Authors: Neil Stanworth
Organisation: ATQ Consultants
Policy Area: Health & wellbeing
The Commissioning Better Outcomes (CBO) Fund is a social impact bond (SIB) programme funded by The National Lottery Community Fund, which aims to support the development of more SIBs and other outcomes based commissioning models in England. The National Lottery Community Fund has commissioned Ecorys and ATQ Consultants to evaluate the programme. A key element of the CBO evaluation is nine in-depth reviews and this review, of the Zero HIV SIB, is one of these.
This report is the first in-depth review of the Zero HIV SIB. Its focus is on stakeholder experiences and learning from the design and development of the SIB up to the point at which it was launched, and the immediate challenges in the period after launch. The interviews with stakeholders whose views are reflected in this report were conducted between September and December 2019.
SIBs are a form of outcomes-based commissioning1 (OBC). There is no generally accepted definition of a SIB beyond the minimum requirements that it should involve payment for outcomes and any investment required should be raised from social investors. The Government Outcomes Lab (GO Lab) defines impact bonds, including SIBs, as follows:
“Impact bonds are outcome-based contracts that incorporate the use of private funding from investors to cover the upfront capital required for a provider to set up and deliver a service. The service is set out to achieve measurable outcomes established by the commissioning authority (or outcome payer) and the investor is repaid only if these outcomes are achieved. Impact bonds encompass both social impact bonds and development impact bonds.”2
SIBs differ greatly in their structure and there is variation in the extent to which their components are included in the contract. This difference underlies the stakeholder dynamics and the extent to which performance is monitored in the SIB. For the purpose of this report, when we talk about the ‘SIB’ and the ‘SIB effect’, we are considering how different elements have been included, namely, the payment on outcomes contract, capital from social investors, and approach to performance management.