evaluation of new care models, pop up uni, 1pm, 3 september 2015
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Evaluation of New Care Models Overall approach Charles Tallack,
Head of Operational Research and Evaluation, NHSE
1
Evaluation to support the aims of the programme../1
Widespread adoption of
new models of care which
have positive impact
Models of care that improve outcomes
and efficiency
Models of care that improve outcomes
and efficiency
Disseminated and taken-up
2
Improved health &
wellbeing, care & quality and efficiency,
at scale
Evaluation to support the aims of the programme../2
Well designed models
Based on sound
theory of change
Evidence- and best-practice-
based
Rapid cycle evaluation and improvement
Evaluation shows improvement in outcomes
and efficiency
Against local
metrics
Against national outcome metrics
Models of care that improve outcomes
and efficiency
Well implemented models
3
Evaluation to support the aims of the programme../3
Knowledge of ‘active ingredients’
Role of context
Interventions used and part
played
Codification and transmission of knowledge
Knowledge of implementation
Models of care that improve outcomes
and efficiency
Disseminated and taken-up
4
Evaluation to understand the elements of the new care models, how they are implemented, what effects they have, for whom, how and why
To develop and describe new care models, for implementation across the country, which will improve health outcomes and efficiency
NCM aim
Evaluation aim
Evaluation phases and questions to be answered
Evaluation needed across the life-cycle
During planning and set up (pre April 2016)
During implementation and model development
After implementation is complete
5
Evaluation phases and questions to be answered
During planning and set up (pre April 2016)
During implementation and model development
After implementation is
complete
• What is the context?
• How was model developed?
• What interventions are planned?
• What enablers are needed?
• What impacts are expected?
• Is implementation as planned? Barriers?
• What is working and not working, and why?
• What are the early results: outcomes, numbers of people affected, changed processes?
• What is the final model?
• What have been the outcomes and impacts?
• What are the key elements of success? 6
Evaluation to understand the elements of the new care models, how they are implemented, what effects they have, for whom, how and why
To develop and describe new care models, for implementation across the country, which will improve health outcomes and efficiency
Monitoring of impact comparing national outcome metrics with counterfactual
Monitoring of progress against outcome, output and process metrics
Interviews, qualitative and quantitative research to establish the “how” and “why”
NCM aim
Evaluation aim
Evaluation phases and questions to be answered
Evaluation activities
Evaluation needed across the life-cycle
During planning and set up (pre April 2016)
During implementation and model development
After implementation is complete
7
Local and national evaluation need to be complementary
National Local
• Monitoring and reporting against core metrics for each vanguard
• Establishment of matched controls for key interventions
• Specification of common elements of local evaluations
• Analysis and synthesis of local data and intelligence
• National “summative” evaluation
• Data collection (e.g. through surveys of patient experience, staff experience)
• Fact finding (e.g. where are interventions being implemented)
• Qualitative and quantitative research and analysis
• Progress tracking, monitoring and reporting against locally defined metrics
8
Proposed oversight and joint working groups
Evaluation oversight group Vanguard reps + ALB NCM rep +
patient rep + clinical rep + independent evaluation expert
Patient experience
measurement
Core metrics and national
reporting
Staff experience measurement
Local evaluation support & approach
Patient experience measurement
Quality of life for patients with
LTCs
9
Better health and care for Sunderland
The power of evaluation!
The story of our care homes pilot evaluation and the post
code saga!
Penny Davison,
Senior Commissioning Manager, NHS Sunderland CCG
Care home pilot and the post code saga! • Delivered Enhanced care in care homes from December 2013 – March 2015
• Carried out evaluation throughout the pilot.
• Learned significant amount along the way!
• How evaluation helped us in new model design
Reduction in emergency admissions and A&E
attendances Significant reduction in
out of hours callouts and GP callouts
Communication has vastly improved
Improvements in clinical effectiveness and patient
safety
Reduction in admissions for foot ulcers
An increase in the number of people supported to die in their preferred place
Improvements in patient experience and satisfaction
Pharmacy contribution – improved patient
safety and saving money
Clinicians feel better equipped to care for the frail and elderly
Outcomes
Power of evaluation! During the pilot
• Focus on innovation
• Create a learning environment
• Gain momentum and support
• Understand our key ingredients of success
Rolling Out the pilot to rest of Sunderland
• Build a model for the rest of Sunderland
• Apply lessons to people at home
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