ActivePublic Health & HealthcareNIHR-supported projectMental Health
What is the impact of introducing an Acute Respiratory Infection (ARI) hub on patient care, clinical outcomes, the workforce and wider urgent and emergency care system in Birmingham and Solihull Integrated Care system
Recipient organisationNIHR Midlands Patient Safety Research Collaboration
NIHR supportRecorded as supported by this research centre
PeriodFeb 2025 — Jul 2027
In plain English
AI plain-English summary
Every winter, tens of thousands of people with coughs and fevers flood into Birmingham and Solihull’s emergency departments, many of whom could be treated elsewhere. This project evaluates a new NHS model—the Acute Respiratory Infection (ARI) hub—that aims to divert those lower-acuity patients away from A&E and into community-based care. The problem is urgent: emergency department visits are at record highs, but admissions are not rising proportionally, suggesting many patients do not need hospital-level treatment. The ARI hub is the latest nationally-directed attempt to fix this mismatch, yet no one has rigorously tested whether it actually works. The researchers will analyse routine data from ambulances, GP surgeries, emergency departments, and the hubs themselves, and interview staff and service leaders to see how the hub affects patient outcomes, workforce strain, and the wider urgent care system. If the hub proves effective, Birmingham and Solihull’s approach could become a national template for reducing respiratory-related pressure on emergency services—quietly reshaping how the NHS handles one of its most common and costly patient surges.
View original technical description
Acute Respiratory Infections (ARI) are one of the most common reasons for general practice consultations and acute hospital admissions. The unprecedented number of ED attendances in the NHS, is not translating into increases in emergency admissions. This has prompted a policy focus on solutions to UEC recovery that promote community-based approaches to supporting lower-acuity patients who present to emergency services. In 2024, NHS England recommended the implementation of the ARI model, which represents the latest nationally-directed, community-based approach to recover UEC services in England. In this project, we will address this national priority area, by evaluating the impact of introducing an Acute Respiratory Infection (ARI) hub on patient care, clinical outcomes, the workforce and wider urgent and emergency care system in Birmingham and Solihull Integrated Care System (ICS). We will conduct a mixed methods study consisting of two inter-linked work packages and community engagement. We will conduct an observational analysis of routinely collected data to evaluate the impact of the ARI hub on clinical outcomes for the local UEC system. Data will consist of routine data from the ambulance service, primary care, emergency departments and locality hubs within the Birmingham and Solihull ICB We will also conduct semi-structured interviews with local and regional service leaders and key UEC staff. We will supplement interview data with relevant local and regional policy and procedural documents, pertaining to the implementation and adoption of the ARI hub model locally. By the end of the project we will have obtained a detailed understanding of how ARI-hubs influence clinical outcomes, patient care, the work force and wider UEC system in Birmingham and Solihull ICB. Findings will be used to identify the aspects of the BSol ICB could be used as a national exemplar for reducing respiratory-related demand on UEC services and to drive local service improvement.
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