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News Article
‘Ham-fisted’ IT rollout ‘threatens service disruption’
Mark Hughes posted a news article in News
NHS England is being warned that the planned rollout of a new “portal” for all NHS primary dental work could lead to widespread disruption. The NHS Dental Services Portal is proposed as a new digital system for managing all NHS dental contract administration, including how dental activity is recorded, validated and paid. It is being rolled out to modernise an old, fragmented process, with the aim of improving efficiency, transparency, and consistency. In an open letter sent to NHS Business Services Authority and NHSE, and shared with HSJ, the Dental Software Suppliers Association raised concerns about the speed of implementation being imposed. Read full article (paywalled). Source: Health Service Journal, 22 June 2026 -
Content ArticlePatient safety incidents (PSIs), defined as unintended or unexpected events that could have or did lead to patient harm, can have profound effects on general practitioners (GPs). Understanding how GPs experience and recover from PSIs is important for workforce wellbeing and patient safety in primary care. The aim of this study was to explore how GPs experience PSIs, how they move on, and how they use available support. Semi-structured interviews were conducted with 22 GPs. Data were analysed using thematic analysis. Three themes were generated: personal and professional consequences, recovery and learning processes, and barriers to healing. GPs described emotional responses, including guilt, self-doubt, and fear of reputational or regulatory consequences. Peer support was valued, but access to structured support was limited. Formal investigations were experienced as distressing and compounded emotional impact. Recovery and learning were facilitated by empathetic, systems-focused cultures, protected time for reflection, and structured opportunities to learn from incidents. Findings highlight importance of compassionate, non-punitive support systems and psychologically safe environments to enable recovery and promote learning.
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News Article
NHSE project to put FDP into primary care
Patient Safety Learning posted a news article in News
NHS England is exploring how to push the federated data platform into primary and community care. A document seen by HSJ reveals the FDP, of which controversial US firm Palantir is the main contractor, was last month being scoped for use in integrated neighbourhood teams. Shifting care to the community is one of the government’s priorities for the health service. It said the “minimum viable product capabilities that address user challenges and are technically feasible to build” were: A triage patient list to prioritise patient by urgency, complexity or eligibility for interventions Tracking and coordinating tool to “assign and track actions with explicit ownership and escalation routes, supported by targeted alerts” Tool to monitor patient outcomes. This would “compare patient progress to baseline and intervention goals and iterate model of care” The British Medical Association last year called for the NHS to move to a publicly owned alternative to Palantir. Asked about the move to involve the FDP in neighbourhood health, a BMA spokesman said: “It is essential that patients can trust that their data is safe and being used responsibly by institutions across the NHS. “To have that trust, patients need confidence not only in the technical safeguards but also in the regulations governing these organisations. If that trust is eroded, there is a real risk that patients who fear their personal health information may be misused could delay seeking care, withhold important information from clinicians, or avoid engaging with vital services altogether." Read full story (paywalled) Source: HSJ, 27 May 2026 -
Content ArticleHow do you create a strong foundation of primary and community care in neighbourhoods? The King's Fund brought together senior leaders from across health and care in England and Singapore to discuss the shift to population health, prevention and neighbourhood-based health and care.
