Local priorities – informing intervention design
Carl Bennett, FCIMSPA, founder/director, Amber Health Insight
Carl introduced the session by explaining that he will help identify where and what strategic information you should be aware of and aligning your interventions towards. He explained that he will ask you to stop and think about how you might generate measurable impact at the local level. The session aims were to provide all operations-based individuals with a great starting point to building interventions that deliver change.
Three main themes:
The session started with quotes from the world of science:
“Anyone who has never made a mistake has never tried anything new”
“Individuals that are poorly adapted, are less likely to survive”
Carl introduced examples of various health reports and explained that to be of value, “all information, data and priorities need to be valid, reliable and current”.
The annual health profiles that Public Health England produce were discussed – Leicester was used as an example. A health profile is a 4 page summary of local priorities.
This comes with a ‘health warning’ – the public need to be involved if things are going to change.
The main emerging issues are:
- Health inequality and inequity: differences in health status or in the distribution of health determinants between different population groups.
- Health literacy: the skills which determine the motivation and ability of individuals to gain access to, understand and use information in ways which promote and maintain good health. It is critical to empowerment. For example, in Stoke on Trent, 49% of the local population have been identified as having poor health literacy – a massive communications challenge.
- Segmentation: The process of defining and sub- dividing a large homogenous market into clearly identifiable segments having similar needs, wants or demand characteristics.
- Commissioning: Carl’s definition is “the act of investing targeted resources (people and £) with the aim of improving health, reducing inequalities and enhancing customer experience using the available evidence and ensuring value for money for the outputs produced and that these align with the local priorities to produce measurable outcomes”
A Sport England youtube video was played which helped illustrate the commissioning concept, titled “Mission impossible”.
Possible disrupters to the cycle were discussed, including continuing austerity, social prescribing and the well- intentioned but ineffective efforts of some service providers who, for example, might provide a traditional sports development programme without aligning it to actual needs.
Diagram: The commissioning cycle, showing where our sector usually “sits”.
Carl made clear that this is what the whole process is about. Why are they important? Answer: they provide an end result of a consequence. Formal structures and models are needed to work effectively in an “outcome-focused” way. A useful example is the “logic model” template which provides a mechanism for demonstrating outcomes. It is a linear process: products and services > service outputs > benefits > intermediate outcomes > overarching strategic outcomes.
Using tools to generate evidence is crucial: if you don’t evaluate – prove your products/services work – then what’s the point? As providers, we need to prove our interventions work. Carl pointed out that in the current climate services that don’t take this approach will get cut. Carl outlined how multiple sources of evidence exist to shape/inform intervention design in health, such as that from NICE, BHF, CLOA, Sport England and the LGA. Public Health England in particular are encouraging all stakeholders to be “data savvy”. And of course, it’s what we DO with the data that’s important. As one quote puts it: “data is the crude oil – it’s how you refine it, how you work with it, that makes it valuable”.
Carl reminded the audience of the key points covered:
- Identifying valid, reliable and current ‘local’ data information and priorities.
- Evidence building is your chance to stand out from the crowd.
- Continuous “horizon scanning” for emerging issues is key.
- “Outcomes” are of absolute importance.
- The importance of data science.