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Found 275 results
  1. Community Post
    I've been posting advice to patients advising them to personally follow up on referrals. Good advice I believe, which could save lives. I'm interested in people's views on this. This is the message I'm sharing: **Important message for patients relating to clinical referrals in England** We need a specific effort to ensure ALL referrals are followed up. Some are getting 'lost'. I urge all patients to check your referral has been received, ensure your GP and the clinical team you have been referred to have the referral. Make sure you have a copy yourself too. Things are difficult and we accept there are waits. Having information on the progress of your referral, and an assurance that is is being clinically prioritised is vital. If patients are fully informed and assured of the progress of their referrals in real-time it could save time and effort in fielding enquiries and prevent them going missing or 'falling into a black hole', which is a reality for some people. It would also prevent clinical priorities being missed. Maybe this is happening, and patients are being kept fully informed in real-time of the progress of their referrals. It would be good to hear examples of best practice.
  2. Community Post
    The US-based Leapfrog Group is a nonprofit organisation that routinely gauges hospital performance to inform purchaser choices as they navigate the healthcare system. While there are discussions on the value of the ratings ... they still pack a punch for organizations who do or don't do well. The latest set of numbers are out: Megan Brooks. One Third of US Acute-Care Hospitals Get 'A' on Patient Safety: Survey - Medscape - Nov 07, 2019.
  3. Content Article
    HSJ 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.
  4. Content Article
    Report, together with formal minutes relating to the report.
  5. Content Article
    This study in the Journal of Patient Safety outlines the development of the Leapfrog composite patient safety score. The researchers aimed to develop a composite patient safety score that provides patients, healthcare providers and healthcare purchasers with a standardised method to evaluate patient safety in general acute care hospitals in the United States. The study concluded that the composite score reflects the best available evidence regarding a hospital’s efforts and outcomes in patient safety.
  6. Content Article
    The King's Fund compared the healthcare systems in different countries by doing three things: Reviewed the research literature and assessed previous attempts to rank and compare health care systems. Interviewed academic experts in international health care policy and experts who had extensive knowledge of the UK, German and Singaporean healthcare systems. Analysed the latest quantitative performance data for the UK health care system and the health systems of 18 higher-income peer countries.  They analysed data in three main domains:  the context the health system operates in (eg, the health status and behaviours of the population)  the resources a health system has (eg, levels of staffing, equipment and health care spending)  how well the health care systems uses its resources and what it achieves as a result (eg, measures of efficiency in delivering services, quality of care, financial protection from the costs of ill health, and health care outcomes). 
  7. Content Article
    Variation persists in the quality of board-level leadership of hospitals. The consequences of poor leadership can be catastrophic for patients. The year 2019 marks 50 years of public inquiries into healthcare failures in the UK. The aim of this article is to enhance our understanding of context-specific effectiveness of healthcare board practices, drawing on an empirical study of changes in hospital board leadership in England. The study suggests leadership behaviours that lay the conditions for better organisation performance. We locate our findings within the wider theoretical debates about corporate governance, responding to calls for theoretical pluralism and insights into the effects of discretionary effort on the part of board members. It concludes by proposing a framework for the ‘restless’ board from a multi-theoretic standpoint, and suggest a repertoire specifically for healthcare boards. This comprises a suite of board roles as conscience of the organisation, sensor, shock absorber, diplomat and coach, with accompanying dyadic behaviours to match particular organisation aims and priorities. The repertoire indicates the importance of a cluster of leadership practices to fulfil the purposes of healthcare boards in differing, complex and challenging contexts.
  8. Content Article
    The government has published its mandate to NHS England. This mandate is intended to apply from 15 June 2023 until a new mandate is published. NHS England has a duty to seek to achieve the objectives in the mandate. The Secretary of State keeps progress against the mandate under review, setting out his views in an annual assessment which is laid in Parliament and published. The government will agree with NHS England how it should report on overall progress against the mandate to support the Secretary of State in keeping this under review. This will include reporting at agreed intervals on other delivery expectations listed beneath the objectives.
  9. Content Article
    As the NHS approaches its 75th anniversary, writers close to it reflect on the numbers behind its problems, and what it will take to heal the wounds.
  10. Content Article
    The publication of a new single, shared improvement approach, ‘NHS Impact’, is an exciting milestone. It reflects recognition, at the highest level in the English NHS, that improvement principles need to be part of the mainstream approach to the challenges facing the sector. Penny Pereira, Q’s Managing Director, considers the new approach, its potential impact and what it means for members and others working to improve health and care in England and beyond.
