There are many different ways to think about outcome, and many frameworks already exist across health- and social-care. It will be useful for us to step across the current boundaries and think about outcomes in an integrated way. We reviewed five national and local outcomes frameworks that are being used to measure quality. These included the Public Health Outcomes framework, the Adult Social-care Outcomes framework, the High-Quality Care for All framework, the NHS Outcomes framework and the Greenwich Integrated Care dashboard.
None of these frameworks are integrated across all settings of care that are relevant for integrated care. Therefore, there was reason to integrate the frameworks for measuring outcomes just as we are integrating care. Together with the working group, we summarised the frameworks into five domains. The most important perspective is the well-being of the person who is receiving services and as such, the first two domains, quality of life and quality of care are the most important:
- Quality of life
- Personal and social goals
- Quality of care
- Service user experience of care
- Financial sustainability
- Professional experience
- Operational performance
It is important that the outcomes that are chosen by commissioners as part of the Whole Systems Integrated Care programme align with the existing outcomes frameworks that are already used across the NHS. This includes the NHS Outcomes framework, the Adult Social-care framework and the Public Health Outcomes framework. The outcomes presented in this chapter are fully aligned with these frameworks.