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Healthcare Excellence Canada 2023-24 impact report highlights how they have supported people from across the country to deliver measurable impact in diverse care settings across the country—working with hundreds of individuals and organisations to deliver programmes involving 1,087 teams that serve more than 920,000 patients and residents each year. Learn more about how Healthcare Excellence Canada (HEC) works to spread innovation, strengthen capabilities and catalyse policy change to support large-scale system improvement, from supporting the healthcare workforce to improving access to healthcare to fostering cultural safety.

New research from Healthwatch shows that people are currently facing multiple cancellations or postponements of care which are having a significant impact on their lives and symptoms, while further increasing health inequalities.   Healthwatch cmmissioned a survey of 1084 people who have seen their NHS care either cancelled or postponed this year to understand the extent of disruption to care amid rising waiting lists, workforce issues, and industrial action, and other pressures on the NHS.   Key findings Over one in three, 39%, have had their NHS care cancelled or postponed two or more times this year. This has included hospital operations, tests, scans, outpatient appointments, and community health service appointments. Nearly one in five (18%) of the respondents have had their care cancelled or postponed at the last minute, which the NHS defines as on the day of or on arrival to an appointment. And almost half, 45%, experienced a cancellation with between one- and seven-days notice. Two-thirds of the respondents, 66%, said cancellations to care had impacted their lives, reporting ongoing pain, worsening mental health, worsening symptoms, and disrupted sleep, among many other problems. NHS pressures widen existing health inequalities Disruptions to care disproportionately affect certain groups, widening existing health inequalities. People who have greater health needs are still facing serious barriers to timely care, and they are also more likely to be more affected by cancellations of care. Unpaid carers, 84%, and neurodivergent people, 83%, were more likely to report negative impacts of cancelled care on their lives, followed by people on low incomes, 80%; and those from minority ethnic backgrounds, 75%. Groups who were more likely to have had two or more NHS postponements or cancellations included disabled people, 52%; neurodivergent people, 51%; and people on lower incomes, ethnic minorities and LGBTQ+ being affected the most, 49%, respectively. The survey also found: More than three-quarters, 79%, of the respondents said the NHS had offered them ‘very little’ or ‘no support’ to manage their mental health risks. More than half, 52%, said they hadn’t been offered support to manage their medical condition during the new wait for care, 24% had had ‘a lot’ or ‘some’ support and 21% said ‘a little’ support. One in seven,15%, were told their care had been cancelled due to industrial action in the NHS, while nearly a quarter, 24%, believed strike action was the reason, though they had not been told this. Nearly half, 41%, said their care was cancelled for another reason; and 20% didn’t know why. Healthwatch calls to action Collect and publish official data on cancellations to understand what is driving non-clinical, clinical or patient-led reasons for delays; Use this data to reduce the high number of last-minute cancellations; Offer more significant support to those most affected by new delays, especially with mental health needs; and Improve administrative processes and communications to close the gap for those who are left in limbo with no new date.

This review covers the impact the Eastern AHSN has delivered throughout the East of England and beyond in 2022/23, including an increased focus on fostering an innovation culture, tackling health inequalities, and supporting innovators to turn their ideas into positive health impact.

National Education for Scotland research and evaluation work has shown wide variations in the standard of significant event analysis (SEAs) undertaken by frontline healthcare teams. The direct implication is that there are many missed opportunities to learn from and improve the safety of patient care. As a consequence, NES developed a robust educational model to enable clinicians, managers and healthcare teams to submit SEA reports for feedback from trained peer groups.

In 2024, the UK’s Chartered Institute of Ergonomics and Human Factors (CIEHF) celebrates its 75th anniversary. To mark the occasion, this article presents the perspectives of 18 Ergonomics and Human Factors (EHF) professionals who were asked to respond to five questions regarding the impact of EHF, contemporary challenges and future directions. The co-authors were in agreement that EHF’s impact has been limited to date and that critical issues need to be resolved, such as: increasing the number of suitably qualified practitioners resolving the research-practice gap increasing awareness of EHF and its benefits. The professionals who took part highlighted the following future directions: advanced emerging technologies such as artificial intelligence the development of new EHF methods enhancing the quality and reach of education and training. The majority felt there will be a need for EHF in 75 years, but many noted that methods will need to adapt to meet new needs.

Healthcare staff deliver patient care in emotionally charged settings and experience a wide range of emotions as part of their work. These emotions and emotional contexts can impact the quality and safety of care. Despite the growing acknowledgement of the important role of emotion, we know very little about what triggers emotion within healthcare environments or the impact this has on patient safety. This systematic review explored the workplace triggers of emotions within the healthcare environment, the emotions experienced in response to these triggers, and the impact of triggers and emotions on patient safety. The various triggers of emotion and the types of emotion experienced that have been identified in this review can be used as a framework for further work examining the role of emotion in patient safety. The findings from this review suggest that certain types of emotions (including fear, anger, and guilt) were more frequently experienced in response to particular categories of triggers and that healthcare staff's experiences of negative emotions can have negative effects on patient care, and ultimately, patient safety. This provides a basis for developing and tailoring strategies, interventions, and support mechanisms for dealing with and regulating emotions in the healthcare work environment.

