A report examined the experiences of older people in care homes and hospitals, primarily in England and Wales. It examined the provision of care, and the steps that could be taken to help prevent the mistreatment of staff, residents and patients. It said that older people received good and excellent care, but it sometimes suffered from a lack of resources, poor organization, and environmental risks. It said many care staff worked in stressful conditions, but that some showed disrespectful and patronizing attitudes towards older people. The report made recommendations.
Source: Carol Lupton and Clare Croft-White, Respect and Protect: The experience of older people and staff in care homes and hospitals, Comic Relief
Links: Report | Summary | Comic Relief press release | UEA press release | CQC press release
Date: 2013-Dec
A report said that over half of London's major accident and emergency departments failed to meet the government's four hour waiting target at least 50 per cent of the time. It raised immediate concerns about provision during the winter months and called for plans to be published. It also called for a longer term, London-wide rethink of provision.
Source: London Assembly Health Committee, Risks to London A&E Services This Winter, Greater London Authority
Links: Report | GLA press release
Date: 2013-Nov
The government responded to a report by a committee of MPs on the Mid Staffordshire National Health Service Foundation Trust inquiry. Two further volumes were published alongside it, which built on the government's initial response and provided more detailed responses to the recommendations from the public inquiry.
Source: The Government Response to the House of Commons Health Committee Third Report of Session 2013-14: After Francis – making a difference, Cm 8755, Department of Health, TSO
Links: Response | MPs report | Cm 8754 I | Cm 8754 II | DOH press release | NHS England press release | NICE press release | CQC press release | Health Service Ombudsman press release | GMC press release | RCN press release | RCM press release | AMRC press release | RPS press release | King's Fund press release | Alzheimer's Society press release | BBC report | Telegraph report | Guardian report
Date: 2013-Nov
A study examined the impact of 'virtual wards' on hospital admissions and other, community based, health and social care services. 'Virtual wards' were designed to use the staffing and systems of a hospital ward to deliver preventive care to patients in their own homes. The study found no evidence of a reduction in emergency hospital admissions, and no evidence of impact on mortality, compared with matched cases from a national sample. There was a reduction in elective hospital admissions and in outpatient attendances in the six months after starting the intervention. The study noted that the three participating sites used different models of 'virtual wards' and raised methodological questions.
Source: Geraint Lewis, Theo Georghiou, Adam Steventon, Rhema Vaithianathan, Xavier Chitnis, John Billings, Ian Blunt, Lorraine Wright, Adam Roberts, and Martin Bardsley, Impact of Virtual Wards on Hospital Use: A research study using propensity matched controls and a cost analysis, National Institute for Health Research
Links: Report
Date: 2013-Nov
A report examined the implementation of seven day consultant present care in the National Health Service across the United Kingdom. It said that changing practices would have resource implications in hospital, primary care and community settings that would require services to be reshaped and reallocated. It said that workforce flexibility and optimal value could be gained by employing more generalist consultants to lead multi-disciplinary teams. It called for in-depth financial modelling of the resource implications.
Source: Seven Day Consultant Present Care: Implementation considerations, Academy of Medical Royal Colleges
Links: Report | AMRC press release
Date: 2013-Nov
A government-commissioned report examined the National Health Service hospital complaints system and made recommendations to the government.
Source: Ann Clwyd and Tricia Hart, A Review of the NHS Hospitals Complaints System: Putting patients back in the picture, Department of Health
Links: Report | DH press release | BBC report | Guardian report | Telegraph report | RCN press release | Ombudsman press release | NHS England comment
Date: 2013-Oct
A report described the working practices of consultants and other senior decision-makers in emergency departments, the pressures they faced, and the impact on their working lives.
Source: Tajek Hassan, Ben Walker, Magnus Harrison, and Fiona Rae, Stretched to the Limit: A survey of Emergency Medicine consultants in the UK, College of Emergency Medicine
Links: Report | CEM press release | Guardian report | Telegraph report | BBC report | Work Foundation comment | BMA press release
Date: 2013-Oct
An audit report said that more people who attended accident and emergency departments were now being admitted to hospital. It said that there was a range of explanations for this, but that the trend needed to be actively managed. It said that the Department of Health, NHS England, and the hospitals regulator should work to align incentives and remove barriers across the health system.
Source: Emergency Admissions to Hospital: Managing the demand, HC 739 (Session 2013-14), National Audit Office, TSO
Links: Report | NAO press release | Alzheimer's Society comment
Date: 2013-Oct
A commission report made 50 recommendations aimed at improving care for acute medical patients. It called for a radical restructuring of the hospital wards where acutely ill patients were treated, together with a new organizational and management structure whose responsibilities for acutely ill medical patients would stretch out from the hospital into the wider community, developing the idea of a local healthcare system.
