Acute Respiratory Infection Hub Process Evaluation

What is the issue?

Acute respiratory infections are a major contributor to the high demand for NHS services all year round, and especially during the winter. In response to this, an acute respiratory infection (ARI) hub model was developed in England to provide more timely and appropriate assessment and treatment to adults and children with respiratory symptoms, in order to reduce the demand for appointments at GP surgeries and inappropriate attendances in emergency departments. The ARI hub model is based on care delivered through COVID assessment hubs during the pandemic. Whilst the ARI hub model has potential to help to reduce the pressures on the NHS, there is currently little known about how ARI hubs have been set up and how they achieve their desired impacts on a national scale.

How are we helping?

We are conducting a 12-month process evaluation with The Healthcare Improvement Studies (THIS) Institute at the University of Cambridge, as part of the Cambridge and RAND Europe National Evaluation Team (CARE-NET), a 5-year, NIHR-funded programme of work.

The goal of the evaluation is to generate an in-depth understanding of ARI hubs across England and to assess the feasibility of a future evaluation to understand their impacts.

The primary research questions are as follows:

1. How are ARI hubs arranged and delivered in England, and what operational and other factors affect their delivery?
2. What outcomes and impacts do stakeholders expect ARI hubs in England to achieve, and what kind of information is collected to assess their effectiveness and costs?
3. What is the feasibility of an outcomes and economic evaluation of ARI hubs, and what design could be appropriate?

The process evaluation will use both quantitative and qualitative methods, including desk-based research, a survey of ARI hub leads, and consultations (i.e. interviews or focus groups) with key stakeholders. Stakeholders will include ARI hub leads, wider health system representatives (such as clinicians and individuals from Integrated Care Boards, Primary Care Networks, and NHS hospital trusts), and members of the public. Further, this evaluation will develop a theory of change to explain how the ARI hubs might bring about their impacts, which will involve a workshop with ARI hub representatives and national/regional NHS ARI hub stakeholders.