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News Article
GP upgrades ‘stuck in layers of approval’
Patient Safety Learning posted a news article in News
A string of bureaucratic barriers are still holding up development of buildings for primary and community care, multiple NHS and industry organisations have warned. Concerns were raised in written evidence to the health and social care committee’s ongoing inquiry into what is needed from the NHS estate to deliver the government’s vision of a neighbourhood health service. Primary Health Properties PLC, the UK’s largest primary care property investor, said it has 19 planned developments of new health centres and around 20 upgrades to existing buildings serving more than 500,000 patients that are “currently stuck due to challenges with local NHS decision-making and agreeing a viable rent”. Rugby Primary Care Network also said the “health on the high street” concept had “completely stalled” in Rugby and was “costing thousands due to acquisition from private landlords”. Warwickshire District Council, meanwhile, said local community estate, including GP surgeries, was “antiquated and out of date”, adding: “What you have got for the most part isn’t good enough to do the job.” NHS organisations and industry sources have raised concerns in recent years over barriers to upgrading primary care premises. HSJ reported how debate over rent prices was contributing to an “untenable stalemate” back in 2024. The government is now seeking to develop and expand hundreds of primary and community facilities to create “neighbourhood health centres”, with some funded publicly and some by a new private finance programme. It issued guidance last week that asked ICBs to set out their planned schemes. Read full story Source: HSJ, 23 April 2026 -
News Article
NHSE rows back on controversial target
Patient Safety Learning posted a news article in News
NHS England has rowed back on what was widely understood to be a new target for the proportion of patients it wanted “diverted” away from waiting lists, after accusations it was rationing care. The controversy surrounds how NHS England plans to ramp up the “advice and guidance” (A&G) model, which allows GPs to seek pre-referral advice from specialist clinicians, and is designed in part to reduce referrals. NHSE guidance published just last month said it would roll out a new model involving a “single point of access” (SPoA), that would “contribute to a diversion rate of at least 25% by March 2027 for at least 10 high volume specialties” in each area. Diverted patients are those who, after the A&G process, are managed in primary or community care instead of being put on the waiting list for secondary care. The guidance was widely interpreted as a 25% diversion rate target for these cohorts of patients. This sparked concern and vocal opposition among GP leaders and patient groups, and accusations of care rationing. However, in a letter to primary care issued late on Wednesday, NHSE said: “There is no national target for specialists, trusts or general practice to divert a fixed proportion of referrals away from hospital care.” Read full story Source: HSJ, 22 April 2026 -
Content ArticleAdvice and guidance (A&G) enables dialogue between specialists and GPs before a referral is made. The aim is to ensure patients are managed in the right setting and to avoid unnecessary hospital referrals. A&G was first introduced as a formal pathway in 2015, so the concept itself is not new. However, its prominence as a policy lever is. The GP Contract 2026/27 outlines that GPs will be required to use A&G “prior to or in place of a planned care referral where clinically appropriate”. The Neighbourhood Health Framework goes further, stating an aim to achieve a “diversion rate of at least 25 per cent by March 2027 for at least 10 high-volume specialties”. This has not come without debate. Wes Streeting recently published a blog to “set out the facts” following media coverage alleging that A&G targets may lead to rationing of care. Transparency will be critical to evaluate whether increased use of A&G leads to better experiences and outcomes, says William Pett in this HSJ article.
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Content ArticleAdvice and Guidance (A&G) has been used in the NHS for years. It helps GPs get advice from specialists on a patient’s condition to decide the best course of treatment. The Department of Health and Social Care sets out the facts following media reports with a letter from the Health and Social Care Secretary Wes Streeting, published in the Daily Telegraph on 31 March.
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Content ArticleThe General Practice Requests for Advice and Guidance (A&G) is an enhanced service within the NHS that supports general practice teams to seek specialist advice from secondary care before or instead of making a planned care referral. This service is designed to support the Government's commitment to move more care from secondary into community settings. It aims to ensure patients receive care in the right place at the right time via the use of specialist advice and guidance by general practice. Participation is optional but practice that have signed up are eligible to claim payment for pre-referral A&G requests made since 1 April 2025. The Royal College of Practitioners (RCGP) proposes 6 key recommendations for the use of A&G which includes shared clinical risk between primary and secondary care and aims to ensure that advice and guidance continues as one option for clinicians within a referral process and must not be mandated. Further support for collaboration between primary and secondary care is essential to enable the backlog of care exacerbated as a result of the pandemic to be managed and streamline patient care. If work is to be transferred from secondary to primary care, via A&G, then resource (time, money and people) must follow the patient and not stay in secondary care. A&G should be optional and not mandated. Other tools to promote closer working between primary and secondary care aiming to streamline patient care are available and should be considered by providers as alternatives, allowing choice. These include direct telephone calls, emails, teledermatology and commercial apps that are able to connect primary and secondary care. Clinical care governance and risk must be shared between primary and secondary care during A&G conversations, and this must be understood by all clinicians and their patients when A&G is used. When using A&G, all clinicians must uphold the standards of good medical record keeping as per GMC advice, documenting decisions and actions, identifying who has made the decisions and is agreeing with the actions, in the patient clinical record. This should apply to both primary and secondary care and not rely solely on primary care updating the clinical records.
