Considering two outcomes paradigms : the improving (person-centred) and the proving (managerialist) agendas

Miller, Emma; Hessle, Sven, ed. (2014) Considering two outcomes paradigms : the improving (person-centred) and the proving (managerialist) agendas. In: Human Rights and Social Equality. Ashgate Publishing, pp. 34-39. ISBN 978-1-4724-1235-5

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There is increasing emphasis on personal outcomes in social work and social care services in the UK and internationally. Outcomes based working can offer real potential to revisit social work values and to ensure that disabled people are more effectively included in decision-making about their lives. There is evidence that outcomes based working supports a shift in focus from matching individual deficits to a limited range of service options, to building on the strengths and capacities of each individual and to more creative ways of achieving outcomes. There is also potential to use aggregated information about individual outcomes to influence service planning and design at the locality level. Whilst the considerable improvement potential of the approach is emerging, it is apparent that there are different understandings and interpretations of outcomes at play in both policy and practice terms. Based on more than five years experience of developing and implementing an outcomes approach to Scotland, this paper locates the new focus on outcomes in its recent policy context and considers key barriers to implementation. It explores understandings of outcomes from the perspectives of service stakeholders ranging from service users and carers to policy-makers, and emphasises the need for a common perspective. This work has shown that there are two core outcomes paradigms are currently at play: the improving agenda as described above, and the ‘proving’ agenda. While the improving agenda involves putting the person at the centre with a change management agenda which focuses on culture, relationship building and flexible approaches to communication, the proving agenda is more consistent with managerialism. It centres on evaluating and evidencing improvement to external stakeholders, leaning towards measurement and standardisation, and has a focus on tools and processes. It is essential to strike the right balance between these approaches. While there is potential for a focus on outcomes to result in improved inclusion of people with disabilities in decision-making, this requires that the improvement agenda should remain paramount.