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CCM Demonstrators: Case Study 2 Intermediate Diabetes Clinics
Intermediate Treatment Centres are being developed in a number of areas to respond to the challenges posed by long term CCM which include unnecessary or inappropriate referral to secondary care for treatments that, with some support, can be more cost effectively provided in the community resulting in greater patient satisfaction, earlier intervention and uptake and improving the skills of primary care staff.

CRG have been commissioned by NLIAH to undertake focus groups and interviews about Intermediate Diabetes Clinics. Research activities include:

Designing a questionnaire for surveying all diabetes patients in five General Practices;
gathering feedback from diabetes patients in the relevant neighbourhood, including representatives from the BME community; providing a baseline position of diabetes staff involved in the pilot on their views on service proposals.
Contact: Andrew Rix (consult@crgresearch.co.uk)

Study of Mentoring Activities in Wales
CRG were commissioned by WAG to: ‘inform the Task and Finish Group of the extent of mentoring activities and provision currently in Wales and propose an outline framework based on the findings of the study’. Objectives for the study included:

• Identifying and mapping organisations that
provided mentoring services for potential
entrepreneurs, start ups and established
businesses
• Establishing the number of mentors who
held appropriate qualifications
• Identifying and establishing what quality
assurance systems were in place to
maintain professional standards
• Identifying and establishing the
availability and nature of mentoring and
training in Wales
• Gauging the Welsh business response to the
establishment of a mentoring brokerage
service
• Gauging mentoring provider response to
operating within a Code of Practice in
Wales
• Identifying best practice models that were
in use in other countries.

Methodology for the study included an extensive telephone survey of business across Wales and a telephone survey of mentoring providers within Wales.
Contact: Debbie Jones (consult@crgresearch.co.uk)

Support to Family Information Service in Wales
CRG Research were awarded a two year contract in October 2009 by the Welsh Assembly Government to provide support to the 22 Family Information Services (FIS) in Wales, to enable them to continue to achieve the minimum standards for FIS. In order to meet the support required of the FIS nine deliverables were identified by the Welsh Assembly Government:

1. Provide a short report on each FIS detailing progress to date and a training needs analysis.
2. Provide a short annual report on each FIS detailing the work they are doing, including examples of good practice.
3. Facilitate arrangements of the quarterly FIS meetings and provide summary reports of the meetings.
4. Issue a quarterly FIS in Wales newsletter and disseminate good practice.
5. Provide one-to-one consultancy support and advice, approximately 5 days per FIS per annum.
6. Run networking meetings on specific identified issues.
7. Facilitate training sessions.
8. Provide support to individual FIS in relation to the requirements of the Minimum Quality Standards, Genesis Cymru Wales 2 Project, any future ESF funded projects, and implementation of the Childcare Act Guidance.
9. Provide expert advice to the Welsh Assembly Government on FIS issues through attendance at events and meeting e.g. Genesis Cymru Wales 2 Operational Group meetings, FIS/CSSIW protocol related meetings.
Contact: Richard Self (consult@crgresearch.co.uk)

Sell2Wales User Groups
CRG Research Ltd have been commissioned by the Department for the Economy and Transport of the Welsh Assembly Government to facilitate user groups for the sell2Wales website. The key aim of the project is to gain “better understanding of the suppliers’ perspective and improve the functionality and usability of the website for the end user” as well as to “to engage with Sell2wales business users on an on-going basis to review the website and make recommendations for improvement”. The appointment involves recruiting, briefing and facilitating 3 Sell2Wales user groups - in North, South and Mid Wales - between February and June 2010. During the meetings the group members will be given the opportunity to:
- Review and evaluate the existing
Sell2wales website
- Identify aspects of the Sell2wales
website that work well
- Identify aspects of the Sell2wales website
that don’t work well and make
recommendations for improvements
- Review and test developments to the
Sell2wales website (made on the basis of
ideas suggested during earlier user group
meetings)
Contact: Richard Gaunt (consult@crgresearch.co.uk)

Health Foundation: Designing Shared Decision Making
Putting the patient at the heart of decisions about their treatment (and at the heart of designing services which deliver patient needs) has become increasingly important in a health service which places an emphasis on informed choice. Patients are in a position, thanks to advances in IT, to access a wide range of sources of information about their condition and clinical staff can offer a number of evidence based treatments to suit individual patients. Striking the right balance between providing reliable and consistent information about a patient’s condition and the consequences of different treatment options has been addressed by the development of Patient Decision Aids which are used in a number of Shared Decision Making processes. Although considerable resources have gone into promoting PDAs and SDM processes implementation and uptake have been slow and spasmodic despite considerable research which shows that the SDM approach, when used with validated PDAs, make better use of resources and add positively to both clinical outcomes and patient satisfaction. Reasons for this have been identified as being primarily cultural as well as being bound up with systemic issues such as perverse incentives built into care pathways linked to target setting.

