We've got to talk about outcomes
The Talking Points Person Outcomes Framework is an evidence based framework comprising the views of people living in the community who use care services about what is important to them in life and the impact of health and social care services on outcomes. This report considers the reporting and use of personal outcomes information in the context of self-management support and the applicability of the framework within different care contexts and at different levels of decision making.
The report recognises that what it means to implement a Personal Outcomes Approach will vary by context, with different implications for each of the core practice elements: engaging, recording and using outcomes information. The Personal Outcomes and Quality Measures project has investigated the implications for these components for a number of scenarios, each with a focus on Support for Self Management.
This work found similarities in approaches to engagement and to some extent in recording practices. However, the Project found significant differences in data use, with efforts to make the links between individual assessment and care plan data and service level and strategic decision making remaining very much in their infancy in health. The project also identified a growing recognition of the importance of addressing the emotional, psychological, social and cultural implications of living with a long term condition, and a firm emphasis on addressing health inequalities. As such, the continued use of measures that are based on narrow understandings of health related quality of life and that neglect the social and material circumstances of people’s lives is increasingly questionable. The inclusion of information derived from outcomes focused support planning in service planning and commissioning decisions holds significant potential, and may be essential in more integrated delivery contexts.
The Project also undertook to test the applicability of the Talking Points Outcomes Framework For People Who Use Services in different care scenarios supporting people living with long term conditions, and to refine as necessary. This work found that very few additional high level outcomes types were required (and these were already recognised as important context-specific additions within the Talking Points Practical Guide). However, it was necessary to ‘unpack’ many of the outcome types into the more specific expressions they found within the care setting. While the resultant set of outcomes ‘prompts’ were developed primarily for use with new and seconded staff within the care setting, existing practitioners have also found them helpful, particularly in highlighting the different layers and depths within many of the outcomes categories. It is hoped that the ‘prompts’ may find wider applications, either directly or by prompting reflection about the applicability of the high level outcome categories across diverse care contexts.
A full set of documents relating to the Personal Outcomes and Quality Measures project is available on the Health and Social Care Alliance Scotland website.