
‘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’…

Inclusive Elective Care Recovery
These case studies present the key features and learning from local initiatives which championed inclusive approaches to elective care recovery.

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…

The NHS as an anchor institution: addressing fuel poverty
The number of households in fuel poverty in Staffordshire and Stoke-on-Trent (SSoT) is higher than the national average. As anchor institutions, NHS organisations can use their assets to influence the health and wellbeing of their local communities. The Strategy Unit was asked by the Midlands NHS…

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.

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.

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.

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…

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…

Socio-economic and environmental impact of Herefordshire and Worcestershire STP
Anchor institutions are large, typically non-profit, public sector organisations whose long-term sustainability is tied to the wellbeing of the populations they serve. They also have a significant impact on the health and wellbeing of their local communities. Health and care organisations act as…
Modelling the impact of covid on waiting lists for planned care
Working with the national collaboration to coordinate covid-related analysis, and the NHSE/I Midlands region, the Strategy Unit has produced a ‘systems dynamics’ model of waiting lists for planned care. The model is freely available for non-commercial use across the NHS. Here, Steven Wyatt and Mike…
How can Integrated Care Systems collect and use more ‘person-centred intelligence’?
Working with our partners Ipsos MORI, we have produced detailed guidance and an offer of services to address this question. This webpage contains information about the work, and all the products from it. Please get in touch if you would like to improve your use of person-…
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.

Exploring Mental Health Inpatient Capacity
This report explores the pressures on inpatient mental health services across Sustainability and Transformation Partnerships in England, drawing on a wide range of datasets, published research and interviews with staff working on mental health services. The report was commissioned by and includes…

PHM Core Team - 2nd July 2019
PHM Academy - Core Team Event 2nd July 2019 We held our first Core Team event on the 2nd July 2019 which was a huge success. All STPs arrived in high numbers and were given the opportunity to hold talks with some of the leading experts, which included:
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…

Scoping study: the economics of caring
There is a clear moral case for supporting unpaid carers. They play an essential role in the lives of the people they care for; they often do so at a cost to their own wellbeing. But what is the economic case for supporting carers? And to what extent does the evidence base support this case?…
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…