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Found 1,519 results
  1. News Article
    The government is planning to reverse reforms of the NHS in England introduced under David Cameron in 2012, a leaked document suggests. The changes would aim to tackle bureaucracy and encourage health services from hospitals to GP surgeries and social care to work more closely. The draft policy paper also says the health secretary would take more direct control over NHS England. The reforms by Mr Cameron's government in 2012 saw the creation of NHS England - to run the health service - and the scrapping of primary care trusts in favour of GP-led clinical commissioning groups to organise local services. Under the latest proposals, set out in a leaked document published by health news website Health Policy Insight, there will be "enhanced powers of direction for the government" to "ensure that decision makers overseeing the health system at a national level are effectively held to account". Instead of a system that requires competitive tendering for contracts - sometimes involving private companies, the NHS and local authorities will be left to run services and told to collaborate with each other, says the draft White Paper, designed to set out proposed legislation. There will also be more focus on GPs, hospitals and social care services working together to improve patient care. Read full story Source: BBC News, 6 February 2021
  2. News Article
    The NHS’s London regional team has told its integrated care systems (ICS) to draw up plans for ‘another possible [covid-19] surge later in 2021’, HSJ has learned. The guidance, dated February 2021 says: “Later in March/early April we will ask for systems to begin to plan for a possible wave 3 covid surge.” The NHS England and Improvement London presentation adds: “[The] purpose of the critical care de-surge plan [is to] ensure that the… bed base can expand safely in the event of a 3rd covid surge and/or other major incident/event.” Any surge in covid cases is likely to be caused by new variants of the virus, such as those originating in Brazil and South Africa, which are more resistant to vaccines, becoming dominant in the UK. At present government advisers think this is unlikely and that even if this scenario did arise, it will be possible to modify vaccines to combat the new strain. The guidance sets out three other “strategic goals” the ICSs should address. But it has “surprised” senior figures from outside London who were waiting for the national framework for tackling the NHS’ growing elective waiting list expected later this month. The presentation said the other key goals were to: ensure “staff get… immediate rest and respite”; set out plans to “desurge critical care”; and plan for elective recovery. Read full story (paywalled) Source: HSJ, 3 March 2021
  3. News Article
    Two-thirds of women at the heart of a review into maternity services at a Welsh health board could have had very different outcomes if they had received better care, a report has found. The Independent Maternity Services Oversight Panel (Imsop) focused on the experiences of pregnant women at Cwm Taf Morgannwg health board. Its maternity services have been in special measures since "serious failings" were found two years ago. Concerns emerged in late 2018 that women and babies may have come to harm because of staff shortages and failures to report serious incidents. This sparked a major independent review, which gave a damning verdict on maternity services in Cwm Taf Morgannwg health board. Published on Monday, the Imsop report focuses on the care of mothers between January 2016 and September 2018. It found that 19 reviews of maternal care (68%) revealed at least one factor where "different management would reasonably have been expected to alter the outcome". The panel's chairman, Mick Giannasi, said: "These findings will be concerning and potentially distressing for the women and families involved, and it will be difficult for staff." "Of the 28 episodes of care, we concluded that in 27 of them, our independent teams who reviewed the care would have done something differently. Put simply, what went wrong, might not have gone wrong if things had been done differently." Read full story Source: BBC News, 25 January 2021
  4. Content Article
    ‘Health systems recovery’ is a term used to describe the process of restoring and improving the functions of a health system that have been exposed to a shock or public health emergency, such as natural disaster, conflict, or a disease outbreak. This paper from Matthew Neilson and Sheila Leatherman discusses what quality in recovery look like.
  5. Content Article
    This guide from the World Health Organization (WHO) focuses on actions required at the national, district and facility levels to enhance quality of health services, providing guidance on implementing key activities at each of these three levels. It highlights the need for a health systems approach to enhance quality of care, with a common understanding on the activities needed by all stakeholders. The guide articulates the key actions required to improve the quality of health services for the entire population. It recognises that the path varies for each country, district and facility – stimulating the reader to consider multiple factors and entry points for action. This planning guide is for staff working at all levels of the health system (i.e. national, district and facility) who have a role in enhancing the quality of health services. It is also relevant to all stakeholders initiating and supporting action at facility, district and/or national levels both in the public and private sectors.
  6. Content Article
    The COVID-19 pandemic has exacerbated preexisting weaknesses in the global supply chain. Regional assessments by the Food and Drug Administration (FDA), European Medicines Agency (EMA), and independent consultants, have demonstrated various contributory causal factors requiring changes in policy, relationships, and incentives within the dynamic and developing networks. Human factors and ergonomics (HFE) is an approach that encourages sociotechnical systems thinking to optimize the performance of systems that involve human activity. The global supply chain can be considered such a system. However, it has neither been systematically examined from this perspective.
