Monday 28 April 2014

Examining variations in hospital productivity in the NHS

"Our analyses suggest substantial scope for productivity improvement across the English hospital sector. It would be worth focusing attention on those hospitals at the top and bottom of the rankings in order to identify specific drivers of differential productivity in those organisations."

Examining variations in hospital productivity in the English NHS
A Castelli, A Street, R Verzulli, P Ward
The European Journal of Health Economics
February 2014

Read more here.

Essential reading on integrated care and shared decision making

The NHS QIPP Right Care team have updated two of their essential reading lists:


The reading lists highlight key research intended to introduce you to the most important information available on the topics. Where they are freely available, full text articles are linked to. If you need any help accessing any of the articles then please get in touch or visit the Medical Library.


Innovation population: the UK's views on innovation

"Every stage of the research showed that people most valued innovation in areas that had a demonstrable impact on health, wellbeing and quality of life."

Innovation population: the UK's views on innovation
Nesta, ComRes
April 2014

Read more here.

The importance of multimorbidity in explaining utilisation and costs

"This work forms a basis for identifying groups that would most benefit from improved integrated care, which might be facilitated by integrated financial arrangements and better pathway management."

The importance of multimorbidity in explaining utilisation and costs across health and social care settings: evidence from South Somerset’s Symphony Project
P Kasteridis, A Street, M Dolman, L Gallier, K Hudson, J Martin, I Wyer
Centre for Health Economics, University of York
February 2014

Read more here.

Commissioning primary care: transforming healthcare in the community

“To provide patients with integrated services, clinical commissioners need to be able to develop and implement a ‘whole-system’ commissioning strategy that brings together primary, community and acute services”

Commissioning primary care: transforming healthcare in the community
NHS Clinical Commissioners
February 2014

Read more here.

A systematic review of medical practice variation in OECD countries

"Combined with engagement from clinicians and policy makers, the continued study of the causes and consequences of variation has the potential to enhance the effectiveness and efficiency of health care systems."

A systematic review of medical practice variation in OECD countries
AN Coralloa, R Croxford, DC Goodmanb, EL Bryanb, D Srivastavac, TA Stukela
Health Policy, 2014; 114: 5-14

Read more here.

Commissioning for value data packs

"NHS England provided every CCG with a comprehensive data pack in October 2013 and area teams in March 2014 to support effective ‘commissioning for value’.

The packs fit directly with NHS England’s ‘call to action’ – planning to make the NHS sustainable into the future – and clearly show area teams and CCGs ‘where to look’ as a first stage to identify real opportunities to improve outcomes and increase value for local populations."

Find out more and access all the resources here.

Financial mechanisms for integrating funds for health and social care

"Compared with ‘usual care’, schemes that integrated funds and resources to support integrated care seldom led to improved health outcomes. Although some schemes succeeded in shifting care closer to home, and some achieved short term reductions in acute care utilisation, no scheme demonstrated a sustained and long term reduction in hospital use." 

Financial mechanisms for integrating funds for health and social care: an evidence review 
A Mason, M Goddard, H Weatherly
Centre for Health Economics, University of York
March 2014

Read more here.

How to provide 24/7 joined up palliative care

"After years of disjointed end of life care services in England, an initiative in Bedfordshire shows how to coordinate services 24 hours a day." 

How to provide 24/7, joined up palliative care
S Picken, D Cakmak
Health Service Journal
16 April 2014

Read more here.

Balancing quality and finance to deliver greater value

“To consider costs without regard for quality is unthinkable; to consider quality without regard for costs is unsustainable.”

Two sides of the same coin: Balancing quality and finance to deliver greater value
NHS Confederation
April 2014, Issue 271

Read more here.

Are interventions to reduce interruptions and errors during medication administration effective?

"There is weak evidence of the effectiveness of interventions to significantly reduce interruption rates and very limited evidence of their effectiveness to reduce medication administration errors. Policy makers should proceed with great caution in implementing such interventions until controlled trials confirm their value." 

Are interventions to reduce interruptions and errors during medication administration effective?: a systematic review
MZ Raban, JI Westbrook
BMJ Quality and Safety, 2014; 23: 414-421

Read more here.

Team-training in healthcare

"Our synthesis suggests that there is moderate to high-quality evidence that team-training can positively impact healthcare team processes and, in turn, clinical processes and patient outcomes. These effects have been demonstrated across a variety of acute care areas."

Team-training in healthcare: a narrative synthesis of the literature
SJ Weaver, SM Dy, MA Rosen
BMJ Quality and Safety, 2014; 23: 359-372

Read more here.

Improving patient waiting times: obesity care

"The main focus of this study was to help prioritise planned investments in new capacity allowing the service to improve patient experience and meet future anticipated demand."

Improving patient waiting times: a simulation study of an obesity care service
AA Tako, K Kotiadis, C Vasilakis, A Miras, C le Roux
BMJ Quality and Safety, 2014; 23: 373-381

Read more here.

Wednesday 16 April 2014

Solving the NHS care and cash crisis

“We have, in short, a health and care system that is both unnecessarily expensive and poorly designed to meet modern needs.”

