Evaluating Person Centred Coordinated Care (PCCC) in Somerset, UK

Problem

Care that is person centred and efficiently coordinated is a priority for individuals, carers, professionals, commissioners and policy makers. The South West Peninsula CLAHRC, in collaboration with South West Academic Health Science Network (SWAHSN) is conducting an evaluation of Person Centred Coordinated Care (PCCC) in Somerset, a county expected to see a significant increase in those aged 65+. Our aim is to evaluate how the new Test and Learn initiative, in South Somerset, Taunton and Mendip is building on the developments of the Symphony project to addresses PCCC.

Approach

This project is part of a wider programme of work to develop practice based theory and support service development for PCCC using a consistent evaluation framework. Using a three tiered longitudinal mixed method approach, the evaluation encompasses qualitative data, structured questionnaire data and service use and cost data. Service use data captured for the entire cohort will allow us to assess patterns of health and social contact following exposure to the intervention and calculate costs. Staff experience data will provide their perspective of the new ways of working, whilst patient perspectives are being sought to assess if care has improved and if there are improvements in health, well-being, perceptions of loneliness and self-management. Core to the approach is an iterative feedback to practice cycle and frequent interrogation and tracking of change of the logic of the intervention model over time.

Findings

Early findings highlighted the complexities in the delivery of the model through comparing site differences: type of hub operation (physical/virtual hub), funding availability, rurality, patient inclusion criteria and IT capacity. These are being captured as part of an iterative feedback loop to help develop and refine the intervention model and support service delivery. The complexities of starting and delivering the service have been documented. Baseline qualitative interviews have been conducted with service users (n=10, for each of the three sites), with follow-ups to take place at six and twelve months. These service users also answered structured questionnaires. A larger cohort (n=100) from each site will also answer the same questionnaires. Qualitative interviews will be conducted with members of staff (n=15, across the three sites). The preliminary results, as well as the logic models for each site, will be presented.

Consequences

It is anticipated that this will contribute towards a robust delivery model for ongoing learning in PCCC by allowing us to detect changes in personal well-being for patients, processes of care delivery, sustainability of the intervention and key performance indicators such as admissions, mortality and bed days per capita. Our aim is to provide evidence of quantifiable and comparable change over time to the outcomes and processes of care for patients by embedding core processes into routine practice.