How to Measure Wellbeing in Outcomes-based Commissioning?

  • Anniina Tirronen Tampere University, Faculty of Management and Business
  • Jari Stenvall Tampere University, Faculty of Management and Business
  • Tony Kinder Tampere University, Faculty of Management and Business
  • Piia Tienhaara Tampere University, Faculty of Management and Business
  • Paula Rossi Tampere University, Faculty of Management and Business
Keywords: outcomes-based commisioning, outcome-based contracts, measuring, co-production, public value


Outcomes-based commissioning has been gaining ground for several years now. Criticism of outcomes-based commissioning usually concerns measuring. However, valid and reliable outcome measures are difficult to find. This study is a case study of the procurement made in the years of 2013 and 2014 in the city of Tampere, Finland. Data were collected in 2015 from the tendering documents and by interviewing 5 civil servants and 8 service providers who all took part in the procurement, and in 2016 from a workshop. Measuring outcomes can be cumbersome, especially when verifying a connection between services and outcomes. However, using surrogates for wellbeing alongside conventional quality and achievement indicators, can allow practitioners to establish whether the values held by the public are embedded in the public value created by a new service model. The paper suggests a new framework for use in tracking the migration of values into value.


Ballard, T., Hicks, N. & Paynton, D. (2016) Outcome-based Commissioning – has its time come?, British Journal of General Practice, 66(644), pp. 219–221.

Bamford, C., Qureshi, H., Nicholas, E. & Vernon, A. (1999) Outcomes in Community Care Practice. Outcomes of Social Care for Disabled People and Carers (New York: Social Policy Research Unit, The University of York).

Bovaird, T. & Davies, R. (2011) Outcome-Based Service Commissioning and Delivery: Does it make a Difference?, In: Groeneveld, S. & Van De Walle, S. (eds) New Steering Concepts in Public Management (Bingley: Emerald Group Publishing Limited), pp. 93–114.

Boyatzis, Richard E. (1998) Transforming Qualitative Information: Thematic Analysis and Code Development (Thousand Oaks, CA: Sage).

Bryson, J. M., Crosby, B. C. & Bloomberg, L. (2014) Public value governance: Moving beyond traditional public administration and the New Public Management, Public Administration Review, 74(4), pp. 445–456.

Cabinet Office (2016) Life Chances Fund (London: Cabinet Office).

Charmaz K. (2006) Constructing grounded theory (London: Sage).

Considine, M., Lewis, J. & O’Sullivan, S. (2011) Quasi-markets and service delivery: flexibility following a decade of employment assistance reform in Australia, Journal of Social Policy, 40(4), pp. 811–833.

Dopson, S. & Locock, L. (2002) The Commissioning Process in the NHS: The theory and application, Public Management Review, 4(2), pp. 209–229.

Edmiston, D. & Nicholls, A. (2018) Social Impact Bonds: The Role of Private Capital in Outcome-Based Commissioning, Journal of Social Policy, 47, pp. 57–76.

Farr, M. (2016) Co-Production and Value Co-Creation in Outcome-Based Contracting in Public Services, Public Management Review, 18(5), pp. 654-672.

Flyvbjerg, B. (2006) Five misunderstandings about case-study research, Qualitative inquiry, 12(2), pp. 219–245.

Fountain, J. (2001) Paradoxes of Public Sector Customer Service, Governance: An International Journal of Policy and Administration, 14(1), pp. 55–73.

Fox, C. & Albertson, K. (2011) Payment by results and social impact bonds in the criminal justice sector: New challenges for the concept of evidence-based policy?, Criminology and Criminal Justice, 11(5), pp. 395–413.

Gemmell, I., Heller, R. F. & Payne, K. (2006) The potential population impact of the UK Government strategy for reducing the burden of coronary heart disease in England: comparing primary and secondary prevention strategies, Quality and Safety in Health Care, 15, pp. 339–343.

Greve, C. (2015) Ideas in public management reform for the 2010s: Digitalization, value creation and involvement, Public Organization Review, 15(1), pp. 49–65.

Harlock, J. (2014) From outcomes-based commissioning to social value? Implications for performance managing the third sector. Working Paper 123 (Birmingham: Third Sector Research Centre).

Hazenberg, R., Seddon, F. & Denny, S. (2014) Investigating the Outcome Performance of Work-Integration Social Enterprises (Wises): Do WISEs offer ‘added value’ to NEETs?, Public Management Review, 16(6), pp. 876–899.