Solving the NHS care and cash crisis: routes to health and care renewal
N Warner, J O’Sullivan
Reform
March 2014

Read more here

Clinical commissioning groups – one year on

"In this audio slideshow, Holly Holder, Fellow in Health Policy, Nuffield Trust, presents the key findings from a survey of GPs in six clinical commissioning groups (CCGs). The survey explored member engagement and primary care development one year after CCGs were introduced."

Holly Holder: clinical commissioning groups – one year on
Nuffield Trust and The King’s Fund 
April 2014

Find out more here.

Avoiding low-value care (video)

"The enormous cost of health care in the United States, driven in part by the fee-for-service payment system, has inspired new efforts to assess the true value of commonly provided services. When a service is widely recognized as providing little or no benefit, what should be done to reduce its use?"

Perspective roundtable: avoiding low-value care
AA Gawande, CH Colla, SD Halpern, BE Landon
New England Journal of Medicine, 2014, 370: e21

Watch the video discussion here.

Securing excellence in GP IT services

"This document sets out the operating arrangements for the delivery of GP IT services across England. It outlines clear accountability, responsibility and financing support for general practice in England to receive high quality IT support services."

Securing excellence in GP IT services: operating model, 2nd edition (2014-16)
NHS England
April 2014

Read more here.

Transforming primary care

"By freeing up time and redirecting several hundred million pounds of public funding for hard pressed family doctors as well as nurses and other community health staff, the aim is to bring about broad-based improvement in care for our highest need patients."

Transforming primary care: safe, proactive, personalised care for those who need it most
Department of Health, NHS England
April 2014

Read more here.

Tuesday 15 April 2014

Improving contraceptive services

"Investment in contraception saves money by reducing unintended pregnancy rates. This, in turn, will reduce costs for: the NHS, the education system, welfare" 

Contraceptive services
NICE local government briefings
March 2014

Read more here.

Community engagement to improve health

"If local authorities and their partners get local communities involved in decisions about how to design or improve services this will make services more effective, cost-effective and sustainable – and there will be greater uptake."

Community engagement to improve health
NICE local government briefings
March 2014

Read more here

Successfully spreading surgical innovation

"If we are to address the slow diffusion of innovation we must learn from experience. This report sets out what makes adoption of surgical innovation different and why we need a new approach."

From innovation to adoption: Successfully spreading surgical innovation
The Royal College of Surgeons of England
April 2014

Read more here.

Monday 14 April 2014

General Medical Services: guidance and audit requirements

"This document provides information on contractual changes in 2014/15 as well as detailed guidance and the assurance management arrangements and audit requirements to support practices and NHS England area teams."

General Medical Services contract 2014/15: guidance and audit requirements
NHS England
March 2014

Read more here.

Cost benefit analysis guidance for local partnerships

"This document outlines a methodology for a cost-benefit analysis (CBA) model originally developed by New Economy, local authorities and other public sector agencies across Greater Manchester (GM). It is designed to simplify and to lower the cost of performing CBA in the context of local programmes to improve public services where analytical and research resources may be relatively limited." 

Supporting public service transformation: cost benefit analysis guidance for local partnerships
HM Treasury, Public Service Transformation Network, New Economy
April 2014

Read more here.

The NHS England business plan for 2014-15 to 2016-17

"The NHS England business plan sets out how NHS England will support commissioning and drive improvements in patient outcomes."

Putting Patients First: The NHS England business plan for 2014-15 to 2016-17
NHS England
April 2014

Read more here.

School nursing: public health services

"This guidance supports effective commissioning of school nursing services to provide public health for school aged children. It also explains how local school nursing services can be used and improved to meet local needs."

School nursing: public health services
Department of Health 
March 2014

Find out more and access all the resources here.

A guide to nursing, midwifery and care staffing capacity and capability

"Nursing, midwifery and care staff, working as part of wider multidisciplinary teams, play a critical role in securing high quality care and excellent outcomes for patients. There are established and evidenced links between patient outcomes and whether organisations have the right people, with the right skills, in the right place at the right time." 

How to ensure the right people, with the right skills, are in the right place at the right time: A guide to nursing, midwifery and care staffing capacity and capability
NHS England
November 2013

Read more here

Positive and Proactive Care: reducing the need for restrictive interventions

"Rigorous governance is needed to ensure that positive and proactive care is the main approach within services to reduce excessive reliance on restrictive interventions and to ensure that if they are used, it is only ever as a last resort, and they are undertaken in a proportionate and least restrictive way."

Positive and proactive care: reducing the need for restrictive interventions
Social Care, Local Government and Care Partnership Directorate
Department of Health
April 2014

Read more here.

Managing patients with complex needs

"The main conclusion is that the service improves health outcomes and leads to a reduction in health service use in both primary and secondary care settings. The financial savings from reduced service use are equivalent to about a third of PCPCS treatment costs."

Managing patients with complex needs: Evaluation of the City and Hackney Primary Care Psychotherapy Consultation Service
M Parsonage, E Hard, B Rock
Centre for Mental Health
March 2014

Read more here.

