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EventSpeaker: Professor Ian Leistikow; Adviser at the Dutch Health & Youth Care Inspectorate and Professor at Erasmus School of Health Policy & Management, Erasmus University Rotterdam, the Netherlands Challenges that health and care faces, translate to challenges for the regulatory authorities. Classic regulatory strategies aimed at compliance increasingly fall short in contributing to quality of (health)care. In this webinar Ian will use the model of ‘value driven regulation’ to show how the Dutch Inspectorate strives to keep up with the dynamics of the sectors it regulates, by keeping its eye on creating societal value. Ian will also give an overview of the broad range of scientific research projects within the Inspectorate aimed at improving the positive impact of its regulation. Find out more
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Content ArticleThe Patient Safety Indicators (PSIs) are a set of quality indicators developed by the Agency for Healthcare Research and Quality (AHRQ) providing information on potential hospital complications and adverse events after surgeries, procedures, and childbirth. They have been used for the past two decades in the USA for monitoring potentially preventable patient safety events in the inpatient setting through the automated screening of readily available administrative data. However, these indicators are also used for hospital benchmarking and cross-country comparisons in other nations with different health-care settings and coding systems as well as missing present on admission (POA) flags in the administrative data. This study sought to comprehensively assess and compare the validity of 16 PSIs in Switzerland, where they have not been previously applied.
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Content ArticleSet up in January 2023, the Times Health Commission was a year-long projected established to consider the future of health and social care in England in the light of the pandemic, the growing pressure on budgets, the A&E crisis, rising waiting lists, health inequalities, obesity and the ageing population. Its recommendations are intended to be pragmatic, practical, deliverable and able to be potentially taken up by any political party or government, present or future.
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Content Article"Our #health system in the UK is in a mess. It has failed to modernise (by this I mean to become fully accountable to #patients and the public, and truly patient-led). Instead, the system has become more and more hierarchical, bureaucratic and crony ridden, mostly as a result of constant meddling and pointless reorganisations instigated by politicians. All political parties in government for the past 30 years have had a hand in this decline." This is my view? What is yours? A new Inquiry gives us all an opportunity to have our say. I am proud to have worked in and for the NHS for most of my working life; proud to have been trained in the #NHS and proud of the work being carried out by clinical teams today. Great work which has benefited patients, often not because of the leadership but despite of the leadership. I'm retired so I can say what I like. If I were working and said anything even vaguely like criticism, however constructive it was, I would be out of a job and my career would be blighted for life. I'm speaking from experience here, unfortunately. I urge everyone to respond to the consultation (link below). In your response think forensically and write it as a statement of truth. Acknowledge the successes and areas that have delivered safe and effective services. If you are being critical give examples and say if it is an opinion or back up what you say with evidence. If we work together across boundaries we can develop a truly patient-led NHS.
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EventuntilKennedys' healthcare team are delighted to invite you to the second session of our annual healthcare seminar programme 2024, which will be held both in-person and virtually on Wednesday 28 February. Guest speaker: John Mead, Technical Claims Director, NHS Resolution John Mead studied at London University and then joined the insurance industry, where he dealt with a wide range of claims against local authorities, some of which reached the Court of Appeal and House of Lords. He moved to NHS Resolution in 1999 and has led the Technical Claims Unit since its creation in 2000, in which he is responsible for overseeing large, complex and potentially repercussive claims against NHS bodies and other scheme members. John is a Fellow of the Chartered Insurance Institute and an accredited mediator. He is an editor for the Journal of Patient Safety and Risk Management, and has contributed to a number of books, most recently Lessons from Medico-Legal Cases in Obstetrics and Gynaecology (2022). This session will be chaired by Kennedys' Partner and Global Head of Healthcare Christopher Malla. Register
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News Article
Department of Education updates National Framework for Children’s Social Care
Patient Safety Learning posted a news article in News
The Department of Education has recently provided an update to the national framework for Children’s Social Care. The key point to be aware of is the increased focus on sharing responsibility and strengthening multi-agency working to safeguard children. This change is likely to impact a wide variety of stakeholders involved in children’s care, including NHS Trusts, ICBs, education partners, local authorities, voluntary, charitable and community sectors and the police. The focus continues to be on a child-centred approach with the intention of keeping children within the care of their families wherever possible; this collaborative working may include working with parents, carers or other family but the wishes and feelings of the child alongside what is in the child’s best interests remain paramount. Joined up working is to be viewed as the norm. For health professionals, you will be expected to have lead roles for children with health needs, such as children who are identified as having special educational needs or disabilities. Read full story Source: Bevan Brittan, 23 January 2024 -
Content ArticleThe NHS remains under immense pressure. Each part of the system is experiencing demand beyond its capacity, which is continually increasing the problem. This is most vividly illustrated in urgent and emergency care settings. Each winter in the past decade has become slightly worse,2 and that trend, which has not been reversed, has resulted in a dire situation that may not yet have reached its nadir. A continuum of often predictable perfect storms has caused a struggling system to reach collapse, writes Tim Cooksley, immediate past president, Society for Acute Medicine in this BMJ opinion piece.