ICHOM (2016) International Consortium for Health Outcomes Measurement. A new definition of success, available at: (January 26, 2018).

Jørgensen, C. H. (2004) Connecting Work and Education: Should Learning be Useful, Correct or Meaningful?, Journal of Workplace Learning. 16(7/8), pp. 455–66.

Kelly, G., Mulgan, G. & Muers, S. (2002) Creating Public Value: An Analytical Framework for Public Service Reform. Discussion paper (London: Cabinet Office Strategy Unit, United Kingdom).

Kinder, T., Stenvall, J., Kuoppakangas, P., Tirronen, A. & Pekkola, E. (2018) Complexity and the co-creation of public service ecosystems, IRSPM, Conference paper, Edinburgh, April 2018 (Edinburgh: IRSPM).

Laitinen, I., Stenvall, J. & Kinder, T. (2017) Co-design and action learning in local public services, Journal of Adult & Continuing Education, 24(1), pp. 1-26.

McHugh, N., Sinclair, S., Roy, M., Huckfield, L. & Donaldson, C. (2013) Social impact bonds: a wolf in sheep’s clothing, Journal of Poverty and Social Justice, 21(3), pp. 247–257.

Meynhardt, T. (2009) Public Value Inside: What is Public Value Creation?, International Journal of Public Administration, 32(3-4), pp. 192–219.

Millar, R. & Hall, K. (2013) Social Return on Investment (SROI) and Performance Measurement, Public Management Review, 15(6), pp. 923–941.

Mitchell, R. C. & Carson, R. T. (1989) Using Surveys to Value Public Goods (New York: RFF Press).

Moore, M. (1994) Public Value as the Focus of Strategy, Australian Journal of Public Administration, 53(3), pp. 296–303.

National Audit Office (2015) Outcome-based payment schemes: government’s use of payment by results (London: National Audit Office).

Neely, A. (ed.) (2007) Business Performance Management (Cambridge: CUP).

Ng, I. C. L., Maull, R. & Yip, N. (2009) Outcome-based contracts as a driver for systems thinking and service-dominant logic in service science: Evidence from the defence industry, European Management Journal, 27, pp. 377–387.

Nicholls, A. & Tomkinson, E. (2015) The Peterborough Pilot Social Impact Bond, In Nicholls A, Paton, A. R. & Emerson, J. (eds.) Social Finance (Oxford: OUP).

O'Flynn, J. (2007) From new public management to public value: Paradigmatic change and managerial implications, Australian journal of public administration, 66(3), pp. 353–366.

OECD (2015) The Innovation Imperative in the Public Sector: Setting an Agenda for Action (Paris: OECD).

Osborne, S. P. (2018) From public service-dominant logic to public service logic: are public service organizations capable of co-production and value co-creation?, Public Management Review, 20(2), pp. 225–231.

Osborne, S. P., Nasi, G. & Flemig, S. (2017) Creating Value through Collaborative Innovation, Paper presented at the 2017 PMRA Conference (Washington, DC: PMRA).

Ostrom, E. (1996) Crossing the great divide: coproduction, synergy, and development, World development, 24(6), pp. 1073–1087.

Ostrom, E. (2010) Beyond Markets and State: Polycentric Governance of Complex Economic Systems, American Economic Review, 100(3), pp. 641–672.

Outcomes Based Healthcare in association with Capsticks (2014) Contracting for Outcomes. A Value-Based Approach. A technical paper, available at: (April 1, 2018).

Paley, C. and Slasberg, C. (2007) Implementing outcome-based commissioning. Journal of Care Services Management, 1(4), pp. 353–361.

Pekkola, E., Tuurnas, S., Stenvall, J. & Hakari, K. (2015) Public Value in Localized Service Delivery? Exploring Different Rationales, Kunnallistieteellinen aikakauskirja, 43(4), pp. 341–354.

Pekkola, E., Kinder, T. & Stenvall, J. (2019) Values into public value, Working Paper (Tampere: Tampere University).

Porter, M. E. (2009) A strategy for health care reform – toward a value-based system, New England Journal of Medicine, 361(2), pp. 109–112.

Porter, M. E. (2010a) What is value in health care?, New England Journal of Medicine, 363(26), pp. 2477–2481.

Porter, M. E. (2010b) Value in health care (Supplementary Appendix 1), New England Journal of Medicine, 363(26), pp. 2477–2481.