  11. Content Article
    The National Institute for Health and Care Research (NIHR) Evidence Collections draw together evidence from important NIHR-funded and wider research. They aim to help people in policy and practice understand recent important research in a topic area. The most recent Collection is Maternity services: evidence for improvement. In this blog, one of the Collection's authors, Candace Imison, describes how it was framed by the findings from a recent investigation into failings in East Kent Hospitals’ maternity services. She focuses on some key messages from evidence on how to identify poor performance and provide effective board governance and oversight.
  12. Content Article
    Does your manufacturing facility experience an undesirable frequency of costly product losses? Are recurring operational issues impacting productivity and morale? Do people believe the causes of these production issues are ‘human error’? Do Quality Differently will show you: How to take a systems-based risk management approach to create more operational success. Practical examples to guide improvement in your operations. Ways to apply comprehensive approaches that reveal and address the combination of factors that influence performance outcomes.
  13. Content Article
    Hospitals can significantly elevate patient satisfaction and enhance the delivery of healthcare services by incorporating best practices from adjacent and non-adjacent sectors. Chetan Trivedi explores several solutions, from multiple sectors, that can serve as a blueprint for hospitals across every key step of the patient journey, spanning from admission to discharge.
  14. News Article
    The US federal government has penalised 764 hospitals — including more than three dozen it simultaneously rates as among the best in the country — for having the highest numbers of patient infections and potentially avoidable complications. The penalties — a 1% reduction in Medicare payments over 12 months — are based on the experiences of Medicare patients discharged from the hospital between July 2018 and the end of 2019, before the pandemic began in earnest. The punishments, which the Affordable Care Act requires be assessed on the worst-performing 25% of general hospitals each year, are intended to make hospitals focus on reducing bedsores, hip fractures, blood clots, and the cohort of infections that before Covid-19 were the biggest scourges in hospitals. Those include surgical infections, urinary tract infections from catheters, and antibiotic-resistant germs like MRSA. This year’s list of penalised hospitals includes Cedars-Sinai Medical Center in Los Angeles; Northwestern Memorial Hospital in Chicago; a Cleveland Clinic hospital in Avon, Ohio; a Mayo Clinic hospital in Red Wing, Minnesota; and a Mayo hospital in Phoenix. Paradoxically, all those hospitals have five stars, the best rating, on Medicare’s Care Compare website. Eight years into the Hospital-Acquired Condition Reduction Program, 2,046 hospitals have been penalised at least once, a KHN analysis shows. But researchers have found little evidence that the penalties are getting hospitals to improve their efforts to avert bedsores, falls, infections, and other accidents. “Unfortunately, pretty much in every regard, the program has been a failure,” said Andrew Ryan, a professor of health care management at the University of Michigan’s School of Public Health, who has published extensively on the programme. “It’s very hard to capture patient safety with the surveillance methods we currently have,” he said. One problem, he added, is “you’re kind of asking hospitals to call out events that are going to have them lose money, so the incentives are really messed up for hospitals to fully disclose” patient injuries. Academic medical centers say the reason nearly half of them are penalised each year is that they are more diligent in finding and reporting infections. Read full story Source: Kaiser Health News, 8 February 2022
  15. News Article
    An Essex maternity department has been served with further warnings by the Care Quality Commission (CQC) and again rated “inadequate”. Serious concerns were raised about the services at Basildon University Hospital in the summer, after several babies were found to have been starved of oxygen and put at risk of permanent brain damage. Despite the CQC issuing warning notices to Mid and South Essex Foundation Trust in June 2020, a subsequent visit on 18 September found multiple problems had persisted. The CQC’s findings at Basildon included: the service was short-staffed and concerns were not escalated appropriately multidisciplinary team working was “dysfunctional”, which sometimes led to safety incidents doctors, midwives and other professionals did not support each other to provide good care. Read full story (paywalled) Source: HSJ, 19 November 2020
  16. News Article
    A quiet revolution in the NHS has happened. After decades of an internal market, NHS England has outlined new changes tying financial allocations and incentives to system-level performance instead. Over the past six months, providers had been allocated block funding based on activity from 2019/20 with top-ups and retrospective funding to support covid pressures, ensuring they financially break even during the crisis. Now, in a letter accompanying funding envelopes for Integrated Care Systems and Sustainability and Transformation Partnerships around the country, NHSE outlined how health service finances will be system managed for the remainder of the year. Systems will have not only control of the kitty (with all system costs to be met from its allocation) but funding will be linked to the performance of their member organisations, with some incentive payments or penalties for over/under performance at a system level. Glen Burley, the chief executive of a group of three acute trusts in the West Midlands, branded the move “very risky” and suggested a more traditional tariff performance would drive performance. Highlighting another of his concerns he said: “We have very little experience of doing so at system level, so this is a very risky tactic in a very risky year.” How systems will manage the shortfalls will hinge on elective delivery, system co-ordination, how to reduce forecast costs and recover income, set, of course, against the threat of a second wave of COVID-19. Read full story Source: HSJ, 17 September 2020
