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Found 61 results
  1. News Article
    Leaders of an integrated care system in the Midlands have warned they cannot make the scale of staffing cuts required to balance the books without putting patients at risk. Indicative analysis produced by Staffordshire and Stoke-on-Trent Integrated Care Board also found its provider trusts would have to cut 10 per cent of their workforce to break even. This would equate to 2,300 posts across University Hospitals North Midlands, Midlands Partnership Foundation Trust and North Staffordshire Combined Healthcare, while the ICB would have to cancel a “very high proportion” of third-sector contracts. The document says this “would bring our teams below safe staffing levels” and have a “profound effect on our ability to deliver safe services”. Read full story (paywalled) Source: HSJ, 23 April 2024
  2. News Article
    Hospitals are preparing to cut spending on doctors and nurses by hundreds of millions of pounds after being ordered to plug a £4.5 billion hole in the NHS budget. Chief executives at hospitals, mental health trusts and community services in England have been ordered to review staffing levels and draw up plans to close some services and merge others. They are also looking at banning or restricting the use of some agency workers. NHS bosses have been alerted in recent days to the scale of the cuts needed after negotiating financial plans for next year. The health service in England has a budget of £165 billion for the 2024-25 financial year, which starts next week. The budget rose by 3.2% in real terms between 2018-19 and 2023-24. Spending has been put under additional pressure by the cost of covering strikes by junior doctors which NHS England has said has cost more than £1.5 billion and affected more than 430,000 patients’ appointments. Saffron Cordery, deputy chief executive of NHS Providers, said services had been stretched by the need to pick up the pieces from a shortage of social care and other community services. She said an ageing population and poor public health meant patients in hospital were sicker and staying longer, needing more care. She said: “Trust leaders are being pushed to the very limits of what is possible, and there will be a situation where they have to make difficult choices about keeping basic services going versus investing in quality and improvement for the future. We are in a situation where we will be patching something that’s already a bit patched-together.” Read full story (paywalled) Source: Times, 31 March 2024
  3. Content Article
    Health Services Research (HSR) conceptual models examine the complexity and “basic science” of patient safety. HSR methods can help quantify patient safety problems, enhance their understanding, and develop and test solutions. However, preventable harm persists and even worsened during the pandemic. One reason is inadequate attention and investment in patient safety over the past two decades. Significant investments are still needed to measure the burden of different patient safety events across settings and to address emerging safety threats. Solutions need to be developed, evaluated, and implemented through rigorous research to ensure widespread, effective adoption. Multidisciplinary strategies are required both to mitigate safety threats before they lead to patient harm, and to close the implementation gap. Outside of AHRQ and VA funding, patient safety research in the United States is underfunded. Efforts to translate HSR to patient care, policy, and clinical practice is essential for patient safety improvements. These efforts require health services researchers to go beyond publishing a paper; they must work closely with healthcare organizational leaders, clinicians, policymakers, and patients to ensure their findings are acted upon, and to help propose and test solutions. The National Center for Patient Safety (NCPS) offers an excellent model to do so by funding dedicated patient safety centres of inquiry (PSCIs) nationally. PSCIs focus on research and implementation activities that promote organization-wide learning. The PSCI model adds significant value to creating a learning health system for safety that invests in patient safety data gathering, analysis, learning, and actionable improvements.
  4. Content Article
    Italian law No. 24/2017 focused on patient safety and medical liability in the Italian National Health Service. The law required the establishment of healthcare risk management and patient safety centres in all Italian regions and the appointment of a Clinical Risk Manager (CRM) in all Italian public and private healthcare facilities. Through a survey, this study in Healthcare looks at the law's implementation since it was passed five years ago. The results demonstrate that it has not yet been fully implemented, revealing: a lack of adequate permanent staff in all the Regional Centres, with two employees on average per Centre. few meetings were held with the Regional Healthcare System decision-makers with less than four meetings per year. This reduces the capacity to carry out functions. the role of the CRMs is weak in most healthcare facilities, with over 20% of CRMs have other roles in the same organisation. some important tasks have reduced application, e.g., assessment of the inappropriateness risk (reported only by 35.3% of CRM) and use of patient safety indicators for monitoring hospitals (20.6% of CRM). the function of the Regional Centres during the Covid-19 pandemic was limited despite the CRMs being very committed. the CRMs' units undertake limited research and have reduced collaboration with citizen associations. Despite most of the CRMs believing that the law has had an important role in improving patient safety, 70% of them identified clinicians’ resistance to change and lack of funding dedicated to implementing the law as the main barriers to the management of risk.
