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Found 274 results
  1. Content Article
    Patient safety standards are critical for the establishment and assessment of patient safety programmes within hospitals. This third edition of the Patient safety assessment manual provides an updated set of standards and assessment criteria that reflect current best practice and WHO guidance. The manual will support the implementation of patient safety assessments and improvement programmes within hospitals as part of the Patient Safety Friendly Hospital Framework to ensure that patient safety is prioritised and facilities and staff implement best practices. The manual is a key tool for use by professional associations regulatory accrediting or oversight bodies and ministries of health to improve patient safety.
  2. News Article
    A quarter of services the Care Quality Commission has recently inspected required enforcement action from the regulator, its chief executive has revealed. Speaking at the launch of the regulator’s annual State of Care report, Ian Trenholm called for a “long-term, sustainable funding solution” from the government to aid a service that was ”genuinely struggling to cope”. Mr Trenholm said “about a quarter of the services” the CQC has inspected in 2022 had resulted in it having to take “enforcement action”. Examples of action taken against NHS trusts in the last year included enforcement measures placed on Nottingham University Hospitals, University Hospitals Sussex, and Princess Alexandra Hospital. In response to a question from HSJ about the robustness of the CQC’s inspection regime following further care quality and safety scandals, Mr Trenholm said observers should not focus solely on the ratings given to trusts by the CQC as there was a lot ”work going on in the background, whether that’s enforcement or otherwise”. He added the CQC had significantly increased the amount of information it was gathering in relation to concerns about services. Read full story Source: HSJ, 21 October 2022
  3. News Article
    An air ambulance service has been praised by inspectors for providing an "outstanding level of care". The Care Quality Commission (CQC) carried out checks on the Essex & Herts Air Ambulance Trust (EHAAT) in August and September. The report said patients felt "truly respected and valued as individuals" and described teamwork as "exemplary". Ben Myer, EHAAT head of clinical delivery, said "everyone worked so hard to make the desired result a reality". The service provides emergency care and transport in Essex and Hertfordshire, and surrounding areas when needed. As well as being rated outstanding overall, the charity was also rated outstanding for being safe, effective, caring, responsive to people's needs - and being well-led. Jane Gurney, EHAAT chief executive, thanked the local community for supporting the service, and issued a personal thank you to "each team member across the charity, whatever their role, all of whom work so hard every day to uphold these high standards". Read full story Source: BBC News, 12 October 2022
  4. News Article
    An MP who has just become a ministerial assistant in the Department of Health and Social Care has called for ‘underperforming’ NHS managers to be ‘sacked’, claiming some executives in the health service earn up to £500,000 per year. James Sunderland, who was made a Department of Health and Social Care parliamentary private secretary just days ago, told a Conservative party conference fringe event that money spent on executives should be reinvested into the coal face. Mr Sunderland, MP for Bracknell since 2019, also said the NHS is “better funded now than at any time in its history”. He said: “The solution is not more money, it’s better managers. We need to get to grips with the senior management of the NHS. People not performing need to be sacked. “We need to reinvest money spent on executives and management into the coalface. It’s about efficiency in how we do business.” Read full story Source: HSJ, 3 October 2022
  5. News Article
    Several ambulance trusts have moved to the highest level of alert in the wake of severe pressure on emergency services in recent days. Internal data seen by HSJ suggests ambulance response times have deteriorated dramatically, while the average time for call handlers to answer 999 calls has increased to almost two minutes in some areas. Staff across the country have been sounding the alarm over the pressures, with one senior source saying the situation was “really dire” again, after a period in which pressures had eased in August and September. The internal data showed ambulance trusts in the South West, East of England, London and the West Midlands had all declared the highest level of alert, known as REAP 4. More are expected to follow. The average response time for category 2 calls in the South West – including suspected heart attacks and strokes – was 1 hour 24 minutes, with 10% of these calls responded to in more than 3 hours 11 minutes. The target is 18 minutes. Emergency departments have also faced severe pressure. An emergency care consultant in Plymouth tweeted that patients were facing 70-hour waits to be admitted to wards, with some waiting 18 hours to be handed over by ambulance staff. Fionna Lowe added: “I have taken to asking families to feed their relatives. It has never been this bad.” Read full story (paywalled) Source: HSJ, 4 October 2022
  6. News Article
