International Seminar

SCIE’s approach to good practice15 April 2009

Amanda Edwards, Deputy Chief Executive

Patricia Kearney, Head of Children’s Services

Mike Fisher, Head of Quality & Research

Summary

Context Good practice Promotion Evidence Some Observations

Why is it important?

Ambitious policy and practice agenda in children’s and adult’s services

“Social Care Institute for Excellence (SCIE) will be expected to promote, identify, and disseminate best practice and innovation, acting as a catalyst for systemwide transformation.”

Putting People First - A shared vision and commitment to the transformation of Adult Social Care, December 2007

Help people make better decisions

Context

Demand for a relevant, swift response Particular nature of central/local government

relationship Role is not always clear Customer needs are very diverse Wide range of stakeholders

Delivery channels

Maximum use of the web, new media and ICT Video as well as text based materials Knowledge hubs/gateways Mobile technology Social networking

Regional Working with partners and regional networks and in Wales and Northern

Ireland to support implementation and improvement Differentiated

Work with independent sector – specific products, expert seminar In partnership

Regulators Joint guidelines with NICE

Centre for Excellence and outcomes in children’s services

Evidence

May not answer the question Gaps in the evidence base Uncertain findings Means different things to different people What counts as evidence is contested

Five sources of knowledge

Organisational knowledge

Practitioner knowledge

A KNOWLEDGE BASE FOR

SOCIAL CARE

User knowledge

Research

Policy

Good practice

SCIE guides resource and services

(Self) reported good practice

Advice and guidance

Good Practice

Good practice – some principles and challenges

Extent to which practice is linked to the intended outcome

Strength of the evidence Explicit about how recommendations are reached Clear presentation Degree of realism Apply to SCIE work – but do we also apply to good

practice advice on Social Care Online or to self reported good practice?

Next steps

Framework for identifying good practice Assessing/rating evidence underpinning SCIE

products Learning from work with other partners

Centre for Excellence and Outcomes in Children’s Services (C4EO) – validated practice

NHS Evidence (portal) – accreditation of guidance producers

Recommendations Should we be more explicit about the process? And should we include costs?

Economic evaluation

So far, SCIE’s reviews do not include

economic evaluation

incorporate economic studies into searching,

mapping and reviews

A societal perspective

takes account of costs and benefits to all

services, and to users and carers

Initial focus on costs

Rating good practice

practice that is effective in achieving the services stakeholders want, at a price they are willing to afford

processes that are accessible and acceptable to users, and that can be implemented in daily practice

outcomes that stakeholders want research evidence is often unavailable or

does not answer these questions

Research evidence lacking

investment in social care research is low many areas lack high quality evidence and

outcomes-based evidence very few controlled trials or economic evidence

user accounts are lacking research runs 2+ years behind practice publication lead times are often 18 months

EBP definition: example

Good practice: factors

What is the practice? A description

Why is it seen as good practice?

A case for the practice

1. What do people think about it?

An account of processes, acceptability and accessibility (a) for people who use services, (b) for providers

2. What happened as a result of the practice?

An account of outcomes and whether stakeholders want them

3. Will it work in day to day services?

Whether the practice is feasible in daily practice (e.g. do we have the skills, treatment locations?)

4. What will people do differently as a result?

What we have learned from the practice?

5. Can we afford it? Is the practice affordable? Information on costs and savings.

Good practice: rating

OVERALL RATING Description and case plus:

1. Good Evidence in all five dimensions supports the practice. Evidence on outcomes includes that they are wanted by users as well as providers

2. Very promising Outcomes are wanted by both users and providers, feasible in daily practice, and no other factor suggests the practice is ineffective or damaging.

3. Promising Outcomes are wanted by either users or providers, one other dimension supports the practice and none suggests the practice is ineffective or damaging.

4. Proven ineffective and/or damaging

Evidence in one or more dimensions is that the practice is ineffective, unacceptable, inaccessible, or damaging.

5. Unproven There is a case for the practice, but no evidence.

International seminar: good practice

Is there a sufficiently robust evidence base to identify good practice?

What are the political issues that need to be addressed in developing good practice?

What are the practice delivery mechanisms to promote the adoption of good practice?