A report said that only one-half (48 per cent) of high-risk surgical patients (those already known to be at an increased risk of death and post-operative complications) received good care in hospitals.
Source: George Findlay, Alex Goodwin, Karen Protopapa, Neil Smith, and Marisa Mason, Knowing the Risk: A review of the peri-operative care of surgical patients, National Confidential Enquiry into Patient Outcome and Death
Links: Report | NCEPOD press release | RCP press release | BBC report | Nursing Times report | Telegraph report
Date: 2011-Dec
A report examined major developments in the governance of public hospitals in Europe, and their implications for national and European health policy.
Source: Richard Saltman, Antonio Duran, and Hans Dubois (eds.), Governing Public Hospitals. Reform strategies and the movement towards institutional autonomy, World Health Organisation (Regional Office for Europe)
Links: Report
Date: 2011-Dec
A report by a committee of MPs said that it was 'clearly a very tall order' to expect that all hospital trusts would meet the coalition government's target of achieving foundation trust status by 2014. Most non-foundation trusts faced financial difficulties, strategic challenges, performance issues, and governance problems. 25 of them had declared that they would never make foundation trust status in their existing circumstances.
Source: Achievement of Foundation Trust Status by NHS Hospital Trusts, Sixtieth Report (Session 2010-12), HC 1566, House of Commons Public Accounts Select Committee, TSO
Links: Report | Kings Fund press release | NHS Confederation press release | BBC report | Guardian report | Public Finance report
Date: 2011-Dec
A report documented 'shocking' accounts of inadequate care received by patients in hospitals in England. It focused on communication, access to pain relief, assistance with toileting, and help with eating and drinking.
Source: We ve Been Listening, Have You Been Learning?, Patients Association
Links: Report | Patients Association press release | BGS press release | Labour Party press release | BBC report | Telegraph report
Date: 2011-Nov
An article examined evidence on the effects of hospital competition on quality of care within the English National Health Service, and considered whether it supported coalition government proposals to extend competition. More research was needed before conclusions could be drawn.
Source: Gwyn Bevan and Matthew Skellern, ' Does competition between hospitals improve clinical quality? A review of evidence from two eras of competition in the English NHS', British Medical Journal, 9 October 2011
Links: Extract
Date: 2011-Oct
Researchers examined whether competition in hospital services undermined socio-economic equity in the utilization of care in the English National Health Service. A negative association was found between market dispersion and elective admissions in deprived areas: the effect of pro-competition reform was to reduce this negative association slightly, suggesting that competition did not undermine equity.
Source: Richard Cookson, Mauro Laudicella, and Paolo Li Donni, Does Hospital Competition Harm Equity? Evidence from the English National Health Service, Research Paper 66, Centre for Health Economics (University of York)
Links: Paper | York University press release
Date: 2011-Oct
A paper used a new dataset of patient-reported outcome measures to assess the degree to which hospital cost variation was associated with variation in patients' health gain. It considered the extent to which judgements about hospital cost performance changed when health outcomes were accounted for. There were no substantial changes in estimates of cost performance when outcomes were explicitly accounted for.
Source: Nils Gutacker, Chris Bojke, Silvio Daidone, Nancy Devlin, David Parkin, and Andrew Street, Truly Inefficient or Providing Better Quality of Care? Analysing the relationship between risk-adjusted hospital costs and patients health outcomes, Research Paper 68, Centre for Health Economics (University of York)
Links: Paper
Date: 2011-Oct
The inspectorate for healthcare and social care said that a significant proportion of hospitals in England were failing to provide adequate basic care to elderly patients.
Source: Dignity and Nutrition Inspection Programme: National overview, Care Quality Commission
Links: Report | CQC press release | Labour Party press release | NHS Confederation press release | BBC report | Community Care report | Guardian report | Public Finance report
Date: 2011-Oct
An article examined the outcomes of elective surgery in independent sector treatment centres (ISTCs) and National Health Service providers. Patients undergoing surgery in ISTCs were slightly healthier and had less severe conditions than those undergoing surgery in NHS providers. But these differences reflected the fact that patients seen by ISTCs tended to be younger, in better health before their operation, and from more affluent areas than those seen by NHS hospitals.
Source: Jiri Chard, Maxine Kuczawski, Nick Black, and Jan van der Meulen, ' Outcomes of elective surgery undertaken in independent sector treatment centres and NHS providers in England: audit of patient outcomes in surgery', British Medical Journal, 19 October 2011
Links: Article | Abstract | RCS press release
Date: 2011-Oct
A think-tank report called for radical changes to improve the process for reorganizing hospital services, and to prevent politicians from blocking essential changes. The existing decision-making process for hospital reconfigurations was 'complex and bureaucratic', posing significant risks to the delivery of safe services.
