NIHRDataInsights/HRCSData huggingface dataset:
Title: Shaping Places Healthier Lives
Funder: The Health Foundation

Abstract: People’s health is strongly determined by the social, economic, commercial and environmental conditions in which they live, known as the ‘wider determinants’ of health. The way these determinants relate to each other can influence the health and wellbeing of the population in a particular place. We have launched a new grant programme, in collaboration with the Local Government Association, to explore how coordinated system-wide action across the wider determinants of health can shape a place to help people to live healthier lives. Shaping Places for Healthier Lives funds strong local partnership projects that aim to make changes to local systems that will encourage better physical and mental health, and that will be sustained beyond the lifetime of the grant programme. Five local councils have been chosen to explore some major health factors This programme does not expect to see a whole system change; this can take many years (decades even). We are looking at how (and whether) councils can be a key partner to lead system change. The five local councils selected for this programme have developed their projects through a three-stage application process, during which they have built their partnerships, engaged and involved residents, and built an understanding of the systems of factors that influence their chosen topic. They will implement aligned approach across these systems, learning and adapting over the three-year period. The local partnerships will address the diverse topics of food security, mental health, and fear of violence and crime in their communities.


Research activity codes: 2.3 PSYCHOLOGICAL, SOCIAL AND ECONOMIC FACTORS
Health categories: GENERIC HEALTH RELEVANCE
Title: The impact of workforce turnover and temporary staff on productivity and health outcomes in the hospital sector
Funder: The Health Foundation

Abstract: Staff retention in the NHS has become a challenge. Recent figures show an increasing trend in nurse shortages and a relatively high turnover for nurses and other medical staff. It is important to assess the costs of these changes in the NHS workforce and their impact on health care service delivery. This project will focus on whether staff decisions to join or leave an NHS organisation have a disruptive effect on operational efficiency and patients’ health outcomes. A team of economics researchers based at London School of Economics and Political Science, and City, University of London, plan to use the most recently available data on Hospital Episodes Statistics, turnover and bank staff from NHS Digital to investigate the relationship between turnover and efficiency. First, they will focus on determining changes in productivity and patient health due to workforce turnover. This analysis will differentiate between internal moves (across NHS trusts) and external moves to or from non-NHS organisations, and consider how the effects are influenced by clinical staff group (nurse or doctor), grade and specialty Second, the impact of bank staff on hospital productivity and health outcomes will be analysed to determine whether reliance on this temporary staff group is cost effective. Given the current lack of evidence-based research in health and social care on whether staff turnover worsens productivity and patient health, the results of this study have the potential to make a significant contribution to NHS workforce planning and efficiency improvement.


Research activity codes: 8.1 ORGANISATION AND DELIVERY OF SERVICES
Health categories: GENERIC HEALTH RELEVANCE
Title: (ICCONIC) International Collaborative on costs outcomes & needs in care
Funder: The Health Foundation

Abstract: ICCONIC is a collaboration of researchers from 12 countries performing a series of international comparisons of high-need, high-cost individuals across the trajectory of healthcare. Although health systems around the world are diverse, they all have similar goals: maximizing quality of care for their populations, offering services that are responsive to patient needs, and providing value for money. One key challenge facing many health systems is how to best design services to provide care to a small number of high-need, high-cost individuals. This is a clinically diverse group of patients ranging from individuals who live with extreme functional limitations, others with persistent behavioural health challenges, and still others with multiple, complex chronic illnesses. These individuals often use high levels of health care services, tend to experience worse patient outcomes, and are often quite expensive to care for. For these reasons, high-need, high-cost populations are arguably the group that stands to benefit the most from a better understanding of the effectiveness of different delivery systems. Despite the enormous importance of this population, there is limited comparable data on how common these types of patients are across countries, and how patterns of utilization and cost differ across health systems. This lack of information limits the potential for mutual learning and potential policy transfer across countries. ICCONIC hopes to address this problem by developing a novel methodology for comparing cost, utilization, and outcomes of high-need, high-cost populations across different healthcare systems.


