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Using Stakeholder Engagement to Inform the Development and Expansion, and Increase Uptake, of NICE Return on Investment Tools
The document discusses NICE's return on investment (ROI) tools, which predict the economic returns of funding certain health interventions. It describes the development of NICE's initial ROI tools on tobacco, physical activity, and alcohol through stakeholder engagement. Stakeholders provided feedback that the tools' metrics were unclear and wanted easier access to guidance information. NICE then created online versions of the tools, testing them with stakeholders who found them simpler to use but still having some technical issues. Next steps include publishing the five web-based ROI tools.
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Using Stakeholder Engagement to Inform the Development and Expansion, and Increase Uptake, of NICE Return on Investment Tools
- 1. Using Stakeholder Engagementto Inform the Development and Expansion, and Increase Uptake, of NICE Return on Investment Tools Tuesday 14 June 2016 Rebecca Maguire Project Manager, Social Care Guidance and Quality Assurance
- 2. What is Returnon Investment? Return on Investment (ROI) is a performance measure used by NICE to predict the economic returns commissioners should expect to receive when they invest in certain health interventions. For example: The amount of money saved treating cardiovascular-related illnesses if pedometers are provided for free. Or The amount of money saved treating tobacco-related illnesses if funding is provided for nicotine replacement therapy poster campaigns.
- 3. What are NICEROI Tools? Each ROI tool includes a portfolio of interventions on a specific topic, which commissioners can use to evaluate the economic returns of funding different packages in their area. NICE has currently published three tools on: • Tobacco • Physical activity • Alcohol use The main purposes of the tools are: • Implementation • Analysis • Cost-effectiveness
- 4. An Introduction toNICE ROI Tools A brief history of the tools Report commissioned by UK Secretary of State on ‘Enabling Effective Delivery of Health and Wellbeing’ 2009 / 10 Department of Health given a recommendation to explore feasibility of providing ROI assessments 2009 An objective is added to NICE’s Public Health 2010/11 business plan to devise methods to enhance processes 2010 The NICE Cost Impact project was formed and an ROI tool on tobacco control was commissioned 2010 Publication of the ROI tool on tobacco control 2011 Two further ROI tools on physical activity and alcohol use were commissioned 2012 Publication of the ROI tools on physical activity and alcohol use 2013 Two further tools on cost-consequence analysis of social & emotional wellbeing and children & young people interventions were commissioned An objective to update and convert the tools to a web- based format was set and work was commissioned 2014-2016 2014-2016 On-going On-going
- 5. Developing the tools:key stakeholders • Public Health England • Clinical Commissioning Groups / other commissioning organisations • Directors of Public Health, data analysts and topic experts at Local Authorities • Brunel University, LeLan and Optimity Matrix • NICE
- 6. Developing the tools:stakeholder engagement methods Development of the tools was informed by: • Telephone interviews • Design-phase workshops • Formative evaluation workshops and consultations • Market intelligence feedback • ‘Get in touch’
- 7. Findings and results:consultation on the tobacco, physical activity and alcohol tools • Many users didn’t understand the metrics • Users wanted more information about the guidance • Users wanted an easy way to view top-level information
- 8. New phase: creatingthe online tools • Stakeholders mostly the same • Less research in the field • Tools created in-house
- 9. Findings and results:testing the web based tools Positives: • Simpler and clearer than Excel tools • Offer more benefits • Easy to use • Easy to input data • Easy to compare packages • Most said would use again Negatives: • Some technical difficulties • Not enough breakdown of information • Language too technical
- 10. Barriers and learning Themain implementation barriers were: • Consultation and publication during transfer of public health responsibilities to LAs • Potential lack of knowledge of economic metrics / cost-consequence analysis These were mitigated by: • Producing a user guide and technical report for each tool • Organising training workshops • Holding online webinar training sessions
- 11. Next steps forNICE ROI tools • Imminent publication of the five web-based tools
Editor's Notes
- #4 This is what we say on the NICE website about the alcohol tool: The alcohol use return on investment tool has been developed to help decision making on interventions and strategies to prevent and reduce alcohol use at local and sub-national levels. The tool enables the user to evaluate a portfolio of interventions in their geographical area (e.g. region, county or local authority) and models the economic returns that can be expected in different payback timescales. The different interventions included in the tool can be mixed and matched to see which intervention portfolio or package provides the best 'value for money', compared with 'no package of interventions' or any other specified package. On a separate note, the cost impact project (fortuitously as the ROI tools were not the purpose of that project) identified features that in the event usefully informed what should be should be covered in an ROI tool: Report health and non-health outcomes and costs in disaggregated format Report a range of economic metrics for short, medium and long term time horizons Develop scenario analyses around different intervention options and compare impact of different packages of interventions against a baseline of “do nothing” of different packages of interventions against each other
- #5 In April 2009 the UK Secretary of State commissioned an independent report, named ‘Enabling Effective Delivery of Health and Wellbeing’, to assess opportunities and barriers in delivery systems and to identify where practical changes could be made. The Secretary of State then asked the Department of Health to take forward a recommendation to explore the feasibility of providing assessments of Cost Impact and Return on Investment, to be available in 2010. In response to these activities the NICE Public Health business plan for 2010-11 included an overall objective to devise a set of methods, congruent with current NICE principles, in order to enhance current NICE public health processes. This gave rise to the cost impact project, which explored NICE’s approach to assessing the cost effectiveness and cost impact of public health interventions.
- #6 Note that the development of the tools included oversight and input from NICE. The tools built on a lot of the work that we refer to as the NICE cost impact project and also draw heavily on our evidence base and previous economic models for tobacco.
- #7 Telephone interviews with commissioners and decision-makers (tobacco, physical activity and alcohol tools only) Initial workshops with commissioners, national influencers and decision-makers, held at the NICE London office and at the offices of the tool developers Formative evaluation workshops and consultations with users to improve uptake and use-ability