Effectiveness Evaluation: Health and Social Care

Effectiveness Evaluation: Health and Social Care

Review of the effectiveness of caps on indemnity cover for doctors in private practice

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Value for Money Report - The Efficiency and Effectiveness of Long-Stay Residential Care for Adults within the Mental Health Services

Value for Money Report – The Efficiency and Effectiveness of Long-Stay Residential Care for Adults within the Mental Health Services Executive Summary and Contents PDF 164kb Chapters 1 and 2 – Introduction and Service Objectives PDF 504kb Chapter 3 plus annexes – Service Effectiveness and Efficiency PDF 3.7mb Chapter 4 – Service Resources PDF 2.4mb Chapters 5, 6 and 7 – Future Funding and Alternative Approaches, Key Performance Indicators, Conclusions and Recommendations PDF 2.4mb Appendices 1 to 6

Report On Public Consultation: Efficiency And Effectiveness Of Disability Services In Ireland

Report On Public Consultation: Efficiency And Effectiveness Of Disability Services In Ireland Click here to download PDF 1.67MB Other Relevant Documents: Click here to download Appendix A PDF 1.06MB Click here to download Summary of Key Proposals from The Review of Disability Policy PDF 250KB

National Clinical Effectiveness Committee (NCEC) Annual Report 2013

This first Annual Report of the NCEC outlines the activity of NCEC and provides information on the development for the first time in Ireland processes for prioritisation and quality assurance of National Clinical Guidelines. The Annual Report sets the agenda for NCEC going forward in line with its terms of reference. Of note two National Clinical Guidelines were quality assured by NCEC and endorsed by the Minister for Health in 2013. These are National Clinical Guideline No. 1 – National Early Warning Score and National Clinical Guideline No. 2 – Prevention and Control Methicillin-Resistant Staphylococcus aureus (MRSA). The implementation of National Clinical Guidelines is a significant patient quality and safety initiative and will improve health outcomes for patients, reduce variation in practice and improve the quality of clinical decisions. Quality assured National Clinical Guidelines will help to further improve the quality, safety and cost effectiveness of healthcare across Ireland. Download the Report  

ASIST suicide prevention training - all-island evaluation report

The findings of a Public Health Agency evaluation report on a suicide prevention training programme were today presented at the North South Ministerial Council Health Sector meeting.ASIST, The Applied Suicide Intervention Skills Training programme, has to date been delivered to more than 20,000 people in the Republic of Ireland and more than 11,000 people in Northern Ireland. This two day course, delivered by a wide range of organisations including those from the voluntary/community sector, for professionals and the public helps individuals provide emergency help to people at risk of suicidal behaviour. It also develops a cooperative network among participants, since often many people have to work together to prevent suicide.Talking about the findings of this work, Dr Eddie Rooney, Chief Executive, PHA, said: "Both the PHA and the National Office for Suicide Prevention (NOSP), based in the Republic of Ireland, are concerned for any loss of life through suicide and we send our condolences to all families who have been bereaved. We know ASIST training brings a positive element to suicide prevention. Those who have been trained said that the two biggest advantages are that they know when, how and have the confidence to help people who are under pressure and that it helps to build positive links between community and voluntary organisations and the health service. I am pleased that this has been borne out in the evaluation and we hope ASIST will continue to be of enormous benefit and will contribute to a reduction in suicidal behaviour and the tragedy that this brings to our community".This evaluation found that within organisations where staff had participated in ASIST training, there were improvements in service development; staff attitudes, confidence and skills in relation to suicide and suicide intervention and in policies and procedures. At a community level, ASIST was found to have contributed to a sense of empowerment through an increased confidence in being able to deal with suicide and suicidal behaviour.The report also shows that the ASIST model offers a common language, helping communication between the community or voluntary organisations and those from a health background. In fact this training helped to cancel out any differences between those with mental health qualifications and those without, in terms of knowledge, skills, attitude and willingness to intervene. The study also confirmed that ASIST training was most relevant to those who were likely to be in contact with a person 'at risk'.In welcoming the publication of the report Geoff Day, Director of the NOSP, said: "This report is an independent evaluation of the ASIST programme, it has allowed us to demonstrate the effectiveness of the programme in increasing community participants confidence and ability to respond to individuals in suicidal crisis.He added: "The fact the evaluation was completed on an all-island basis allows the NOSP and the PHA to avoid duplication of resources, improve coordination of suicide prevention training programmes across both jurisdictions and allows us to learn from different approaches used in suicide prevention across the island of Ireland."He reiterated the Health Service Executive commitment to the continued implementation of quality assured training programmes as part of Reach out: the National Strategy for Action on Suicide Prevention.ASIST training is being rolled out in Northern Ireland as part of the implementation of the 'Protect Life' suicide prevention strategy, which was published by the Department of Health, Social Services and Public Safety in 2006.A copy of the evaluation report can be found below and in the publications section of this website, by clicking here

