Evaluation of modernisation of adult critical care services in England: time series and cost effectiveness analysis

Status: Published 

What was this study about? 

In May 2000, the Department of Health in England published Comprehensive Critical Care: A review of adult critical care services.  This review advocated the need to ‘modernise’ services and outlined a modernisation programme that was expected to take three to five years to complete.

Two months later, the Department published its long-term vision and commitments for health care in general, The NHS Plan, which included a 30 percent increase in the number of adult critical care beds. To achieve this, an additional £299 million was invested between 2000 and 2003 to increase capacity. 

The aim of this study was to evaluate the impact of modernisation and increases in capacity on the provision, use and outcomes (including cost effectiveness) of critical care, and to explore the impact of modernisation on the organisation, delivery and culture of critical care. 

What did the study find? 

From late 2000, the capacity of adult critical care in England increased and this was associated with a reduction in the severity of admissions, fewer transfers and discharges for non-clinical reasons, and better risk-adjusted outcomes. While it is unclear which factors were responsible, collectively the interventions represented a highly cost effective use of NHS resources. 

Who led the study? 

Andrew Hutchings, London School of Hygiene & Tropical Medicine 

The study was funded by the NIHR Service Delivery and Organisation (SDO) Programme (Project: 133/2006)