A new direction in population health management?
The world of population health management is no longer purely the domain of academics, public health policy makers, strategic commissioners and health data anoraks. It’s shifting into the mainstream.
It’s well understood that with demand for healthcare continuing to outstrip the growth in resources, there’s a greater imperative than ever for health systems to align resources to interventions and cohorts in a way that delivers the best population health outcomes.
What is less well understood is how to deliver it in practice.
Whilst we know that prevention is better than cure, making the case for shifting resources to preventative measures and early intervention is challenging given the intense pressures faced by frontline health services. Even in the new world of sustainability and transformation plans, tensions can still arise when the ‘right thing to do’ from a long-term, whole-system perspective clashes with the short-term interests of individual organisations or stakeholders.
In this context, we need an approach to population health management that is both evidence-based and pragmatic. How do we go about it?
One of the keys is embedding evaluation in business as usual. Too often evaluation is an afterthought – a ‘nice to have’ if there’s money available. In reality, it should be at the heart of everything the NHS does, driving all its decision making. We need to know which interventions work and which don’t, in what contexts and for what cohorts. For interventions that are working, we need to know how to make them even better, and how to successfully apply them at greater scale.
To do this, we need to apply robust quantitative and qualitative analyses to identify the active ingredients in successful interventions. An example of this is Capita’s recent evaluation work with the Rushcliffe and Mid Nottinghamshire Vanguards, where we used a range of evaluation methods to get beneath the surface of interventions – quantifying the outcomes being achieved and, crucially, unpicking the contextual and non-contextual factors driving the outcomes.
One key element of this is building a much better understanding of user behaviour. Sometimes new interventions in the NHS don’t lead to the shifts between care settings that are expected, simply because the understanding of user behaviour is poor. It’s crucial that we go beyond traditional patient surveys to other sources, such as discreet choice analysis and patient activation measures.
Because population health management is so huge, it can be hard to know where to start, or what direction to take next. For that reason, we’ve created a practical guide to help NHS organisations and systems take the next steps on their journey.
To guide you on the incremental steps that you could take to become an Integrated care system, we’ve created a hub of helpful of practical guides, opinion pieces and case studies, where we draw upon our experience of supporting the transition from pathfinders to vanguards and STPs to emerging integrated care systems and underline the guiding principles for supporting transformation to an integrated care system.