Outcomes from social prescribing Evidence from Southwark and elsewhere Jane Harris 16th May 2019

Overview Why measure outcomes in social prescribing? How to choose which outcomes to measure How to choose useful measures of these outcomes What is currently being measured in Southwark? Suggestions for effective indicators to use

A useful way of thinking about outcomes: the logic model IF MONITORING THEN Inputs Activities Outputs Outcomes Impacts £ The resources needed to implement the project / programme, e.g. staff The things the programme does The “products” that result from the activities The immediate consequences and change that are a result of the activities The longer-term results in people’s lives or in a system, which the service or activity may contribute towards, but which go beyond the direct and immediate change

The next step: identifying outcome measures to enable evaluation Outcomes Possible indicators & measurement tools Data collection methods Outcomes for individuals and their carers Improved mental wellbeing Improved scores on SWEMWBS Individual completes every 3 or 6 months (self or 1:1) Increased ability to manage own health Improved PAM scores Outcomes for staff in referral agencies Improved morale Change over time in responses to NHSE survey Electronic or paper? NHSE or local admin? Improved understanding of VCS options Change over time in responses to local survey Possible bespoke e-survey, every 12 months Outcomes for voluntary organisations Increased sustainability Change over time in responses to NHSE VCSE survey Increased capacity to manage referrals Outcomes for the health and care system Reduction in GP consultations Reduction seen per GP records 6 monthly report by GPs? Reduction in hospital bed days Secondary Uses Service (SUS) data Agreement with CSU to supply data for people who give consent

Outcomes being measured in Southwark Increased engagement in activities Increased confidence Increased happiness Increased independence Increased ability to manage own health Improved home environment Reduction in use of health services WAYS OF MEASURING Case studies Bespoke questionnaires (self- report) Friends and Family Test Onward referrals Patient Activation Measure (?) Number of GP appointments (PCN service) Number of A&E visits (PCN service) Hospital admissions (PCN service)

Observations from the review so far Many different approaches being taken to measuring outcomes. Not many services are using validated outcomes measures. Qualitative methods are most popular and in some cases these are most appropriate – for example, some people with dementia may not be able to complete questionnaires. Sometimes there is confusion in reports between outputs and outcomes. There are obvious challenges in devising an approach which is proportionate and feasible within the resources available. In particular, we know it is challenging for voluntary organisations to develop systems for collecting information on outcomes. Accessing health service usage data may be challenging, but worth doing – good partnership working is essential.

Possible criteria for choosing outcome measures Has it been validated and tested to ensure psychometric validity? This is important, because if it has not, the tool is not a reliable measure of the change the service is seeking. How long does it take to complete? Ideally, we would not want to use measures that usually take longer than 5 minutes, as people are less likely to complete them. Who is it aimed at? Is it a measure that is specific to a particular group, or can it be used across service user groups? Is it widely used in similar services? If it is, findings from your service can be compared with findings from elsewhere. Is it free to use? If there is an equivalent measure which is free there will be no need to incur cost. Are there any other considerations? For example, how has the measure generally been received by service users?

Possible tools to use

Thank you and any questions? Finally Thank you and any questions? Jane Harris janeharris@cordisbright.co.uk 020 7330 9170