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News Article
England's poorest 'get worse NHS care' than wealthiest citizens
Patient Safety Learning posted a news article in News
England’s poorest people get worse NHS care than its wealthiest citizens, including longer waiting for A&E treatment and worse experience of GP services, a new study has shown. Those from the most deprived areas have fewer hip replacements and are admitted to hospital with bed sores more often than people from the least deprived areas. With regard to emergency care, 14.3% of the most deprived had to wait more than the supposed maximum of four hours to be dealt with in A&E in 2017-18, compared with 12.8% of the wealthiest. Similarly, just 64% of the former had a good experience making a GP appointment, compared with 72% of those from the richest areas. Research by the Nuffield Trust and Health Foundation thinktanks found that the poorest people were less likely to recover from mental ill-health after receiving psychological therapy and be readmitted to hospital as a medical emergency soon after undergoing treatment. The findings sparked concern because they show that poorer people’s health risks being compounded by poorer access to NHS care. Read full story Source: The Guardian, 23 January 2020 -
News Article
Revealed: Dozens of hospitals ignoring NHS safety warnings
Patient Safety Learning posted a news article in News
Dozens of hospital trusts have failed to act on alerts warning that patients could be harmed on its wards, The Independent newspaper has revealed. Almost 50 NHS hospitals have missed key deadlines to make changes to keep patients safe – and now could face legal action. One hospital, Birmingham Women’s and Children’s Foundation Trust, has an alert that is more than five years past its deadline date and has still not been resolved. Now the Care Quality Commission (CQC) has warned it will be inspecting hospitals for their compliance with safety alerts and could take action against hospitals ignoring the deadlines. National bodies issue safety alerts to hospitals after patient deaths and serious incidents where a solution has been identified and action needs to be taken. Despite the system operating for almost 20 years, the NHS continues to see patient deaths and injuries from known and avoidable mistakes. NHS national director for safety Aidan Fowler has reorganised the system to send out fewer and simpler alerts with clear actions hospitals need to take, overseen by a new national committee. Last year the CQC made a recommendation to streamline and standardise safety alerts after it investigated why lessons were not being learnt. Professor Ted Baker, Chief Inspector of hospitals, said: “CQC fully supports the recent introduction of the new national patient safety alerts and we have committed to looking closely at how NHS trusts are implementing these safety alerts as part of our monitoring and inspection activity.” He stressed: “Failure to take the actions required under these alerts could lead to CQC taking regulatory action.” Read full story Source: The Independent, 30 December 2019 -
News ArticleAn 88-year-old woman with a broken neck died after being transferred three times between two hospitals in the space of just 48 hours, The Independent has reveal. The death of Jean Waghorn, who died after contracting pneumonia in hospital, sparked criticism from a coroner who said the NHS trust had ignored earlier warnings over moving patients between hospitals. Senior coroner Veronica Deeley had issued two official alerts to Brighton and Sussex Hospitals Trust last year after the deaths of frail elderly patients who were wrongly shuttled between hospitals. But despite this, in June this year Ms Waghorn, who broke her neck after falling at home, was repeatedly transferred between the Princess Royal Hospital in Sussex and Brighton’s Royal Sussex County Hospital. She caught pneumonia and died two days later. The hospital, which is rated good by the CQC, has now apologised and said it has learned lessons from the case. A spokesperson said it did take action following the previous warnings and added that work was ongoing to ensure the changes were consistently applied. Read full story Source: The Independent, 17 December 2019
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Content ArticleThis paper ranks the performance of the UK health care system with that of 18 similar, wealthy countries since 2000 or the earliest year for which data is available. It covers the level of health spending, overall life expectancy, the health care outcomes of the major diseases and the outcomes for treatable mortality and childbirth.
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Content ArticleThere are too many integrated care systems (ICSs) in some parts of the country, especially the South West and Midlands, writes Alastair McLellan and Dave West in this HSJ article. This means that effective integration will struggle due to limited resources, leadership capacity and ability to influence large providers. It is also a problem widely acknowledged at the centre and within the regions. The proposed structure for ICSs is overly complex, consisting of a partnership board with little statutory power, which is meant to give strategic direction to an executive board which in practice will be held accountable for all decisions, but which is also meant to give up as much power and money as possible to “place based” entities which remain ill defined and have no statutory standing.
