YHEC provides a comprehensive range of health economics services, analyses and evaluations to the NHS and other local public sector organisations. Our services help the NHS to address priorities outlined in the NHS Long Term Plan. We also work with a variety of other organisations providing and commissioning care across the health and social care sectors. YHEC has more than 30 years’ of experience of providing services to the NHS and public sector and the types of economic analyses we provide include: The services we provide to the NHS and public sector support clients in developing their decision making. Our models and analysis range from simple cost calculators to more complex evaluations of new innovations and interventions. Our client base includes: The schematic provides examples of the range of priority areas within which YHEC has recently provided support to clients.
Urgent & emergency care
Demand and capacity modelling
We have developed a number of demand and capacity models to assist healthcare commissioners and providers to plan future services. Examples include urgent and emergency care services, ambulance services and diagnostics. The models estimate and project the impact of a range of factors affecting demand, such as demographic changes, new clinical guidelines/practices and the introduction of new technologies.
Evaluation of paramedic initiatives
This new service model, supported by NHS England, deploys specialist and advanced paramedics in the primary care sector, to relieve pressure on GP practices, ambulance services and the wider system. The evaluation considered the available evidence from the pilot sites, literature and clinical opinion to form a view on the potential economic benefits that could be generated when rotational paramedic models are established and running in an optimal way.
Cost benefit model: technology in ED
We are working with an acute trust to evaluate the economic impact of a digital system for people attending the emergency department (ED). Patients are able to enter their clinical history while waiting to be seen by an ED clinician. The evaluation will produce an economic model which can be used to demonstrate the impact of the system in ED departments.
Return on investment: UEC interventions
Stakeholders in an Urgent and Emergency Care Vanguard introduced a number of channel shift interventions to reduce the demand on the emergency care system. YHEC developed a return on investment model to estimate the projected financial return of these interventions over a five year period.
Primary Care
Demand and capacity modelling
We have developed a number of demand and capacity models to assist healthcare commissioners and providers to plan future services. Examples include urgent and emergency care services, ambulance services and diagnostics. The models estimate and project the impact of a range of factors affecting demand, such as demographic changes, new clinical guidelines/practices and the introduction of new technologies.
Incentive modelling (QOF)
YHEC is experienced in modelling the economic impact of incentives. For example, between 2009 and 2016, YHEC was part of the National Collaborating Centre for Indicator Development, providing economic analysis of the cost-effectiveness of the provision of financial incentives to primary care in the UK through the Quality and Outcomes Framework (QOF).
Digital health evaluation
We have undertaken a range of evaluation of digital technologies to understand the potential for reducing healthcare utilisation. Examples include telehealth systems for patient/clinician communication, self management tools for long term conditions, and apps for oral health promotion.
Economic evaluation of frailty initiatives
With the increasingly elderly population, approaches to recognise and manage frailty are being introduced, particularly in primary care. We have undertaken cost consequence analysis projects to evaluate the economic impact of proactive approaches to caring for frail elderly populations, such as nurse-led comprehensive geriatric assessment and polypharmacy medication reviews.
Cancer
Diagnostic demand & capacity modelling
We have developed a demand and capacity model for diagnostic tests used in the diagnosis of cancer. These include radiology, ultrasound, endoscopy and pathology. The model projects the increase in demand for test over five years, taking account of growth assumptions and forthcoming developments that may affect patient flows.
Evaluation of interventions for early diagnosis
We are working with a Cancer Vanguard on an economic evaluation of their programme of interventions for earlier diagnosis of cancer. These include interventions to improve access to services, and redesigned clinical pathways for lung, colorectal and prostate cancer.
Cancer quality of life metrics
We are analysing post-treatment cancer patient’s quality of life data for a national pilot led by NHS England and Public Health England. More broadly, we can advise on quality of life measures for service evaluation/improvement activities and analyse quality of life data.
Cost benefit models for vague symptoms
New clinical pathways and services are being introduced by acute trusts to investigate non-specific symptoms (e.g. unexplained weight loss), which do not meet the criteria for two-week wait cancer referrals. We have evaluated the cost impact of new pathways and services compared to ‘usual care’.