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Content ArticlePrisoners have a right to the same standards of healthcare available to people in the community, and although we might suspect that people in prisons don't always receive the care they need, this is a difficult issue to get at through research. So how can we meaningfully compare hospital use between those in prison and those who are not? Miranda Davies and Eilís Keeble used a novel matched control methodology to show that prisoners use services less than people with similar health characteristics who are not incarcerated.
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EventuntilThe health and care system continues to face profound challenges, whether it’s staff shortages, financial pressures, all-time low public satisfaction, or record high waiting times for elective care. At this free online event, our expert panel will provide insight and context into the wider health and care landscape, the challenges the sector is facing, and the big issues they want to see progress on in 2024. In the run-up to the anticipated general election, our panel will also explore how recent trends, political parties’ policy proposals and future developments could affect those working in the sector, as well as people, patients and communities. Join the discussion and share your comments and questions about the wider challenges and opportunities facing the health and care sector. Register
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Content ArticleThis article provides an overview of the proposed Patient Safety Structural Measure on the Centers for Medicare and Medicaid Services (CMS) list of Measures Under Consideration (MUC) 2023 and summarises the public comment submitted by Patient Safety Learning on this.
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Content ArticleMany healthcare improvement approaches originated in manufacturing, where end users are framed as consumers. But in healthcare, greater recognition of the complexity of relationships between patients, staff, and services (beyond a provider-consumer exchange) is generating new insights and approaches to healthcare improvement informed directly by patient and staff experience. Co-production sees patients as active contributors to their own health and explores how interactions with staff and services can best be supported. Co-design is a related but distinct creative process, where patients and staff work in partnership to improve services or develop interventions. Both approaches are promoted for their technocratic benefits (better experiences, more effective and safer services) and democratic rationales (enabling inclusivity and equity), but the evidence base remains limited. This Element explores the origins of co-production and co-design, the development of approaches in healthcare, and associated challenges; in reviewing the evidence, it highlights the implications for practice and research.
