From 180fc0cabe68057e4146d030b85f0ab70c5f8f8c Mon Sep 17 00:00:00 2001 From: Matt Dray <18232097+matt-dray@users.noreply.github.com> Date: Mon, 20 Jul 2026 16:42:13 +0100 Subject: [PATCH 1/4] Move sidebar layout under visualisations page --- R/app_ui.R | 85 +++++++++++++++++++++++++++--------------------------- 1 file changed, 43 insertions(+), 42 deletions(-) diff --git a/R/app_ui.R b/R/app_ui.R index 1f31aca..269795a 100644 --- a/R/app_ui.R +++ b/R/app_ui.R @@ -10,37 +10,6 @@ app_ui <- function(request) { selected = "Visualisations", # start with this panel open fillable = FALSE, # scrollable pages (i.e. don't fit cards to window extent) - sidebar = bslib::sidebar( - id = "sidebar", - open = "closed", - width = 400, - bslib::accordion( - id = "sidebar_accordion", - open = FALSE, - multiple = TRUE, - bslib::accordion_panel( - title = "Datasets", - icon = bsicons::bs_icon("table"), - mod_select_geography_ui("mod_select_geography"), - mod_select_provider_ui("mod_select_provider") - ), - bslib::accordion_panel( - title = "Types of Potentially-Mitigatable Activity (TPMAs)", - icon = bsicons::bs_icon("hospital"), - mod_select_strategy_ui("mod_select_strategy") - ), - bslib::accordion_panel( - title = "Bookmark", - icon = bsicons::bs_icon("bookmark"), - shiny::bookmarkButton( - label = "Generate shareable URL", - title = "Bookmark your selections and get a URL for sharing", - icon = NULL - ) - ) - ) - ), - bslib::nav_panel( id = "nav_panel_overview", title = "Overview", @@ -99,17 +68,49 @@ app_ui <- function(request) { title = "Visualisations", icon = bsicons::bs_icon("graph-up"), - mod_show_strategy_text_ui("mod_show_strategy_text"), - mod_plot_rates_ui("mod_plot_rates"), - bslib::layout_columns( - col_widths = c(6, 6), - mod_table_diagnoses_ui("mod_table_diagnoses"), - mod_table_procedures_ui("mod_table_procedures") - ), - bslib::layout_columns( - col_widths = c(6, 6), - mod_plot_age_sex_pyramid_ui("mod_plot_age_sex_pyramid"), - mod_plot_nee_ui("mod_plot_nee") + bslib::layout_sidebar( + sidebar = bslib::sidebar( + id = "sidebar", + open = "open", # no longer needs to be toggled -- it only exists here + width = 400, + bslib::accordion( + id = "sidebar_accordion", + open = FALSE, + multiple = TRUE, + bslib::accordion_panel( + title = "Datasets", + icon = bsicons::bs_icon("table"), + mod_select_geography_ui("mod_select_geography"), + mod_select_provider_ui("mod_select_provider") + ), + bslib::accordion_panel( + title = "Types of Potentially-Mitigatable Activity (TPMAs)", + icon = bsicons::bs_icon("hospital"), + mod_select_strategy_ui("mod_select_strategy") + ), + bslib::accordion_panel( + title = "Bookmark", + icon = bsicons::bs_icon("bookmark"), + shiny::bookmarkButton( + label = "Generate shareable URL", + title = "Bookmark your selections and get a URL for sharing", + icon = NULL + ) + ) + ) + ), + mod_show_strategy_text_ui("mod_show_strategy_text"), + mod_plot_rates_ui("mod_plot_rates"), + bslib::layout_columns( + col_widths = c(6, 6), + mod_table_diagnoses_ui("mod_table_diagnoses"), + mod_table_procedures_ui("mod_table_procedures") + ), + bslib::layout_columns( + col_widths = c(6, 6), + mod_plot_age_sex_pyramid_ui("mod_plot_age_sex_pyramid"), + mod_plot_nee_ui("mod_plot_nee") + ) ) ), From 9738b4f91d8e1d14a326a2749880c6cdfe164426 Mon Sep 17 00:00:00 2001 From: Matt Dray <18232097+matt-dray@users.noreply.github.com> Date: Mon, 20 Jul 2026 16:42:40 +0100 Subject: [PATCH 2/4] Remove observer that auto-hides/shows sidebar --- R/app_server.R | 11 ----------- 1 file changed, 11 deletions(-) diff --git a/R/app_server.R b/R/app_server.R index 79d467c..e144d1c 100644 --- a/R/app_server.R +++ b/R/app_server.R @@ -24,17 +24,6 @@ app_server <- function(input, output, session) { as.numeric(Sys.getenv("BASELINE_YEAR", 202324)) }) - # Open sidebar --- - shiny::observe({ - if (input$page_navbar == "Visualisations") { - # Sidebar options only relevant to visualisations - bslib::toggle_sidebar("sidebar", open = TRUE) - } else { - bslib::toggle_sidebar("sidebar", open = FALSE) - } - }) |> - shiny::bindEvent(input$page_navbar) - # Open sidebar accordions ---- shiny::observe({ # Data must load before accordions open From ad291060f655df216289d417af241e1537a8c919 Mon Sep 17 00:00:00 2001 From: Matt Dray <18232097+matt-dray@users.noreply.github.com> Date: Mon, 20 Jul 2026 16:50:07 +0100 Subject: [PATCH 3/4] Update snapshot tests --- tests/testthat/_snaps/app_ui.md | 388 ++++++++++++++++---------------- 1 file changed, 193 insertions(+), 195 deletions(-) diff --git a/tests/testthat/_snaps/app_ui.md b/tests/testthat/_snaps/app_ui.md index 151480f..55b4769 100644 --- a/tests/testthat/_snaps/app_ui.md +++ b/tests/testthat/_snaps/app_ui.md @@ -3,7 +3,7 @@ Code ui Output - + -
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Purpose
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The Government’s 10-Year Plan for Health sets an ambition to reduce reliance on hospitals and deliver care closer to where people live. But which forms of hospital care might be avoided or transferred into community settings? And how much hospital activity can be avoided?

