Part-time GPs and the decline in continuity of care: a cause or a symptom?
In our recent paper we explore why levels of care continuity have been declining and what might be done to turn things around.
Two sides of the same coin
Hospital demand arising from GPs not seeing patients, is eating into the resources that they would use to manage down the elective backlog. In turn, this is creating more demand for GPs.
Are GP consultation rates rising or falling? Who or what should we believe?
If the "data suggests" GP appointments are substantially higher than pre-pandemic, then what is behind patients reporting recieving fewer appointments?
GP services: new analysis and fresh insights
In our latest analysis for the Midlands Decision Support Network (MDSN), we explore the long standing problem of access to GP practice consultations we consider the implications, and explore potential solutions.
Diagnosing harms?
All medicines are poisons. Everything that cures could kill if administered in the wrong doses, to the wrong people, at the wrong times, in the wrong ways.
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 system such as the NHS is likely to have had unintended consequences. Midlands ICBs wanted to understand the impact of diagnostic growth on hospital services.
Socio-economic inequalities in coronary heart disease
There are substantial differences in mortality rates from cardiovascular disease between socio-economic groups. Our new tool provides an overview, for ICBs, of the points on the care pathway where inequalities emerge and are amplified
‘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.
Infant feeding problems, lockdown and attendance at Emergency Departments: what’s going on?
From our previous work, with Nuffield Trust and Health Foundation, we know that lockdown had a significant effect on attendance at Emergency Departments (ED). We also know that this effect was very unevenly distributed: some demographic groups stayed away far more than others.
The impact of social care on demand for urgent hospital care: have we reached a consensus?
The care home COVID crisis and the effects of longstanding staffing and funding shortages has meant that social care has featured heavily in the media over the last 12 months.
Decisions to admit patients are not solely determined by clinical risk
Whether or not to admit a patient is one of the most routine yet important decisions a doctor in an Emergency Department
Some positive news for integrating GP practices with hospital trusts
The drive for greater integration of health and care services has been the central theme of UK health policy for most of
Strategy Unit analysis published showing changes in use of emergency departments under lockdown
We know that patterns of access to healthcare have changed during the 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 experiences can be profound.
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 uncovers new insights and has the potential to reshape received wisdom about the performance of A&E departments, carrying important implications for healthcare policy and system leadership.
Making the case for integrating physical and mental health services in England - National overview
This is a national overview report of our Making the case for integrating physical and mental health services reporting which took place in July 20
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 provid
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 integrate with a mental health trust, or set up a stand-alone community trust or Community Interest Company? Seven years on, this report explores the impact this choice had on the level and growth in emergency hospital use in older people and considers the wider implications for the NHS as it develops new models of care and integrated care systems
Changes to Admission Thresholds
This analysis builds on a paper, Changes in Admission Thresholds in Engli