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News Article
Nearly 1.7 million Texans lose Medicaid as state nears end of “unwinding”
Patient Safety Learning posted a news article in News
Nearly 1.7 million Texans have lost their health insurance — the largest number of people any state has removed — in the months since Texas began peeling people from Medicaid as part of the post-pandemic “unwinding.” Around 65% of these removals occurred because of procedural reasons, according to the state. Texas’ Health and Human Services Commission has neared the end of a chaotic and overburdened process to remove people from state Medicaid insurance who became ineligible during the coronavirus pandemic. The state had not unenrolled people before this year because of federal pandemic rules, which forbid states from cutting coverage. As a result, more than 5 million Texans had continuous access to healthcare throughout the pandemic through Medicaid, the joint federal-and-state-funded insurance program for low-income individuals. In Texas, the program’s eligibility criteria is so restrictive, it mainly covers poor children, their mothers while pregnant and post partum, and disabled and senior adults. But the effects of speedrunning this process have reverberated: Still-eligible Texans were kicked off both in error and for procedural reasons, adding to backlogs of hundreds of thousands of Medicaid applications and pushing wait times back several months. “The state handled this with an incredible amount of incompetence and indifference to poor people,” U.S. Rep. Lloyd Doggett, D-Austin, told The Texas Tribune. “It's really appalling.” Read full story Source: The Texas Tribune, 14 December 2023 -
Content Article
Designing in risk: Measuring safety part 3
NMacLeod posted an article in Improving patient safety
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The relationship between management and the workforce, in very simplistic terms, can be considered one of reward in return for effort. The contracted effort is communicated through a roster. In organisations that have a continuous operation, blocks of effort are distributed to maintain the flow of output. The organisation of effort, then, is a legitimate function of management. Norman's previous blog looked at performance variability under normal conditions. In this blog, Norman looks at the impact of physiological states and how management’s organisation of effort degrades decision-making.- Posted
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Event
IHI/BMJ International Forum on Quality and Safety in Healthcare
Sam posted an event in Community Calendar
untilThemed Together to Regenerate Health and Care, the programme will showcase inspirational improvement work from all sectors and explore how we can create a system of health and care that truly meets the needs of our communities. You can now explore six new topic streams - Safety, People, Population, Change, Leadership and Science, and find sessions that address the challenges that you and your organisation face. Register -
Content ArticleA lack of coordination between the everyday primary and community services relied on by people using the NHS is leading to sub-standard care, missed opportunities for home or community-based treatments, and undue strain on hospitals that are already overstretched. There must be significant reform in terms of better staff training, improved data-sharing, flexible healthcare structures and collaboration across different professions in the healthcare system. These reforms will realise the potential of an integrated NHS and deliver more efficient healthcare services ensuring value for money and satisfied, healthier patients. This is the major conclusion of the report 'Patients at the centre: integrating primary and community care'. This report highlights the need for a seamlessly integrated patient-centric healthcare sector where patients are given the type of care they need, when, where, and how they need it; whether that be access to a GP, a pharmacist or a district or mental health nurse. The Government should focus more on preventative rather than reactive care to tackle the needs of an ageing population, many of whom are coping with complex health issues requiring intricate and continuous care.
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Content ArticleHealthcare Inspectorate Wales (HIW) is the independent inspectorate of the NHS and regulator of independent healthcare in Wales. The findings of their Annual report outline the sustained pressure on healthcare services across Wales, highlighting risks relating to emergency care, staffing concerns, poor patient flow and the accessibility of appointments. It sets out how the HIW carried out their functions across Wales, seeking assurance on the quality and safety of healthcare through a range of activities. This includes inspections and review work in the NHS, and regulatory assurance work in the independent healthcare sector. The report provides a summary of what HW's work has found, the main challenges within healthcare across Wales, and HIW's view on areas of national and local concern.
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Content ArticleThis is the fourth Health Effects of Climate Change in the UK report, which provides evidence, analysis and recommendations based on climate change projections for the UK. Climate change affects most health determinants directly or indirectly by influencing the weather conditions we experience on a day-to-day basis. Climate change can increase risks to health directly through greater severity and frequency of extreme weather events such as flooding, drought, heatwaves or wildfires. Heatwaves, for example, have already led to excess deaths in England and they can increase burden on health and care services, increase strain on water, energy and transportation infrastructure and can have implications such as crop loss and reduced air quality that can also impact health. Many infectious diseases are highly climate sensitive, and with warmer temperatures we can expect an increased risk of new and emerging infectious diseases in the UK, including those transmitted through mosquito and tick bites. The impact of climate change on individuals will vary, with the worst effects on disadvantaged and vulnerable populations, which could widen health inequalities further.
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Content ArticleThe latest Lancet Countdown report underscores the imperative for a health-centred response in a world facing irreversible harms. Climate inaction is costing lives and livelihoods today, with new global projections revealing the grave and mounting threat to health of further delayed action on climate change. But bold climate action could offer a lifeline for health. This year’s report launches just weeks before the COP28 which has a health focus for the first time. The findings underscore the opportunity of a lifetime that COP could help deliver – through commitments and action to accelerate a just transition. Without profound and swift mitigation to tackle the root causes of climate change and to support adaptation efforts, the health of humanity is at grave risk. Our 2023 Report tracks the relationship between health and climate change across five key domains and 47 indicators, providing the most up-to-date assessment of the links between health and climate change.