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Content ArticleThe government has published its much-awaited Neighbourhood Health Framework. It sets out in new detail what neighbourhood health aims to do and how this will be achieved, building on the 10 Year Health Plan, the Neighbourhood health guidelines 2025/26 and the Medium Term Planning Framework. The framework describes neighbourhood health as putting the person at the centre of how local services are organised and delivered – including GP and community services, urgent care and outpatients, as well as services commissioned by local authorities such as social care and public health. The new guidance brings some long-awaited clarity to commissioners and providers about what neighbourhood health should deliver. There is much to welcome. But questions remain around whether targets can ease pressures on the acute sector as well as improve patient care and experience; whether focus can be maintained on long term population health priorities among a plethora of specific shorter term delivery goals; whether permissiveness in designing local services and rigid structures can coexist; and, fundamentally, whether integrated care boards (ICBs) and other organisations have the capacity to action it all. In this King's Fund article, experts set out their more detailed analysis of the framework. They consider the parts to celebrate, the aspects that raise some concerns, what’s missing, and the questions that remain outstanding.
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Content ArticleThe 10 Year Health Plan for England envisions a major shift from hospital to community, towards the creation of a Neighbourhood Health Service. This is intended to bring care into local communities, convene professionals into patient-centred teams and end fragmentation. This policy paper, published by the Department of Health and Social Care, sets out how Integrated Care Boards (ICBs), local authorities, health and wellbeing boards and other partners should create and deliver neighbourhood health services. Neighbourhood health puts the person at the centre of how we deliver their health and care by organising services so they can work together to serve a defined population. This policy paper describes the aims of this approach as follows: Improve people’s health and care outcomes, reduce health inequalities and help them stay well at home This will be done by: focusing on prevention and proactive care management, including using data to effectively manage risk and prevent escalation strengthening primary and community services working better with specialists traditionally based in hospitals, public health, adult and children’s social care, VCSEs and other partners. Organise services around the person with more convenient, personalised and joined-up care Orientate services around a person’s needs, rather than organisational convenience. A strong digital approach will be critical to this. This includes: improving access to care (by phone, online or in person) moving more outpatient care from hospitals into neighbourhoods improving continuity of care for those with longer-term needs more effectively co-ordinating services for those with the most complex needs, for example, those at end of life. Reduce pressure on more acute services - including hospitals and care homes This will be done by: using effective neighbourhood working to decrease avoidable hospital admissions or attendances and facilitate timely discharge reducing the de-conditioning that happens to many people when they spend time in hospital reducing avoidable care home admissions ensuring acute services are focused on those who need them most. Cut waste and duplication This will be done by: integrating services across health, local government and wider partners making full use of digital opportunities ensuring the NHS is more sustainable.
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News Article
NHS has ‘hollowed out’ community care, says government adviser
Patient Safety Learning posted a news article in News
The NHS has “hollowed out” community and primary care and become a “national hospital service”, according to the influential lead of a government review of social care. Baroness Louise Casey, who is chairing an independent commission on reforming social care reporting to the prime minister, made her comments during a speech at the Nuffield Trust’s annual summit today. During her address she also criticised integrated care boards for paying private firms “to find ways to cut how they pay out Continuing Healthcare budgets” and allowing them to take a profit if they were successful. She said this was “quite astonishing”. The respected Whitehall trouble-shooter warned ministers she would be “watching” them to make sure Continuing Healthcare funding was not “sucked up into the world of acute hospitals”. She said: “It is my belief that we really have a national hospital service, not a national health service, and that may feel tough and may feel unfair, but that’s what it looks like to me… “As the NHS has evolved, it has withdrawn from the community, reducing the number of beds they offer other than for acute or specialised care, putting many more staff into hospitals whilst hollowing out the staff numbers in community and primary care provision.” Read full story (paywalled) Source: HSJ, 5 March 2026 -
Content ArticleIncreasing the amount of advice and guidance – where hospital specialists provide advice to GPs so that they can manage the patient without a referral to hospital – is a key part of ambitions to bring down NHS waiting lists. Lucina Rolewicz, Stuti Bagri and Sarah Scobie look at whether the target to increase advice and guidance is likely to be met, and what it might mean for those hopes that it will reduce waiting lists.
