HISTORY

In 1993, following a conference for the Mental Health Foundation a multicentre collaborative group, led by Professor Michael Barkham won a competitive tender to develop an outcome measure (OM), and Clinical Outcomes in Routine Evaluation (CORE) was born. The phenomenal success of CORE came not just from being in the right place at the right time to meed demand for improved outcome monitoring, or even from providing royalty free measures, but also, crucially, through understanding what users need in order to make the system accessible and useful.

Building on robust academic foundations, CORE Information Management Systems Ltd (CORE IMS) was formed by John Mellor-Clark and Alex Curtis Jenkins in 2001.

Over the past 10 years CORE IMS has developed unique expertise in helping service providers and commissioners introduce best practice in routine outcome measurement with the help of a range of bespoke resources. These include training for routine measurement, bespoke software to enhance data quality and resource appropriate feedback, outcome data management training and support, and the management of a unique national research database (NDB) to resource benchmarking for comparative service performance appraisal. Staffed by a dedicated team, CORE IMS serves over 250 UK services (estimated to comprise of over 3500 psychology, psychotherapy and counselling practitioners) across a range of clinical settings.

The success of the CORE endeavour has been marked by the rapidity with which organisations, particularly those in the fields of primary healthcare and the psychological therapies, have integrated the system into routine practice, and the willingness of purchasers and commissioners to accept CORE data as a valid performance indicator. Along the way, CORE OMs are generating scientifically important findings concerning therapeutic change in clinically representative settings. In its evolved form, the CORE methodology scores highly in ease of use and external validity, but its demonstrated overlap with other measures brings non-empirical factors into play for those choosing between CORE and competing comparable measures. In addition, CORE's developers recognised from the outset that CORE measures may need to be complemented by other domain-specific measures to do justice to complex clinical situations. Measures such as CORE are a complement to, not a substitute for, clinical judgement. CORE training has always conveyed the importance of balancing the "exactness" of a validated measure, with the clinicians own judgement , especially in risk assessment.

Service providers are in the midst of a revolution in accountability. If the challenging move towards payment by results is completed, account will have to be given of what was done for whom and to what effect. CORE is well placed to play a central role in this process, and to help clinicians reflect on individual results. Equally, services will be assisted in comparing benchmarks with peers, and in undertaking pragmatic practice-based research into who and what works best. Each step brings closer an exciting future of outcome-informed practitioners.


 

 
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