The European Commission began a consultation on the role of the European Union in patient safety and quality of care. The consultation would end on 28 February 2014.
Source: Patient Safety and Quality of Healthcare: Actions at EU level – background paper for a public consultation, European Commission
Links: Consultation document | Outline
Date: 2013-Dec
The inspectorate for healthcare and social care published a report that set out changes to the monitoring, regulation, and inspection of community health services.
Source: A Fresh Start for the Regulation and Inspection of Community Health Care: Working together to change how we regulate and inspect community health services, Care Quality Commission
Links: Report | CQC press release
Date: 2013-Dec
The European Commission began a consultation on the role of the European Union in patient safety and quality of care. The consultation would end on 28 February 2014.
Source: Patient Safety and Quality of Healthcare: Actions at EU level – background paper for a public consultation, European Commission
Links: Consultation document | Outline
Date: 2013-Dec
An article examined whether policy initiatives driving the development of health and social care partnerships were delivering improved outcomes, particularly the outcomes valued by people who used services. It identified features of partnership that particularly contributed to improved outcomes. These included continuity of staff, and sufficient staff and resources – including the availability of long-term and preventative services.
Source: Alison Petch, Ailsa Cook, and Emma Miller, 'Partnership working and outcomes: do health and social care partnerships deliver for users and carers?', Health and Social Care in the Community, Volume 21 Issue 6
Links: Abstract
Date: 2013-Dec
An article examined the use of the care programme approach (CPA) for people with mental health problems and concurrent intellectual disability (dual diagnosis) in one National Health Service foundation trust in England. The study found that progress in implementing CPA was limited. It identified six key contextual challenges that had obstructed progress.
Source: Michael Kelly and Charlotte Humphrey, 'Implementation of the care programme approach across health and social services for dual diagnosis clients', Journal of Intellectual Disabilities, Volume 17 Number 4
Links: Abstract
Date: 2013-Nov
A report highlighted concerns about existing and anticipated shortages of nursing staff in the National Health Service in England. It said there were nearly 20,000 nursing vacancies currently unfilled, with a likely shortage of 47,545 registered nurses by 2016. It said there had been a 15 per cent cut in the number of nursing student places commissioned since 2010-11 and that the true level of staff shortage was higher than the official figures suggested. The report called for: mandatory safe staffing levels; mandatory use of workforce planning tools; longer term planning for workforce needs, informed by workforce reviews; and investment in the existing workforce's professional development.
Source: Frontline First: Running the red light – November 2013 special report, Royal College of Nursing
Links: Report | RCN press release | Guardian report | BBC report
Date: 2013-Nov
A report outlined the first stage of the review of urgent and emergency care in England. It called for a fundamental shift in provision, with more extensive services delivered outside of hospital, and with more serious or life threatening conditions being treated in centres with appropriate expertise and facilities. The report said that the Urgent and Emergency Care Review Team would now work with National Health Service commissioners towards trialling new delivery models, work with Monitor to develop new payment mechanisms, and complete the service specification for the new NHS 111 service. In the longer term, further work would be needed on costing, clinical standards, performance measures, contracting issues, and workforce development.
Source: Transforming Urgent and Emergency Care Services in England: Urgent and emergency care review end of Phase 1 report – high quality care for all, now and for future generations, NHS England
Links: Report | Appendix 1 | Appendix 2 | Appendix 3 | NHS England press release | King's Fund press release | RCN press release | BBC report
Date: 2013-Nov
A report examined the degree of financial resilience in National Health Service trusts in England. It said that many trusts had adequate governance and monitoring in place, but highlighted areas of concern, particularly over the degree of some trusts' reliance on non-recurrent support funding.
Source: Alternative Therapy: Strengthening NHS financial resilience – summary findings from our financial health checks of English NHS trusts and foundation trusts, Grant Thornton
Links: Report | Grant Thornton press release
Date: 2013-Nov
The government published a new National Health Service outcomes framework. The framework was intended: to provide a national overview of performance; to act as the primary accountability mechanism, in conjunction with the Mandate, between the Secretary of State for Health and NHS England; and to encourage a focus on health outcomes rather than process. The new framework also described changes to the process for the development of indicators. It was published alongside an updated Mandate for 2014-15, and was accompanied by a technical appendix.