Obesity - an acknowledged public health challenge

As we face a difficult economic climate, in which inequalities may worsen, the PHA faces many challenges in its efforts to improve the health of the population. One such challenge is the issue of obesity. Recently, in the Draft Programme for Government and, again today, in anticipation of the publication of the Consultation on the Review of Health and Social Care Services in Northern Ireland, the specific issue of obesity has been highlighted in the media.The PHA is committed to playing a lead role in tackling this major health issue and has been systematically examining the evidence of best practice and effectiveness to ensure that investment and working in partnership will bring clear benefits. A welcome consequence of any success would be a reduction in the impact of the physical, and emotional costs of obesity related ill-health to individuals - and the financial costs to an overstretched healthcare system.A multi-facetted approach to tackling obesity is required for Northern Ireland. This will mean working across government departments, looking at relevant legislation, taxation, food standards and labelling, as well as supporting a raft of programmes within education, workplace, and at the local community level."The prevalence of overweight and obesity has risen dramatically in recent years in Northern Ireland and is now the norm to be overweight, rather than the exception. The Northern Ireland Health and Social Wellbeing Survey (2010-11) indicated that 36% of adults are overweight and a further 23% are obese; this means that approximately 3 in 5 adults in Northern Ireland carry excess weight. A similar proportion of males and females were obese (23%) however males were more likely to be overweight (44%) than females (30%).Data from the Northern Ireland Health and Wellbeing Survey (2010-11) reported that 27% of children aged 2-15 years are obese or overweight. The findings presented here are based on the guidelines put forward by the International Obesity Task Force. Using this approach, 8% of children were assessed as obese, with similar results for boys (8%) and girls (9%). Obesity has serious implications for health and wellbeing and is associated with an increased risk of heart disease and stroke, type 2 diabetes, some cancers, respiratory problems and joint pain.Evidence indicates that being obese can reduce life expectancy by up to 9 years; and it can impact on emotional and psychological well-being and self-esteem, especially among young people.Obesity also impacts on wider society through economic costs, loss of productivity and increased demands on our health and social care system. It is estimated that obesity in Northern Ireland is resulting in 260,000 working days lost each year with a cost to the local economy of £500 million.The good news is that the intentional loss of significant weight (approx 10kg) in overweight and obese adults has been shown to confer significant health benefits, decreased morbidity and may also reduce obesity-related mortality.Key programmes and interventions are undertaken by the PHA in order to prevent and reduce overweight and obesity. The programmes/interventions are supported by significant ongoing work at local level. Examples include:the promotion of breastfeeding; local programmes to increase awareness of good nutrition and develop cooking skills, for example 'Cook It!'; promotion of more active lifestyles, for example, Walking for Health' and 'Teenage Kicks'; development of community allotment schemes; programmes for primary school children, for example Skip2bfit and Eat, Taste and Grow; and sports and other recreation, for example 'Active Belfast'. The PHA's multi media campaign 'It all adds up!' to encourage children to become more active and understand the importance of keeping fit, in a fun and exciting way, ran until October 2011. It encouraged parents and carers to go to the website www.getalifegetactive.com and download the PHA logbook It all adds up! to plan activities as a family. The logbook helped children and parents plan and keep track of their participation in physical activity at school, home and in the community. PHA is currently developing a public information campaign and other supportive work to increase public awareness of obesity as well as to provide advice and support for those who want to make real changes. The campaign development is well underway and is anticipated for launch in late Spring 2012. Like many common health problems, people living in disadvantaged circumstances suffer most and the PHA is committed to tackling this aspect of health inequality. The good news is that even a modest weight loss, of 1-1 Â_ stones, can help to reduce the risk of many of the health problems resulting from being overweight or obese. Information on losing weight through healthier eating and being more active can be found on the PHA websites - www.enjoyhealthyeating.info and www.getalifegetactive.com . These websites provide help and advice for anyone who wants to improve their eating habits and fitness levels, by making small, sustainable, healthy changes to their lifestyle. The PHA leaflet, Small changes, big benefits is also available to download from the PHA website, 'Publications' section.

Assessing The Effectiveness of HACCP Implementation and Maintenance

The primary objective of the study was to assess the effectiveness with which HACCP (Hazard Analysis Critical Control Point) has been implemented and maintained in food manufacturing plants in Northern Ireland and the Republic of Ireland. Where inadequacies in implementation or maintenance of the HACCP system were highlighted the study sought to identify the contributory factors, with a view to making specific recommendations to overcome these limitations.

Effectiveness of brief alcohol interventions in primary care populations.

