Category: Blog

The launch event for the Thames Valley Value Lab recently was the springboard for insightful discussions among attendees from a range of organisations, on the challenges and possible solutions in health and social care, now and in the future.

The launch theme: From Insight to Impact: Strategic commissioning for value, outcomes, and equity, was explored through presentations and breakout rooms. The wider context of the national landscape and the NHS 10 Year Health Plan for England set the scene, alongside the changing role of Integrated Care Boards (ICBs). 

Value Lab was launched in tandem with the ICB, with the aim of evaluating NHS services and making more informed decisions about healthcare allocation for more than 2.5 million patients across the region. The Value Lab launch marks an important step in its development.

A stark statistic was highlighted at the event: the highest need group in society, which is 3% of our population, accounted for one third of all emergency calls and hospital bed days. Widening inequalities and the need for organisations to work differently together were presented as facets of the way forward. Balancing cash constraints with ethical considerations, the meaning of ‘value’ and the notion of ‘decommissioning’ (if an initiative is not working) were explored, in recognition of the complexities and realities of improving services.

The setting for the launch, St Luke’s Chapel, Radcliffe Observatory at the University of Oxford, provided a backdrop for reflection.

Apostolos Tsiachristas is Associate Professor of Health Economics, University of Oxford and NIHR Thames Valley Theme Lead for Knowledge Mobilisation Implementation and Partnerships. Below he shares his thoughts on the impact of the launch.

1 – What’s your overview of the launch of Value Lab?

‘It was great to see so many people from different organisations – all the different stakeholders, from ICB’s, local authorities, VCSCs, NHS Trusts, academics and patient representatives, so highly engaged with strategic commissioning, because this is what the Value Lab is about. It was also great to see the breadth of their interests, which are very much aligned, alongside their eagerness to participate and contribute.

It was a great start with interesting discussions. There’s lots of work that we have identified to be done. We need to start by identifying needs in the populations in setting up the infrastructure that we can use for strategic commissioning, and the governance mechanisms that are necessary in order to do that. But equally importantly, I think we’re identifying many key partners who can do this work together. NIHR ARC Thames Valley was at the centre of these discussions and I’m pleased with that.”

2 – What was the inspiration for the creation of the Value Lab?

“As part of the ARC Oxford Thames Valley, we started working on a value framework. We tested this with the ICB (BOB ICB previously). The idea was that we needed to use more evidence in commissioning and six months ago all the dots were aligned. The two local ICBs were merging, the need for strategic commissioning was as necessary as ever due to the increasing demand for care and required waste reductions in the NHS.  The contribution of ARC Thames Valley, with myself serving as Lead for Knowledge and Mobilisation Partnerships, was crucial in working closely with the ICB to bring the Value Lab to life, not just as an idea, but with the capacity and a clear plan of action to deliver it.”

3 – What does value in health and care mean in practice day-to-day?

“This is a question that needs to be answered by stakeholders not just by academics. We’ve done some work where we asked the public, about what they want to get out of the health system for the pounds they spend through taxes. We identified through our research: quality of life, life expectancy, patient experiences, inequalities, the size of the population who are benefitting and of course the opportunity cost of all this. Now we’re going to be working more on this topic in the Value Lab, the ICB and our partners to see whether we need to expand this value set – e.g. by including elements like independence, integrity and wellbeing. We’re going to keep working on this until we can define a value set that we can base strategic commissioning on.”

4 – What would you say success would look like in 12 months’ time?

“Success in the short-term for me would mean to have the infrastructure, governance, people and momentum in place as well as some good examples of strategic commissioning through the Value Lab. Then we can learn further through our experience over the period of a year and refine the methods and improve the evidence base.

I don’t expect that the Value Lab will be used to commission all services in the ICB across the Thames Valley – £5.8 billion a year – immediately, but if within a year we’re set for a better understanding of the data and the know-how, I think that would be a solid achievement for success in the next steps.

Hopefully in a pilot, we’ll be using Value Lab knowledge to demonstrate that improving quality of and access to services and patient experience in the short term, may be translated to people’s health outcomes in the future.”

5 – What’s the one thing that you hope participants took away with them from the day?

“The collaborative mentality from the ICB and stakeholders. It was a key moment when we were all in the room, agreeing that we need to partner, agreeing that we need to work all hands-on deck, to face the current challenges in the NHS. Understanding that we’re all together and that we can work together on these challenges was the key message.”