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Content ArticleOver the two decades before the pandemic, the number of NHS patients admitted to hospital increased year-on-year, despite a reduction in the number of hospital beds. Since the Covid-19 pandemic, fewer patients have been admitted to NHS hospitals and length of stay has risen, raising questions about NHS productivity, quality of care and the prospects of meeting ambitions to recover services. This report by the Health Foundation analyses data around hospital admissions and suggests reasons for these trends.
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Content ArticleThis strategy sets out how the Care Quality Commission (CQC) will listen, inform and involve people and work in partnership with organisations that represent people. The new strategy will run to 2026 and has four objectives: Build a trusted feedback service where people’s experiences drive improvements in care Create a trusted, accessible public information service designed around people’s expectations and needs Develop an inclusive approach to proactively involving people who use services, their family, carers and organisations that represent or act on their behalf in shaping our plans, policies and products Work in partnership with organisations that represent or act on behalf of people who use services to improve care
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Content ArticleCommunity public access defibrillators (CPADs) contain an automated electronic device (AED) that, in the event of a sudden out of hospital cardiac arrest, can provide lifesaving treatment by delivering an electric shock to the heart. CPADs can be found in public areas such as disused telephone boxes or community centres, and often the defibrillators are locked and a special code is needed to open the unit. In this blog, Sharon Perkins, HSIB Maternity Investigator, looks at the issues surrounding the accessibility of CPADs. During the course of a maternity investigation, the HSIB team became aware of instances where access to CPADs had been restricted by their location and lack of registration.
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Content ArticleIn this blog, Sophie Jarvis, NIHR Public Partnerships Manager, Una Rennard, a public contributor, and Bryher Bowness, a PhD Student at King’s College London, highlight the role of people who care for friends and family in health and social care research, and why they should be involved.
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Content ArticlePersonalised Care will benefit up to 2.5 million people by 2024. It aims to give people the same choice and control over their mental and physical health that they have come to expect in every other aspect of their life. Personalised care is based on ‘what matters’ to people and their individual strengths and needs. This webpage by NHS England contains information about the following aspects of personalised care: Patient choice Shared decision making Patient activation and supported self-management Social Prescribing and community based support Personalised care and support planning Personal health budgets
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Content ArticleThis report by the charity INQUEST, which provides expertise on state related deaths and their investigation to bereaved people, highlights that families are facing persistent challenges following the death of a loved one in mental health services. Based on conversations at one of INQUEST’s Family Consultation Days, the report shows that families face numerous hurdles during investigations and inquests into their loved ones’ deaths, and that processes are not delivering the change required. The Family Consultation Day heard from 14 family members who were bereaved by deaths in the care of mental health services or settings for people with learning disabilities and/or autism, and had faced or were going through inquests and investigations.
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Content ArticleThe NHS in England’s annual budget is £161 billion. Yet across the sector there is huge cause for concern, including the still-growing backlog, workforce issues, the state of the estate and the relentless demand on primary care. In this blog, ex-NHS strategic health authority chief executive Mike Farrar and Health Policy Insight editor Andy Cowper look at how these issues can be tackled to provide an NHS that meets the needs of the population. They cover the following subjects: Politics, policy and prevention System working and pivoting to prevention - how to shift resources Building a compelling case for change Moving towards less top-down-ism Being clear about what an ICS is for Culture change and mindsets shifts Resourcing change
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Content ArticleAre whistleblower reward programmes a charter for malicious complaints, as some claim, or are they a genuine incentive providing a safety net against retaliation? How successful are these programmes in recovering fraud and other proceeds of crime and serious organised crime? This paper aims to answer these questions—it was produced by WhistleblowersUK in collaboration with US lawyers who contributed to the development and improvement of US reward programmes. It aims to address questions about the legislation around US reward programmes, dispel some of the myths and look at some of the objections attributed to British attitudes about rewarding whistleblowers.
