• Analysis has a crucial role to play in shaping care for individual patients as well as across organisations and health systems. It also has a role in helping to improve quality and safety by identifying areas for improvement and monitoring service delivery. 
  • There is a widely acknowledged problem that health services often cannot access the right level of skilled analysts. This can lead to decisions being made on based on limited or inappropriate evidence.
  • In this paper, Martin Bardsley explores issues around both supply and demand that need to be addressed to ensure good quality analysis is able to improve care.

Download Understanding analytical capability in health care.

Key points

  • The ability to use information is an essential element in any health care system.
  • Analysis is critical to a range of issues facing the health service in the UK. These might include:
    • the implementation and evaluation of new models of care in England
    • planning across organisational boundaries
    • implementing and tracking initiatives to assure and improve the quality of care.
  • A skilled workforce that is able to manipulate, analyse and interpret data is essential for a modern health care system. However, there is a widely acknowledged problem that health services often cannot access the right level of skilled analysts. While this is partly a question of the number of analysts, it is also a problem that the health service is not making best use of the analysts it does have.
  • There are key issues around both supply and demand that need to be addressed. Supply is about providing the means for health care organisations to recruit, retain and develop analysts and provide them with the tools to do the job. Managing demand will involve raising awareness among senior managers of the importance and potential of good quality analysis.
  • There are a number of groups and initiatives that can support improvements in the analytical workforce, including education and training, professional development and networking.
  • There are also some key issues that are more challenging, and subject to the wider change agenda. These include:
    • supporting training and development opportunities that are linked to the needs of the service
    • helping analysts work in larger teams that span across organisations
    • providing room for innovation, development and testing of new analytical applications
    • creating new relationships with the experts to improve the quality of support and evidence 
    • stimulating the demand for good quality analysis among NHS leaders. 


Julian Simcox

Yes. the NHS is short on Analytics -- sadly this report misses the paradigm shift now needed -- namely the need to be able to analyse data over time and distinguish between signal and noise. See this paper: http://www.saasoft.com/blog/?p=4178

Given that the HF is leading the nation in the development of Improvement Science skills, this missed linkage surprised and disappointed me.

Clive Smee

This paper is quite right to identify key weaknesses around the supply and demand for analysts in the health care system. Looking only at the centre – DH and its agencies – there are now perhaps twice as many analysts as when I retired as Chief Economist and Chief Analyst in 2002. But a common assessment of those with long enough memories is that these analysts are perhaps half as effective or influential as 15 years ago. One reason is undoubtedly the frequent reorganisation of the central DH bodies leading to fragmentation of advice and responsibilities, too often accompanied by demoralising requirements on analytical staff to re-apply for their jobs. ( Since the move of the Executive to Leeds over 20 years ago it is not clear that any of these reorganisations has been properly evaluated.) A second reason is that analysts’ access to Ministers has been greatly squeezed by the proliferation of other more senior posts across the DH group; the rapid turnover and at times downgrading of Chief Economist/Chief Analyst posts; and a wave of thinking at Ministerial level that can best be described as discouraging to those wishing to ”speak truth to power”. Ministers who only listen to what they want to hear will not get good advice.

Dr Jonathan Kirk

Thank you for this excellent addition. My feeling is that lack of analytical capability is one of a number of rate limiting steps limiting our ability to learn from information. Clearly understanding when to intervene and when to leave well alone (i.e. understanding of variation) is key at many levels from individual patient interventions to system wide monitoring. Developing that capability can release operational capacity and help us to avoid losses of misinterpretation. However I would contend that analysis is only part of the story - just as quantitative information is only part of the story. If we look more broadly we tend to find a whole series of gaps - starting with the questions we ask and the interactions that we have in place to collect real time information, through standards of data collection, how that data is processed, to analysis, presentation, interpretation, identification of learning, escalation/mitigation of risk, sharing information.....etc etc. Even the very best analytics if undermined by other confounding factors and operation frailties will still come up short I suspect. The Health Foundation's Framework for Measurement and Monitoring offers valuable insight into some of those frailties, by directing us to consider the wider picture. Doing so helps surface unknown unknowns and opens our eyes to a range of hitherto unconsidered barriers to improvement that need to be considered in tandem.

Martin Bardsley

Thanks for the comment Julian. I agree that the ability to use data that is linked over time is really important - as is the use of data linked between different parts of the care pathway. Its an area I have been especially interested in and keen to promote in my work and something The Heath Foundation continues to support. However I think the problem caused by the shortfall of analytics extends into many other areas an techniques and I wanted my report to look across a wider agenda..

martin bardsley

Thank you for the comments Jonathan and Clive.

On Jonathans points - I did take a fairly wide view of 'analysis' as I was struck by the number of people I spoke to who raised the importance of analysts being able to frame the questions and answers in the 'right way' - and in my mind that also includes being able to work within the local context. But you are probably right to offer a cautionary note.

Adrian Rabe

Thank you for the timely report on this particular human resource. Analysts are indeed scarce, overworked and underpaid, easily overlooked as health budgets face greater and greater strain. Perhaps this is symptomatic of the expected effects of devolution on the NHS, where local commissioners and trusts are now tasked to look after the nitty-gritty of healthcare operations and have to make sacrifices somewhere along the way.

Perhaps it is important to look at solutions to this problem. Maybe analytical expertise must be re-conceived as a centralized resource that provides healthcare intelligence for national health policy, with the flexibility to also provide regular and bespoke analytical services to local providers and commissioners. Such a system is somewhat akin to specialised commissioning currently managed directly by NHS England.

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