Source: The NHS Outcomes Framework 2014/15, Department of Health
Links: Framework | Technical appendix | Mandate 2013-2015 | NHS England press release | Foundation Trust Network press release | RCOG press release | NCB press release
Date: 2013-Nov
A report examined the prevention of suicide of mental health patients in the United Kingdom. It said that mental health service providers looking after patients at risk of suicide should: reduce absconding on in-patient wards; boost specialist community services such as crisis resolution, home treatment, assertive outreach, and services for patients with dual diagnosis; implement NICE guidance on depression; and share information with criminal justice agencies.
Source: National Confidential Inquiry into Suicide and Homicide by People with Mental Illness, Patient Suicide: The impact of service changes – a UK wide study, University of Manchester
Links: Report | University of Manchester press release
Date: 2013-Nov
A government report examined the prevalence, prevention, and impact of dementia in England and set out the priorities for future action.
Source: Dementia: A state of the nation report on dementia care and support in England, Department of Health
Links: Report | DH press release | Alzheimer's Society press release | RCN press release | Guardian report
Date: 2013-Nov
The regulator for National Health Service foundation trusts said that almost one in four National Health Service walk-in centres had closed in recent years, despite being popular with patients. Commissioners who had closed centres cited concerns that included: that the centres were generating unwarranted demand; that they led to duplication when patients self-referred to multiple services; and that they caused confusion among patients about where to go for care. Commissioners also commonly said they felt they were 'paying twice' for patients who attend walk-in centres, since most users were registered with a family doctor practice elsewhere. The report invited further evidence to be submitted.
Source: Walk-in Centre Review: Preliminary report, Monitor
Links: Report | Survey | DOH press release | Monitor press release | NHS Partners press release | Guardian report
Date: 2013-Nov
An audit report said that maternity services in England had provided overall good outcomes, with services that were generally well received by women. However, there were unexplained differences seen throughout the country and service satisfaction was lower for women from Black and minority ethnic groups. It noted the high cost of negligence insurance and raised questions over how well performance was monitored. It said that the presence of consultants in departments had increased, but noted the shortage of trained midwives. The report made recommendations.
Source: Maternity Services in England, HC 794 (Session 201314), National Audit Office, TSO
Links: Report | NAO press release | Royal College of Midwives press release | NCT press release
Date: 2013-Nov
A report examined access to mental health therapies in England. It acknowledged progress, but said that: many people were still waiting too long for treatment; almost three fifths were not offered a choice of treatment; and there was a lack of equity in access. The report made a range of recommendations for government, commissioners and providers.
Source: We Still Need to Talk: A report on access to talking therapies, Mind
Links: Report | Mind press release
Date: 2013-Nov
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 report by a committee of MSPs said that National Health Service boards had engaged well with their enquiries, and with the work that had arisen from the previous year's report. It said that boards needed to strike a balance between savings and efficiencies, meeting local needs, and achieving quality and consistency of services across Scotland. It outlined further work to be completed on measuring the quality of outcomes, and maintenance backlogs. The committee anticipated using its new budget adviser to inform the ongoing approach.
Source: NHS Boards Budget Scrutiny, 10th Report 2013, SP Paper 419, Scottish Parliament Health and Sport Committee
Links: Report | Scottish Parliament press release
Date: 2013-Nov
A report examined access to talking therapies in England. It said that the Department of Health's Improving Access to Psychological Therapy programme, introduced in 2007, had been interpreted and implemented differently across locations and had reduced overall choice and access in some cases. It made a range of recommendations for policy-makers, commissioners and regulators.
Source: Getting the Right therapy at the Right Time, We Need to Talk Coalition
Links: Report | BBC report | Guardian report
Date: 2013-Nov
A report examined whether health and well-being boards had included mental health issues as a priority in their joint health and well-being strategies. It said that many strategies had not met the government's recent commitment to achieve parity of esteem between mental and physical health.
