Research findings may not always be simple or conclusive, but they are almost always useful. Health services are changing, driven by the need to alleviate pressures in secondary care. Various community/enhanced schemes have been proposed as the answer, and many are in operation. However, research into these schemes has focused on safety and clinical efficacy, rather than whether they are actually economically viable, or acceptable to patients.
The College’s Enhanced Scheme Evaluation Project (ESEP) has delivered findings to help fill this gap. In analysing the performance of minor eye conditions schemes (MECS) in South East London, the project was able to compare the performance of two boroughs before and after the introduction of their schemes, and to a neighbouring borough without a scheme. ESEP has already published evidence around safety and satisfaction – these latest findings provide an economic analysis. Although savings were made, there were differences between the boroughs, with savings of 13.8% in one and increased costs of 3.1% in the other.
Although the areas had very similar characteristics, there are differences in the way services are configured, and the results of this study describe a complicated picture. This is why intermediate-tier services must take into account variable factors and the complex local interactions of the health service.
The College supports its members by providing knowledge and we look forward to ESEP’s further outputs in the next year. The College is continuing to invest in further research to help the profession engage with commissioners to ensure service models are evidence based.