The project is divided into three phases:
- Scoping: meetings with policymakers and healthcare professionals engaged with healthcare delivery in south east London to further refine the project parameters.
- Co-design: working with key stakeholders to co-design the methods for learning and dissemination and identify priority areas for rapid evaluation.
- Implementation: mapping the resilience capacities of the south east London health system using qualitative and quantitative research methods. Rapid evaluation projects will generate evidence-based health service and policy recommendations.
Scoping phase key findings
- Stakeholders viewed resilience through the lens of resistance and the ability of healthcare professionals to withstand the pressures placed on the healthcare system by the pandemic.
- Many changes to health policy and service delivery were defined as “innovations”, but there was little available evidence about the effectiveness (or not) of the changes.
- Many innovations remain undocumented, and no formal, robust evaluations were found.
The Conceptual Framework represents the complex relationships between various interlinked concepts that influence health system resilience. The framework sets out different pathways and starting points for quantitative and qualitative inquiry and highlights the need for a multi-level approach to analysis. For example, when undertaking a rapid evaluation of an intervention, the resilience framework can be used as a guide to developing the monitoring and evaluation tools. Data collection considers contextual factors, the shocks and stressors of interest, the relevant target populations, interventions, and mechanisms (“resilience for whom, of what and through what”). Data are then synthesised using the framework, for example, by thematically grouping interventions by temporal dimension (before, during or after a shock), resilience capacities, or the targeted level of the intervention.
Theory of change
Although Resilient Health Systems (RHS) is a research project, the approach that underpins the collaboration between KHP WCH and SEL ICS is interventional. The Resilient Health Systems Theory of Change highlights how the project is expected to lead to change in the south east London health system.