Developing an evaluation framework for personalised care 

A report by Kirsteen Redmile, Lead Change Manager for the It's All About People Personalisation Programme.   

In June 2023, colleagues came together to support the development of an evaluation framework.

The work intends to provide reporting options for both the It's All About People Personalisation Programme Team and the wider system.

Our ambition is to be able to recognise the progress being made by the team, within the wider context of the system, along with the work of our extended family of empowered, enabled, champions and ambassadors. 

The first phase was to agree an approach. Supported by the NHS Lincolnshire Integrated Care Board (ICB) Population Health Management (PHM) Team, we discussed the merits of a 'logic model' approach and exchanged thoughts on how difficult this task could be. The PHM team highlighted the potential enormity of a system-wide evaluation instead of an intervention-specific one. 

We spent time looking through the various individual plans and funding submissions to find common goals and objectives that had been set for our team. We themed these by cutting up printouts, moving items between groups, and eventually sticking them down onto a flip chart. We now had our 'buckets' - the eight ‘containers’ of our outputs.

We invited strategic partners and people with lived experience to attend a Microsoft Teams meeting, facilitated by the PHM team, where we asked people to think of long-term objectives for personalisation to be realised in Lincolnshire.

The list grew exponentially as contributions were made, supported, and expanded.

Those taking part and submitting their ideas included the NHS Lincolnshire ICB Living with Cancer team, Every-One Lincolnshire (on behalf of co-production), Lincolnshire County Council, Lincolnshire Partnership NHS Foundation Trust (LPFT), United Lincolnshire Hospitals NHS Trust (ULHT), Lincolnshire Community Health Services NHS Trust (LCHS), NHS Lincolnshire ICB and more. 

The once empty logic model was now weighted heavily towards long-term outcomes, so the process of filtering began. Volunteers came forward to create a small working group that would make sense of the copious notes and ambitions. 

Prior to this work, the system had been looking to create a new relationship between people and the health and care system in Lincolnshire. Our Shared Agreement had been developed and contains Five Foundations. It was felt that the outcomes in the logic model fitted well into these Foundations and that to achieve commonality of language, it would be beneficial to continue their use.

Three further areas cut across the foundations: Workforce, Involved and in control, and Choice and taking risks. 

The outcomes were collated under each of the headings and then separated into short, medium, and long-term headings.

The short-term headings were decided by the current level of stakeholder engagement, so these are more straightforward to achieve.

The medium-term headings related to objectives that required more work with the people of Lincolnshire to achieve. 

Finally, the long-term headings were those that required everyone to be engaged and so would take much more time to achieve a consensus. 

It was then time to identify the types of activities and outputs required to achieve the outcomes in the short, medium and long term. These were pulled from further workshops with stakeholders, team meetings, and our previous buckets exercise.

We also looked at the ‘Together We Can’ statements to help influence our thoughts.

By the end of August, we had two lists of activities and outputs; System and Personalisation Team, so it was time to reconvene the stakeholder group for a second workshop facilitated by PHM colleagues.

On the 5 September, we presented our work back to the wider group and shared with them an ambition to create two SMART objectives for each of the Our Shared Agreement Five Foundations previously discussed.

Several break-out rooms later and we are delighted to see them starting to take shape.

Whilst language and nuance start to push and pull, the overall sense of progress is inspiring. It is not yet complete, but it feels like we are making sense of a complex world and we look forward to being able to share further progress with you after the next session.  

To contribute to our evaluation framework, please contact us.