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Content Article
Patient-led assessments of the care environment (PLACE)
Patient Safety Learning posted an article in Environmental
PLACE assessments will provide motivation for improvement by providing a clear message, directly from patients, about how the environment or services might be enhanced. The 2023 programme is planned for launch in early September 2023. -
Content ArticleIn 2008, five ‘serious untoward incidents’ occurred on a small maternity unit in a hospital in the UK. The prevailing view, held by clinical staff, hospital managers, and executives, was that these events were unconnected and did not signal systemic failures in care. This view was maintained by the testimony of staff and governance procedures which prevented the incidents from being considered together. Drawing on the inquiry report of the Morecambe Bay Investigation (2015), Dawn Goodwin examines how the prevailing view was built and dismantled, eventually being replaced with a very different description of events. Overturning this view required affected parents to engage with governing bodies and legal processes, challenge clinical staff, lobby for inquests, and mobilise social media and the national press. Tracing how different descriptions of events weaken or gather force as they travel through different forums, processes, and are presented to different audiences, she explores the sociology of knowledge around establishing failures of care.
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Content ArticleOn 7 March 2023 the coroner commenced an investigation into the death of Ian Darwin, aged 42. The investigation has not yet concluded and the inquest has not yet been heard. However, during the course of the investigation the inquiries revealed matters giving rise to concern. The coroner concluded that in his opinion there is a risk that future deaths could occur unless action is taken.
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Content ArticleIn February 2022, NHS England published its Delivery Plan for Tackling the Covid-19 Backlog of Elective Care, aiming for an unprecedented 30% rise in elective activity by 2024-25. In an effort to cut waiting times and the number of people waiting for first appointments, the plan set an improbably ambitious target of reducing follow-up outpatient visits by 25% by March 2023 from 2019-20, to leave more capacity for first appointments. All first appointment waits of over 52 weeks were to be abolished by 2025. In this BMJ opinion piece, David Oliver looks at why the targets are unlikely to be met.
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Content ArticleEven those at the top admit the NHS can’t do what is being asked of it today. But it is far from unsalvageable – we just need serious politicians who will commit to funding it, writes Gavin Francis, who shares his experience as a GP in this Guardian long read.
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Content ArticleChris Graham of the Picker Institute and Jacob Lant from charity National Voices join host Annabelle Collins to discuss patient experience revealed by recent national surveys, how the findings should be used to improve quality and reduce health inequalities, and whether there is a bigger role for “real-time” experience measures.
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Content ArticleThis 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.
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Content Article
My last blog, "Forgotten heroes" – the sequel, built upon a very moving BBC Panorama programme Forgotten heroes of the Covid front line. The BBC documentary told the sad story of healthcare workers (HCWs) who had bravely and knowingly put themselves in harm's way to care for their patients during the darkest days of the pandemic. Many lost their lives, while many more were rendered so severely injured by the disease (Long Covid) that they were (and remain) unable to work and have been unceremoniously sacked by their NHS Health Trusts/Boards. The way that an organisation manages its activities is known as 'governance'. Good governance will lead to high standards of ethics, morality, care and compassion for the people who work within it and those who may be affected by its acts and omissions. Hence, when applied to a whole country, it is known as 'Government', its departments and agencies. In this blog, I propose a possible hypothetical scenario that may have led to the tragic situation revealed by the BBC documentary. I hope this will lead you to consider the standards of 'governance' that apply to the 'duty of care' which a Government owes to its HCWs during a pandemic and what, morally and ethically, should be done to support those "forgotten heroes" if the Government’s governance should be found to be severely lacking. But is the scenario I am asking you to imagine hypothetical or is it real? I shall leave that to your judgement – and that of the Covid-19 Public Inquiry. -
Content ArticleAs the National Health Service celebrates 75 years, this book reflects not only on its successes but also on its challenges. Society, medicine and technology have all changed considerably since its founding in 1948 so what can, and should, the NHS do to adapt to remain fit for purpose?This thought-provoking book is made up of interviews with healthcare leaders, policymakers and practitioners, journalists and patient representatives. Bookended with chapters linking the interviews with the history and the future of the NHS, the book addresses questions such as:What are the NHS’s strengths and weaknesses?How could the NHS be adapted and how should it be set up if founded today?How should the NHS recognised the relationship between physical health, mental health, social care and public health?How should the NHS be funded?How do we understand the social contract between patients, medical and allied professions and the government?How can we manage workforce development?How should the NHS address issues around social justice and equity of access?Timely and important, this book promotes debate and critique around key issues in managing healthcare. Relevant to all those working in the NHS, it is also a valuable contribution for healthcare professionals undertaking further study on management and leadership.
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Content ArticleNew research from Healthwatch shows that people are currently facing multiple cancellations or postponements of care which are having a significant impact on their lives and symptoms, while further increasing health inequalities. Healthwatch cmmissioned a survey of 1084 people who have seen their NHS care either cancelled or postponed this year to understand the extent of disruption to care amid rising waiting lists, workforce issues, and industrial action, and other pressures on the NHS.
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Content ArticleAt the time of her death, Heather Findlay, aged 28 years, was in the care of the East London Foundation Trust (ELFT), detained under section 2 of the Mental Health Act at Mile End Hospital. At approximately 3pm on 11 June 2020, she was on s17 escorted leave, standing with a healthcare assistant (HCA) at the front gates of the hospital having a cigarette, when she turned to the HCA, said “I’m sorry I have to do this to you” and ran away. ELFT contacted the Metropolitan Police Service (MPS) at 3.17pm, but by 3.58pm, Ms Findlay had been found by a member of the public in a nearby park. At inquest, the jury came to a conclusion of death by suicide and giving a medical cause of death of: 1a hypoxic ischaemic encephalopathy 1b sodium nitrate toxicity.
