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Payment by Outcome: A Commissioner's Toolkit

Sturgess, Gary L and Cumming, Lauren M. with Dicker, James; Sotiropoulos, Alexis and Sultan, Nadiya; 2011
2020 Public Services Trust
Payment-by-outcome is a form of performance management where the providers of public services are remunerated according to the outcomes they achieve rather than their effort. This report continues the work begun in Better Outcomes (below) and explores the tools that a payment-by-outcome approach brings to  public performance management. It draws on insights from the relevant academic and public policy literature as well the lessons from selected case studies. 

The main case studies are examined in greater depth through four additional working papers which cover sectors where payment-by-outcome has already been implemented, notably welfare to work but also, in a parallel context, pharmaceutical pricing, as well as areas where it may prove promising, such as long-term condition and offender management.


The Profit Motive 
January 2011
A history of suspicion towards the profit motive in public services can be traced from the New Testament via Shakespeare, Kipling and Johnson. But there are also plenty of examples of public service companies that have overcome this wariness to win public and government trust.


Put to the Test
Gary L Sturgess
Ethos - September 2010
A review of the evidence on the financial benefits of market testing public services and and examination of  issues around sustainable market design.


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July 2011

For our latest briefing on the best in public services research on competition and contracting around the world, click here.

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Last Updated: 06 October 2011