Slides from the first North East Hampshire and Farnham evaluation symposium on prevention, which took place on the 10 January 2017.

1. Evaluation Symposium
1: Prevention
Happy, Healthy, At
Home
Workshop 1:
Early findings
from the
Farnham locality

2. Deep dive evaluations are being undertaken for 3 new models of care:
• Centralised Urgent Care Centre
• Integrated Care Team
• Referral Management Service
The evaluations focus on the progress made and impact of the new
models of care being implemented
This session: Demonstrates some of the ways of evaluating how people
are using health services before and after the new care model
Early findings from the Farnham locality
evaluation

3. Examining the impact of new ways of working in primary care: how can we
evaluate the impact of Farnham Centralised Urgent Care Centre?
The New Care Model: To provide a central point of access for urgent primary care
appointments for 4 GP surgeries, diverting ‘urgent’ patients and generating capacity in
GPs (not yet launched)
Key evaluation questions:
• Is capacity in GP practices being released?
• Are waiting times for routine appointments reducing?
• Is there a reduction in the number of A&E and out of hours attendances?
(Compared with an equivalent period prior to implementation of the service?)
• What are the cost benefits of the service?

4. Farnham Centralised Urgent Care Centre:
some data pre-implementation of the full facility
Initial results (for A&E Attendances and OOH calls):
Other areas we can look at:
• Waiting times for GP routine appointments
• Length of GP routine appointments
• Length of GP working day

5. Examining the impact of integrated working: how can we evaluate the
impact of integrated care teams?
The New Care Model: To provide integrated care through MDT input to patients in the
community, with a focus on admission avoidance and early discharge planning
Patients are allocated to the integrated care team as appropriate to their needs
Key evaluation questions :
• Are the number of emergency admissions for MDT appropriate conditions reducing,
or at least is further growth being prevented?
• Is the emergency admission length of stay for MDT appropriate conditions reducing,
thus indicating earlier discharge?
• Is the ambulance service able to show decreased conveyance rates through closer
integration with the integrated care hub?
• What are the cost benefits of the service?

6. • Data collection has begun for ‘avoided’ A&E attendances and ambulance
conveyances
Farnham Integrated Care Teams: early findings
Initial results for emergency admissions (all conditions, per 1000 weighted population):
Since launch, total emergency admissions for
Farnham patients have started to reduce
This is not seen in other NEHF
localities

7. Farnham Integrated Care Teams
• Sample analysis of ICT registered patients, based on activity 120 days either side of referral for
emergency admissions and A&E attendances
• This has shown a positive impact in terms of A&E attendance and emergency admission rates
Initial results demonstrating impact of ICT’s on A&E and emergency admissions:

8. The New Care Model: To more accurately determine the most appropriate route for all
non-urgent, routine medical and surgical referrals
Key evaluation questions :
• What is the volume of referrals being reviewed?
• How many of the reviewed referrals fall into the following categories:
• Proceed with referral, with or without additional exploration of alternatives
• Re-direct referral to an alternative service
• Where do re-directed referrals go to?
• What impact does this have on secondary care activity?
• What are the cost benefits of the service?
Examining the impact of new ways of managing referrals from GPs: Farnham
Referral Management Service

9. Referral Management Service
Purpose: To more accurately determine the most appropriate route for all non-urgent,
routine medical and surgical referrals
Initial results:
Referrals to the service
Referrals to the service
Service Activity - Findings:
(Ave) / week
redirected
of all cardiology
referrals redirected
of all T&O
referrals redirected
• Pain & Rheumatology
referrals generally allowed
to proceed
Redirected referrals

10. Referral Management Service
• Total GP referrals had been increasing
• Levelled out since start of RMS and
begun to decrease
• Also analysed for 4 main local
providers (Frimley Park Hospital
receives most)
• Too soon for robust findings but early
indications are good
What is the Impact on Acute Services?
GP Referrals to Secondary Care Acute Outpatients
• Analyse patients discharged after first
appointment
• Specialties where most redirections occur
• Decreasing numbers could indicate that
acute referrals are appropriate

11. Methods of evaluating use of health care services:
summary
Our approach for evaluation of Farnham new care models:
• A range of tools being used
• Bringing together different metrics appropriate to each care model
• Analysing the new care setting and impact on acute care/primary care
• Various user-friendly visualisation methods, including:
• Trends
• Activity hotspots
• Length of stay distribution
• Varying age groups
• Specific service users where possible