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Content ArticleThe Health and Social Care Select Committee report on the future of general practice examined the pressure currently facing general practice, highlighting the challenges being faced by general practice and provided clear recommendations to respond to them. This document sets out the Government’s reply to each of these recommendations.
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Content ArticleThe presentation was held following the inaugural William Rathbone X Lecture, given by Professor Alison Leary, who spoke on the highly topical subject, ‘Thinking differently about nursing workforce challenges.’ The presentation can be watched from The Queen's Nursing Institute website.
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Content ArticleA casually centred proposal identifying how Fire and Rescue Services can improve pre-hospital care and quality of life outcomes for burn survivors. David Wales and Kristina Stiles have released this report looking at the burn survivor experience in the pre-hospital environment. The work makes ten operational recommendations and also two 'lessons learned' recommendations exploring strategic partnership working and the resulting fragmented services.
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Content ArticleThe health needs of the population are changing, and many people need more co-ordinated care across primary, community, social and hospital services. More co-ordinated care requires organisations and staff to collaborate well across organisational and professional boundaries,
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Content ArticleThis article from Sarcoma UK was written by Dermot’s family to develop their reflections and recommendations on the recent publication of the Healthcare Safety Investigation (HSIB) report, Variations in the delivery of palliative care services to adults.
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Content ArticleNHS urgent and emergency care is under intolerable strain. This strain is increasingly causing harm to patients. Timely and high quality patient care is often not being delivered due to overcrowding driven by workforce and capacity constraints. While the covid-19 pandemic has accentuated and arguably expedited the crisis; the spiral of decline in urgent and emergency care has been decades long and unless urgent action is taken, we may not yet have reached its nadir, writes Tim Cooksley and colleagues in this BMJ opinion article.
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Content ArticleMental health is an important component of individual well-being and social participation. According to the Organisation for Economic Co-operation and Development (OECD) between one in six and one in five people experience a mental health problem in any given year and an estimated one in two people experience a mental health problem in their lifetime. There is a need to measure patients’ experience of mental health care delivery and effects of mental health treatment approaches. Patients are in a unique position to contribute to the quality of health care since they are the only ones who experience the whole episode of care from primary care in communities through hospital care to rehabilitation and follow up in general practice. Health professionals in contrast experience only a snap shot of the entire patient’s journey in the health care system. PREMs ((patient-reported experience measures) and PROMs (patient-reported outcomes measures) are means to assure that the patient voice in health care will be heard and institutionalised. This supplement focuses on how to include the patient voice in mental health, in terms of PREMs and PROMs.
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Content Article
The pain and distress of not being able to see an NHS dentist are "totally unacceptable", an inquiry has told the government. A review was launched after a BBC investigation found 9 in 10 NHS dental practices across the UK were not accepting new adult patients. Some people drove hundreds of miles for treatment or even resorted to pulling out their own teeth, the BBC found. The government says it invests more than £3bn a year in dentistry. But a damning report, by the Commons' Health and Social Care Committee, says more needs to be done, and quickly. The House of Commons Committee report with recommendations to government can be viewed at the link below. The Government has two months to respond. -
Content Article
The King's Fund: Activity in the NHS (19 June 2023)
Patient Safety Learning posted an article in Data and insight
Over the past 10 years, it has often been stated that the NHS treats more than a million people every 36 hours, but is that still true? Here, the King's Fund analyse NHS activity (eg, calls, appointments, attendances and admissions) and explore some of the underlying trends that lie behind these headline statistics. Following the disruption caused by the Covid-19 pandemic, NHS activity has almost returned to pre-pandemic levels. -
Content ArticleHealth and care services in England are not always able to provide individualised, equitable and coordinated palliative and end of life care (PEoLC) to meet the holistic needs of people and their families. To understand the impact of inconsistent palliative care, the Healthcare Safety Investigation Branch (HSIB) looked at the case of Dermot, a 77-year-old cancer patient. Dermot's case shows the gap between what is needed and what is available. HSIB make three safety recommendations to NHS England aimed at improving the delivery of palliative and end of life care.
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Content ArticleHSJ brought together a panel of trust chief executives drawn from its annual list of the NHS’s Top 50 CEOs. Their discussion explored how trusts will cope with the renewed financial challenge and what values-based leadership means to them. Many of the CEOs at the roundtable complained there no longer seemed to be any reward for good financial performance now that the health of system finances trumped those at individual organisations.
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Content ArticleWhat is the optimal skill mix for virtual wards? Do new roles such as clinical pharmacists or advanced practitioners act as substitutes for, or additions to, existing staff? What works to retain staff? How much do current rates of attrition and turnover cost the NHS and social care? Evidence gaps in workforce research are holding back healthcare improvements, say Tara Lamont, Cat Chatfield, and Kieran Walshe in this BMJ opinion piece.
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Content ArticleIncreasing numbers of people are at risk of developing frailty. People living with frailty are experiencing unwarranted variationin their care. This toolkit will provide you with expert practical advice and guidance on how to commission and provide the best system wide care for people living with frailty.
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Content ArticleToo many women are dying from disadvantage in one of the poorest parts of England, according to ground breaking new research which serves as an urgent wake-up call for levelling up efforts. The report by Agenda Alliance and Changing Lives, Dismantling disadvantage has found that in 2021 a woman in the North East of England was 1.7 times more likely to die early as a result of suicide, addiction, or murder by a partner or family member than in the rest of England and Wales. Today’s new research was conducted to better understand the lives and needs of disadvantaged women in the North East, including Newcastle, coastal areas and Gateshead and Sunderland; some of the poorest regions in the country. Working with women with lived experience at every stage, the study involved 18 in-depth interviews, 47 survey responses; focus groups; data analysis and multiple meetings with affected women, practitioners and policy makers.