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Content ArticleFor many people, accessing care through general practice can feel like opening the door to a maze. Equally, GPs find themselves in a tangled web of administrative burdens, mounting time pressures and are navigating a maze of referrals to get patients specialist help when they need it. In this report, the Royal College of General Practitioners and the Patients Association to highlight how general practice can be made truly accessible and navigable for all. 1. Every patient should find the NHS easy to navigate The NHS must provide clear and consistent information to support patients as active partners in decisions about their healthcare, including knowing where to go to get help. Patients and GPs must be equal partners in co-designing care pathways so that they reflect their real experiences and needs and are easier for everyone to navigate. Patients with complex health or communication needs must be equally supported to navigate NHS services and participate as partners in decisions about their care. 2. Every patient should be able to see their GP when they need to Governments must set out clear plans to train, employ and retain enough GPs so that patients can access care from their GP when they need it, addressing both the workforce numbers, the employment structures and funding models that determine where and how GP’s can work. To make it easier for patients to see a GP who they know and knows them, practices should be resourced to offer continuity of care. 3. Every patient should be able to access their information and track referrals via user-friendly systems Patients and GPs must be equal partners in the design of simpler, user-friendly systems which allow patients to see key information about their care, including being able to easily track specialist referrals. This can only be achieved with significant government investment in systems that are easier to use, better connected, and that reduce administrative burden. A diverse and representative group of patients must be active and equal partners in the co-production and review of the systems, including those who cannot access online systems to mitigate digital exclusion.
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Content ArticleThe NHS Primary Care Patient Safety Strategy sets the ambition and vision for patient safety in primary care and encourages discussion and exploration across all primary care platforms. In February 2025, NHS England informed general practices that having regard to the primary care patient safety strategy and signing up for an administrator account with the Learn From Patient Safety Events (LFPSE) service would become a contractual requirement in 2025/26. This maturity matrix is a tool that is intended to help general practices understand where they are on their patient safety journey and what actions they can take to improve. It is also designed to aid Integrated Care Boards (ICBs) in understanding what might be considered as evidence of practices having taken due regard. Please note the full document at the link below can only be accessed when logged into the NHS Futures Collaboration Platform.
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News Article
Huge rise in number of people in England’s A&Es for coughs or hiccups
Patient_Safety_Learning posted a news article in News
Millions of people are turning to A&E departments in England for minor ailments including coughs, blocked noses and hiccups, according to data that health leaders say lays bare a failure to give patients prompt access to primary care. Emergency wards are designed for serious injuries and life-threatening emergencies only. But many are becoming swamped with patients whose health concerns should be dealt with elsewhere, including a near tenfold increase in people seeking help for a cough. Read full story Source: Guardian, 31 December 2025 -
Content Article
On 3 July 2025, the UK Government published its 10 Year Health Plan for England. In the following months there has been much commentary on the practical implications of this and how it will impact patient safety, and healthcare more broadly. This article brings together reflections from organisations and individuals on the Plan’s vision for the future of the NHS. The 10 Year Health Plan for England identifies four major challenges shaping the future of healthcare in England: An ageing population living with multiple health conditions. Changes in illness, with more than a quarter of the population having a long-term health condition. Higher public expectations of how the NHS should provide services. Increases in cost, with health spending in England meeting the Organisation for Economic Co-operation and Development (OECD) average but achieving worse outcomes. To take on these challenges, and act on the opportunities available, the 10 Year Health Plan reimagines the NHS through three radical shifts: 1. Hospital to community- envisioned by the initiation of “a historic expansion of provision in people’s neighbourhoods. By bringing more integrated services into local communities, patients will have more power to tailor care to their individual needs and more convenient access.” 