Impact and benefits
The response to Year of Care has been overwhelmingly positive from everyone involved, be they people with conditions, clinicians, or managers.
The pilot programme demonstrated important impacts on patient and clinical experience and behaviour, practice organisation and wider influence on local health communities in diabetes.
The core philosophy and prototype was successfully tested for transferability to 12 other communities using quality assured training and support. The prototype has now been adapted for other single and multiple long term conditions (LTCs) and for people with multimorbidity.
Care planning has also been successfully introduced to specialist care settings, and into the Personal Health Budgets programme.
Impact of systematic care planning during the pilot and roll out programme is summarised for Year of Care evidence base and impact:
- People with LTCs reported improved experience of care and real changes in self care behaviour
- Care planning works across diverse populations thus addressing inequalities
- Professionals reported improved knowledge and skills, and greater job satisfaction
- Practices reported better organisation and team work
- Productivity improved - care planning is cost neutral at practice level, there are savings for some
- Care planning takes time to embed; changes in clinical indicators across populations may be seen after two of three care planning cycles
- The adoption of care planning stimulated wider system redesign.
Paul McClintock, a GP involved in the original care planning pilots, explains the benefits he has seen:
Impact of Year of Care Partnerships in diabetes
Care planning with people with type 2 diabetes became the norm in the majority of practices across our pilot communities; 76% on practice registers experienced at least one care planning consultation.
In the disadvantaged community of Tower Hamlets where indicators of diabetes were among the worst 10% in England, a number of improvements have been seen in a relatively short period of time:
- Positive answers to the question ‘have I had about the right amount of involvement in my care?’ rose from 52% in 2006 to 82% in 2009.
- By 2012: 95% had at least one annual care planning consultation and 40% had more than one.
- 96% had the three ‘traditional’ components of diabetes care (HbA1c, BP and cholesterol) measured·
- The proportion of people with ‘good’ control of all three indicators for development of diabetes complications (HbA1c, blood pressure and cholesterol) increased from 24% to 35% (England average 20%).
- The National Diabetes Audit reported that 72.4% of people had all nine NDA items measured in the previous 15 months. This is the highest percentage in England (average 54.3%)
- Specialists now regularly work with primary care colleagues in quarterly multidisciplinary meetings.
Further details about the impacts and benefits for people with LTCs, clinicians and commissioners are described in detail in the final Year of Care report.