Future evaluation of the Integrated Personal Commissioning programme

Mapping the logic and assessing evaluability

by Megan Sim, Catherine L. Saunders, Eleanor Winpenny, Tom Ling

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The Integrated Personal Commissioning (IPC) Programme is a new programme that joins up health and social care funding for individuals with complex needs and gives them greater control over how their combined health and social care budget is used. Nine demonstrator sites have been selected for the first wave of roll-out, which began on 1 April 2015.

RAND Europe was invited by NHS England to provide support for the nine demonstrator sites, and at the national level, in collaboration with the NHS England team at this early stage of roll-out. RAND Europe carried out a workshop with each site to support the development of the logic model behind their local plans, and to identify suitable metrics to measure local progress against these logic models. With the national team, RAND Europe used this learning from the workshops to help define how to evaluate the IPC programme with a common logic model, and provide advice for evaluation going forward.

We found that there are differences in how well prepared each site is for an evaluation, though all are in a position to draw upon and adapt the generic theory of change model and therefore have a model that can be evaluated. Ongoing evaluation could help produce site-level data to support local decision-makers and also support future decision-making nationally. Both of these aims would be supported by common measurements collected across the sites, and by a comparative evaluation.

Key Findings

Within IPC there were three core streams of activity leading to desired outcomes.

These three streams are around empowered individuals, sustainable commissioning and a vibrant market of providers. The main impact agreed across sites was the improved quality of life for patients and their carers. Reduced institutional and acute care, and more efficient use of money and resources, were also identified across sites as overall impacts for IPC.

There are differences in how well prepared each site is for an evaluation.

All are in a position to draw upon and adapt the generic theory of change model and therefore have a model that can be evaluated. However, each site has recognised that they are unlikely to get it right the first time and that they will want to adapt and improve their activities.

Recommendations

  • An ongoing evaluation could help produce site-level data to support local decision-makers. In addition, a scheme-wide evaluation could draw together the lessons from the first cohort to support future decision-making nationally.
  • The methodological approaches and issues identified in this report should feed into the design of a future evaluation of the demonstrator sites as well as a national evaluation.
  • The national evaluation will need to capture elements across all three core strands of the programme, and elements across activities, outputs, outcomes and impacts. The evaluation will also need to be able to compare IPC results to a counterfactual.

Table of Contents

  • Chapter One

    Context and introduction

  • Chapter Two

    Rationale for logic models

  • Chapter Three

    Logic model development

  • Chapter Four

    Evaluation design

  • Chapter Five

    Discussion

The research described in this report was sponsored by National Health Service (NHS) England and conducted by RAND Europe.

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