The IFIC Podcast

Episode 1: Evaluation Explained — In Conversation with Tom Ling
In the first episode of this series, IFIC Chief Executive Dr Niamh Lennox-Chhugani is joined by Tom Ling, Senior Research Leader and Head of Evaluation at RAND Europe, and former President of the European Evaluation Society.

Drawing on decades of experience leading complex evaluations, Tom reflects on why evaluating integrated care remains so challenging — and why so much evaluation struggles to meaningfully inform practice, policy, and improvement. The conversation explores how evaluation can move beyond technical proficiency towards approaches that are more useful, more engaging, and more closely connected to the realities of people delivering and receiving care.

They also discuss Tom’s recent article, Reframing the Evaluation of Integrated Care: Examples from the NHS in England, which you can read here:
https://www.rand.org/pubs/external_publications/EP71109.html

Key insights from Tom Ling

On how evaluations are communicated

“We produce almost astonishingly boring reports… some of them are unreadable. And even the executive summaries… are kind of 12 pages of really dense material.”

On what integrated care actually is

“It is treated in many evaluations as if it is a thing in the same sense that a new drug is a thing… That isn’t what integrated care is. It is an aspiration.”

On the danger of single measures

“Don’t get sucked into believing that one single measure is going to give you the perfect measure of integrated care. It will always be misleading.”

On the gap between what’s measured and what matters

“Very often what we’re asked to measure and what policymakers sometimes think they want to know isn’t the thing that matters most to patients, and indeed clinicians and carers.”

On involving people on the front line

“They’d given their energy, their time, their insights to the evaluators… and at the end of the process, the evaluators produced a study and a report which they couldn’t make sense of and didn’t describe their world. That has to be unacceptable.”

On the need for a better mix of evaluation approaches

“What we really need is a much longer scale study… instead of… the same evaluation questions… the same kind of time scale.”

On embedding evaluative thinking in decision-making

“That model is much more likely to create innovative insights and better thinking where you get evaluative thinking informing decisions.”

In this episode of the International Foundation for Integrated Care's podcast series, 'Measuring the Impact of Integrated Care,' Niamh Lennox-Chhugani, is joined by Dr Jason Cheah, Deputy Group CEO (Strategy, Planning and Resourcing) of the National Healthcare Group (NHG) and the CEO of Woodlands Health (WH). He is also Adjunct Professor at the LKC School of Medicine.

Dr Cheah oversees cluster-wide strategy, finance, communications, resourcing and planning functions in NHG. These include driving financial and systemic changes within the Group towards accountable care, implementing capitation design, cost management, and workforce transformation. He also oversees and drives the organisational transformation roadmap and implementation plans for NHG, while also working to strengthen the organization's culture and identity.

In this episode of the International Foundation for Integrated Care's podcast series, 'Measuring the Impact of Integrated Care,' Niamh Lennox-Chhugani, is joined by David Harrison, an experienced accountant in the UK's health and social care system and Treasurer of IFIC's board. 

David has a public-sector management, economics and commercial background.  He is a qualified chartered accountant and MBA who, since qualifying, has worked extensively in the public and private sectors.

David’s advisory work on integrated care dates back to 2016.  He is designated as one of NHS England’s integrated care “subject matter experts”, having been deployed in several roles, from policy developer to implementor, by NHS England to support and accelerate the adoption of integrated care in England.

Most recently, David spent four years as chair of a substantial, employee-owned social enterprise, delivering a mix of community health services and primary care services.

Key Moments

In this podcast episode hosted by the International Foundation for Integrated Care, Neve Cahill converses with David Harrison, covering key discussions on measuring the impact of integrated care.

[02:35]They explore the transition to integrated care in England, the collaboration challenges between various health and social care organizations, and the importance of developing impact and outcome frameworks.

[08.33] Harrison highlights the necessity of senior leadership engagement, planning collaboratively to align institutional performance with system-level goals, and fostering trust among partners.

[14:10] How can integrated care systems isolate what improvements are necessary.

[21:40] The importance of collaborative planning so action can be taken early, instead of trying to understand problems when reviewing measurements after the fact.

In this episode of the International Foundation for Integrated Care's podcast series, 'Measuring the Impact of Integrated Care,' Niamh Lennox-Chhugani, is joined by Dr Ng Yeuk fan, Director of Corporate Development in Yishun Health and Khoo Teck Puat Hospital, Singapore.

Yeuk Fan is a consultant public health physician experienced in health systems and services planning and development. At Yishun Health and Khoo Teck Puat Hospital, he is responsible for Health Systems and Services Planning and Evaluation, Insights and Analytics, Corporate Planning, and Organization Development. He is also Associate Professor in Saw Swee Hock School of Public Health and Duke-NUS Medical School. His interests include integrated and value based care, systems thinking and health systems transformation.

 

Key Discussion Points

[05:12] – Discussion on real-world examples of integrated care implementation.
[10:45] – Challenges faced by healthcare professionals in adopting integrated care models.
[15:30] – Yeuk Fan shares insights on the importance of patient-centered approaches.
[20:20] – Discussion on how to evaluate the impact of integrated care on patient outcomes.

In this episode of the International Foundation for Integrated Care's podcast series, 'Measuring the Impact of Integrated Care,' Niamh Lennox-Chhugani, is joined by Ellen Nolte Director of the NIHR Policy Research Unit in Policy Innovation and Evaluation, a collaboration between the LSHTM, the Care Policy Evaluation Centre at the London School of Economics and Political Science, and University of Glasgow

Ellen Nolte is an expert in public health and her research primarily focuses on health services, international healthcare comparisons, and performance assessment, particularly addressing the needs of people with complex and long-term health issues.

Her work also explores person-centred health systems and the role of health system factors in improving care coordination and integration across sectors.

 

 

Key Discussion Points

 

[5:30-9:00] Defining impact in the context of integrated care, including the OECD's broad definition of impact and the nuances of treating integrated care as an intervention.

[9:00-12:00] Discussion on the difference between evaluation impact and the beneficiaries' perception of impact, stressing the need to clarify these differences.

[12:00-15:00] Examination of the policy perspective on integrated care, focusing on cost reduction and the importance of considering the broader impacts beyond just cost savings.

[15:00-18:00] Ellen emphasises the need for context-specific evaluation and the challenges of measuring integrated care across different settings and baselines.

[18:00-21:30] The importance of understanding patient and staff experiences and the relational aspects of care in evaluating integrated care.

[21:30-24:00] Discussion on the significance of allowing space and time for learning and making mistakes in integrated care implementation and evaluation.

[24:00-27:00] Highlighting the shift towards longer-term contracts in integrated care to provide stability and enable local systems to evolve.