2. Analogue to digital - transforming the NHS “from being a bricks and mortar service to a digitally led one, where patients can access care online and offline 24 hours a day, 365 days a year. By embracing the digital revolution, we will give patients the ability to control their appointments, choose their providers and access the help they need to manage their health and their care.” 3. Sickness to prevention - with a goal to “halve the gap in healthy life expectancy between the richest and poorest regions, while increasing it for everyone, and to raise the healthiest generation of children ever. This will boost our health, but also ensure the future sustainability of the NHS.” Commentaries on the Plan and its implications for the future of health and care Below are several different perspectives on the 10 Year Health Plan for England that we have added to the hub: Patient Safety Learning In our response to the Plan we highlighted that although it disappointingly does not recognise patient safety as one of its core themes, it does set out a welcome ambition to tackle some of the key underlying causes of avoidable harm. We sought to elaborate on this, setting out why patient safety needs to be at the core of the delivery of this new Plan. Much of the focus of our response concerns two of its three radical shifts: “Hospital to community” and “Analogue to digital”. Our response notes: In seeking to create a Neighbourhood Health Service, service redesign and plans should ensure that patient and staff safety is core to how care is delivered, unnecessary hospital admission is prevented and early discharge is supported. If the NHS is to become a fully digitally enabled service, patient safety will need to be at the heart of the introduction, implementation and operationalisation of new technologies and innovations, particularly AI-enabled care. A strong emphasis is placed on patient choice in the Plan, but relatively little is said about the role of patient and public involvement in shaping healthcare services—beyond engagement through new digital portals. Coupled with the proposed centralisation of patient experience functions within the Department of Health and Social Care there are valid concerns this could weaken the strength and independence of the patient voice. The absence of considering and responding to problems with NHS culture is a significant oversight in the 10 Year Health Plan. If the healthcare system is to truly be transformed over the next decade, then we cannot simply proceed by ignoring these issues or assuming they will resolve themselves. The Plan does not address the absence of systematic approaches to sharing learning about avoidable harm, the inadequacy of joined up approaches and user-centred design in solution development. Read more here. From analogue to digital: Tackling inequality and digital exclusion in the future NHS In this blog, Katie Heard from the Good Things Foundation considers the digital implications of the 10 Year Health Plan. She reflects on the benefits and risks for those who are digitally excluded, what more can be done and how existing resources can help support further progress. Read more here. Compassionate leadership and the 10 Year Health Plan: address moral injury In this blog Naja Felter and Alistair Thomson, noting the recognition of moral injury in the 10 Year Health Plan, make the case for compassionate leadership. They highlight there is ample evidence for the impact of this style of leadership in health and social care, including higher quality care, greater patient satisfaction, lower levels of workforce stress and burnout, and improved financial organisational performance. Read more here. Dazed and confused? Policy ideas behind the 10-Year Health Plan In this article, Phoebe Dunn, Nicholas Mays and Hugh Alderwick ask whether the 10-Year Health Plan is a coherent blueprint for ‘reimagining’ the NHS, or a collection of ideas pulling in different directions? They identify five policy ideas that seem to guide key proposals in the Plan, draw on evidence about their potential impact, and stand back to see what it all adds up to for the NHS. Read more here. Patient Power: energising the 10-Year Health Plan through patient partnership This is a video of a Patients Association online event that considered what needs to be done to ensure patient partnership is in the foundations of the 10 Year Health Plan. The session explored what meaningful patient agency looks like in practice, drawing on real-life insights from the Patients Association helpline and focus groups. Watch the recording. How will waiting times in community health services affect the shift towards neighbourhood health? Community services are under growing strain, with more than 1.1 million people waiting for care, and the steepest rise among children and young people. In this Quality Watch article, Jessica Morris notes that focus to date has largely been on efforts to improve waits for hospital care, but as neighbourhood health services are rolled out, addressing pressures on community services will be essential if the ‘hospital to community’ shift is to become a reality. Read more here. Podcast: Alan Milburn on the 10-year health plan In this podcast, The Health Foundation speaks to Alan Milburn about the future of the NHS and his thoughts on the government’s 10-Year Health Plan. Alan was Secretary of State for Health from 1999 to 2003, during the Blair governments, with his tenure seeing the development of the NHS Plan (2000) and record levels of investment. As Lead Non-Executive Director at the Department of Health and Social Care, Alan also had a hand in writing and developing the new plan. Read more here. What does the NHS 10 Year Plan mean for dementia? In this article, Alzheimer’s Research UK reflects on what the Plan means for people affected by dementia. It considers how it will potentially impact dementia diagnosis, new treatments, improving brain health and prevention. Read more here. Share your views with us What is your opinion on the 10 Year Health Plan? In the coming months we would like to feature more perspectives on how ideas and proposals flowing from this Plan are impacting how the NHS approaches patient safety. We would welcome your views and experiences of this. You can comment below (sign up to the hub first for free) or email the team directly at [email protected] to share your views. -