Integrating Care Locally
Vanguard new models of care evaluations
We have undertaken economic impact evaluations for new models of care such as virtual wards and multi-specialty community providers. These have aimed to measure the impact of new ways of working across health and social care utilisation.
Demand & capacity modelling
We have developed a number of demand and capacity models to assist healthcare commissioners and providers to plan future services. Examples include urgent and emergency care services, ambulance services and diagnostics. The models estimate and project the impact of a range of factors affecting demand, such as demographic changes, new clinical guidelines/practices and the introduction of new technologies.
Evaluations of innovations for self management
As part of the NHS Innovation Accelerator economic evaluation we developed cost consequence analyses of web-based support network providing support for people with similar long-term conditions or health interests. The analysis sought evidence of the potential for cost savings to the NHS from patients requiring less healthcare, such as GP appointments.
Evidence reviews for new models of care
We are able to conduct a rapid reviews of evidence and best practice to support the development of economic models and/or business cases. Recent examples include: a review of both published and grey literature around the structure and organisational models and benefits of integrated care organisations; evidence for the cost effectiveness of musculoskeletal secondary prevention interventions.
Funding & Efficiency
Cost savings & benefits realisation modelling
We carry out economic evaluations of new technologies and innovations for local healthcare providers and commissioners, identifying evidence for cost savings to the health and social care system, such as cash-releasing efficiencies and reduced demand on services. We also aim to identify and measure wider benefits, such as improved health outcomes and staff/patient satisfaction, and to measure these against the incremental intervention costs.
Burden of illness modelling
Burden of illness modelling includes estimating the cost of diagnosing, treating and managing the condition on a population level. Recent examples of burden of illness studies/models that we have developed include diabetes, congenital cytomegalovirus (CMV) and sepsis.
Carter Review efficiency modelling
We have recently undertaken a project looking at the cost of single use instruments compared with reusable instruments for a specialised therapeutic area. We are in the process of adapting our model so that we can easily compare the estimated costs of single and reusable instruments across a broad range of specialties within the NHS.
Cost impact of new services e.g. cancer diagnostic pathways
We have undertaken studies to establish the cost impact of services from an NHS and social care perspective. Examples include new clinical pathways, new service models such as multi-speciality providers, telecare/telehealth and alternative approaches to providing primary care services.
Harnessing technology & innovation
Evaluation of new technology in NHS settings
We undertake economic evaluations to estimate the budget impact, return on investment or cost-effectiveness of new technologies in an NHS setting. Examples include pharmaceutical products, devices and new service designs or procedures in a wide range of clinical areas. Recent examples include interventions to reduce healthcare acquired infections and therapies for people with cancer.
Digital health evaluation
We have undertaken a range of evaluation of digital technologies to understand the potential for reducing healthcare utilisation. Examples include telehealth systems for patient/clinician communication, self management tools for long term conditions, and apps for oral health promotion.
Research dissemination
YHEC adds to the body of economic evidence by seeking to publish our research findings and economic evaluation projects in peer review journals, organisational websites and national reports.
Return on investment of new innovations
We conduct analyses to estimate the return on investment of new innovations and and technologies for use in the NHS. For example the NHS Innovation Accelerator economic evaluation, which included innovations such as medical devices, apps for patients, web-based support services, and digital solutions for medical records.
Public Health
Behavioural science to promote screening and prevention
We have used behavioural science methods to review and advise on the design of future interventions and programmes to improve screening uptake. More broadly, we can use behavioural science methods to explore barriers to the uptake of clinical guidelines and new ways of working and to provide evidence-based solutions.
Modelling impact of physical health checks in mental illness
We are able to develop models which analyse the economic impact of specific services, and which can also be used to estimate the potential impact of introducing similar services in other areas. Such an example is an economic impact model to estimate the potential savings from services to improve the physical health of people with severe mental illness.
Prevention and early intervention evaluations
We conduct evaluations of services which aim to promote patient wellbeing and also reduce incidence of poor health. Examples includes return on investment for falls prevention approaches and evaluation of social prescribing services to reduce isolation and improve mental health.
Return on investment of early interventions e.g. MSK
We have developed return on investment (ROI) models for early interventions to promote health, for use by national and local organisations. Recent examples are ROI models for falls prevention, oral health, and the secondary prevention of musculoskeletal conditions such as back pain.