Health and social care policy

Increasing healthcare demands from a growing, ageing and sicker population coupled with limited increases in healthcare spending mean that the NHS is required to deliver unprecedented efficiency and productivity gains as well as services that are good value for money. These increasing challenges also imply fast-growing social care needs in a context of extremely scarce public resources, therefore requiring an assessment of whether these resources provide good value for money.

CHE's research on efficiency and productivity contributed to the methodological development of measures of NHS output, input and productivity at national, regional, organisational and specialty level. Measures of NHS productivity are produced on an annual basis.  These assess how productive the NHS has been in using the available inputs (such as staff) to deliver outputs such as GP consultations and hospital stays. This calculation helps the government to set the size of the NHS budget. 

Our researchers also investigate the marginal productivity of NHS, social care and public health expenditure to capture how changes in public expenditure impact health and care outcomes and the wider economy to inform resource allocation decisions.

Finally, and focussing on mental health care, our research  investigates the cost, quality and efficiency of mental healthcare providers, providing useful information for regulators and commissioners.  This work includes estimating the marginal cost of quality of mental health services and developing composite measures of provider performance.

Incentives influence how providers of health and care services allocate their resources and can therefore have a direct impact on the volume and quality of care delivered. Incentive design is an important lever to influence how productive and efficient a health and care system is.

CHE conducts research to understand what incentives work and in what circumstances. In our work we explore the role of financial incentives such as those generated by the reimbursement system or pay-for-performance arrangements, as well as non-financial incentives such as public reporting initiatives.

Consumers (patients) and suppliers of health and social care interact in markets where the government intervenes through regulation and funding to promote equitable access to care. 

Market forces are important in healthcare including competition, demand, supply and equilibrium. Competition can be relevant for improving quality or keeping costs low, and mechanisms like rationing may need to be used to set demand equal to supply. 

Waiting times are an important feature of care markets where prices are regulated with waiting times rising when demand is higher than supply. CHE conducts research across all areas of demand, supply and markets for health and social care including the analysis of the determinants and consequences of waiting times, drivers of demand for care and innovations in supply.