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.
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.
Inclusive Elective Care Recovery
These case studies present the key features and learning from local initiatives which championed inclusive approaches to elective care recovery.
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.
Population health implications of the Covid-19 pandemic
Our new report for The Midlands Decision Support Network (MDSN) presents findings of the effects of the care disruption, from the Covid-19 pandemic, on population health. The in-depth analysis identifies which patients and health conditions should be the focus of future efforts in reducing inequalities caused by the pandemic.
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
Helping ICSs to reduce inequalities in access to planned care
Are there inequalities in access to planned care? If so, what are they? Which groups ‘gain’ and which groups suffer? And what could be done to address any inequalities? In pursuing their objective of reducing inequalities, what could Integrated Care Systems (ICSs) do? What strategies and approaches are likely to be successful?
What matters when waiting? – involving the public in NHS waiting list prioritisation
As the NHS emerged out of the pandemic, it was confronted with the challenge of not only recovery of unprecedented waiting lists, but with inequalities which required attention. NHS leaders challenged providers to restore inclusively and at University Hospitals Coventry and Warwickshire NHS Trust, we have developed a way of doing just that, whilst simultaneously reducing waiting times for all.
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.
Treating people on waiting lists: who decides what is fair?
Waiting lists for elective care are in the news. The national plan has been issued, with the expectation that lists will continue to rise for some years - and that long waiting will not disappear anytime soon. Addressing this ‘backlog’ will remain a fundamental challenge for some time to come.
Estimating the impact of the proposed reforms to the Mental Health Act on the workload of psychiatrists
In January 2021, the Government published a White Paper, setting out its plans to reform the Mental Health Act.
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
Inequities in children and young people’s mental health services
Good mental health during early years and childhood has a great bearing on health throughout life.
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.
Evidence review: Early diagnosis of cancer
Detecting cancers early is essential to saving lives and reducing the need for invasive treatments.
Learning from lockdown: support for people experiencing homelessness
There are few clearer measures of societal health than homelessness.
Mental Health Surge Model
Early in the Covid pandemic, it became clear that people’s mental health would suffer. Whether through bereavement, unemployment, social isolation, not being able to access support services – or a host of other routes – an alarming picture began to emerge and attract attention.
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.
Accessibility of perinatal mental health services for women from Ethnic Minority groups
Barriers to accessing mental health care during pregnancy and the first postnatal year (perinatal period) seem to be greater for ethnic minority women.