How effective and cost effective are innovative combinatorial technologies and practices for supporting older people with long-term conditions to remain well in the community? An evaluation protocol for an NHS Test Bed in North West England

Introduction:
The Lancashire and Cumbria Innovation Alliance (LCIA) Test Bed is a partnership between National Health Services in England (NHS), industry (led by Philips) and Lancaster University. Through the implementation of a combination of innovative health technologies and practices, it aims to determine the most effective and cost effective ways of supporting frail older people with long-term conditions to remain well in the community. Among the Test Bed’s objectives are to: improve patient activation and the ability of older people to self-care at home; reduce healthcare system utilisation; and deliver increased workforce productivity.

Methods and Analysis:
Patients aged 55 years and over are recruited to four cohorts defined by their risk of hospital admission, with long-term conditions including COPD, dementia, diabetes and heart failure. The programme is determined on an individual basis, with a range of technologies available. The evaluation is adopting a two-phase approach: Phase 1 includes a bespoke patient survey and a mass matched control analysis; and Phase 2 is using observational interviews with patients, and weekly diaries, action learning meetings and focus groups with members of staff and other key stakeholders. Phase 1 data analysis consists of a statistical evaluation of the effectiveness of the programme. A health economic analysis of its costs and associated cost changes will be undertaken. Phase 2 data will be analysed thematically with the aid of Atlas.ti qualitative software. The evaluation is located within a logic model framework, to consider the processes, management and participation that may have implications for the Test Bed’s success.

Ethics and Dissemination:
The LCIA Test Bed evaluation has received ethical approval from the Health Research Authority and Lancaster University’s Faculty of Health and Medicine Research Ethics Committee. A range of dissemination methods are adopted including deliberative panels to validate findings and develop outcomes for policy and practice.