Toby challenged the orthodoxy of performance measurement in the context of targets around obesity and began to outline avenues for innovative alternative ways of addressing performance.

Toby argued that payment by results and outcomes based performance management models are inherently flawed and create unwelcome paradoxes. Instead of improving the lives of service users, his research suggests that focusing on outcomes and results distorts both the priorities and practice of organisations and workers, leading to poorer results for those most in need.

Listen to Heresy #1: Is Payment by Results Doomed to Fail?