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Our work

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carer holding had with elderly person in wheelchair
Blog post 24/09/2025

A missing element in ‘shifting care’

Our Director, Peter Spilsbury, outlines the scale of the task when it comes to making ‘the shift from hospital to community’.

13/05/2024

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.

graphic showing inequality being erased with eraser
Report 04/11/2022

What are the ethical challenges in addressing inequities?

Produced by Angie Hobbs - the world’s first Professor in the Public Understanding of Philosophy – this paper examines the ethical questions raised by our report outlining strategies for reducing inequity.

Long read 27/09/2022

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?

Report 09/05/2022

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.

Blog post 11/03/2022

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.

Blog post 11/12/2018

Why community alternatives to hospital admission don’t (typically) reduce total admission levels

Repeatedly, published evaluations show that community/primary care services interventions with a stated intention to reduce total (or forecast total) emergency admissions to hospital don’t achieve the expected result**

Blog post 01/06/2018

Do you like to integrate horizontally or vertically? NHS positions examined

Our latest research paper explores the impact of the different options for integration implemented as a result of the Transforming Community Services policy in 2010. This accompanying commentary reflects on potential implications for the current policy drive towards Integrated Care Systems.

Report 01/06/2018

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

Report 01/12/2017

Scoping study: the economics of caring

There is a clear moral case for supporting unpaid carers.

Report 12/05/2017

Making the Case for Integrating Mental and Physical Health Care - Full Report.

An analysis of the physical health of people who use mental health services: life expectancy, acute service use and the potential for

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