Source: Jonathan Scrutton, A Place for Parity: Health and wellbeing boards and mental health, Centre for Mental Health
Links: Report | CMH press release
Date: 2013-Nov
A report provided an atlas of diagnostic services within the National Health Service in England. It highlighted geographical variation in the provision of services.
Source: The NHS Atlas of Variation in Diagnostic Services: Reducing unwarranted variation to increase value and improve quality, RightCare
Links: Report | RightCare press release
Date: 2013-Nov
A report said that there was a looming capacity crisis in ophthalmology services in England. It said that increased demand, a lack of strategic direction, poor local planning of services, and inconsistent commissioning practices were behind patients' reports of cancellations of appointments and delays in treatment. The report recommended a range of urgent actions, including an inquiry.
Source: Saving Money, Losing Sight: RNIB campaign report, Royal National Institute of Blind People
Links: Report | Summary | RNIB press release | BBC report | Telegraph report
Date: 2013-Nov
The independent 'consumer champion' for health and social care in England published its first annual report. Although 72 per cent of the public said they got good quality care, almost 94 per cent thought that services 'could be improved' and 1 in 3 people expressed concern about basic levels of safety. The report said that this demonstrated the need for a set of rights to be developed and this would form a key part of their work over the coming year.
Source: Healthwatch England Annual Report 2012/13, Healthwatch England
Links: Report | Healthwatch press release | NCT press release
Date: 2013-Oct
The government began consultation on proposals for new constitutional requirements for National Health Service Trusts and clinical commissioning groups. The consultation would close on 31 December 2013.
Source: Health Service Bodies Audit Committees: Consultation about proposed new constitutional requirements for NHS Trusts and Clinical Commissioning Groups, Department of Health
Links: Consultation document
Date: 2013-Oct
A report provided an overview of research into the quality of health and social care services in England, making recommendations. This was the first report in the five year QualityWatch programme.
Source: Is the Quality of Care in England Getting Better? QualityWatch Annual Statement 2013 – summary of findings, QualityWatch (Nuffield Trust/Health Foundation)
Date: 2013-Oct
The government responded to a report by a committee of MPs on its post-legislative scrutiny of the Mental Health Act 2007.
Source: Post-legislative Scrutiny of the Mental Health Act 2007: Response to the Report of the Health Committee of the House of Commons, Cm 8735, Department of Health, TSO
Links: Response
Date: 2013-Oct
The Chief Medical Officer published her annual report for 2012.
Source: Chief Medical Officer, Annual Report of the Chief Medical Officer 2012: Our children deserve better – prevention pays, Department of Health
Links: Report | DH press release | Centre for Mental Health press release | RCOG press release | RCM press release
Date: 2013-Oct
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 provided an overview of the medical profession, looked at major trends, and identified challenges facing doctors. The report noted that more needed to be done to improve patients' ability to raise concerns about poor medical care. It also noted that doctors reported more concerns about their colleagues in 2012.
Source: The State of Medical Education and Practice in the UK, General Medical Council
Links: Report | GMC press release | BBC report
Date: 2013-Oct
A special issue of a journal explored the strengths of health system performance comparison and discussed avenues for future improvement.
Source: Health Policy, Volume 112 Issue 1-2
Links: Table of contents
Date: 2013-Oct
The Local Audit and Accountability Bill was given a second reading. The Bill was designed to abolish the Audit Commission for local authorities and the National Health Service in England; change the accounting rules, audit procedures, reporting, and publicity requirements for various local and other public authorities; and make provision about council tax referendums.
Source: Local Audit and Accountability Bill, Department for Communities and Local Government, TSO | Debate 28 October 2013, columns 678-730, House of Commons Hansard, TSO
Links: Bill | Explanatory notes | Hansard | Briefing
Date: 2013-Oct
A report examined the the activities of health and wellbeing boards during their first year, what they had achieved, and whether they were providing effective leadership across local systems of care. The report discussed policy implications.
Source: Richard Humphries and Amy Galea, Health and Wellbeing Boards: One year on, King s Fund
Links: Report | Kings Fund press release
Date: 2013-Oct
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
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 study of National Health Service culture and behaviours found that the quality of care in the English NHS was too often compromised by a lack of clearly defined goals, too much regulation, and highly variable staff support.
