1. Copyright 2014 Right Care Mara Airoldi Systems Modelling for Performance Optimisation & Service Equity Department of Management London School of Economics March 2014 Commissioning for Value STAR - Socio-technical allocation of resources Engaging stakeholders in decisions Online Learning Series Right Care for Populations

2. STAR tool Socio Technical Allocation of Resources Available for free (with supporting material) at: http://www.health.org.uk/learning/star/ http://www.health.org.uk/learning/star/

3. When is STAR most helpful? Routine data analysis Strategic decisions, identification of problems Modelling, ‘deep dive’

4. STAR for commissioning value: 3 components 1.Social process – to engage stakeholders – ‘Decision Conferencing’ (LD Phillips) – A structured conversation 2.Technical models grounded in – Health economics (cost/QALY principle) – Decision analysis (possibility to include equity & feasibility criteria) 3.Visual aids – To make difficult concept easier to understand

5. STAR as a structured conversation: key questions addressed What interventions are/should be available? Who benefits? How many people benefit? How much do they benefit? How much does it cost?

6. Commissioning value Data required Scale Costs Value (population benefit) Horse & rabbit stew ✖ Value ✔ Scale ✔ Costs

7. Star for commissioning value Data Visual Models CostsValue Scale Stakeholders: managers, doctors, patients & carers, agencies

8. Visual models: 3 visual aids 1.Rectangles of population health 2.Value for money triangles 3.Efficiency frontier

9. Numbers who benefit Population health gain Average QALY gain per person Rectangles of population health

10. costs Population Health gain QALY gain / person Numbers who benefit VfM Value for Money (VfM) Triangles Value

11. Population health gain Good VfM Costs Good or poor VfM? -ve VfM Poor VfM

12. A theory of priority setting against budget constraint? Costs Budget constraint QALYs Size of triangle matters A

13. Star for commissioning value Data Visual Models CostsValue Scale Stakeholders: managers, doctors, patients & carers, agencies

14. 14 Online Learning Series Right Care for Populations Follow Right Care online Subscribe to get a weekly digest of our blog alerts in your inbox, Receive occasional eBulletins Follow us on Twitter @qipprightcare Find the full series at: www.rightcare.nhs.uk/resourcecentre Find the STAR tool and supporting resources at: http://www.health.org.uk/learning/star/ Full Star Casebooks can be found at: www.rightcare.nhs.uk/resourcecentre