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Found 181 results
  1. News Article
    Health systems are still struggling to meet their financial plans, despite hundreds of millions being raided from investment budgets to help balance the books. Senior leaders in most regions said the cash falls short of their existing financial gaps. Earlier this month, NHS England announced that £800m would be made available to integrated care systems (ICSs) to offset the additional cost of strikes. HSJ understands ICSs reported a combined deficit that was £1.5bn worse than planned in the six months to October, which implies a gap of several hundred million pounds unless systems can report substantial surpluses for the second half of the year. HSJ spoke to senior sources in all seven regions, with more than half saying their systems would still fail to deliver breakeven, despite the funding transfers. A source in the South East said their system’s share of the funding “won’t touch the sides”, adding that NHSE was playing “hardball”. Another local source said they had identified a set of “nuclear options” to balance the books, but these would be “catastrophic for quality of care and/or nigh-on impossible to deliver”. Read full story (paywalled) Source: HSJ, 22 November 2023
  2. Content Article
    The scale of the health inequalities challenge can often feel daunting and overwhelming for system leaders, but tackling health inequalities is one of the four statutory purposes of integrated care systems (ICSs) to support communities to live long, healthy lives. This article outlines a project the NHS Confederation has launched to support healthcare leaders adopt best practice to address this issue.
  3. News Article
    The NHS should better track patients with the greatest clinical need so they can move to the front of the queue for treatment, a former government waiting list tsar has said. Anthony “Mac” McKeever told HSJ the health service could improve how it works through its elective backlog by using a system introduced during the covid pandemic to prioritise the most pressing cases. He said a “large chunk” of cases were still not given a code to say how long they are considered to be able to wait for surgery, which is at the heart of this process. Mr McKeever retired as Mid and South Essex Integrated Care Board chief executive this month following nearly five decades in the health service, including as a trust leader. Although Mr McKeever said he only knew the regional situation for the East of England, he would be “very surprised” if the national picture was any different. Waiting list expert Rob Findlay agreed this was a reasonable assumption. Read full story (paywalled) Source: HSJ, 17 November 2023
  4. Content Article
    Structural, 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.
  5. Content Article
    'Gridlock' of patients in urgent and emergency care is often attributed to a lack of onward capacity for people leaving hospital, leading to delayed discharges that back up the system. But does this explanation often favoured by government and policy makers tell the whole story? The Nuffield Trust's Quality Watch investigates whether the pattern is visible in patient journeys through urgent and emergency care at the integrated care system level.
  6. Content Article
    A new report from the Public Policy Projects (PPP) calls on integrated care systems (ICSs) to harness the unique capabilities of the pharmacy sector and implement a pharmacy-led transformation of healthcare delivery. The report, Driving true value from medicines and pharmacy, is chaired by Yousaf Ahmad, ICS Chief Pharmacist and Director of Medicines Optimisation at Frimley Health and Care Integrated Care System, and is the culmination of three roundtable events attended by key stakeholders from across the pharmacy sector and ICS leadership. Insight from these roundtables has also been accepted as evidence in the Health and Care Select Committee’s recent inquiry into the future of the pharmacy sector.
  7. Content Article
    Good practice guidance for integrated care boards (commissioners and providers) produced by NHS England. This community rehabilitation and reablement model, published alongside the intermediate care framework, aims to ensure that the individual (and their families) is at the centre of discussions and that any transition points will be as seamless as possible.
  8. Content Article
    The ICS Delivery Forum is a series of regional conferences hosted by Public Policy Projects. Each event convenes local ICS leadership, key health and care experts and other stakeholders including industry leaders. A series of panel discussions and case study presentations are given throughout the day. This document summarises the key insights from the Leeds ICS Delivery Forum event held in Leeds on 28 June 2023. The document placed these discussions into the broader context of health and care transformation, both at a local and national level. As such, wider sources and research are used to expand upon the key points.
  9. Content Article
    This editorial in the HSJ outlines the financial issues facing Integrated Care Systems (ICS) in England, drawing attention to deficits reported in Greater Manchester, West Yorkshire and East London. HSJ Deputy Editor Dave West highlights that neither the Government nor the opposition are keen to signal new funding adequate to deal with these funding gaps.