Source: Michael West, Richard Baker, Jeremy Dawson, Mary Dixon Woods, Richard Lilford, Graham Martin, Lorna McKee, Madeleine Murtagh, and Patricia Wilkie, Quality and Safety in the NHS: Evaluating progress, problems and promise, Lancaster University Management School
Links: Report | LUMS press release
See also: Mary Dixon-Woods, Richard Baker, Kathryn Charles, Jeremy Dawson, Gabi Jerzembek, Graham Martin, Imelda McCarthy, Lorna McKee, Joel Minion, Piotr Ozieranski, Janet Willars, Patricia Wilkie, and Michael West, 'Culture and behaviour in the English National Health Service: overview of lessons from a large multimethod study', BMJ Quality & Safety, Online first
Date: 2013-Sep
A report by a committee of MPs said that the National Health Service needed to be an organization in which an open dialogue about care quality was part of its natural culture, rather than a duty that only arose in cases of service failure. Hospitals in England should each day publicly display the number of nurses they had on duty on each ward. There should be a more accessible complaints system for patients, and an end to 'gagging clauses' on staff.
Source: After Francis: Making a Difference, Third Report (Session 2013-14), HC 657, House of Commons Health Select Committee, TSO
Links: Report | Committee press release | NHS Confederation press release | RCN press release | BBC report | Guardian report
Notes: In February 2013 a public inquiry (led by Robert Francis) reported on serious failings in care by the Mid Staffordshire NHS foundation trust.
Date: 2013-Sep
An article examined whether the thinking underlying attempts to improve efficiency within the English National Health Service (through the use of 'markets and targets') could be enhanced by using concepts from behavioural economics. People were more likely to be motivated if they identified with the ethos of the policy; and the threat of losses would often provoke more of a response than the promise of gains.
Source: Adam Oliver, 'Markets and targets in the English National Health Service: is there a role for behavioral economics?', Journal of Health Politics, Policy and Law, Volume 37 Number 4
Links: Abstract
Date: 2013-Sep
An article examined the widening involvement of the European Union in healthcare, focusing on the issue of quality of care. The depth of EU 'interference' had increased from sharing information to standardization and even to the first signs of enforcement.
Source: Hans Vollaard, Hester van de Bovenkamp, and Karsten Vrangbaek, 'The emerging EU quality of care policy: from sharing information to enforcement', Health Policy, Volume 111 Issue 3
Links: Abstract
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 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 report was published of an independent review (led by Don Berwick) of patient safety in the National Health Service in England. It said that: the quality of patient care, especially patient safety, should be paramount; patients and carers needed to be empowered, engaged, and heard; staff should be supported to develop and improve; and there should be complete transparency of data. Recommendations included:
Staffing levels needed to be adequate: but decisions should be taken locally based on evidence.
The NHS should continue to use mortality rate indicators to detect potentially severe problems: but these should not be used to generate league tables.
New criminal offences should be created around recklessness or wilful neglect or mistreatment by organizations or individuals, and for healthcare organizations that withheld or obstructed the release of relevant information: but the use of criminal sanctions should be extremely rare, and unintended errors should not be criminalized.
The report did not recommend that a statutory duty of candour for healthcare workers be introduced, saying that this duty was adequately addressed in professional codes of conduct and guidance.
Source: A Promise to Learn – A Commitment to Act: Improving the safety of patients in England, Department of Health
Links: Report | DH press release | Alzheimers Society press release | BMA press release | GMC press release | Kings Fund press release | National Voices press release | NHS Alliance press release | NHS Confederation press release | NHS England press release | RCGP press release | RCN press release | RCP press release | RCS press release | RPS press release | Scottish Government press release | Unison press release | BBC report | Guardian report | Telegraph report
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
Researchers examined whether the quality of family doctor practices affected which practice patients chose. It was found that patients were more likely to choose practices that were nearer to their home, had a higher proportion of family doctors qualified in Europe, had a higher proportion of female family doctors, and had a lower average family doctor age. Given other practice characteristics, patients were more likely to choose practices that earned more quality points under the 'QOF' pay-for-performance scheme.
