The scheme aims to improve the effectiveness of residential rehabilitation in the UK by collating and sharing information about the outcomes, effectiveness and quality of these services.

To explain why this work is needed, we must consider how the residential rehab sector is structured.

Residential rehab is purchased, usually on a client-by-client basis, in a market place of public, private and not for profit providers. Providers offer their services to purchasers who work with clients (and on behalf of the public purse) to make decisions about placements.

There are usually a small number of people making these purchasing decisions within each DAT and (taking account of the size of the drug treatment system as a whole) the number of actual placements per DAT area is small.

The purchaser (usually a care manager) has relatively little information on which to base his or her decisions. In particular, they know little about the actual performance of providers. Even if they take the trouble to record and analyse data for all their placements, the number of people involved is too small to make general conclusions and comparisons. Even providers of services know little about their performance compared to other providers.

This poor market knowledge on the part of providers and purchasers has consequences:

• Care managers often make placement decisions based on arbitrary criteria such as habit or brand loyalty.
• Providers make decisions on price based on similarly arbitrary criteria such as historical position.
• The lack of clarity about outcomes undermines efforts to improve quality.
• There is a poor relationship between the service provided, the problem severity of clients, price and outcome.

These market inefficiencies mean that excellent services sometimes close, terrible services sometimes stay open, fewer clients get the treatment they need and the residential sector as a whole under-performs.

A partial solution to these problems is to radically increase the flow of information and market knowledge between purchasers and providers. This is the solution being pursued by the Rehab Outcomes Project:

• Collecting and collating outcome and activity data
• Feeding this back into the market to support decision-making by both purchasers and providers.