Results for 'outcomes'
Results 21 - 26 of 26
This guide sets out the issues that need to be considered when developing a business case to invest in preventive services and to ensure that any decision are based on robust and reliable data. The guide focuses on the following arguments: the importance of 'investing to save', arguing that prevention is cheaper in the long term; promotion of service innovation; placing the focus of commissioning on outcomes rather than outputs; and managing a shift in spending from acute to prevention to reduce demand over time. The guide outlines key four activities required to build a business case: understanding needs; understanding current costs; assessing possible interventions; and deciding how to measure the value and outcome of the interventions. It also provides a summary business case for prevention and using a Social Impact Bond (SBI) to finance a business case for prevention. An example case study of making a business case for prevention services in early years services in Greater Manchester is included.
NHS CONFEDERATION. Community Health Services Forum
Explains outcomes-based commissioning and outlines how it might help enable service transformation. Outcomes-based commissioning incentivises high-value interventions, shifting resources to services in the community, a focus on keeping people healthy and in their own homes, delivering outcomes that matter to people using the services, and coordinated care. It discusses the opportunities that outcomes-based commissioning gives for providers of community services, including the main technical considerations that will need to be addressed. Health outcomes have become the standard for measuring successful care. More and more people are living with long-term, and often multiple, conditions. This briefing argues that successful care for this group of people is not about providing a cure or a certain number of procedures, but about enabling and supporting them to live as well as possible with their conditions over the long term. Achieving this will involve transforming the system so that all of its parts work in an integrated way towards the outcomes people want and need most. Unlocking the unmet potential in community settings is crucial in both transforming care and improving efficiency. The briefing includes practical examples showcasing how community providers are using innovative ways of supporting and enabling people with high levels of clinical need to be cared for at home or more locally, and are working in partnership with other health and care providers. It will be of interest to all commissioners and providers considering developing an outcomes-based commissioning approach that includes community health services. It is particularly relevant to providers of community services.
UNIVERSITY OF YORK. Social Policy Research Unit
This report provides final findings of a study conducted with ten participating councils to investigate the benefits of homecare re-ablement. The study aimed to identify features of an effective and cost efficient services; maximise outcome and duration of benefits; and to understand and reduce the demands on other formal care, including other social services. The study comprised of three groups of councils: intervention sites which were enablement staff led; intervention sites with mixed staff teams; and comparison sites where service users had not undergone a phase of home care re-ablement. The previous interim study reflected on initial findings from the intervention sites. This report also adds findings from the comparison sites and long term impact from the follow up review stage. Main findings are discussed in the areas of assessment arrangements; discharge and onward referral arrangements; key features of re-ablement services; team skill mix; staff commitment, attitude, knowledge and skill; service users and carer views; and a strong vision of the service.
NATIONAL INSTITUTE FOR HEALTH RESEARCH. School for Social Care Research
A scoping study investigated approaches to prevention services in local authorities which enable older people to retain their independence for as long as possible to maintain their quality of life and reduce pressure on local authority and NHS budgets. The study involved a survey of Directors of Adult Social Services in 9 local authorities to identify what they viewed as their top 3 investments in prevention services for older people, and interviews with lead managers for each intervention. It also reviewed local and national evidence as to whether these interventions lead to a delay or reduction in uptake of social care services This paper summarises the key findings from the research. It explains that the top 3 interventions were reablement (a top 3 approach for all of the local authorities surveyed), technology-based interventions (among the top 3 interventions in 6 authorities), and information and advice (among the top 3 in 3 authorities), while a number of other prevention interventions were identified by one local authority each. It reports on how local authorities seek evidence and guidance on prevention services and factors influencing how local funding was spent, and on assessment of the outcomes and impact of prevention interventions. It also summarises national and local evidence for the top 3 interventions.
MILLER Robin, et al
Purpose: The purpose of this paper is to explore the delivery of preventative services for older people from third sector organisations (TSOs) and the extent to which current commissioning arrangements enables the aspirations of policy to be achieved.
Design/methodology/approach: Semi-structured interviews with key-contacts within a sample of TSOs which had been identified by directors of Adult Social Services as delivering one of the top three preventative interventions in their local authority area.
Findings: There was evidence of considerable trust between local authorities and TSOs and as a consequence TSOs were given autonomy to develop holistic and integrated models of delivery that supported rather than diverted the TSOs’ core missions. Both sectors found it difficult to set target outcomes and connected performance frameworks for preventative services. As a consequence a major element of the commissioning cycle is not being completed and TSOs cannot be confident that they are using their resources as effectively as possible.
Research limitations/implications: This study was based in one English region, and would benefit from being extended to other English regions and home nations.
Practical implications: Universities, policy makers, commissioners and the third sector need to work together to develop common outcome frameworks for preventative services and to gather consistent data sets that can be more easily synthesised to give a “realistic” understanding of the impact of different interventions and delivery models.
Originality value: The paper contributes to the limited evidence bases of commissioning of TSOs and preventative services.
HIRANI Shashivadan Parbati, et al
Background: Home-based telecare (TC) is utilised to manage risks of independent living and provide prompt emergency responses. This study examined the effect of TC on health-related quality of life (HRQoL), anxiety and depressive symptoms over 12 months in patients receiving social care.
Design: A study of participant-reported outcomes [the Whole Systems Demonstrator (WSD) Telecare Questionnaire Study; baseline n = 1,189] was nested in a pragmatic cluster-randomised trial of TC (the WSD Telecare trial), held across three English Local Authorities. General practice (GP) was the unit of randomisation and TC was compared with usual care (UC).
Methods: Participant-reported outcome measures were collected at baseline, short-term (4 months) and long-term (12 months) follow-up, assessing generic HRQoL, anxiety and depressive symptoms. Primary intention-to-treat analyses tested treatment effectiveness and were conducted using multilevel models to control for GP clustering and covariates for participants who completed questionnaire measures at baseline assessment plus at least one other assessment (n = 873).
Results: Analyses found significant differences between TC and UC on Short Form-12 mental component scores (P < 0.05), with parameter estimates indicating being a member of the TC trial-arm increases mental component scores (UC-adjusted mean = 40.52; TC-adjusted mean = 43.69). Additional significant analyses revealed, time effects on EQ5D (decreasing over time) and depressive symptoms (increasing over time).
Conclusions: TC potentially contributes to the amelioration in the decline in users’ mental HRQoL over a 12-month period. TC may not transform the lives of its users, but it may afford small relative benefits on some psychological and HRQOL outcomes relative to users who only receive UC.
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