Nuffield Trust | January 2019 | Rural health care: A rapid review of the impact of rurality on the costs of delivering health care
The Nuffield Trust was commissioned by the National Centre for Rural Health and Care to explore the key issues around the impact of rurality and sparsity on the costs of delivering health care.
The aims of the review were to:
outline the policy considerations around accounting for unavoidable costs in providing health care in rural areas
review and summarise key evidence on the additional costs of delivering health care in rural areas
describe, quantify and critique current NHS allocation formulae in the four UK nations with respect to adjustments for rurality.
Their analysis suggests that while the association between rurality, overstretched services and financial pressure are unclear, NHS trusts with ‘unavoidably small’ sites do appear to underperform: as well as having generally longer waiting times and lengths of stay, they are also in greater financial difficulty.
Nuffield Trust | January 2019 | Are patients benefiting from integrated care?
As QualityWatch publishes a scrolling data story investigating whether the drive in recent years to integrate services more closely has resulted in any tangible improvements for patients, Sarah Scobie puts the study in context and explains the findings. They find there is limited evidence that patients are benefiting from better integrated care: only one of the seven indicators has improved, three have deteriorated, and three show either no change or an inconsistent pattern (Source: Nuffield Trust).
Nuffield Trust | December 2018 | 2018: So what did happen in health and social care?
In its review of this year, the Nuffield Trust examines what happened in health and social care during 2018. The review reflects on areas such as accountable care, virtual GPs, Brexit negotiations and the pay review body.
Nuffield Trust | December 2018 | Snowed under? Understanding the effects of winter on the NHS
A new explainer from the Nuffield Trust unpacks what winter means for the NHS, in terms of its impact on health, demand for services, and how the NHS responds.
Even moderately cold weather (an average temperature of 5–8 degrees celsius) results in increased illness and higher death rates.
Flu epidemics have a major impact when they occur, but there is significant variation from year to year in how many people and which groups are affected.
Primary care deals with most of the increase in winter-related illness. Small changes in the ability of primary care teams to manage peaks in demand become amplified across the wider care system.
The number of A&E attendances actually decreases in winter, but the proportion of people admitted increases.
A higher proportion of patients with longer lengths of stay in winter means hospitals have less flexibility to manage demand.
Given recent trends, we can expect the pressure on the NHS this winter to be similar to last year.
Although A&E waiting times tend to grab the headlines, health systems should consider a broader range of factors when assessing winter pressures, from deaths related to cold temperatures and provision of services in the community through to the way acute medical patients are managed in hospital. (Source: Nuffield Trust)
Nuffield Trust | December 2018 | In safe hands? The need to know more about safety in health care
In the latest blog on the Nuffield Trust blog, Sarah Scobie considers whether safety is being measured and monitored appropriately and what steps could improve it in the long run; long run? Scobie argues for a shift in our understanding.
Nuffield Trust| December 2018 |Safety in health and social care
QualityWatch-the Nuffield Trust and Health Foundation programme providing independent scrutiny into how the quality of health and social care is changing over time- have reviewed and updated their indicators looking at how the safety of NHS care has changed over time. Although there are some gaps in the data, due to limited information in areas such as primary care and community settings, they have been able to identify indicators at a national level across many aspects of safety. While some measures show an improvement, such as the management of venous thromboembolism and hospital cleanliness, other measures, such as the proportion of hip fracture cases that have prompt surgery, have not improved. Please find below a summary of our safety indicators, and click on the links for more content and analysis (Source: Nuffield Trust).