Chapter 9
Completing the cycle: evaluation

It is all very well planning development or setting up a new service, such as extending your range and activity in supporting self care. But is the outcome what you planned for, and are the developments sustained? This chapter suggests how you might monitor or evaluate that your PCT or practice team now promote and support self care for patients and the public as you set out to do.

Evaluation and monitoring are essential components of any programme or service. Incorporate these into any plan to establish a culture of self care or support self care, from the beginning. Time and effort spent on evaluation should be in proportion to the activity that is being evaluated. Keep it as simple as possible and avoid wasting resources on unnecessarily bureaucratic evaluation.

Evaluation sets out measurable targets and timescales that are realistic for the particular context and problems of the population group you are monitoring and auditing. Agree on short, medium and longer term outcomes with all the ‘stakeholders’ in the PCT and/or practice, before the evaluation begins.1 There are always risks that other factors may crop up that are not under your control and that the outcomes you originally expected if your initiative worked well, are no longer viable or possible.

Use an approach that is appropriate and relevant to your patients or local population:

agree what criteria you will use for the outcome of the evaluation, e.g. that you
measure what you set out to measure
invite external review either from an independent person (e.g. the PCT facilitator) or by comparing what you have done against external standards (e.g. what another PCT or practice that is known for its self care work has done)
assess how well you have done in one area. You might include one or more of: activity, personnel, provision of service, organisational structure or objectives, in your evaluation. You might focus on self care support in relation to particular health topics like sore throat, back pain, asthma or cough.

What to evaluate

You might assess any or every aspect of your strategy and plans for supporting self care and how they were put into practice. Here are some ideas you could use for evaluation - most of them are challenging:

everyone participated in the actual initiative, by measuring their performance
the objectives of the action plan to promote and support self care were well phrased, simple, measurable, achievable, realistic and timely
everyone supported and adhered to any changes within the action plan
the proposed strategy for self care support and associated action plan were implemented
training needs that were identified were addressed appropriately
the way that self care was promoted and supported justified the effort and cost
there was good leadership of the self care support strategy and action plan throughout the PCT and/or practice team
progress achieved in promoting and supporting self care was conveyed to everyone affected and results discussed
there was an emphasis on teamworking and support
the PCT/practice culture and environment were conducive to supporting self care
the quality of patient care was improved; health and wellbeing was improved.

Design the evaluation

You might focus your evaluation on:

1 what actually happened – such as the content of self care support interventions

2 how it worked out – how well the self care support interventions were put into practice; how well the different components were integrated

3 the outcome –what you achieved as a result of your self care support interventions.

You might evaluate the ‘what’, ‘how’ and ‘outcome’ of your various self care support programme, or just one of these, such as the ‘how’ only. Evaluating the outcome, and what you achieved or the changes made to the service you provide to patients as a result, will be more challenging to evaluate than the ‘what’ and the ‘how’ aspects.

part 2

Chapter 9 Completing the cycle: evaluation

What to evaluate

Design the evaluation

Chapter 9
Completing the cycle: evaluation