North of Scotland Public Health Network Implementation of the National Delivery Plan for Specialist Children’s Services in the North of Scotland: Developing a Needs Based Approach to Evaluation
Project Summary Context – NDP Specialist Children’s Services – North of Scotland Planning Group (NoSPG) – North of Scotland Public Health Network (NoSPHN) – National Public Health Network (ScotPHN)
Stage 1 CONTEXT: A strategic, needs based, approach to planning with evidence of added value and the health impact of investment 1. Need to clarify your plans by demonstrating understanding of: – the need and extent of the need (problem) including baseline data (so impacts pre and post investment can be measured) – evidence base for the services / interventions proposed – the political and policy contexts – the current and past efforts to address the need or problem and lessons learned from these efforts 2. Matching to regional criteria (priorities) 3. Demonstrate how you will know if you have achieved your desired outcomes (developing indicators to measure outcomes) in short (12 and 30 months?) and longer term.
Logic model methodology – Needs assessment / evidence – Resource inputs – Activities – Outputs – Outcomes / impacts
Delivering the evaluation • Service staff are responsible for measuring and demonstrating outcomes • What support will be required? – NoSPHN staff (capacity? / advisory role) – Commission out (buy some help in) – Build capacity within services to deliver – Working across the other regions / nationally? • Develop the model so it is transferable across other regional service developments (ideally)? • Agreement on method asap and in place by end of year.
Stage 2: Evaluation applied to regional projects • Child and Adolescent Neurology Network • Paediatric Gastroenterology • Network to support delivery of General Surgery in Childhood ISD National Quality Indicators Group
Examples of Populated Models • ‘Working backwards to move forwards’ • Building the logic chain through an outcome-based approach • Practical example being developed: the neurology network
North of Scotland Public Health Network – North of Scotland Child & Adolescent Neurology Network (NeSCAAN) Working Backwards to Move Forwards I s a Regional Approach Appropriate to Delivering your Clinical Service? (Based on NoSPG Regional Planning Criteria) Yes No Step 1 – Moving from I dentifying Needs and the Evidence-Base to I dentifying Outcomes Outcomes/ I mpacts Outputs Activities Resources/ I nputs Needs Assessment What benefits, in What resources are Evidence-base What services need What activities need Step Step Step terms of outcomes, required to What are the needs of to be delivered to to be undertaken to 3 4 2 should your patients undertake activities your patients? achieve the stated deliver your service? experience from your within your service? What is the evidence- benefits/outcomes Service? base for your service? for your patients? I dentify, Agree and Specify Below (Examples of) Clinical Outcomes Clinical Outputs Clinical Activities Clinical I nputs Clinical Needs - Rate of misdiagnosis - Peripheral specialist clinics - Develop specialist nurse - Provision of keto- - Specialist care - Type of neurological e.g. neuromuscular clinic genic and assessment - 2 0 epilepsy and 3 0 assessment undertaken. - Develop peripheral and diets - Number of children neurology clinics specialist clinics - Radiography Non-Clinical commenced on anti- equipment Needs epileptic drugs Non-Clinical Outputs Non-Clinical Activities - Medication - Co-ordinated - MCN Steering Group - Establish MCN Steering care plans Non-Clinical Outcomes - Programme of Group Non-Clinical - MCN accreditation education and training - Develop programme of Resources/ I nputs Evidence-Base - Children and carer (CPD) CPD events - Specialist medical, - SIGN guidance satisfaction with service nursing, AHP staff - NICE guidance - Network Manager
Outcomes/ I mpacts Outputs Clinical Outcomes - Rate of misdiagnosis Clinical Outputs - Type of neurological - Peripheral specialist clinics assessment undertaken e.g. neuromuscular - Number of children 2 0 epilepsy and 3 0 - commenced on anti- epileptic neurology clinics drugs Non-Clinical Outputs Non-Clinical Outcomes - MCN Steering Group - MCN accreditation - Programme of - Children and carer education and training (CPD) satisfaction with service
North of Scotland Child & Adolescent Neurology Network (NeSCAAN NeSCAAN) ) North of Scotland Child & Adolescent Neurology Network ( Children resident within the North of Scotland requiring assessm Children resident within the North of Scotland requiring assessment, treatment and follow ent, treatment and follow- -up care in relation to up care in relation to REACH REACH neurological conditions of which childhood epilepsy accounts for approximately 50% of paediatric neurology practice neurological conditions of which childhood epilepsy accounts fo r approximately 50% of paediatric neurology practice (Target (Target Population) Population) Long- -term consequences term consequences High Level, Long High Level, Long- -Term Outcomes Term Outcomes Long [National Policy - - National Delivery Plan National Delivery Plan [National Policy Scottish Government Strategic Scottish Government Strategic Objectives] Objectives] Intermediate Outcomes Intermediate Outcomes Programme/Service Objectives Programme/Service Objectives Benefits resulting from the service Benefits resulting from the service Short Term Outcomes Short Term Outcomes Outcomes related to service delivery Outcomes related to service delivery Services delivered Services delivered Outputs Outputs What needs to be done to What needs to be done to Activities/Processes Activities/Processes deliver the service deliver the service “Results Results “ Resources/Inputs Resources needed to Resources needed to Resources/Inputs Chain” Chain ” deliver the service deliver the service of the Logic of the Logic Model Model Needs- - Assessment Assessment Needs Evidence- Evidence -base base Outcome- -Focused Approach Focused Approach – – A Framework for A Framework for Outcome Evaluation Evaluation
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