Developing Social Impact Bonds: Our experience in the South West July 2016 Jon Siddall Director of Innovation
Developing Social Impact Bonds: Introduction Why are we interested in SIBs? What are we doing about it? Case study- what we ve learnt
Academic Health Science Networks (AHSNs): Brief background Spreading innovation, improving health, generating economic growth Established by NHS England in 2013 Connect NHS and academic organisations, local authorities, the third sector and industry Create the right conditions to facilitate change
Academic Health Science Networks (AHSNs): Brief background
SW AHSN: Brief background Informing the planning, commissioning and measurement of service development Accelerating the adoption of innovation into the health and care system Enhancing quality of health and care service delivery
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Why are we interested in SIBs: The need for innovation The definition of insanity is doing the same thing over and over again and expecting different results "
Why are we interested in SIBs: The need for risk capital SIBs Risk capital Improve outcomes Reduce demand Improve individual outcomes & reduce demand Prevention & early intervention Acute intervention
Why are we interested in SIBs: The right source of risk capital The importance of the social in Social Impact Bonds: Investor values aligned to those of the health and care sector Modest expectations of financial returns Appetite for risk The patience to invest over multiple years
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What are we doing about it? Identify and develop SIB opportunities Opportunities focused on system priorities (STPs and 5YFV) Opportunities with measureable outcomes: Access to reliable data Time horizons attractive to investors Facilitate relationships with funders and investors
What are we doing about it? Three SIB projects in development Scale-up 1. Type 2 diabetes 2. Socially isolated older people Black-box 3. Alcohol dependency
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Case study: Background The issue we set out to address Who s involved SIB development process
Case study: The issue we set out to address Alcohol misuse third leading risk factor for death and disability after smoking and obesity in England. Increasing demand on acute care system from alcohol dependent populations- multiple attendances, multiple admissions and increasing length of stay. Alcohol also plays a significant role in broader social outcomes- breakdown of families/ relationships, employment, debt.
Case study: Who s involved Complex, system-level issue involving primary care, community care, acute care, public health, social care SIB project provides a platform for taking a collaborative approach to tackling a complex issue. Key partners: NHS Clinical Commissioning Group Local Authority Public Health Commissioners (x2) NHS Provider Trust (x2) Community sector providers/ infrastructure orgs Academic partners External consultants The Big Lottery Fund- Commissioning Better Outcomes
Case study: SIB development process Analysis Outcome Metrics 1. Target issue: System level- activity and cost Experience of individuals- journey analysis 2. Intervention model Rapid review of existing evidence 3. Outcome metric development: Financial modelling- system metrics Individual outcome metrics 4. Business case proposal (commissioners) Business Case Market Engagement 5. Provider/ investor engagement 6. Contract design and procurement Procurement
What we ve learnt The story so far SIB development is both a social and a scientific process: Evidence (quantitative research & qualitative research) People, relationships and building collective understanding Access to linked data can be critical- system level analysis Navigating the investment lexicon Source of capital important