Source: Rita Santos, Hugh Gravelle, and Carol Propper, Does Quality Affect Patients Choice of Doctor? Evidence from the UK, Research Paper 88, Centre for Health Economics (University of York)
Links: Paper
Notes: Also published as Working Paper 13/306, Centre for Market and Public Organisation (University of Bristol)
Date: 2013-Jul
The first results were published from the National Health Service 'friends and family test'. The test asked patients in England whether they would recommend accident and emergency and inpatient wards to their loved ones, based on their own experience. Only 63 per cent of people who had visited accident and emergency units in the previous month would be active 'promoters' of the service.
Source: Press release 30 July 2013, NHS England
Links: NHS England press release | Downing Street press release | CQC press release | FTN press release | NHS Confederation press release | NHSPN press release | RCN press release | Telegraph report
Date: 2013-Jul
A report said that the productivity of the National Health Service in England had increased by 3.2 per cent in 2010-11 (the first year of the coalition government), mainly as a result of staff cuts. NHS productivity had increased by 8 per cent since 2004-05. There had been year-on-year increases in the number of people receiving treatment, and continued improvements in 30-day survival rates.
Source: Chris Bojke, Adriana Castelli, Katja Grasic, Andrew Street, and Padraic Ward, NHS Productivity from 2004/5 to 2010/11, Research Paper 87, Centre for Health Economics (University of York)
Links: Paper | CHE press release
Date: 2013-Jul
A report said that most community-based interventions designed to reduce emergency hospital admissions did not achieve their aim.
Source: Martin Bardsley, Adam Steventon, Judith Smith, and Jennifer Dixon, Evaluating Integrated and Community-Based Care: How do we know what works?, Nuffield Trust
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
The inspectorate for healthcare and social care began consultation on plans for improving the inspection process, including plans to inspect all care services, National Health Service trusts and foundation trusts, and independent acute hospitals; and develop a ratings system to help people choose between services and to encourage services to make improvements.
Source: A New Start: Consultation on changes to the way CQC regulates, inspects and monitors care, Care Quality Commission
Links: Consultation document | CQC press release | ARMC press release | BMA press release | NHS Confederation press release | UKHCA press release | Guardian report | Public Finance report | Telegraph report
Date: 2013-Jun
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
The coalition government published the Care Bill. The Bill was designed to:
Introduce a cap on the cost of social care in England, and give carers the legal right to support from their local council.
Provide protection to people whose care provider went out of business.
Give everyone over 65 a legal entitlement to a personal care budget.
Introduce a rating system for hospitals and care homes, and give new powers of intervention to the chief inspector of hospitals.
Create two new public bodies, Health Education England and the Health Research Authority, designed to provide additional training and support for health professionals.
Source: Care Bill [HL], Department of Health, TSO | The Care Bill Explained: Including a response to consultation and pre-legislative scrutiny on the Draft Care and Support Bill, Cm 8627, Department of Health, TSO
Links: Bill | Explanatory notes | Impact assessments | Cabinet Office briefing | Care Bill Explained | Hansard | DH press release | HOL research brief | Acevo press release | Alzheimers Society press release | Care and Support Alliance press release | Carers UK press release | Childrens Society press release | CIH press release | CSW press release | Fawcett Society press release | Labour Party press release | NPC press release | NPI blog post | PRTC press release | BBC report | Community Care report | Guardian report (1) | Guardian report (2)
Date: 2013-May
An article compared outcomes in England and Wales before and after policy changes in the governance of schools and hospitals. The governance model of 'trust and altruism' resulted in worse reported performance in Wales as compared with England on what were each government's key objectives. 'Naming and shaming' worked in England, as compared with Wales, resulting in improved examination performance and eliminating the endemic problem of long waiting times.
Source: Gwyn Bevan and Deborah Wilson, 'Does "naming and shaming" work for schools and hospitals? Lessons from natural experiments following devolution in England and Wales', Public Money and Management, Volume 33 Issue 4
Links: Abstract
Date: 2013-May
A new book examined efforts to compare the performance of health systems in different countries, and identified and explored the practical and conceptual challenges that arose. It discussed data and methodological challenges, as well as broader issues such as the interface between evidence and practice.
