Introduction

A service might choose to hold a community appointment day (CAD) to improve access to care, reduce waiting times, and provide a more holistic approach to patient support.

Holistic Approach: By bringing together different services and community organisations, these days allow patients to address multiple needs in one location, rather than having to navigate separate appointments.

Personalised Care: A key aspect of community appointment days is the focus on “what matters to you” conversations, which helps tailor the support provided to individual needs and preferences.

De-medicalised Setting: By holding appointments in a community setting like a leisure centre, the atmosphere is less clinical and more relaxed, potentially reducing anxiety and encouraging engagement.

Improved Access and Reduced Waiting Times: Community appointment days can address the issue of long waiting lists by offering same-day access to assessments, advice, and support, including rehabilitation and self-management resources.

Build Partnerships: These events also foster stronger connections between healthcare providers, community organisations, and the individuals they serve, creating a more integrated and responsive system of care.

Community Empowerment: Community appointment days can empower patients to take a more active role in their own care by providing them with the knowledge, resources, and support to manage their conditions effectively.

Pre-CAD Check List	Completed
CAD coproduction patient engagement group established
Identified partner/3rd sector support/participation
Project Protocol Completed
Team Roles Established/agreed
Resources identified/requested
Logic Model Completed
Health Equity Assessment Completed
CAD Essential Ingredients Included Essential Ingredients
Data protection/ GDPR Included

CAD Project Protocol

The protocol outlines the intervention’s goals, objectives, methods, and expected outcomes, providing a clear framework. The protocol serves as a reference document for all team members, ensuring they understand their roles and responsibilities, as well as the expected procedures for each stage of the intervention, facilitates communication among team members and stakeholders by providing a shared document that outlines the project’s details.

A good protocol addresses ethical issues related to the intervention, such as informed consent, confidentiality, and data security, promoting responsible and ethical practices. The protocol provides a framework for monitoring the intervention’s progress and evaluating its impact, enabling adjustments to be made as needed to improve effectiveness.

Project Protocol is a statement of;

• Why – are you doing the evaluation activity – what is the gap and what is the influence you aim to have?
• What – is the question(s)?
• How – are you going to answer the question?
• Who – is going to form the team to do the work, who is going to steer it/report to, who are the key stakeholders to engage with?
• What next – what is the plan to take the findings to achieve the impact that you need?

A protocol does not need to be a lengthy document (2 sides of A4) the protocol should sit alongside the project logic model. These two documents provide a clear and organised framework for the project, ensuring all team members understand the objectives, methods, and timeline.

	Project Name
	Project/Service Lead
1	Background – this section should include background information of the service/ topic area
1.1	Rational – Why are you doing the CAD, what is the gap and what is the influence you aim to have?
1.2	Objective – What is the objective of holding a CAD? For example – How can we support people to self-manage their conditions? Is it to inform service redesign?
2	Methods What methods are going to be used to answer the above questions? What resources will be required? Will patient groups or persons with lived experience be involved in the design, development and/or delivery? Have you considered how you will reduce inequity?
2.1	Data Collection/Measures – Do you have baseline data? What are you going to measures and how? Who will record this? Will the support of evaluation researchers and/or Health intelligence data analysts be required?
2.2	Analysis – quantitative/ qualitative – How will this be carried out and who will do this? Will the support of evaluation researchers and/or Health intelligence data analysts be required?
2.3	Reporting – Who will write up the reports? Where do you intend to share the reports?
3	Project Team & Roles
3.1	Who is going to form the team to do the work, who is going to steer it/report it, who are the key stakeholders to engage with?
3.2	Resources Required – consider if support is required from Health Intelligence for data, researchers for evaluation development and impact analyses, is comms involvement required?

CAD Evaluation Plan

This sheet will help determine the type of evaluation required and identify what support may be required. Below are some key components that should be considered:

1. Process Evaluation: assesses the implementation, focusing on delivery and patient/public staff satisfaction/immediate outcomes on the day.
   1. What worked well and less well, and why?
   1. What could be improved?

Process evaluations typically use a wide range of methods, both qualitative and quantitative. They will often cover subjective issues such as perceptions of the day and objective issues such as patient attendance using administrative data.

Conducted by: service lead/ project manager of the CAD

• Project Plan/Logic Model: helps to identify;
  • What resources will be required
  • What actions and measures will be included

• Outcomes/Impact Evaluation: this type of evaluation is often used when the intention is for changes in service delivery or to improve service uptake. The focus is on the changes caused by the intervention, measurable achievements.
  • What measurable outcomes, both intended and unintended, occurred?
  • How much of these outcomes can be attributed to the intervention?
  • Have different groups been impacted in different what, how and why?
  • How has the context influenced outcomes?

Support Needed: This type of evaluation may require support (researcher & senior data analyst). A request should be made at the start of CAD design to ensure that there is adequate time to plan and the available capacity to support.

• Logic Model: The project/service lead will need to complete a logic model that includes (as above)
  • Baseline Measures – Identify data essential for assessing impact.
  • Identify comparative group – patient waiting lists, those who attend CAD those who do not

Further Considerations

Assessment of health inequalities and identify what you can do to help reduce inequalities.

• consider the equity issues to be addressed for a population in the planning or preparatory stages of programme or service development
• consider the requirements of the Equality Act 2010
• demonstrate compliance with the public sector equality duty (PSED)

HEAT has similarities to other health equity assessment tools but is unique in providing a lighter yet systematic framework for assessing and driving action to reduce health inequalities and provides an easy to follow template Health Equity Assessment Tool (HEAT): what it is and how to use it – GOV.UK

Evaluation Logic Model Guide

Intervention:	What is actually being evaluated, i.e. the project.
Inputs:		Activities:	Outputs:		Outcomes:				Impact:
Resources used to implement intervention		Parts of the intervention	Specific, direct deliverable s of the project that provide the conditions necessary to achieve the outcomes		What will change and who will benefit				High-level goal that the project will contribut e towards achieving (cannot be achieved solely by the project)
					Indicators:
					What will be measured to show each outcome has been achieved.	Measure each indicator at baseline and at least one follow-up (target). May be useful to have intermediat e milestones.	Each target should be specific, measurable , achievable, realistic, time-bound (SMART)
					Sources:
					Where is the informatio n coming from?
Assumptions :	Conditions needed/ resources available to allow progression from inputs to impact