Specialised Commissioning Alert: acute services

Showing posts with label acute services. Show all posts

19 January 2021

Understanding the drivers of growth in health care expenditure is crucial for forecasting future health care requirements and for the efficient use of resources. This paper considers total hospital admitted care expenditure in England between 2009/10 and 2016/17.
Decomposition techniques are used to separate changes in expenditure into elements due to changes in the distribution of characteristics, of both individuals and the services they receive, and due to changes in the impact of characteristics on expenditures. Growth in aggregate expenditure was due to increases in total patient admissions together with a substantial shift towards episodes of non-elective care, particularly the use of long-stay care. Decomposition of patient level expenditure suggests efficiency gains in treatment across the full distribution of expenditures, but that these were outweighed by structural changes towards a greater proportion of patients presenting with high-dimensional comorbidities. This is particularly relevant at the top end of the expenditure distribution and accounts for a large proportion of the total expenditure growth.

This research examined the effectiveness of two integrated care models (Salford Together and South Somerset Symphony Programme) in terms of patient experience, generic health status (EQ-5D); and total costs of secondary care.
Both intervention sites showed an increase in total costs of secondary care (approximately £74 per registered patient per year in Salford, £45 in South Somerset) and cost per user of secondary care (£130–138 per person per year). There were no statistically significant effects on health status or patient experience of care. There was a more apparent short-term negative effect on measured outcomes in South Somerset, in terms of increased costs and avoidable emergency admissions, but these reduced over time.

Only hospitals with a neuroscience centre can meet the requirements for a thrombectomy service and so the hospitals delivering the service will need to cover a wide geographical catchment.
The Clinical Senate reviewed the requirements for safe and effective delivery of a thrombectomy service across a wider geography and looked ahead to the potential delivery of a 24/7 service and the implications for the service in the interim. This report aims to understand the issues from the different perspectives of the local trusts, the hyper-acute stroke unit and the patients and their families.

This report looks at unwarranted variation in theatre productivity and ways to improve how care is delivered in England
The work, by Deloitte, found that hospitals could carry out over 291,000 more routine operations, like hip replacements and cataract surgeries, a year by improving how they schedule their surgical lists.

About the findings:

This paper reports one of the first quantitative evaluations of the impact of consulting advice on efficiency of public sector organisations using an extensive dataset covering English NHS acute care hospital trusts over a four-year period.
The findings show a significantly positive relationship between consulting expenditure and organisational inefficiency.
These results lend support to critical accounts of management consulting, highlighting the need for organisations to be circumspect in deciding whether and how to use these services.
2 page Summary here