The goal is to develop methods of measuring quality of care and burden of disease, and evaluating interventions designed to improve healthcare.
Our work has had substantial impact on measurement of quality in the NHS, in particular developing measures of patient experience in primary care and interpreting measures of patient experience in cancer. Our studies in primary care have yielded new insights about the impact of pay-for-performance programmes in the NHS (NEJM 2009) on exception reporting in primary care (NEJM 2008), and how financial incentives have diverted attention from aspects of care that were not incentivised (BMJ 2011).
We have also shown the impact of hospital pay for performance schemes on reducing in-hospital mortality (NEJM 2012).
Other work has informed NHS policy on areas including targets for hospital readmission rates, the impact of initiatives designed to better integrate care, and the contribution of leadership training to improving hospital quality.
Our two-decade cohort study of dementia in England has informed health service provision by producing reliable prevalence estimates, adding to our understanding of neuropathology (NEJM 2009), and showing that a cohort effect exists in dementia prevalence, with later-born populations having a lower risk of prevalent dementia than those born earlier in the past century (Lancet 2013).
We will expand work on quality measurement in the NHS, showing how valid data on patient experience can be used to improve care, working in primary care, in acute hospitals, and with patients who have cancer. Our work will demonstrate how care can be better integrated and we will continue with long-term studies to improve the care of people with dementia.
To inform the blood service in England, we will complete a trial of 50,000 blood donors to determine the optimum safe interval between blood donations, as well as conduct further trials to assess how best to screen for iron deficiency and to prevent anaemia through personally-tailored dietary advice.