Centre for Health Services Studies, University of Kent, Canterbury, Kent, UK.
Weston Education Centre, King's College London, London, UK.
Health Soc Care Community. 2019 Jul;27(4):1085-1094. doi: 10.1111/hsc.12726. Epub 2019 Feb 5.
We report on two evaluability assessments (EAs) of social prescribing (SP) services in South East England conducted in 2016/7. We aimed to demonstrate how EAs can be used to assess whether a programme is ready to be evaluated for outcomes, what changes would be needed to do so and whether the evaluation would contribute to improved programme performance. We also aimed to draw out the lessons learned through the EA process and consider how these can inform the design and evaluation of SP schemes. EAs followed the steps described by Wholey, New Dir Eval 33:77, (1987) and Leviton et al., Annu Rev Public Health 31:213, (2010), including collaboration with stakeholders, elaboration, testing and refinement of an agreed programme theory, understanding the programme reality, identification and review of existing data sources and assessment against key criteria. As a result, evaluation of the services was not recommended. Necessary changes to allow for future evaluation include gaining access to electronic patient records, establishing procedures for collection of baseline and outcome data and linking to data on use of other healthcare services. Lessons learned include ensuring that: (a) SP schemes are developed with involvement (and buy in) of relevant stakeholders; (b) information governance and data sharing agreements are in place from the start; (c) staffing levels are sufficient to cover the range of activities involved in service delivery, data monitoring, reporting, evaluation and communication with stakeholders; (d) SP schemes are co-located with primary care services; and (e) referral pathways and linkages to health service data systems are established as part of the programme design. We conclude that EA provides a valuable tool for informing the design and evaluation of SP schemes. EA can help commissioners to make best use of limited evaluation resources and prioritise which programmes need to be evaluated, as well as how, why and when.
我们报告了 2016/7 在英格兰东南部进行的两次社会处方（SP）服务评估（EA）。我们旨在展示如何使用 EA 来评估一个计划是否准备好进行结果评估、需要进行哪些更改以及评估是否会有助于提高计划绩效。我们还旨在总结 EA 过程中获得的经验教训，并考虑如何将这些经验教训应用于 SP 计划的设计和评估。EA 遵循了 Wholey 等人描述的步骤，《新 DirEval》33:77（1987 年）和 Leviton 等人，《年度公共卫生评论》31:213（2010 年），包括与利益相关者合作、详细阐述、测试和完善商定的计划理论、了解计划现实、确定和审查现有的数据源以及根据关键标准进行评估。因此，不建议对服务进行评估。允许进行未来评估的必要更改包括访问电子患者记录、建立收集基线和结果数据的程序以及与其他医疗保健服务使用数据进行链接。经验教训包括确保：(a) SP 计划的制定要有相关利益相关者的参与（和支持）；(b) 从一开始就制定信息治理和数据共享协议；(c) 人员配备足以覆盖服务提供、数据监测、报告、评估和与利益相关者沟通所涉及的各种活动；(d) SP 计划与初级保健服务相结合；以及 (e) 建立转诊途径和与健康服务数据系统的联系作为计划设计的一部分。我们得出结论，EA 为 SP 计划的设计和评估提供了有价值的工具。EA 可以帮助决策者最佳利用有限的评估资源，确定需要评估的计划以及如何、为何和何时进行评估。