  5. News Article
    The UK’s National Institute for Health and Care Research (NIHR) has launched a £50m “Challenge” funding call to tackle inequalities in maternity care. The funding call aims to establish a research consortium to deliver research and capacity building over five years. The call was announced as part of the Department for Health and Social Care’s women’s health priorities for 2024. Recent evidence suggests that Black women in the UK are almost three times more likely to die during pregnancy or up to six weeks after pregnancy compared to white women. Asian women are twice as likely to die during pregnancy or shortly after, compared to white women. The new consortium is hoped to bring together experts across the UK to help change numbers like these. The research aims to focus on inequalities before, during and after pregnancy. According to NIHR, a key aim is to identify specific areas where measurable improvements can be made. Relevant charities, patient groups, community groups and the life sciences industry will be involved in the research where appropriate. Professor Marian Knight, scientific director for NIHR Infrastructure, said: “I am hugely excited about what this research can achieve – funding truly innovative approaches to tackle maternity inequalities will save women’s and babies’ lives – this is a challenge the NIHR is ideally placed to deliver.” Read full story Source: FemTech World, 15 March 2024
  6. News Article
    Local NHS organisations are facing intense “pressure” from NHS England’s national and regional teams to cut staffing numbers to improve the service’s financial outlook for 2024-25. Multiple sources have told HSJ that first draft financial returns submitted by the 42 integrated care systems indicate a combined deficit of around £6bn for the service. The £6bn figure is likely to fall substantially as NHS England meets individually with integrated care systems with the worst numbers. The need to reduce the number is prompting “horrible” conversations about service cuts, according to HSJ sources. One local leader in the South East region said the need to reduce staffing numbers constituted a “very significant part of the pushback on first-cut numbers”. A senior source in the Midlands added: “We’ve got virtually no workforce growth in our plan now… and we’ve still got a deficit. To get to breakeven we’d have to be looking at quite a significant workforce reduction.” Another leader in the South of the country said there was “big pressure” to get down to pre-pandemic staff numbers, “despite [the] increases in acuity, demand and backlogs as a consequence of covid”. Read full story (paywalled) Source: HSJ, 18 March 2024
  7. News Article
    At least 50,000 people will die from pancreatic cancer over the next five years unless the government gives more funding to improve how quickly the condition is diagnosed and treated, a major charity has warned. Pancreatic Cancer UK hit out at 50 years of “unacceptably slow progress” compared to other types of cancer as it warned that thousands of lives will be lost unless £35m of “urgent” investment is put towards improving survival rates of the disease. The charity predicted that pancreatic cancer – described by experts as the “quickest-killing cancer” – is expected to kill more people each year than breast cancer by 2027, which would make it the fourth-biggest cause of cancer deaths in the UK. The charity has also called for a commitment to treat everyone diagnosed with the cancer within 21 days, which it says would double the number of people getting treatment in time. Figures show that, compared to the 52.5% survival rate across the 20 most common cancers in the UK, those with pancreatic cancer have just a 7% survival rate. Around 10,500 people are diagnosed with the disease each year, with 9,558 deaths a year, according to Cancer Research UK, with more than half of people dying within three months of diagnosis. Read full story Source: The Independent, 12 March 2024
  8. News Article
    Almost £35 million will be invested to improve maternity safety across England with the recruitment of additional midwives and the expansion of specialist training to thousands of extra healthcare workers. The investment, which was announced as part of the Spring Budget 2024, will be provided over the next 3 years to ensure maternity services listen to and act on women’s experiences to improve care. The funding includes: £9 million for the rollout of the reducing brain injury programme across maternity units in England, to provide healthcare workers with the tools and training to reduce avoidable brain injuries in childbirth investment in training to ensure the NHS workforce has the skills needed to provide ever safer maternity care. An additional 6,000 clinical staff will be trained in neonatal resuscitation and we will almost double the number of clinical staff receiving specialist training in obstetric medicine in England increasing the number of midwives by funding 160 new posts over 3 years to support the growth of the maternity and neonatal workforce funding to support the rollout of maternity and neonatal voice partnerships to improve how women’s experiences and views are listened to and acted on to improve care. Health and Social Care Secretary Victoria Atkins said: "I want every mother to feel safe when giving birth to their baby. Improving maternity care is a key cornerstone of our Women’s Health Strategy and with this investment we are delivering on that priority - more midwives, specialist training in obstetric medicine and pushing to improve how women are listened to in our healthcare system. £35 million is going directly to improving the safety and care in our maternity wards and will move us closer to our goal of making healthcare faster, simpler and fairer for all." Read full story Source: Gov.UK, 10 March 2024
