Transcript Document

Do health and social care
partnerships deliver better
outcomes for service users
(and how would we know
if they did)?
Jon Glasby, Health Services Management Centre
Doubts over value of £3bn Sure Start
The first major evaluation of the government's
flagship £3bn Sure Start programme… has
revealed no overall improvement in the areas
targeted by the initiative. Although some
Sure Start schemes were successful, an
independent study … revealed that Sure Start
as a whole failed to boost youngsters'
development, language and behaviour. It also
showed children of teenage mothers did
worse in Sure Start areas than elsewhere.
Doubts over value of £3bn Sure Start
cont.
The findings… represent only an early snapshot
of the programme's effectiveness, and
academics involved in the £20m evaluation
emphasise that they do not mean the
scheme, which varies widely around the
country, will not succeed in helping children in
deprived areas in the long term
Outline
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The evaluation challenge (see Helen
Dickinson’s session on Wednesday)
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Key policy challenges
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Is partnership a concept that has had its day?
1. The policy context (in theory)
Partnership
Better Services?
Better Outcomes?
(Do they? How? For whom? In what contexts?)
1. The evaluation challenge
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What are the outcomes of partnership working?
Complex policy initiatives
Multiple stakeholders and perspectives
Proving you’ve prevented something?
Long-term programmes/outcomes
What would have happened anyway?
Etc etc etc.
1. The evaluation challenge

Focusing on evidence of what works v
evidence of what doesn’t work?
 From evidence-based practice to practicebased evidence?
 A new approach to ‘knowledge-based
practice’?
2. The policy context (and the neglect of
social care?)
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Only important when impacting on NHS?
 Whatever happened to the Green Paper?
 The Wanless Review
 Missed opportunities (case management,
commissioning, intermediate care, SAP,
LINks etc.)
2. Key policy drivers – same as the
NHS?
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Demography
 Medical advances
 Financial difficulties (and changes in healthsocial care divide)
 Changing public expectations?
2. Key priorities/questions
Does prevention ‘work’ and how do we do it?
 How should we fund long-term care?
 How do we work with universal services and
the NHS at the same time?
 What is an outcomes-based approach (and
do policy makers really mean what they say)?
 Will direct payments and individual budgets
really bite and, if so, what does this mean?
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3. Is partnership a concept that
has had its day?
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A term that is used, misused and abused?
 Is it worth it?
 Who is accountable if it goes wrong?
 Is there a plan B?
 Will it work when finances get tight?
Etc etc.
3. The importance of being clear about
outcomes
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What outcomes are we trying to achieve?
 How well do we do this now?
 What needs to happen next?
Context ------ Process ------ Outcome
Conclusions
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Increasing scepticism (and this is healthy)
 Need to develop more sophisticated
approaches to ‘the evidence’
 Importance of outcomes
 Don’t through the baby out with the bathwater