Author: CLAHRC
Development, implementation and evaluation of a tool for forecasting short term demand for beds in an intensive care unit
Health services research: building capacity to meet the needs of the health care system
CLAHRC PhD student Ryan Palmer enjoys success at the Health Services Research UK conference
CLAHRC PhD student Ryan Palmer enjoyed success at the recent prestigious Health Services Research UK conference in Nottingham.
Ryan (pictured above) is a Health Foundation Improvement Science PhD Student working under the primary supervision of Professor Martin Utley.
His research, part of our Methodological Innovation theme, focuses on patient flow between community and hospital services and he won one of the runner up prizes for best oral presentation held at the conference, which brings together researchers and NHS organisations, alongside third sector bodies, professional groups and private sector associates.
Ryan’s poster (below) and oral presentation focused on patient flow within community healthcare.
Ryan is based at one of our CLAHRC partner organisations – North East London NHS foundation Trust – where is he is helping the Trusts leaders and managers model patient flow and referral patterns so they can better design and plan services.
GP-based testing for HIV is cost-effective in areas of high prevalence and should be rolled out in 74 local authorities
New CLAHRC research published in The Lancet HIV has found that offering HIV testing to people on registration with a new GP in areas of high prevalence of the disease is cost-effective and will save lives.
Researchers based at the London School of Hygiene & Tropical Medicine and Queen Mary University of London (QMUL) carried out the study in areas with high prevalence of HIV – involving 86,000 people from 40 GP surgeries.
The promising results prompted CLAHRC researchers to call for a roll-out of HIV screening to all 74 high HIV prevalence local authorities in England (those with more than two diagnosed HIV infections per 1,000 adults).
HIV treatment is expensive, particularly when diagnosis is late. Early diagnosis means earlier intervention and treatment, saving the NHS money.
Building on earlier research from a trial in Hackney – a socioeconomically deprived inner London borough with an HIV prevalence rate of 8 per 1000 adults – the trial involved 40 general practices where they tested the effect of rapid fingerprick HIV testing as part of the standard health check during registration. They found it led to a four-fold higher HIV diagnosis rate.
Using a mathematical model that includes all the costs associated with HIV testing and treatment, the team now show that primary care HIV screening in high prevalence settings becomes cost-effective in 33 years (according to National Institute for Health and Care Excellence [NICE] criteria).
The CLAHRC North Thames study was carried out in partnership with NHS City and Hackney and involved University College London, Homerton University Hospital NHS Foundation Trust, University of Warwick, and University of British Columbia.
Dr Werner Leber from QMUL said: “We’ve shown that HIV screening in UK primary care is cost effective and potentially cost saving, which is contrary to widespread belief. This is an important finding given today’s austerity. Financial pressures, particularly within local authority’s public health budgets, mean that the costs of HIV testing are under intense scrutiny, and in some areas investment in testing has fallen.”
Read the full paper
Rebecca F Baggaley, Michael A Irvine, Werner Leber, Valentina Cambiano, Jose Figueroa, Heather McMullen, Jane Anderson, Andreia C Santos, Fern Terris-Prestholt, Alec Miners, T. Déirdre Hollingsworth, Chris J Griffiths.
Cost-effectiveness of screening for HIV in primary care: a health economics modelling analysis.
The Lancet HIV. DOI:10.1016/S2352-3018(17)30123-6
Mutualistic Coupling Between Vocabulary and Reasoning Supports Cognitive Development During Late Adolescence and Early Adulthood
Changing general surgery procedures could improve care for patients and save the NHS millions
The Getting it Right First Time (GIRFT) programme has completed a review of general surgery and stated that the NHS could see a significant reduction in the amount of people unnecessarily admitted for emergency general surgery if more acute hospitals introduced consultant-led surgical assessments at their ‘front door’.
Analysis by the GIRFT team shows this change could lead to up to 30% fewer general surgery emergency admissions a year where no operation is delivered, and could cut the NHS’s annual cost for this (£361million) by £108m.
CLAHRC North Thames is evaluating the planned changes to orthopaedics, to identify lessons to inform future efforts to improve the organisation and delivery of services.