Excessive drinking contributes significantly to social problems, physical and psychological illness, injury and death. Hidden effects include increased levels of violence, accidents and suicide. Most alcohol-related harm is caused by excessive drinkers whose consumption exceeds recommended drinking levels, not the drinkers with severe alcohol dependency problems. One way to reduce consumption levels in a community may be to provide a brief intervention in primary care over one to four sessions. This is provided by healthcare workers such as general physicians, nurses or psychologists. In general practice, patients are routinely asked about alcohol consumption during registration, general health checks and as part of health screening (using a questionnaire). They tend not to be seeking help for alcohol problems when presenting. The intervention they are offered includes feedback on alcohol use and harms, identification of high risk situations for drinking and coping strategies, increased motivation and the development of a personal plan to reduce drinking. It takes place within the time-frame of a standard consultation, 5 to 15 minutes for a general physician, longer for a nurse.A total of 29 controlled trials from various countries were identified, in general practice (24 trials) or an emergency setting (five trials). Participants drank an average of 306 grams of alcohol (over 30 standard drinks) per week on entry to the trial. Over 7000 participants with a mean age of 43 years were randomised to receive a brief intervention or a control intervention, including assessment only. After one year or more, people who received the brief intervention drank less alcohol than people in the control group (average difference 38 grams/week, range 23 to 54 grams). For men (some 70% of participants), the benefit of brief intervention was a difference of 57 grams/week, range 25 to 89 grams (six trials). The benefit was not clear for women. The benefits of brief intervention were similar in the normal clinical setting and in research settings with greater resources. Longer counselling had little additional benefit.This resource was contributed by The National Documentation Centre on Drug Use.

The effectiveness of brief alcohol interventions in primary care settings: A systematic review

Numerous studies have reported that brief interventions delivered in primary care are effective in reducing excessive drinking. However, much of this work has been criticised for being clinically unrepresentative. This review aimed to assess the effectiveness of brief interventions in primary care and determine if outcomes differ between efficacy and effectiveness trials. Approach. A pre-specified search strategy was used to search all relevant electronic databases up to 2006. The authors also hand-searched the reference lists of key articles and reviews. They included randomised controlled trials (RCT) involving patients in primary care who were not seeking alcohol treatment and who received brief intervention. Two authors independently abstracted data and assessed trial quality. Random effects meta-analyses, subgroup and sensitivity analyses and meta-regression were conducted.This resource was contributed by The National Documentation Centre on Drug Use.

The development of professional guidelines for the eye examination of people with dementia

Recently published guidelines��in the UK��relating to sight tests among people with dementia go some of the way to addressing the specific needs of this group. However, there is still a long way to go in terms of improving the provision of eye care services and optimising the visual health of this group.A��study, published by the Thomas Pocklington Trust,��which examines this subject - The development of professional guidelines for the eye examination of people with dementia - was presented at the first ever national “Dementia and Sight Loss conference” in London (1st December) - a forum where 100 dementia and sight loss professionals met to discuss ways to tackle the challenge of concurrent dementia and sight loss. The study, by researchers at the University of Bradford Schools of Optometry and Health Studies, reviewed procedures for sight tests and eye examinations among those with dementia. It found that policy and practice were hampered by a serious lack of basic research into concurrent dementia and sight loss and prompted recommendations which could lead to improved procedures, tools and techniques.Recommendations prompted by the study outline seven steps towards improving policy and practice:Conduct a systematic study of the availability and uptake of sight tests among people with dementia. Set up a website for people with dementia and their carers with information on how dementia affects eye health, and the importance of eye examinations. Develop education and training for optometrists and care home staff. Compile a list of optometrists experienced in providing eye care for people with dementia. Develop a template for recording the results of eye examinations in people with dementia – something which can be endorsed by professional bodies and made available to care homes. Measure the effectiveness of eye care, such as sight tests and cataract removals, on the quality of life of people with dementia. Research clinical testing methods so that guidelines can be strengthened. Measuring contrast sensitivity, for example, in someone with dementia could be vital as an inability to judge contrasts can make daily tasks impossible.To access the discussion paper please follow this link: The development of professional guidelines for the eye examination of people with dementia ��

Low-income Groups and Behaviour Change Interventions: A review of intervention content and effectiveness

This is the second paper in a series, Kicking Bad Habits, on how people can be encouraged to adopt healthy behaviour. Looking at interventions targeted specifically at low-income groups, this paper asks which interventions are effective in getting people to quit smoking, eat healthily and exercise. It reveals that the most frequently used techniques are providing information and encouraging people to set goals, which can be particularly effective at changing behaviour in disadvantaged groups.

Health inequalities intervention tool: cost effectiveness of interventions

This note sets out the cost effectiveness performance of the interventions currently presented in the Health inequalities intervention tool . These interventions have been chosen for their cost effectiveness performance as health interventions as well as for their impact on the life expectancy gap.