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We have been looking at costs of autism diagnostic assessment in NHs in
community child health and hoping to conduct RE looking further at
models of service delivery. Wevhave already looked at cost saving from
an integrated CAMHS, child development service approach to assessing
children with possible autism and or ADHD, conditions which commonly co
occur but often managed in different services. Integrated approach
appears more cost effective and gives better patient journey. Happy to
discuss Janet
Ian male
Consultant community paediatrician.

>----Original Message----
>From: [log in to unmask]
>Date: 05/02/2019 8:36
>To: <[log in to unmask]>
>Subj: Re: Query 2 of 2: Any examples of realist reviews of health
service/system core functions/principles?
>
>
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>
>Hi Rob
>I'm doing a review for the House of Commons Health & Social Care
Committee.
>on models where local care (primary, community, social) are doing the
job
>of integrating systems. I've started with the policy and grey
literature
>(as academic literature tends to be at least 3 years behind what's
>happening. The Parliamentary briefings from 2016-2018 have not
identified
>any economic evaluation.
>
> I've talked to vapour commissioners, who all confirm that investment
in
>some models (such as social prescribing) has been done without looking
at
>demand or estimating capacity. In terms of evaluation, I'm supervising
a
>NIHR Fellow who interviews commissioners and managers nationally and
found
>that most evaluations are focusing on assessing individual health and
>wellbeing using SWEMWBS etc (not economic evaluation). There are small
>scale economic evaluations appearing for a few local projects but they
are
>using diverse methods so apart from being able to note that they all
>indicate value for money it hasn't been possible to synthesise them so
far.
>The theories of change for integration look different but in fact are
all
>based on the same principles, so I think I can produce a model for
that
>aspect.
>
>How far along are you? Do you want to make a contribution to the
review and
>is it worth having a chat at some point. I have a call set up with
Kerryn
>Husk for this Friday.
>
>Best wishes
>Janet
>
>Janet Harris
>Parliamentary Fellow Integration of Health & Social Care
>Reader in Knowledge Mobilisation
>University of Sheffield
>School of Health and Related Research (ScHARR)
>30 Regent Street
>Sheffield S1 4DA
>England
>
>+44 (0)114 222 2980
>
>
>
>
>
>
>
>On Tue, 5 Feb 2019 at 07:33, Anderson, Rob <[log in to unmask]>
wrote:
>
>> PLEASE NOTE: When you click 'Reply' to any message it will be sent
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>> RAMESES List members. If you only want to reply to the sender please
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>> [log in to unmask] from the 'To:' section of your email.
>>
>> Good morning/afternoon/evening Ramesesians.
>>
>>
>>
>> I am working with colleagues to conduct a realist review to examine
how
>> (and why) investing in different core functions of primary care
>> services/systems (e.g. care coordination, first-contact care,
continuity of
>> care, person-centredness/holistic care) may lead to economic impacts
or
>> savings, from a health system perspective.
>>
>>
>>
>> So …
>>
>> Q2. Does anyone know of any good examples of realist reviews that
have
>> sought to identify and evidence causal pathways between the such
core
>> functions/principles within health systems/services, and the
performance*
>> of those health systems/services?
>>
>> * e.g. effectiveness, efficiency, cost.
>>
>>
>>
>> I appreciate this is a somewhat broader question than my Q1!!
>>
>>
>>
>> Many thanks,
>>
>> Rob
>>
>>
>>
>>
>>
>> *I aspire to achieve a sensible work-life balance: *
>>
>> *I don’t expect a reply to any emails outside of your normal working
>> hours. Similarly please expect the same from me.*
>>
>>
>>
>> *Rob Anderson*
>> Associate Professor of Health Services and Implementation Research
>>
>>
>>
>> Director of ESMI <http://medicine.exeter.ac.uk/esmi/> research
group
>>
>> Programme Director of MSc in Applied Health Services Research
>> <http://www.exeter.ac.uk/postgraduate/taught/medicine/health-services-research-msc/>

>>
>>
>>
>> +44 (0)1392 726085
>>
>> ESMI, South Cloisters, St. Luke’s campus
>>
>>
>>
>> *Quote of the month(-ish):*
>>
>>
>>
>> “An accurate concise, and unbiased synthesis of available evidence
is
>> arguably one of the most valuable contributions a research community
can
>> offer decision makers.”
>>
>> “ … there needs to be a culture shift so that evidence synthesis is
>> recognised as an exciting, intellectually challenging, high-status
and
>> respected activity for researchers.”
>>
>>
>>
>> From Donnelly et al 2018 ‘*Four principles for synthesizing
evidence*’. Nature,
>> Vol.558, 361-364 <https://www.nature.com/articles/d41586-018-05414-4>.

>>
>> Encouragingly, the co-authors include Prof Chris Whitty
>> <https://www.gov.uk/government/people/christopher-whitty>, Chief
>> Scientific Adviser to the Department of Health and Social Care, so
also
>> leads the NIHR.
>>
>>
>>
>>
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