Title: Policy Research Unit in Economics of Health and Social Care Systems
Funder: Department of Health (England)

Abstract: The Economics of Social and Health Care Research Unit (ESHCRU) is joint collaboration between the Centre of Health Economics (CHE) at the University of York and the Personal Social Services Research Unit (PSSRU) at the London School of Economics and the University of Kent. ESHCRU is supported by a grant awarded by the English Department of Health: Policy Research Unit in Economics of Health and Social Care Systems ESHCRU brings together our significant expertise and experience of the H&SC sectors. In consultation with the DH we have developed a research programme that is empirical but theoretically based, that is problem focused but also innovative, and that works to a coherent programme but is also flexible enough to address new and emerging problems Our aim is to inform and guide policy-making in the health and social care sectors (H&SC) by undertaking high quality, robust and policy-relevant research, based on the discipline of economics. 1 Funding and resource flows in the care system This theme analyses the arrangements for raising funds and for distributing them across services and individuals to ensure that H&SC needs of the population are met equitably and efficiently. Our aims are to assess: • The effectiveness of alternative policies in producing desired outcomes; • How efficiently resources can be used to achieve outcomes; • How equitable policies are by looking at how they affect different groups in society. 2 Market analysis and system management This theme is about understanding which type of market for H&SC services – from regulated internal markets to decentralised market models – best achieves strategic goals. Our aims are to analyse: • The potential for use of markets in H&SC to improve overall performance; • The impact that different configurations of markets can make on prices, outputs, quality and outcomes • How the best configurations could be implemented in practice. 3 Quality measurement and productivity and efficiency analysis In the current economic climate it is particularly important that we are able to identify and monitor changes in quality, efficiency and productivity. Our work will support the development of a more systematic evidence base that will allow the DH to: • Develop policies to achieve efficiency and outcome-based commissioning and • Re-deploy resources to produce more efficient mixes of services both within and across the H&SC sectors. 4 Responsive work We place great emphasis on providing a responsive facility to requests for reviews, scoping exercises, and expert advice and opinion. Our aim is to achieve a good balance between responsive and core work, providing a rapid and targeted response to immediate policy issues whilst retaining a strong focus on the substantive strategic research programme agreed with the DH. Our research strategy • is focussed on policy and practice issues, deploying and developing methodologies to tackle the research question • involves strong empirical work built on rigorous theoretical frameworks. Whilst centred on quantitative economic analysis, our approach draws on the full breadth of the economics discipline (eg institutional and industrial economics) as well as bringing in other disciplines as appropriate. Political science, psychology and sociology help us adapt standard economic theories and methods to key features of H&SC, such as the importance of organisational structures, the presence of multiple stakeholders, and the influence of attitudes and motivations. • employs advanced econometric techniques such as panel data, multilevel and limited dependent variables models used to analyse appropriately data complexities encountered in H&SC. We draw on our expertise in identifying and estimating causal effects of policy instruments and interventions using data derived from a range of non-experimental sources. • exploits our extensive knowledge of existing datasets. We draw on our accumulated experience of NHS and social care administrative data, extending and improving our unique historical datasets and enriching them with new data collections and further linking to socio-economic data. The use of existing evidence and data is maximised by the application of the techniques and approaches noted above. • builds a firm basis for a programme of research that addresses policy and research issues of enduring importance regardless of changes that take place in the organisational and political context. Our research will assist in planning the reconfiguration of service models and in the optimisation of the use of available resources, including the specification of alternative strategies for meeting particular expenditure constraints. We shall provide evidence to inform key market configuration choices, such as the degree of separation of commissioning from providing; the alignment and continuity between H&SC sectors; alternative commissioning and contracting arrangements; and devolution of budgets to individuals and to lower level decision makers such as GPs. Our analyses will quantify variations in H&SC across the country; identify those factors associated with best practice; and inform policy about what configurations are more likely to yield gains in quality and productivity. Our overall research programme will help to improve the health and well-being of the population, recognising distributional concerns and population diversity.


Research activity codes: 8.2 HEALTH AND WELFARE ECONOMICS;8.3 POLICY, ETHICS AND RESEARCH GOVERNANCE
Health categories: GENERIC HEALTH RELEVANCE