Source: Irene Papanicolas and Peter Smith, Health System Performance Comparison: An agenda for policy, information and research, Open University Press
Links: Summary
Date: 2013-Apr
A report by a committee of the Northern Ireland Assembly said that the 'vast majority' of services provided by health and social care trusts were of a very high quality. But the number of serious adverse incidents, often involving the death of a patient or service user, was 'shocking' and suggested that the standards of care being delivered required continued scrutiny and improvement.
Source: Report on the Safety of Services Provided by Health and Social Care Trusts, Thirteenth Report (Session 2012-13), Northern Ireland Assembly Public Accounts Committee, TSO
Links: Report | NIA press release
Date: 2013-Apr
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 said that a new employment contract for National Health Service consultants introduced in 2003, which had included a 27 per cent pay rise over three years, had failed to increase productivity.
Source: Karen Bloor, Nick Freemantle, and Alan Maynard, 'Trends in consultant clinical activity and the effect of the 2003 contract change: retrospective analysis of secondary data', Journal of the Royal Society of Medicine, Volume 105 Issue 11
Links: Article | RSM press release
Date: 2013-Apr
An article examined patient experiences of, and satisfaction with, family doctor-led walk-in centres (designed to allow people to see a family doctor without prior appointment in case of urgent need). It was found that the centres increased access to primary care, and that most patients were satisfied with the service.
Source: Mubashir Arain, Jon Nicholl, and Mike Campbell, 'Patients' experience and satisfaction with GP led walk-in centres in the UK; a cross sectional study', BMC Health Services Research, Volume 13
Date: 2013-Apr
The coalition government published its initial response to an inquiry report into serious failings in healthcare by the Mid Staffordshire Foundation Trust. Performance ratings would be introduced for hospitals and care homes; there would be a statutory duty of candour for organizations that provided care and were registered with the Care Quality Commission; and a pilot would be set up under which nurses would work for up to a year as healthcare assistants as a prerequisite for receiving funding for their degree.
Source: Patients First and Foremost: The initial government response to the report of the Mid Staffordshire NHS Foundation Trust Public Inquiry, Cm 8576, Department of Health, TSO
Links: Report | Hansard | DH press release | Alzheimers Society press release | AMRC press release | BIHR press release | BMA press release | CMH press release | CSP press release | GMC press release | Kings Fund press release | Labour Party press release | Mind press release | NHS Confederation press release | PHSO press release | RCGP press release | RCM press release | RCN press release | RCOG press release | RCP press release | 2020health press release | Community Care report | Daily Mail report | Guardian report | Public Finance report | UnionNews report
Date: 2013-Mar
A think-tank report examined patterns of spending and labour productivity in the National Health Service in England since 2003-04. The proportion of trusts in deficit had risen steadily: in the most recent year 32 trusts out of 250 had been in deficit, and 9 had reported a deficit for 3 years or more. The financing costs of private finance initiative (PFI) contracts had risen sharply since 2009: 7 acute trusts were paying out more than 5 per cent of their total revenue through PFI. There appeared to have been very little improvement in labour productivity across the hospital sector in recent years.
Source: Nick Jones and Anita Charlesworth, The Anatomy of Health Spending 2011-12: A review of NHS expenditure and labour productivity, Nuffield Trust
Links: Report | Nuffield Trust press release | BMA press release | Intergenerational Foundation press release | Guardian report
Date: 2013-Mar
An article examined the patterns of health loss in the United Kingdom, the leading preventable risks that explained some of these patterns, and how outcomes compared with a set of comparable countries in the European Union and elsewhere in 1990 and 2010. For both mortality and disability, overall health had improved substantially in absolute terms from 1990 to 2010. But the UK's performance in terms of premature mortality was persistently and significantly below the mean of European countries, and required additional concerted action. Further progress in tackling premature mortality would probably require improved public health, prevention, early intervention, and treatment activities. The growing burden of disability needed an integrated and strategic response.
