Blog: What was the question again?

Steven Wyatt, the Strategy Unit

We hear a lot about what’s stopping the NHS making the most of its army of talented analysts. Some say we just need more data, or data of better quality. Others point to deficiencies in our infrastructure, IT kit or the software we use. But I’m not so sure. For me the biggest shortfall is in good questions that we can feasibly address. 

It’s easy for analysts to take the position that it’s for managers and clinicians to come up with the questions that they want us to explore. But the reality is that although managers and clinicians have a firm grasp of the challenges that the NHS faces, they don’t know what’s in the analyst’s kitbag. And so the questions they generate are limited by the few methods they are familiar with. This can lead to repetitive, poorly designed projects that waste the talents of and ultimately deskill our analysts. The only way to resolve this problem is for analysts to engage managers and clinicians in detailed conversations about the challenges they face. If analysts can take a step towards their colleagues and start these conversations, then they will be better placed to propose analytical projects that might help the NHS, and keep themselves mentally stimulated in the process. 

Every year, the Midlands Decision Support Network (MDSN) conducts a few large analytical projects on behalf of the 11 Integrated Care Boards in the region. Previous analysis has explored patterns of healthcare use in the last 2 years of life, socio-economic inequalities in access to planned care and novel ways of classifying outpatient activity to facilitate service redesign. The topics are selected by the ICBs from a list prepared by the Strategy Unit. To create the long-list, we put out a call for ideas across our networks, including more than 700 analysts from a wide range of health and care organisations in the region. In previous years the response to this call has been limited and the list has largely been populated by the Strategy Unit. This year we noticed a step-change. The majority of the ideas came from analysts and their managers in local health systems. And the ideas were great. A rich mix varying by sector, focus and method. This is cause for great optimism. Health systems that can identify good questions are well-placed to make good use of their analysts. It seems to us that the MDSN’s focus on problem structuring, analytical leadership, and decision quality is paying off. 

The long-list of 32 ideas were considered by the MDSN Strategy Group and 3 lucky projects were selected for attention later this year. But the list has great value in itself. It could keep me happily and productively occupied for the remainder of my career, but that would be greedy. So, we’re publishing the list here for others to draw on. If you’re a manager of NHS analysts or an NHS analyst with some freedom to choose what you do, then you might want to consider working on one or more of these questions.  

One of the principles of the MDSN is that the code for each project should be shared so that others can readily reproduce or build on it. If you are able to take one of these projects forward, then it would be great if you could adopt this principle too. This way the NHS gets the most from its investment in analysis. 

If you are a commissioner of analysis or research and want to speak to us about taking one of the long-listed ideas forward, please do get in touch. 

To our friends in private sector consultancies, let me be clear. This is not a request for bids or proposals. The NHS has the capability to address these questions for itself and will learn a great deal from doing so. To our colleagues in academia, please do let us know if you have published relevant work on these topics. We are confident that these questions have not been fully addressed or translated into practice, but insights from aligned research or methodological advice is always welcomed.