Benefits of Value-based approach highlighted in new public health report
Public sector organisations should be adopting an “equitable, sustainable and transparent” use of resources to achieve better outcomes for the people they serve.
That’s the message from Cardiff and Vale University Health Board’s Executive Director of Public Health, Fiona Kinghorn, who has focused her latest annual report on the benefits of a ‘Value-based’ approach.
Based on current and future economic circumstances, she stressed it is vital that all public services and bodies can demonstrate best use of public money to meet the needs of their communities, and measure the difference they make over time.
She said the concept of a Value-based approach is one that can help in this regard. In short, a Value-based approach helps to ensure that everything public organisations are investing – both time and money – will have positive outcomes for the people they serve.
“Value considers what matters most to people,” said Fiona. “When it comes to value, the ‘experts’ are not just the professionals who are designing and delivering the services, but local people who experience services.
“Taking a Value-based approach means a shift from the service providers deciding what is most important, to finding out what is important to people.”
She explained that by putting value at the heart of decision-making, organisations need to rethink how services are delivered with the aim of adding value at every step.
“This can be thought of on a small scale, for example a team within the public sector agreeing how the budget is spent to add maximum value, and at the other end of the spectrum in strategic partnerships (such as the Regional Partnership Board or the Public Service Boards) agreeing across organisations collectively where money is best spent to get the most value for local people.”
The concept of a Value-based approach is broken down into five sections in the report:
Equitable: Everyone who needs it has the same opportunity to access services and achieve the best outcomes for them;
Sustainable: Services should be long-lasting, cost and resource effective, with environmental impact in mind;
Transparent: It should be clear why services were chosen and why some aren’t available. Not every preference can be met all the time;
Outcome focused: Services find out what outcomes are important to local people, and work towards these with them as partners;
Quality: Services are safe and work how they should, making the journey through services a positive experience.
Fiona said public services can achieve a Value-based approach by putting more of a focus on prevention, involving people in decisions and getting feedback on their experiences and outcomes.
She added: “A Value-based approach is about measuring outcomes that matter to people in a way that is consistent and comparable – so that we can identify which services deliver the most value.
“We then also need to look at how much each service costs in financial and resource (e.g. staffing) terms, and the quality of the experience for the user. The benefit of a Value-based approach is that it considers the outcomes that people get from their interaction with a service; the quality of the service and the cost of the service in the round, rather than just measuring one factor independently.”
The report also highlights the four main types of value – known as the “four pillars”:
1. Personal value: What outcomes are important to the person from the services they receive, and how the actual outcomes relate to the outcomes the person was hoping for;
2. Societal value: What is important to our local population. Also known as ‘population value,’ it considers the value services contribute to society (e.g. helping more people stay in employment to support the economy);
3. Allocative value: Where can the resources we have be best allocated. For example, the work to encourage all households to fit smoke alarms has reduced deaths and injuries from fire in the UK over the last 30 years
4. Technical value: Do the interventions actually deliver? Technical value considers how well are the resources we have chosen meeting our desired outcomes and goals
Fiona said these tools should be adopted as standard practice throughout the public sector to drive change that recognises three elements concurrently: quality, cost and outcomes that matter to people.
“We need to re-think how public services are delivered, adding value at every step,” she concluded.
To read the report in full please go to Key Publications - Cardiff and Vale University Health Board (nhs.wales).
You can watch a helpful animation on the Vale-based approach at Delivering Better Outcomes for People Through a Value-based Approach - English - YouTube