Content ArticleThis Review, published in the Lancet, considers the impact of AI applications on different domains of health-care quality–effectiveness, safety, timeliness, efficiency, patient-centred care, health-care provider experience, equity, and planetary health—and on the primary care-specific attributes of accessibility, comprehensiveness, coordination, and continuity.
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Content ArticleIn this blog for the Care Quality Commission, Professor Bola Owolabi, Chief Inspector of Primary Care and Community Services, discusses the State of Health and Adult Social Care in England 2024/25 report.
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Content ArticleThe estimated number of Americans who are medically disenfranchised—at risk of lacking access to primary care due to an inadequate supply in their local community—has nearly doubled since 2014. The insufficient number of primary care providers in the United States poses a serious public health threat, leaving nearly one-third of the population vulnerable to preventable chronic diseases and emerging threats like Covid-19 and influenza. This report describes America’s medically disenfranchised population and how, with expanded resources, Community Health Centers can begin to address gaps in primary care.
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Content Article
Stephen Heard is a Patient Safety Partner at Norfolk Community Health and Care Trust. He is also, as an RAF veteran himself, employed by Arden and GEM Commissioning Support Unit as one of a small part time team of regional leads for the Royal College of GPs (RCGP) veteran friendly accreditation scheme. In this blog, he explains how GP practices can support veterans and their families in ensuring they are and remain safe after transiting from the services into civilian life. He lists a number of services that veterans (anyone who has served at least one day in HM Forces) can be signposted to as part of their civilian care. Stephen emphasises that many veterans are vulnerable on transition and access to these programmes preferably via a veteran friendly GP practice can be critical to their safety. Research has shown that the first port of call for a veteran seeking help will often be the local GP practice. I would like to emphasise to you and your colleagues the significance of the Royal College of General Practitioners Veteran Friendly Accreditation Scheme for primary care, as endorsed by NHS England in alignment with the Armed Forces Covenant. The Veteran Friendly Accreditation Scheme shows staff at GP practices how to handle queries from the 2.4 million veterans nationally (+3m dependents) and signpost them to the most appropriate pathway or support group as per the list below: Op Restore: The Veterans Physical Health and Wellbeing Service provides specialist care and support to veterans who have physical health problems as a result of their time in the Armed Forces. https://www.england.nhs.uk/commissioning/commissioned-services/ Op Courage: The Veterans Mental Health and Wellbeing Service is a dedicated mental health service for individuals leaving the Armed Forces (those within 6 months of leaving the military in England), veterans and reservists. NHS commissioning » Nationally commissioned services (england.nhs.uk) or [email protected] Op Nova: Provides one to one non clinical support to veterans who are at risk of being arrested or already have been, are due to leave prison or have been released from prison. Op NOVA | Forces Employment Charity Op Community: Provides care navigation and signposting to the wider Armed Forces community with a specific focus on Serving families. www.armedforcesnetwork.org/armed-forces-community/families/single-point-of-contact/ Op Fortitude: Delivers a centralised referral pathway into veteran supported housing. www.riverside.org.uk/care-and-support/veterans/opfortitude/ Op Sterling: Programme to help older LGBT+ veterans, service personnel and their families. www.ageuk.org.uk/our-impact/programmes/how-we-deliver-advice/operation-sterling/ Veterans Prosthetics Panel (VPP): Funding on a named veteran basis to NHS Disablement Service Centres (DSC) to ensure that veterans who have service attributable limb loss can access high quality prosthetics. www.nhs.uk/nhs-services/armed-forces-community/veterans-service-leavers-non-mobilised-reservists/ Integrated Personal Commissioning for Veterans Framework (IPC4V): Delivers a personalised care approach for the small number of Armed Forces personnel who have complex and enduring physical, neurological and mental health conditions that are attributable to injury whilst in Service. www.england.nhs.uk/commissioning/armed-forces/integrated-personal-commissioning-for-veterans-ipc4v/ Personalised care for veterans. NHS England and the MOD have published a new personalised care approach for those veterans who have a long-term physical, mental or neurological