Evaluation of Integrated Care in Wigan
As part of their integration programme, Wigan partners have put in place Integrated Neighbourhood Teams (INTs) across the Borough. The role of the INT is to provide a multi disciplinary approach to the case management of people identified as being at high risk. WSP has undertaken a two year evaluation of the INTs adopting an action learning approach, with ongoing feedback to local partners as the work progressed. The evaluation framework was developed through local engagement to identify ‘what would constitute success’. The resulting framework covered four domains – service utilisation, patient / client and carer experience and outcomes, co-ordinated services and access to services. For service utilisation local partners wanted to look at the impact of people being placed on one of four pathways (INT, GP, EoL and mental health / drugs & alcohol).
The evaluation has adopted a range of approaches. Detailed quantitative analysis at a Borough and locality (3) level has been undertaken to identify if there have been quantifiable benefits achieved through people being placed on a pathway. In addition, a dashboard was developed at a cluster (16) level that allows local partners to investigate at a more granular level local impact. To assess the sustainability of the quantitative benefits of INT pathway implementation a system dynamics model was constructed. This allows ‘what if’ questions to be asked.
A key feature of the evaluation has been the use of a Relational Value (Rv) tool to assess the quality of local relationships. Relationships were seen as a key factor in delivering co-ordinated services. The tool was used to assess, in a structured and systematic way, relational value between INT Facilitators and GP practices – a key relationship.
Wigan partners have used the findings of the evaluation as it has progressed to refine their approach to INTs and their broader integration programme. The findings are now being used to inform and shape the commissioning of integrated community hubs.