An article reported a study that found that admission to hospital on weekend days was associated with a considerable increase in risk of subsequent death compared with admission on weekdays.
Source: Nick Freemantle et al., 'Weekend hospitalization and additional risk of death: an analysis of inpatient data', Journal of the Royal Society of Medicine, Volume 105 Issue 2
Links: Article | Abstract | BBC report
Date: 2012-Dec
An article said that the incidence of preventable deaths in acute hospitals in England was much lower than previous estimates. Nonetheless, 5.2 per cent of deaths were judged to have had a 50 per cent or greater chance of being preventable.
Source: Helen Hogan, Frances Healey, Graham Neale, Richard Thomson, Charles Vincent, and Nick Black, 'Preventable deaths due to problems in care in English acute hospitals: a retrospective case record review study', BMJ Quality & Safety, Volume 21 Issue 9
Links: Abstract | LSHTM press release | Newcastle University press release | Telegraph report
Date: 2012-Dec
A report presented data on the performance of National Health Service hospitals in England. 29 per cent of hospital beds were occupied by patients who were admitted to hospital unnecessarily and could have been treated elsewhere, leading to serious problems of overcrowding.
Source: Fit for the Future?, Dr Foster Ltd
Links: Report | Labour Party press release | NHS Confederation press release | RCN press release | RCP press release | BBC report | Guardian report | Telegraph report
Date: 2012-Dec
An article said that the introduction of pay for performance in all National Health Service hospitals in one region of England had been found to be associated with a clinically significant reduction in mortality.
Source: Matt Sutton, Silviya Nikolova, Ruth Boaden, Helen Lester, Ruth McDonald, and Martin Roland, 'Reduced mortality with hospital pay for performance in England', New England Journal of Medicine, Volume 367 Number 19
Links: Abstract | Manchester University press release | Telegraph report
Date: 2012-Nov
A paper examined whether greater competition between hospitals was associated with higher quality. The direction and strength of the association depended on the quality measure: there was a negative association between competition and some mortality indicators but not others, a positive association between competition and some readmission rates but not others, and a negative association between competition and patients' satisfaction. Further theoretical and empirical modelling was required.
Source: Hugh Gravelle, Rita Santos, Luigi Siciliani, and Rosalind Goudie, Hospital Quality Competition under Fixed Prices, Research Paper 80, Centre for Health Economics (University of York)
Links: Paper
Date: 2012-Nov
A report said that most National Health Service trusts were losing money on their accident and emergency services. The Department of Health should re-examine the policy of paying for some emergency admissions at 30 per cent of the standard tariff. The risks and responsibility for avoiding emergency admissions should be more fairly shared between acute trusts and primary and community care.
Source: Driving Improvement in A&E Services, Foundation Trust Network
Links: Report | Foundation Trust press release | Guardian report
Date: 2012-Oct
A think-tank report said that mergers of failing hospitals should be halted because this approach only worsened problems. Private firms and successful National Health Service trusts should instead be encouraged to step in when hospitals were in trouble.
Source: Paul Corrigan, John Higton, and Simon Morioka, Takeover: Tackling failing NHS hospitals, Reform
Links: Report | NHS Confederation press release | Public Finance report
Date: 2012-Sep
A report said that the demand on hospital services was increasing to the point where acute care could not keep pace in its existing form. There were one-third fewer general and acute beds than there had been 25 years previously: but the previous decade alone had seen a 37 per cent increase in emergency admissions. This was coupled with a change in patients' needs: nearly two-thirds (65 per cent) of people admitted to hospital were over 65 years old, and an increasing number were frail or had a diagnosis of dementia. Hospital buildings, services, and staff were often not equipped to deal with those with multiple, complex needs.
Source: Hospitals on the Edge? The time for action, Royal College of Physicians
Links: Report | RCP press release | Labour Party press release | NHS Confederation press release | Patients Association press release | RCOG press release | Guardian report | Public Finance report | Telegraph report
Date: 2012-Sep
A think-tank report said that 7,000 fewer emergency hospital beds would be needed by the National Health Service if all areas of England achieved the rate of admission and average length of stay for over-65s as those with the lowest use. This equated to a potential opportunity to reduce the number of overnight stays by 2.3 million per year and to reinvest £462 million a year in community and primary care services.
Source: Candace Imison, Emmi Poteliakhoff, and James Thompson, Older People and Emergency Bed Use: Exploring variation, King s Fund
Links: Report | Kings Fund press release | BBC report | Guardian report
Date: 2012-Aug
The competition watchdog for the National Health Service published a paper highlighting the types of actions taken by hospital trusts facing competition that were likely to improve the quality of the patient's treatment.