Research activity codes: 8.1 ORGANISATION AND DELIVERY OF SERVICES
Health categories: GENERIC HEALTH RELEVANCE
Title: Improving labour productivity in primary care: the role of skill mix, technology and patients
Funder: The Health Foundation

Abstract: Each year there are approximately 300 million NHS primary care consultations. The number of patients each GP is responsible for has increased over the past decade, along with the number and complexity of consultations. Despite recent investment announcements and the recruitment of additional medical workforce in primary care, it is important that there is continual improvement in general practice efficiency, to prevent the growing population and increasingly complex and multi-morbid patients eroding this investment. Areas identified for improvement include the greater use of technology, optimising staffing skill mix and the greater use of role substitution. However, there are currently few evidence-based recommendations for the targets to achieve in these areas. This Efficiency Research project aims to improve understanding of the measurement and determinants of primary care labour productivity. The project team will use routinely collected data from English GP practices to produce and measure an accurate definition of primary care labour productivity, and examine factors that affect its variability and determinants, such as staffing levels and skill mix, technology and patient population. At the end of the project, a set of valuable evidence-based recommendations for improving labour productivity in primary care will be produced. These will be of interest to a range of audiences, including policy-makers, health care professionals, commissioners, researchers and patients. Reproducible algorithms for routine measurement of productivity by all primary care data holders will also be developed and could potentially be implemented by GP practices across the UK.


Research activity codes: 8.5 RESOURCES AND INFRASTRUCTURE (HEALTH SERVICES)
Health categories: GENERIC HEALTH RELEVANCE
Title: OPTimising routine collection of electronic Patient-Reported Outcomes into disease registries (OPT-ePRO)
Funder: The Health Foundation

Abstract: Patient-reported outcomes reflect the personal impact of illness and treatment, as assessed by patients themselves. Having high-quality patient-reported outcome data in disease registries can enrich national audits and research, enhance clinical care and inform commissioning decisions and the redesign of health services. However, routinely collecting these data electronically and on a national scale requires support across stakeholder groups, including patients, clinicians and commissioners. This project, led by the University of Manchester, aims to engage these key stakeholders in the routine collection of electronic patient-reported outcomes (ePROs). It will use the UK Renal Register (UKRR) as an exemplar, making it the first national audit that can routinely and electronically collect patient-reported outcomes data, alongside clinical data. The project will also produce a roadmap to inform a strategy for rolling out routine renal ePRO collection at a national level. The researchers will explore how renal units can successfully engage patients in ePRO data collection, as part of usual care pathways. This will lead to the design and development of a comprehensive strategy for the UKRR to optimise routine collection of ePROs across patient groups. Three renal units (Salford Royal, King’s College London and Lister Hospital, Stevenage) will then implement the strategy. Using a mixed-methods approach, the research team will identify and investigate barriers to patient and clinician engagement, and address them as they arise by iteratively refining the strategy. They will also gain a more in-depth understanding of the needs of specific patient groups who have lower levels of engagement with ePRO collection,and explore what materials and resources are available to offer these groups additional support. The findings from this, and from interviews and a national meeting with representatives from stakeholder groups, will lead to the production of the roadmap. The roadmap will present recommendations for national stakeholder groups and renal service providers on how to scale up renal ePRO collection across units in the UK.


Research activity codes: 2.4 SURVEILLANCE AND DISTRIBUTION;8.1 ORGANISATION AND DELIVERY OF SERVICES
Health categories: GENERIC HEALTH RELEVANCE
Title: The health of places and the health and outcomes of individuals in those places
Funder: The Health Foundation

Abstract: Understanding how the health of individuals is related to where they work, rest and play is key to designing policies that improve place-based health, and deliver social and economic outcomes. However, the definition of ‘place’ is not straightforward. Most research uses Lower-layer Super Output Area (LSOA), a level of administrative geography designed to have 1,500 inhabitants. These are the smallest areas at which detailed statistics are made available. The majority of health measures are reported at an organisational level, such as Clinical Commissioning Group (CCG) or GP practice level. But it is often important to have more granular data, as analysing at CCG level can mask much of the differences within these areas. This project aimed to address these limitations by considering a series of research questions: What is the most accurate way to attribute available health information to small geographical areas? Can available data be used to create new geographical areas that contain individuals who are more similar in terms of health experience? Is the social fragmentation of a place associated with the health and wider social and economic outcomes of the individuals within that place? What definitions of place produce the strongest association between the average health of the place and the individuals within that place? Does the association between health and wider social and economic outcomes vary across places? This project will provide evidence on how place impacts on health. This evidence will then be shared in order to inform policy and decision making, which could have further impact on the overall health of the population.


