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NIHR CLAHRC North Thames – The impact of Delayed Discharge

Unnecessary delays in discharge from hospital are not only costly to the NHS, but are detrimental to the health and wellbeing of patients: they can lead to decreased emotional and physical independence and increase the risk of further illness. For some patients the impact of delayed discharge may lead to premature admission to a care home instead of a return home. This systematic review aims to assess the impact of delayed/timely discharge on patient outcomes and health care costs.

NIHR CLAHRC North Thames – STAR and diabetes prevention

There are currently 2.6 million people with Type 2 diabetes in England, accounting for just under nine per cent of the annual NHS budget (£8.8 billion a year). There are currently 5 million people in England at high risk of developing Type 2 diabetes and, if current trends persist, one in ten will develop Type 2 diabetes. At this rate, diabetes, pre diabetes and the complications of these conditions would result in a massive increase in the burden of disease and costs of treatment. Evidence shows that prevention is cost-effective for many cases of Type 2 diabetes. But these interventions do not save costs to the NHS. This is because interventions to prevent diabetes can be expensive if sustained for a long period of time, but also because the benefits are relatively short and they translate into savings only in the long term. NIHR CLAHRC North Thames is currently working on a project which aims to review local economies’ plans to prevent diabetes in terms of their scale against the population estimated to be at risk and estimate the cost and impact of those plans.

Valuing Active Life in Dementia

Valuing Active Life in Dementia (VALID) aims to promote independence, meaningful activity and quality of life for people with dementia and their family carers living in the community. We are conducting the economic evaluation of a new form of community occupational therapy for people with dementia and their family carers.

NHS Litigation Authority - Economic Evaluation of the Incentivisation Scheme in support of Sign up to Safety

The NHS Litigation Authority (NHS LA) is supporting Sign up to Safety (SuTS), a campaign launched in June 2014 aiming to improve and strengthen the safety of patients in the NHS. As part of the scheme financial incentives have been given to Trusts to reduce harm leading to clinical claims. UCL is conducting the economic evaluation of the scheme to assess the impact of the incentives in reducing errors, incidents and claims in the NHS.

ABLE - Age of Transfused Blood in Critically Ill Adults

At present red blood cells (RBCs) are stored for up to 42 days prior to transfusion. There is currently insufficient evidence concerning the relative safety of different RBC storage times prior to transfusion in critically ill patients. In this project we assess the clinical and cost-effectiveness of transfusing fresher RBCs (stored for ≤7 days) compared with current standard aged RBCs in critically ill patients requiring blood transfusions.

STROKE- Economic evaluation of stroke treatment

Every year, 15 million people worldwide suffer a stroke. Nearly 6 million die and another 5 million are left permanently disabled. For acute ischemic stroke, intravenous recombinant plasminogen activator (IV-tPA) has demonstrated efficacy and cost-effectiveness when administer to eligible patients. However, the prognosis for patients remains disappointing in part because IV-tPA alone is often unable to achieve recanalization, especially when there is a major vessel occlusion. In this case, there is increasing evidence that mechanical thrombectomy has the potential to improve recanalization rates and outcomes for patients with ischemic stroke. We use a Markov model to model the lifetime cost-utility of mechanical thrombectomy compared to IV-tPA alone in the UK and Italy.

NSPCC – The cost of child maltreatment in the UK

According to NSPCC (2011) child abuse includes “all forms of physical and/or emotional ill-treatment, sexual abuse, neglect or negligent treatment or commercial or other exploitation, resulting in actual or potential harm to the child’s health, survival, development or dignity in the context of a relationship of responsibility, trust or power”. This project has developed the first comprehensive estimates of the costs of child maltreatment in the UK across different short- and long-term outcomes. We used an incidence-based approach to calculate the lifetime costs of child maltreatment.

London Speech and Language TherapyWorkforce Scoping Project

University College London (UCL), in partnership with the Royal College of Speech and Language Therapists (RCSLT), was commissioned by Health Education North Central and East London (HENCEL) to undertake a scoping project of the speech and language therapy (SLT) workforce in London. The project investigated the whole London workforce, including those working outside the NHS to: a) provide a snapshot of the current London SLT workforce; b) estimate the levels of current unmet client need for SLT services in London; and c) predict future unmet need for SLT services in London up to 2025, taking account of a range of variables that might impact future need.

Phase 2: modelling workforce transformation example

We model the impact of a specific technology-based workforce transformation project on the SLT workforce in London. We focus on a novel teleswallowing model for the assessment of swallowing problems in residents of nursing or residential homes, which make up a significant proportion of all referrals to community-based SLT settings.