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Content Article
HSJ Primer: Breaking point (25 April 2022)
Patient Safety Learning posted an article in Workforce and resources
Recently the Financial Times health and data reports produced an incisive piece showing the world what is all too readily apparent to people in the NHS: bed capacity has been stretched to breaking point. The report said this “calls into question [the NHS’s] ability to meet a commitment to increase non-urgent hospital treatment by 30 per cent above pre-pandemic levels over the next three years”. It also demonstrates the dangerous congestion that is causing ambulances to stack up outside emergency departments and medically fit patients to languish in vital beds past their due time for discharge. This congestion is causing dangerous delays, leading to a rising number of serious incidents in ambulances queuing to get to the front door of the ED. There is doubtless much that can be done inside hospitals to improve efficiency, alleviate bottlenecks and improve patient flow. -
Content ArticleProvider collaboratives are partnerships that bring together two or more NHS trusts (public providers of NHS services including hospitals and mental health services) to work together at scale to benefit their populations. While providers have worked together for many years, the move to formalise this way of working is part of a fundamental shift in the way the health and care system is organised, moving from an emphasis on organisational autonomy and competition to collaboration and partnership working. This King's Fund explainer looks at provider collaboratives in England, the opportunities they provide and the unresolved questions to consider when thinking about their role in the changing health and care landscape.
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Content ArticleQuality and Outcomes Framework (QOF) might be back this month – but for practices the work never went away, practices managers have told Management in Practice. NHS England announced the resumption of the payments system last December after QOF was part-suspended in 2021/22 to free up time for Covid vaccinations. But while the QOF system was on hold, many practices have carried on with QOF targets throughout the pandemic, continuing to measure their performance against these indicators.. Now the programme has officially returned, despite concerns that the system does not take into account the significant impact of the pandemic on long-term conditions, and could financially penalise practices. Practice managers are, once again, having to get to grips with targets, and needing to organise appointments for patients most in need of a face-to-face review, while dealing with day-to-day work pressures and staff shortages. Here practice managers share their thoughts on the comeback of QOF, what it will mean for them and their practices, and whether its return is too much, too soon.
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Content ArticleFollowing the Shrewsbury maternity scandal where "at least 201 babies would have survived with better care", outgoing CQC chief inspector of hospitals Ted Baker said the NHS should listen to criticism to be able to change. Ted Baker said the NHS faced a resistance to being challenged and "for anyone to refuse to listen to criticisms of what the NHS does I think is a big mistake." Listen to Ted Baker's, CQC's outgoing chief inspector, full interview on Times Radio.
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Content ArticleNow that the national plan to tackle the elective backlog is public, thoughts will be turning to how to achieve the challenging task ahead. A week before the plan was published, the King's Fund held a roundtable, supported by Novartis, with local health care leaders to discuss just that. The overwhelming theme from this discussion was that effective communication within local systems will be essential to success. The national strategy has set out the ambition, but ultimately solutions will be implemented locally. Five relationships stood out as being vital. Local areas and their neighbours. Primary and secondary care. Leaders and their workforce. NHS and patients. Local systems and their data.
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Content ArticleThis Healthcare Safety Investigation Branch (HSIB) investigation explores the care of patients who present to child and adolescent mental health services (CAMHS) with questions about their gender identity and are referred to specialised gender dysphoria services. Gender dysphoria is a sense of unease, distress or discomfort that a person may have because of a mismatch between their biological sex and their gender identity. For example, a child who is registered as male at birth might feel or say that they are a girl, or feel that neither ‘boy’ nor ‘girl’ are the right word to describe how they feel about themselves. Gender dysphoria is not identified as a mental illness by the NHS, but some people may develop mental health problems because of gender dysphoria.
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Content ArticleWe need to make community-powered prevention a valued part of the system, writes Prof Donna Hall in this HSJ article. Mark Spencer is a GP who has completely reinvented his role. Tired of sitting in his surgery day after day prescribing medicines to the same people with the same conditions, he decided to get out into the communityand talk to them about what needed to change. The result is Healthier Fleetwood - a remarkable flowering of multiple community-led groups. The groups cover a wide range of issues from men’s mental health to obesity. But they all share one thing in common - they use the power of human connection and support to prevent illness in the first place rather than simply manage it. This is why there are groups dedicated simply to singing or crafts as a way of keeping people mentally and physically healthy, as well as those more directly focused on “conditions”. The results speak for themselves - reduced obesity, falling admissions to accident and emergency (pre-covid), and a doubling of GP numbers made possible by more sustainable finances. And, most importantly, dozens of stories of people’s lives transformed, even saved.
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Content ArticleDr Navina Evans, chief executive of Health Education England, explains how the NHS is meeting the challenge of workforce planning.
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Content ArticleThis Health Foundation long read explores how the NHS in England can better use routine health data to help address current challenges, including winter pressures, the ongoing coronavirus response and the growing elective care backlog. It examines the longstanding barriers to widespread use of data and data science, consider what actions might help to overcome these, and explore whether the data strategy for health and social care will deliver the change needed.
