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…
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.
Midlands Population Health Management Academy
The Midlands Population Health Management Academy was part of a programme of support, commissioned by NHS England and NHS Improvement (Midlands) working in partnership with the Local Government Association and Public Health England. The Programme ran from March 2019 to March 2020. It was designed…
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…
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…
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…
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…
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…
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…
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.