
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…
Analytical Collaboration for COVID-19
Between March and December 2020 the Health Foundation; King’s Fund; Nuffield Trust; and the Strategy Unit collaborated to provide analytical support to the health and care system to help in the fight against COVID-19. The organisations worked in a coordinated way to provide analysis and expertise…
Strategy Unit analysis of air quality highlights inequalities
Poor air quality is the largest environmental risk to public health in the UK and central London has the highest levels of particulate matter and nitrogen dioxide. The Guy’s and St. Thomas’ charity, now operating its programmes under the Impact on Urban Health banner, have committed to 10 years of…

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…

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

Health service use in the last two years of life
Health and care services get just one opportunity to support people at the end of their life. When this support is compassionate and appropriate, unnecessary suffering can be avoided and grieving can be eased. When this is not the case, harm and distress can result. The difference in these…

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…

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.
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-centred intelligence.
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.

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…