Evaluating DHA programmes
It is essential to undertake formal evaluation to understand the impact on the person using services in relation to their health outcomes, quality of life and wellbeing. Outcomes for other groups including district nurses, providers and care workers are also important.
Evaluation should be an integral part of the delegation process and considered from the outset of a DHA programme. Data gathered from evaluation will also be helpful in the ongoing construction of business cases to further develop DHA.
Key questions to ask regarding evaluation are: when it will be conducted; how frequently; how will it be done; what data will be required; who will be involved in evaluation activities. With regard to the latter, evaluation may be on a small scale or may involve support from wider partners such as local universities and research organisations.
Evaluation will support robust understanding of the effectiveness of DHA programmes. In the tables below, we set out by stakeholder group potential outcomes from DHA programmes, how these could be measured and where data to do this may be sourced. While you may not use all of these, do consider carefully at the outset what the DHA should achieve and how this will be evaluated.
People who draw on services
| Potential outcome | How to measure | Data sources |
|---|---|---|
| Improved quality of care | Continuity of care | Feedback from people who draw on services and their carers |
| Levels of anxiety and refusals | District nurse monitoring and care provider records | |
| Timely administration of insulin | District nurse monitoring systems e.g. System 1 and EMIS | |
| Medication errors/adverse incidents | District nurse Datex system |
District nurses
| Potential outcome | How to measure | Data sources |
|---|---|---|
| ImproveIncreased scale and scope of DHA i.e. more activities being delegated. Measuring expansion of numbers and range of activities over time is important in evaluating success of the programme. If the numbers decline and there are a significant number of ‘returns’ to DN care, this can be problematic. | Number of people who draw on services receiving DHA Number of participating care homes Number of activities that are delegated Number of people who draw on services receiving DHAs returned to DN team | District nurse teams collect this data (or DHA programme leader if in place) |
Care providers
| Potential outcome | How to measure | Data sources |
|---|---|---|
| Improved quality of care delivered and improved satisfaction of people who draw on services | Metrics as above for people who draw on services satisfaction Reductions in safeguarding referrals Improved CQC ratings | See above table for people who draw on services See above table for people who draw on services CQC website |
| More skilled workforce | Numbers of staff undertaking training and competence development for DHA | DHA trainer records |
| Improved recruitment and retention | Reduced turnover rate over time and also in comparison to regional and national rates Time taken to fill vacancies | Provider / SfC ASC-WDS/ICB data Provider records |
| Improved attendance | Reduced sickness absence Reduced reliance on agency/ bank staff | Provider / SfC ASC-WDS/ICB data |
Care Workers
| Potential outcome | How to measure | Data sources |
|---|---|---|
| Increased pay | Pay rates above NLW/RLW | Provider / SfC ASC-WDS/ICB data |
| Career progression | Numbers of care workers moving to the Enhanced Care Worker role | Provider/ SfC ASC-WDS/ICB data |
| Improved job satisfaction | Staff attitude surveys | Provider data |
Implementing DHA programmes: checklist