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Content ArticleTechnology holds promise for the future of healthcare. It can prevent illness, enable early diagnosis, empower health management and support general wellbeing. But how might people use technology to have more control over their health and wellbeing? And do they want to? This report explores the role of technology in managing, improving and supporting health and wellbeing. The NHS Confederation, in partnership with Google Health, commissioned Ipsos to explore people’s behaviours, attitudes and beliefs about responsibility and control when it comes to their health, the role that health technologies play in this and their expectations about the future of healthcare. A survey of more than 1,000 adults in the UK – a third of whom live with one or more long-term conditions (LTCs) – and interviews with individuals with LTCs and who have frequent interaction with the health system, forms the centrepiece of this report.
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Content ArticleThis stocktake by NHS Confederation highlights insights from medicines optimisation forums on the experience of ICS medicines optimisation so far: the opportunities that exist, the barriers experienced, the support that is needed, and what the vision for medicines optimisation could achieve.
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Content Article
In 2022, an illustration of a Black foetus in the womb by Nigerian medical illustrator and medical student Chidiebere Ibe, went viral. The image sparked an important conversation around representation in medical imagery and the impact this has on health outcomes for patients who are Black, Indigenous and people of colour (BIPOC). Research showed that only 5% of medical images show dark skin and only 8% of medical illustrators identified as BIPOC. A collaboration between Chidiebere Ibe, Deloitte and Johnson & Johnson, Illustrate Change aims to build the world's largest library of BIPOC medical illustrations for use in medical education and training. So far, the library contains images relevant to the following specialties: Dermatology Eye disease General health Haematology Maternal health Oncology Orthopaedics -
Content ArticleAcademic Health Science Networks (AHSNs) host England’s fifteen Patient Safety Collaboratives. They are experts in supporting quality improvement projects using methodology from the Institute of Healthcare Improvement model for improvement. This resource pack by The AHSN Network provides an overview of the different ways Patient Safety Collaboratives can support safety improvement projects and includes case studies and resources.
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Content ArticleThis standard has been produced by NHS England to promote consistent delivery and quality of specialist orthodontic care provision to patients in England. It aims to ensure that resources invested by the NHS in specialist care are used in the most effective way, provide the best possible quality and quantity of care for patients and meet need rather than serve demand. The standard includes the following information: What is orthodontics? Complexity assessment Illustrative patient journey Assessing need Understanding current provision Model of care Clinical standard National key performance indicators Quality and outcome measures
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Content ArticleThe widespread adoption of effective hybrid closed loop systems would benefit people living with type 1 diabetes by improving the amount of time spent within target blood glucose range. Hybrid closed loop systems (also known as 'artificial pancreas' typically utilise simple control algorithms to select the best insulin dose for maintaining blood glucose levels within a healthy range. Online reinforcement learning has been utilised as a method for further enhancing glucose control in these devices. Previous approaches have been shown to reduce patient risk and improve time spent in the target range when compared to classical control algorithms, but are prone to instability in the learning process, often resulting in the selection of unsafe actions. This study in the Journal of Biomedical Informatics presents an evaluation of offline reinforcement learning for developing effective dosing policies without the need for potentially dangerous patient interaction during training.