Source: Chris Pike, Inside the Black Box: How competition between hospitals improves the quality and integration of services, Working Paper 5, Co-operation and Competition Panel for NHS-Funded Services
Links: Paper
Date: 2012-Jul
An article examined new governance arrangements for National Health Service foundation trusts. It said that the trusts had failed to deliver social ownership and local accountability. Policy-makers should re-frame the governance apparatus associated with mutualism and social ownership in terms of the concept of 'meta-regulation'. This would help to steer foundation trusts towards sustainable forms of compliance via non-coercive, non-intrusive means.
Source: John Wright, Paul Dempster, Justin Keen, Pauline Allen, and Andrew Hutchings, 'The new governance arrangements for NHS foundation trust hospitals: reframing governors as meta-regulators', Public Administration, Volume 90 Issue 2
Links: Abstract
Date: 2012-Jul
A report said that National Health Service hospitals had substantial scope to improve their efficiency by adopting best practice – by tackling cases of 'inexplicable' higher costs or lengths of stay.
Source: James Gaughan, Anne Mason, Andrew Street, and Padraic Ward, English Hospitals Can Improve their Use of Resources: Analysis of costs and length of stay for ten treatments, Research Paper 78, Centre for Health Economics (University of York)
Links: Paper | York University press release
Date: 2012-Jul
A study (in three parts) examined the optimal number, size, and distribution of hospital services in Wales. It said that there was a strong case for re-configuring some hospital services. This had a positive aspect (patient outcomes could be improved) and a negative aspect (some services would collapse because of shortages of key staff) if changes were not made proactively. Although these problems had been developing over time, the need for change had become urgent in some key specialties, as levels of medical staffing became acute.
Source: Katie Norton, Marcus Longley, and Michael Ponton (with Amy Simpson and Susan Kimani), The Best Configuration of Hospital Services for Wales: A review of the evidence – Quality and Safety, Welsh Institute for Health and Social Care (University of Glamorgan) | Michael Ponton, Marcus Longley, and Katie Norton (with Amy Simpson and Susan Kimani), The Best Configuration of Hospital Services for Wales: A review of the evidence – The Workforce, Welsh Institute for Health and Social Care | Katie Norton, Marcus Longley, and Michael Ponton (with Amy Simpson and Susan Kimani), The Best Configuration of Hospital Services for Wales: A review of the evidence – Access, Welsh Institute for Health and Social Care
Links: Report (1) | Report (2) | Report (3) | Summary | WLGA press release
Date: 2012-May
An article examined the impact of hospital mergers in England on a large set of outcomes including financial performance, productivity, waiting times, and clinical quality. There was little evidence that mergers achieved gains other than a reduction in activity. Given that mergers reduced the scope for competition between hospitals, the findings suggested that further merger activity might not be the appropriate way of dealing with poorly performing hospitals.
Source: Martin Gaynor, Mauro Laudicella, and Carol Propper, 'Can governments do it better? Merger mania and hospital outcomes in the English NHS', Journal of Health Economics, Volume 31 Issue 3
Links: Abstract
See also: Martin Gaynor, Mauro Laudicella, and Carol Propper, Can Governments Do It Better? Merger mania and hospital outcomes in the English NHS, Working Paper 12/281, Centre for Market and Public Organisation (University of Bristol)
Date: 2012-May
An article examined whether hospitals with a good organization of care (such as improved nurse staffing and work environments) could affect patient care and nurse workforce stability in European countries. The percentage of nurses reporting poor or fair quality of patient care varied substantially by country. Nurses with better work environments were half as likely to report poor or fair care quality and give their hospitals poor or failing grades on patient safety. Each additional patient per nurse increased the odds of nurses reporting poor or fair quality care, and poor or failing safety grades. Patients in hospitals with better work environments were more likely to rate their hospital highly and recommend their hospitals. Results were similar in the United States of America. Improvement of hospital work environments might be a relatively low-cost strategy to improve safety and quality in hospital care and to increase patient satisfaction.
Source: Linda Aiken, Walter Sermeus, Koen Van den Heede, Douglas Sloane, Reinhard Busse, Martin McKee, Luk Bruyneel, Anne Marie Rafferty, Peter Griffiths, Maria Teresa Moreno-Casbas, Carol Tishelman, Anne Scott, Tomasz Brzostek, Juha Kinnunen, Rene Schwendimann, Maud Heinen, Dimitris Zikos, Ingeborg Stromseng Sjetne, Herbert Smith, and Ann Kutney-Lee, 'Patient safety, satisfaction, and quality of hospital care: cross sectional surveys of nurses and patients in 12 countries in Europe and the United States', British Medical Journal, 20 March 2012
Links: Article
Date: 2012-Apr
An article examined the external and internal governance of National Health Service foundation trusts (FTs), which enjoyed increased autonomy. It was found that it was easier to increase autonomy for public hospitals than to increase local accountability. Hospital managers were likely to be interested in making decisions with less central government control, whereas mechanisms for local accountability were 'notoriously difficult' to design and operate.
