Local evaluation of Morecambe Bay PACS Vanguard: 12 month report

This report discusses the findings from the first 12 months of the Health and Social Care Evaluation (HASCE) project to evaluate the New Care Model (NCM) programme delivered by Morecambe Bay PACS Vanguard, Better Care Together (BCT). This evaluation, commissioned by the Bay Health and Care Partners, sets out to answer specific questions set by the national New Care Models Team (NCMT). It does this via qualitative data collection and analysis on programme processes and outcomes and a health economics evaluation of resource use and outcome, triangulated with quantitative data provided by University Hospitals Morecambe Bay Trust (UHMBT) Business Intelligence team. The ambition of the NCM requires a more nuanced approach to cause and effect than simple measures of frequency and correlation, as these would be unlikely to capture the specific kinds of change, and the incremental progress this may involve. Consequently, this evaluation is based on a realist approach. This approach assumes that physical and social systems are ordered, yet infinitely complex. Realist evaluation analyses programmes and intervention in terms of their contexts, mechanisms and outcomes. This produces testable hypotheses on who a programme works for, in what context, and why; as part of an ongoing cycle of evaluation. There were a number of challenges concerning the delivery of BCT itself and how this related to the possibilities of its evaluation. The lack of clear and consistent criteria for ‘what success looks like’, the size and shape of particular interventions, where BCT ‘begins’ and ‘ends’ in terms of inclusion of activities, and identifying the specific contribution of vanguard resources to existing interventions in relation to other funding sources were all identified as problems for the evaluators to overcome.