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Content ArticleThis is the 15th annual clinical radiology census report by The Royal College of Radiologists. The census received a 100% response rate, meaning this report presents a comprehensive picture of the clinical radiology workforce in the UK as it stood in October 2022. Key findings The workforce is not keeping pace with demand for services. In 2022, the clinical radiology workforce grew by just 3%. In comparison, demand for diagnostic activity is rising by over 5% annually, and by around 4% for interventional radiology services. The UK now has a 29% shortfall of clinical radiologists, which will rise to 40% in five years without action. By 2027, an additional 3,365 clinical radiologists will be needed to keep up with demand for services. This will have an inevitable impact on the quality-of-care consultants are able to provide. Only 24% of clinical directors believe they had sufficient radiologists to deliver safe and effective patient care. Interventional radiologists are still limited with the care they can provide. Nearly half (48%) of trusts and health boards have inadequate IR services, and only 1/3 (34%) of clinical directors felt they had enough interventional radiologists to deliver safe and effective patient care. Stress and burnout are increasingly common among healthcare professionals, risking an exodus of experienced staff. 100% of clinical directors (CDs) are concerned about staff morale and burnout in their department. 76% of consultants (WTE) who left in 2022 were under 60. We are seeing increasing trends that the workforce is simply not able to manage the increase in demand for services. 99% of departments were unable to manage their reporting demand without incurring additional costs. Across the UK, health systems spent £223 million on managing excess reporting demand in 2022, equivalent to 2,309 full-time consultant positions. Access the full census report here Related content: The benefits of a nursing led Vascular Access Service Team: A White Paper to outline a standardised structure and approach for the NHS to deliver vascular access services in every hospital (27 June 2022)
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In this interview, we speak to sociologist Dr Marieke Bigg about why she decided to write her debut non-fiction This won’t hurt: How medicine fails women. Marieke discusses how societal ideas about the female body have restricted the healthcare system’s approach to women’s health and describes the impact this has had on health outcomes. She also highlights areas where the health system is reframing its approach by listening to the needs of women and describes how simple changes, such as allowing women to carry out their own cervical screening at home, can make a big difference. -
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Language Matters pocket guides (April 2023)
Patient-Safety-Learning posted an article in Diabetes
The language used by healthcare professionals can have a profound impact on how people living with diabetes, and those who care for them, experience their condition and feel about living with it day-to-day. At its best, good use of language; verbal, written and non-verbal (body language) which is more inclusive and values based, can lower anxiety, build confidence, educate and help to improve self-care. On the other hand, poor communication can be stigmatising, hurtful and undermining of self-care and have a detrimental effect on clinical outcomes. Language Matters Diabetes is a global movement that aims to improve the way in which healthcare professionals and wider society talks about and to people with diabetes. These three pocket guides for different groups aim to address use of language about diabetes and people with diabetes in order to improve experiences of care and tackle stigma. Language Matters pocket guide: Healthcare professionals Language Matters pocket guide: Parents and families Language Matters pocket guide: Media and social media -
Content ArticleIn December 2022, Public Policy Projects brought together oncology experts and key stakeholders for a roundtable to discuss how effective partnership working in healthcare environments can reduce health inequalities in breast cancer outcomes. The objective of the roundtable was to create a series of actionable insights and recommendations for health providers to create a more resilient health and care system and, ultimately, improve breast cancer outcomes in the UK. This document is a summary of the key outcomes, insights and recommendations that were generated from the roundtable. It is not an exhaustive report of facilitating and enabling partnerships to tackle health inequalities, but rather a particular view from a group of key sector stakeholders.
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EventuntilTaking place as part of Clinical Audit Awareness Week, this webinar will feature Vin Diwakar, Medical Director for Secondary Care and Transformation, discussing the bigger picture around taking action on clinical audit and how the newly launched NHS Impact can support improvements based on findings and recommendations. We will also hear from Michael Sykes, Senior Research Fellow at Northumbria University and Quality Improvement Lead for the National Diabetes Audit on how supporting the quality improvement capabilities of national audit recipients, and creating the opportunity for them to collaborate, may improve outcomes. There will be an opportunity for group discussions and insights. Register for the webinar
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Content ArticleDespite their widespread use, the impact of commissioners’ policies for body mass index (BMI) for access to elective surgery is not clear. Policy use varies by locality, and there are concerns that these policies may worsen health inequalities. This study in BMC Medicine aimed to assess the impact of policies for BMI on access to hip replacement surgery in England. The authors used National Joint Registry data for 480,364 patients who had primary hip replacement surgery in England between January 2009 and December 2019. They found that rates of surgery fell after localities introduced policies restricting access to surgery based on BMI, whereas rates rose in localities with no policy. Localities with BMI policies have higher proportions of independently funded surgery and more affluent patients receiving surgery, indicating increasing health inequalities, and policies enforcing extra waiting time before surgery were associated with worsening mean pre-operative symptom scores and rising obesity. The authors recommend that BMI policies involving extra waiting time or mandatory BMI thresholds are no longer used to reduce access to hip replacement surgery.