  17. News Article
    Yesterday marked the second World Patient Safety Day, and this year’s theme shined a light on health worker safety – those on the frontline of the pandemic have been selfless in their sacrifices to care for an ailing global population. What has become ever clearer is that a health system is nothing without those who work within it and that we must prioritise the safety and wellbeing of health workers, because without safe health workers we cannot have safe patients. Improving maternity safety has been a priority for some time – although rare, when things go wrong the consequences are unthinkable for families and the professionals caring for them. Maternity negligence makes up 50% of the total value of negligence claims across all NHS sectors, according to the latest NHS Resolution annual report and accounts. It states there were claims of around £2.4 billion in 2019/20, which is in the region of £6.5 million a day. This cost says nothing of the suffering families and professionals associated. However, without investing in the maternity frontline we cannot hope to make integral systemic changes to improve maternity safety and save mothers’ and babies’ lives, writes Sara Ledger, head of research and development at Baby Lifeline in the Independent. "We owe it to every mother and baby to rigorously and transparently scrutinise the safety of maternity services, which will be in no small way linked to the support staff receive." Read full story Source: The Independent, 17 September 2020
  18. News Article
    A trust which was heavily criticised for poor infection prevention and control last summer has been praised for making improvements. East Kent Hospitals University Foundation Trust was served with an enforcement notice by the Care Quality Commission in August last year, citing “serious concerns” about patient safety. The trust had twice the national rate of patients infected with COVID-19 after admission to hospital. But a new report, issued today, found significant improvements, with several areas of outstanding practice. The conditions imposed on the trust after last year’s inspection of the William Harvey Hospital in Ashford were also lifted, following the visit by the CQC in early March. Cath Campbell, CQC’s head of hospital inspections in the South East, said the improvements were particularly commendable as the trust had been under extreme pressure as a result of the pandemic. She said: “Leaders adopted learnings from other trusts, and from NHS Improvement which led to the development of a detailed infection prevention and control improvement plan. The trust then set up an improvement group to focus on implementing the actions in the plan and put a committee in place to review internal audit data and led improvements based on this information. “Although there were still one or two areas for improvement which we have advised the trust to look at now, overall this is a very positive report.” Read full story (paywalled) Source: HSJ, 23 April 2021
  19. News Article
    Regulators have sent an improvement director into a North West acute trust amid multiple allegations of poor care and ‘cover up’ across different specialties. University Hospitals of Morecambe Bay Foundation Trust, which spent 18 months in special measures midway through the last decade, is again now the subject of significant regulatory intervention from NHS England. The regulator has appointed Simon Bennett as a board-level improvement director, which comes after he undertook a similar assignment at the struggling Stockport FT. It comes amid ongoing external investigations into the trust’s urology and trauma and orthopaedics specialties, where serious allegations have been made about attempts to cover up poor care. The trust has a troubled history of care failings and regulatory intervention, including a major maternity scandal which culminated in the Kirkup Inquiry in the first half of the 2010s, and being placed in special measures in 2014. It was widely recognised that positive progress was subsequently made to implement the inquiry recommendations and improve services, which culminated in the trust exiting special measures in late 2015, and being rated “good” by the CQC in early 2017. However, the recent allegations and investigations have again brought regulatory intervention. Read full story (paywalled) Source: HSJ, 20 April 2021
  20. News Article
    With the annual NHS Staff Survey recently published, expectation was that this year might look a little different, all things considered. For the mental health sector, the dial didn’t move massively on key questions. The sector still came out bottom for staff who agreed they’d be happy with the standard of care if a friend or family member needed it - otherwise called the “family and friends test”. Although the survey was not that revelatory this year, it is still a helpful barometer for trusts’ safety and quality culture. Sheffield Health and Social Care Foundation Trust comes out lowest on all of the main quality and safety-related questions. On the crucial family and friends question, just 47% of the trust’s staff agreed that would be happy with the standard of care. The trust has been one of the worst performers on the survey for a number of years but appears to have deteriorated further. Sheffield Health and Social Care FT also came out worst on the following key safety culture related questions: When errors, near misses or incidents are reported, my organisation takes action to ensure that they do not happen again I would feel secure raising concerns about unsafe clinical practice My organisation acts on concerns raised by patients/service users. The last two questions are a vital indicator of a trust’s approach to safety and quality. If staff do not feel secure to raise concerns, or if a trust does not act on patient concerns can it really address problems before they escalate? Read full story (paywalled) Source: HSJ, 12 March 2021
