Putting it into practice: measurement and evaluation

Effective measurement and evaluation of self-management support can provide evidence of impact and insight into potential improvements. This can be done at the individual level, service and organisational level, and commissioning and planning level, taking into account what is important at each level. Measurements from different levels can be combined to provide a complete picture of the effectiveness of self-management support. Although tricky, there are emerging resources that can help with measuring what really matters.

Individual level

Developing an understanding of individuals’ experiences and their desired outcomes enables tailored support to be delivered to people with long-term health conditions. This takes into account people’s sense of wellbeing, quality of life, disability, emotion, sense of social support and their confidence to self-manage. Clinical outcomes are also important, such as biomedical disease markers and medication usage.

A range of tools exist to measure this, such as:

  • Patient Activation Measure (PAM)
  • Health Education Impact Questionnaire (HEIQ)
  • Patient Reported Outcome Measures (PROMs)
  • Person Centred Outcome Measures (PCOM) or Personally Determined Outcome Measures (PDOMs).,

Qualitative approaches such as surveys and interviews with service users can also be effective, alongside emotional touch points and narratives. A combination of these can be best as it can be challenging to find a measure that captures everything related to the individual.

Service and organisational level

Measures at the individual level can be aggregated with service data to provide detail on where and how improvements can be made. This focuses on service users’ access to timely and appropriate services and outcomes for workforces such as job satisfaction and rates of sickness absence.

Measurement tools include:

  • Consultation and Relational Empathy (CARE) Measure
  • Person-Centred Care Assessment tool
  • Health Literacy Questionnaire.

Observing clinical encounters and service user-led ‘mystery shopping’ can also provide insight into these areas.

Commissioning and planning level

Focusing at a population level, outcomes for local people, impact of local services and associated cost-effectiveness can be incorporated. This understanding can help commissioners support current services and develop new services to effectively promote self-management support.

Informed by meaningful involvement of people with long-term health conditions, measurement and evaluation can help create insight to drive changes to support self-management as effectively and efficiently as possible.

Traditional measurement and evaluation commonly focus on activity and clinical outcomes, with little consideration of what people with long-term health conditions think is important. Person-centred outcomes can be complex to design and measure, but working together with people with long-term health conditions to co-design measurement and evaluation approaches will ensure a person-centred focus.

Further reading

Helping measure person-centred care. Health Foundation.

An in-depth summary of the evidence, techniques and strategies for measuring person-centred care www.health.org.uk/sites/default/files/HelpingMeasurePersonCentredCare.pdf

Evaluation: what to consider. Health Foundation.

A quick guide to support evaluation www.health.org.uk/sites/default/files/EvaluationWhatToConsider.pdf

Measuring what really matters. Dr Alf Collins.

Thought paper on the challenges and opportunities of measuring person-centred care www.health.org.uk/sites/default/files/MeasuringWhatReallyMatters.pdf

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