Evaluating integrated and community-based care: how do we know it works?
BARDSLEY Martin, et al
Over the last five years the Nuffield Trust has undertaken evaluations of over 30 different community-based interventions. In many cases the authors have been tasked with identifying whether service changes have led to a reduction in emergency admissions and the associated cost to the NHS. Using these indicators, the results have been almost overwhelmingly negative. The one exception was Marie Curie Nursing Services for terminally ill patients. In this paper the authors outline the main community-based interventions they have evaluated and their impact, and identify nine points that may help those designing, implementing and evaluating such interventions in future. The paper could provide useful learning for the new health and social care integration ‘pioneer’ sites that will be appointed by the Department of Health by September 2013. (Edited publisher abstract)