A new piece of guidance has been published by NHS England that makes recommendations on how to measure personalised care.
‘Measuring supported self-management: Five steps to help teams choose approaches’ is available to read online and was authored by Professor Debra De Silva at The Evidence Centre.
Self-management is a key pillar of the NHS Long Term Plan – to encourage people to manage a range of health conditions at home, thereby avoiding trips to hospitals. The measurement of self-managed care also plays a key role in tracking the progress and efficiency of personalised care services.
The guidance set out provides five steps to achieve good supported self-management, and they are:
Step 1: Identify and involve stakeholders
Step 2: Clarify what you want to achieve
Step 3: Decide what to measure
Step 4: Decide how to measure
Step 5: Plan who, when and where to measure.
The steps are designed to be linked but do not need to complete in sequence.
The first step is all about communicating with key stakeholders and creating a shared vision that will benefit patients. As well as stakeholders, communicating with those who have long-term health conditions, and providers of supported self-management interventions or services that collect and analyse information, could be pivotal to a successful self-management project.
The guidance says, “sometimes people make decisions about what to measure without consulting others. This can mean different services or teams use varying measures. The benefit of using the same measures as others in your health and care system is that you can then track changes over time and embed measuring supported self-management across the system.”
The next step is based on setting a solid target for the measurement of self-management.
The guidance says: “Don’t jump straight into trying to choose a measure, survey or tool without being clear about what you are trying to achieve. If you first think through what you are doing and why you will find it easier to decide what to measure and how.”
Mapping what you want to achieve is also set out in the guidance.
The third step is about which indicators are best to measure and the guidance sets out examples for healthcare teams.
The guidance says that the best indicators are often:
Comparative: so you can compare over time or between user groups or services.
Understandable: if your team does not understand what a metric is measuring, it will be harder to use in practice, as it will not feel meaningful or helpful.
Easy to quantify: numerical information is easier to compare and monitor over time. It tells you by ‘how much’. Ratios, rates or proportions are usually easier to compare than absolute raw numbers. However, qualitative information helps you answer ‘why’, so it can also have an important place in your measurement strategy. You should also be able to answer the question, ‘what will I do differently based on the measure?’ If you cannot, the metric may not be useful.
The fourth step in the guidance gives more detail on how to decide what to measure and how to measure it. The report recommends the best methods for this research and includes surveys, interviews, and focus groups.
Finally, the fifth step covers who, when and where to measure, and details on how to finalise and address any practical issues that remain. Key recommendations are also set out in the conclusion of the guidance: plan when to measure, allow enough time to test your approach, make sure everyone is trained and informed, and plan how the information will be analysed and shared.
The full guidance is available online here.