Integration of health and social care services is complex and costly. The evaluation of the effectiveness of integrated care is challenging due to the nature of integration but is necessary if the argument for integration is to be sustained.
Dr Nick Goodwin of The Kings Fund identified 'For health and care systems it is important to adopt and use a set of measures that align with the main elements of a national, regional or local strategy for person centred coordinated care. The complexity and the necessary variety in how integrated care strategies need to be developed, means that outcomes and measures need to be chosen to suit local and national priorities.'
Frequently asked questions
How can you measure impact of integration?
There are a range of models that can be used to measure the impact of integration. Most of the NHS programmes have nationally defined models. Measuring the impact of integration can be a challenge. In addition to nationally defined measures locally defined metrics may be required to ensure that local objectives/requirements are being met.
The Policy Innovation Research Unit identified the following outcomes associated with integration:
(a) securing better outcomes and experiences for individuals, and (b) obtaining better use of resources across health, care and support systems at national and local levels.
What forms of evaluation are used
The Policy Innovation Research Unit (PIRU) has identified that the following forms of evaluation are commonly used:
- The New Models of Care Vanguards are utilising a Logic model to aid locally defined evaluation of outcomes and service effectiveness. This model clarifies and graphically displays what the proposed programme intends to do, accomplish and impact. It is commonly utilised in Outcomes Based Approaches (Link to outcomes based commissioning section) as it encourages an outcomes based focus rather than process based focus.
- New Models of Care Core metrics have been established of: Finance and efficiency metrics, Care and quality metrics and Health and wellbeing metrics.
- The Commissioning for Quality and Innovation (CQUIN) scheme establishes national metrics to evaluate health services but also local milestones which (amongst other objectives) evaluate the process of integration.
- BCF Metrics are defined nationally and include measures of DTOC, non-elective admissions to nursing/residential placements and reablement effectiveness.
- Dashboards are nationally defined service specific metrics established by NHS England for the evaluation of quality through defined metrics. Dashboards are a means of drawing comparisons cross providers.
Case studies and examples
LGA support and resources
LGA Inform a repository for information that contains 80 performance data sets that local government bodies are required to submit.
Selected tools and resources from our partners
- 2010 to 2015 government policy: local council transparency and accountability Appendix 5 Single Data List
- NHS Outcomes Framework
- Public Health Outcomes Framework
- Adult Social Care Outcomes Framework (ASCOF)
- Health Education Outcomes Framework
- HSJ blog Sir John Oldham and Jacquie White: The art of the impossible – capitated budgets for long term conditions
- Using Logic Models in Evaluation: A briefing
- New Care Models evaluation: Core metrics
- CQUIN Guidance
- Local CQUIN Guidance
- PIRU Integrated care and support Pioneers: Indicators for measuring the quality of integrated care. Final report
- Evaluating Integrated and Community Based Care: How do we know what works?