Better access, better care, better lives: Barking, Dagenham, Redbridge and Havering Prime Minister’s Challenge project

Within this project we are evaluating two services as part of the Barking, Dagenham, Redbridge and Havering Prime Minister's Challenge Fund: a patient-centred primary care service for people with complex care needs and new out-of-hours GP hubs.


Published: 10/03/2017

Project status: Completed

1. Management of individuals with complex care needs

Barking and Dagenham, Redbridge, and Havering (BHR) CCGs have been implementing a new integrated service (Health 1000) for older people with multiple care needs. The aim has been to provide more co-ordinated care: bringing together what have been provided by a mix of primary, secondary and social care services and, where possible, bringing care to the individual rather than the other way round. The intended result has been better quality care with reduced pressure on existing services.

The Nuffield Trust is evaluating this service by assessing the following:

  • who is using the new service
  • the experiences and views of individuals using the new service
  • the experiences and views of staff delivering the service
  • the impact on the use of healthcare resources (primary and secondary)
  • the impact on health outcomes
  • the impact on cost.

2. The impact of a single specialist primary care provider for older people in nursing homes

In 2006, the Health 1000 service that has been providing integrated care for older people with complex needs took over all primary care provision for residents of four nursing homes within the three boroughs.

The Nuffield Trust have been commissioned to evaluate the impact of this change on the way residents of the homes use of hospital services and to assess the experiences of staff delivering care.

3. Improving access to primary care through the provision of additional out-of-hours capacity

The Nuffield Trust was commissioned by the Barking and Dagenham, Havering and Redbridge (BHR) Clinical Commissioning Groups to evaluate their local initiative to improve public access to primary care by providing additional capacity outside of core hours. This initiative was part funded by the Prime Minister’s Challenge Fund, with extra funding from the CCGs.

The Nuffield Trust has adopted a mixed methods approach combining analysis of local patient data with information from interviews and surveys of patients and staff. The focus of the evaluation is on the following key questions:

  • Has the availability of primary care services increased across the three boroughs?
  • Has the provision of the new primary care services improved patient access?
  • What is the impact of extended primary care provision on other health care services in the area?
  • Has the provision of the new services improved patient outcomes including patient experience?
  • What is the impact of the new primary care services on cost?