Measurement of outcomes within a multicentred randomized controlled trial in the evaluation of the experimental NHS...

This paper reports outcome data from a multicentred randomized controlled trial (RCT) undertaken as part of the evaluation of the experimental NHS nursing homes. A small sample size within centres and differential non-response due to death and physical or mental frailty limits the statistical power of this trial and biases subject-reported outcomes toward the views of elderly people who were less frail. There were no significant differences in survival or personal well-being, or changes in behavioural ability, mental state or perceived health status between propositi and controls. There were significant differences in the views of responding propositi and controls suggesting that the experimental NHS nursing homes were preferred by residents. The results of this pragmatic trial suggest that there is no evidence to conclude that NHS nursing homes should not be provided as NHS continuing-care accommodation. Policy decisions should also take account of the other studies undertaken as part of the evaluation. Further research is needed to develop more appropriate outcome measures for this client group.