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…
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…
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
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…
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…
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…
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 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.
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.
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…
Clinical Workforce Scenarios for the Black Country
The future is highly uncertain. Unless we consider the diverse factors that could affect health, our plans will lack creativity and sustainability. The challenges facing NHS systems are headline news: NHS structures are frequently the subject of organisational change; new policy directives; funding…
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…
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: Innovation and Evaluation
The problems facing health and care services are so well known as to be documented in the media most days. These problems arise from a mismatch between need and provision: a mismatch where there is no reason to assume fundamental change. So innovation – in both product and process – is needed. Yet…
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…