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Implementing a Value-Based Outcomes Framework in a Local Authority Reablement Service: A Mixed-Methods Study of Critical Success Factors

Gareth Cooke Orcid Logo, Hamish Laing Orcid Logo

Research Square

Swansea University Author: Hamish Laing Orcid Logo

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DOI (Published version): https://doi.org/10.21203/rs.3.rs-8231927/v1

Abstract

AbstractObjectives: To identify the Critical Success Factors (CSFs) for implementing a value-based outcomes framework within a local authority adult social care reablement team, exploring the rationale, barriers, and implementation strategies.Design: A pragmatic, mixed-methods study, combining quali...

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Published: https://www.researchsquare.com/article/rs-8231927/v1 Research Square Company
URI: https://cronfa.swan.ac.uk/Record/cronfa71517
first_indexed 2026-02-28T14:23:13Z
last_indexed 2026-03-01T05:28:21Z
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fullrecord <?xml version="1.0"?><rfc1807><datestamp>2026-02-28T14:54:40.2853467</datestamp><bib-version>v2</bib-version><id>71517</id><entry>2026-02-28</entry><title>Implementing a Value-Based Outcomes Framework in a Local Authority Reablement Service: A Mixed-Methods Study of Critical Success Factors</title><swanseaauthors><author><sid>be60df55bc8e44cf2aacf7230876588d</sid><ORCID>0000-0002-5661-7937</ORCID><firstname>Hamish</firstname><surname>Laing</surname><name>Hamish Laing</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2026-02-28</date><deptcode>CBAE</deptcode><abstract>AbstractObjectives: To identify the Critical Success Factors (CSFs) for implementing a value-based outcomes framework within a local authority adult social care reablement team, exploring the rationale, barriers, and implementation strategies.Design: A pragmatic, mixed-methods study, combining qualitative data from two semi-structured focus groups with quantitative data from an online staff survey.Setting: Torfaen County Borough Council reablement service, Wales, UK.Participants: 46 adult social care staff (including reablement workers, social workers, and team managers) responded to the survey. Two focus groups were conducted: one with reablement practitioners (n=9) and another with team managers and wider representatives (n=19).Results: Staff demonstrated strong support for person-centred outcomes but low awareness of Value-Based Healthcare (VBHC) principles (only 4% were familiar). Key barriers included resistance to change (34%), limited organisational capacity (34%), and financial constraints (17%). A central tension existed between frontline person-centred care and system-level efficiency pressures. Leadership was identified as the primary enabler (44% of respondents), alongside service user involvement in goal-setting (46%) and a phased implementation approach (15%). Digital systems were not perceived as a primary barrier or solution, with issues centring on the inconsistent use of existing tools rather than their absence.Conclusions: Implementing a value-based framework in social care is feasible but requires a tailored approach distinct from clinical models. Success is contingent on strong leadership to navigate cultural change, co-production with service users to define meaningful outcomes, and a modular implementation strategy to build momentum. Investment should focus on change management and process redesign rather than new digital infrastructure. This study provides a transferable framework for local authorities seeking to embed value-based care principles to demonstrate impact in an era of constrained budgets.</abstract><type>Journal Article</type><journal>Research Square</journal><volume/><journalNumber/><paginationStart/><paginationEnd/><publisher>Research Square Company</publisher><placeOfPublication>https://www.researchsquare.com/article/rs-8231927/v1</placeOfPublication><isbnPrint/><isbnElectronic/><issnPrint/><issnElectronic/><keywords>Value-Based Health Care, Reablement, Social Care, Local Authorities, Outcomes, Implementation Science, United kingdom</keywords><publishedDay>0</publishedDay><publishedMonth>0</publishedMonth><publishedYear>0</publishedYear><publishedDate>0001-01-01</publishedDate><doi>https://doi.org/10.21203/rs.3.rs-8231927/v1</doi><url/><notes>This is a pre-print, pending peer reviewed publication</notes><college>COLLEGE NANME</college><department>Management School</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>CBAE</DepartmentCode><institution>Swansea University</institution><apcterm>SU College/Department paid the OA fee</apcterm><funders>VBHC Academy School of Management.</funders><projectreference>MSc in Advanced Health and Care Management (Value-Based) Project</projectreference><lastEdited>2026-02-28T14:54:40.2853467</lastEdited><Created>2026-02-28T14:10:27.3853192</Created><path><level id="1">Faculty of Humanities and Social Sciences</level><level id="2">School of Management - Business Management</level></path><authors><author><firstname>Gareth</firstname><surname>Cooke</surname><orcid>0009-0005-0387-2925</orcid><order>1</order></author><author><firstname>Hamish</firstname><surname>Laing</surname><orcid>0000-0002-5661-7937</orcid><order>2</order></author></authors><documents/><OutputDurs/></rfc1807>
