North West London integrated care pilot evaluation

Area of work:

Evaluation, Integrated care

Many health economies around England have been implementing and testing different approaches to integrated care as a way to deliver financial efficiencies along with better quality care and improved patient experience. The Nuffield Trust, in partnership with Imperial College London, has undertaken an evaluation of the North West London integrated care pilot.

In July 2011, North West London launched a large scale and ambitious project to integrate care for its population of older people (over 75s) and those living with diabetes.

The pilot, which spans five London boroughs, brings together organisations from the acute, primary care, community care and social care sectors. Care planning, multi-disciplinary groups and an IT tool for data sharing are being implemented with the intention of creating seamless pathways of care for these often complex groups.

By combining qualitative and quantitative methods we are seeking to understand how effectively the pilot is bringing about cultural and behaviour change, and how it is impacting upon service use

At the outset, the pilot set out some ambitious aims in terms of reduced emergency admissions and potential cost savings.

The Nuffield Trust and Imperial College London have undertaken an evaluation of the first year of the pilot. The study was funded by the Imperial College Healthcare Charity and was organised into four work programmes, each generating its own research volume:

Strategic implementation and policy context: this element, undertaken by the Nuffield Trust, examined how the pilot is operating at an organisational level and how national policy and local contextual factors have shaped it;

Service use and cost: this Nuffield Trust work programme sought to measure the impact of the pilot in terms of service use and cost using an innovative method that links anonymous patient records over time;

Health outcomes: Imperial College London undertook work programme three, which measured the impact of the pilot on health outcomes;

Patient and professional experience: Imperial College London also undertook the fourth component exploring the patient and professional experience of the pilot.

By combining qualitative and quantitative methods, the evaluation sought to understand how effectively the pilot is bringing about cultural and behaviour change as well as how it is impacting upon service use. A short research summary: Evaluation of the first year of the Inner North West London Integrated Care Pilot (May 2013) details the overall findings.

Implemented at a time of far-reaching policy change, the pilot provides a rich insight into the challenges and opportunities that integrated care initiatives are likely to face in the reformed NHS.