Elective care | Emergency care | Finance and payments | Policy | Primary, community and social care services
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.
Better use of analysis | Policy
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.
Emergency care | Policy
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…
Inequalities | Policy | Primary, community and social care services
New care models - what's the evidence
High level findings from a series of evidence reviews on new care models.
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…
Lessons from the Vanguard: Procurement
Dudley was unique within the New Care Models programme for using a large-scale procurement exercise. This exercise therefore offers lessons for both policy and practice. These lessons are set out in a short ‘lessons from the vanguard’ paper, joint-authored by the Strategy Unit and Dudley Clinical…
Finance and payments | Policy
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…
Elective care | Emergency care | Policy | Primary, community and social care services | Public health and prevention
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…
Identifying Potential QIPP Opportunities - Dudley Example
Given the pressures within the NHS, being able to identify opportunities for efficiencies and improvements is vital to inform commissioning intentions. This report is an example of analytical work which to support commissioners. The objective of this report is to provide information to…
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…
Stage 2 Clinical Assurance Evidence Framework
Service change assurance exists to give confidence to the NHS and public that proposals are well thought through, have taken on board a wide range of views and will deliver real benefits. At the heart of the NHS England assurance process are the ‘five tests for service change’ that are in the…
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 improving quality and using resources more efficiently. The Strategy Unit, inspired by earlier research published by the Nuffield Trust, has created a ground…
Elective care | Emergency care | Inequalities
Future Fit - acute hospitals options appraisal
The Strategy Unit worked as a strategic partner of the NHS Future Fit Programme in Shropshire and Telford & Wrekin from its initiation and until it was able to move to public consultation. A key output was the comprehensive appraisal of acute hospital options, the recommendations from…
Integrated Impact Assessment for Major Hospital Reconfiguration
The Strategy Unit worked as a strategic partner of the NHS Future Fit Programme in Shropshire and Telford and Wrekin from its initiation and until it was able to move to public consultation. A key output was a comprehensive Integrated Impact Assessment of acute hospital options that enabled…
Elective care | Emergency care | Primary, community and social care services
Integrated care: rapid evidence scan
Exploring what integration can mean in different contexts, we have summarised evidence on effectiveness and cost effectiveness of integrated care, alongside lessons for implementation and considerations for measurement and evaluation.
Unplanned admissions: rapid evidence scan
Reducing unplanned admissions is a key priority for local health economies. This rapid evidence scan will help you to navigate the evidence base on various service interventions and their impact on unscheduled care.
Elective care | Emergency care
The Effect of Demographic Change on Acute Hospital Utilisation
Recognising that the effect of population ageing can be overstated, we set out to ask what effect an older population will have on demand for health and care services. Here, we explain why typical approaches ‘overlook the fact that rising life expectancy makes … older people “younger”,…
Scoping the Future (CRUK)
Within the context of rising demand for diagnostic services and concerns about capacity, Cancer Research UK commissioned this project to explore the issues for endoscopy services, to inform national strategic recommendations.
Elective care | Emergency care
Modelling Patients Flows under Potential Configurations of Emergency Centres with Specialised Services
Onsite, 24/7 access to complex vascular surgery, hyper acute stroke services and primary percutaneous coronary interventions are expected to be a pre-requisite for a hospital to be designated as an emergency centre with specialised services. This paper sets out the patient access and patient…