Use of Resources assessment framework

A framework for evaluating how providers are making use of resources, leadership and governance in order to provide high quality care that is efficient and sustainable | NHS Improvement


Following sector-wide feedback, we’ve produced this framework, finalising our approach to the Use of Resources assessment. This will help us to better understand how effectively and efficiently providers are using their resources – including finances, workforce, estates and facilities, technology and procurement – to provide high quality, efficient and sustainable care for patients, and will help us to deliver tailored support to providers.

The Use of Resources assessment will also help us to identify providers’ support needs under the Single Oversight Framework (SOF), and deliver targeted support accordingly. We are now updating the SOF to reflect these and other changes in our oversight approach and will publish an updated version in October, following feedback.

Read the full overview here

New models of care in practice

New models of care in practice: Cambridgeshire and Peterborough Clinical Commissioning Group | NHS Confederation

A vanguard in Cambridgeshire and Peterborough has focused on helping people who are experiencing mental health crisis and demonstrating how, with the right support, they can get the help they need at home or in the community and avoid a trip to A&E. This is improving patient care as well as providing savings for the local health system.


Economic evaluations of seasonal influenza vaccination for the elderly

The Council of the European Union (EU) has recommended that action should be taken to increase influenza vaccination in the elderly population | BMJ Open


Image source: Joe The Goat Farmer – Flickr // CC BY 2.0

Objectives: The aims were to systematically review and critically appraise economic evaluations for influenza vaccination in the elderly population in the EU.

Results: Of the 326 search results, screening identified eight relevant studies. Results varied widely, with the incremental cost-effectiveness ratio ranging from being both more effective and cheaper than no intervention to costing €4 59 350 per life-year gained. Cost-effectiveness was most sensitive to variations in influenza strain, vaccination type and strategy, population and modelling characteristics.

Conclusions: Most studies suggest that vaccination is cost-effective (seven of eight studies identified at least one cost-effective scenario). All but one study used economic models to synthesise data from different sources. The results are uncertain due to the methods used and the relevance and robustness of the data used. Sensitivity analysis to explore these aspects was limited. Integrated, controlled prospective clinical and economic evaluations and surveillance data are needed to improve the evidence base. This would allow more advanced modelling techniques to characterise the epidemiology of influenza more accurately and improve the robustness of cost-effectiveness estimates.

Full reference: Shields. G.E. et al. (2017) Systematic review of economic evaluations of seasonal influenza vaccination for the elderly population in the European Union. BMJ Open. 7:e014847


Targeted screening offers same benefits as health check at lower cost

Millet, D. GP Online. Published online: 8 November 2016


Offering health checks to just the 8% of patients most at-risk of developing cardiovascular disease offers similar health benefits to national screening at a far lower cost, researchers have concluded. Offering health checks to all patients aged 40-74 in the national NHS Health Check is a ‘poor use of resources’, a modelling study has suggested.

A targeted approach to assessing cardiovascular disease in patients provides similar benefits to national screening, but at a fraction of the cost.

A total of 10,000 patients aged 30-74 who did not have existing cardiovascular disease or diabetes were involved in the study. Researchers from the University of Birmingham ran several simulations to model the costs of different approaches to screening patients. It showed that performing no case finding and inviting all the patients involved in the study for a cardiovascular check would yield 30.32 QALYs (quality-adjusted life years) – years lived without disease – at a cost of £706,000. In another simulation, they ranked the patients by cardiovascular risk and invited only the top 8% to attend a check. This yielded 17.52 QALYs, but cost considerably less at £162,000.

Read the overview here

Read the original research article here

Cost-effectiveness of Collaborative Care for Adolescents With Depression in Primary Care

Wright, D.R. et al. (2016) JAMA Pediatrics. 170(11) pp. 1048-1054


Question:  The Reaching Out to Adolescents in Distress (ROAD) collaborative care model has been found to be effective in treating adolescent major depressive disorder, but is it cost-effective?

Findings:  A randomized clinical trial conducted at 9 primary care clinics in Washington State suggests that collaborative care results in an increase of 0.04 quality-adjusted life-year over usual care at $883 above usual care, for a mean incremental cost-effectiveness ratio of $18 239 per quality-adjusted life-year gained.

Meaning:  Even by the most conservative standards, the ROAD collaborative care model is a cost-effective approach for treating adolescent depression.

Read the abstract here

Physiotherapists in General Practice

BMA backs greater use of physiotherapy


Image source: CSP

New guidance supporting greater patient access to physiotherapists in primary care may help to alleviate pressures faced by GPs, the BMA has said. The guidance document, Physiotherapists in General Practice, published by the Chartered Society of Physiotherapy, outlines how physios can be better used to support general practice. It is accompanied by an online calculator designed to help estimate costs for a surgery considering whether to include physios within their teams.

GPC policy lead for education, training and workforce Krishna Kasaraneni, who provided one of the forewords to the guidance report, welcomed the plans. He added that initiatives designed to diversify and widen expertise within general practice had the potential to reduce workload pressures as well as improve access to specialist musculoskeletal services for patients.


It is believed that between 20 to 30 per cent of consultations within GP surgeries relate to musculoskeletal complaints, with physiotherapists able to assess, diagnose and treat a wide range of conditions autonomously.

Read the overview and find the cost calculator here

Read the full report here

Improving the oral health of children: cost effective commissioning

Public Health England| Resources to support local authorities investing in the local commissioning of oral health improvement programmes for pre-school children.


Image source: PHE


Public Health England’s (PHE) rapid evidence review and ROI tool were commissioned from the York Health Economics Consortium and developed in partnership with PHE.

The ROI tool allows effectiveness data on oral health interventions to be used to estimate the potential economic benefits from each intervention. The tool uses the best available evidence to estimate the reduction in tooth decay as a result of the intervention, the costs of delivering each of the programmes and the cost savings.

Local authorities can use the ROI tool to inform their commissioning decisions, providing an estimate of the return on investment of these programmes using the oral health profile of their local population.

Read the full overview here