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Purpose
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The Government’s 10-Year Plan for Health sets an ambition to reduce reliance on hospitals and deliver care closer to where people live. But which forms of hospital care might be avoided or transferred into community settings? And how much hospital activity can be avoided?

By reviewing the evidence, talking to clinicians, and analysing data, we have identified 34 Types of Potentially-Mitigatable Activity (TPMAs).

These include care delivered in inpatient wards IP, outpatient clinics OP and accident and emergency departments A&E.

This activity can be mitigated through four mechanisms: prevention, de-adoption, redirection/substitution and hospital efficiency.

This tool allows you to explore these TPMAs: to see the level of these activities in your area or hospital, or examine trends and geographical variation.

This app is in continuous development. Please give feedback by clicking the link in the top-right.

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Types of Potentially-Mitigatable Activity (TPMAs) by mechanism
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Types of Potentially-Mitigatable Activity (TPMAs) by mechanism
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The challenge
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Health and care services know that a shift in care is needed. +

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The challenge
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Health and care services know that a shift in care is needed. But where should they start? In a complex and highly resource-constrained environment, how can they identify evidence-based opportunities to safely move care from hospital to community?

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Explore opportunities
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This tool uses novel analysis to show the nature and scale of acute activity that can potentially be shifted. + +

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Explore opportunities
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This tool uses novel analysis to show the nature and scale of acute activity that can potentially be shifted. Using this insight, commissioners and providers can confidently develop strategies to make the opportunity a reality.

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Types of Potentially Mitigatable Activity (TPMAs)
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Based upon detailed analysis, evidence and clinical engagement, The Strategy Unit have identified 92 types of acute hospital activity which are potentially mitigatable (i.e. could be reduced by deliberate action). + +

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Types of Potentially Mitigatable Activity (TPMAs)
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Based upon detailed analysis, evidence and clinical engagement, The Strategy Unit have identified 92 types of acute hospital activity which are potentially mitigatable (i.e. could be reduced by deliberate action). These are called Types of Potentially Mitgatable Activity (TPMAs).

Some TPMAs focus on activity avoidance (i.e. avoiding inpatient admissions, or A&E attendances) and some focus on efficiencies (i.e. reducing inpatient length of stay).

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Example
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An example TPMA is ‘Falls Related Admissions’.

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Example
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An example TPMA is ‘Falls Related Admissions’.

This TPMA identifies emergency admissions related to falls in those aged 65 or over. Its focus is admission avoidance, and the tool allows users to explore variation in admission rates across local authorities or NHS trusts. You can read a full description.

Note that some spells will fall into more than one TPMA. This TPMA overlaps with ‘Older People with Frailty Admissions (High Frailty Risk)’ and ‘Emergency Readmissions Within 28 Days’, among others.

