RSS 1.0Evidence and Knowledge Mobilisation
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New care models - what's the evidenceAs health and care economies start to plan how they will deliver against the commitments in the NHS Long Term Plan for England, it's a good time to reflect on how the thinking and learning from the Five Year Forward View might be taken forward. Notably, the New Care Models programme, which set out a series of different models of care. We've blogged previously about the evidence review we were commissioned to deliver by the National Institute for Health Research's Health Services and Delivery Research programme. Ours was one of five reviews funded - we looked specifically at the Multispecialty Community Provider model, which focused on an enhanced role for primary care. Since completing our report, we've been working closely with the project leads of the other four evidence reviews funded to collate and share our findings. We've prepared a high level summary of the five reviews, available to download here, to provide a quick view of the headline messages.
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Reviewing the evidence on digital inclusionDigital technology is a significant part of our daily lives. It has changed the way we interact with each other, the services we use, and the ways we work. The NHS is no exception. Digital technology has begun to change the way health and care services are delivered. And the Covid-19 pandemic radically accelerated the use of these technologies – speeding the transition to delivering remote care, for example. Every technological change brings advantages and drawbacks. The best uses of new technology will realise the gains while minimising the risks: both sides of this equation need to be identified and planned for. Widening inequalities is a widely cited risk. A significant proportion of people are currently digitally excluded, meaning they are unable to engage in digital care. Furthermore, people who are digitally excluded are more likely to be socially disadvantaged and already experience health inequality. So how can we reap the benefits of digital health while not worsening inequalities? What barriers do digitally excluded people face, and how can they be overcome? We have published an evidence signpost and an evidence scan on digital inclusion covering such questions (links below). This work was commissioned by Hereford and Worcestershire ICS prior to the Covid-19 pandemic to help support their ‘Primary Care Accelerator Programme’. Findings are likely to be of use to others planning digital health care. Please get in touch with any comments or questions by emailing shiona.aldridge@nhs.net
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Unplanned admissions: rapid evidence scanThe summary builds on our previous work exploring interventions to reduce unplanned admissions (Aldridge and Turner, 2013) and provides an update of the literature published since 2013. In the interests of time, this review has focused on secondary research only, in the form of syntheses of evidence and systematic reviews. This helps to ensure a focus on research-based findings which have been tested and validated; however, learning from practice may offer valuable lessons, particularly on new and emerging approaches, if highly contextual.
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Referral management: rapid evidence scanThis rapid scan of the evidence base on demand management formed part of a broader analysis of the current challenges and opportunities to manage demand, specifically within the context of a primary-care led model. The aim of the review was to identify relevant research and practice-based evidence to inform an overall approach to demand management.
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Integrated care: rapid evidence scanThis rapid evidence scan was prepared to summarise evidence in relation to integrated care, to inform a series of local workshops to inform service redesign. The review explores what integration can mean in different contexts, evidence on effectiveness and cost effectiveness, lessons for implementation and considerations for measurement and evaluation.
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Evidence review: Early diagnosis of cancerThere is room for improvement in current performance. In 2018, 55% of cancers were diagnosed in ‘early’ stages; the target is to diagnose 75% by 2028. But how? For services trying to improve performance, where should they start? Which cancers pose the greatest risk if not discovered early? Which population groups are most at risk? What service changes are likely to be effective in improving early diagnosis? The Black Country and West Birmingham ‘Healthier Futures’ Academy commissioned us to look at these questions. We didn’t find any sliver bullets in the literature, but the evidence did illuminate several ways forward that can be explored and developed. These findings are likely to be of use to other areas. So, as part of our commitment to share our work for public benefit, it is presented here.
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Autism evidence scan identifies knowledge gapsDiagnosing autism takes account of a person’s differences in social interaction and communication, sensory sensitivity, interests and behaviours. Yet autism varies hugely from person to person, both in how it looks and how it is experienced. This is because the term autism covers a broad range of different conditions, rather than a single category or condition. Understanding and accounting for this variation presents challenges for local organisations which plan and deliver services for autistic people. The high volume and coverage of academic research on autism means that making sense of the evidence can be difficult for commissioners and other professionals involved in organising and delivering these services.
