Getting to a COBIC Contract

Working with CCGs across the country we have designed an approach to support commissioners in contracting for Capitated Outcomes-Based Incentivised Commissioning.

Wherever you are on this journey, we can help you identify how to work best with your staff and other supporting services to develop and deliver this approach.

Our highly experienced team can support you along the four stages:

1. Workshops.

We have developed a series of interactive workshops* that build consensus, understanding, and support implementation of COBIC contracts. These are grounded in your local health and care economy and bring learning from across the UK. COBIC workshops help you:

  • Understand the potential benefits of the COBIC commissioning approach
  • Understand the different contracting options and ways of engaging providers
  • Learn from captivated outcomes-based incentivised commissioning pioneers at home and abroad
  • Give your team the mandate to press ahead with a case for change
  • Tackle challenge questions specific to your health economy

 2. The business case. 

The COBIC Business Case for Change rapidly evaluates your local context, your current commissioning model and the potential benefits of shifting to programme budgets based on populations (not institutions) to contract for the outcomes that matter to patients.

We have found that our clients like the fact that it:

  • Explores the potential scope, activity, budget, and resource for the next steps
  • Aligns with your existing programmes and strategies
  • Analyses the relative strengths/weaknesses of the current system, benchmarking it to others
  • Engages key people and secures the mandate to being the process of change

3. Outcomes that matter. 

This focuses on identifying what your local population wants and defines the outcomes for each service and the population to be served. An outcomes and indicator framework is developed that is applied to the COBIC contract by:

  • Working with patients and service users who lead the design of the outcomes that matter to them
  • Applying international and national evidence and experience
  • Testing and further development of outcomes and indicators with clinicians and wider stakeholders
  • Creates a framework that priorities outcomes, selects indicators, and identifies methods of measurement

4. Implementation and contract options.

This provides the implementation and contracting options that lead the way to a COBIC contract, and involves:

  • Creating the payment mechanisms and incentivisation to implement the outcome and indicator framework
  • Discussions with providers, existing and new, to consider the design of new delivery models
  • Appraisal of the contracting and procurement options, suitable to your local needs
  • Confirming the budget, scope, and duration of the COBIC contract
  • Support in preparation for, and negotiation of, the contract with providers
  • Finalisation of the contract
  • How to run and performance manage the COBIC contract

We work with an alliance of experts, powered by PwC, to implement this programme at scale and pace.

We recognised CCGs are at different states in implementing this approach, and as well as supporting you to deliver these, we offer membership to the COBIC Club.


Find out more about how we can support you, call 01993 750 005, or email

  • "Outcomes-based commissioning is now fundamental to our approach and will maximise health gain for the citizens of England and value for money for taxpayers."
    Everybody Counts: Planning for Patients 2014/15 to 2018/19, NHS England
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