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Content ArticleIn January 2020, the World Health Organization declared Covid-19 a global health emergency. Healthcare systems around the world faced enormous pressures as hospital admissions increased. Amongst others, med-tech companies experienced a vast increase in demand for Covid-19 related products, alongside declining demand for non-essential products, and so had to adapt their supply chains to ensure the sustained, timely delivery of medical devices. In addition, teams had to navigate disruptions to global supply chains due to various border lockdowns and tighter trade and export restrictions worldwide. Prior to the unprecedented demands of the pandemic, med-tech supply chain management was not a hot topic in the news, or generally known amongst the public. However, it has recently gained traction across the news worldwide as supply chain managers have worked relentlessly to re-establish the equilibrium within this ever-changing landscape. The med-tech industry should look to continue to re-build their supply chains, so that they can be more agile and flexible, and respond to potential future issues efficiently and effectively.
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Content ArticleNHS Resolution has published a set of three reports which explore clinical issues that contribute to compensation claims within Emergency Departments.
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Content Article
In this blog Patient Safety Learning sets out its initial response to the report of the Independent review of maternity services at Shrewsbury and Telford Hospital NHS Trust (also known as the Ockenden Maternity Review).- Posted
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Content ArticleThe Independent review of maternity services at the Shrewsbury and Telford Hospital NHS Trust was commissioned in 2017 to assess the quality of investigations relating to newborn, infant and maternal harm at the Trust. When it commenced this review was of 23 families’ cases, but it has subsequently grown to cover cases of maternity care relating to 1,486 families, the majority of which were patients at the Trust between the years 2000 and 2019. Some families had multiple clinical incidents therefore a total of 1,592 clinical incidents involving mothers and babies have been reviewed with the earliest case from 1973 and the latest from 2020.
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Content ArticleThe East of England share their race strategy.
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Content ArticleGP practices are usually run separately from hospitals. In some places in England and Wales, the NHS organisations responsible for managing hospitals are now also running local GP practices. It is difficult in some areas for practices, which are small organisations, to recruit GPs and keep going. It is also desirable to coordinate GP services with hospital care. For these reasons, it may help if the organisations managing hospitals also run GP practices.
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Content ArticleSadly, we live in a world where racism, misogyny, ableism and other forms of discrimination and prejudice exist. As an organisation that is rooted in and serves our community, we are not exempt from such discriminatory beliefs and behaviours, writes Solent Trust’s Anna Rowen in this HSJ article.
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Content Article
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In this blog Patient Safety Learning’s Chief Executive, Helen Hughes, discusses the connection between procurement, supply chains and patient safety, ahead of an upcoming Safety for All Campaign webinar on this topic. -
Content ArticleRoger Kline, Research Fellow at Middlesex University Business School, comments on the Government “Action Plan” on racism.
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Content ArticlePlans to establish integrated care systems (ICSs) as statutory bodies in the health and care bill foreshadow further changes to the organisation of the NHS. Unlike previous reorganisations, the changes expected to occur in 2022 have developed from within the NHS rather than being imposed by the government. Not only this, but leaders in the NHS have also played a major part in shaping the nature of these changes in partnership with the centre. This paper from the NHS Confederation focuses on the changes needed to create the conditions in which ICSs can improve outcomes for patients and the public and outlines a series of simple rules to guide those leading the reform programme. The ideas put forward are intended to provide a basis for debate with healthcare leaders and others in England about next steps. The paper starts from the premise that a key role of leaders is to harness the intrinsic motivation of health and care staff and public health teams to perform to the best of their abilities. The distinctive contribution of ICSs is to work with partners in making use of all available assets and leading improvements in patient care and outcomes that require actions across the organisations and services that make up the health and care system. Staff must be fully engaged in this work as it is through their actions that patients and the public will experience improvements
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Content ArticleNigeria is projected to become one of the most populous countries in the world, and is rightly taking its place on the world stage. The Lancet Nigeria Commission tells the story of the country through a health lens, and details recommendations that will enable the country and its people to fulfil their potential, and seize the opportunity ahead. It has been led by Nigerians for Nigerians. The Commissioners call for the creation of a new social contract that redefines the relationship between citizen and state. They argue that health has, to date, been neglected by successive governments and consequently the citizens of Nigeria, and must be recentred as a vital investment in the population – one that will reap political and economic benefits. Nigeria is poised to define the future of West Africa, the African continent, and the whole world. This Commission lays out how best to realise that ambition.
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