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Content ArticleOver the past two years, AHRQ has examined equity and its connections to agency activities in alignment with its mission to improve healthcare for all Americans. A new special issue of Health Services Research sponsored by AHRQ summarises the state of evidence and identifies opportunities to drive more equitable care.
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Content Article
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In a three-part series of blogs for the hub, Norman Macleod explores how systems behave and how the actions of humans and organisations increase risk. In part 1 of this blog series, Norman suggested that measuring safety is problematic because the inherent variability in any system is largely invisible. Unfortunately, what we call safety is largely a function of the risks arising from that variability. In this blog, Norman explores how error might offer a pointer to where we might look. -
EventuntilNHS Resolution’s Safety and Learning team, are hosting a virtual forum on perspectives on delivering health in the prison and justice system. The purpose is to raise awareness of the cost and scale of harm, discuss the realities, best practice, challenges and recommendations around collaborating to support healthcare delivery in the justice system. We will hear from a diverse range of experts in the field. The format is interactive, with presentations followed by questions and panel discussion. Event programme: Learning from prison claims - NHS Resolution The realities of delivering healthcare in prison - Practice Plus Group Good practice and themes from inspections - HM Inspectorate of Prisons The medico-legal aspect of prison health claims - Bevan Brittan Q&A panel discussion. Register
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Content Article“Crisis,” “collapse,” “catastrophe” — these are common descriptors from recent headlines about the NHS in the UK. In 2022, the NHS was supposed to begin its recovery from being perceived as a Covid-and-emergencies-only service during parts of 2020 and 2021. Throughout the year, however, doctors warned of a coming crisis in the winter of 2022 to 2023. The crisis duly arrived. In this New England Journal of Medicine article, David Hunter gives his perspective on the current state of the NHS.
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Content ArticleStructural, economic and social factors can lead to inequalities in the length of time people wait for NHS planned hospital care – such as hip or knee operations – and their experience while they wait. In 2020, after the first wave of the Covid-19 pandemic, NHS England asked NHS trusts and systems to take an inclusive approach to tackling waiting lists by disaggregating waiting times by ethnicity and deprivation to identify inequalities and to take action in response. This was an important change to how NHS organisations were asked to manage waiting lists – embedding work to tackle health inequalities into the process. Between December 2022 and June 2023, the King’s Fund undertook qualitative case studies about the implementation of this policy in three NHS trusts and their main integrated care boards (ICBs), and interviewed a range of other people about using artificial intelligence (AI) to help prioritise care. It also reviewed literature, NHS board papers and national waiting times data. The aim was to understand how the policy was being interpreted and implemented locally, and to extract learning from this. It found work was at an early stage, although there were examples of effective interventions that made appointments easier to attend, and prioritised treatment and support while waiting. Reasons for the lack of progress included a lack of clarity about the case for change, operational challenges such as poor data, cultural issues including different views about a fair approach, and a lack of accountability for the inclusive part of elective recovery. Taking an inclusive approach to tackling waiting lists should be a core part of effective waiting list management and can contribute to a more equitable health system and healthier communities. Tackling inequalities on waiting lists is also an important part of the NHS’s wider ambitions to address persistent health inequalities. But to improve the slow progress to date, NHS England, ICBs and trusts need to work with partners to make the case for change, take action and hold each other to account.
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Content ArticleHealth at a Glance provides a comprehensive set of indicators on population health and health system performance across OECD members and key emerging economies. These cover health status, risk factors for health, access to and quality of healthcare, and health system resources. Analysis draws from the latest comparable official national statistics and other sources. Alongside indicator-by-indicator analysis, an overview chapter summarises the comparative performance of countries and major trends. This edition also has a special focus on digital health, which measures the digital readiness of OECD countries’ health systems, and outlines what countries need to do accelerate the digital health transformation.
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Content Article
Roger Kline's writings
Patient Safety Learning posted an article in Suggest a useful website
Roger Kline is a research fellow at Middlesex University Business School prior to which he held senior positions in eight UK trade unions. Roger has an extensive knowledge and experience of workplace culture, primarily in the public sector. On his web page you can find a selection of his published papers, books and blogs.
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