Aquarius Population Health

Service Delivery

Transforming clinical decisions.

We help you visualise current patient care pathways and benchmark them against guidelines. Working together we can understand how current practice might be optimised to yield better outcomes for patients and more efficient services.

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Case Studies

Improving the NHS Blood Culture Pathway in England

Bloodstream infections (BSI) are common and cause severe disease and death. Blood cultures are used to identify whether patients have a bacterial or fungal BSI and assess whether the microbe will be resistant to any antimicrobial therapies (AMTs) helping clinicians to prescribe AMTs to patients who truly need them. NHS England’s blood culture audit indicated low adherence to best practice guidelines and trusts have raised concerns regarding the resource implications of achieving compliance.

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Cervical screening and HPV testing: Opportunities for rapid tests

We explored the use of a rapid, on-demand human papillomavirus (HPV) test. Interviews with UK experts revealed that a co-located, on-demand HPV test following cytology could reduce the time to cervical screening results by up to a week, with a near-patient primary HPV test followed by cytology triage could radically change the testing paradigm. A follow-up tool we built in Excel was used to understand cervical screening burden and HPV testing across Europe.

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The cost of pelvic inflammatory disease and potential cost-savings of chlamydia screening

We worked with clinicians from St Georges University who had published a trial estimating the incidence of pelvic inflammatory disease (PID) among women screened and unscreened for chlamydia. Patient data was analysed, and the average cost of managing PID was estimated to be £163 in community and hospital settings, and that over £60,000 could be saved in London alone from screening for chlamydia. This paper has been cited widely and results have informed policy and further modelling studies.

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Estimating the true costs of splitting HIV antiretroviral drugs

There is a temptation to switch to cheaper generic antiretroviral drugs compared to fixed-dose combination therapy for HIV patients in the interests of cost savings. However, in our analysis we found that there were no costs saved when including all patient care including drugs, additional clinic visits and monitoring. We also found that switching may cause confusion for some patients, risking loss of adherence. This evidence can help commissioners make better policy decisions about drug provision.

Continue Reading–>

Increased efficiency and improved treatment for stable HIV patients in England

Collaborators at St Georges Hospital wanted to understand the impact of changing service provision for stable HIV patients, as no evidence existed on what was best for clinics. We built a tool in Excel, and results indicated that 6-monthly appointments and 3-monthly home delivery of drugs is the cheapest option and could yield £2000 savings per patient, translating to an annual cost reduction of ~£8 million for the estimated 4000 eligible patients not currently on home delivery in England in 2012.

Continue Reading–>

Case Studies

Improving the NHS Blood Culture Pathway in England

Bloodstream infections (BSI) are common and cause severe disease and death. Blood cultures are used to identify whether patients have a bacterial or fungal BSI and assess whether the microbe will be resistant to any antimicrobial therapies (AMTs) helping clinicians to prescribe AMTs to patients who truly need them. NHS England’s blood culture audit indicated low adherence to best practice guidelines and trusts have raised concerns regarding the resource implications of achieving compliance.

Continue Reading–>

Cervical screening and HPV testing: Opportunities for rapid tests

We explored the use of a rapid, on-demand human papillomavirus (HPV) test. Interviews with UK experts revealed that a co-located, on-demand HPV test following cytology could reduce the time to cervical screening results by up to a week, with a near-patient primary HPV test followed by cytology triage could radically change the testing paradigm. A follow-up tool we built in Excel was used to understand cervical screening burden and HPV testing across Europe.

Continue Reading–>

The cost of pelvic inflammatory disease and potential cost-savings of chlamydia screening

We worked with clinicians from St Georges University who had published a trial estimating the incidence of pelvic inflammatory disease (PID) among women screened and unscreened for chlamydia. Patient data was analysed, and the average cost of managing PID was estimated to be £163 in community and hospital settings, and that over £60,000 could be saved in London alone from screening for chlamydia. This paper has been cited widely and results have informed policy and further modelling studies.

