A unique partnership driving improvement with data

1.    Tell us about the Improvement Analytics Unit and what it’s trying to achieve.

Over the last decade, and more recently as part of its Long Term Plan, the NHS has been developing complex initiatives to improve patients’ health across England. 

Measuring the impact of such changes is crucial to improve the efficiency and effectiveness of our health system – robust evidence can support better policy decisions, improving the quality of health and care services provided, and ultimately people’s health. Decision-makers at both local and national level need to understand the impact of new initiatives to inform policy and promote spread of new practice. 

Over three years ago the Health Foundation and NHS England joined forces to establish the Improvement Analytics Unit (IAU). We use sophisticated approaches to add to the understanding of the impact of complex changes being made in the NHS using existing data collected across the health and care system every single day. By doing so we hope to raise expectations of the standard of evidence used to inform decision-making and help to build applied analytics capability within health and care.

2.    Why is there a need for a partnership between NHS England and NHS Improvement and the Health Foundation? How do the two organisations complement each other?

Our organisations share a common goal: to support improvement to bring about better health and care and ensure the NHS can continue to meet the needs of people in the future.

While there is a wealth of data available within the NHS, the capability required to develop applied analytical approaches is not always available in the system. NHS EI provides access to these data and the national programmes established to support delivery of the commitments made in the Long Term Plan. The Health Foundation brings to the table its technical expertise, reputation for producing robust evidence and credibility from being independent of implementation. 

The partnership approach is allowing us to draw on the technical and methodological skills that exist in the Health Foundation and the academic community, in a way that allows those skills to be transferred into the analytical capability of NHS England and NHS Improvement. The NHS EI analytical team that hosts the IAU and national programmes provides an embedded mechanism for delivering change.

Both the Health Foundation and NHS EI are committed to maintaining the independence of the IAU’s work and openness and transparency, with the Health Foundation maintaining editorial control of all the IAU’s publications, and by sharing details of the methods and data used in all our analyses.

3.    What lessons have you learned while developing and implementing the partnership?

We have been privileged to see some of the incredible efforts being made by people across the health and care system every day to improve people’s lives and their health. Robust findings like those we produce can often have important implications for their improvement work, sometimes leading to significant changes to the approach implemented or even stopping an initiative that is not working. 

However, interpreting the learning isn’t always straightforward. We know that the changes we’re evaluating are complex and can take time to deliver impact on the ground. We also know that, even with the advanced analytics techniques we use, it can still be challenging to get to the bottom of what is driving the results we find. Often you need to combine the results produced by the IAU with other local intelligence to accurately interpret what’s going on, and what changes should be made to improve effectiveness of the improvement programme. This mixed methods approach, using qualitative research (our own and other research already available) to complement the advanced analytics we deliver, is being developed further as we implement a new strategic model for the IAU.

A key priority of the NHS Long Term Plan is to make better use of investments. We need therefore to inform decisions on how to invest resources effectively while at the same time adopting innovative approaches to improve quality of care, and ensuring that decisions on the effectiveness of programmes are not made too soon, before the true impact can be felt.

Because of this, it is important that we keep people engaged throughout the whole process of the evaluation, from design to final product, to help understand how to appropriately interpret the findings. 

4.    What have you achieved over the past three years?

Over a relatively short period of time, the unit has been able to provide a set of robust evidence to help local initiatives determine whether they were having the desired effect, or whether they needed to implement changes in order to succeed. 

This was the case, for example, for the analyses undertaken to assess impact of four vanguard interventions launched as part of the framework for enhanced health in care homes. A further report, Emergency admissions to hospital from care homes: how often and what for?, looked at the national picture of emergency admissions from care homes and also brought together the learnings from these four sites. It found that across three of the four sites there were encouraging results, with some NHS initiatives being shown to reduce potentially avoidable admissions by over a quarter.

Perhaps our most important achievement is the demonstration that it is possible to use data collected in the health and care system to understand the impact of changes being made and to support improvement at a local and national level. We have shown it is possible to overcome perceived barriers of information governance, data quality and analytics capability to deliver value from this data for the NHS.

5.    What are your ambitions for the future of the IAU? 

In 2018, the Health Foundation commissioned an independent evaluation of the IAU. While highlighting some of the key features that make the IAU unique – such as the use of innovative and cutting-edge analytics and the rapid cycle evaluation – the evaluation also identified some areas for improvement. 

We are now building on those recommendations to improve the services the IAU provides. This includes building in qualitative work to produce insight about what is causing the impact observed, and to help identify key messages for policy makers. 

We are using the skills and capabilities built up in the IAU to make results available earlier, engaging with people working on the ground and supporting delivery nationally, to decide if there is sufficient evidence to inform decisions or whether further work needed. 

Finally, we will shift our focus towards supporting national programmes seeking to support delivery on the ground, but our evaluations will remain centred around looking at the impact of changes made in local places.

Ultimately, however, our real ambition is to no longer be needed – because the capability to use data and apply advanced analytics techniques is more readily available across the NHS. So, our challenge over the next two years, alongside continuing to deliver more evaluations, is to spread the knowledge and capability we have developed as a unit far and wide.

Focusing change in key areas to improve health and health care

Our partnership with NHS EI is one of many ways we are investing in large-scale initiatives and working with external partners to focus change in key areas of health and care. Read more about our partnership work. 
 

This content originally featured in our email newsletter, which explores perspectives and expert opinion on a different health or health care topic each month.