New Care Model - Local Evaluation of Morecambe Bay PACs Vanguard

The new care models programme, being implemented through the vanguards, aims to catalyse the widespread adoption of new models of care that improve the health and wellbeing of patients, the quality of care that patients receive, and the efficiency of the overall system. Evaluation of the vanguards is an essential component of achieving these goals and is a core part of the approach that has been developed by the central evaluation team at NHS England.

The overall aim of this study is to undertake a detailed process and impact evaluation of the Better Care Together Morecambe Bay PACs Vanguard . The study should be both formative and summative in its design. As such, it should be used to shape the delivery of the programme as it is delivered, as well as provide summative findings on the impact that the programme is having. The design of the evaluation must account for the local contextual factors with the interventions the vanguard is testing.

There are a set of common principles and a number of evaluation questions to ensure findings are useful both locally and nationally (see Local Evaluation Strategy Section 3):

• What is the context (e.g. history, culture, economic and social circumstances, relationships, health inequalities, local and national policies, national legislation) in each vanguard into which new care models have been implemented?
• What key changes have the vanguards made and who is being affected by them? How have these changes been implemented?
• What is the change in resource use and cost for the specific interventions that encompass the new care models programme locally? How are vanguards performing against their expectations and how can the care model be improved?
• What expected or unexpected impact is the vanguard having on patient outcomes and experience, the health of the local population and the way in which resources are used in the local health system e.g. equality? This should be compared against a counterfactual in which the vanguard interventions have not been delivered?
• Which components of the care model are really making a difference?
• What is causing the outcomes demonstrated in particular elements of the programme, systems, patients or staff?
• How will the attribution of outcomes within the vanguard be assessed?
• What are the ‘active ingredients’ of a care model? Which aspects, if replicated elsewhere, can be expected to give similar results and what contextual factors are prerequisites for success?
• What are the unintended costs and consequences (positive or negative) associated with the new models of care on the local health economy and beyond?

As well as providing value to the Better Care Together Morecambe Bay PACs Vanguard and its wider local health economy, the evaluation should generate an evidence base that will enable the central new care models team to answer key policy questions about the spread and replicability of the new care models

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