91探花

Population Health Management (PHM) is an approach that aims to improve population health through data-driven planning and the delivery of proactive care. This involves moving to a proactive system that seeks to prevent illness before it occurs, as well as address health inequalities. This is ever more important given current and growing pressure on NHS services, and the need for sustainable services that promote equality. Adopting a PHM approach could be hugely beneficial for health and care systems.

In the past 12 months, 91探花has conducted PHM reviews with several integrated care boards (ICBs) as part of their internal audit processes. While ICBs have approached PHM in different ways, and the scopes of the reviews varied, there were common themes that could be identified across them. The following are the five key takeaways that we found that can serve as key lessons for all ICBs in their approaches to PHM moving forwards.

1. How can ICBs communicate the benefits of PHM to their staff?

To adopt a PHM approach, those who work in the ICB must first understand what this means. ICBs have used different techniques for communicating PHM to their staff including educational videos, sharing successful examples of PHM projects, and through creating communities of practice.

However, while the term PHM may be relatively new, the components of a PHM approach are not. Therefore, it is possible that individuals within an ICB are already doing work that involves a PHM approach without labelling it as such, as they are not aware of the term. It is therefore useful to use these examples to show staff that, while the terminology may be new, they already have some of the capabilities needed to adopt a PHM approach.

2. PHM analytics: data integration and staff training for effective analysis

The need for a PHM analytics platform that contains linked data and that can be used to conduct population health analysis has been a common theme from ICBs. Linked to this is the importance of robust data governance frameworks to facilitate the integration of data from different sources while protecting patient confidentiality. However, having access to data and an analytics platform is not enough to enable a PHM approach, it also requires that individuals across the organisation have the analytical capability to use that platform and data to inform service delivery. This may require providing staff with training in analytical techniques. It is also crucial that there is accountability for actioning any insights gained through population health analysis, to ensure that problems are not just understood but addressed.

3. Tackling health inequalities: engaging existing communities with hard-to-reach groups

ICBs recognised that involving people with lived experience in the design of services can help them to address health inequalities within their populations, and that having strong links within the community can allow them to tailor messages to different cohorts and increase engagement with health services. These links can be through engagement teams within the ICB or by identifying relevant volunteer sector partners and utilising their networks to reach out to communities that are harder to engage with, which are often the groups who suffer most from health inequalities.

4. Evaluate PHM initiatives and scale up good practice

Most PHM projects will start on a small scale at PCN or place level. However, when a project has proven to be successful, it is important to then scale it up to ICB level. Determining which projects to scale up requires that evaluation methods are embedded within PHM projects, so that their level of success can be ascertained. Those evaluation methods could include assigning those who receive interventions codes so that the impact can be measured, or the use of productivity metrics.

5. Embedding PHM within current ways of working

While ICBs may begin their PHM journey with a separate PHM programme of work and governance structure, many have found that the best approach is to see PHM not as a separate piece of work done by a particular group. Instead, it is a way of working that should be embedded within the system and an approach that should be adopted by everyone within the ICB. As a result, we found that some  ICBs that were further along in their PHM journey were actually removing their specific PHM programmes and governance structures, and instead looking to embed PHM throughout their organisation. They sought to achieve this by aligning ICB strategies with a PHM approach, including PHM in the terms of reference for wider governance groups and increasing staff access to population health analysis. 

In summary, while PHM presents a significant opportunity for improving population health and achieving more equitable healthcare, it requires a common understanding, developed analytics and evaluation capability, community engagement, and integration into existing organisational practices. These lessons from recent reviews offer a roadmap for ICBs to enhance their PHM efforts, and in doing so improve health outcomes for their populations.

Support that we can offer

Our research, evaluation and analytics team have extensive experience working within the healthcare sector to generate evidence for change, aiming to improve health and care outcomes. The team offers a comprehensive review of population health maturity for ICBs through a tried and tested progress matrix, as well as solutions to support assessment, modelling, monitoring, and evaluation. Our approach focuses on using data and evidence to drive meaningful change.

91探花will be hosting a forum to discuss PHM – evaluating and adopting best practices on Thursday 26 September. This event is ideal for those closely involved with PHM strategy and leadership for ICBs including (but not limited to) Chief / Deputy Chief Medical Officers, PHM Directors, Strategic and Analytical Leads. Register your place at our "PHM – evaluating and adopting best practices" forum below.

If you would like to discuss anything further, please get in touch with Steve Hodgson.