    Underperforming hospitals face special measures before what ministers warn will be one of the worst winters in the history of the NHS. Thérèse Coffey, the health secretary, told a fringe event at the Conservative Party conference that there was too much “variation in what patients experience” as her department plans to impose closer control on failing hospitals. Robert Jenrick, the NHS minister, said that the government “shouldn’t be tolerant of those parts of the NHS which are underperforming” and had demanded quicker improvement from more than a dozen hospitals. He acknowledged that NHS staff were overstretched in the aftermath of the pandemic, saying that he wanted to “put boosterism to one side” and accept that the shortage of doctors and nurses was the biggest problem facing the health service. However, he also questioned why some hospitals were doing so poorly when other nearby hospitals with similar problems were seeing much shorter waits. “A very striking dynamic is the variability that we see within the NHS and I think this is where we as Conservatives have a message, which is that we shouldn’t be tolerant of those parts of the NHS which are underperforming.” Read full story (paywalled) Source: The Times, 4 October 2022
  7. News Article
    NHS England has issued a new deadline to treat patients who have been waiting more than two years for treatment, a month after saying it had ‘virtually eliminated’ the longest waits, it has emerged. The goal of no-one waiting more than 104 weeks for treatment by July this year was one of the first milestones in the elective recovery plan hammered out between NHSE and ministers. They were not eliminated by the end of July, but the number was reduced to 3,000, having stood at 22,000 in January. The remaining group consisted of nearly 1,600 patients who had been offered faster treatment elsewhere but did not want to travel, 1,000 who required complex treatment and could not be transferred to another provider and 168 who were not treated by the deadline, according to information issued in the summer by NHSE. Now integrated care systems have been told there is a new “national expectation” to treat the remaining, final two-year waiters by the end of September. HSJ was told the goal has been framed as an ambition rather than a target because it includes patients who have chosen to wait longer. Read full story (paywalled) Source: HSJ, 21 September 2022
  8. News Article
    The global response to the first two years of the Covid-19 outbreak failed to control a pandemic that has led to an estimated 17.7 million deaths to date, a major review has concluded. The Lancet Commission on lessons for the future from the Covid-19 pandemic, produced by 28 world leading experts and 100 contributors, cites widespread failures regarding prevention, transparency, rationality, standard public health practice, operational coordination, and global solidarity. It concludes that multilateral cooperation must improve to end the pandemic and manage future global health threats effectively. The commission’s chair, Jeffrey Sachs, who is a professor at Columbia University and president of the Sustainable Development Solutions Network, said, “The staggering human toll of the first two years of the Covid-19 pandemic is a profound tragedy and a massive societal failure at multiple levels.”In its report, which used data from the first two years of the pandemic and new epidemiological and financial analyses, the commission concludes that government responses lacked preparedness, were too slow, paid too little attention to vulnerable groups, and were hampered by misinformation.Read full story Source: BMJ, 14 September 2022
  9. Content Article
    How can your team improve decision-making and performance in an unpredictable world? The field of Naturalistic Decision Making (NDM) supports organisations in understanding and leveraging expertise. Over the past 40 years, NDM researchers and practitioners have helped clients achieve higher ROI, improve safety, and increase efficiency. In this presentation series captured from our 2022 NDMA Open House, you'll hear directly from leaders in the NDM field. They'll share a variety of key concepts, case studies, tools, and insights that you can use to improve how your team makes decisions—especially when stakes are high and conditions are uncertain.
  10. Content Article
    Women should be able to have confidence that they will receive safe, effective, compassionate maternity care that focuses on their individual needs. That is the experience of many people. But too many families still face care that puts the safety and wellbeing of women and babies at risk. This Parliamentary and Health Service Ombudsman (PHSO) report looks at themes from maternity complaints families have brought to us, to shine a light on their experiences and encourage others to let their voices be heard. It shares case summaries and guidance to help families complain and help NHS organisations understand the issues.
  11. Content Article
    The Productive Ward focuses on improving ward processes and environments to help nurses and therapists spend more time on patient care, thereby improving safety and efficiency. Productive Ward will allow healthcare teams to redesign the way they work, eliminating waste and releasing staff time to invest in patient care. Teams are enabled to maximise quality, reduce harm, develop more efficient processes, and ensure that patients feel safe and well cared for.
  12. Content Article
    This report from the King's Fund looks at the reality of caring for acutely ill medical patients at the NHS front line and asks how care in hospitals can be improved. It comprises a series of essays by frontline clinicians, managers, quality improvement champions and patients, and provides vivid and frank detail about how clinical care is currently provided and how it could be improved. The essays are introduced and summarised by Chris Ham and Don Berwick and the report serves as the starting point of an ongoing appreciative inquiry into improving care processes, particularly for acutely ill medical patients.
