Skip to main content

Evaluation of complex integrated care programmes: the approach in North West London

Several local attempts to introduce integrated care in the English National Health Service have been tried, with limited success. The Northwest London Integrated Care Pilot attempts to improve the quality of care of the elderly and people with diabetes by providing a novel integration process across primary, secondary and social care organisations. It involves predictive risk modelling, care planning, multidisciplinary management of complex cases and an information technology tool to support information sharing. This paper sets out the evaluation approach adopted to measure its effect.

In an article published in the International Journal of Integrated Care, Felix Greaves and colleagues present a mixed methods evaluation methodology. It includes a quantitative approach measuring changes in service utilization, costs, clinical outcomes and quality of care using routine primary and secondary data sources. It also contains a qualitative component, involving observations, interviews and focus groups with patients and professionals, to understand participant experiences and to understand the pilot within the national policy context.

This study design considers the complexity of evaluating a large, multi-organisational intervention in a changing healthcare economy. Greaves and colleagues base the evaluation within the theory of evaluation of complex interventions. They present the specific challenges faced by evaluating an intervention of this sort, and the responses made to mitigate against them.

Greaves and colleagues hope this broad, dynamic and responsive evaluation will allow them to clarify the contribution of the pilot, and provide a potential model for evaluation of other similar interventions. Because of the priority given to the integrated agenda by governments internationally, the need to develop and improve strong evaluation methodologies remains strikingly important.

Comments

Popular posts from this blog

What is the difference between primordial prevention and primary prevention?

Primordial prevention and primary prevention are both crucial strategies for promoting health, but they operate at different levels. Primordial prevention aims to address the root causes of health problems and improve the wider determinants of health. It focuses on preventing the emergence of risk factors in the first place by tackling the underlying social, economic, and environmental determinants of health. This involves broad, population-wide interventions such as: Policies that promote healthy food choices: Think about initiatives like taxing sugary drinks to discourage unhealthy consumption, or providing subsidies for fruits and vegetables to make them more accessible. Urban planning that prioritises well-being: This could include creating walkable neighborhoods with safe cycling routes, ensuring access to green spaces for recreation and relaxation, and designing communities that foster social connections. Social programs that address inequality: Initiatives aimed at reducing pov...

New NHS community mental health centres in England

The Government has announced it will create over 100 new community mental health centres across England, which will work alongside GPs and other NHS organisations/ The centres will offer offer walk-in support as well as seeing patients referred from elsewhere in the NHS. GPs have long called for faster access to specialist mental health support for patients, so the expansion of community mental health services is a welcome development. If these new centres improve access to multidisciplinary teams, reduce waiting times and provide more integrated care, they can improve patient outcomes while reducing pressure on both general practice and specialist mental health services. Close collaboration between GPs, mental health professionals, social care and the voluntary sector will be essential because many people with mental health problems also have wider social and physical health needs. The success of these centres will depend on how they are implemented. They need to be adequately staffe...

Protecting Young People from Meningococcal B Disease: The NHS Targeted Vaccination Programme

Meningococcal group B (MenB) infections are rare but can have devastating consequences. The decision to offer a targeted two-dose vaccination programme to Year 13 students and young people entering university or residential further education reflects concerns about recent outbreaks of meningococcal disease and the higher risk of transmission when large numbers of young adults mix closely for the first time in shared accommodation. The MenB vaccine has a well-established safety record, and evidence from the UK infant immunisation programme has shown substantial reductions in disease among vaccinated children. A targeted programme for those entering higher-risk settings is therefore a reasonable precautionary measure while further evidence is gathered on whether the recent increase in clusters represents a temporary fluctuation in disease patterns or a more sustained change in the epidemiology of MenB infection. The success of the programme will depend on achieving high uptake and ensuri...