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Research & theory

Evaluation of complex integrated care programmes: the approach in North West London

Authors:

Felix Greaves ,

Imperial College London, GB
About Felix

Clinical Research Fellow, Department of Primary Care and Public Health

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Yannis Pappas,

GB
About Yannis

PhD MA, Lecturer, School of Health Sciences, City University London, UK EC1VOHB

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Martin Bardsley,

GB
About Martin
PhD FFPH, Head of Research, The Nuffield Trust, London, UK. W1G 7LP
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Matthew Harris,

GB
About Matthew
DPhil MBBS, Clinical Lecturer, Department of Primary Care and Public Health, Imperial College London, UK. W6 8RP
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Natasha Curry,

GB
About Natasha

BA, Senior Fellow, The Nuffield Trust London, UK. W1G 7LP

 

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Holly Holder,

GB
About Holly
MSc, Researcher, The Nuffield Trust London, UK. W1G 7LP
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Ian Blunt,

GB
About Ian
MSc, Senior Research Analyst, The Nuffield Trust London, UK. W1G 7LP
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Michael Soljak,

GB
About Michael
PhD FFPH, Research Fellow, Department of Primary Care and Public Health, Imperial College London, UK. W6 8RP
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Laura Gunn,

GB
About Laura
PhD MS, Associate Director and Biostatistician, Department of Primary Care and Public Health, Imperial College London, UK. W6 8RP
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Azeem Majeed,

GB
About Azeem
MD FRCGP, Professor of Primary Care, Department of Primary Care and Public Health, Imperial College London, UK. W6 8RP
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Josip Car

GB
About Josip
MD PhD, Clinical Senior Lecturer, Department of Primary Care and Public Health, Imperial College London, UK. W6 8RP
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Abstract

Background: Several local attempts to introduce integrated care in the English National Health Service have been tried, with limited success. The Northwest London Integrated Care Pilot attempts to improve the quality of care of the elderly and people with diabetes by providing a novel integration process across primary, secondary and social care organisations. It involves predictive risk modelling, care planning, multidisciplinary management of complex cases and an information technology tool to support information sharing. This paper sets out the evaluation approach adopted to measure its effect.

Study design: We present a mixed methods evaluation methodology. It includes a quantitative approach measuring changes in service utilization, costs, clinical outcomes and quality of care using routine primary and secondary data sources. It also contains a qualitative component, involving observations, interviews and focus groups with patients and professionals, to understand participant experiences and to understand the pilot within the national policy context.

Theory and discussion: This study considers the complexity of evaluating a large, multi-organisational intervention in a changing healthcare economy. We locate the evaluation within the theory of evaluation of complex interventions. We present the specific challenges faced by evaluating an intervention of this sort, and the responses made to mitigate against them.

Conclusions: We hope this broad, dynamic and responsive evaluation will allow us to clarify the contribution of the pilot, and provide a potential model for evaluation of other similar interventions. Because of the priority given to the integrated agenda by governments internationally, the need to develop and improve strong evaluation methodologies remains strikingly important

How to Cite: Greaves F, Pappas Y, Bardsley M, Harris M, Curry N, Holder H, et al.. Evaluation of complex integrated care programmes: the approach in North West London. International Journal of Integrated Care. 2013;13(1):None. DOI: http://doi.org/10.5334/ijic.974
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Published on 08 Mar 2013.
Peer Reviewed

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