Tower Hamlets has been at the forefront of innovation development in health and care and is well recognised for pioneering new work practices and leading the way in new initiatives and projects. These new ways of working and initiatives demonstrate the ambition and passion of stakeholders across the system to tackling the challenges experienced with improving outcomes for its population. 

From a system perspective, the next step in improving population health outcomes is the implementation of an Shared Outcomes Framework. The purpose of the Outcomes Framework is to provide a high-level vision to serve as an anchor to help Tower Hamlets health and care system make informed decisions regarding what care provision to develop and what improvement work to prioritise.

Evidence from other health and care systems which have embarked on transformation, demonstrates that having a shared vision and system wide outcomes is vital to develop a common language across the health and care system. This in turn supports stakeholders to move past practical impasses that can arise when teams and organisations have different goals.

Tower Hamlets Together recognise the importance of a Shared Outcomes Framework and how it can act as a vital tool in a time/resource constrained system such as theirs to:

• guide system priority setting and those working in the system are clear about the priorities
• help those in the system be confident that they support wider system aims and what local people say is important to them
• provide a common point of reference to empower front line staff, and all in the system, to take large and incremental steps to help meet the outcomes articulated
• enable smooth joint working as it offers a clear articulation of shared ambitions

I-Statements are a personal statement about ones feelings, beliefs and values. The 'I Statements’ developed reflect things that citizens of Tower Hamlets want from health and care services or in their lives.

Since 2017-18 the I-Statements are increasingly being used by commissioners, providers and the community, for example to:

• develop tenders for the procurement of health and care services
• team annual planning within social care
• develop the Health and Well-being strategy
• develop services and quality improvements
• evaluate care and support provided
• structure community consultation and engagement activities

In 2018-19 a Shared Outcomes Framework based on the set of ‘I’ Statements was developed in partnership with system stakeholders, supported by Bourne Advisors Ltd.  The aim of the Outcomes Framework is to act as a ‘tool’ for which Tower Hamlets Together can use to assess how the health and care system is progressing towards making the I-Statements a ‘reality’ for the citizens over the next 5-10 years.

The aspiration is for the Outcomes Framework to be adopted fully by all partners within Tower Hamlets so that commissioners, providers and the community can use the outcomes to drive forward improvements in how health and care is commissioned, designed, delivered, evaluated and improved.

The Outcomes Framework was co-designed with THT stakeholders, including representatives and leads of the three life course work streams and was completed at the end of June 2019.  It is reflective of the broad challenges and needs experienced by the three-life course work stream population groups (Born Well Growing Well; Adults Living Well; and Adults with Complex Needs), it includes the following elements:

• set of domains with which categorise / group the I-Statements
• description that underpins each domain
• description that underpins each I-Statement
• proposed short list of system wide outcomes and/or indicators associated with the I-statements

The Outcomes Framework was signed off by the THT Board in September 2019.  In 2020 THT started to adopt the Outcomes Framework to develop a systems dashboard as a way of identifying how the system is progressing to achieving the I-Statements through the various programmes and initiatives that are being delivered locally.