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Content ArticleGaslighting at work can take many forms and is often subtle, causing the victim to question their perception. This blog gives some examples of gaslighting at work and suggests ways to deal with it if you believe you are experiencing gaslighting from a colleague.
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Content Article
Complexity resources (NHS England)
Patient-Safety-Learning posted an article in NHS England
NHS England has collated this set of resources about understanding complexity. Understanding complexity video by NHS Horizons Understanding and Working with Complexity blog by Andrew Singfield Spread and Complexity in the NHS blog by Diane Ketley Looking at Spread – Three Helpful Lenses blog by Diane Ketley Spreading and scaling up innovation and improvement paper by Trisha Greenhalgh Changing how we think about healthcare improvement paper and audio recording by Jeremy Braithwaite ‘Adaptive Spaces’ for an emerging future blog by Q community What is Adaptive space? A Brief Introduction video by Gareth Evans Adaptive Space in Action video by Matthew Mezey Adaptive space – Overview of the work of Mary Uhl-Bien video by Diane Ketley How ‘Adaptive Spaces’ enable innovation in healthcare and beyond webinar with Mary Uhl-Bien How to master the art of creating ‘Adaptive Spaces webinar with Mary Uhl-Bien Mary Uhl-Bien in Conversation: COVID-19, complexity leadership and spread of innovation video recording with Mary Uhl-Bien Adaptive spaces, networks…. and a challenge called spread blog by Diane Ketley Complexity leadership theory: Shifting from Human Capital to Social Capital paper by M Arena and Mary Uhl-Bien How to Catalyse Innovation in Your Organisation paper by M Arena et al Navigate Complexity: Three Habits of Mind blog by Sonja Blignaut Three habits of mind video by Jennifer Garvey Berger and Keith Johnston Cynefin framework introduction video and book chapter by Jennifer Garvey Berger and D Snowden Stacey framework blog and video recording by R Stacey -
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Community Pharmacy Standard (PRSB, May 2023)
Patient-Safety-Learning posted an article in Community pharmacies
Community pharmacies are offering an increased range of services to support care for people in the community. It is therefore essential that they are able to record and share vital information about a person’s care with GP practices and other services. Using digital standards, we can ensure that care professionals and citizens have timely access to relevant information, leading to better, safer and more personalised care in the community. This Community Pharmacy Standard developed by the Professional Record Standards Body (PRSB) defines the information that should be recorded in the community pharmacy and sent to the person’s GP, for all the services covered by the English Community Pharmacy Contractual Framework. -
Content ArticleIt is hard to separate litigation from the debate surrounding patient safety and the quality of healthcare. When we talk about developing an NHS patient safety culture, issues such as litigation and clinical negligence costs always seem to feature somewhere in discussions. In this article in the British Journal of Nursing by John Tingle, Lecturer in Law at Birmingham Law School, outlines approaches to improving patient safety in the NHS and examines the extent to which these have been driven by the desire to reduce litigation.
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Age-Friendly Health Systems (AFHS) is an initiative that aims to follow evidence-based practices while minimising harm in older patients. The evidence-based elements of high-quality care are known as the 4Ms: What Matters Medication Mentation Mobility During the early days of the Covid-19 pandemic, a team from the Oregon Health & Science University (OHSU) decided to examine the equity of their care for older adults. The resulting study published about the age-friendly work at OHSU is the first to include data about health equity as part of AFHS outcomes and illustrates the importance of creating equitable care at clinical and institutional policy levels. This blog looks at the process the team went through to assess and collect data about age-related equity.