  7. Content Article
    The Healthcare People Management Association (HPMA) is the professional voice of HR in healthcare. Set up over 40 years ago, it has over 4,000 members ranging from HR directors and deputy directors through to trusts and CCGs. Its aim is to support and develop HR staff to improve the people management contribution in healthcare and ultimately improve patient care.
  8. News Article
    New planning guidance asks local NHS organisations to prepare for a major waiting-list catch-up by seeking “top quartile performance in productivity”, but also to “safely mobilise all… available surge capacity over the coming weeks” as the service battles rising covid levels “in almost all parts of the country”. An end-of-year planning letter was issued by NHS England to local NHS chief executives last night. It warns: “With covid-19 inpatient numbers rising in almost all parts of the country, and the new risk presented by the variant strain of the virus, you should continue to plan on the basis that we will remain in a level 4 incident for at least the rest of this financial year and NHS trusts should continue to safely mobilise all of their available surge capacity over the coming weeks. “This should include maximising use of the independent sector, providing mutual aid, making use of specialist hospitals and hubs to protect urgent cancer and elective activity and planning for use of funded additional facilities such as the Nightingale hospitals, Seacole services and other community capacity.” Read full story (paywalled) Source: HSJ, 24 December 2020
  9. News Article
    Staff at a teaching hospital which has struggled with emergency care pressure this winter have warned that patient safety is being compromised as crowding is becoming “normalised”. A letter sent by a group of clinical staff at Cambridge University Hospitals Foundation Trust to the trust board calls for immediate action to tackle concerns. It says: “The normalisation of crowding, the lack of effective flow management and the lack of effective escalation policies and procedures are resulting in patient safety, dignity and comfort being repeatedly and seriously compromised.” Details of the letter were shared with HSJ but it is unclear how many and which staff it is signed by. Read full story (paywalled) Source: HSJ, 23 December 2020
  10. Content Article
    It is a time of transition in NHS finance. The planned recovery from years of deficits and debts that plagued parts of the NHS in recent years has been hit by the enormity of the COVID-19 shock. Alongside this planned recovery, the NHS has been moving away from its decades-long journey toward competition between individual organisations and using market-like approaches to improve performance, to a design based on collaboration and improving population health. Before the COVID-19 pandemic, the NHS was working to restore financial health and deliver on fundamental reform; now, it must achieve these objectives with the added challenge of recovering from the damage of COVID-19. In this article, The King's Fund looks at the history of NHS finances over recent years to draw out learning for this new design. It will be important to apply this learning if the system is to avoid the recurrent ‘resets’ to NHS finance that have been necessary but have only provided temporary solutions, and deliver a new approach that is consistent with the wider objectives of collaboration and integration. 
  11. Content Article
    Organisation-wide improvement in health care is an important element of the provision of patient safety. Whereas in the past, capabilities and metrics have tended to drive improvement within the NHS – organisations now need to provide strategies to create the infrastructure and the knowledge required to give high quality care. These strategies lead to effective and successful organisational improvement programmes. Having staff with the right skills and having the right culture within an organisation are also seen as vital when looking at transforming care and embedding quality improvement (QI).
  12. News Article
    Think 2020 has been awful for the NHS? Next year is shaping up to be far worse – and most of the huge hole it’s in was dug long before Covid. The virus has merely finished off the job. The health service does not have the beds, staff or equipment to recover the ground it lost during the first two waves of the coronavirus pandemic, but the government is blocking desperately needed improvements, and another round of organisational upheaval is on its way. Roughly one in 11 clinical posts are vacant, and it would hardly be a surprise to see many staff rush for the retirement door once the worst of the pandemic is behind us. The NHS can’t solve the problem without long-term certainty over funding for staff. Around 140,000 patients in England have been waiting more than a year for surgeries such as a hip replacements, up a hundredfold from a year ago. With the whole system beset by delays long before we had even heard of coronavirus, the lack of spare capacity means it will take years to help many patients. Unprecedented interruptions and delays to cancer tests and treatments have been exacerbated by the pitiful state of diagnostic equipment. Access to CT and MRI scanners is far behind countries with a fraction of our wealth, such as Slovenia and Slovakia. Y In the midst of all this turmoil, the NHS in England faces another round of legislative and organisational upheaval next year, the likely arrival of a new chief executive, and a potential fight with Downing Street over the extent of political control. Read full story Source: The Guardian, 18 December 2020
  13. Content Article
    Serious complications and deaths resulting from maternity care have an everlasting impact on families and loved ones. The families who have contributed to the Ockenden Review want answers to understand the events surrounding their maternity experiences, and their voices to be heard, to prevent recurrence as much as possible. They are concerned by the perception that clinical teams have failed to learn lessons from serious events in the past. The learning of lessons and embedding of meaningful change at The Shrewsbury and Telford Hospital NHS Trust and in maternity care overall is essential both for families involved in this review and those who will access maternity services in the future. After reviewing 250 cases and listening to many more families, this first report identifies themes and recommendations for immediate action and change, both at The Shrewsbury and Telford Hospital NHS Trust and across every maternity service in England.
