Latest series: Neighbourhood Insights
Join the Strategy Unit for a new series of SU Insights events exploring Neighbourhood Health and the care shift from hospital to community.
Shifting care from hospital to community has long been an NHS ambition - yet progress has proved elusive.
The 10 Year Health Plan for England is blunt: the NHS remains hospital-centric, fragmented and detached from communities. Framed as “reform or die”, the Plan places the Neighbourhood Health Service at the heart of change.
Previous efforts have often faltered through a failure to ‘do the detail’: good intentions not translating into well-designed action, plausible ideas not delivering in practice, and evaluation crowded out by the search for positive case studies.
Through our work with national and local programmes - including the National Neighbourhood Implementation Programme, the New Hospitals Programme, and others - the Strategy Unit has developed practical evidence, analysis and tools to address these challenges. Neighbourhood INSIGHTS is how we share that learning.
We want to reach people from across health, social care and the voluntary sector. Sessions will be suitable for service designers and managers, leaders, clinicians, strategic commissioners, national planners and policy makers: anyone interested in how analysis, evidence and critical thinking can help their work.
Across the series, we will explore:
- The nature and scale of the challenge when it comes to shifting care.
- Why previous efforts have come unstuck.
- Where to start in designing services to prevent unnecessary hospital activity.
- The likely ingredients for success in neighbourhood working – and what to avoid.
- How to model the effects of shifting care, given the complexity of local systems.
- Tools to track shifts of care, using specifically-designed measures, and ways of spotting promising practice using data.
- And much more.
Across the series, we will hear from a range of expert voices — including Steven Wyatt, Jess Morley, Thea Stein, Minal Bakhai, Adam Lent, Connie Junghans Minton and many more.
Event 2: The risks of risk stratification in neighbourhood health
The theory behind risk stratification is seductive. Almost irresistible.
Run algorithms over (mainly) primary care data. Identify individuals at high risk of unplanned hospital care. Intervene early. Prevent poor outcomes.
It sounds compelling.
But in practice, it has not worked as expected. In some cases, the reverse may be closer to the truth - with evidence suggesting this approach may even increase the use of unplanned care.
So, what has gone wrong?
What does this tell us about how we use data and analytics in neighbourhood health? And where does this leave those planning and delivering services designed to shift care from hospital to community?
This session explores:
- Why risk stratification has not delivered on its promise
- What the evidence actually shows about its impact
- The unintended consequences of data-driven targeting approaches
- What this means for neighbourhood health design and delivery
- How we should think differently about prevention and risk
This session, chaired by Fraser Battye, will present insights from Steven Wyatt (Strategy Unit), Jess Morley (Yale University) and Thea Stein (Nuffield Trust).
Thank you to everyone who attended the first Neighbourhood Insight Event - Looking back, looking forward.
If you missed the session, or would like to revisit, you can view the recording below:
About this session
We’ve been here before.
For decades, the NHS has sought to become less hospital-centric and more community-focused. Yet progress has been uneven. What can we learn from this history? As neighbourhood health develops, where must attention focus to avoid repeating past mistakes?
At the same time, we are heading into a very different future.
Some aspects of the future are uncertain - but demographic change is not. Population ageing is set to increase demand on community-based services.
This session explores:
- What history tells us about why reform efforts have struggled
- How demographic change will shape demand for community services
- Which services are likely to see growth
- What strategies may help manage rising demand
- What commissioners and planners need to know now
The session presents findings from Strategy Unit work reviewing recent policy history and predicting future demand for community services.
Related content and resources
A report exploring the scale and complexity of delivering a meaningful shift from hospital to community care https://www.strategyunitwm.nhs.uk/publications/missing-element-shifting-care
Insights from our work in Birmingham and Solihull, showing how advanced analytics can support practical shifts in care. https://integratedcarejournal.com/shifting-care-in-birmingham-and-solihull/
A long read describing our analysis of what has driven the growth in hospital activity. https://www.strategyunitwm.nhs.uk/news/what-explains-recent-growth-hospital-activity
A blog by Fraser Battye examining the challenges and tensions in delivering the shift from hospital to community. https://www.strategyunitwm.nhs.uk/news/right-drift-left-shift
Thank you to everyone who joined the SU Insights session Creating an ‘Internal Consultancy’
This event explored insights from academic research - from the Universities of Bristol and York – with practical lessons from the Strategy Unit and NHS Transformation Unit.
The recording is now available for those who missed it or wish to revisit the conversation.
Watch the recording here:
About the event:
The government wants to reduce the use of management consultants. Chancellor Rachel Reeves has argued that spending on consultants “got out of hand under the last Government, and we will rein them in”.
