Evaluating the impact of a joint social care and NHS initiative to promote social participation and patient activation for older people in North Wales

In Wales, the number of people aged 65+ is projected to increase by 55% between 2012 and 2035, representing more than a quarter of the population.

1- Rates of chronic diseases are also rising. Public expenditure on social care and continuing health care for older people is expected to rise.

2- New legal powers within the Social Services and Well-being (Wales) Act will necessitate Local Authorities and Health Boards to work together to identify need, promote well-being and develop integrated services. The Health Precinct in Conwy is an example of such an initiative.

Aims of the research: To undertake a realist evaluation of the Health Precinct to develop an explanatory theory of 'what works, for whom, why and in what contexts' for related programmes that seek to integrate social and health care services to enable social participation. In addition, we will quantify the social return on investment generated by the programme.

Objectives:

1- To understand participants engagement with the programme; the impact on their social participation; how/whether they have been involved with co production
2- To analyse the demographic data of all participants to determine the distribution of key parameters: age range, gender and socio-economic deprivation
3- To undertake a social return on investment analysis to explore the social value generated
4- To identify and track the implementation and engagement mechanisms and processes used by the Health Precinct, and their inter-relationships in service user, organisational level and social contexts and evaluate intended and unintended impacts over time
5- To determine if/how the programme develops and sustains interactions and promotes the development of social participation and independence
6- To generate programme theory that provides an understanding of the relationship of the factors that are important for the replication of this and related programmes

The main research question is - What impact does the Health Precinct programme have on the wellbeing and social participation of its participants, and what are the factors that lead to successful implementation of, and engagement with, the programme?

This will be evaluated through four sub questions:

1- What is the demographic distribution of participants, including age, gender and deprivation?
2- What is it about the Health Precinct that works for service users, how and in what contexts?
3- What are the barriers and enablers to successful implementation of the programme for individuals and within its broader organisational, social and policy contexts?
4- What is the social return on investment of the programme?

Plan of investigation:

Three work-streams are planned:

WS1: A realist evaluation of engagement and impact of the Health Precinct from the perspective of service users and other relevant stakeholders.
WS2: Mapping the demographics of service users.
WS3: A social return on investment analysis Potential benefits to social care service users and the organisation and delivery of effective social care services in Wales.

All too often, services are designed by clinicians rather than by users of services. Service users are at the centre of this research, with a strong PPI element being present throughout. Evaluation of the Health Precinct and what works for whom and why will allow more informed decision-making about resource allocation.