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Found 185 results
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Content ArticleNaaheed Mukadam and colleagues investigated the incidence of diagnosed dementia and whether age at diagnosis and survival afterward differs among the UK's three largest ethnic groups. They used primary care electronic health records, linked Hospital Episode Statistics and mortality data for adults aged ≥65 years. They compared recorded dementia incidence 1997–2018, age at diagnosis, survival time and age at death after diagnosis in White, South Asian, and Black people. The study found that dementia incidence was higher in Black people. South Asian and Black people with dementia had a younger age of death than White participants and Black participants. The authors concluded that South Asian and Black peoples’ younger age of diagnosis and death means targeted prevention and care strategies for these groups should be prioritised and tailored to facilitate take-up.
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Content ArticleThis review by the National Confidential Enquiry into Patient Outcome and Death (NCEPOD) looks at current NCEPOD data to identify themes relating to healthcare inequalities. It was was commissioned by Healthcare Quality Improvement Partnership (HQIP) on behalf of the Healthcare Inequalities team at NHS England and NHS Improvement, as part of the National Clinical Audit and Patient Outcomes Programme (NCAPOP). The review identifies four area of healthcare inequalities: Protected characteristics - age and disability Socioeconomic deprivation Inclusion health groups Organisation of healthcare services
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Content ArticleTo be effective, clinical governance should reach every level of a healthcare organisation—it requires structures and processes that integrate financial control, service performance and clinical quality in ways that will engage clinicians and generate service improvements. In this article for the BMJ, the authors argue that because clinicians are at the core of clinical work, they must be at the heart of clinical governance. They look at problems with the prevailing model of clinical governance and describe an alternative approach.
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Content ArticleThis article explores the question of why change management was an issue in the NHS in the 1980s. It reports the results of a study which explored reasons for variability in the observed rate and pace of strategic service change in the NHS. The article introduces the metaphor of 'receptive' and 'non-receptive' contexts for change, as well as outlining eight 'signs and symptoms' of receptivity. It provides a logic and language which may enable a better understanding of the processes of change in the NHS.
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Content ArticleWith Liz Truss becoming the new Prime Minister today after winning the Tory leadership contest, what are the health and care commitments from the 2019 Conservative Party Manifesto that she inherits? Mark Dayan, Lucina Rolewicz and Jessica Morris explore the progress of the main health and care promises that were made. Which are on course to be delivered and which are not?
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Content ArticleHealthcare service innovations are considered to play a pivotal role in improving organisational efficiency and responding effectively to healthcare needs. However, healthcare organisations often encounter difficulties in sustaining and sharing innovations. This qualitative study aimed to explore how healthcare innovators of process-based initiatives see and understand factors that either facilitated or obstructed the implementation of innovation. The authors found that even though the innovations studied were very varied, innovators often highlighted the significant role of the evidential base of success, the inter-personal and inter-organisational networks, and the inner and outer context.
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Content ArticleIn healthcare, there is a well-recognised gap between what we know should be done, and what is actually done. This article considers new models that look at the implementation of evidence-based practice in healthcare systems, particularly looking at the application of a conceptual model called 'sticky knowledge'.
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Content ArticleThe General Pharmaceutical Council (GPhC) has written via email to pharmacists and owners of pharmacies with the GPhC’s voluntary internet pharmacy logo, to address ongoing patient safety concerns affecting the online sector. The emails highlight that over 30% of the GPhC's open Fitness to Practise cases relate to online pharmacy—a disproportionate number for the sector of the market that online services occupy. Common issues raised in these cases include: medicines being prescribed to patients on the basis of an online questionnaire alone, with no direct interaction between the prescriber and either the patient or their GP . prescribing of high-risk medications or medications which require monitoring without adequate safeguards. prescribing of medicines outside the prescriber’s scope of practice. high volumes of prescriptions being issued by the prescriber in short periods of time. The emails also recognise the benefits and risks of online pharmacies, outline how the GPhC may take enforcement action against an online pharmacy, and recommend what actions pharmacists and pharmacy owners should take in response to the patient safety concerns raised. You can view the emails in full: Email to owners of pharmacies with the internet pharmacy logo Email to pharmacists
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Content ArticleCrisis resolution teams (CRTs) provide treatment at home to people experiencing mental health crises, as an alternative to hospital admission. This study in the International Journal of Mental Health Nursing aimed to measure whether CRTs adhere to a model of good practice, using one-day fidelity reviews of UK crisis teams. The authors found that despite a national mandate to implement the CRT model, there are wide variations in implementation in the UK and no teams in the sample achieved overall high fidelity.