  10. Content Article
    The ICS Delivery Forum is a series of regional conferences hosted by Public Policy Projects. Each event convenes local ICS leadership, key health and care experts and other stakeholders including industry leaders. A series of panel discussions and case study presentations are given throughout the day. This document summarises key insights from the Manchester ICS Delivery Forum event held on 25 May 2023. The document places these discussions into the broader context of health and care transformation, both at a local and national level, so wider sources and research are used to expand upon the key points. It looks at the following aspects of integration in Manchester: Community engagement Working with VCSE organisations Governance
  11. Content Article
    It is more important than ever that Integrated Care Systems (ICS) invest urgently in community mental health. The introduction of the Community Mental Health Framework in 2019 presented a once-in-a-generation opportunity for mental health systems.   With ringfenced transformation funding coming to an end in April 2024 and in a climate of crisis and uncertainty, we need to ensure these changes are embedded.  Rethink Mental Illness have launched their new report, 'Building Community into the Integrated Care System; A practical guide to developing robust community mental health', where they: Summarise the significant challenges facing mental healthcare. Provide a toolkit of practical, workable solutions to common barriers to transformation. Explore the role that the VCSE sector can have in pursuing the four core aims and future goals of ICSs.  
  12. Event
    until
    The introduction of integrated care systems (ICSs) has placed a renewed focus on how organisations can work together to integrate care to meet the needs of local populations. However, much of the activity to integrate care, improve population health and tackle inequalities will be driven by commissioners and providers collaborating over smaller geographies (often referred to as ‘places’) within ICSs. This King's Fund conference will provide an opportunity to discuss how effectively place-based care is being delivered across the health and care system, how place-based partnerships – collaborative arrangements that typically include the NHS, local government and others such as voluntary, community and social enterprise (VCSE) sector organisations and social care providers with responsibilities for planning and delivering services – are evolving, and whether more needs to be done to involve places and communities in developing local approaches to reducing health inequalities. Conference sessions will also explore how ICSs and mayoral combined authorities are developing approaches to supporting the development of healthy places in their locality. You will hear from local partners from the voluntary, community and social enterprise (VCSE) sector, local government and more widely across the health and care system about their role in developing integrated plans, healthy places and neighbourhoods. Register
  13. News Article
    A district general hospital has accused a major teaching trust of ‘failing to adhere to arrangements’ made around the provision of acute stroke services, sparking patient safety warnings in a local integrated care board’s (ICB) risk register. Harrogate and District Foundation Trust’s accusation that its neighbour, Leeds Teaching Hospitals Trust, is failing to comply with protocol around acute stroke pathways was published in West Yorkshire ICB’s risk register. The ICB’s September risk register also said the “risk to patient safety is significant and probable if the situation remains unresolved”. The issues centre on the provision of hyper-acute stroke unit beds, which provide the first two to three days of care for patients with newly diagnosed strokes, and what happens to patients requiring acute stroke care following their initial HASU stay. West Yorkshire ICB said in its September’s performance report that the problem had “grown due to two recent clinical incidents,” but added “there is no quick solution to this problem”. Harrogate has raised concerns with the ICB in recent months that “a number of patients are not receiving HASU level care at Leeds”. Read full story (paywalled) Source: HSJ, 3 October 2023
  14. Content Article
    There is widespread variation in the instance and quality of meaningful patient involvement across the 42 Integrated Care Systems (ICSs) of NHS England. This is seen throughout the structures, policies and processes of the ICSs, from the omission of patient representatives on decision-making bodies—such as Integrated Care Boards (ICBs)—to the neglect of clear consultation when decisions are made concerning a patient’s care. This report present the results of research and analysis conducted by the Medical Technology Group (MTG). It shows that where a patient lives is the biggest determinant to whether they are involved in their care meaningfully, or at all. It makes recommendations for the Government, NHS England and ICS's on the approach that should be taken to ensure meaningful patient engagement.
  15. Content Article
    Four enablers of effective collaboration between integrated care systems and ambulance services.
  16. News Article
    Former commissioning chiefs have been accused of presiding over a ‘culture of bullying’ at the predecessor organisation to Norfolk and Waveney Integrated Care Board, as part of a legal claim from a former employee. The accusations, which have been made in an employment tribunal case, relate to former chief executive Melanie Craig and other former executives at what was then Norfolk and Waveney Clinical Commissioning Group. Ms Craig now leads Suffolk Community Foundation, a local voluntary sector organisation. The claims have been made by a former long-standing assistant director for mental health services, Clive Rennie, who has claimed unfair dismissal. However, the integrated care board said it disputes the claims and is defending the case. In a witness statement to the tribunal, which began this week, Mr Rennie alleges there was an “authoritarian and dictatorial style of management” and described a “culture of bullying and misuse of power that had emerged under the leadership of Melanie Craig and which included the executive team”. Read full story (paywalled) Source: HSJ, 6 September 2023
  17. Content Article
    In 2011, the government acknowledged a large treatment gap for people with mental health conditions and sought to establish ‘parity of esteem’ between mental and physical health services. From 2016, the Department of Health & Social Care (DHSC) and NHS England made specific commitments to improve and expand NHS-funded mental health services. NHSE, working with the Department and other national health bodies, set up and led a national improvement programme to deliver these commitments. This report by the House of Commons Public Accounts Committee assesses progress made in delivering these commitments. The report acknowledges that NHS England has made progress in improving and expanding mental health services, but says this was "from a low base."
