Category Archives: Healthy Settings

Right care: wrong answers

Dropkin, G. Journal of Public Health, https://doi.org/10.1093/pubmed/fdx136

Published: 03 November 2017

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Background

NHS RightCare is an NHS England programme describing itself as ‘a proven approach that delivers better patient outcomes’. It identifies opportunities for savings and quality improvements, comparing each Clinical Commissioning Group (CCG) with the ‘Best 5’ of a fixed set of ‘Similar 10’ CCGs chosen using equally weighted demographic and deprivation indicators. This article tests whether these indicators are sufficient and equal weighting is appropriate, and evaluates significance.

Methods

Robust public data on lung, colorectal, and breast cancer mortality is modelled using the indicators and incidence. Peers chosen using the preferred models are compared with the Similar 10. Confidence intervals are obtained for comparator group averages. RightCare significance is simulated.

Results

Preferred models have unequally weighted covariates. Incidence is the strongest predictor of lung cancer mortality. The ‘Similar 10’ are inappropriate comparators. RightCare significance ignores variability of comparator outcomes, causing 12% Type I errors. Whilst RightCare shows 1842 annual avoidable lung cancer deaths in 80 CCGs, only 168 deaths in 8 CCGs appear exceptional using appropriate peers and CIs.

Conclusion

CCGs cannot expect to match the average performance of the RightCare ‘Best 5’. Until the methodology is examined with data of known quality, claims that RightCare is a ‘proven approach’ are unsubstantiated.

 

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Current, future and avoidable costs of stroke in the UK – Societal costs of stroke in the next 20 years and potential returns from increased spending on research

By The Stroke Association (2017)

This report estimates that the current cost of stroke to the UK is £26 billion every year, a threefold increase from the previous estimated cost of £9 billion. The figures also predict that a growing and ageing population, increasing numbers of stroke survivors, and rising care costs are crucial factors behind the increasing financial burden of stroke over the next 20 years.

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Public Health: Everyone’s business

by NHS Providers (2017)

NHS Providers has published Public health: everyone’s business? This second report in the Provider Voices series uses 12 interviews with health leaders from across the NHS and local government, as well as academics, to help gain an understanding of NHS providers’ role in shaping and delivering public health and care

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Sector-led improvement for public health, prevention and early intervention

By Local Government Association (2017)

The LGA is working with partners at Public Health England and the Association for Directors of Public Health to deliver sector-led improvement activity in 2017/18 for public health, prevention, and early intervention through the care and health improvement programme funded by the Department of Health.

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Urban green space interventions and health

By WHO (2017)

This report aims to fill the knowledge gap on the benefits of urban green spaces. It outlines the results of an evidence review and an assessment of local case studies on urban green space interventions, and finds that increasing or improving urban green space can deliver positive health, social and environmental outcomes for all population groups, particularly among lower socioeconomic status groups. It highlights the need to include more health and equity outcomes in studies on green space interventions in future.

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Welfare confidentiality: sanctions, support and behaviour change

By Welfare Confidentiality Project (2016)

Below is the overview, summarising our key first wave findings on the effects and ethics of welfare conditionality. It draws on data from interviews with 52 policy stakeholders, 27 focus groups conducted with practitioners, and 480 ‘wave a’ qualitative longitudinal interviews with with nine groups of welfare service users in England.Overview

Below are nine first wave findings papers covering each of our study’s policy areas in more detail.

First wave findings: anti-social behaviour

First wave findings: disabled people

First wave findings: homelessness

First wave findings: jobseekers

First wave findings: lone parents

First wave findings: migrants

First wave findings: offenders

First wave findings: social tenants

First wave findings: Universal Credit

Big cuts planned to public health budgets

by The King’s Fund (2017)

Central government cuts have forced councils to reduce planned spending on vital public health services such as sexual health clinics and reducing harm from smoking, alcohol and drugs by £85 million, according to new analysis by The King’s Fund.

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Click here to view the King’s Fund analysis