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Content ArticleThere is a paradox of representation in public involvement in research; public contributors are seen as either too naïve to meaningfully contribute or too knowledgeable to represent ‘the average patient’. More expert contributors who have experience in research can therefore be a target for criticism. This study in the journal Health Expectations aimed to examine how representation was discussed in two different scenarios—expert involvement and lived experience. The authors analysed the case of a Lived Experience Advisory Panel (LEAP) chosen for direct personal experience of a topic and the case of an expert Patient and Public Involvement (PPI) panel. They concluded that researchers tend to enact a confirmation logic that seeks a simple, unified patient voice to legitimise decisions. Contributors are therefore limited in their ability to realise a synthesis logic that would actively blend different types of knowledge.
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Content ArticleIn this blog, Bob Matheson, Head of Advice and Advocacy at the charity Protect, explains the case of Dr Chris Day and how it highlights the vital importance of reforms to UK whistleblowing law. Protect is campaigning for Reform of whistleblowing legislation in the UK. The author highlights loopholes in UK law that Dr Day has faced throughout his long legal battle with Health Education England (HEE). These gaps mean that whistleblowers lack certain important legal rights and protections, and this in turn may prevent individuals from raising concerns.
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Content ArticleA Learning Health System (LHS) is a model of how routinely collected health data can be used to improve care, creating ‘virtuous cycles’ between data and improvement. This requires the active involvement of health service stakeholders, including patients themselves. However, to date, research has explored patients being ‘data donors’ rather than considering patients as active contributors. This study in the journal Health Expectations aimed to understand how patients should be actively involved in a LHS.
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Content ArticleScrutiny of NHS chief executive officers (CEOs) has tended to focus on the generally short tenure of their position. The implications of high turnover have been assessed but there has been limited research looking at CEOs who remain in post for long periods, whether in the same organisations or in multiple ones. This study by researchers from the University of Manchester draws on interview data collected in 2019 with 10 long serving CEOs in the English NHS, with an average tenure of 17 years.
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Content ArticleThese tools and resources from the National Institute for Health and Care Excellence (NICE) accompany the NICE guidance on Hypothermia: prevention and management in adults having surgery. Resources available for download include: Audit and service improvement baseline assessment tool Implementation support advice document Education information Shared learning information Practical steps to improving the quality of care and services using NICE guidance
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Content ArticleThis report by the Institute for Fiscal Studies (IFS) looks at which staff are more likely to leave the NHS acute sector. There is still little analysis available on the reasons why staff leave the NHS, but increasing our understanding of the complex factors that cause people to leave the health service would allow the NHS to develop more effective retention strategies. The report uses the Electronic Staff Record, the monthly payroll of directly employed NHS staff, to analyse the leaving rates of consultants, nurses and midwives, and health-care assistants (HCAs) between 2012 and 2021. The authors highlight that many other factors that influence retention remain unknown, and much more research is needed in this area.
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Content Article
PHSO - Our strategy 2022 to 2025 (5 April 2022)
Patient-Safety-Learning posted an article in PHSO investigations
This document sets out the Parliamentary and Health Services Ombudsman's (PHSO) strategy 2022-25 and outlines its vision to be a voice for improvement in public services, providing an independent, impartial and fair complaints handling service. The document describes how PHSO will achieve its three strategic objectives: People who use public services have a better awareness of the role of the Ombudsman and can easily access our service People we work with receive a high quality, empathetic and timely service, according to international Ombudsman principles We contribute to a culture of learning and continuous improvement, leading to high standards in public service -
Content ArticleFormal evaluations of programmes are an important source of learning about the challenges faced in improving quality in healthcare and how they can be addressed. The authors of this narrative review in BMJ Quality & Safety aimed to integrate lessons from evaluations of the Health Foundation's improvement programmes with relevant literature. They argue that securing improvement may be hard and slow and faces many challenges, but formal evaluations assist in recognising the nature of these challenges and help in addressing them.
