In Gloucestershire, we have developed a bespoke offer for PHM support. This offer is driven by Business Intelligence analysts and outlined below.

One Glos approach

Infrastructure

PHM Leadership:

We have representation from across One Gloucestershire to engage and collaborate to drive forward PHM.

Information Governance (IG):

We ensure IG are engaged in the cycle to enable sharing and use of the data.

Data availability:

Use of the ICB Linked data asset to provide quality information to inform the PHM cycle.

Analytical capacity:

We ensure that analysts are involved in the onset of a PHM project to assist in the cycle.

Local offer

Understand

  • Using data to understand your population.
  • Gather information from various sources to paint a clear picture.
  • Look for patterns and trends that tell a story about your population over time.
  • Use easy to understand visuals to help explain what the data means.

Identify

  • Pinpoint specific groups of people who may need extra support.
  • Consider factors like age, health circumstances and what evaluation might look like.
  • Focus on groups where targeted efforts could make a difference.
  • Segment and stratify the population to find at risk groups.

Design

  • Create tailored plans that address the unique needs of each group.
  • Involve community members and local experts in designing solutions.
  • Use impactability modelling to determine patients most likely to respond to care.
  • Define key indicators and outcomes to be measured and evaluated for success.

Act

  • Start with small, manageable steps that can grow over time.
  • Data collection for evaluating the key indicators and outcomes.

Evaluate

  • Keep track of how well your efforts are working across an agreed time period.
  • Ask for feedback from the people you are trying to help.
  • Be ready to adjust your approach based on what you learn.
  • Use a mixture of process, outcome and balancing measures.

Improve, Expand and Embed

  • Think about how to keep successful programs running in the future.
  • Look for ways to expand what works to help even more people.
  • Build partnerships to ensure on-going support and resources and continued evaluation.