spelling 2026-02-28T14:54:40.2853467 v2 71517 2026-02-28 Implementing a Value-Based Outcomes Framework in a Local Authority Reablement Service: A Mixed-Methods Study of Critical Success Factors be60df55bc8e44cf2aacf7230876588d 0000-0002-5661-7937 Hamish Laing Hamish Laing true false 2026-02-28 CBAE AbstractObjectives: To identify the Critical Success Factors (CSFs) for implementing a value-based outcomes framework within a local authority adult social care reablement team, exploring the rationale, barriers, and implementation strategies.Design: A pragmatic, mixed-methods study, combining qualitative data from two semi-structured focus groups with quantitative data from an online staff survey.Setting: Torfaen County Borough Council reablement service, Wales, UK.Participants: 46 adult social care staff (including reablement workers, social workers, and team managers) responded to the survey. Two focus groups were conducted: one with reablement practitioners (n=9) and another with team managers and wider representatives (n=19).Results: Staff demonstrated strong support for person-centred outcomes but low awareness of Value-Based Healthcare (VBHC) principles (only 4% were familiar). Key barriers included resistance to change (34%), limited organisational capacity (34%), and financial constraints (17%). A central tension existed between frontline person-centred care and system-level efficiency pressures. Leadership was identified as the primary enabler (44% of respondents), alongside service user involvement in goal-setting (46%) and a phased implementation approach (15%). Digital systems were not perceived as a primary barrier or solution, with issues centring on the inconsistent use of existing tools rather than their absence.Conclusions: Implementing a value-based framework in social care is feasible but requires a tailored approach distinct from clinical models. Success is contingent on strong leadership to navigate cultural change, co-production with service users to define meaningful outcomes, and a modular implementation strategy to build momentum. Investment should focus on change management and process redesign rather than new digital infrastructure. This study provides a transferable framework for local authorities seeking to embed value-based care principles to demonstrate impact in an era of constrained budgets. Journal Article Research Square Research Square Company https://www.researchsquare.com/article/rs-8231927/v1 Value-Based Health Care, Reablement, Social Care, Local Authorities, Outcomes, Implementation Science, United kingdom 0 0 0 0001-01-01 https://doi.org/10.21203/rs.3.rs-8231927/v1 This is a pre-print, pending peer reviewed publication COLLEGE NANME Management School COLLEGE CODE CBAE Swansea University SU College/Department paid the OA fee VBHC Academy School of Management. MSc in Advanced Health and Care Management (Value-Based) Project 2026-02-28T14:54:40.2853467 2026-02-28T14:10:27.3853192 Faculty of Humanities and Social Sciences School of Management - Business Management Gareth Cooke 0009-0005-0387-2925 1 Hamish Laing 0000-0002-5661-7937 2
title Implementing a Value-Based Outcomes Framework in a Local Authority Reablement Service: A Mixed-Methods Study of Critical Success Factors
spellingShingle Implementing a Value-Based Outcomes Framework in a Local Authority Reablement Service: A Mixed-Methods Study of Critical Success Factors
Hamish Laing
title_short Implementing a Value-Based Outcomes Framework in a Local Authority Reablement Service: A Mixed-Methods Study of Critical Success Factors
title_full Implementing a Value-Based Outcomes Framework in a Local Authority Reablement Service: A Mixed-Methods Study of Critical Success Factors
title_fullStr Implementing a Value-Based Outcomes Framework in a Local Authority Reablement Service: A Mixed-Methods Study of Critical Success Factors
title_full_unstemmed Implementing a Value-Based Outcomes Framework in a Local Authority Reablement Service: A Mixed-Methods Study of Critical Success Factors
title_sort Implementing a Value-Based Outcomes Framework in a Local Authority Reablement Service: A Mixed-Methods Study of Critical Success Factors
author_id_str_mv be60df55bc8e44cf2aacf7230876588d
author_id_fullname_str_mv be60df55bc8e44cf2aacf7230876588d_***_Hamish Laing
author Hamish Laing
author2 Gareth Cooke
Hamish Laing
format Journal article
container_title Research Square
institution Swansea University
doi_str_mv https://doi.org/10.21203/rs.3.rs-8231927/v1
publisher Research Square Company
college_str Faculty of Humanities and Social Sciences
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hierarchy_top_id facultyofhumanitiesandsocialsciences
hierarchy_top_title Faculty of Humanities and Social Sciences
hierarchy_parent_id facultyofhumanitiesandsocialsciences
hierarchy_parent_title Faculty of Humanities and Social Sciences
department_str School of Management - Business Management{{{_:::_}}}Faculty of Humanities and Social Sciences{{{_:::_}}}School of Management - Business Management
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description AbstractObjectives: To identify the Critical Success Factors (CSFs) for implementing a value-based outcomes framework within a local authority adult social care reablement team, exploring the rationale, barriers, and implementation strategies.Design: A pragmatic, mixed-methods study, combining qualitative data from two semi-structured focus groups with quantitative data from an online staff survey.Setting: Torfaen County Borough Council reablement service, Wales, UK.Participants: 46 adult social care staff (including reablement workers, social workers, and team managers) responded to the survey. Two focus groups were conducted: one with reablement practitioners (n=9) and another with team managers and wider representatives (n=19).Results: Staff demonstrated strong support for person-centred outcomes but low awareness of Value-Based Healthcare (VBHC) principles (only 4% were familiar). Key barriers included resistance to change (34%), limited organisational capacity (34%), and financial constraints (17%). A central tension existed between frontline person-centred care and system-level efficiency pressures. Leadership was identified as the primary enabler (44% of respondents), alongside service user involvement in goal-setting (46%) and a phased implementation approach (15%). Digital systems were not perceived as a primary barrier or solution, with issues centring on the inconsistent use of existing tools rather than their absence.Conclusions: Implementing a value-based framework in social care is feasible but requires a tailored approach distinct from clinical models. Success is contingent on strong leadership to navigate cultural change, co-production with service users to define meaningful outcomes, and a modular implementation strategy to build momentum. Investment should focus on change management and process redesign rather than new digital infrastructure. This study provides a transferable framework for local authorities seeking to embed value-based care principles to demonstrate impact in an era of constrained budgets.
published_date 0001-01-01T05:29:57Z
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