Research activity codes: 2.2 FACTORS RELATING TO PHYSICAL ENVIRONMENT;2.3 PSYCHOLOGICAL, SOCIAL AND ECONOMIC FACTORS
Health categories: GENERIC HEALTH RELEVANCE
Title: The economic and social value of health from childhood to later life
Funder: The Health Foundation

Abstract: While much is known about the impact of socioeconomic factors on health, there are gaps in knowledge about the impact of an individual’s health on their economic and social status. This project assessed the causal impact of physical and mental health on educational and employment outcomes. It took a life-course approach, using rich, longitudinal data, and used indicators of health status from childhood to mid-life to predict subsequent outcomes. The outcomes examined included educational development and attainment (cognitive scores, qualifications); economic outcomes (employment status, earnings, social class); and socio-emotional outcomes (childhood behaviour, quality of life, social support, marital/partnership status). The knowledge produced by the project spans a range of areas of pressing interest for policy, including young people’s emotional and behavioural problems, education and employment, mental health, the effect of the COVID-19 pandemic, and menopause.


Research activity codes: 2.3 PSYCHOLOGICAL, SOCIAL AND ECONOMIC FACTORS
Health categories: GENERIC HEALTH RELEVANCE
Title: WORKTECC: Workforce Operations that Realise Knowledge-based Transformational Eff
Funder: The Health Foundation

Abstract: NHS staff who provide home-based care spend a lot of time travelling, and the care provided by different professionals and provider organisations is often poorly coordinated. More efficient ways of delivering this care could reduce costs while also improving patient and staff experience. This round two Efficiency Research project will explore whether workforce operations used by other industries can improve the efficiency of home-based NHS care, and if so, how. For example, online supermarkets use operational research algorithms to design delivery routes that incorporate customer preferences on delivery times, while minimising journey times. The project will be led by operational researchers at University College London (UCL). The team will first investigate what efficiency means to patients, professionals and health care commissioners, exploring agreements and differences in their perspectives. They will also build shared understanding by developing mathematical expressions linking the different aspects of efficiency. This information will form the basis for modelling work to identify innovations and strategies in the research literature that could improve efficiency. The work will include assessing the potential for some of the tasks currently performed by NHS staff to be carried out by the social care or voluntary sectors. The project will look at the current delivery of home-based NHS services at two sites (Barking and Dagenham, and Redbridge) and analyse the capacity for change in these systems. The team will identify strategies that offer the best prospects of major efficiency gains at the two sites, as well as generalisable lessons for other sites.


Research activity codes: 8.1 ORGANISATION AND DELIVERY OF SERVICES
Health categories: GENERIC HEALTH RELEVANCE
Title: Health of Older People in Places (HOPE): an asset for economic and social improv
Funder: The Health Foundation

Abstract: Evidence shows that older people who live in more deprived areas are more likely to retire early and/or take up a disability pension. The health of people who live in these places has been cited as one of the main reasons for these geographic differences in outcomes after leaving employment. This suggests that if a higher proportion of people in a place had better health, those older people would be able to stay in the labour market for longer, and local economies would benefit economically and socially from the extended working lives of residents. However, there is lack of understanding of just how policymakers should go about ‘improving’ older people’s health so that they can remain in work. Most extended working lives policies focus on intervening on ‘unhealthy’ individuals, regardless of where they live. This project by University College London investigated whether a place-based approach could be a more effective method of intervention. The research looked at what we mean by a ‘healthy’ person, what geographic scale interventions should be targeted at, and why we see improvements in the health of a place (ie is the health of the pre-existing population actually improving or have more healthy people moved in and/or unhealthy people moved out?). An evidence review looked at which concepts and metrics of health are appropriate to measure the health of the older population in a given place, and UK census data was used to investigate a series of analytical questions. Project findings will be shared with key stakeholders to inform national public health and economic policy.


