Working across government agencies
Working relationships with other programmes and activities both in the health sector and in related sectors such as social welfare, housing, labour and education, will help achieve high level outcomes. For example, the National Health Committee's document on the Social Cultural and Economic Determinants of Health points to the impact that non-health sector activities have on health outcomes. The Ministry of Health's Improving Quality programme contributes directly to increasing trust and security in the health system. Leading for Outcomes, in taking a whole system view, is able to 'knit' these valuable but often disconnected pieces of work into the larger fabric that will produce the outcomes we seek.
Government agencies must take a Managing for Outcomes approach 1. better evidence to strengthen decision-making You can download the SSC's Managing for Outcomes framework at the bottom of this page.
Leading for Outcomes has its origins in the State Service Commission's (SSC) Managing for Outcomes framework, a project to achieve a more responsive Public Service through:
2. better communication and improved interactions with stakeholders
3. greater transparency and clearer accountability to Parliament and the public.
The SSC requires that all government departments adopt “a more strategic and outcomes-focused approach to management and reporting.” Departments must expand their focus beyond planning to “the full cycle of management, encompassing direction-setting, planning, implementation, delivery and review.”
They must be able to more clearly demonstrate how these activities contribute to achieving Government's desired outcomes. By clarifying and understanding the links between activities and outcomes, a rational basis is laid for future interventions or changes to existing activities. The results of these can be evaluated and a continuous and transparent cycle of improvement entered into.
This shift of focus from planning to the full management cycle calls for better gathering and use of evidence to improve the design and delivery of major interventions. To achieve this, departments will need to develop a strong sense of the context in which they work, what they do in that context and how what they do relates to Government aspirations. We will need to “understand and explain how and through what interventions (we) aim to achieve these outcomes, and why this course is the best one to adopt.” The result of these activities will be sound advice to the Minister on the most appropriate course of action - which interventions to fund and which outcomes to pursue.
There should be a coherent and logical flow from outputs to societal outcomes.
Ideally, any piece of our work programme - or the activities of those working in the publicly funded health sector - should have a role in contributing to one or more of the Government's desired outcomes (Better Health; Reduced Inequalities; Trust and Security; Better Participation and Independence - link to the Ministry of Health's Statement of Intent for more detail).
An activity's role in the Outcomes Framework should be logical, supported with
the best evidence possible, and able to be communicated clearly to the various stakeholders.
A framework that moves from the specific programme or intervention to the broader outcome has been developed as an outcomes hierarchy. This should allow for close scrutiny at each level of program, system configuration, indicators of systemic behaviour, our theoretical 'take' on what we are doing and why and, finally, the desired outcome. The rationale for our actions can then be subjected to a more rigorous approach of research and debate.
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