Source: Christopher Murray et al., 'UK health performance: findings of the Global Burden of Disease Study 2010', The Lancet 5 March 2013
Links: Abstract | DH press release | IHME press release | Labour Party press release | BBC report | Guardian report | Telegraph report
Date: 2013-Mar
A survey found that almost two-thirds of people (61 per cent) had had to wait longer than 48 hours to book an appointment with their family doctor, and that more than half (57 per cent) said the process was either 'very difficult' or 'could have been easier'. As many as three-quarters of people (79 per cent) said that they would not feel safe relying on out-of-hours services in a medical emergency.
Source: Primary Care: Access Denied?, Patients Association
Links: Report | Labour Party press release | RCGP press release | Guardian report
Date: 2013-Mar
The coalition government announced (via an interview with the Daily Mail newspaper) an immediate ban on clauses in compromise agreements that prevented National Health Service staff from raising concerns about healthcare standards when they left their jobs.
Source: Daily Mail, 13 March 2013
Links: Daily Mail report | NHS Employers press release | Patients First press release | Guardian report | Telegraph report
Date: 2013-Mar
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
A report made a series of recommendations designed to promote safe and high-quality patient care in the National Health Service. They included: a legal duty of honesty; an end to 'gagging' clauses for departing staff; whistle-blowing protection rights for patients and their families; legal rights for patients to participate in producing a care plan; a legal right to an independent advocate for the most vulnerable patients; ring-fenced funding for local 'Healthwatch' organizations, and an end to restrictions on their freedom to comment on policy.
Source: After Francis: Doing Justice, National Voices
Links: Report | National Voices press release
Date: 2013-Mar
The report was published of a government-commissioned review into whether ratings of provider performance should be used in health and social care in England. It said that a 'clear gap' had arisen in terms of the provision of comprehensive and trusted information on care quality. The costs and benefits of implementing a ratings system might be favourable for providers of social care and for family doctors, given the potential for choice and the nature of care provided in those settings. The benefits were less certain for hospitals, given the way that ratings were designed and used: a number of conditions would have to be fulfilled for any potential benefits of hospital ratings to be fully realized.
Source: Jennifer Dixon, Martin Bardsley, Emma Churchill, Alisha Davies, William Bains, Mark Dayan, and Irene Papanicolas, Rating Providers for Quality: A Policy Worth Pursuing?, Nuffield Trust
Links: Report | Nuffield Trust press release | Ipsos MORI press release | LGA press release | National Voices press release | Community Care report | Guardian report | Telegraph report
Date: 2013-Mar
A report by a committee of MPs said that the National Health Service had achieved its financial savings target, but this had in large part come from freezing wages. It expressed concern that other savings were being achieved by rationing patients' access to certain treatments described as being 'of low clinical value', but waiting for which meant pain and a poorer quality of life. The finances of some NHS trusts were fragile, and there was a risk that they might resort to simple cost-cutting rather than finding genuine efficiency savings.
Source: Department of Health: Progress in Making NHS Efficiency Savings, Thirty-ninth Report (Session 201213), HC 865, House of Commons Public Accounts Select Committee, TSO
Links: Report | Committee press release | Kings Fund press release | Labour Party press release | RCN press release | Public Finance report
Date: 2013-Mar
An article sought to develop a measure of the effectiveness of primary care in terms of population health outcomes. The public health impact (PHI) measure was a potential alternative metric of practice performance, measuring the estimated mortality reduction in the registered population. Rewards under the existing pay-for-performance scheme were not closely aligned to the public health impact of practices.
Source: Mark Ashworth, Peter Schofield, Tim Doran, Richard Cookson, Matthew Sutton, Paul Seed, Amanda Howe, and Robert Fleetcroft, 'The public health impact score: a new measure of public health effectiveness for general practices in England', British Journal of General Practice, Volume 63 Number 609
Links: Abstract
Date: 2013-Mar
A report made a series of recommendations on patient safety in response to the Francis report (February 2013) into failings at the Mid Staffordshire NHS Foundation Trust. They included: making the development of standards for the care of vulnerable older patients the first priority; giving responsibility for leading the development of standards of care to the Care Quality Commission, with participation from patients, healthcare staff, and other relevant stakeholders; using National Health Service recruitment, induction, and appraisal processes to promote the values of the NHS constitution and to raise awareness of the constitution among staff; clarifying the regulatory arrangements for health providers; and enhancing the role of routinely collected, real-time data as a means of measuring care quality.