  9. News Article
    Health services for Londoners with eating disorders are struggling to cope with demand, a new report warns. Data from London's mental health trusts shows adult referrals have increased by 56% - from 3,000 to nearly 8,000 - in the last six years Child and adolescent referrals increased by 158%, from 1,400 to 4,000, in the same time period. The report has been compiled by the London Assembly's health committee. It has made 12 recommendations to London Mayor Sadiq Khan and City Hall officers, which include assessing other physical and mental health indicators as well as just patients' bodyweight as per their BMI. One consultant clinical psychologist told the committee that "almost all of the eating disorder services in London do not have the staffing levels available to safely provide the care required". Read full story Source: BBC News, 7 March 2024
  10. News Article
    NHS leaders have welcomed the £6bn budget boost Jeremy Hunt handed the beleaguered service to help it meet rising demand, tackle the care backlog and overhaul its antiquated IT system. The chancellor gave the NHS in England an extra £2.5bn to cover its day-to-day running costs in 2024/25, after the Institute for Fiscal Studies had warned that it was set to receive less funding next year than this. Julian Hartley, the chief executive of hospital body NHS Providers, said the money would offer “much needed – but temporary – respite” and “some breathing space” from the service’s acute financial difficulties, which have been exacerbated by inflation and the costs incurred by long-running strikes by NHS staff. However, there was little to stabilise England’s creaking adult social care system, and Hunt’s budget delivered an ongoing squeeze on resources, said the Association of Directors of Adult Social Services (ADASS). “Millions of adults and carers will be disappointed,” said Anna Hemmings, joint chief executive of ADASS. “Directors can’t invest enough in early support for people close to home, which prevents them needing hospital or residential care at a greater cost.” Read full story Source: The Guardian, 6 March 2024
  11. Content Article
    A new BMA report, “It’s broken” Doctors’ experiences on the frontline of a failing mental healthcare system", based on first-hand accounts of doctors working across the NHS, reveals a ‘broken’ system of mental health services in England. The current economic cost of mental ill health has been estimated to be over £100 billion in England alone*, but this report demonstrates that across the NHS, doctors are in an ongoing struggle to give patients the care they need because the funding is just not enough, there are not enough staff, and the infrastructure and systems are not fit for purpose. The report makes plain that without a concerted effort from central government to resource mental healthcare based on demand (which continues to grow beyond what the NHS can respond to) as well as changes in society to promote good mental health, the future looks bleak. The BMA carried out in-depth interviews with doctors across the mental health system, including those working in psychiatry, general practice, emergency medicine, and public health.
  12. Content Article
    The Scottish Government needs to develop a clear national strategy for health and social care to address the pressures on services, says a review by Audit Scotland. Significant changes are needed to ensure the financial sustainability of Scotland's health service. Growing demand, operational challenges and increasing costs have added to the financial pressures the NHS was already facing. Its longer-term affordability is at risk without reform.
  13. News Article
    Scotland's NHS is unable to meet the growing demand for health services, a spending watchdog has warned. A review by Audit Scotland said the increased pressure on the NHS was now having a direct impact on patient safety and experience. The watchdog also claimed there was no "overall vision" for the future of the health service. The annual report on the state of Scotland's health service highlighted that the NHS was facing soaring costs, patients were waiting longer to be seen and there were not enough staff. Stephen Boyle, Auditor General for Scotland, said this had "added to the financial pressures on the NHS and, without reform, its longer-term affordability". He added: "Without change, there is a risk Scotland's NHS will take up an ever-growing chunk of the Scottish budget. And that means less money for other vital public services. "To deliver effective reform the Scottish government needs to lead on the development of a clear national strategy for health and social care. "It should include investment in measures that address the causes of ill-health, reducing long-term demand on the NHS." Read full story Source: BBC News, 22 February 2024
  14. Content Article
    The King's Fund 'Mental health 360' aims to provide a ‘360-degree’ review of mental health care in England. It focuses on nine core areas, bringing together data available at the time of publication with expert insights to help you understand what is happening in relation to mental health and the wider context. The nine core areas covered are: Prevalence Access Workforce Funding and costs Quality and patient experience Acute mental health care for adults  Services for children and young people Inequalities Data.
