Cambridge and Peterborough high intensity users

The Cambridgeshire and Peterborough Integrated Care Board (ICB) developed the North and South Place plans to enhance support for individuals at risk of increased use of unplanned care services. These plans focus on understanding the root causes of challenges faced by these individuals and connecting them to neighbourhood-based care and support.

Background 

In Cambridgeshire and Peterborough, some people use A&E and emergency services far more than others. This is often due to long-term health conditions, difficult life circumstances, or a lack of the right support at the right time. Without intervention, these individuals are likely to keep relying on emergency care, adding pressure to an already stretched NHS.

To tackle this, the Cambridgeshire and Peterborough ICB introduced a two-tier support system:

  • Tier 1 helps people who have visited A&E more than 10 times in the past year, providing personalised support to better manage their health.
  • Tier 2 focuses on those at risk of becoming frequent A&E users, offering early help before their needs escalate.

Early data shows this approach is making a real difference helping people stay well, reducing unnecessary hospital visits, and easing pressure on emergency services. However, the project is still ongoing, and more work is needed to understand its full impact.

To support this, health economists evaluated the program to see how well it’s working and what improvements can be made. These findings will help shape future decisions, ensuring NHS resources are used effectively. If the results continue to be positive, this approach could influence national policy and be adopted across the country, helping more people get the care they need while keeping emergency services available for those in urgent need.

Project Aims

This economic evaluation aimed to evaluate the impact of the Tier 2 service model on health resource utilisation, associated costs, and health outcomes.

The mixed methods work support the economics analysis on aspects that are either difficult to evaluate given the data captured or to compliment insights, generated from the analysis. It focused on evaluating staff and stakeholders’ views on the implementation and impact of the Tier 2 service and how this differs between the South and North place.

Project Activity

The evaluation team employed a health economics evaluation approach and quantitative data analysis of routinely collected service data to assess the cost-consequence of the HIU program on individual’s health service utilisation and outcomes.

Anticipated or actual outputs 

The evaluation addressed the following questions:

  • What are the resources used for the intervention?
  • What are the costs of implementing the program?
  • What are the consequences of implementing the intervention?
  • Are there differences in patient outcomes between North and South?
  • What is the distribution of access of the Tier 2 services relative to user socio-economic attributes e.g., deprivation?
  • Does the intervention have a differential impact relative to health and social care utilisation among subgroups?

Download the study findings here

Who was involved?

  • Joao Rocha (PI) Lead Health Economist- Health Innovation East; Cambridge and Peterborough Strategic Commissioning Unit
  • Adam Wagner- University of East Anglia
  • Godsfavour Ilori Health Economist, Evaluation team, Health Innovation East
  • Katherine Cummergen, Health Innovation East, Evaluation

Contact:

Joao Rocha- joao.rocha1@nhs.net

Adam Wagner- adam.wagner@uea.ac.uk

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