Contracting for health outcomes: from concept through theory to implementation
In this new report, jointly authored with colleagues from the University of York and The Royal Orthopaedic Hospital NHS Foundation Trust, we set out in detail how an outcomes-based contract for elective knee replacements might be constructed, and the potential implications for commissioners, providers, and policy-makers.
Part-time GPs and the decline in continuity of care: a cause or a symptom?
In our recent paper we explore why levels of care continuity have been declining and what might be done to turn things around.
Two sides of the same coin
Hospital demand arising from GPs not seeing patients, is eating into the resources that they would use to manage down the elective backlog. In turn, this is creating more demand for GPs.
Are GP consultation rates rising or falling? Who or what should we believe?
If the "data suggests" GP appointments are substantially higher than pre-pandemic, then what is behind patients reporting recieving fewer appointments?
GP services: new analysis and fresh insights
In our latest analysis for the Midlands Decision Support Network (MDSN), we explore the long standing problem of access to GP practice consultations we consider the implications, and explore potential solutions.
Diagnosing harms?
All medicines are poisons. Everything that cures could kill if administered in the wrong doses, to the wrong people, at the wrong times, in the wrong ways.
How is growth in diagnostic testing affecting the hospital system?
Diagnostic services, such as medical imaging, endoscopy, and pathology, have grown substantially in recent years and at a faster rate than most other healthcare services. Increased diagnostic testing brings benefits to patients, but rapid growth of this service area within a complex, adaptive system such as the NHS is likely to have had unintended consequences. Midlands ICBs wanted to understand the impact of diagnostic growth on hospital services.
Socio-economic inequalities in coronary heart disease
There are substantial differences in mortality rates from cardiovascular disease between socio-economic groups. Our new tool provides an overview, for ICBs, of the points on the care pathway where inequalities emerge and are amplified
Inequalities in access to healthcare - what’s our next move?
Our research, published in the Lancet Regional Health Europe, highlights substantial inequities in access to elective hip replacement surgery. We found no evidence that these inequities reduced between 2006 and 2016.
Strategies to reduce inequalities in access to planned hospital procedures
UPDATE 10th August: Now including briefing note for Integrated Care Boards on legal duties in respect of reducing inequalities. This report guides ICBs through the process.
The impact of social care on demand for urgent hospital care: have we reached a consensus?
The care home COVID crisis and the effects of longstanding staffing and funding shortages has meant that social care has featured heavily in the media over the last 12 months.
Decisions to admit patients are not solely determined by clinical risk
Whether or not to admit a patient is one of the most routine yet important decisions a doctor in an Emergency Department
Socio-economic inequalities in access to planned hospital care: causes and consequences
Tacking inequalities in health is a long-standing NHS policy objective. Variation in the experiences and outcomes of different communities during the COVID-19 pandemic served to bring this issue back into focus.
Some positive news for integrating GP practices with hospital trusts
The drive for greater integration of health and care services has been the central theme of UK health policy for most of
Health service use in the last two years of life
Health and care services get just one opportunity to support people at the end of their life. When this support is compassionate and appropriate, unnecessary suffering can be avoided and grieving can be eased. When this is not the case, harm and distress can result. The difference in these experiences can be profound.
Modelling the impact of covid on waiting lists for planned care
Working with the national collaboration to coordinate covid-related analysis, and the NHSE/I Midlands region, the Strategy Unit has produced a ‘systems dynamics’ model of waiting lists for planned care. The model is freely available for non-commercial use across the NHS. Here, Steven Wyatt and Mike Woodall explain what we did and how we did it.
Horizontal or Vertical: Which way to integrate?
In 2011, Primary Care Trusts faced a difficult choice. The Transforming Community Services policy required a complete break of commissioner and provider functions. But what should PCTs do with the community health services they delivered; vertically integrate with an acute trust, horizontally integrate with a mental health trust, or set up a stand-alone community trust or Community Interest Company? Seven years on, this report explores the impact this choice had on the level and growth in emergency hospital use in older people and considers the wider implications for the NHS as it develops new models of care and integrated care systems
Scoping the Future (CRUK)
Within the context of rising demand for diagnostic services and concerns about capacity, Cancer Research UK commissioned this project to explore the issues for endoscopy services, to inform national strategic recommendations.