Musculoskeletal conditions: return on investment tool

Return on Investment of Interventions for the Prevention and Treatment of Musculoskeletal Conditions | Public Health England

This tool has been designed to aid healthcare commissioners and providers in England who wish to assess the cost-effectiveness of interventions for the prevention musculoskeletal (MSK) conditions.

It is hoped that the tool will aid decision-making and increase the uptake of cost-effective interventions aimed at the prevention of MSK conditions. Conditions within the scope of this tool are: Lower back pain; chronic knee pain and osteoarthritis (hip and knee).

Full detail at Public Health England

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Mental health services: cost-effective commissioning

Return on investment resources to support local commissioners in designing and implementing mental health and wellbeing support services. | Public Health England

Public Health England has produced a series of resources around mental health services.

The commissioning report summarizes the evidence on promoting good mental health and reducing the impact of poor mental health, generated through a rapid evidence review.

The return on investment (ROI) tool and user guide:

  • builds on the evidence in the commissioning report
  • can be adapted to local conditions
  • presents results showing the economic benefits of each intervention
  • show you how to use the ROI tool

The barriers and facilitator report identifies issues that can make the commissioning of mental health and wellbeing interventions easier or more difficult in a local area.

Local authorities, clinical commissioning groups, Health and Wellbeing Boards and their local partners (for example schools, employers, police) can use these set of resources to improve the provision of mental health services.

The documnets can be accessedd via Public Health England

Where next for commissioning?

Councillor Izzi Seccombe, chairman of the Local Government Association Wellbeing Board, shares her view on where next for commissioning as part of Provider Voices – a new publication series from NHS Providers.

Local government has been actively commissioning services for decades and sees commissioning as a continuous ongoing process, which starts with an assessment of needs, followed by an identification of priorities, market and demand management, contract development and procurement. The NHS sometimes focuses narrowly on procurement, and would benefit from adopting a whole-cycle approach.

Commissioning is far wider than contracting and procurement. Assessing the quality and outcomes of commissioned services is vital to ensure value for public money and to inform future commissioning decisions.

Local government is moving away from commissioning activities or input towards commissioning for outcomes. This approach is person-centred and doesn’t just treat individual health conditions. Its focus is on what matters to the individual: what makes their life worthwhile, and what they want to get out of their life.

Read the full post here

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

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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

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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

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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