Measuring impacts of integrated prevention services: rapid evidence review and qualitative analysis

Background

The complex challenges facing health and social care in Wales directed the Welsh Government to establish an Integrated Community Care System (ICCS). The ICCS involves a shift towards integrated and preventative care approaches, but measuring the impact of such approaches is challenging due to a lack of robust measurement tools and frameworks.

Methods

A rapid evidence review of existing measurement frameworks and tools for assessing the preventative impact of integrated care was conducted; early findings were sense-checked against current practice with national and international stakeholders. Social Sciences Citation Index; MEDLINE; CINAHL were searched from 2000 to October 2025, plus a large range of organisational websites. 3 reviewers used Rayyan software to screen against inclusion criteria, data were extracted into an Excel spreadsheet for narrative synthesis. Online focus groups with stakeholders were analysed using framework analysis.

Results

4671 records were screened; 36 included in the rapid review; 13 reported on the development of measures and 33 reported on 62 measures themselves. 14 participants from policy, practice and academia, were interviewed online. While there is a wide range of tools and frameworks available, a one-size-fits-all approach may not be suitable to measure preventative impact across a range of services focused on different outcomes and needs. Focus group participants emphasised the importance of co-production to define what successful prevention looks like for each service or intervention. Identifying mechanisms and linked proxy outcomes by which preventative outcomes could be reached was important. Burden on staff and services needs to be carefully considered when implementing a new tool.

Conclusions

The review emphasised the importance of co-production to define ‘success’ for each service, before selecting suitable outcome measures.

Key messages

• A one-size-fits-all approach may not be suitable to measure preventative impact across a range of services focused on different outcomes and needs.

• Co-production is needed to define what success looks like in terms of prevention for different services, interventions and stakeholders.