health condition or disability. www.england.nhs.uk/personalisedcare/ipc-for-veterans/personalised-care-for-veterans/ There are also the following linked programmes: Veteran Aware: Operated by the Veterans Covenant Healthcare Alliance (VCHA) to improve NHS care for the Armed Forces community by supporting trusts, health boards and other providers (Acute, Community and Mental Health) to identify, develop and showcase the best standards of care. https://veteranaware.nhs.uk/ Step into Health: NHS Employers scheme to facilitate employment for service leavers and their families. https://www.militarystepintohealth.nhs.uk/ Veteran Friendly Framework: Designed to accredit care homes to improve their awareness of the needs for veterans. https://www.britishlegion.org.uk/get-involved/things-to-do/campaigns-policy-and-research/campaigns/veteran-friendly-framework Many Veterans are vulnerable and access to these programmes is critical to their safety. Integrated Care Boards will often have Veterans within the Core20plus5 NHS England Health Inequality Improvement framework, designed to reduce healthcare inequalities. -
Content ArticleThis is the second in a series of reports by the Health Services Safety Investigations Body (HSSIB) on the theme of healthcare provision in prison. The first investigation focused on the delivery of emergency care. This investigation looks at improving patient safety in relation to continuity of care for patients detained in prison. In the context of this investigation, ‘continuity of care’ means maintaining a patient’s healthcare throughout the prison system regardless of their location. The investigation considered the movement of patients between prisons, to and from court, and on release. It also looked at patient attendance at appointments for internal primary care services and secondary care outpatient appointments. Findings of this report include: ‘Did not attend’ (DNA) rates for outpatient appointments for patients in prison during 2024 were high, at 52% and 57% for males and females respectively. This compares to a DNA rate in the general population of 26% for both sexes. Female prison patients are often taken to outpatient appointments by male prison officers or a mix of male and female officers. This can affect the patients’ decision making about whether to go or not, particularly for appointments that are for sensitive female clinics such as obstetrics and gynaecology. The use of telemedicine in prison healthcare has declined since the end of the COVID-19 pandemic and it is used rarely in comparison to face-to-face appointments. Telemedicine has the potential to reduce the burden of prison officer escort duties for outpatient appointments (which costs £48m to £50m per year), increase the number of outpatient appointments available per day to patients in prison, and reduce the number of appointments that patients refuse to go to. Patients in prison may not attend pre-arranged appointments because of a lack of information about the appointment caused by privacy and security issues. For example, they may not be informed about timings, the nature of the appointment, or the health reasons and importance of attending. This means they are not able to make an informed decision about their health and whether they want to attend or not. Patients in prison are more likely to miss outpatient appointments than patients in the community, due to the prison regime and logistics beyond the control of the patient. Prison healthcare departments rely on relationships they have developed and maintained with hospital booking teams in order to arrange appointments that fit in with the prison regime. This is due to a lack of formal arrangements between prisons and their local hospitals. Patients who are released following a court appearance, who had treatment planned, are not routinely given information about upcoming appointments they may have. This means they may unknowingly miss booked appointments, delaying their care and treatment. Details about patients who are being transferred to different areas are not always communicated effectively between prison healthcare teams and hospital booking teams. Often hospital booking teams are not made aware that a patient has been transferred until an appointment is missed, which means treatment is delayed. In this report HSSIB recommends that: HM Prison and Probation Service updates Prison Service Order 3050, ‘Continuity of healthcare for prisoners’, including guidance on communication of information about prison patients when transferring between prisons, and on the process when prison patients are released from court. This will reduce variation and ensure better continuity of care for patients when being transferred or on their release. HM Prison and Probation Service standardises the approach to the provision of prison officer escorts for outpatient appointments to protect the dignity of patients and reduce variability of escort slots. This will assist in reducing the likelihood of patients refusing to attend healthcare appointments, while balancing appointment availability, thus improving the continuity and equality of care. NHS England, via regional commissioning teams, works with HM Prison and Probation Service to identify barriers to using telemedicine for outpatient appointments, and then implements local solutions to promote and enhance the capability and usability of telemedicine. This aims to reduce the burden on prisons of providing escorts and the likelihood of patients not attending appointments.
