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National Evaluation of POPP: The Evidence Base

National Evaluation of POPP: The Evidence Base. Report authors and core team : Karen Windle, Richard Wagland, Julien Forder , Francesco D’Amico, Dirk Janssen, Gerald Wistow

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National Evaluation of POPP: The Evidence Base

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  1. National Evaluation of POPP: The Evidence Base Report authors and core team: Karen Windle, Richard Wagland, JulienForder, Francesco D’Amico, Dirk Janssen, Gerald Wistow Wider national evaluation team: Roger Beech, Ann Bowling, Angela Dickinson, Kate Ellis, Catherine Henderson, Emily Knapp, Martin Knapp, Kathryn Lord, Brenda Roe

  2. POPP Programme • £60 million ring-fenced funding for council-based partnerships to lead locally innovative pilot projects for older people. • Overall aim was to improve the health, well-being and independence of older people through: • Provide person centred and integrated responses for older people • Encourage investment in approaches that promote health, well-being and independence for older people and • Prevent or delay the need for high intensity or institutionalised care. • 19 pilot sites funded May 2006 – 2008 • 10 further pilot sites May 2007 – 2009

  3. The National Evaluation Research Questions Measurement Interviews and focus groups (operational staff, users and users outside of the POPP programme) Structured questionnaire to key informants Standardised user questionnaire completed at two time points (before and after intervention); EQ-5D, service change, demographic data ‘Difference in Difference’ Analysis (Emergency Bed Days) Financial/ Activity data Process • Did the POPP programme change partnership working and practice across the sites? • What was the level of older people’s involvement across the programme? Outcome • Did the interventions improve users quality of life? • Did the POPP programme reduce use of high intensity-services?

  4. POPP Interventions Gardening/ handyperson/ befriending/ learning/leisure Holistic assessments/ Hospital aftercare/Falls Prevention/ Peer Monitoring and support/Falls follow-ups Rapid Response Teams/ Hospital at Home/ Intensive support teams/ Case Management/ Proactive Case Finding 146 core projects, 530 upstream projects

  5. Users within the interventions • Total of 264,637 users either contacted or were referred to the POPP interventions • 77% of the population aged 70 and over, with a third (32%) aged 85 and over • One-third was married (33%), the remainder widowed, divorced, separated or single. • 81% lived in their own homes, but almost a fifth lived in sheltered housing, residential and nursing care • Fewer men were using services that address lower-level needs (1:3) than those focused toward secondary or tertiary support (1:1) • The age at which respondents use services differs with levels of deprivation • Weekly income (where reported) was £100 less per week than the median income for general population (Age Concern 2008)

  6. Standardised user questionnaire -before the POPP intervention and up to six months after the project (62 projects; n=1,529) EQ-5D, Health-related quality of life Measured on mobility, self-care, usual activities, pain/discomfort, Anxiety/Depression Used quasi-comparison group (British Household Panel Survey) to benchmark the outcomes Outcomes & Impact: Measuring changes in health-related quality of life

  7. Outcomes & Impact:Health Related QoL: POPP & Quasi-Comparison group

  8. Outcomes & Impact: HRQoL: Categories of Projects

  9. Outcomes and Impact: Overall Emergency Bed-Days

  10. Outcomes & Impact: EBDs;Secondary/Tertiary and Primary Prevention • Secondary and Tertiary prevention PCTs: headline saving of -£1.40 on EBDs for £1 extra POPP spend, with a range of -£1.00 to -£1.90. • Primary prevention PCTs: headline saving of -£0.70 for £1 extra POPP spend, with a range of £0.10 to -£1.40

  11. Outcomes and impact: Overall programme cost-effectiveness

  12. Outcomes and Impact:Overall change in service use & costs

  13. Outcomes and Impact:Categories; change in service use & costs

  14. HRQoL and/ or efficiencies? HE = 0.70p per extra £ HE = £1.40 per extra £

  15. Summary • Good data enables analysis of effectiveness • Good data respects the participants voice • Good data enables analysis of quality • Good data ensures the work that the enormously hard work and effort that you have carried out is not compromised • Good data ensures we can build on the evidence base, changing policy and practice

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