Box 1.

Evaluation of initiatives arising from Our Health, Our Care, Our Say

Initiative	Description of initiative	Description of evaluation
Care closer to home demonstration sites	New services in community, aiming to reduce demand on hospitals. Included GPs with special interests, community-based consultant clinics, telephone support. Five demonstration sites in each of six specialities.	Aim: to describe organisation and implementation, impact on access, quality, and costs. Design: interviews with providers and commissioners, postal survey of patients using new services and a limited number of control patients. Compared costs of new services in six sites against national tariff.
Improving Access to Psychological Therapies	Two demonstration sites based on different approaches to significantly expanding availability of psychological therapies: high volume low intensity or case management.	Aim: to assess organisational implications of the new approaches and whether they are cost-effective and acceptable to patients. Design: cohort study of costs and outcomes for patients in demonstration sites compared with control sites and national datasets; mixed methods study of system impacts; questionnaire and qualitative study of patient experience.
Individual budgets	Service users allocated budgets according to social care needs that can be used to purchase care, equipment, housing, and employment support.	Aim: to assess implementation, cost-effectiveness, and user experience. Design: randomised controlled trial plus interviews with service users, carers, and staff.
Information prescriptions	Individualised information in relation to needs. Twenty pilot sites established, providing different forms of information prescription for different types of patients.	Aim: to assess effectiveness and impact on patients and services and to gather learning about implementation. Design: qualitative research with staff; survey of patients, carers, and staff; collection of data about activity and estimates of resources used; action learning events with pilot sites.
New types of workers	Twenty-eight pilot sites developing a range of new care roles intended to address policy objectives such as patient-centred care, improved access, supporting care at home.	Aim: to support pilot sites to develop new roles and management systems. Design: documentary analysis of pilot proposals and reports; interviews and focus groups with managers, workers, and people using services.
NHS LifeCheck	Self-assessment tools to help people identify their health behaviour and make changes. Developed around three lifestages: parents of babies; teenagers; mid-life. Pilot sites established for each lifestage.	Aim: to gain feedback about improving the tools and to explore their acceptability to potential user groups. Design: interviews and focus groups with potential users and staff, a survey of young people, and analysis of use of the website for Teen LifeCheck.
Partnerships for Older People Projects	Twenty-nine pilot sites were established to develop and evaluate innovative partnerships between health, social care, and third sector agencies to promote health and independence of older people.	Aim: to develop explanatory framework to understand most effective approach. Design: documentary analysis; collection of activity data from pilot site; interviews and focus groups with service users; a survey of people before and after accessing a partnership; comparison with routine data about emergency data from non-matched control sites.
Self-referral to physiotherapy	Six pilot sites allowed patients to refer themselves for physiotherapy rather than needing referral from a doctor.	Aim: to evaluate impact in terms of waiting times, changes in activity and identify uptake by different groups of people. Design: historical and prospective data about activity and waiting times, a minimum data set about patients following introduction of self-referral, and feedback forms from GPs and physiotherapists.
Social enterprise pathfinders	Twenty-six pathfinder projects to develop organisations providing a range of community health and social services on a social enterprise model.	Aim: to assess success in meeting social enterprise pathfinder goals. Design: mixed methods including interviews, focus groups, workshops, telephone survey of pathfinders, and collection of data on costs. Mainly formative approach.
Whole System Demonstrator sites	Three primary care trusts designated as demonstrator sites. Implemented integrated health and social care through system redesign. Focus on people with long-term conditions or complex needs supported through assistive technologies.	Aim: To assess impact on service use, patient outcomes, cost-effectiveness, patient, carer and providers experiences, factors associated with successful implementation. Design: large cluster randomised controlled trial with nested qualitative research on users and providers experiences.