Urgent Community Response – What Works?
The Strategy Unit, with our partners Ipsos, has been commissioned by NHS England and NHS Improvement (NHSEI) to provide a long-term national evaluation of the Urgent Community Response programme rolled-out across England. The programme aims to shift resources to home and community-based services as part of the NHS commitment to providing the right care, to the right people, at the right time. And there are a range of outputs from the early work that provide learning for local systems as they develop their services.
Infant feeding problems, lockdown and attendance at Emergency Departments: what’s going on?
From our previous work, with Nuffield Trust and Health Foundation, we know that lockdown had a significant effect on attendance at Emergency Departments (ED). We also know that this effect was very unevenly distributed: some demographic groups stayed away far more than others.
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
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
Strategy Unit analysis published showing changes in use of emergency departments under lockdown
We know that patterns of access to healthcare have changed during the 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 experiences can be profound.
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.
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 uncovers new insights and has the potential to reshape received wisdom about the performance of A&E departments, carrying important implications for healthcare policy and system leadership.
New care models - what's the evidence
High level findings from a series of evidence reviews on new care models.
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**
Evaluation of an Integrated Mental Health Liaison Service (Rapid Assessment Interface and Discharge Service) in Northern Ireland
A high proportion of patients treated for physical health conditions also have co-morbid mental health problems; and there is growing acceptance of
Making the case for integrating physical and mental health services in England - National overview
This is a national overview report of our Making the case for integrating physical and mental health services reporting which took place in July 20
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 provid
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.
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
HSJ Article - Why are A&Es feeling the strain?
Article published by HSJ on 3rd November 2017.
Changes to Admission Thresholds
This analysis builds on a paper, Changes in Admission Thresholds in Engli
Evaluation of the Dudley Multidisciplinary Teams (MDTs) Summary of Final Report
Multi-disciplinary Teams (MDTs) in primary care are a core component of Dudley's care model; they are also widely used elsewhere.
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