March 2022 Evidence reviews

Autism evidence scan identifies knowledge gaps

Diagnosing autism takes account of a person’s differences in social interaction and communication, sensory sensitivity, interests and behaviours. Yet autism varies hugely from person to person, both in how it looks and how it is experienced. This is because the term autism covers a broad range of…
March 2022 Strategy Unit information

We don’t just need to hear ‘you are more affected’ - what’s the action?

The experience of minority ethnic people symptomatic for COVID-19 in the first UK wave of the pandemic.
November 2021 Inequalities | Policy | Primary, community and social care services

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. It said which services and supports are needed to help people whose behaviour challenges services or who have mental health problems. This was because too many people were living…
October 2021 Better use of analysis | Policy

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.

10 min review test2 October 2021 Mental health | Policy

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. The Government invited views on the paper and in July 2021, it published a summary of the consultation responses and its plans to address the issues raised. The proposed reforms aim to…
October 2021 Better use of analysis | Elective care | Policy

‘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’t…
July 2021 Mental health | Primary, community and social care services

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. By contrast, poor mental health can cast a long shadow. Consequences may include depression, self-harm, and poor physical health. Services recognise this. They aim to provide access to support in a…
July 2021 Inequalities | Policy | Public health and prevention

Measuring the effect of the coronavirus pandemic on population health

Measuring the effect of the coronavirus pandemic on population health One feature of the pandemic has been the fast-flowing stream of facts and numbers about the impact of Covid-19. At the same time, we’ve had to absorb the meaning of terms that were previously the preserve of epidemiologists and…
June 2021 Better use of analysis | Elective care | Emergency care | Inequalities | Primary, community and social care services | Public health and prevention

Less noise and more light: using criteria-driven analysis to tackle inequalities

Reducing health inequality is a long-standing aim of health policy. Yet the gap between policy aim and population outcome has grown in recent years: on most measures health inequalities have got worse.
June 2021 Policy | Primary, community and social care services | Public health and prevention

Increasing vaccine uptake

The purpose of this work was to identify the key features of local initiatives which encourage vaccine uptake in different population groups, and share these for others to learn from.
10 min review May 2021 Elective care | Inequalities | Policy | Primary, community and social care services

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.
April 2021 Inequalities | Policy | Primary, community and social care services | Public health and prevention

Reviewing the evidence on digital inclusion

Digital technology is a significant part of our daily lives. It has changed the way we interact with each other, the services we use, and the ways we work.    The NHS is no exception. Digital technology has begun to change the way health and care services are delivered. And the Covid-19 pandemic …
April 2021 Elective care | Policy | Primary, community and social care services | Public health and prevention

Evidence review: Early diagnosis of cancer

Detecting cancers early is essential to saving lives and reducing the need for invasive treatments. So, in 2019, the NHS Long Term Plan set a national target for increasing the proportion of cancers diagnosed at an early stage. There is room for improvement in current performance. In 2018, 55% of…
March 2021 Policy

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…
February 2021 Better use of analysis | Inequalities | Public health and prevention

Strategy Unit analysis of air quality highlights inequalities

Poor air quality is the largest environmental risk to public health in the UK and central London has the highest levels of particulate matter and nitrogen dioxide.  The Guy’s and St. Thomas’ charity, now operating its programmes under the Impact on Urban Health banner, have committed to 10 years of…
February 2021 Inequalities | Mental health | Policy | Primary, community and social care services | Public health and prevention

Learning from lockdown: support for people experiencing homelessness

There are few clearer measures of societal health than homelessness. On this count, and despite its enormous material wealth, England is in poor shape. Relative to the recent past, and any country we might want to compare ourselves to, we have a problem with homelessness. The causes of homelessness…
January 2021 Elective care | Finance and payments | Inequalities

Equity and Cost Growth in Specialised Services

NHS specialised services provide care for people with complex or rare medical conditions. Treatments for these conditions are often expensive: While specialised services support a small proportion of the population, approximately one-sixth of the total NHS budget - over £19 billon - was allocated…
November 2020 Better use of analysis | Inequalities | Mental health

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.
October 2020 Inequalities | Policy | Public health and prevention

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
October 2020 End of life | Inequalities

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…