  13. News Article
    Ministers have effectively ditched NHS England’s planned new bundle of A&E targets and want trusts to be firmly regulated on the existing four-hour standard and 12-hour breaches, HSJ understands. Multiple senior figures familiar with the process, from inside the NHS and government, said the performance focus for the next two years will be on the two existing accident and emergency waiting time measures, as well as ambulance handover delays. For the last three years, NHS England has been lobbying government to scrap the headline four-hour target, and replace it with a bundle of measures which have been trialled at around a dozen providers. This work has been led by medical director Steve Powis. HSJ understands the decision to continue using the existing four-hour target was driven by concerns among ministers and senior NHS figures that the bundle of measures was too confusing, both for patients and as a means for government to hold the service to account. Read full story (paywalled) Source: HSJ, 23 November 2022
  14. News Article
    A GP practice serving one of Greater Manchester’s most deprived communities has been banned from operating for four months after regulators uncovered a catalogue of basic failures - including failing to follow up on a child reporting breathing difficulties for three days. Jarvis Medical Practice in Glodwick has had its registration with the Care Quality Commission (CQC) suspended after ‘serious concerns’ passed to the body led to a snap inspection last month. Inspectors found the practice, based at Glodwick Primary Care Centre, was failing 20 separate standards, many of them relating to patient safety. It noted ‘poor quality’ and conflicting records that were sometimes impossible to properly understand and urgent home visits delayed or not carried out at all. In one case a patient with a lump apparently received no physical examination and was not referred for tests or scans ‘due to Covid-19’. Inspectors also found examples of patients with breathing difficulties, including a child, who were not dealt with for days after they got in touch. In one case no further contact was made for 11 working days, with no explanation provided in the patient's notes. The practice, which serves more than 5,000 patients in the Oldham neighbourhood of Glodwick, has now been suspended by the CQC until October 11. Read full story Source: Manchester Evening News, 17 July 2020
  15. News Article
    Daniel Mason was born half a century ago without hands, with missing toes, a malformed mouth and impaired vision. From an early age, he and his family had to deal with people asking about his disabilities. The impact on his life has been considerable. Daniel’s mother Daphne long suspected the cause of his problems was a powerful hormone tablet called Primodos that was given to women to determine whether they were pregnant. But when she raised her concerns with doctors, they were dismissed. Now, at last, Daphne has been vindicated with official confirmation this week that her fears were right, in the landmark review by Baroness Cumberlege into three separate health scandals that has exposed a litany of shameful failings by the NHS, regulatory authorities and private hospitals. This damning report shows again the danger of placing a public service on a pedestal, with politicians happy to spout platitudes but scared to tackle systemic problems or confront the medical establishment. But how many more of these inquiries must be held? How many more disturbing reports and reviews must be written? How many more times must we listen to ministerial apologies to betrayed patients? How much more must we hear of ‘lessons being learned’ when clearly they are largely ignored? Read full story Source: Mail Online, 9 July 2020
  16. News Article
    The trusts which are likely to face the fiercest struggle to deliver quality care in the immediate future have been identified through an analysis carried out exclusively for HSJ. Analyst company Listening into Action has taken data from the NHS Staff Survey 2019 to produce “a set of ‘workforce at risk’ numbers that point to the likelihood (or not) of workforce stability and continuity challenges adversely affecting the care a trust’s key assets are able to deliver in the year ahead”. The analysis shows a strong correlation between staffs’ perceptions of how well they are supported, and care quality — and therefore reveals which trusts face the toughest challenge to improve performance. Read full story (paywalled) Source: HSJ, 9 March 2020
  17. News Article
    Today the results of the National NHS Staff Survey 2019 are out. This is of the largest workforce surveys in the world with 300 NHS organisations taking part, including 229 trusts. It asks NHS staff in England about their experiences of working for their respective NHS organisations. The results found that 59.7% of staff think their organisation treats staff who are involved in an error, near miss or incident fairly. While an improvement on recent years (52.2% in 2015) work is needed to move from a blame culture to one that encourages and supports incident reporting. It also found that 73.8% of staff think their organisation acts on concerns raised by patients/service users. It is vital that patients are engaged for patient safety during their care and there is clear research evidence that active patient engagement helps to reduce unsafe care. Patient Safety Learning has recently launched a new blog series on the hub to develop our understanding of the needs of patients, families and staff when things go wrong and looking at how these needs may be best met.