And yet there are good arguments for using consultants. The ability to access flexible support with specialist skills for example. Independence can matter too.
Are there ways of retaining the benefits, while avoiding some of the downsides and excesses associated with ‘consultancy’? Are there ways of creating specialist, flexible from inside public services? And how can ‘internal’ and ‘external’ expertise be combined?
Event highlights include:
- The latest research on ‘Internal’ and ‘External’ management consulting.
- Reflections on experiences of external and internal consultancy - Jessica Boothroyd and Peter Spilsbury
- Panel discussion and Q&A
Key speakers:
- Peter Spilsbury Director, Strategy Unit
- Andrew Sturdy, Professor of Organisation and Management, University of Bristol
- Jessica Boothroyd, Delivery Director, NHS Transformation Unit
- Fraser Battye (Chair), Head of Policy, Strategy Unit
Related content and resources
https://www.strategyunitwm.nhs.uk/news/are-internal-consultancies-good-option-nhs
Sign up here to be the first hear about future SU Insights events: https://www.smartsurvey.co.uk/s/Strategy_Unit_Updates/
Stay tuned for future SU Insights sessions, where we continue to explore critical topics in healthcare policy, strategy, and analysis.
Thank you again for being part of this conversation!
Thank you to everyone who joined the ‘SU Insights’ session ‘Downsides of Digital’!
This event in collaboration with the Health Foundation featuring Professor Trish Greenhalgh and experts explored the critical questions on the downsides of digital, drawing on research to reflect the implications of digital technology in health and care.
The recording is now available for those who missed it or wish to revisit the conversation.
Watch the recording here:
About the event:
There is widespread enthusiasm for the use of digital technology in health and care services, and shifting ‘from analogue to digital’ is one of the government’s priorities for the NHS. This shift promises significant gains in efficiency and productivity, and there are growing examples showing its potential in practice.
Event highlights include:
- Fresh perspectives on the risks of using digital technology in health and care.
- Insights into where digital technology can be helpful or harmful in health care.
- An overview of our recently published discussion document on the downsides of digital.
- Engaging presentations and discussions on the latest research, evidence and analysis.
Key speakers:
- Fraser Battye, Head of Policy, Strategy Unit
- Trish Greenhalgh, Professor of Primary Care Health Sciences, University of Oxford
- Ellen Coughlan, Improvement Fellow, Health Foundation
- Ben Shemesh, Senior Improvement Analyst, Health Foundation
- Mahmoda Begum (Chair), Strategic Communications Lead, Strategy Unit
Related content and resources
What are the downsides of digital? The paper describes the downsides at three ‘levels’: the Relational, the Organisational, and the Environmental. Read more
Resources from the Remote by Default Study presented by Trish Greenhalgh can be found here.
Resources from The Health Foundation:
Our inaugural ‘SU Insights’ session on Contracting for Health Outcomes, sparked insightful discussions on the evolving landscape of outcomes-based commissioning. The recording is now available for those who missed it or wish to revisit the conversation.
Watch the recording here:
About the event:
The concept of outcomes-based commissioning was heralded as transformative in healthcare about 15 years ago, yet many of these innovative models failed to live up to expectations. This session revisited the topic with fresh perspectives, exploring whether technical developments can make outcomes-based commissioning more feasible today. Our expert panel examined the reasons for past failures and proposed practical, targeted approaches for future success.
Event highlights include:
- Insights into the evolution of outcomes-based commissioning and lessons learned from past efforts.
- Discussion of the latest technical advancements that could enable more successful applications today.
- Engaging panel discussions with leading experts in health economics, policy, and clinical practice.
Key speakers:
- Steven Wyatt, Head of Research and Policy, The Strategy Unit
- Matthew Revell, Consultant Orthopaedic Surgeon & Executive Medical Director, The Royal Orthopaedic Hospital NHS FT
- Martin Campbell, Head of Pricing, NHS England
- Luigi Siciliani, Professor of Health Economics, Centre for Health Economics (University of York)
- Edward Jones, Senior Policy Advisor, NHS Confederation
- And the host for this event - Fraser Battye, Head of Policy, The Strategy Unit
Related content: Contracting for health outcomes: from concept through theory to implementation in Elective knee-replacement surgery https://www.strategyunitwm.nhs.uk/publications/contracting-health-outco…;
Past events
Sign up here to be the first hear about future SU Insights events - Sign up here!
Stay tuned for future SU Insights sessions, where we continue to explore critical topics in healthcare policy, strategy, and analysis.
Thank you again for being part of this conversation!
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