Source: The Francis Public Inquiry Report: A Response, Nuffield Trust
Date: 2013-Mar
A report examined how effective developed (OECD) countries had been in reducing waiting times for healthcare.
Source: Luigi Siciliani, Michael Borowitz, and Valerie Moran (eds), Waiting Time Policies in the Health Sector: What Works?, Organisation for Economic Co-operation and Development
Links: Report
Date: 2013-Feb
The coalition government published guidance setting out how the 'friends and family test' results for the National Health Service would be calculated and presented.
Source: The NHS Friends and Family Test: Publication Guidance, Department of Health
Links: Guidance
Notes: The 'friends and family test' asks the following standardized question: 'How likely are you to recommend our ward/A&E department to friends and family if they needed similar care or treatment?'
Date: 2013-Feb
An audit report in Scotland said that the Scottish Government and health boards needed to improve the management and scrutiny of National Health Service waiting lists to assure patients that they were being treated fairly. Key aspects of the existing systems were inadequate and insufficient information was found in patient records.
Source: Management of Patients on NHS Waiting Lists, Audit Scotland
Links: Report | Audit Scotland press release | Scottish Government press release | SNP press release | Public Finance report
Date: 2013-Feb
The report was published of a public inquiry (led by Robert Francis) into serious failings in care by the Mid Staffordshire NHS foundation trust. Years of abuse and neglect at the hospital between 2005 and 2008 had led to the unnecessary deaths of hundreds of patients. The report made 290 recommendations, saying 'fundamental change' was needed to prevent the public losing confidence in the National Health Service. In particular, it recommended:
The merger of care regulation into a single body, and the creation of a Chief Inspector of Hospitals.
Senior managers to be given a code of conduct, and made liable to disqualification if they were not fit to hold such positions.
Hiding information about poor care to become a criminal offence, as would failing to adhere to basic standards that led to death or serious harm.
A statutory obligation on doctors and nurses for a duty of candour so they were open with patients about mistake.
An increased focus on compassion in the recruitment, training, and education of nurses, including an aptitude test for new recruits and regular checks of competence.
The Department of Health was also criticized for being too 'remote' and embarking on 'counterproductive' reorganizations.
Source: Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry, HC 898, TSO
Links: Report (Volume 1) | Report (Volume 2) | Report (Volume 3) | Summary | Hansard | DH press release | Alzheimers Society press release | AMRC press release | BIHR press release | BMA press release | Carers UK press release | Civitas blog post | CMH press release | CPS press release | CQC press release | CSW press release | GMC press release | Kings Fund press release | LGA press release | Monitor press release | NELCP press release | NHS Commissioning Board press release | NHS Confederation press release | Patients Association press release | PCAW press release | PHSO press release | PSA press release | RCGP press release | RCM press release | RCN press release | RCOG press release | RCP press release | RNHA press release | RPS press release | RSPH/IHM press release | Skills for Care press release | BBC report | Community Care report | Daily Mail report | Guardian report | Public Finance report
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 by a committee of MPs said that there were continuing shortcomings in the performance of the health and social care regulator for England.
Source: 2012 Accountability Hearing with the Care Quality Commission, Seventh Report (Session 201213), HC 592, House of Commons Health Select Committee, TSO
Links: Report | Additional written evidence | CQC press release | Labour Party press release | RCN press release | NHS Confederation press release | BBC report | Daily Mail report | Guardian report | Public Finance report
Date: 2013-Jan
A report said that the delivery of healthcare to patients with an established obesity problem was 'extremely patchy'. The National Health Service needed to improve its management of the large numbers of patients presenting with severe complex obesity.
Source: Action on Obesity: Comprehensive care for all, Royal College of Physicians
Links: Report | RCP press release
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