Health service use in the last two years of life
The Strategy Unit updated June 2021

• A series of reports that describe the health services that patients use in the last 2 years of their lives. Reports are available for the Midlands region as a whole and for each of the 11 Sustainability and Transformation Partnerships or Integrated Care Systems in the region.

Unlocking the digital front door - keys to inclusive healthcare

Unlocking the digital front door - keys to inclusive healthcare
National Voices  May 2021

• This report explores how the move to remote service models impacted people and how the Voluntary, Community and Social Enterprise sector (VCSE) has led innovative ways to deliver healthcare and support people during the COVID 19 pandemic. Also available is a literature review and insight data, personal narratives and recommendations for better practice, better policy, and better innovations.

Healthcare utilization among migrants to the UK

Healthcare utilization among migrants to the UK: cross-sectional analysis of two national surveys.
J Health Serv Res Policy. 2021 Jan;26(1):54-61. doi: 10.1177/1355819620911392. Epub 2020 Mar 19. 

• We explored health service utilization among migrants to the UK across primary care, inpatient admissions and maternity care, outpatient care, mental health, dental care and physiotherapy. This study finds that newly arrived migrants tend to utilize less health care than the UK population and that this pattern was at least partly explained by better health, and younger age.

The association between living alone and health care utilisation in older adults

The association between living alone and health care utilisation in older adults: a retrospective cohort study of electronic health records from a London general practice
BMC Geriatrics 2018 18:269 3 December 2018

• A retrospective analysis of health records of patients over the age of 64 living in south east London [n=1447], found that living alone was significantly associated with a higher probability of utilising emergency department (odds ratio 1.50) and general practitioner services (odd ratio 1.40).

Reducing emergency admissions: unlocking the potential of people to better manage their long-term conditions

Reducing emergency admissions: unlocking the potential of people to better manage their long-term conditions
Health Foundation August 2018

This briefing summarises research that explores the link between how well patients feel able to manage their long-term conditions such as asthma, diabetes and depression and their use of health care. Analysis using the Patient Activation Measure (PAM) and healthcare utilisation across a whole health economy found that self-management capability is associated with lower healthcare utilisation and less wasteful use across primary and secondary care.

Summary of
Self-management capability in patients with long-term conditions is associated with reduced healthcare utilisation across a whole health economy: cross-sectional analysis of electronic health records 

BMJ Qual Saf Published Online First: 23 August 2018. doi: 10.1136/bmjqs-2017-007635

Abstract

Improving patient flow - evidence from Monitor

Improving patient flow: evidence to help local decision-makers
Monitor 3 September 2015

• Findings from three Monitor publications offering evidence that may help local NHS decision-makers evaluate options for improving patient flows through local health and care systems.
• Includes: 
• Understanding urgent and emergency care performance
• Schemes to deliver care closer to home (to be published)
• Improving productivity in elective care  (to be published)
• Other options for improving patient flow - including case studies from Nuffield Trust around reducing length of stay.

https://www.gov.uk/government/publications/improving-patient-flow-evidence-to-help-local-decision-makers

Why did patients wait longer in A&E?

A&E delays: why did patients wait longer last winter?
Monitor 3 September 2015

• Analysis of the sudden 4.7 percentage point decline in A&E performance against the four-hour target in Q3 2014/15. 
• The report tests 10 hypotheses and concludes that the most important national cause was hospitals’ inability to accommodate the increase in admissions from A&E departments generated by the increase in A&E attendances because hospitals were running at very high occupancy rates of 90% or above. 
• Data indicates 27% more delayed transfers of care out of acute hospitals.
• The other half of the decline is likely to be explained by local drivers of A&E performance. 
• Documents include main report, findings at a glance, conclusions from 10 tested hypotheses, econometric analysis and next steps.
• The Next steps suggested are: 
• Improving patient flow in the rest of the hospital 
• Getting a better understanding of the impact of social and community care 
• Supporting the mid-long term sustainability of A&E departments 
• Supporting efforts to tackle local issues including the establishment of an Emergency Care Improvement Programme (ECIP) to help the most challenged urgent care systems, with a focus on patient flow.

An examination of patient flow through acute hospitals

Unblocking patient flow
Nuffield Trust, October 2014

• This presentation highlights approaches to improving patient flow through acute hospitals.
• It includes data (assigned to the Oak Group) indicating that 20-25% of admission and 45-55% of bed days could be cared for at a lower level of care. 
• Data around the reasons for non-qualified days are presented