Linking Health Outcomes to
Other Community Planning
Priorities
Avril Blamey
Senior Public Health Advisor
Policy Evaluation and Appraisal team
NHS HS
Outline
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Previous limitations in the planning process
What would better plans look like?
Starting with ”badged” health outcomes
Making the links to other CPP priorities
Identifying contributions for partners
Underlying values and rationales
Do-ability and testability
What does and doesn’t matter?
Previous limitations in the planning process
Interventions
Expected
Consequences
Goals
Problems
Interventions
Targets
Indicators
What would better plans look like?
• Provide clarity about what you hope to achieve at start of
intervention
• Focuses activity on what must be done to achieve the outcome
• Shows plausible links between inputs, activities and outcomes
• Develops plausible, testable and do-able plans
• Tools for outcome focussed planning (Logic models, RE-AIM
Framework)
• Does health need to be the primary or secondary outcome?
Why have we traditionally started with
badged/topic outcomes?
• It’s easier?
• Partly organisational/professional boundaries (NHS led)
• Individual rather than structural interventions easier to
evaluate/research
• Evidence/monitoring structures developed that way in health
• Funding streams often support topic, disease approaches
• Easier to control and predict?
• Not necessarily more important
• Not necessarily more effective
Making the links
Topic
Alcohol
Theme
Employability
/economy
Less short and long term absence
Rehabilitation
Environment
Safer environments
Less litter due to underage drinking
Community
Safety
Perceptions of safety
Reduced violence
Transport
Increased use due to above
Taxi schemes
Partner contributions
Role
Alcohol
Partne
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Community
Diversionary activities
Education schemes
Parental involvement
NHS
Treatment services
Brief interventions
Workplace polices
Local authority
School education
Community education (diversionary)
Overprovision
Enforcing legislation
Police
Test purchasing
ASBOs/parental reporting
Underlying values and
rationales
• Targeting is clear and appropriate (e.g ROA and reduced
inequalities as target) and linked to clarity of equity outcome
• Access to and experience of services/ interventions are
appropriate to target groups re inequalities ( inequalities
sensitive practices)
• Commitments and successes are shared
• Plans are plausible, testable and doable
Is it plausible?
Consider some key assumptions being made
• Will proof of age/test purchasing reduce underage drinking?
– Do underage people buy their drink from on/off-sales?
– If so will these venues implement proof of age as intended?
– Do/will young people get their alcohol from parents/ older
friends?
– Will access from parents/ older adults increase?
Plausibility
• Current alcohol plans focus on curbing binge and
underage drinking not on price and general
availability
– Without such measure will overall consumption
be addressed?
– Overall consumption is strongest indicator of
liver damage so will this outcome be achieved?
Do ability and Testability
• Staff, resources, timescales, skills
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SMART objectives
Programme monitoring
Use of existing data
New primary data
Prioritised and focused evaluation plans
Should health be the primary
or secondary outcome?
• Does the staring point matter if;
• Outcomes are explicit, shared and specific (e.g.
inequalities or population health)
• Values and targeting is overt and appropriate
• Interventions sensitive to excluded groups
• Plans are plausible, testable and doable