  21. News Article
    Clinicians within a major teaching hospital’s cancer services have raised multiple concerns over patient safety, which they believe have resulted from badly planned service changes in response to the covid crisis. HSJ has spoken to several staff members who have worked in the haematology speciality at University Hospitals Birmingham Foundation Trust since last June, when the services underwent significant changes to free up capacity for coronavirus patients. This involved most haematology services at Heartlands Hospital in east Birmingham moving to the trust’s main Queen Elizabeth Hospital site in Edgbaston. The staff, who all wished to remain anonymous, told HSJ the transfer happened at just one week’s notice and was poorly planned. Once implemented, they said QEH’s newly enlarged service suffered from extreme staffing shortages, leading to several “never events”, such as patients being given the wrong blood type. In one resignation letter, a nurse who had transferred to QEH told managers patients’ “basic care needs are not being met”. The nurse said most shifts were understaffed, with examples of three nurses looking after 30 patients and added in the resignation letter: “I am witnessing strong and knowledgeable colleagues breaking down on each shift. “Furthermore, never events are happening at an alarming rate, necessary resources are commonly unavailable and communication between all levels of seniority is poor…" Read full story (paywalled) Source: HSJ, 2 February 2021
  22. News Article
    Bosses at the controversial NHS gender-change clinic for children have been removed after regulators highlighted a string of failures. The management team of the Gender Identity Development Service (GIDS) in London has been 'disbanded', documents reveal. It comes weeks after the clinic, run by the Tavistock and Portman NHS Trust, was judged 'inadequate' by the Care Quality Commission. Watchdogs said staff were afraid to raise concerns about patient safety for fear of 'retribution' from bosses. A report said: 'Staff did not always manage risk well. Many of the young [patients] were vulnerable and at risk of self-harm." The management team of the Gender Identity Development Service (GIDS) in London has been 'disbanded', documents reveal. It comes weeks after the clinic, run by the Tavistock and Portman NHS Trust, was judged 'inadequate' by the Care Quality Commission. "The size of the waiting list meant staff were unable to proactively manage the risks to patients waiting for a first appointment." Read full story Source: MailOnline, 31 January 2021
  23. News Article
    The percentage of patients visiting A&E who are seen within four hours has hit a “terrifying” new low in Scotland, latest figures show, with ministers urged to “get a grip” on the growing crisis. The figure has been declining since the summer amid high demand, staffing shortages and a lack of patient flow through hospitals. In the week to 3 October, just 71.3% of patients were seen within four hours, a five percentage point drop on the previous week, according to a data published by Public Health Scotland. The figure is the lowest since records began in 2015, with the Scottish Government target set at 95%. With 25,000 visits to A&E in that week, it means more than 7,000 patients waited longer than four hours. Some 1,782 people waited more than eight hours, while a record 591 patients waited longer than 12 hours. Last week, Scotland’s Health Secretary, Humza Yousaf, warned that Scotland’s NHS faces an “incredibly difficult winter” despite announcing a £300 million funding boost. But opposition parties have now accused him of “overseeing a scandalous situation” and leaving A&E departments “beyond breaking point”. Read full story Source: The Scotsman, 12 October 2021
  24. News Article
    U.S. News has just released its list of the best hospitals with associated rankings and ratings. Scores are based on several factors, including survival, patient safety, nurse staffing and more. U.S. News reviews hospitals performance in 15 adult specialties, 10 pediatric specialties and 17 surgical procedures and medical conditions affecting millions of people across the country. Find all of the rankings and ratings here
  25. Event
    This one day masterclass is part of a series of masterclasses focusing on how to use Human Factors in your workplace. Leadership in the NHS is the responsibility of all staff. Understanding human factors will allow healthcare to enhance performance, culture and organisation. These masterclasses have been re-designed in line with the new Patient Safety Syllabus. It will look at why things go wrong and how to implement change to prevent it from happening again or mitigate the risks. This masterclass will focus on systems to improve patient safety. For further information and to book your place visit https://www.healthcareconferencesuk.co.uk/conferences-masterclasses/systems-approach-patient-safety-masterclass or click on the title above or email kate@hc-uk.org.uk hub members can receive a 20% discount. Email info@pslhub.org for discount code.
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