Figure 1
The PHM cycle [5].
Figure 2
Building blocks for PHM implementation.
Adapted from Main et al (2022) and Siegel et al (2019) [13, 14].
Figure 3
Revised PHM framework showing factors influencing implementation.
Key: ALS = Action Learning Sets, BI = Business Intelligence, GP = General Practice, ICS = Integrated Care System, IMD = Index of Multiple Deprivation, LA = Local Authority, PCN = Primary Care Network, PHM = Population Health Management, PPIE = Patient and Public Involvement and Engagement, VCSE = Voluntary, Community and Social Enterprise, WDH = Wider Determinants of Health.
Table 1
Research participants by sector.
| PARTICIPANT SECTOR | NUMBER OF PARTICIPANTS | % |
|---|---|---|
| Primary Care Networks | 25 | 23% |
| VCSE organisations | 19 | 17% |
| General Practitioners | 14 | 13% |
| Acute providersa | 15 | 14% |
| NHS commissioners | 17 | 15% |
| Local authority/Public Health | 10 | 9% |
| Pharmacy | 3 | 3% |
| Health Innovation Networkb | 3 | 3% |
| Other providersc | 2 | 2% |
| Police | 1 | 1% |
| Other | 1 | 1% |
| Total | 110 | 100% |
[i] Note: a: includes the mental health provider; b: formerly the Academic Health Science Network; c: includes drugs and alcohol and social care providers.
Key: VCSE = Voluntary, Community and Social Enterprise.
Table 2
Summary of stakeholder attendance at ALSs by locality.
| STAKEHOLDER TYPE | LOCALITY | TOTAL | |||
|---|---|---|---|---|---|
| A | B | C | D | ||
| GP | 4 | 4 | 5 | 6 | 19 (9.6%) |
| PCN | 10 | 7 | 20 | 8 | 45 (22.7%) |
| NHS ICS | 10 | 12 | 18 | 15 | 55 (27.8%) |
| LA (incl. PH) | 4 | 7 | 7 | 8 | 26 (13.1%) |
| Acute providers | 6 | 5 | 1 | 2 | 14 (7.1%) |
| Other providers | 3 | 2 | 11 | 3 | 19 (9.6%) |
| VCSE | 6 | 3 | 6 | 5 | 20 (10.1%) |
| Total (%) | 43 (21.7%) | 40 (20.2%) | 68 (34.3%) | 47 (23.7%) | 198 |
[i] Key: GP = General Practice, ICS = Integrated Care System, LA = Local Authority, PCN = Primary Care Network, VCSE = Voluntary, Community and Social Enterprise.
Table 3
Summary of contextual factors, ALS progress and PCN innovations in development.
| LOCALITY | SETTING | COLLABORATION HISTORY | ALS COMPLETED | LOGIC MODEL | PROJECT TOPICS | STAGE OF PHM CYCLE REACHED |
|---|---|---|---|---|---|---|
| A | Rural | Strong | 6/6 | Partial (lacked inputs and outputs definition) | 1. ‘Z’ drug dependency | 3–4/5 |
| B | Rural | Weak | 5/6 | Partial (lacked inputs and outputs definition) | 2. Suicide and mental health prevention in rural males | 2/5 |
| C | Rural/urban | Moderate | 5/6 | Developed | 3. Did Not Attend individuals at practice | 2–3/5 |
| Developed | 4. High Frequency Users attending GP practices and Emergency Departments | 2–3/5 | ||||
| D | Rural/urban | Strong | 5/6 | Partial (lacked inputs definition) | 5. Supporting children/families living with a drug/alcohol misuser | 3/5 |
| Partial (lacked inputs definition) | 6. Over 50’s individuals experiencing social isolation | 3/5 |