NIHR Signal New screening pathway could help to identify a rare, single-gene form of diabetes

A screening pathway using blood and urine tests followed by two genetic (DNA) tests identified all people with a rare subtype of diabetes called monogenic diabetes. The screening pathway performed better than current practice based on age at diagnosis and family history which misses 63%. It is, therefore, a useful approach for ruling out this form of diabetes and probably cheaper overall than offering every young person with diabetes DNA testing.


Monogenic diabetes, caused by a mutation in a single gene can be misdiagnosed as type 1 diabetes, leading to unnecessary insulin treatment. Those recruited for this study were 98% white and tested at an average of 14 years after diagnosis.


From the NIHR Dissemination Centre

NIHR Signal National tobacco control policies linked to improvements in children’s health

National smoke-free legislation in advanced economies is linked to reduced rates of preterm birth, asthma hospitalisations and serious throat and chest infections in children. Comprehensive smoke-free policies appear to be more effective than policies with only partial or selective introduction.


Smoking increases health risks for the smoker and others through second-hand exposure. Although the number of people smoking in the UK is falling, eight million UK adults still smoke, and an estimated five million children are exposed to second-hand smoke. Children are vulnerable to smoke due to their small, developing lungs and immune systems.


From the NIHR Dissemination Centre

Health At A Glance 2017

OECD - This report outlines the latest comparable data and trends on different aspects of the performance of health systems in OECD countries. The analysis of the UK health system finds that the overall health of Britons is similar to the OECD average and that access to care is generally strong but that the indicators for quality of care are below the OECD average. Click here for Kings Fund Blog

Literature review: the economic costs of lung disease and the cost effectiveness of policy and service interventions

This report, conducted by York Health Economics Consortium on behalf of the British Lung Foundation and British Thoracic Society, identifies published evidence on the economic costs of lung disease and the cost-effectiveness of different NHS activities, programmes and campaigns to combat lung problems.

It’s time CCGs put a stop to restricting weight loss surgery

People who are seriously obese will develop other medical conditions as a result of obesity. This often compounds the obesity and takes a toll on their general health, and the healthcare economy. It’s also been established that for some, surgery can help them lose significant weight and return to a healthier lifestyle. It is proven to be safe, effective and saves the NHS money in the long term. So it is clear that bariatric surgery should be made more readily available to those who need it when everything else has been tried.

Estimating The Economic Burden Of Respiratory Illness In The UK

This report from the British Lung Foundation finds that lung disease costs the economy £11 billion every year. Of this, almost £10 billion is spent on direct costs to the NHS: GP appointments, time in hospital, treatments and medication. It calls for the government to support the first ever taskforce for lung health.

The Economics of Health Inequality in the English NHS: the Long View

This paper from the Centre for Health Economics provides a historical overview of health inequality policy in England and how government policy and academic research has evolved over time in response to shifts in socioeconomic inequalities.

Defining And Measuring Unmet Need To Guide Healthcare Funding: Identifying And Filling The Gaps

Budget allocations to CCGs include adjustments for meeting unmet health care needs and tackling health inequalities. This literature review from the Centre for Health Economics aims to identify and understand the available evidence regarding unmet health need. The study found that whilst there was evidence to support identifying unmet health need, there was a gap in the evidence on how budget allocations are best used to reduce unmet need.

Uncertainty and risk in HTA decision making

The quality of decision-making in key public sector bodies dealing with resource allocation is a major determinant of their efficiency. One of the most difficult and contentious areas of decision-making is the way that uncertainty is dealt with. This report from the Office of Health Economics is concerned with uncertainty as it affects the cost effectiveness aspects of health HTA.

Best Practice For Perinatal Mental Health Care: The Economic Case

This Personal Social Services Research Unit (PSSRU) report examines the economic case for investing in early interventions that reflect best practice in England. The study included a comparison of the potential costs and consequences associated with such interventions compared with one or more alternative course of action.

Why population health analytics will be vital for the vanguards

From Primary and Acute Care Systems (PACS) to Multispecialty Community Providers (MCPs) and from Enhanced Health in Care Homes (EHCHs) to Acute Care collaborations (ACCs), each of these models has at its heart the Triple Aim of improving the health and wellbeing of local communities, providing a better experience of care for patients, and delivering lower per capita cost for the taxpayer.

To achieve the Triple Aim, the leaders of a new care model will first want to understand the health needs of its population, then analyse the quality, equity and efficiency of the care that is currently being provided, before identifying opportunities for improvement. Some early questions for these leaders to ask themselves are therefore:

• What data will we need to collect, collate, disseminate and publish?
• How will we obtain and use these data legally, securely and ethically?
• How will we use data to understand the needs and experiences of our population, to target preventive care and other initiatives most efficiently, and to monitor improvements in the Triple Aim?

Four Case Studies To Explore The Added Value Of Oxford Academic Health Science Network (AHSN)

Office of Health Economics (OHE) -
The Oxford AHSN commissioned OHE Consulting and RAND Europe to explore the value of the various projects and programmes that the network has developed and implemented since it was established in 2013. In order to do this four case study projects were analysed: anxiety and depression clinical network; maternity clinical network; energy project; and intermittent pneumatic compression. The four case studies were chosen as examples of areas in which the Oxford AHSN has played a crucial role in improving patient care, and areas in which analysis of added value is feasible.

Psychoeducation with problem-solving PEPS therapy for adults with personality disorder: a pragmatic randomised controlled trial to determine the clinical effectiveness and cost-effectiveness of a manualised intervention to improve social functioning

Health Technology Assessment

If effective, less intensive treatments for people with personality disorder have the potential to serve more people. To compare the clinical effectiveness and cost-effectiveness of psychoeducation with problem-solving (PEPS) therapy plus usual treatment against usual treatment alone in improving social problem-solving with adults with personality disorder.

Public health post-2013

House of Commons Health Select Committee -
This report is the result of a short inquiry on the impact of the Health and Social Care Act reforms on the public health landscape. It warns of risks of widening health inequalities and a false economy due to cuts in local authority and public health budgets. It calls for a Cabinet Officer minister to be given specific responsibility for embedding health across all areas of government policy at a national level and for greater and bolder action to tackle public health issues such as childhood obesity.

Understanding The Basic Economics Of Tobacco Harm Reduction

Institute of Economic Affairs (IEA) -
This report examines the economics behind smoking cessation policies and argues that minimising taxes on low-risk tobacco products (e-cigarettes or smokeless tobacco) has the potential to improve public health.

CCG Inequality Indicators

Centre for Health Economics (CHE) -
Indicators developed by CHE have been adopted by the NHS to help local areas reduce potentially avoidable A&E admissions arising from social inequality. The indicators focus on emergency admissions for patients with long-term conditions and they highlight variations between CCGs on inequality performance. Between April 2015 and April 2016, there were 264,000 excess hospitalisations associated with socioeconomic inequality. CHE have developed an online tool which allows you to explore inequalities within CCGs.

CSP launches updated Falls Prevention Economic Model online

The latest version of the Falls Prevention Economic Model, with fresh data and research, is now live on the CSP’s website.

A healthier life for all: the case for cross-government action

The Health Foundation and the All-Party Parliamentary Health Group have jointly published a comprehensive, accessible collection of essays setting out the current and emerging threats to health and wellbeing and what we know about what works to address them.

The essay collection concludes that addressing the wider determinants of health is critical to ensuring the prosperity and wellbeing of British society as well as easing pressure on the NHS. The essays support the view that a more proactive approach to tackling poor health across all policy areas is urgently needed, to help ensure individuals, families and communities can thrive.