By drawing on our strong economic foundations and methodologies, we aim to strengthen health and social care through economic research focused on helping decision makers make better informed, long-term policy decisions. By exploring how resources are allocated and understanding the trade-offs involved, we aim to provide robust, high-quality evidence to support a stable health and care system which meets the needs of everyone.
We see a need to go beyond current approaches and challenge the conventions of economic research through multidisciplinary discovery and by taking a longer-term view. Our collaborative approach, rooted in trusted relationships and shared learning among diverse stakeholders, ensures that our research will be policy-driven and aligns with the needs of the sector.
Pathfinder Portfolio
At the end of Phase 1, the Unit will produce a Pathfinder Portfolio – a series of documents which present and examine opportunities for research that have the potential to drive impact in how decisions are made in health and social care.
The purpose of the pathfinders is to help structure our research plan in Phase 2, presenting a summary of questions, knowledge and literature gaps, opportunities and challenges within broad thematic areas and topics developed in collaboration with health and care leaders, policy makers and diverse perspectives, including those of the public.
Below is a list of the pathfinder topics we are currently working on. If you would like to know more about them, or have your say in developing them, then please get in touch!
The health and care sector needs to train more young people to provide care for an aging population. But the number of young people in the UK is going to shrink in the next decades because of historically low birth rates. This means that the sector may need to train some young people that are less keen to do so or who would normally not have been considered suitable. We do not know how these large increases in recruitment might change the workforce over time.
In this pathfinder, we explore two issues: Will these ‘additional’ workers be different to those that would be trained anyway? If yes, how will this change the way they work and provide care? This Pathfinder aims to explore these unknowns and understand the potential impacts on health care delivery over the next decades.
There are many characteristics of workers that might change when the NHS begins to train more. In this pathfinder, we focus on two characteristics that are widely believed to be important: a worker’s ability and their altruistic motivation (i.e. how much they care about their patients). We find a small and very recent literature that measures altruism in health care workers in the US, Germany and Denmark. These studies show that a worker’s altruism affects their clinical choices. However, there are large gaps in evidence around the effect of motivation on how much an individual works, e.g. whether they work part-time, retire early, or delay completion of their training. The literature on ability shows that academic achievement (e.g. GCSE or A-level results) is a good but imperfect predictor of training outcomes.
The UK lacks large cohort studies that measure ability and motivation and link it to career outcomes and care delivery. We make some suggestions for how the data could be improved. Conducting further research into this topic is crucial because it will help us plan the future workforce better and more realistically.
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The health and social care workforce is crucial for delivering care to those in need. However, both sectors face ongoing challenges in recruiting and retaining staff. With increasing demand and an aging population, the NHS and social care sectors must expand significantly in the coming years. The ability to meet this demand depends on effective policies around pay and working conditions. This study examines how wages, contracts, and job conditions affect the supply of health and social care workers.
Knowledge gap
While workforce shortages are well-documented, there is limited research on how pay and conditions influence staff decisions to join, stay, or leave the sector in the U.K. Most studies focus on doctors and nurses, leaving major gaps in understanding the social care workforce. Existing research also overlooks how to measure the value of job conditions – such as shift patterns, job security, and career development – and how this might impact recruitment, retention and hours of work. Additionally, centralised pay structures may not account for regional workforce challenges, and more needs to be understood about how local pay flexibility could improve staffing levels.
Value
By exploring how financial and non-financial incentives affect workforce supply, this research can provide policymakers with evidence-based recommendations. Understanding and measuring the true drivers of staff recruitment and retention will help determine whether simply increasing wages is enough or if broader changes – such as more flexible pay models, improved working conditions, or better career development opportunities – are needed to sustain the workforce.
Impact
The findings will support better workforce planning and help decision-makers design policies that attract, retain and increase the hours of work of health and social care workers. By addressing workforce shortages effectively, the research will contribute to a more stable and sustainable care system, ensuring that services remain accessible to those who need them most.
