Building an evaluation framework for personalised care that can start to show a new relationship between people and the health and care system.

Kirsteen Redmile - October 2023.  

How can we do this? Demonstrate the impact of personalisation, strength-based approaches and new relationships that can sometimes be seen as the 'pink and fluffy stuff' and too hard to do? 

In June 2023, colleagues and people with lived experience came together to start to answer that question, and through creative and innovative ways develop an evaluation framework that enables us to demonstrate the importance and impact of working in a personalised and strength-based way and how that can lead to new and improved relationships.  

Our ambition is to clearly show the effect of personalisation on people, workforce and the wider health and care system, whilst acknowledging that this is about generational behaviour change and therefore a long-term commitment from the Lincolnshire Integrated Care system.  

This work will also help 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.  

We started by understanding the work that was already going on and how this could support our ambition; the ‘Our Shared Agreement’ is a programme of work that has been set up by colleagues and people with lived experience to start to explore, illustrate and articulate what a new relationship could and should look like between people and the Lincolnshire Health and Care system.  

To date, the Our Shared Agreement has 5 Foundations, which will and should change over time, and really resonate with the Personalisation programme so we agreed to find a way to include them in this work;

Supported by the Population Health Management (PHM) Team, we discussed the merits of a 'logic model' approach, how we could build in the 5 foundations and exchanged thoughts on how challenging this task could be as a system-wide evaluation framework instead of a specific area of focus.  

We agreed that we would use this approach and that both teams would learn together.  

We spent time looking through the various individual plans and funding submissions to agree on the common goals and objectives for our team and the wider system.  We themed them by cutting up printouts, moving items between groups and eventually sticking them down onto a flip chart. We now had our 'buckets'. (A loving term to describe eight ‘containers’ of our outputs.)  

Collaborating, we invited strategic partners and people with lived experience to attend a virtual meeting, facilitated by the PHM team, where we asked people to think of long-term outcomes for personalisation which could be realised in Lincolnshire (5+ years) and did they fit into our buckets or not.  

The list grew and grew as contributions were made, supported, and expanded by people and colleagues from a range of organisations and programmes, such as the living with cancer team, maternity, Every-One, LCC, LPFT, ULHT, Lincs ICB, LCHS and LVET.   

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 to make sense of the copious notes, views, thoughts, and exciting ambitions.  

We collated the outcomes under each of the 5 foundations and 3 cross cutting themes; 'Workforce', 'Involved and in control', 'Choice and taking risks'. These were separated into short (up to 2 years), medium (up to 5 years), and long-term (+5 years) buckets.  

It was then time to identify the types of activities and outputs that could be done to work towards achieving our outcomes. These were pulled from further workshops with stakeholders, team meetings and our previous buckets exercise. We also looked at the Think Local Act Personal (TLAP) ‘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 5th 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 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. 

More to come on the ‘Our Shared Agreement’ in the November ‘It’s all about people’ Sway.