NIHR Applied Research Collaborations (NIHR ARCs) across the country paired up with their corresponding regional Health Innovation Networks (HINs) to solve the most significant issues in local health systems.
14 regional ARC and HIN pairs have been working on the NHS Insights Prioritisation Programme (NIPP), which started in November 2021 to accelerate the evaluation and implementation of promising innovations which support post-pandemic ways of working; building service resilience and delivering benefits to patients.
The partnership between ARC and HIN in Yorkshire & Humber looked at the evaluation of unscheduled care coordination hubs (UCCHs) to reduce hospital attendance in the region. UCCHs provide access to timely unscheduled care in the community for patients who have immediate care needs and are at risk of ambulance transfer to hospital. UCCHs provide the potential for more timely and appropriate care in or close to the patients’ home, avoiding unnecessary conveyance to hospital, with the benefits of reducing ambulance wait times and avoidable admission.
A mixed methods evaluation of the three pilot UCCH sites to examine service design and utilisation, acceptability and sustainability, integration with and impact on the urgent and emergency care (UEC) system was undertaken. Alongside this an evaluation of the implementation of UCCHs, using ‘tests of change’ as an implementation strategy and rapid qualitative assessment as an evaluation tool of this process was completed.
The report found UCCHs leads to better patient and service experiences and have the potential to reduce 999 call wait times. However, there is no one-size-fits-all model and UCCHs need to respond to local needs and expertise. The report recommends that:
- More work is required to develop integration with ambulance services, evaluate impact on reducing ambulance dispatches, and understand the return on investment.
- New sites should develop business cases using a “test of change” implementation process with stakeholder engagement.
- Implementation should be at the ICS level for scalability, involving all stakeholders especially ambulance services.
- ICS implementation should address challenges such as ownership, governance, staffing, and commissioning.
- Integration with ambulance services is crucial.
- Data systems must be in place to monitor and evaluate activity and outcomes
- Policy makers should facilitate ICS commissioning to support system changes rather than mandating the model.
UCCHs show promise for improving patient experiences and reducing hospital visits, but require careful implementation tailored to local contexts, stakeholder engagement, ambulance integration, and ongoing monitoring and evaluation.
Professor Suzanne Mason, Deputy Director and Urgent Care theme lead at ARC Yorkshire & Humber and national ARC lead for Urgent and Emergency Care explains:
‘The NIPP programme has enabled regional collaboration between the Health Innovation Networks and the NIHR Applied Research Collaborations that has allowed us to rapidly mobilise our regions expertise in evaluation and implementation, working together to analyse UCCHs. The findings and recommendations will help Integrated Care Systems understand the benefits of UCCHs for patients and the service, and how they might implement these new approaches in their local system effectively’.
Dr Neville Young, Director of Enterprise and Innovation at Health Innovation Yorkshire & Humber added:
“The NIPP programme has been a great vehicle for Health Innovation Yorkshire and Humber to work collaboratively with colleagues in the NIHR Applied Research Collaboration Yorkshire & Humber to rapidly impellent and evaluate the UCCH programme. The work built on already strong relationships in the region and the outputs will help ICSs understand how to implement the programme to achieve the desired benefits when delivering a UCCH in their own geographies.”
NIHR ARCs and HINs received £4.2m from NHS England for these collaborative projects.
The partnerships tested and evaluated innovative approaches within their local Integrated Care Systems (ICSs). Each project focused on four priority areas:
- Remote consultation – a discussion between a clinician or patient which is not carried out face-to-face.
- Remote monitoring – using technology to support people at home to collect clinical data and share it securely with a clinician.
- New approaches to service delivery – improving services, particularly for those experiencing health inequalities for access to services.
- Health and social care workforce innovation – how staff can help innovation in service delivery and develop new ways of working.
New regional and national reports, out today, distil the key findings and learnings from these joint endeavours.
Read the summary report and individual findings for each project.
