NHS Institute: Making the shift

HSMC worked with the NHS Institute for Innovation and Improvement in a programme of work on making the shift from secondary to primary care.

HSMC also worked with the NHS Institute on an analysis for the World Economic Forum of the scope for improving quality of care for people with long term conditions such as diabetes and COPD as part of an international study.


One of the areas of interest in the programme is long-term conditions and two reports resulting from this work have been published.

Making the Shift: A review of NHS experience (pdf; 271KB; opens in new window)

Making the Shift: Success factors - A rapid review of best practice in shifting hospital care into the community (pdf; 1.13MB; opens in new window)

HSMC has recently published two reports setting out the results of the evaluation of the Making the Shift programme:

The final report of the evaluation describing the work done in 14 projects in five areas to shift care from hospitals to the community. The evaluation found that varying progress was made in the 14 projects and that a common challenge was to put in place effective arrangements for managing these projects and achieving shifts in the ambitious timescale of the programme. The report identifies key lessons that were distilled from the programme that the NHS needs to take on board in future programmes of this kind.

The case studies included projects on back pain care, COPD, end of life care, gynaecology, and diabetes. The evaluation of these projects shows the complexity of bringing about change in the NHS, and the need to put in place effective project management arrangements, engage different stakeholders, and decide on measures for reviewing progress. The report emphasises the need for projects to be implemented as part of a local strategy for service improvement if change is to be organisation-wide.