Copyright 2014 Right Care

Mara AiroldiSystems Modelling for Performance Optimisation & Service EquityDepartment of ManagementLondon School of EconomicsMarch 2014

Commissioning for Value

STAR - Socio-technical allocation of resourcesEngaging stakeholders in decisions

Online Learning Series

Right Care for Populations

STAR tool

• Socio Technical Allocation of Resources

• Available for free (with supporting material) at: http://www.health.org.uk/learning/star/

When is STAR most helpful?

Routine data analysis

Strategic decisions, identification of problems

Modelling, ‘deep dive’

STAR for commissioning value: 3 components

1. Social process – to engage stakeholders– ‘Decision Conferencing’ (LD Phillips)– A structured conversation

2. Technical models grounded in– Health economics (cost/QALY principle)– Decision analysis (possibility to include equity & feasibility

criteria)

3. Visual aids– To make difficult concept easier to understand

STAR as a structured conversation: key questions addressed

• What interventions are/should be available?

• Who benefits?• How many people benefit?• How much do they benefit?• How much does it cost?

Commissioning value

Data required

• Scale• Costs• Value

(population benefit)

Horse & rabbit stew

✖Value

Scale Costs

Star for commissioning value

Data

VisualModels

Costs Value Scale

Stakeholders: managers, doctors, patients & carers, agencies

Visual models: 3 visual aids

1. Rectangles of population health2. Value for money triangles3. Efficiency frontier

Numbers who benefit

Population

health gain

Av

era

ge

QA

LY

ga

in p

er

pe

rso

n

Rectangles of population health

costs

Population

Health gain

QALY gain/ person

Numbers who benefit

VfM

Value for Money (VfM) Triangles

Value

Population health gain

Good VfM

Costs

Good or poor VfM?

-ve VfM

Poor VfM

A theory of priority setting against budget constraint?

Costs

Budget constraint

QALYs

Size of triangle matters

A

Star for commissioning value

Data

VisualModels

Costs Value Scale

Stakeholders: managers, doctors, patients & carers, agencies

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Online Learning Series

Right Care for Populations

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Find the full series at:

www.rightcare.nhs.uk/resourcecentre

Find the STAR tool and supporting resources at:

http://www.health.org.uk/learning/star/

Full Star Casebooks can be found at:

www.rightcare.nhs.uk/resourcecentre