Learning about what works in urgent community response
The initial report from the national urgent community response (UCR) evaluation, along with an economic modelling tool to help service providers and systems understand the impact of UCR, is now available.
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…
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.
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.
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…
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…
Primary and Community Qualitative Insights
The COVID-19 response required rapid change and innovation across health and care. As part of a wider package of evaluation support, from April to June, the Strategy Unit led some qualitative work (training and supporting CCG staff to conduct interviews) across an STP to capture learning from…
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…
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…
Neighbourhood Network
The Strategy Unit wants to support Neighbourhood Working. We want to help make a success of different services – health, social care, voluntary sector (etc) – coordinating their efforts to improve health outcomes for local populations. To do this, we have initiated a learning network. …
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…
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…
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”,…