Improving Wheelchair Services

These documents summarise the discussions at the Wheechair Summit, which brought together wheelchair users with NHS clinicians, managers and third sector organisations to improve services, both locally and nationally.

Find out more and access all the resources here.

Friday 11 April 2014

Race equality and health inequalities

"This paper argues that within the English health system the ‘Equality and Diversity’ and ‘Health Inequalities’ agendas remain poorly integrated at both national and local level...This paper suggests that the disconnect between Equality and Diversity and Health Inequalities work hampers progress towards better understanding of the processes that perpetuate poor health outcomes."

Race equality and health inequalities: towards more integrated policy and practice
Better Health briefing paper 32
S Salway, L Carter, K Powell, D Turner, G M George, TH Ellison
Race Equality Foundation
March 2014

Read more here.

Commissioning in adult social care

Between May 2013 and February 2014 the Local Government Information Unit worked in partnership with home care provider Mears to deliver a series of roundtables for the Adult Social Care Thought Leader Series, including those on:

  • Market Management
  • Monitoring and Evaluation
  • Personalisation and Co-Production
  • Integration
  • Workforce Issues

This document brings together the notes from the series.

Commissioning in adult social care: the LGiO and Mears thought leader series - a summary
Local Government Information Unit, Mears
April 2014

Read more here.

Blood Sugar Rush: Diabetes time bomb in London

"The London Assembly Health Committee has sought to tease out what is driving the increase in Type 2 diabetes across London, and how the delivery of diabetes care is managed and where improvements can be made in providing that care."

Blood Sugar Rush: Diabetes time bomb in London 
London Assembly Health Committee
April 2014

Read more here.

The reality behind improving cancer survival rates

"By addressing issues such as morbidities, delays in diagnosis and cancer recurrence, we can improve care for patients, improve their outcomes and save the NHS money."

Cancer’s unequal burden – The reality behind improving cancer survival rates
Macmillan Cancer Support
April 2014

Read more here.

Mental Healthwatch handbook

"This handbook provides information on how Healthwatch can help improve mental health with a range of partners including central government, service users, comissioners, providers, the voluntary sector and councils."

Mental Healthwatch handbook: Improving mental health with your community
National Survivor User Network
April 2014

Read more here.

Department of Health Improvement Plan

"The plan has been developed following an assessment of the 4 critical themes of organisational effectiveness: performance; efficiency and innovation; capability; strategic risk and leadership of change. It sets out where the department is currently, what it has achieved, where it needs to be in future and the improvements that the department needs to make to get there."

Department of Health Improvement Plan
Department of Health
April 2014

Read more here.

A new settlement for health and social care

"In our view, the weight of evidence makes it clear that the present settlement lacks transparency, is inefficient, puts too much weight on individual rather than collective responsibility, and raises a significant moral concern about the lack of equity of treatment for similar levels of need."

A new settlement for health and social care: Interim report
K Barker (Chair), Commission on the Future of Health and Social Care in England
The King’s Fund
April 2014

Read more here.

Accountable care organisations: Testing, evaluating and learning what works

"Now more than ever the NHS needs to be able to innovate at scale and pace and testing out a variety of ways of integrating care should be encouraged."

Accountable care organisations in the United States and England: Testing, evaluating and learning what works
Stephen Shortell, Rachael Addicott, Nicola Walsh, Chris Ham
The King's Fund
March 2014

Read more here.

Best BMJ Quality & Safety articles 2013

"This special collection reflects the depth and breadth of content from BMJ Quality & Safety, which encourages innovation and creative thinking to improve the quality of health care and the science of improvement."

Articles included in the collection are:
  • Identification of doctors at risk of recurrent complaints: a national study of healthcare complaints in Australia
  • The global burden of unsafe medical care: analytic modelling of observational studies
  • Systematic review of the application of the plan–do–study–act method to improve quality in healthcare
  • Assessing adverse events among home care clients in three Canadian provinces using chart review
  • 'Care left undone’ during nursing shifts: associations with workload and perceived quality of care
  • Allocating scarce resources in real-time to reduce heart failure admissions: a prospective, controlled study
  • Culture and behaviour in the English National Health Service: overview of lessons from a large
    multimethod study
BMJ Quality & Safety: A collection of key articles
The Health foundation
April 2014

Read more here.

The four health systems of the United Kingdom: how do they compare?

"Overall, this research suggests that despite hotly contested policy differences between the UK health systems since devolution on structure, competition, patient choice and the use of non-NHS providers, there is no evidence linking these policy differences to a matching divergence of performance, at least on the measures available across the four UK countries."

The four health systems of the United Kingdom: how do they compare?
G Bevan, M Karanikolos, J Exley, E Nolte, S Connolly, N Mays
The Health Foundation, Nufffield Trust
April 2014

Find out more and access all of the resources here.



Reducing harm to patients

"This briefing follows a March 2014 speech by the Secretary of State for Health at Virginia Mason Medical Center in Seattle. In his speech, Jeremy Hunt MP set out a new ambition to reduce avoidable harm to patients in the NHS."

Briefing: Reducing harm to patients
The Health Foundation
March 2014

Read more here.