Phase 4 - Deliver

4.4 Work with your board to address problems

However much scenario planning you’ve done, delivering a SIB is difficult and issues will come up during the lifetime of the contracts.

If there are clear governance and decision-making processes in place, it is much easier to deal with the inevitable unforeseen challenges as they happen and support timely improvement in service delivery?

Having mechanisms in place up-front will help you feel confident to raise urgent and critical issues with the board – a monthly forum, if appropriate. Try to see your board as allies: share information about problems or setbacks and ask for help when it’s needed. The board should support you in modifying outcomes if required and may be able to bring in additional resources.

Masterclass: Addressing an issue with your board

Tips contributed by a SIB provider

  1. Acknowledge the problem

e.g. We have recruited fewer participants than forecast

  1. Collate supporting data to build a full picture of the consequences

e.g. Actual vs forecast recruitment numbers, participation in activities

  1. Analyse reasons for difference

e.g. Project kick-off delayed by staff absence during the summer holiday period

  1. Gather recommendations from the team and summarise for the board
  • What do we need to do more/less of?

  • What additional resources are required?

  • What is the forecast impact on timing and outcomes?

  1. Make decisions with input from board
  • Replace project manager within two months

  • Reduce expected outcomes by 5%


Here are some common SIB delivery issues we have come across, and how boards have helped to avoid or address them.

Table title
Problems with delivery organisation staffing:


Solution (to avoid or address problem)

Delays to recruit well-qualified staff

  • Recruited the entire frontline team in advance of contract signature (at investor’s own risk) so that they would be ready to deliver at full speed from day one

  • Adjusted the pay scale and terms of contract to be better able to attract well-qualified staff

Variable management of staff performance, resulting in sub-optimal delivery

  • Implemented a bonus scheme to reward high performing teams for excellent performance

  • Implemented an active performance management scheme to train or replace staff who were not delivering the highest quality services

  • Paid for and recruited a ‘programme manager’ after the first year to oversee the service and drive improved management.  This role was not in the original specification or budget

  • Recruited a ‘trainee’ frontline staff member, ready to step into a role as soon as it became vacant, to mitigate against the effects of staff turnover

  • Fast-tracked team members to training courses, paying transport costs, to ensure that staff were trained rapidly and could commence delivering services immediately

  • Offered to carry on delivering the service after the contract cap had been hit, to drive more outcomes and better value for money

Failure to keep the team fully functioning right up to the end of the programme

  • Implemented a retention scheme to reward high performing frontline staff who continued delivering right up until the contract end date

Table title
Problems with recruiting participants:


Solution (to avoid or address problem)

Failure to market the programme to those responsible for referrals (e.g. social workers)

  • Ran a marketing campaign to pitch the programme to social workers, e.g. workshops, visits, videos and case studies to explain the benefits for families, along with clear referral pathways and instructions for eligibility

  • Offered incentives in return for participation levels e.g. guaranteeing rent arrears for certain clients – to clear logistical and perceived barriers to engagement

Inadequate IT system for referral of participants

  • Built, paid for and implemented a new IT system for all GP practices, which flags up suitable patients and encourages GPs to refer them to the service

Insufficient resources within the referring authority to manage the essential tasks required

  • Paid for ‘care experienced mentors’ to help young people make the transition out of residential care.   These mentors were not in the original budget

  • Paid for a formal medical and psychological assessment of all children referred to the service for adoption, from the country’s leading child mental health assessment team

  • Paid for and seconded an additional social worker into the referring authority, to ensure that all referral tasks are completed effectively

  • Paid for a full academic evaluation to identify the benefits and recommend improvements mid-programme

Table title
Problems with claiming outcomes:


Solution (to avoid or address problem)

Poorly-defined contractual outcomes lead to lack of clarity in claims

  • Brought delivery staff to contract review meetings to avoid a back-and-forth situation and bring a dose of reality to contract discussions

  • Set up a working group including commissioner and provider, during which particularly thorny hypothetical ‘test cases’ were probed and tested to their limits

  • Signed contract amendments to redefine or add parameters to outcomes when all variations and permutations have been explored

Administrative or teething problems with claims process

  • Took each site administrator out for lunch or coffee to ask about particularities of their site and gain buy-in for a monthly process. Used this information to map the different systems and processes used across all sites

  • Developed a two-step claim validation process where a manager dip tests a handful of claims each month, tracing the paperwork back to ensure validity

  • Reverted to Excel when our system confused or lengthened the process. Data can always be bulk-uploaded at a later date

Masterclass: Tips for performance management and governance

Contributed by Dr Dr Tony Munton, managing director, TheRTK

TheRTK works with organisations to help them get the greatest value from their performance data, so that it becomes a key strategic asset. The key issues that organisations usually need help with are around performance management and governance.

Tips for performance management:

  • Keep it simple! A key reason for failure of a performance management system is having too many KPIs. Keep things basic. Pick three top KPIs – your top three “obsessions”.

  • Every month, provide a summary dashboard (see tool below) showing for all three KPIs:

    • What is the “story behind the curve”? (i.e. why does the graph look like that?)

    • Who are your partners, to get the numbers to change?

    • What do you know about what works to change the numbers? Where are the gaps in your knowledge?

    • What are you going to do about it (by next month)?

  • TheRTK’s approach is based on the outcomes-based accountability framework (also known as results-based accountability), developed by Mark Friedman in the US. There are plenty of resources and worksheets for using this approach here

Tips for good governance:

  • Bear in mind that people are naturally reluctant to collect performance data, because it can show poor performance

  • It’s important to create a culture that is tolerant of failure, and one where you know if performance is failing, so that you can do something about it

  • Adopt the mantra: “if you're not measuring it every month, it's not a KPI.” Investors will demand that KPIs are being tracked, before they invest



Sample Agenda for Board Meeing
Contributed by ThinkForward

Download Tool

A sample agenda for an SPV board meeting including regular agenda items, operational updates and compliance logs.

Next: Phase 4 checklist