Continue Reading–>

Estimating the true costs of splitting HIV antiretroviral drugs

There is a temptation to switch to cheaper generic antiretroviral drugs compared to fixed-dose combination therapy for HIV patients in the interests of cost savings. However, in our analysis we found that there were no costs saved when including all patient care including drugs, additional clinic visits and monitoring. We also found that switching may cause confusion for some patients, risking loss of adherence. This evidence can help commissioners make better policy decisions about drug provision.

Continue Reading–>

Increased efficiency and improved treatment for stable HIV patients in England

Collaborators at St Georges Hospital wanted to understand the impact of changing service provision for stable HIV patients, as no evidence existed on what was best for clinics. We built a tool in Excel, and results indicated that 6-monthly appointments and 3-monthly home delivery of drugs is the cheapest option and could yield £2000 savings per patient, translating to an annual cost reduction of ~£8 million for the estimated 4000 eligible patients not currently on home delivery in England in 2012.

Continue Reading–>

Publications

Identifying the common barriers to optimal COPD care in Japan, Canada, England, and Germany through Evidenced Care Pathways


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Modelling the impact of using a DNA compared to mRNA HPV assay as part of the cervical screening programmes in Sweden and Denmark

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Rapid testing and treatment for sexually transmitted infections improve patient care and yield public health benefits

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Point-of-care tests for infectious diseases: Barriers to implementation across three London teaching hospitals

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Modelling the burden of non-muscle-invasive bladder cancer in Europe

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Mapping the diagnostic pathway for breast cancer in England and comparison to Europe

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Providing integrated HIV treatment and care for stable patients in general practice

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How can European countries improve cervical cancer prevention for women?

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Read Summary →

Read Publication

Exploring the value of a rapid, on-demand test for the detection of human papillomavirus

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Read Summary →

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The financial and service implications of splitting fixed-dose antiretroviral drugs – a case study

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Read Summary →

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The cost and tariff reimbursement of idiopathic pulmonary fibrosis in England

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Treatment for stable HIV patients in England: can we save costs and improve patient care?

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The cost-effectiveness of point of care tests for chlamydia and gonorrhoeae in sexual health clinics

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Read Summary →

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Cost effectiveness of screening for Chlamydia trachomatis in Ireland

Journal Article

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Read Publication

What is the cost of pelvic inflammatory disease and how much could be prevented by screening for chlamydia?

publication_icon

Read Summary →

Read Publication

Publications

Identifying the common barriers to optimal COPD care in Japan, Canada, England, and Germany through Evidenced Care Pathways


Publication

Read Summary →

Read Publication

Modelling the impact of using a DNA compared to mRNA HPV assay as part of the cervical screening programmes in Sweden and Denmark

Publication

Read Summary →

Read Publication

Rapid testing and treatment for sexually transmitted infections improve patient care and yield public health benefits

Publication

Read Summary →

Read Publication

Point-of-care tests for infectious diseases: Barriers to implementation across three London teaching hospitals

Publication

Read Summary →

Read Publication

Modelling the burden of non-muscle-invasive bladder cancer in Europe

presentation_icon

Read Summary →

Read Publication

Mapping the diagnostic pathway for breast cancer in England and comparison to Europe

presentation_icon

Read Summary →

Read Publication

Providing integrated HIV treatment and care for stable patients in general practice

presentation_icon

Read Summary →

Read Publication

How can European countries improve cervical cancer prevention for women?

presentation_icon

Read Summary →

Read Publication

Exploring the value of a rapid, on-demand test for the detection of human papillomavirus

presentation_icon

Read Summary →

Read Publication

The financial and service implications of splitting fixed-dose antiretroviral drugs – a case study

publication_icon

Read Summary →

Read Publication

The cost and tariff reimbursement of idiopathic pulmonary fibrosis in England

View Poster

Read Summary →

Read Publication

Treatment for stable HIV patients in England: can we save costs and improve patient care?

publication_icon

Read Summary →

Read Publication

The cost-effectiveness of point of care tests for chlamydia and gonorrhoeae in sexual health clinics

publication_icon

Read Summary →

Read Publication

Cost effectiveness of screening for Chlamydia trachomatis in Ireland

Journal Article

Read Summary →

Read Publication

What is the cost of pelvic inflammatory disease and how much could be prevented by screening for chlamydia?

publication_icon

Read Summary →

Read Publication

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