one individual in the organisation, it was the belief of all the buyers I spoke to! I probed deeper and discovered this dated back to a misinterpretation of an email. The misinterpreted email had made a difference, but unfortunately it the impact was undesirable.  As I challenged this misinterpretation, I then had to overcome the disbelief that I was correct.  They say real life is stranger than fiction; they're right.

Anyway, I tip my hat to Lansley questioning impact. I'm sure he will also test his proposed commissioning approaches in the same way; perhaps through robust piloting?

Could we now apply that same sort of evidence based approach to procurement policy - does it make a difference? If it does, which interventions are the most effective and why?  That's the reason why I expressed disappointment at the NAO not probing further into the outcome of the police forces decision not to use centrally set up framework contracts.  Had they done that we could have had some evidence to help in the national/local buying debate - pity that opportunity was missed.

Background reading
Oakeshott, I. (2012) 'Battered Lansley certain of victory in NHS fight', The Sunday Times, 29 January, p.12.

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