As the USA's largest health insurer, the Centers for Medicare & Medicaid Services (CMS) has established quality standards, metrics, and programmes to improve healthcare not just for the 170 million individuals supported by its programmes, but for all Americans. The 2024 National Impact Assessment of CMS Quality Measures Report (Impact Assessment Report) assesses the quality and efficiency impact of measures endorsed by the consensus-based entity and used by CMS. The report findings suggest that improvements in measure performance are associated with patient impacts and costs avoided for select CMS healthcare quality priorities and programmes, particularly prior to the Covid-19 pandemic. During 2020 and 2021, a relatively large proportion of measures had worse than expected performance, including significant worsening of key patient safety metrics. Covid-19 created challenges for most health systems that limited capacity to sustain improvement for certain priorities and goals during a pandemic. CMS continued progress in increasing the proportion of outcome measures and reducing burden through use of fewer measures across the portfolio. Persistent health equity gaps for historically disadvantaged groups were identified for the vast majority of measures analysed, and perspectives from focus groups underscored the critical need to develop equity measures that address bias in care delivery and deficits in cultural competency, unmet health-related social needs, access, and health literacy.

The aim of this study was to investigate the incident reporting process (IR1s), to calculate the costs of reporting incidents in this context and to gain an indication of how economic the process was and whether it could be improved to yield better outcomes. A retrospective analysis of a sample, 10.47% (n=150) selected from 1432 medication incident report summaries, generated at Birmingham Children's Hospital, a specialist tertiary referral paediatric centre, during 2014 and collated through the national Datix incident reporting system software was analysed and the associated staff time required to complete each step of the incident reporting process was costed. The staff costs for various grades of staff were averaged across the staff actually involved, using data calculated by the Personal Social Services Research Unit. The analysis showed that the incident reporting process involved 262 staff on 2942 occasions (19.16 staff episodes per incident form completed) at a cost of £337.16 per incident form completed. The study showed that the incident reporting system was a labour intensive process. The numbers of staff involved in the process particularly as a result of the email distribution activity did appear to have room for efficiencies. However, it proved to be relatively inexpensive from a cost perspective. With redesign, arguably the emphasis could be moved away from the recording process to learning in order to gain improved patient safety outcomes.

The Covid-19 pandemic led to unprecedented healthcare disruption across the UK. In England, the number of patient referrals waiting to be treated in hospital was more than 7·2 million at the end of October, 2022. In response, the UK Government set up an elective recovery taskforce (ERT) in December, 2022, to help NHS England tackle this backlog. Ahmar Shah and colleagues estimated the extent of healthcare disruption during the Covid-19 pandemic to aid decision making regarding the necessary capacity increases that are required to address the ensuing backlog. The study, published in The Lancet, found NHS waiting list for elective treatment increased between 1 Jan 2012, and the start of the Covid-19 pandemic, suggesting a gradual service decline. The waiting list then substantially increased during the pandemic, but this substantial increase is likely to represent a substantial underestimation of the backlog because of the anticipated large numbers of people who have still not come forward for care. Even if the ambitious target of 30% increase in capacity is achieved during the next 3 years, several years (beyond the end of 2025) will be needed for the backlog to clear. This study emphasises the need to improve health-care system resilience to ensure that the effects of any future emergencies on the provision of routine care are minimised.

In this analysis, the Health Foundation looks at the outlook for health funding following the 2022 Autumn Statement, draws out some implications for clearing the NHS estate maintenance backlog and looks at the potential impact of pay and other cost pressures on NHS spending power.  Key points The 2022 Autumn Statement saw the Chancellor promise an extra £3.3bn for the NHS and £1.4bn for capital investment in 2023/24 and 2024/25. In cash terms, spending in 2024/25 will be almost £14bn higher than in 2022/23. Much of this additional spending will be needed to meet inflation. After accounting for inflation, real-terms funding in 2024/25 will be £6bn higher than in 2022/23. This means that in real terms, core day-to-day spending on the NHS will rise by 2% a year by 2024/25, while capital spending will grow by just 0.2%. Overall, the Department of Health and Social Care’s funding settlement will increase by 1.2% a year in real terms over the next 2 years. This is higher than planned at the last Spending Review but far below the 3.6% long-term average growth rate. The NHS continues to face rising cost pressures that will erode the spending power of this settlement, with pay being the most significant. Health service inflationary pressures may be higher than the government estimates through the central GDP deflator forecast. The different methods used to estimate inflation for the whole economy show that the buying power of this settlement is uncertain. The unknown outcome of future pay negotiations and volatility in the cost of other key inputs add further uncertainty around the actual cost pressures the health care sector will face.

This study in JAMA Health Forum aimed to assess the costs of inpatient falls and cost benefits associated with the Fall TIPS (Tailoring Interventions for Patient Safety) Program. The authors carried out an economic evaluation across a large cohort of 900,635 patients. The average total cost of a fall was $62 521 ($35 365 direct costs), and injury was not significantly associated with increased costs. The Fall TIPS Program was associated with $22 million in savings at study sites across the five year study period. The findings of this study indicate that implementation of cost-effective, evidence-based safety programs was associated with lower cost and care burdens associated with inpatient falls and are a step toward safer, more affordable patient care.

A themed review may be useful in understanding common links, themes or issues within a cluster of investigations or incidents. It will seek to understand key barriers or facilitators to safety using reference cases (e.g. individual datix incidents or previous investigations).  Dr Sam Machen shares her thematic review template, which can be downloaded below.

This report sets out the impact the Point of Care Foundation’s programmes have had on people who use and deliver health and care services, in its mission to humanise healthcare.