Source: Pauline Allen, Justin Keen, John Wright, Paul Dempster, Jean Townsend, Andrew Hutchings, Andrew Street, and Rossella Verzulli, 'Investigating the governance of autonomous public hospitals in England: multi-site case study of NHS foundation trusts', Journal of Health Services Research and Policy, Volume 17 Number 2
Links: Abstract
Date: 2012-Apr
A report said that the vast majority of hospitals had inadequate basic nursing establishments on older people's wards, and unsatisfactory arrangements to provide additional skilled support when needed at short notice. A linked report called for the introduction of mandatory nurse-to-patient ratios.
Source: Nicky Hayes and Jane Ball, Safe Staffing for Older People's Wards, Royal College of Nursing | Mandatory Nurse Staffing Levels, Royal College of Nursing
Links: Report (1) | Report (2) | RCN press release | NHS Confederation press release | BBC report | Guardian report | Nursing Times report
Date: 2012-Mar
An article examined the results of hospital reconfiguration, based on three case studies in the English National Health Service. Differences in implementation between the three cases reflected the nature of the proposed changes and local politics, rather than the strength of the evidence for change. National policy had tended to over-emphasize the importance of consultation using evidence, and had underplayed these influencing factors.
Source: Naomi Fulop, Rhiannon Walters, Perri 6, and Peter Spurgeon , 'Implementing changes to hospital services: factors influencing the process and "results" of reconfiguration', Health Policy, Volume 104 Issue 2
Links: Abstract
Date: 2012-Feb
A think-tank briefing examined the use of hospital beds for emergency admissions. More than 70 per cent of hospital bed days were accounted for by emergency admissions: using the beds more efficiently could save large sums of money and deliver benefits for patients. There was a particular need to cut the small but disproportionate number of old and very old patients who arrived as emergencies but ended up staying for at least a fortnight.
Source: Emmi Poteliakhoff and James Thompson, Emergency Bed Use: What the Numbers Tell Us, King s Fund
Links: Briefing | Guardian report
Date: 2012-Jan
The coalition government announced a series of measures designed to improve nursing care in hospitals in England. Nurses would be freed from 'non-essential paperwork and excessive bureaucracy' so that they could spend more time with patients. A new Nursing Quality Forum would look at how the best nursing practice could be spread throughout the National Health Service, and how nursing leadership on hospital wards could be strengthened. A new patient-led inspection regime would also be established, covering food, privacy, cleanliness, and dignity.
Source: Press release 6 January 2012, Department of Health
Links: DH press release | Conservative Party press release | Labour Party press release | RCP press release | Unison press release | BBC report | Nursing Times report
Date: 2012-Jan
An article examined the motivation for introducing activity-based funding for hospitals in European countries. The evidence available suggested that activity-based funding had been associated with an increase in activity, a decline in length of stay, and/or a reduction in the rate of growth in hospital expenditure in most of the countries under consideration.
Source: Jacqueline O'Reilly, Reinhard Busse, Unto Hakkinen, Zeynep Or, Andrew Street, and Miriam Wiley, 'Paying for hospital care: the experience with implementing activity-based funding in five European countries', Health Economics, Policy and Law, Volume 7 Special Issue 1
Links: Abstract
Date: 2012-Jan
A review of hospital efficiency found that there were 'many ways' in which hospitals could improve efficiency and reduce the need for cutbacks in services for patients. It cited length of stay and day surgery rates as examples of where there were still opportunities for efficiency to be improved.
Source: Jeremy Hurst and Sally Williams, Can NHS Hospitals Do More with Less?, Nuffield Trust
Links: Report | Nuffield Trust press release | BBC report
Date: 2012-Jan
An analysis found that hospital treatment in England was associated with improvements in health. Variability in treatment impact was generally more pronounced in respect of mobility, usual activity, and pain/discomfort than on others.
Source: Nils Gutacker, Chris Bojke, Silvio Daidone, Nancy Devlin, and Andrew Street, Analysing Hospital Variation in Health Outcome at the Level of EQ-5D Dimensions, Research Paper 74, Centre for Health Economics (University of York)
Links: Paper
Date: 2012-Jan