Source: Future Hospital Commission, Future Hospital: Caring for medical patients, Royal College of Physicians
Links: Report | RCP press release (1) | RCP press release (2) | AMRC press release | FTN press release | Kings Fund press release | NHS Confederation press release | NHS Employers press release | NHS England press release | RCGP press release | RPS press release | BBC report | Guardian report | Telegraph report
Date: 2013-Sep
The coalition government set out plans to help prevent future failures of care and safety at National Health Service hospitals in England. In future, hospital trusts placed in 'special measures' would have their freedom to operate as autonomous bodies suspended. Trusts that aspired to become foundation trusts would in future no longer be able to do so unless and until they had been rated as 'good' or an 'outstanding' by the healthcare inspectorate. Hospitals with the highest standards of patient care and safety would help those that had problems: each trust in special measures would be partnered with one of the best trusts in 'improvement contracts'.
Source: Press release 19 September 2013, Department of Health
Links: DH press release | RCN press release | BBC report | Guardian report
Date: 2013-Sep
A report said that a new 'quality mark' should be introduced to help hospitals provide the best quality of care for older patients.
Source: Response to the Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry, Royal College of Physicians
Links: Report | Summary | RCP press release
Date: 2013-Sep
A think-tank report examined the role of governors in National Health Service foundation trusts. It considered how they fitted within the overall governance of the Trusts, and how effective and representative councils of governors were.
Source: Effective and Representative? A review of NHS foundation trusts councils of governors, Smith Institute
Links: Report
Date: 2013-Sep
The competition watchdog said that many private hospitals faced little competition in local areas, leading to higher private medical insurance premiums and charges for private patients. It also highlighted restrictions on competition resulting from incentive schemes that encouraged consultants to choose particular private providers for diagnosis and treatment, and the lack of available information on the performance of hospitals and consultants.
Source: Private Healthcare Market Investigation: Notice of possible remedies under Rule 11 of the Competition Commission Rules of Procedure, Competition Commission
Links: Report | Summary of findings | Competition Commission press release | BBC report | Guardian report
Date: 2013-Aug
The coalition government announced that National Health Service hospitals in England would get an extra £500 million over two years to help struggling accident and emergency services, following warnings that some were on the brink of collapse.
Source: Press release 8 August 2013, Department of Health
Links: DH press release | BMA press release | FTN press release | MHP blog post | NHS Confederation press release | NHS England press release | RCGP press release | RCN press release | Unison press release | BBC report | Guardian report | Public Finance report
Date: 2013-Aug
An article examined hospitals performance in England, relaxing the assumption of independence between mortality and readmissions implicitly adopted in many empirical applications.
Source: Mauro Laudicella, Paolo Li Donni, and Peter Smith, 'Hospital readmission rates: Signal of failure or success?', Journal of Health Economics, Volume 32 Issue 5
Links: Article
Date: 2013-Aug
The new Chief Inspector of Hospitals announced 'radical' changes to the way in which hospitals in England were inspected. He said that he would lead significantly bigger inspection teams, headed by clinical and other experts who included trained members of the public. They would spend longer inspecting hospitals and cover every site that delivered acute services and eight key service areas: accident and emergency; maternity; paediatrics; acute medical and surgical pathways; care for the frail elderly; end of life care; and outpatients. The inspections would be a mixture of unannounced and announced, and they would include inspections in the evenings and weekends (when it was known that people could experience poor care).
Source: Press release 18 July 2013, Care Quality Commission
Links: CQC press release | BMA press release | RCS press release | 2020health blog post
Date: 2013-Jul
A report by a committee of MPs said that plans put in place to relieve the pressure on accident and emergency units in England were not good enough, and that 'confusing' and 'contradictory' information had been given to MPs about the action being taken.
Source: Urgent and Emergency Services, Second Report (Session 2013-14), HC 171, House of Commons Health Select Committee, TSO
Links: Report | Additional written evidence | Committee press release | Carers UK press release | NHS Confederation press release | RCGP press release | RCN press release | RCP press release | Unison press release | Unite press release | BBC report | Daily Mail report | Guardian report | Public Finance report | Telegraph report
Date: 2013-Jul
An article said that there had been a 24 per cent improvement in mortality in acute general trusts in England over a period of 5 years (as measured by the summary hospital-level mortality index). Part of this improvement was an artificial effect caused by changes in the depth of coding of comorbidities and other effects due to change in case-mix or non-constant risk.
Source: Richard Jacques, James Fotheringham, Michael Campbell, and Jon Nicholl, 'Did hospital mortality in England change from 2005 to 2010? A retrospective cohort analysis', BMC Health Services Research, Volume 13
Date: 2013-Jun
A paper examined how local 'purchasers' of healthcare (such as the former primary care trusts) and hospitals negotiated quality targets when a fixed proportion of hospital revenue was required to be linked to quality. It was found that the number of quality targets was determined by the purchaser's population health and its budget, the hospital type, whether the purchaser delegated negotiation to an agency, and the quality targets imposed by the supervising regional health authority.