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Content Article
How nurses' uniforms impact aged care
Nick Warrick posted an article in Staff safety
Nurses’ uniforms play a vital role in aged care, influencing professionalism, patient comfort and care continuity. Inconsistent use or absence of uniforms can lead to confusion among staff and families, negatively impacting patient interactions and decision making. Uniforms also shape public perceptions, particularly in aged care facilities where professionalism fosters trust and reassurance among the elderly. Non-compliance with uniform policies poses challenges, from diminished team cohesion to overlooked enforcement. Practical, well-designed uniforms enhance nurses’ ability to perform tasks while ensuring comfort and movement flexibility. Policies supporting compliance—clear rules, consistent enforcement and resource allocation—are essential for maintaining standards. How nurses' uniforms impact aged care A major concern in the global nursing community is the impact of nurses' uniforms on patients and their families, especially aged care patients. Often, it is found that a lack of uniforms can cause confusion among care-givers and thus negatively impact patient-care decisions. Uniforms, or a lack thereof, also influence the public's perception of your professionalism. With hospital wards requiring high levels of compliance, unfortunately many healthcare workers are classed as non-compliant. Non-compliance includes failure to wear the correct uniform as well as more egregious infractions. The problem is not only found in public hospitals but also in private ones, where the care-giver takes the responsibility on themselves to ensure that their uniform is worn at all times. Importance of uniforms in aged care In aged care homes, while a lack of uniforms may not negatively impact patient care, it can negatively impact interactions between nurses. If a nurse does not have their uniform on, especially in an aged care home, the other nurses do not know who they are. This can break down the continuity of care. It can also lead to confusion for families and friends of the patients. It's also pretty clear that uniforms can make your facility seem more professional, especially among the aging population. That perception could go a long way to helping patients feel more comfortable. Non-compliance issues Non-compliance issues when it comes to uniforms may not be monitored very closely. This applies to everything from large hospitals to small aged care facilities. If the rules regarding uniforms are not enforced, the number of non-compliant care-givers will continue to grow and impact those living in the centre. Enforcing uniform policies is about more than just aesthetics. Wearing uniforms is for the practicality and comfort of the care-givers and patients. For example, nurses often have to lie on the floor or get onto their knees during a patient assessment, which is much easier when nurses wear a uniform that does not restrict movement. If requiring a specific uniform, it's important to set up the support and infrastructure to ensure the policy is being followed. This is often skipped over. Having clear policies, including consequences, will help. But you also need to dedicate sufficient resources to following up so the staff does not slip into bad habits. To make compliance easier for the staff, designing uniforms with them in mind is the first step. Of course, you'll want to design a uniform that is comfortable and allows them to perform their job well. You'll also want it to represent your particular branding and the image you wish to present. A uniform can be a one way to alleviate some of the difficulties that nurses face when performing their myriad tasks. With a custom uniform design, you can set your staff on the road to compliance and better patient care. -
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