What do people value in health and social care?

What are the elements of value in health and social care? Do we understand what it is that people most value? And do we have adequate ways to describe the value that people and communities create through their contributions to building and managing wellbeing?

These are among the questions we – the members of the Realising the Value programme consortium – want to discuss with wide range of stakeholders, as we work towards a new articulation of ‘value’ that is capable of supporting the NHS Five Year Forward View.

We are inviting you to comment below on our Discussion Paper, ‘How should we think about value in health and care?’. As well as some background about different concepts of value, the paper contains a set of propositions on which we would like your views.

Looking at a future where health and social care (and other services and support) are increasingly integrated, and where statutory services work in new ways to support people’s own efforts to stay well, we suggest that a common, aligned and consensual framework for defining and measuring value should have the following features:

  • Be focused on the overall ‘impacts’ achieved by people and services working together (not on the results from single interventions or single ‘units’ of care)
     
  • Define these impacts in a longer term view, and around what matters most to people (for example, wellbeing, independence, control, social connectedness, confidence to manage)
     
  • Work with people in ‘coproduction’ to define the outcomes that together achieve those impacts
     
  • Be capable of comprising both ‘objective’, quantifiable measures of value, and those that might seem more ‘subjective’ but are based on stakeholder values
     
  • Include a new, appropriate place for clinical outcomes that recognises their importance to people’s health and progress but does not dominate wider, more holistic personal and community outcomes
     
  • Enable locally based judgements and decisions on how best to achieve value with people and communities, recognising that this is often based on sustained relationships with community groups, service users and providers

The paper asks whether these are the right propositions to develop, and asks readers – whether as service managers, clinicians and other professionals, commissioners, expert patients and service users, or voluntary and community sector groups and organisations – to help us.

If you know of approaches to value that may be useful, or programmes that are designed to achieve the kinds of value we are investigating; if you have experience of trying ‘public value’ or ‘social value’ approaches, or of using ‘triple bottom line’ methods of measuring value; or if you have experience or insight into aligning value across health and social care, please let us have the benefit of your thoughts.

As we develop these lines of enquiry and put them together with robust evidence and practice knowledge of the effectiveness of person- and community-focused interventions we want to help create a new consensus on how to articulate and capture health and care.

Author

Don Redding

Don Redding is Director of Policy for National Voices, the leading coalition of health and social care charities, which brings patient, service and carer voices into national policy de…