During the first wave of the COVID-19 pandemic, there was an unprecedented level and pace of change in health and care services, with rapid implementation of new pathways and service models, coupled with a dramatic shift to digital and remote provision. This triggered an urgent need to understand whether these major changes were indeed positive changes, or potentially harmful. However, at the time of the first wave there was no pre-existing national approach to evaluating the effectiveness and impact of these changes.
To gain further insight into the issues and potential solutions, UCLPartners led a piece of work as part of the AHSN Network Health and Care Reset campaign to explore how the system might prioritise and resource rapid service evaluations going forward, with a view to shaping recommendations that could help the system learn and grow for the future.
On behalf of the AHSN Network, UCLPartners commissioned the London School of Hygiene & Tropical Medicine to carry out a series of interviews with key stakeholders from a range of organisations and settings to gather evidence of perceptions and experiences across the system. The emerging findings were shared along with regional insights from AHSN colleagues Ben Bridgewater, Chief Executive of Health Innovation Manchester and Sarah Robens, Evaluation Lead and Spread Fellow at South West Academic Health Science Network as part of an AHSN Network sponsored roundtable discussion in December with 12 leaders from national NHS bodies, NIHR national and local organisations, NICE and third sector representatives.
This work revealed some great examples of individual and organisational leadership and innovation during the pandemic in response to the need for rapid evaluation at regional level. These included a local system approach to collectively define trials and diagnostics to evaluate and respond to national priorities on research, and a regional example of rapid development of the approach to service evaluation, allowing teams to gather information quickly and in a way that was meaningful and useful to stakeholders in real-time.
However, the work also highlights the absence of any pre-existing national programme to evaluate the changes in the NHS that were rapidly implemented at scale, and issues related to funding and capacity in the system. While the Beneficial Changes Network programme is a positive step that seeks to address this gap, integrating robust applied research with rapid service evaluation, bigger questions remain about how service evaluations should be prioritised, funded, resourced and conducted in order to better align with the needs of the system.
Our White Paper, Rapid evaluation of health and care services – shaping a sustainable solution for the post-COVID reset draws on the insights of a range of stakeholders to set out recommendations for how rapid service evaluation could be funded, co-ordinated and delivered, not just during but beyond the pandemic.
Read the White Paper, and find out more in this blog, ‘Evaluation of service transformation needs more money, staff and focus’ by Professor Mike Roberts.