Source: Candace Imison, Reconfiguring Hospital Services, King?s Fund
Links: Report | Kings Fund press release | RCP press release | Guardian report
Date: 2011-Sep
A think-tank report said that the government would have to spend an extra £5 billion on the National Health Service if it wanted to prevent 40 hospitals closing by 2013. A better model of healthcare delivery would involve a policy of 'no bailout'. The expectation that money would always be found to avoid the embarrassment of a hospital closure weakened the case for making necessary changes, and confused the incentives for everyone in the system.
Source: Paul Corrigan and Caroline Mitchell, The Hospital Is Dead, Long Live the Hospital, Reform
Links: Report | Reform press release | BBC report
Date: 2011-Sep
A paper examined the impact of the foundation trust policy on hospital performance. Foundation trusts generally performed better than other hospitals: but these differences appeared to be long-standing rather than an effect of the policy, and there was some evidence of a convergence in performance between foundation trusts and non-foundation trust hospitals.
Source: Rossella Verzulli, Rowena Jacobs, and Maria Goddard, Do Hospitals Respond to Greater Autonomy? Evidence from the English NHS, Research Paper 64, Centre for Health Economics (University of York)
Links: Paper
Date: 2011-Jul
A paper examined which factors mattered to patients and their family doctors when they chose a hospital for treatment. Many patients had a good choice of hospitals within a reasonable distance of where they lived, and nearly 4 in 10 patients chose not to receive treatment at their nearest hospital and instead travelled to a hospital further afield. Patients were more likely to choose a hospital if it provided higher-quality care; and they preferred hospitals with shorter waiting times, lower hospital-acquired infection rates, and lower overall mortality rates. The paper highlighted the importance of the family doctor in helping patients to choose the most appropriate hospital for treatment.
Source: Walter Beckert, Mette Christensen, and Kate Collyer, Working Paper – Volume 1 Number 4, Choice of NHS Funded Hospital Services in England, Co-Operation and Competition Panel for NHS-Funded Services
Links: Paper
Date: 2011-Jul
A paper estimated the performance of English National Health Service acute trusts for the years 1996-2008, based on health outcomes after elective treatment, using a latent variable approach.
Source: Irene Papanicolas and Alistair McGuire, Using a Latent Variable Approach to Measure the Quality of English NHS Hospitals, Working Paper 21/2011, LSE Health and Social Care (London School of Economics)
Links: Paper
Notes: Latent variables are not directly observed but are instead inferred using mathematical models.
Date: 2011-May
A new book examined neglect and abuse in the healthcare system, in particular in hospitals. Neglectful care was a 'systemic blight' – whereas policy and good-practice statements gave precisely the opposite message.
Source: Michael Mandelstam, How We Treat the Sick: Neglect and abuse in our health services, Jessica Kingsley Publishers
Links: Summary
Date: 2011-Apr
The older people's watchdog for Wales said that the treatment of some older people in hospital was 'shamefully inadequate'.
Source: Dignified Care? The experiences of older people in hospital in Wales, Older People s Commission for Wales
Links: Report | OPCW press release | BBC report
Date: 2011-Mar
A think-tank report examined whether reconfiguration of hospital services was an appropriate response to the need to drive up quality and drive down costs (based on analysis of proposed reconfiguration in south-east London). Market forces alone were unlikely to result in improvements in quality of care in many hospitals, and could result in deterioration in some cases. The proposed transfer of commissioning from primary care trusts and strategic health authorities to family doctor consortia increased the risks of deterioration in quality of care for some patients, and a widening of the quality gap between best and worst performers. There might be a need to consolidate services across hospital sites. Decisions about reconfiguration would need to balance improved healthcare outcomes against the potential costs of reduced competition and choice.
Source: Keith Palmer, Reconfiguring Hospital Services: Lessons from south east London, King's Fund
Links: Report | Summary | Kings Fund press release | BBC report | Public Finance report
Date: 2011-Mar
A think-tank report recommended deploying midwife-led care much more widely for women at a low and medium risk of problems: this could improve outcomes for women and babies, and reduce costs for the National Health Service.
Source: Jane Sandall et al., Staffing in Maternity Units: Getting the right people in the right place at the right time, King s Fund
Links: Report | Kings Fund press release | NCT press release | RCM press release | BBC report
Date: 2011-Mar
A report by a committee of MPs said that National Health Service spending had increased by 70 per cent over the decade from 2000-01 – but productivity had fallen by an average of 0.2 per cent a year, and by an average of 1.4 per cent a year in hospitals. National pay contracts were a key problem, and had not been used to manage staff effectively.
Source: Management of NHS Hospital Productivity, Twenty-sixth Report (Session 2010-11), HC 741, House of Commons Public Accounts Select Committee, TSO
Links: Report | CBI press release | Public Finance report
Date: 2011-Mar
A report examined ways of improving patients' experiences of hospital care. Well-informed patients who felt that they were listened to and were comfortable in their surroundings were less likely to develop complications or need readmission.
Source: Feeling Better? Improving patient experience in hospital, NHS Confederation
Links: Report | NHS Confederation press release | Public Finance report
Date: 2011-Jan
