As part of the initial stages of Star, two pilots were undertaken:
NHS Isle of Wight pilot (July 2008)
Faced with significant health inequalities within their population, decision makers chose to focus on areas where investment would help reduce these and produce the greatest benefit in health. Six separate patient and stakeholder workshops identified the key issues in these areas and put forward a total of 21 strategic initiatives to improve quality of life and reduce health inequalities in the Isle of Wight.
The LSE worked with NHS Isle of Wight on their commissioning strategy for 2008 onwards, successfully helping it target additional resources for maximum health gain.
NHS Sheffield pilot (August 2009)
In a challenging health economy, NHS Sheffield wanted to better understand the cost effectiveness of different elements of its spending. Focusing on eating disorders, NHS Sheffield and the LSE team organised a decision conference over two days. The conference involved 25 stakeholders including patients, carers, clinicians and managers from all local providers of eating disorder services. As a result of the workshop, commissioning managers put together a business case for shifting investment in eating disorder services to boost overall health gains and reduce spending.
Learning from our first two pilots enabled us to further develop the Star approach before testing it in three more pilot sites looking at a variety of conditions and local contexts.
Gloucestershire pilot (November 2012)
NHS Gloucestershire focused on ophthalmology, where the local health economy had incurred a significant overspend in the last couple of years. Stakeholders discussed the data for six ophthalmology interventions at a half day workshop. Participants gained a better understanding of the costs to benefit ratio of one of the most widely used interventions offered to the health economy.
Tower Hamlets pilot (January 2013)
This was the first pilot that discussed co-morbidities, resulting in valuable practical feedback on how to adjust the Star tool to accommodate this type of analysis. The interventions discussed during this workshop focused on colorectal cancer and diabetes.
East Sussex pilot (March 2013)
The pilot workshop discussed different approaches to reducing emergency admissions to hospital for older people living in care homes. Having a diverse group of attendees, including expert GPs, lead commissioners and social care specialists, led to important insights regarding the efficiency spend on certain interventions.