South Somerset Symphony Vanguard

The South West Academic Health Science Network (SW AHSN) is working in collaboration with the South Central and West Commissioning Support Unit and the Centre for Health Economics at the University of York to evaluate the South Somerset Symphony Vanguard.

The role of the SW AHSN is to consider the impact the Symphony Vanguard is having on strategic and operational measures of activity and to explore components of the model which help to make a difference.

The aim of this qualitative work-stream is to investigate the Health Coach role as a key element of Enhanced Primary Care.

The approach

A method called ‘difference-in-differences’ is being used for the evaluation of both Complex Care Teams and Enhanced Primary Care. This approach compares the differences in outcomes between the group being studied, and a control group – people who are separated from the rest of the study and used as a benchmark to measure against the studied group.

The primary data source was a dataset from South Somerset (Symphony), comprising annual information about each anonymised individual in the Somerset population.

Perceived impacts of the health coach role on patients

Ten different impacts were identified from the interviews and have been themed as follows:

  • General improvements on tailored patient outcomes
  • Patients’ resilience had been positively affected
  • Increase in confidence to self-manage
  • Health coaches were supporting carers
  • Reduction in social isolation
  • Positive lifestyle change
  • Supporting weight loss
  • Self-management of diabetes care
  • Reduction in patients ‘bouncing around the system
  • Identification of unseen problems

Perceived impacts of the health coach role on staff and practices

  • Six different impacts were identified from the interviews and have been themed as follows:
  • GPs reported general positive improvements in their own day
  • GPs reported positive changes to their appointment arrangements
  • GP colleagues stress levels had reduced
  • Repeat GPs advice or instructions
  • Health coaches’ ability to undertake additional practice tasks
  • Helped minimise GP appointments

Perceived impacts of the health coach role on the wider system

One system-wide impact was identified: many interviewees reported patients had avoided demand on hospital services due to the work of health coaches. This frequently involved health coaches taking pro-active action.

For further information about this evaluation, please contact Dr Andrew Sibley, SW AHSN, andrew.sibley@swahsn.com