Menopause and the NHS workforce
The impact of the menopause on the NHS workforce. The Strategy Unit and Health Economics Unit report on their mixed methods findings.
Evaluation of Building the Right Support: Final Reports
Building the Right Support was a national plan to provide better support to people with a learning disability or autism.
Advancing the analytical capability of the NHS and its ICS partners
The Strategy Unit were asked by the Strategy and Development Team in the Directorate of the Chief Data and Analytics Officer, NHSE/I, to make recommendations for advancing analytical capability across the health and care workforce.
‘To risk stratify or not risk stratify, that is the question’ (At least, it should be)
Risk stratification tools are ubiquitous in healthcare. The concept is simple and seductive. By predicting the risk of future adverse events, we should be able to target efforts to avoid/mitigate them. Doing so would save both money and misery. But, as Niels Bohr said wryly, “Prediction isn’…
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.
A framework for understanding policy change
A new policy, strategic direction or major programme is announced. How do we begin to understand, interpret and explain it? And how can we start the task of analysing and critiquing it? I see three main approaches: 1: Personal views As an individual, we might ask whether we like or agree with the…
COVID-19: breaking the cycle of deprivation and ill health
Promoting whole-system action on the wider determinants of healthy life expectancy in the shadow of the COVID-19 pandemic
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…
How can we learn from changes in practice under COVID-19
During the COVID-19 pandemic we have seen rapid changes in ways of working. We have seen an increase in collaboration, particularly through digital platforms, the sharing of data, and people describing ‘true system working’. So how do we capture innovations and changes in practice? How do we learn…
How will we know if Integrated Care Systems reduce demand for urgent care?
The implications of a blended payment system are far reaching: Decisions about planned activity levels will determine the total funding envelope for urgent care within a system and will influence the behaviour of healthcare providers and the services they deliver to patients.
Opening the ‘black box’ of scenario planning through realist synthesis
Scenario planning is recognised as an effective aid to strategic planning in complex, uncertain conditions. It is an approach that the Strategy Unit is increasingly building into its work with health and care systems and third sector organisations.
Waiting Times and Attendance Durations at English A&E Departments
In March 2019, NHS England is expected to report the outcome of its review of constitutional waiting times targets. This report reviews the factors that have led to the decline in performance against one of these targets - the 4-hour target for Accident and Emergency Departments. The analysis…
The Potential Economic Impact of Virtual Outpatient Appointments in the West Midlands: A scoping study
The Strategy Unit was recently approached to examine the case for a shift from traditional outpatient services to the use of virtual and remote access technologies for appropriate outpatient appointments. An essential part of this assessment was broadly scoping the potential socio-economic impacts…
The Status of Electronic Palliative Care Coordination Systems in the West Midlands
Commissioned by NHS England, this report describes the state of electronic palliative care coordination systems in the West Midlands. It draws on a review of the literature, interviews with local NHS staff and responses to information requests. As people approach the end of their lives…
Risk and Reward Sharing for NHS Integrated Care Systems
Risk and reward sharing is a simple and attractive concept, offering a commissioner the opportunity to co-opt and incentivise a provider to moderate growth in healthcare demand by sharing in the savings or cost over-runs. The Centers for Medicare and Medicaid Services (CMS), a US government…
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…
Palliative and End of Life Care Report for Children and Young People
Commissioned by NHS England, this report describes the the characteristics and levels of resource required by children and young people (CYP) (0-25 years) with life limiting conditions and/or life threatening conditions (LLC). The scope of this report does not attempt to explain or address the…
Palliative and End of Life Care in the West Midlands
Commissioned by NHS England, this report describes the status and context of palliative and end of life care services in the six Sustainability and Transformation Partnerships in the West Midlands. The report contains data on trends and forecast numbers of deaths, place of death, palliative…
Changes in Dementia Incidence, Prevalence, Severity and Mortality
Dementia is a key priority for NHS England and is estimated to affect around 676,000 people in the country. Our analysis is intended to help understand the need for future dementia diagnosis and treatment services in a specific area and to help commissioners to identify and…
Changes to Admission Thresholds
This analysis builds on a paper, Changes in Admission Thresholds in English Emergency Departments, which explores changes in the casemix of patients attending emergency departments (EDs) and the propensity of EDs to admit patients. The report incorporates additional analysis commissioned by…