Porter, M. E. (2010c) Measuring health outcomes: the outcomes hierarchy (Supplementary Appendix 2), New England Journal of Medicine, 363(26), pp. 2477–2481.

Porter, M. E. & Guth, C. (2012) Redefining German health care: moving to a value-based system (Berlin: Springer Science & Business Media).

Porter, M. E. & Teisberg, E. O. (2006) Redefining health care: creating value-based competition on results (Boston: Harvard Business School Press).

Qureshi, H., Patmore, C., Nicholas, E. & Bamford, C. (1998) Overview: Outcomes of social care for older people and carers (York: Social Policy Research Unit, The University of York).

Radnor, Z., Osborne, S. P., Kinder, T. & Baranova, P. (2014) Operationalizing Co-Production in Public Services Delivery: the Contribution of Service Blueprinting, Public Management Review, 16(3), pp. 402–423.

Rees, J. (2014) Public sector commissioning and the third sector: Old wine in new bottles?, Public Policy and Administration, 29(1), pp. 45–63.

Ronicle, J., Fox, T. & Stanworth, N. (2016) Commissioning Better Outcomes Fund Evaluation: Update Report (London: Big Lottery Fund).

Rutgers, M. R. (2015) As Good as It Gets? On the Meaning of Public Value in the Study of Policy and Management, The American Review of Public Administration, 45(1), pp. 29–45.

Sanjuan, P., Magallares, A. & Gordillo, R. (2011) Self-serving attributional bias and hedonic and eudemonic aspect of wellbeing, In: Brdar I (ed) The Human Pursuit of WellBeing: A Cultural Approach (Berlin: Springer).

Schreier, M. (2014) Qualitative content analysis, In: Flick, U. (ed) The SAGE handbook of qualitative data analysis (London: SAGE Publications Ltd) , pp. 170–183.

Schreurs, B. (2005) Attracting potential applicants to the military: the effects of initial face-to-face contacts, Human Performance, 18(2), pp. 105–122.

Sinervo, L. M. (2011) Kunnan talouden tasapaino monitulkintaisena ilmiönä. Acta Universitatis Tamperensis 1628. Academic Doctoral Thesis. (Tampere: Tampere University Press).

Slay, J. & Penny, J. (2014) Commissioning for outcomes and co-production. A practical guide for local authorities (London: New Economics Foundation (NEF)).

Smith, J., Dixon, J. & Mays, N. (2005) Practice based commissioning: applying the research evidence, British Medical Journal, 331, pp. 1397–1399.

Spence, D. T., Bandesha, G., Horsley, S. & Heller, R. F. (2008) Evidence-based commissioning: using population impact measures to help primary care trusts estimate the benefit of interventions in diabetes and heart failure, Quality and Safety in Health Care, 19, pp. 31–36.

Stoker, G. (2000) Urban Political Science and the Challenge of Urban Governance, in Pierre J (Ed.), Debating Governance: Authority, Steering, and Democracy, OUP, Oxford.

Stoker, G. (2006) Public value management: a new narrative for networked governance?, The American review of public administration, 36(1), pp. 41–57.

Strokosch, K. & Osborne, S.P. (2016) Asylum Seekers and Coproduction of Public Services: Understanding the Implications for Social Inclusion and Citizenship, Journal of Social Policy, 45(4), pp. 673–690.

Taunt, R., Allcock, C. & Lockwood, A. (2015) Need to nurture: outcomes-based commissioning in the NHS (London: The Health Foundation).

Tirronen, A., Hakari, K. & Stenvall, J. (2014) Tulosperusteinen palvelujen järjestäminen julkisella sektorilla – kirjallisuuskatsaus, Kunnallistieteellinen aikakauskirja, 4, pp. 449–463.

University of Birmingham (2014) Commissioning for Better Outcomes: A Route Map,available: (April 1, 2018).

Voelker-Morris, R. (2004) Outcome-based evaluation: Practical and theoretical applications. CultureWork: A Periodic Broadside for Arts and Culture Workers, 8(4).

Wadia, A. & Parkinson, D. (2011) Outcome and outcome indicator banks: Availability and use (London: Charities Evaluation Services (CES)).

Williamson, O. E. (1975) Markets and Hierarchies: Analysis and Antitrust Implications (London: Free Press).

Yin, R. K. (2011) Applications of case study research (Newcastle upon Tyne: Sage).