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CASE STUDY: pH Associates (an OPEN Health company) and NHS Service Evaluation

The focus of NHS service evaluation is to define or assess current care, and the real world insights gained from service evaluation can be incredibly powerful for informing best practice and optimising patient care. pH Associates (an OPEN Health company), the Real World Evidence Experts, have a wealth of knowledge and experience in designing and running service evaluations in the NHS, as the following case studies show:

An evaluation of outpatient services at a leading IBD centre

With limited resources and an increasing caseload, the NHS team recognised that service change was needed to ensure the continuing delivery of world class care to their patients. However, with the existing challenges to the service poorly understood, a mixed methodology service evaluation - including both retrospective and prospective data collection - was designed to identify the opportunities for service improvement. The insights gained from the service evaluation allowed the team to focus on making sustainable improvements to their service, including the implementation of joint multidisciplinary MDT clinics which reduced the number of separate hospital visits that patients had to make. The project has also formed the template for a series of IBD service evaluations at other NHS Trusts, and has also recently been submitted for a Health Services Journal Award.

An evaluation of a novel cardiac rehabilitation model at a single NHS Trust

The impact of a locally redesigned cardiac rehabilitation (CR) service was assessed using a joint service evaluation and research study approach. Outcomes data collected retrospectively from patients referred to the previous service, were compared to data collected prospectively from patients referred to the new service. The findings were positive, demonstrating that following service redesign, CR uptake and completion rates increased, time from discharge to entering CR decreased, and six-month cardiac-related emergency readmissions were reduced. The results of the service evaluation and study have been presented at the British Association for Cardiovascular Prevention and Rehabilitation Conference (2015), and published in BMC Cardiovascular Disorders.

Evaluating the impact of the introduction of direct oral anticoagulants in primary and secondary care

A number of direct oral anticoagulants (DOACs) are now in use in the UK, and while DOACs don't require the same intensive monitoring as warfarin, the impact of their introduction on NHS services is poorly understood. To evaluate this, two local anticoagulation service evaluations were performed - one in a hospital and one in general practice - consisting of service mapping interviews, retrospective review of patients' medical records, and a patient experience survey. In the secondary care service, where uptake of DOACs was high, the service was able to reduce the number of clinics it ran while still seeing more patients, following DOAC introduction. Patients also had fewer anticoagulation-related hospital inpatient admissions in the post-DOAC period. In the primary care setting, where DOAC uptake was lower, the service structure and staffing remained largely the same, although patient numbers increased modestly following DOAC introduction. In both services, patients treated with DOACs reported having fewer questions or concerns about their treatment compared to non-DOAC patients. The findings from these two very different anticoagulation services following the introduction of DOACs, have formed the basis for abstract submission to the British Society for Haemostasis & Thrombosis Conference (2017).

For further details about pH Associates (an OPEN Health company) and its Real World Evidence offerings, please contact Samantha Oliver or Amanda Pulfer, Joint Managing Directors at pH Associates either via email: SamanthaOliver@phassociates.comAmandaPulfer@phassociates.com, or telephone: 01628 897 968