> they represented a range of of existing services (e.g. visits > reduced or prevented the need needs, including medical, social to hospital), the impact of these for residential care. and those not easily fitting a changes (e.g. not needing a taxi) and clearly distinct medical or social any changes in non-service-specific The economic evaluation did not need activities (e.g. reduced isolation). use a societal perspective – not all savings to service users and their > some were waiting for long-term Health care families are included (such as taxis) provision professional interviews – however, where consequences on > they comprised a range of ages income were present, these were and ethnicities. Interviews with a number of health noted and presented distinctly. care professionals (HCPs) validated Once a long list was identified, the assumptions underlying the The identified outcomes were costed screening interviews were conducted economic evaluation. Since the using the standard tariffs devised with the potential participants to primary aim was to avoid asking by the Personal Social Services discuss their situation further, verify the HCP to comment directly on a Research Unit (PSSRU, 2014) the fulfilment of criteria and ascertain patient known to them, vignettes and NHS National Tariff prices for whether they would consent to were created based on anonymous 2014/15 (Monitor and NHS England, the research. (See Appendix A for situations, as identified in the case 2013), which are accepted widely details on the numbers selected studies. These were presented to across the health care professions. and Appendix B for the screening the HCPs and they were asked to Further definitions for the analysis interview schedule). comment on the relative impact of can be found in Appendix E. Health care professional interviewees the wheelchair in those scenarios. Following identification of the were sought from a range of (See Appendix D for the interview outcomes, we adopted a simple professions (including medical, schedule). decision analytic model, using the nursing, occupational therapy Of the six HCPs identified across service user’s own perspective to and social work). This range was key regions where the service user examine the alternative journey of the mapped against the outcomes of the case studies were based, three service user if the wheelchair had service user interviews. were interviewed (two occupational not been available and the reported therapists and one nurse). outcomes had not been achieved. Case studies Costs were modelled for the 13 Analysis timescale of the wheelchair loan and Nine case studies were conducted, which comprised semi-structured The economic evaluation focused projected only when the service user interviews with individuals who on self-reported outcomes from the indicated a consequence due to not had loaned a wheelchair from the service user and/or their carer/family having a wheelchair (e.g. needing Red Cross on a short-term basis. member. In addition to the case longer to recover). (See Appendix C for the interview studies, interviews with health care schedule). providers validated the logic of the Four of the interviews included calculations and assumptions made questioning an accompanying family in the analysis. member alongside the wheelchair Analysis was based primarily on the user, three interviews involved only identification of outcomes specific the user, and for one interview only to health and social care savings. 14 the carer was present. These specific outcomes were: The interviews sought to understand > reduced or prevented the perspectives of the wheelchair unnecessary GP attendance users, family members and carers regarding the short-term wheelchair > reduced or prevented attendance loan service, including the effect at A&E of the service on the users’ health, > reduced or prevented admission lifestyle and the type of care they from A&E needed; and what they think would have happened if the service had not > reduced or prevented ambulance been available. use The participants’ responses were > reduced or prevented hospital then analysed to identify reported attendance, admission or outcomes, such as changes (or re-admission projected changes) in the use > reduced or prevented the need 13 Eight face-to-face and one via telephone. for on-going care and support 14 In one case the user had recently died. 10