Evaluation of New Care Models Evaluation of Complex Care conference Nuffield Trust, 22 June 22 June 2015

New Care Models programme announced in Five Year Forward View to contribute to addressing three “gaps” 2 Radical upgrade in prevention Health & wellbeing gap 1 1 New models of care Care & quality gap 2 2 Efficiency & investment Funding & efficiency gap 3 3

New Models of Care Multispecialty Community Providers - moving specialist care out of hospitals into the community Integrated primary and acute care systems - joining up GP, hospital, community and mental health services Acute care collaboration - local hospitals working together to enhance clinical and financial viability Enhanced health in care homes - offering older people better, joined up health, care and rehabilitation services Urgent and emergency care - new approaches to improve the coordination of services & reduce pressure on A&E departments.

29 Vanguards developing their visions locally 4 Care modelApplicant PACSWirral University Teaching Hospital NHS FT PACSMansfield & Ashfield & Newark & Sherwood CCGs PACSYeovil Hospital PACSNorthumbria Healthcare NHS Trust PACSSalford Royal Foundation Trust PACSLancashire North PACsHampshire & Farnham CCG PACSHarrogate & Rural District CCG PACSIsle of Wight Care modelApplicant MCPCalderdale Health & Social Care Economy MCPDerbyshire Community Health Services NHS FT MCPFylde Coast Local Health Economy MCPVitality MCP West Wakefield Health and Wellbeing Ltd (new GP Federation) MCPNHS Sunderland CCG and Sunderland City Council MCPNHS Dudley Clinical Commissioning Group MCPWhitstable Medical Practice MCPStockport Together MCPTower Hamlets Integrated Provider Partnership MCPSouthern Hampshire MCPPrimary Care Cheshire MCPLakeside Surgeries MCPPrincipia Partners in Health Care modelApplicant Care HomesNHS Wakefield CCG Care HomesNewcastle Gateshead Alliance Care HomesEast and North Hertfordshire CCG Care HomesNottingham City CCG Care HomesSutton CCG Care HomesAiredale NHS FT

Improved health & wellbeing, care & quality and efficiency, at scale Widespread adoption of new models of care which have positive impact Models of care that improve outcomes and efficiency Well designed models Based on sound theory of change Evidence- and best- practice- based Well implemented models Rapid cycle evaluation and improvement Evaluation shows improvement in outcomes and efficiency Against local metrics Models of care that are replicable Knowledge of “active” ingredients Role of context Interventions used and part played Knowledge of implementation Codification and transmission of knowledge Disseminated and taken-up Against national outcome metrics Elements of the evaluation Evaluation to support the aims of the programme

What is the context? How was model developed? What interventions are planned? What enablers are needed? What impacts are expected? Is implementation as planned? Barriers? What is working and not working, and why? What are the early results: outcomes, numbers of people affected, changed processes? What is the final model? What have been the outcomes and impacts? What are the key elements of success? During planning and set up (pre April 2016) During implementation and model development After implementation is complete Evaluation to understand the elements of the new care models, how they are implemented, what effects they have, for whom, how and why To develop and describe new care models, for implementation across the country, which will improve health outcomes and efficiency. Monitoring of impact comparing national outcome metrics with counterfactual Monitoring of progress against outcome, output and process metrics Interviews, qualitative and quantitative research to establish the “how” and “why” NCM aim Evaluation aim Evaluation phases and questions to be answered Evaluation activities Evaluation needed across the life-cycle