  15. News Article
    Disrepair in NHS buildings led to thousands of potentially-harmful incidents last year including critically ill patients being moved when rainfall came through the ceiling. Sewage leaks, floods and failing equipment also featured in incident records obtained by the BBC under the Freedom of Information Act. Health chiefs called on the government to nearly double its capital spending. The government said "significant sums" had been invested to modernise the NHS. Heath Secretary Victoria Atkins said the government accepted that some hospital buildings "are not as we would wish them to be" but added that it was for NHS chief executives to decide how to spend the money. According to NHS data, the care of more than 2,600 acute hospital patients was disrupted last year by estates and infrastructure failure. The NHS Confederation, which represents trusts, has published a report setting out what health care leaders want the next government to prioritise. It has called on the government to increase capital spending on the health service from £7.7bn to £14.1bn. Matthew Taylor, its chief executive, said: "Put simply, a lack of capital funding can leave patients at risk." Read full story Source: BBC News, 21 February 2024
  16. Event
    until
    The landscape of the health and care system in England is challenging and complex, and the system is facing profound challenges. At this event, which will take place virtually over two days, policy and leadership experts from The King’s Fund will help you gain a greater understanding of how the health and care system in England works and how it is changing, giving balanced and honest views about the pressures and opportunities it faces. In the run-up to the anticipated general election, our experts will also explore which health and care topics are likely to dominate at the election and which are not, and what this means for people working in the sector.  Delegates will:  make sense of how the NHS is structured and funded learn how various components at system, place and neighbourhood levels come together to create integrated care systems (ICSs) gain an understanding of the key components of primary care and the role they play in the health care system hear about health inequalities and how groups from the voluntary, community and social enterprise (VCSE) sector support wider efforts to improve health inequalities gain a clear understanding of how the social care system is structured, who works in it, and how it is funded learn about the current pressures facing the health care workforce and what this means for the sustainability of the system have the opportunity, through a dedicated session, to ask any questions not answered throughout the event. Register
  17. News Article
    Health service dentistry in Northern Ireland could be caught in a "death spiral" without radical action, more than 700 dentists have warned. They say a combination of factors could make the service unsustainable. These include a potential ban on dental amalgam metals used in fillings, budget pressures and a "financially unviable contractual framework". The dentists have called on the Department of Health (DoH) "to show leadership and take action now". A DoH spokesperson said the department "valued the important role" of dentists and was "aware of the ongoing pressures on dental practices". In an open letter to Peter May, the top civil servant at the DoH, dentists from the British Dental Association (BDA) Northern Ireland warned that services were under "intolerable pressure". The letter said: "Despite clear evidence and repeated warnings issued by the BDA about the death spiral health service dentistry in Northern Ireland appears to be in, we have seen inaction from the authorities." The dentists added that a move away from health service dentistry was "well and truly underway" and dentists would "be increasingly driven out of health service dentistry to keep their practices afloat". Read full story Source: BBC News, 30 January 2024
  18. News Article
    People in some more rural areas are missing out on specialist treatments they should be getting, while Londoners are receiving a lot more than their “fair share”, new NHS England figures suggest. NHS England has suggested the main cause is “systematic shortfalls in access [in] remote communities”, leaving “unmet need” for specialised services in these areas. However other factors, including coding and reporting practices, year-to-year fluctuation, and weaknesses in the formula, are also likely to be confusing the picture, sources said. The variation is being uncovered now because NHSE is preparing to fund many specialised services via allocations to integrated care boards. These allocations will be based on estimates of their populations’ healthcare needs, rather than NHSE negotiating payments directly with provider trusts – as it has since 2013. Read full story (paywalled) Source: HSJ, 3 January 2023
  19. Content Article
    This observational cross-sectional study in the American Journal of Surgery aimed to quantify the association between US state trauma funding and both in-hospital mortality and transfers of injured patients. The authors concluded that Increased state trauma funding is associated with decreased adjusted in-hospital mortality and fewer interfacility transfers to a second acute care hospital.
