EVO Framework

The EVO Framework has been designed to help teams improve patient care at the system level, by supporting evidence driven value-based decisions at the specialty/service level.

By bridging the divide between quality and cost improvement, this framework encourages dialogue and empowers diverse teams to make decisions and measure improvement using value.

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Value, in this context, is defined as outcomes (or quality) relative to costs (or resources). The focus is firmly on prioritising the health outcomes for patients using the resources available.

The Framework itself takes the form of a free of charge physical project management handbook which NHS Trusts are awarded on completion of a successful application. (The application is signed by the medical director, director of finance and the Trust’s board.)

Using the EVO Handbook the Trusts existing operational, clinical, project, improvement and finance staff work together to evidence the need for change and implement improvements in three services simultaneously over a 20 week period.

There are no external parties involved in the process and the Trust teams are empowered to make decisions, implement changes and for the first time are able to measure the impact of their clinical transformations using value.

Measuring healthcare improvement

Watch the EVO launch session from the Finance Leadership Summit, launching EVO, July 2023

Click here to watch now

The NHS has a wealth of documented programs that have successfully used patient-level information costing systems (PLICS) data to drive improvement, including the Clinical Practice Groups at the Royal Free London NHS Foundation Trust, The WAVE Programme at Nottingham University Hospitals NHS Trust and the Waste Reduction Programme at Leeds Teaching Hospitals NHS Trust. EVO was inspired by the potential of this data set to provide specialty/service level teams with an evidence base from which measurable and meaningful improvements can be made.

A successful pilot of the framework, initially developed by Future-Focused Finance and the HFMA’s Healthcare Costing for Value Institute, took place in 2019 with four trusts, covering acute, mental health and community services. Case studies from these pilot sites can be found at the bottom of this page.

Since the pilot, EVO has undergone significant development as part of the One NHS Finance initiative, with the support of the Finance Leadership Council and EVO Collaborators.

Case study

Gloucestershire Health and Care NHS Foundation Trust: February 2020 – Allied Health Professionals, Diabetes Wound Care

Read it here

Case Study

Great Western Hospitals NHS Foundation Trust: March 2020 – Cardiology, Gynaecology, Trauma and Orthopaedics

Read it here

Case Study

North Staffordshire Combined Healthcare NHS Trust: March 2020 – Adult Community Mental Health Teams, Crisis Care, Memory Assessment Service

Read it here

Case Study

University Hospitals Birmingham NHS FT: 2013 October 2020 – Dermatology, Trauma and Orthopaedics, Vascular Surgery

Read it here