  18. Content Article
    The State of Integrated Care Systems 2022/23 examines the progress that local systems have made, and opportunities for further development. The NHS Confederation’s ICS network collected the views of 47 integrated care board chairs and chief executives, and integrated care partnership chairs, in the spring, as well as holding roundtables. The results found they are generally positive about relationships – with 88% agreeing that “partners within my ICS are working collaboratively”. However, when asked about whether a range of organisations in their area “have the requisite level of resourcing and maturity to deliver the ambitions outlined in your integrated care strategy”, there were signs of concerns about primary care networks, provider collaboratives and place-based partnerships, all of which saw less than 50% of leaders agree.
  19. Content Article
    This briefing was commissioned by the Maternal Mental Health Alliance who are dedicated to ensuring all women, babies and their families across the UK have access to compassionate care and high-quality support for their mental health during pregnancy and after birth. One woman in five experiences a mental health problem during pregnancy or after they have given birth. Maternal mental health problems can have a devastating impact on the women affected and their families. NICE guidance states that perinatal mental health problems always require a speedy and effective response, including rapid access to psychological therapies when they are needed. Integrated care systems (ICSs) have a unique opportunity to ensure that all women who need support for their mental health during the perinatal period get the right level of help at the right time, close to home.
  20. Content Article
    This paper attached clarifies what statutory duties, accountabilities and responsibilities providers, Integrated Care Boards (ICBs) and NHS England hold for quality. Please note this is a working document and will be updated.
  21. News Article
    Patients in all but one integrated care system found it more difficult to contact their GP practice by phone this year compared to last year. GP patient survey data, published this month, showed the proportion of patients who found it “very” or “fairly easy” to get through by phone had fallen across almost every ICS by as much as seven percentage points. The measure fell nationally from 53 to 50%. The drop in performance comes as NHS England and the government ramp up focus on ease and speed of access to GPs as part of the primary care recovery plan, published in May. An NHSE spokesperson said: ”Despite GP teams experiencing record demand for their services, with half a million more appointments delivered every week compared to before the pandemic, the GP survey found that the majority of patients have a good overall experience at their GP practice. “However, the NHS recognises more action is needed to improve access for patients, which is why it published a recovery plan in May.” Read full story (paywalled) Source: HSJ, 31 July 2023
  22. Content Article
    This toolkit summarises good practice for Integrated Care Boards (ICBs) and primary care commissioners and providers regarding the provision of primary care services for people seeking asylum who are living in initial and contingency accommodation. It aims to ensure equality in access to services and improved long-term health outcomes for residents in Home Office accommodation, minimising health inequalities and encouraging collaborative working with accommodation providers and other local stakeholders.
  23. Content Article
    The major conditions strategy is a national framework being developed by the Department of Health and Social Care (DHSC) and the Office for Health Improvement and Disparities (OHID). It will focus on six major groups of conditions: cancers cardiovascular diseases, including stroke and diabetes chronic respiratory diseases dementia mental ill health musculoskeletal disorders This briefing by NHS Confederation examines how the upcoming major conditions strategy can set the conditions to prevent, treat and manage multimorbidity in England.
  24. Community Post

    Better use of data for medication safety in hospitals

    Kenny Fraser

    Kenny Fraser posted a topic in Medicine management

    NHS hospital staff spend countless hours capturing data in electronic prescribing and medicines administration systems. Yet that data remains difficult to access and use to support patient care. This is a tremendous opportunity to improve patient safety, drive efficiencies and save time for frontline staff. I have just published a post about this challenge and Triscribe's solution. I would love to hear any comments or feedback on the topic... How could we use this information better? What are hospitals already doing? Where are the gaps? Thanks
  25. News Article
    Adults across an integrated care system area are facing ‘unacceptable’ 10-year waits for an NHS assessment for attention deficit hyperactivity disorder, the longest known wait for such services in England. Herefordshire and Worcestershire integrated care board has warned in board papers of “exceptionally high waiting times for ADHD assessment and treatment for Worcestershire patients (10 years+), with workforce challenges and service fragility compromising service delivery”. HSJ understands the long waits for ADHD diagnosis, which is a national problem, is predominately affecting adults with approximately 2,000 people on Herefordshire and Worcestershire’s ADHD list alone. Local provider Herefordshire and Worcestershire Health and Care Trust also warned on its website that its paediatric services were also “experiencing unprecedented demand”. Read full story (paywalled) Source: HSJ, 19 July 2023
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