Research activity codes: 2.3 PSYCHOLOGICAL, SOCIAL AND ECONOMIC FACTORS
Health categories: GENERIC HEALTH RELEVANCE
Title: Social and economic consequences of health status: Causal inference methods and longitudinal, intergenerational data
Funder: The Health Foundation

Abstract: This project led by the University of Bristol explored the impact of childhood obesity on education outcomes. It sought to improve understanding of the causal health impact on social and economic outcomes. The research included: analysis of data from studies including UK Biobank, the Avon Longitudinal Study of Parents and Children, and the Norwegian Mother and Child cohort study analysis of results from in-depth interviews use of Mendelian randomisation – which uses genetic variants as variables to avoid bias from confounding and reverse causality – to find out whether the associations between health and social and economic outcomes are causal.


Research activity codes: 2.3 PSYCHOLOGICAL, SOCIAL AND ECONOMIC FACTORS
Health categories: GENERIC HEALTH RELEVANCE
Title: The causal impact of health status on labour market outcomes: consequences for individuals and households
Funder: The Health Foundation

Abstract: Work is a key route to financial security and psychosocial wellbeing and is generally good for people’s health. But there can be adverse effects from long hours, stress and job insecurity. Health is an important determinant of employment, affecting a person’s chances of gaining employment and adequate reward. Deterioration in health is often the catalyst for people leaving the labour market, and those with poor health have a much lower employment rate than the rest of the population. This project aimed to shed new light on the causal relationships between an individual’s health status and work outcomes. The project team primarily used data from the UK Household Longitudinal Study and the Quarterly Labour Force Survey to analyse the impact of factors such as age, gender, job/contract type, health status and household composition on the relationship between an individual’s health and their participation in work.


Research activity codes: 2.3 PSYCHOLOGICAL, SOCIAL AND ECONOMIC FACTORS
Health categories: GENERIC HEALTH RELEVANCE
Title: Trends in socio-economic determinants of health inequalities in Scotland
Funder: The Health Foundation

Abstract: Socioeconomic factors play a critical role in influencing health and health inequalities. These socioeconomic factors include the pay, security and nature of the jobs that people do. They include households’ financial security, which influences the extent to which people are exposed to stress and anxiety, the time and resources people have to adopt healthy behaviours, and their ability to secure a decent standard of living generally. They also include the physical environment in which people live, both in terms of housing – poor quality or overcrowded housing can affect health in various ways – and neighbourhoods more generally (which influence opportunities for work, play and exercise, and exposure to pollution). The aim of this report is to examine trends in key socioeconomic determinants of health in Scotland since 1999, the year of the establishment of the Scottish parliament. The report is based on six thematic chapters which examine trends in: the labour market; household income and financial security; education and social mobility; housing; public services; and neighbourhoods. A seventh chapter examines trends in socioeconomic determinants of health during the Covid-19 pandemic and the emerging cost-of-living crisis.


Research activity codes: 2.3 PSYCHOLOGICAL, SOCIAL AND ECONOMIC FACTORS
Health categories: GENERIC HEALTH RELEVANCE
Title: Retention of the clinical and ambulance workforce in English NHS hospitals
Funder: The Health Foundation

Abstract: Staff retention has been described as the biggest workforce challenge facing the NHS. High turnover and high vacancy rates are costly and affect staff productivity and morale, and ultimately patient outcomes. Improving workforce retention can lead to cost savings through a reduction in the use of temporary staff, better use of skills and improved staff wellbeing. This project aims to improve the understanding of causes and consequences of the NHS’s staff retention problems. The project involves two research questions: ‘What are the determinants of variations in NHS workforce retention, in both acute care and mental health hospitals?’; and ‘What are the causal effects of workforce retention on admitted patients’ health outcomes (mortality, emergency re-admissions, length of stay and waiting times) in emergency, elective and mental health care?’. The project team will use hospital workforce data from NHS Digital, combined with other existing databases, to uncover the association between workforce retention and factors determining its variation over time and across hospitals. They will also examine the impact on workforce retention of a series of recent policies, such as the new junior doctors contract, the new pay/progression contract, and political events such as Brexit. The results of this project will inform health care policy-makers, hospital managers and clinical professional bodies about the determinants of hospital workforce retention, and the effect of policies on this. It will ultimately help persuade local and national policy-makers of the benefits of acting to improve retention, and help them address retention problems.


Research activity codes: 8.5 RESOURCES AND INFRASTRUCTURE (HEALTH SERVICES)
Health categories: GENERIC HEALTH RELEVANCE