Valuing PSS outputs and quality changes

Abstract

The Gershon review of efficiency recommended that target improvements in efficiency should be met both through financial savings and through improvements in quality of outputs. This paper reports on a pilot project designed to feed into an approach for local authorities to quantify in monetary terms quality gains in the provision of personal social services (PSS), with a specific application to the provision of home care for older people. There are a number of practical and theoretical problems with attributing monetary values to aspects of quality. The approach described here builds on ongoing work into the measurement of PSS outputs for the purposes of National Accounts and measuring changes in productivity and efficiency more widely. This approach distinguishes what services could provide (capacity for benefit) from the quality of what is provided in practice. By attaching a financial valuation to capacity for benefit we are able to attribute a monetary valuation to changes in the quality of provision measured (in the case of home care) through service user experiences of their care. Capacity for benefit (CfB) is defined in terms of eight domains of outcome that services address and four levels of need (no needs, all needs met, low needs, high needs) within these domains. In addition we identify whether people are living in their own homes, as a key attribute of care provision. The characteristics of the service (in terms of domains of outcome and whether living at home) and service users (in terms of level of need that need to be met) determine the CfB of a given service