  14. News Article
    Cancer screening programmes designed to save hundreds of lives have been delayed by up to a year as services struggle with staff and equipment shortages, HSJ can reveal. Of the 14 Lung Health Check Programme sites announced last year, four — or just under a third — have either halted programmes they had started or delayed beginning them, with some now expected not to be operational until after March. The areas chosen for the scheme activities, which often involved mobile computed tomography units in vans, have high rates of late diagnosis lung cancer. A study published in the New England Journal of Medicine in February showed CT scanning of high risk groups led to a 26% reduction in deaths in men and between a 39 and 61% reduction in women. NHS England confirmed “activity had resumed” in nine areas while one has started this month, meaning four areas remain out of action. The organisation declined to answer HSJ’s questions on which services were not running and why. Read full story (paywalled) Source: HSJ, 1 December 2020
  15. News Article
    Hospitals across England could see oxygen supplies at worse levels this winter than at the peak of the first coronavirus wave – when some sites were forced to close to new admissions. An alert to NHS hospitals this week warned that because of the rise in admissions of COVID-19 patients, there is a risk of oxygen shortages. Trusts have been ordered to carry out daily checks on the amount of oxygen in the air on wards to reduce the risk of catastrophic fires or explosions. The problem is not because of a lack of oxygen but because pipes delivering the gas to wards will not be able to deliver the volume of gas needed by all patients. This can trigger a cut-off in supply and a catastrophic drop in pressure, meaning patients would be denied the oxygen they need to breathe. Read full story Source: The Independent, 20 November 2020
  16. Content Article
    The collapse of healthcare services round the world, the behaviour of some of the “agencies” enforcing quarantining, and high levels of patient harm during the COVID-19 pandemic, undoubtedly warrant a strong response. We need a new agenda for change if we are to address the current threat to patient centred healthcare and patient safety globally. Kawaldip Sehmi, CEO International Alliance of Patient Organizations, summarises the key messages and actions from the 9th biennial Global Patients Congress 2020, 
  17. News Article
    Hospital food standards are set to be put on a statutory footing, with trusts held to account by the Care Quality Commission, according to the chair of a government-commissioned review. Philip Shelley, who led the review into hospital food following seven patient deaths from listeria last year, told HSJ the incident was an “absolute condemnation” and that trusts must use the review to improve food standards. The review, published last month, also calls for capital investment to refurbish hospital kitchens and replace old and inefficient equipment, which is likely to cost several hundreds of millions of pounds. The government has accepted the recommendations and Mr Shelley will lead a group of experts to oversee the review’s implementation across the NHS during the next three years. Among the review’s recommendations is the “enhanced role” for the CQC when it inspects NHS trusts. The review states there is currently “very little evidence to prove that food and drink standards are being monitored closely enough” and it therefore recommends placing the standards on a statutory footing from which the CQC can hold trusts to account. Read full story (paywalled) Source: HSJ, 17 November 2020
  18. News Article
    A community trust was told to urgently review prescribing of stimulant medications for children after concern that some were posted to families but never arrived. Bridgewater Community Healthcare Foundation Trust was told that sending prescriptions through the post may be a potentially unsafe practice by the Royal College of Paediatrics and Child Health. The warning came in a report from the college after it was invited by the trust to review its community paediatrics service The trust was urged to work with primary care and clinical commissioning groups to establish shared care for children who needed these medications. Stimulant medicines are often used for children with attention deficit hyperactivity disorder. The review also found there was a “a very significant risk for patient care” with letters, reports and prescriptions being delayed or going missing due to “recurrent issues” with the post in the building used by the team covering St Helen’s. It highlighted issues with the safeguarding procedures at the trust, with each locality team having its own processes and handling a small number of cases, and called for urgent work to streamline services. Read full story (paywalled) Source: HSJ, 11 November 2020
  19. Content Article
    Identifying improvements in maternity care to help reduce the risk of delays in crucial interventions during labour when a baby is suspected to be unwell is the focus of this latest Healthcare Safety Investigation Branch (HSIB) report. The report was compiled after a review of 289 of our maternity investigations into intrapartum stillbirths, neonatal deaths and potential severe brain injuries. In 14.9% of the cases the delay was a contributory factor. The review identified issues such as inadequate staffing, poor infrastructure and high workload as contributory factors to the delays. Evidence from national reports confirms that such delays are a recognised patient safety risk. 