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The UK has long relied on international migration to fill gaps in its health and social care workforce. Training new UK professionals takes years, so recruiting workers from abroad has been a quick way to address shortages. However, experts warn that while immigration helps in the short term, a long-term solution requires better pay, working conditions, and funding for UK staff. This research looks at how many migrant workers are in the sector, where they come from, and the impact they have on healthcare and social care services.
Knowledge gap
There is limited research on the impact of migrant health and social care workers in the UK, especially on patient care, workforce stability, and regional staffing shortages. There is also little data on how well migrant workers integrate into the workforce, their career progression, and whether they face challenges like lower pay or poor working conditions. Another area lacking research is the reasons why UK-trained professionals are leaving for other countries and what could be done to retain them.
Value
Research on international migration of health and social care workforce provides essential evidence for policymakers to improve workforce planning in health and social care. Understanding the role of migrant workers in improving staffing and reducing vacancies, in particular in underserved areas, helps ensure services remain sustainable. Assessing the contribution migrant staff make to care quality could provide evidence of the importance of immigration policies in supporting health and social care provision. Moreover, evidence on labour market outcomes of migrant workforce can inform policies aimed at supporting their integration, preventing discrimination, and maximising their contribution to the UK health and social care sectors.
Impact
The findings can inform better workforce policies to maximise the contribution health and care staff are making to the sector. Insights into pay, working conditions, and migration trends can help improve job satisfaction and staff retention. Ultimately, this research can help create a more stable and effective health and social care workforce, benefiting both workers and the people who rely on these services.
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Health and social care services rely on a variety of skilled workers to meet the changing needs of the population. Planning for the right mix of skills is essential to ensure that care is effective and efficient. This Pathfinder explores how different combinations of roles and skills impact workforce productivity and service quality.
Knowledge gap
There is limited understanding of the best way to balance different roles within health and care teams. Although new roles like advanced nurse practitioners and physician associates have been introduced, there is little evidence on their cost-effectiveness. Additionally, professional boundaries can slow down the adoption of new roles, making it harder to adjust the workforce to changing needs.
Value
By studying how skill-mix affects productivity, motivation, and job satisfaction, we can design better workforce strategies. This research can help decision-makers ensure that care providers have the right skills in the right places, making services more effective while keeping costs under control.
Impact
Understanding skill-mix can improve patient outcomes, increase job satisfaction for healthcare workers, and make the health system more efficient. Policymakers can use this knowledge to shape workforce strategies that address future health and care challenges, ensuring high-quality care for all.
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The decision to use a particular tool or way of working is described as a decision to ‘adopt’ a technology. Diffusion is the pattern made up of a sequence of adoption decisions. This research explores how new tools and ways of working spread throughout the NHS and social care, focussing on the factors which influence decisions to adopt a technology. It investigates why some parts of the system adopt new practices faster than others, and considers the system-wide factors that drive change. We also consider the diffusion of ‘disinvestment’, which is a decision to stop using low value technologies. The rate of technology diffusion may depend on the motivations of the actors responsible for adopting it, or the characteristics of the technology itself. Systems that are slow to adopt new valuable ways of working, or slow to move away from low value technology may be able to make adjustments that improve overall benefits.
Knowledge Gap
Existing research often focuses on how a particular example of a technology has spread. This narrow focus tells us little about how to build a health and care system that will be able to make the best adoption decisions as new developments emerge. Developing a way to categorise different technologies is difficult, but it would help us understand and use economic research in this area. Existing research does not tell us much about how the speed of adoption and disinvestment impacts overall population health and care outcomes and on inequality in outcomes.
Value
This research focuses on the speed and unevenness of technology diffusion across the NHS and social care with the aim to estimate the benefits forgone from imperfect diffusion. This research will explore “market failures” and system characteristics that can lead to inefficient adoption and disinvestment rates and analyse what can be done to change the speed of adoption.
Impact
This research aims to identify barriers to the spread of beneficial health and care innovations, informing policies to improve efficiency, quality of care, and population outcomes. Combining new knowledge on what can be done, with new knowledge on the payoff from changing the speed and spread of adoption, will provide stakeholders with insight into valuable ways to improve system performance.
