Our team’s experience includes leading the Los Angeles County Department of Mental Health; rehabilitation services for USA veterans; employment services contracts for a million people in the UK with social, physical, and mental health barriers to work, and; the mobilization of performance-based health contracts for 35 million people in Afghanistan. Prior experience also includes development and negotiation of the world’s first and second Development Impact Bonds in Adolescent Sexual Health and oversight of the performance of eleven Social and Development Impact Bonds across the world, including in homelessness, school exclusion, sexual & reproductive health and refugee integration.
Our Expertise
Expertise
Increasing performance and outcomes of mental health systems
Experts in performance management, outcomes measurement and program design & contracting, we enhance the capacity, impact and sustainability of mental health programs and the systems they operate within.
Our team brings together extensive experience in outcomes-based and mental health programming.
Our expertise lies in:
1. Program design, contracting and oversight
We partner with commissioners and funders, designing and / or refining services to be culturally relevant whilst delivering outcomes that matter for individuals within each system. We use innovative, performance-based contracting to tie implementation strategies directly to actions that achieve our impact goals.
Key elements of our approach, include:
- A robust discovery process to identify current programming, local context and user voice;
- A clear application of the Results Chain to identify key moments on the critical path to drive desired results and outcomes;
- Application of our proficiency in data collection, analytics & management, developing bespoke solutions;
- Robust budgeting and operating model development;
- Stakeholder collaboration and change management navigation, knowing that an outcomes-based lens can be a different way of working;
- Engagement with mental health experts, including HBGI’s Chief Medical Offer.
Our work on programs ranges from directly commissioning services with donor monies and managing these contracts, working in partnership with program funders and service providers, to providing oversight and advice on existing programs, or leading and supporting impact bonds.
In HBGI-commissioned programs, we will begin with a discovery phase. This allows us to understand the extent of the issue we are looking to address, existing care pathways and gain insights from users on the ground as to what matters to them and what an effective program might look like. This is key to determining what the intervention looks like.
At the design stage, use the theory of change to model to start with the end-goals (impact) in mind and then articulate the chain of results ‘Results Chain’ which will lead us there. From this Results Chain, we identify the inflection points – the key moments on the critical pathway on which our Impact Goals hinge – and build into the contract payment for delivery of those results and outcomes, ensuring they can be measured and validated. We take a pragmatic contracting approach, recognizing that overly complex outcomes-contracts often fail and ignore the end users of the service.
To set programs up for success we ensure programs are costed correctly, creating an operating model with the service provider and shadow budget. Where HBGI are involved at the program implementation stage, our Contract & Performance Directors will work with program funders and service providers to pilot programs and course-correct any challenges, ensuring the desired outcomes are delivered. We will co-create the correct data management approach and if necessary, work with our partners to implement new systems.
With significant expertise in advising, setting up or Chairing Impact Bonds, our team have a very clear knowledge of best practice in outcomes-based contracting, as well as some of the pitfalls. From ensuring all stakeholders are aligned to the same goals, to setting up complex governance and innovative financing, and managing the financial triggers and data audit, we are absolute specialists in anything and everything outcomes-contract related
Lastly, knowing that an outcomes-based lens can be a different mindset and way of working, we collaborate with our stakeholders to fully understand how any new intervention will work in practice and manage the teams through the change management process.
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2. Performance management
Performance Management is all about guiding service providers and managers to optimize delivery. Together we focus on what ‘success’ looks like for end-users and agree clear measures behind this (i.e. what do you mean by ‘performance?’), to help make decisions and drive action. Whether at program or system level, we develop performance management operating systems and then embed a regular cycle of tracking, reporting and reviewing that performance – with the objective of continuous improvement. It goes beyond data and ‘managing to the numbers’. It involves working closely with partners to align incentives, create a performance culture, and always keep the end users’ outcomes at the center of the conversation.
When we undertake performance management, we view it as a collaboration with our partners. Projects kick off with a discovery phase to understand the existing landscape, key stakeholders, available data, and the definition of success for both implementers and contract managers. Our work balances the technical data collection and diving into analytics against the human side of service delivery and other challenges that exist, such as the realities of budgets and billing. We fully recognize that new data cannot be obtained overnight, and view it as an iterative process.
Once clear on the goal, we work with partners to implement monthly performance cycles and create a ‘Performance Pack’. This brings together the data to unlock decision-making and the ‘so what’. We use our expertise on mental health and individual outcomes to build new data collection metrics, such feedback from individuals on the service they are experiencing and what kind of outcomes they want to achieve. This can be done relatively simply but has a huge impact on refocusing program delivery. Where partners have the appetite, we take performance management one step further and evolve the contracting mechanism to connect it more closely to performance.
Through providing a new lens on existing services and looking at the data different, Performance Management unlocks decision-making to help increase the reach, quantity, and quality of services.
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3. Capacity building
We are committed to empowering our stakeholders with the skills and knowledge necessary to drive sustainable, system-wide change. We dive deep into partner organizations, providing hands-on support and tailored training. By developing practical tools like performance packs and open-source resources, we equip providers to excel in an outcomes-based environment. Our active participation in performance management meetings fosters collaboration and ensures everyone is aligned towards shared goals. This comprehensive capacity building strategy is fundamental to realizing our mission.
Performance management and outcomes-based contracting require a shift in mindset. To facilitate this transition, we embed ourselves within our partners’ operations, working closely with teams from frontline staff to leadership. Through regular performance management meetings and working with all stakeholders to define a vision of success, we provide guidance, support, and accountability, ensuring everyone is working cohesively towards shared objectives. We also facilitate sustainable change through setting up the systems and frameworks in such a way that an outcomes-based approach can be continued in the future.
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4. Reflecting the voice of the user
We believe that listening to those with lived experience is vital. Their voices inform every aspect of our work, ensuring our solutions are grounded in real needs. In all our work, we bring in user voice through local partners, our Lived Experience Council, and by engaging the end users themselves to inform program design, implementation, and evaluation of success.
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If you would like to speak with us about any of our work, please contact us.
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