29 April 2021

Jeremy Hooper, Conclusio Health Analyst, looks at intelligent targeting of data

For many years now, the NHS has recognised the need for data to support its understanding of variation in the utilisation of health services and associated health outcomes of the population. With the embedding of primary care networks within integrated care systems the analysis and interpretation of data becomes even more important.  Primary care networks supporting local populations will need to deliver services differently as population demographics and need will vary in each of the places they serve. However, while the process outcomes will be different, the hope is that overall population health outcomes will improve similarly.  This needs an effective framework for measuring overall outcomes and an understanding of how the service delivery might impact on them.

Too often the longer term objectives are overtaken by short term solutions to immediate problems, resulting in sub-optimal outcomes.  NICE recently published updated guidance on the management of chronic pain in adults, which is designed to reduce dependence in the population on prescription based analgesics and in particular opioids. This follows the revelations in America around opioid addiction and drug companies not doing enough to reduce dependence.  It is also supported by evidence that other non-pharmacological solutions can provide effective benefits to patients.

NICE believes that by switching patients to different drugs, or through the use of exercise classes, acupuncture or cognitive behavioural therapy, the use of analgesics in the population suffering from non-specific chronic pain will reduce and, overall, there will be a saving to the NHS.  The NICE analysis looks at the narrow costs and not the wider implications around workforce or the management of withdrawal for patients, this is to be addressed in further guidance to be published in the near future. There may well be consequences that will impact on other areas of healthcare.

Mental health services were stretched prior to the COVID-19 pandemic and we are seeing an increasing demand for these services due to the pandemic; from frontline staff suffering from PTSD to those who have lost loved ones needing bereavement support.  Adding patients with chronic pain to the list of new referrals is going to add additional difficulties.  This failure to look at the wider implications of the implementation of new guidance presents a skewed view of its benefits and is likely to impact negatively on the implementation.  Presenting the wider picture, including the likely challenges, provides health systems with realistic expectations that they can begin to plan for and look to implement effectively.

Supporting health systems and primary care networks to understand the data and to ask the right questions will be essential if they are to support the delivery of the NHS Long Term Plan.