  18. News Article
    The ghosts of medical errors haunt Dr. Peter Pronovost. Two deaths, both caused by mistakes. First, his father’s, who died as the result of a cancer misdiagnosis. Then a little girl, a burn victim who succumbed to infection and diagnostic missteps at the hospital where Pronovost worked early in his career. Those deaths led Pronovost to pursue a medical career dedicated to patient safety, and to create the medical checklist he has become known for worldwide. Now, he’s implementing his second act, at University Hospitals in the USA, as its Chief Transformation Officer, a job he has held since late 2018. His goal: To transform a $4 billion health care system by reducing shortcomings in medical care and increasing the quality of treatment. The challenge fits Pronovost, says one of his former Johns Hopkins University professors, Dr. Albert Wu. “He’s one of the few people for whom the title might be appropriate, because his work has led to significant changes and innovations in how we deliver health care in the United States. “He’s a once-in-a-generation guy.” Read full story Source: Cleveland.com, 9 February 2020
  19. Content Article
    At the moment, we’ve got maternity scandals day in, day out, which are pure evidence of the fact that our maternity units are just not up to scratch. They’re unsafe for mothers, unsafe for babies, and that is not acceptable.  Suzanne White, a former radiographer and a clinical negligence lawyer for the past 25 years, looks at the maternity safety scandals across the NHS and considers if any lessons have been learnt.
  20. Content Article
    The positive deviance approach seeks to identify and learn from those who demonstrate exceptional performance. This study from Baxter et al. sought to explore how multidisciplinary teams deliver exceptionally safe care on medical wards for older people. Based on identifiable qualitative differences between the positively deviant and comparison wards, 14 characteristics were hypothesised to facilitate exceptionally safe care on medical wards for older people. This paper explores five positively deviant characteristics that healthcare professionals considered to be most salient. These included the relational aspects of teamworking, specifically regarding staff knowing one another and working together in truly integrated multidisciplinary teams. The cultural and social context of positively deviant wards was perceived to influence the way in which practical tools (eg, safety briefings and bedside boards) were implemented. This study exemplifies that there are no ‘silver bullets’ to achieving exceptionally safe patient care on medical wards for older people. Healthcare leaders should encourage truly integrated multidisciplinary ward teams where staff know each other well and work as a team. Focusing on these underpinning characteristics may facilitate exceptional performances across a broad range of safety outcomes.
  21. Content Article
    The focus on error detection and its management has not produced the expected gains in patient safety, primarily because these methods are not well suited to a complex adaptive system such as healthcare. Behaviours that produce errors are variations on the same processes that produce success, so focusing on successful practices may be a more effective tactic. One approach to focusing on success is positive deviance. While positive deviance can be used to describe the behaviour of an exemplary individual, the term can also be extended to describe the behaviours of successful teams and organisations.  Originating in international public health projects, positive deviance has recently been embraced to improve quality and safety of healthcare delivered in organisations. The premise is that solutions to common problems mostly exist within clinical communities rather than externally with policy makers or managers, and that identifiable members of a community have tacit knowledge and wisdom that can be generalised. Lawton et al. explain more in this BMJ article.
  22. Content Article
    Safety culture has been shown to be a key predictor of safety performance in several industries. It is the difference between a safe organisation and an accident waiting to happen. Thinking and talking about our safety culture is essential for us to understand what we do well, and where we need to improve. These cards from Eurocontrol are designed to help us to do this.
  23. Content Article
    The Competition and Markets Authority (CMA) has published an open letter calling for all hospitals to comply with the Private Healthcare Market Investigation Order. The Order entered into force on 1 October 2014 and requires the performance measures of private healthcare facilities, and the performance measures and fees of consultants providing privately-funded healthcare services to be published by the Private Healthcare Information Network (PHIN).The CMA has asked PHIN and its members to provide a detailed roadmap outlining how the Order will be complete by June 2026. Over the next few months there will be opportunities for all interested parties to contribute to this roadmap, including consultant representative groups, insurers and other stakeholders.
  24. Content Article
    Waiting is a feature of public healthcare systems but must be managed to avoid adverse impacts on patients. The NHS sets performance standards for waiting times for elective and cancer care. Its performance against these was deteriorating before the COVID-19 pandemic and has worsened since it began. Millions of patients’ care was disrupted, meaning backlogs increased. This report looks in detail at backlogs and waiting times for elective and cancer care in the NHS in England. It explains how the current increased backlogs and waiting times have arisen, including the impact of the COVID-19 pandemic. The report sets out: how waiting times performance for elective and cancer care are tracked in the NHS, and how long patients have been waiting relative to the performance standards; the causes of increasing longer waits before the pandemic and the disruption caused by the pandemic; and the steps the Department and NHSE&I have already taken to address the increasing backlogs and waiting times, and the constraints and challenges the NHS faces in making a full recovery.
  25. Content Article
    This publication by National Voices, the leading coalition of health and social care charities in England, highlights the factors currently affecting timely access to care for people living with ill health, disability or impairment. It calls for system leaders to prioritise rebuilding timely access to health and care, and to take an approach that considers the whole system and its context and the whole person and their circumstances.
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