  20. News Article
    Patients, including those with the coronavirus, are being kept “head to toe” on trolleys in accident and emergency departments in Manchester, with some forced to wait up to 40 hours for a bed. The “dangerous” situation has sparked warnings from the president of the Royal College of Emergency Medicine over the “potentially lethal” crowding of patients in A&Es across the country this winter. Katherine Henderson said she was “absolutely terrified” by what was happening in some departments. She said she had warned NHS England about the dangers of crowding patients in A&E but that not enough action had been taken. She told The Independent: “Crowding in A&E is unsafe, but with coronavirus it is potentially lethal. We have said this endlessly to NHS England." “Everyone agrees crowding is bad, but what they’re not doing is translating that into action.” After hearing of the situation in Manchester, she added: “Exactly what we said should not happen is happening. I am absolutely terrified by this. What more can I do? I have highlighted this risk everywhere I can over the past few months.” Read full story Source: The Independent, 11 November 2020
  21. Content Article
    On 23 September, Improvement Cymru, the all-Wales Improvement service for NHS Wales, hosted an online session with colleagues from Holland to talk about patient flow in hospital. 
  22. Content Article
    There are large numbers of patients with olfactory disturbance in the UK and shortfalls in assessment and support amongst mainstream practice in both primary and secondary care leading to significant quality‐of‐life impairment and potential missed diagnoses. The aim of this study from Erskine and Philpott was to determine the key themes which can be identified from the accounts of anosmia sufferers and to identify important areas to target for future research or service development.
  23. News Article
    The NHS has been returned to the highest level of risk on its emergency preparedness framework, a move which allows national leaders tighter control over local resources and decision making. NHS England chief executive Sir Simon Stevens announced the decision at a press conference this morning. He said: “Unfortunately, again we are facing a serious situation [due to rising coronavirus infections and hospital admissions]. That is the reason why at midnight tonight the health service in England will be returning to its highest level of emergency preparedness, EPPR level 4, which of course we had to be at from the end of January to the end of July.” Placing the NHS on level 4 of Emergency Preparedness Reslience and Response framework allows system leaders to take control of decisions over mutual aid and other local priorities. Sir Simon was joined by NHSE/I medical director Steve Powis and Alison Pittard, dean of the Faculty of Intensive Care Medicine. They used the press conference to stress the threat the NHS faced from the second covid peak, but also set out more positive news on the covid vaccine programme. Read full story Source: HSJ, 4 November 2020
  24. Content Article
    Elderly people in care homes in Cornwall were abused and neglected while failings led to reports of concerns not being investigated, a new Safeguarding Adults Review has found. The Morleigh Group, which operated seven homes in Cornwall and has since shut down, was exposed in a BBC Panorama investigation in 2016. A new Safeguarding Adults Review which was commissioned as a result of the TV show has been published making a number of recommendations to all agencies which were involved in the case. The review was completed in April 2019 but has only just been made public - Rob Rotchell, Cornwall Council Cabinet member for adult social care said that this was due to the number of agencies being involved.
  25. News Article
    An NHS hospital at the epicentre of the coronavirus second wave is facing the threat of action by the care watchdog as it struggles to keep patients safe, The Independent has learned. Senior NHS bosses in the northwest region have been accused of putting politics ahead of patient safety and not doing enough to help the hospital to cope with the surge in Covid patients in recent weeks. The Care Quality Commission (CQC) warned the Liverpool University Hospitals Trust on Friday that it could face action after an inspection carried out last week in response to fears raised with the regulator. In a message to his colleagues on Friday, Liverpool University Hospitals (LUH) Trust medical director Tristan Cope warned the hospital had been overwhelmed by coronavirus and standards of care could no longer be maintained. He criticised NHS England and said the trust had been “abandoned” as coronavirus cases surged. He confirmed the CQC’s intention to take action against the trust but said the regulator had failed to appreciate the pressure staff in the hospital were under. Dr Cope, a consultant in anaesthesia and critical care, said: “LUH is now essentially overwhelmed by the demand. We cannot maintain patient flow and usual standards of care. We have put forward a proposal to further reduce elective [planned] activity, but maintaining capacity for the most urgent cases that would suffer from a two-four week delay." “It is a very sound plan that our divisional teams have worked up. However, NHS England are prevaricating and delaying with the usual request for more detail, more data, etc. It is clear to me that the politics is outweighing the patient safety issues of the acute crisis." Read full story Source: The Independent, 3 November 2020
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