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…
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’…
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…
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…
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…
Mental Health Surge Model
Early in the Covid pandemic, it became clear that people’s mental health would suffer. Whether through bereavement, unemployment, social isolation, not being able to access support services – or a host of other routes – an alarming picture began to emerge and attract attention.
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…
Accessibility of perinatal mental health services for women from Ethnic Minority groups
Barriers to accessing mental health care during pregnancy and the first postnatal year (perinatal period) seem to be greater for ethnic minority women.
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-…
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.
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…
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…
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…