Source: Eleonora Fichera, Hugh Gravelle, Mario Pezzino, and Matt Sutton, Choice of Contracts for Quality in Health Care: Evidence from the British NHS, Research Paper 85, Centre for Health Economics (University of York)
Links: Paper
Date: 2013-Jun
An article examined the potential of staff satisfaction as an indicator of institutional performance across acute National Health Service hospitals in England. Only a weak correlation was found between staff satisfaction and hospital death rates.
Source: Richard Pinder, Felix Greaves, Paul Aylin, Brian Jarman, and Alex Bottle, 'Staff perceptions of quality of care: an observational study of the NHS Staff Survey in hospitals in England', BMJ Quality & Safety, Volume 22 Issue 7
Links: Abstract
Date: 2013-Jun
A report called for fundamental change in the design, funding, and running of emergency care systems. It said that emergency care was facing its biggest challenge in well over a decade as a result of 'unsustainable' workloads and a lack of sufficient numbers of middle-grade doctors and consultants. It recommended urgent action to redesign workloads, improve funding, and reform performance measurement.
Source: Taj Hassan, Philip McMillan, Chris Walsh, and Ian Higginson, The Drive for Quality: How to achieve safe, sustainable care in our emergency departments?, College of Emergency Medicine
Links: Report | CEM press release | FTN press release | NHS Confederation press release | RCP press release | RCPsych press release | RCS press release | 2020health press release | BBC report | Guardian report | Public Finance report | Telegraph report
Date: 2013-May
An ombudsman report highlighted failings throughout the patient experience of hospitals. It said that 'systemic' problems were leading to missed opportunities to learn from mistakes and make National Health Service hospitals better.
Source: The NHS Hospital Complaints System: A Case for Urgent Treatment?, Parliamentary and Health Service Ombudsman, TSO
Links: Report | PHSO press release
Date: 2013-Apr
An article examined whether hospital ownership affected the level of quality reported by patients whose care was funded by the National Health Service in areas other than clinical quality. It was found that the experience reported by patients in public and private hospitals was different. Most dimensions of quality were delivered differently by the two types of hospitals, with each sector offering greater quality in certain specialties or to certain groups of patients. However, in overall terms hospital ownership by itself did not affect the level of quality of the average patient's reported experience.
Source: Virginie Perotin, Bernarda Zamora, Rachel Reeves, Will Bartlett, and Pauline Allen, 'Does hospital ownership affect patient experience? An investigation into public-private sector differences in England', Journal of Health Economics, Volume 32 Issue 3
Links: Abstract
Date: 2013-Apr
The inspectorate for healthcare and social care published its first dedicated reviewed of privacy, dignity, and nutrition in care homes and hospitals in England. Although most older people were having their needs met, a number of hospitals and care homes needed to make improvements.
Source: Time to Listen in NHS Hospitals: Dignity and nutrition inspection programme 2012, Care Quality Commission | Time to Listen in Care Homes: Dignity and nutrition inspection programme 2012, Care Quality Commission
Links: Report (NHS) | Report (care homes) | CQC press release | Labour Party press release | NHS Confederation press release | RCN press release | BBC report | Community Care report | Guardian report
Date: 2013-Mar
An article examined whether hospital competition undermined socio-economic equity in the utilization of healthcare. A negative association was found between market competition and elective admissions in deprived areas. However, the authors point out that the effect of pro-competition reform had been 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', Journal of Health Economics, Volume 32 Issue 2
Links: Abstract
Date: 2013-Feb
A paper examined whether a hospital's quality was affected by the quality provided by other hospitals in the same market, drawing on data for English hospitals in 2009-10. A hospital's quality was found to be positively associated with the quality of its rivals for 7 out of the 16 quality measures, and in no case was there a negative association. In those cases where there was a positive association, an increase in rivals' quality by 10 per cent increased a hospital's quality by 1.7 per cent to 2.9 per cent.
Source: Hugh Gravelle, Rita Santos, and Luigi Siciliani, Does a Hospital's Quality Depend on the Quality of Other Hospitals? A spatial econometrics approach to investigating hospital quality competition, Research Paper 82, Centre for Health Economics (University of York)
Links: Paper
Date: 2013-Jan
A report highlighted 'huge variations' in the way in which hospitals in England displayed information about how to make a complaint, and incomplete and unclear support to patients. 35 per cent of staff had insufficient training in complaints handling.
Source: Complaint Handling in NHS Trusts Signed up to the CARE Campaign: Reality, Criteria and Identification of Best Practice, Patients Association
Links: Report | Patients Association press release | Guardian report
Date: 2013-Jan