Download DocumentationProviding health and social care in England is becoming more expensive. A large part of government funding goes toward paying healthcare and social care workers, and even more staff are expected to be hired in the future. But if more money keeps going into these services, there will be less available for other important areas like schools, the police, or the military. So, we need to explore whether some care tasks can be done differently – perhaps in a way that requires fewer workers.
Automation means using technology to do jobs that people usually do. Health and social care have traditionally been hard to automate because they require human skills like decision-making, dexterity, and empathy. However, artificial intelligence (AI) and robots are advancing quickly and changing jobs in many industries. Some experts believe AI and robots could also help control rising costs in health and social care.
In this pathfinder, we examine which health and social care tasks might be automated in the future. We look at past research on automation in other industries and apply those ideas to health and social care. Our goal is to understand what technology can realistically achieve and where human workers remain essential. We also explore how automation might impact employment opportunities and the well-being of workers in this field.
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Dentistry and adult social care in England operate somewhat like a marketplace, with services provided by many mostly independent providers. Large shares of the demand are, however, publicly funded and commissioned (paid for) by the NHS and local authorities (LAs), respectively. Due to funding pressures, the NHS and LAs use their market power to keep (real) prices paid to independent providers down and increase contributions for those using these services. This market imbalance has led to a shift from public commissioned services to more private service provision and concerns that quality of care is impacted by low care tariffs.
Knowledge gap
There is little known about the drivers behind independent health and care providers’ decisions to provide less publicly commissioned services and more services paid privately. These decisions do have, though, important equity implications, and can increase pressure on other parts of the healthcare system (e.g., avoidable hospitalisations) as well on families (e.g., unpaid care).
Value
Research could provide evidence on:
- The factors affecting dentists’ and social care providers’ decisions to provide more (or solely) privately paid services vs. publicly commissioned.
- The impact of reduced provision of public funded primary care and social care services on avoidable hospital admissions, and development of other health conditions.
- The impact that public Adult Social Care provision for cared-for persons and carers have on unpaid carers’ quality of life, health and labour market attachment.
Impact
By investigating these factors, the research aims to provide evidence that can inform policy decisions and potentially mitigate the negative consequences of the current market dynamics in dental and social care. This could lead to improvements in access to care, quality of care, and support for the workforce in these sectors, ultimately benefiting both service users and providers.
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The resources available to the health and care sectors must be balanced between addressing current and future needs. Long-term investment decisions may have costs greater than benefits at first, take a long time to pay off, and be to some extent irreversible, meaning that once resources are committed, they cannot be easily reallocated. This review focuses on three key areas characteristic of long-term investment: preventative medicine, working against future poor health; capital expenditure, including purchasing and maintaining buildings and other technology; and preparing for and adapting to climate change. It asks whether the NHS invests appropriate resources in future health, and how we can measure the benefits of further investment.
Knowledge gap
The NHS may underinvest in activities that have long-term payoffs due to several structural and financial challenges. The organisations responsible for funding prevention may not directly benefit from the long-term savings it generates. Capital expenditure often depends on time-limited national funds which are allocated for specific purposes and must be applied for, limiting flexibility. Locally controlled capital funding is often diverted to cover day-to-day operational costs. The future costs of climate change may not be considered in current capital expenditure plans, even though they could be reduced or adapted. There is a need to explore whether current spending levels are not the best and to identify the reasons why long-term investments may be neglected.
Value
This research will investigate if spending more on prevention, buildings and equipment, and adapting to climate change would be better for the NHS in the long run. It will explore different ways of accounting for long-term benefits and costs, if the way the NHS gets its money makes it hard to invest for the long haul, and if there are better ways to encourage long-term thinking. By understanding these issues, policymakers can make better-informed decisions about where to spend money and how to allocate resources for long-term impact.
Impact
Addressing barriers to long-term investment could bring multiple benefits. Prevention efforts could reduce the burden of illness, improving population health and lowering future healthcare costs. Better buildings and equipment could make the NHS more efficient, improve patient care, and make staff more productive. Preparing for climate change (by reducing our impact and adapting to changes) could protect the NHS from future problems and save money in the long term.
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