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Content ArticleThis report by the National Confidential Enquiry into Patient Outcome and Death (NCEPOD) examines the quality of care provided to patients aged 16 years and over who were admitted to hospital following an out-of-hospital cardiac arrest (OHCA). The report is based on the findings of a study that looked at the clinical care delivered to patients from the time of an OHCA to discharge from hospital or death. The review of the clinical pathway included the community and emergency service response, hospital admission and inpatient care (in particular cardiac and critical care services). Data were also collected to assess organisational aspects of care within acute hospitals.
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Content ArticleThis statement from Chair Peter Wyman addresses allegations of bullying and racism within NHS Blood and Transplant as reported in The Times on 21 August 2022. In the statement, Peter Wyman says, "I cannot overstate the importance we place in ensuring we have a strong, positive and inclusive culture so we can serve the public and patients who need us. “Issues of racism and bullying came to light in parts of our organisation two years ago after an in-depth staff listening exercise. We’ve moved on a lot in the past two years. Our actions have included providing a safe way for staff to raise and discuss issues by appointing a Freedom to Speak Up Guardian, improving recruitment processes to be more inclusive, matured how we manage conflict and grievances and refreshing our code of conduct so we all know the behaviours that are expected of us. We continue to measure progress through ongoing staff engagement. “We are making progress but like every good organisation we should always be challenging ourselves to do even better. In particular, I want to ensure we have a culture that enables each of us to be our best, that encourages everyone to speak up without fear or favour if they see something wrong or something which might be done better. I want a culture where everyone is valued for who they are and what they contribute. "There can be no place for any form of discrimination, bullying or harassment.”
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Content Article
AYPH Youth health data website
Patient-Safety-Learning posted an article in Children, young people and families
This website from the Association for Young People's Health (AYPH) aims to provide useful data about young people’s health for healthcare professionals, researchers and other professionals working with young people. At its heart is a data compendium called ‘Key Data on Young People’s Health’ produced AYPH, which gives up to date national data on key health outcomes for 10-24 year olds. The website also include links to other resources and sources of data about the key issues facing young people. -
Content ArticleThis NCEPOD report looks at the quality of care provided to patients with Parkinson’s disease (PD) aged 16 years and over who were admitted to hospital when acutely unwell. It highlights the findings of a review into the pathway of care for patients with Parkinson’s disease (PD) which explored multidisciplinary care and organisational factors in the process of identifying, screening, assessing, treating and monitoring their ability to swallow. You can view and download the following diagrams related to the report: Full report Summary report Summary sheet Recommendation checklist Infographic Slide set Commissioners' guide Fishbone diagram Recommendations Audit toolkit
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Content ArticleRecent data shows that people aged 10–25 in the poorest areas of the UK will die earlier than those in richer areas. It’s also predicted that people aged 10–14 living in the most deprived areas will live 18 more years in ill health than their peers in the least deprived areas. In this blog for The Health Foundation, Association for Young People's Health (AYPH) policy fellow Rachael McKeown outlines data recently published by AYPH that shows the scale and complexity of young people’s health inequalities, and the need for action.
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Content ArticleClinical governance can be defined as ‘the framework through which healthcare organisations are accountable for continuously improving the quality of their services and safeguarding high quality of care’. This article aims to provide an introduction to clinical governance based on UK practice. The article defines and examines how UK health systems priorities safe care, effective care, person-centred care and assured care.
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Content ArticleThis National Confidential Enquiry into Patient Outcome and Death (NCEPOD) report highlights the results of a study into quality of care received by people aged 0-24 receiving long-term ventilation (LTV). It aimed to identify remediable factors in the care provided to children and young people who were receiving, or had received, LTV.
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Content ArticleYoung people from different backgrounds with different lived experiences can have different physical and mental health outcomes. This briefing document by the Association for Young People’s Health (AYPH) offers a definition for health inequalities that is specific to young people, and a conceptual framework to help identify key causes and factors that influence health outcomes. As well as highlighting the impact of Covid-19 on young people's health and wellbeing, the paper focuses on different factors that will affect young people's health outcomes now and in the future, including education, employment, housing, geographical area, development of behaviours and relationships.
