Over the past few months, and as part of the Realising the Value programme partners, we have been focusing our efforts on building and strengthening the evidence base for person- and community-centred approaches in the UK. With a still-emerging evidence base, and in support of the NHS Five Year Forward View vision to develop a new relationship with people and communities, it is important now more than ever that we focus on gathering good examples of why and how these approaches “work”.
Not only that, but we understand we could do much more given the current momentum, so we are currently consolidating all the available evidence and developing over the next months an economic model and practical toolkits for each of the five areas of practice.
These tools will support policymakers to better understand the likely impact of these approaches in either their locality or nationally (for specific contexts), in order to facilitate implementation and greater adoption across the country. At the same time, we hope these tools will help commissioners, policymakers and practitioners to understand the potential of these approaches to improve health and wellbeing outcomes, NHS sustainability and social value. These are the three dimensions of value, or three “axis” that these approaches are measured by, which will be compared against investment costs to assess their effectiveness and “value for money” proposition.
We understand that in order to have a robust economic model that is used, a large and contrasted pool of evidence is needed (among many more factors). This is why we are building the economic model from the current evidence base that the programme has developed in collaboration with the Institute of Health & Society, Newcastle University. As discussed in the report, we understand that the evidence is still emerging, having good data already for some areas such as peer support and self-management education, and apparent gaps for other areas such as asset based approaches, where evidence is still maturing.
This is one of the many reasons why, for the past few months, we have been engaging and co-producing the evidence base with local partner sites for each of the areas of practice. We understood their ways of working and documented their positive stories/outcomes, so that the evidence gaps could be filled with successful frontline practice examples. This was a great opportunity for us also to get past through the data and get to a much deeper level of understanding; through our day-workshops with each of the sites, we managed to put names to faces for very enthusiastic and brilliant colleagues and “change agents”, learned their journeys and got inspired with their success stories.
Through these detailed day-workshops and follow up sessions, we mapped their key outcomes, costs, outputs, and overarching themes across areas that could benefit the development of the economic model. Also, we learnt how some sites have developed their own innovative measurements (PROM) to monitor wellbeing and specific concerns to users (MyCAW for Penny Brohn, Living Well), while others applied standardised scales (Peer Support using SWEMWBS), whilst everybody observed satisfyingly positive improvements on mental wellbeing.
As we were further listening to their successful stories and analysing their evaluation methods, we realised that the initial evidence base was getting stronger, but also that we were managing to fill some of the gaps for those areas with maturing evidence (Unlimited Potential, Inspiring Communities Together and Creative Minds are good examples of it). Positive health behaviour change was also accurately monitored for some of these areas for sustained periods of time and for broad demographics, allowing further thinking on sustainability of outcomes (Being Well Salford).
Over the next couple of months, further engagement with consortium partners, advisors, experts, commissioners and local sites will help co-produce the economic model and toolkits, and guarantee the robustness and validity of them (please also share your interest with us if you are a commissioner or policymaker who would like to participate in this co-production process). The findings from the economic model and the tools for commissioners will be published as part of a final package of findings and resources from the Realising the Value programme in the autumn 2016, helping to make recommendations to decision makers to support the case for change for these approaches to scale up and become common practice nationally.
To find out more about the programme please visit www.realisingthevalue.org.uk.
This blog was written by David Fernandez, Consultant at PPL Consulting.