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Opportunities to shift care from hospitals to community (care shift)
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A key use case of the tool is helping systems explore opportunities to move care from hospital to communities. + +

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Opportunities to shift care from hospitals to community (care shift)
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A key use case of the tool is helping systems explore opportunities to move care from hospital to communities. This is a central pillar of the NHS 10-Year Health Plan for England.

Some TPMAs are about mitigation potentially achieved through improved internal hospital efficiency (e.g. stopping low value procedures) and a significant number (55) are focussed on avoiding hospital use through actions in community, primary care or public health intervention.

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You can use a checkbox in the tool to isolate TPMAs predominantly related to care shift.

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How much hospital activity can be reduced?
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The current evidence base means that the TPMAs are broad in definition. + +

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How much hospital activity can be reduced?
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The current evidence base means that the TPMAs are broad in definition. Whilst the activity shown in the tool has been classified as ‘potentially mitigable’, no one would suggest that all such activity can or should be mitigated.

A judgement is required of what proportion of the activity could be reduced. It should be informed by the knowledge and experience of those involved, alongside available evidence.

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Suggestions
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This app is in continuous development. You can provide general feedback by clicking ‘Give feedback’ in the top-right.

The Strategy Unit has established a formal process to review, update, and maintain the set of TPMAs used in this app and the New Hospital Programme Demand Model. If you have any thoughts about improving an existing TPMA or adding a new TPMA, then please get in touch and we will feed your comments and ideas into this process.

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Data
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The primary data source is Hospital Episode Statistics (HES).

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Data
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The primary data source is Hospital Episode Statistics (HES).

Data is shown for a given baseline financial year, which is currently 2023/24, though trend information is also shown. Counts of less than five are suppressed.

The data was prepared as part of the modelling process for the New Hospital Programme (NHP). The model project information website contains further details, such as age-sex standardisation of TPMAs and how we derive hospital catchments for rate calculations.

You can find the Python source code in the inputs_data scripts of the open nhp_data GitHub repository.

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Definitions
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Visit the New Hospital Programme (NHP) project information website to:

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Definitions
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Visit the New Hospital Programme (NHP) project information website to:

  • view definitions for TPMAs related to inpatients, outpatients and A&E activity types
  • see a TPMA lookup, including names, codes and deprecation status
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Navigation
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Use the top navigation bar to visit the:

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Navigation
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Use the top navigation bar to visit the:

  • Context tab for an explanation of TPMAs and the purpose of this app.
  • Visualisations tab for summaries of your selected dataset and TPMA
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  • Types of Potentially-Mitigatable Activity (TPMAs) section, with filters for activity type, TPMA category and association with care-shift
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Interface
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You can hover over the information symbol for further details.

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Interface
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You can hover over the information symbol for further details.

Click the button in the Bookmark section of the sidebar to save your selections and get a shareable URL. Clicking the link will return you to the app with your choices loaded.

Make more space for selections or visualisations by clicking the:

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    About the app
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    This app was built and is maintained by The Strategy Unit. - The source code can be found in the open tpma-explorer GitHub repository.

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    From 5220209f7519aacac20ee4f2b72ef7a157068ea0 Mon Sep 17 00:00:00 2001 From: Matt Dray <18232097+matt-dray@users.noreply.github.com> Date: Mon, 20 Jul 2026 16:54:43 +0100 Subject: [PATCH 4/4] Add YH as contributor --- DESCRIPTION | 3 ++- 1 file changed, 2 insertions(+), 1 deletion(-) diff --git a/DESCRIPTION b/DESCRIPTION index df9ad17..b3e8a70 100644 --- a/DESCRIPTION +++ b/DESCRIPTION @@ -5,7 +5,8 @@ Authors@R: c( person("Matt", "Dray", , "matt.dray@nhs.net", role = c("aut", "cre")), person("Tom", "Jemmett", , "thomas.jemmett@nhs.net", role = "aut"), person("Zoë", "Turner", , "zoe.turner3@nhs.net", role = "ctb"), - person("Claire", "Welsh", , "claire.welsh8@nhs.net", role = "ctb") + person("Claire", "Welsh", , "claire.welsh8@nhs.net", role = "ctb"), + person("YiWen", "Hon", , "yiwen.hon@nhs.net", role = "ctb") ) Description: A Shiny-app-in-a-package to explore data related to Types of Potentially-Mitigatable Activity (TPMAs) with the goal of finding