Using an Action Learning model the project will facilitate the implementation of SDM tools in various specialties including Breast Cancer, Urology, Obstetrics, Head and Neck Cancer, children’s ENT across sites in Cardiff and Newcastle, some of which are exclusively secondary care and some of which straddle the boundaries between primary and secondary care.

The aims of our Shared Decision Making Programme are:
• To demonstrate that shared decision making
can feasibly, affordably and sustainably
become a core characteristic of routine
clinical care, both within primary and
secondary care, at large-scale;
• To build practical and transferable
knowledge about how this can be achieved
and what the conditions for success are.

The specific objectives of the programme are to:
• Raise awareness of shared decision making
and the benefits that are achievable in
terms of the patient experience, cost-
effectiveness, quality and safety;
• Embed shared decision making into current
systems and clinical pathways;
• Commit senior management teams to
supporting the concept of patient
involvement in decision making as a
fundamental value which underpins the work
of the organisation and to start
realignment of incentives and performance
measures accordingly;
• Increase the extent to which patients
perceive themselves to be involved in
their care (key decisions);
• Engage a number of clinical teams such
that they become advocates of shared
decision making within the larger
organisation, sustain the approach beyond
the end of the project and feel motivated
to disseminate shared decision making to
colleagues, both internal and external to
their organisations;
• Capture sufficient learning about the
determinants of success and failure in
order to inform and roll out an
implementation process.
Contact: Andrew Rix (consult@crgresearch.co.uk)

Evaluation of Northern Ireland Civil Service Policy Skills Learning and Development Programme
The Northern Ireland Civil Service (NICS) ‘Policy Skills Learning and Development Programme’ is a pilot programme for ‘Policy Professionals’, aiming to ensure the NICS has the capacity and capability to develop and deliver policies and programmes to suit local requirements and circumstances. Precipitated by the changing structural landscape in government, and an internal ‘Policy Capability Audit’ conducted in 2008 (which highlighted 1 in 10 of the current cohort of policy workers are expected to retire within 5 years, 55% of the current cohort having been in post less than 3 years, and almost half of this 55% having no previous policy experience), the programme has been developed to provide a nationally recognised qualification linked to National Occupational Standards (NOS).

The 12 month programme included 5 modules (the strategic environment, policy maintenance, policy development, policy implementation and policy evaluation), with each module having a taught component, action learning set, mentoring session, assessed self-reflective learning assignment and assessed work-based learning assignment. The evaluation has been commissioned by DBIS.
Contact: Richard Gaunt (consult@crgresearch.co.uk)

Evaluation of Cymorth and Flying Start
Cymorth and Flying Start are major Welsh Assembly Government DCELLS initiatives to support disadvantaged children and young people – and their parents and carers. CRG are acting as subcontractors to SQW and are responsible for three of the ten areas for in-depth studies – Anglesey, Carmarthenshire, Ceredigion.
Contact: Richard Gaunt (consult@crgresearch.co.uk)

Youth Justice Board: Youth Restorative Disposal Evaluation
The Youth Restorative Disposal (YRD) aims to reduce the number of first time entrants in to the criminal justice system, involve the victim in the resolution of the offence and deliver an effective low level response to young people committing very minor offences. The YRD has been piloted in 8 police force areas since April 2008 and CRG have been commissioned to undertake a process evaluation in order to inform decisions regarding national roll out. Monitoring information collected for the areas will provide information about participants and offences for which the YRD is being utilised. A quantitative survey of key stakeholders (Police, YOT, Children’s Services) will inform mapping of implementation processes across all 8 pilots. A further 4 case study areas (at BCU level) will be selected in order to undertake a combination of in depth interviews with providers and practitioners, short interviews with victims and young people and observations of YRD sessions will provide qualitative information. A cost benefit analysis will provide information on the costs of delivering the disposal in comparison with other actions.
Contact: Andrew Rix (consult@crgresearch.co.uk)

Impact Evaluation of Bookstart in Wales.
Bookstart, run by the national charity Booktrust, was the first national baby book-giving programme in the world. It is a multi-agency partnership, including publishers, Library services, Health Visitor teams, the Booktrust charity and the Welsh Assembly Government. The Bookstart Baby pack is gifted to families at babies' 7-9 month health check with their health visitor and the Bookstart Early Years Pack is gifted to families at the 2 year health check. The aim of the evaluation is to assess the outcomes of the programme with regards to all or some of the following: - Booksharing within the family, attitudes towards books / reading, quality of engagement with books, effective sign posting to other public services and learning opportunities, access to books – purchases /library usage.
Key evaluation tasks include desk research, analysis of management information; scoping interviews with national key informants, 6 local area case studies; a comprehensive survey of beneficiary parents/carers at two data-points to capture experiences and explore impacts; interviews with Bookstart coordinators and other local stakeholders, and detailed analysis and reporting.
Contact: Mark Beynon (consult@crgresearch.co.uk)