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…
ICS intelligence functions – a toolkit to support the implementation of NHSE guidance
In 2020, NHSE announced the expectation that ICSs should develop “shared cross-system intelligence and analytical functions that use information to improve decision-making at every level.” This expectation has been followed by more detailed
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.
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.
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.
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…
‘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…
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…
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.
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.
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 …
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…
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…
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…
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
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…
Outcomes based commissioning: A framework for local decision making
This local decision-making framework aims to empower systems as they look to design new contracting approaches aimed at improving outcomes.
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.