  20. News Article
    The traditional model of NHS dentistry is gone for good, experts are warning. The Nuffield Trust think tank said the service had been cut back so much it was now at the most perilous position in its 75-year history in England. It said restoring services would probably need an unrealistic amount of money and called for radical reform, suggesting NHS support may need to be completely scaled back for some adults. The Nuffield Trust said funding for NHS dentistry had suffered huge cuts in recent years. Some £3.1bn was spent in 2021-22 - a drop of £525m since 2014-15 once inflation is taken into account. It said the number of treatments being done each year was now six million lower than it was before the pandemic. The Nuffield Trust said tough policy choices needed to be made, suggesting one option could be to start charging adults for the full cost of treatment beyond emergency work and check-ups. Shawn Charlwood, chairman of the British Dental Association's general dental practice committee, said the report "reads like the last rites for NHS dentistry" and that "patients and this profession deserve some honesty here". He added: "The government say NHS dentistry should be accessible for all who need it. "The plain facts are we're not seeing any evidence of the reforms or the resources to realise that ambition." Read full story Source: BBC News, 19 December 2023
  21. Content Article
    NHS-funded dental services in England are in near-terminal decline: nearly six million fewer courses of NHS dental treatment were provided last year than in the pre-pandemic year; funding in 2021/22 was over £500m lower in real terms than in 2014/15; and there are widespread problems in accessing a dentist. So what is to be done? This major new policy briefing from the Nuffield Trust proposes a series of short-term actions relating to appointment recall intervals, commissioning and the workforce. It also sets out two approaches for longer-term action, which involve improving the current dental model or adjusting the NHS offer.
  22. News Article
    The national clinical director for older people has announced he is leaving NHS England and said a major government funding settlement will be needed to maintain progress and take community services to the ‘next stage’. Adrian Hayter joined NHSE in 2019 as NCD for older people and integrated person centred care. Dr Hayter, who is also a longstanding GP partner in Berkshire, said community services were now much more prominent at NHSE — and in its asks of the service – than they were four years ago. He said: “When I first came in, there wasn’t very much in planning guidance about what was happening in the community at all. Now that is different and we are expecting a range of initiatives in 2024. “But the future is that all of these things are not individual programmes - they’re all part of a particular approach to how we manage and support people for as long as possible in their own homes. “Urgent community response [where services are required to respond within two-hours to urgent needs, referred from a range of services] and virtual wards are a continuum of care. “And the growth of virtual wards have helped extend what happens in the community all the way through to the acute level care.” National long-term funding for several of the new services – badged in the 2019 long-term plan as “Aging Well” – is also now due to end, with integrated care boards instead asked to commission them locally. Dr Hayter warned that, as well as moving those services closer together, there needed to be a future government spending review settlement aimed at growing community services, to meet the needs of the rapidly ageing population. Read full story (paywalled) Source: HSJ, 18 December 2023
  23. Content Article
    This toolkit from the Institute from Healthcare Improvement (IHI) equips patient safety and finance leaders with tools and a collaborative approach to make a compelling business case for organizational investments to advance patient and workforce safety initiatives.
  24. Content Article
    What is the impact of the poor condition of equipment and buildings? In September, the Chief Financial Officer of NHS England, Julian Kelly, told the Public Accounts Committee that every day ‘hospitals are having to shut units and decant patients into other spaces’. St Peter’s Hospital in Essex, a former Victorian workhouse, has had to relocate some inpatient services to other hospitals this winter amid issues with a leaking roof, weak flooring and broken lifts. And Queen Elizabeth Hospital in King’s Lynn has more steel props to stop RAAC (reinforced autoclaved aerated concrete) collapsing in its buildings than it does hospital beds. Underinvestment impacts the delivery of care, causing disruption for patients, and adding to the burden on staff who have to negotiate working in dilapidated buildings on top of their workload.  
  25. News Article
    The NHS in England has a record repair bill of almost £12bn, new figures show, with ministers needing to find more than £2bn for urgent maintenance to prevent catastrophic failure. The annual report on the condition of the health service’s estate said on Thursday that the cost of improving rundown buildings and decrepit equipment was two and a half times larger than in 2011-2012, when it stood at £4.7bn. The cost of the “high-risk” backlog – situations where the need to repair or replace facilities and equipment must be urgently addressed to prevent serious failure, significant injury or major disruption to clinical services – rose by almost a third to a record £2.4bn. This was £0.3bn in 2011-2012. However, investment to reduce the backlog fell in the last year from £1.41bn to £1.38bn, a fraction of what is needed to restore the NHS estate back to acceptable levels of risk. The stark figures cover a time prior to the health service becoming embroiled in the crumbling concrete crisis which initially hit school buildings. Sir Julian Hartley, the chief executive of NHS Providers, said that “too many NHS buildings are quite simply falling to bits”, and that we need “a step change in the government’s approach to planning and funding essential capital investment in the NHS”. He said: “The eye-watering cost of trying to patch up creaking infrastructure and out-of-date facilities is mounting at an alarming rate. “Mental health, hospital, community and ambulance services are crying out for much-needed funding for critical projects to overhaul ageing estates and to give patients and staff the safe, reliable conditions they need." Read full story Source: The Guardian, 14 December 2023
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