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Strategy Update
Recently published guidance, policies, articles and reports
October - December 2016
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Focus on Sustainability and Transformation Plans
NHS transformation plans promising but unrealistic, CIPFA warns.
Despite sustainability and transformation plans (STPs) emerging as a good means of addressing the need for financial stability, some strategies drawn up do not include enough substance to prove they are tackling the problems realistically, according to a new report released 18th November by CIPFA.
Effective governance and engagement within STPs
NHS Clinical Commissioners in partnership with NHS Confederation, National Voices and the Centre for Public Scrutiny have launched the STP checklist for governance and engagement. The checklist aims to support those delivering change within their Sustainability and Transformation Plan (STP) footprints to work through key governance and accountability challenges. The checklist sets out a series of questions that can be asked locally and within boards to support effective discussion and decision-making.
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To access full text you may have to log in to your NHS Athens account (click here to register for free). If full text is not available then please email us to request a copy.
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International healthcare systems: Spain
The NHS Confederation has published the concluding episode in an international healthcare systems podcast. What the NHS can learn from international healthcare systems: Spain features an interview with Santiago Delgado, Director of Business Development at Spanish healthcare provider Ribera Salud. It features the Alzira model, a public-private partnership model that has revolutionised care across Spain.
NHS providers has published The state of the NHS provider sector. This report examines the state of the 238 hospital, mental health, community and ambulance NHS trusts in England. It examines how they are performing, the challenges they face and how they are responding. It combines analysis and commentary, published data and the views of NHS trust chairs and chief executives. It focuses on four key issues: quality and patient access, finance, workforce and transformation.
Effect of market structure on hospital quality for elective procedures
The University of York Centre for Health Economics has published Market structure, patient choice and hospital quality for elective patients (Research paper 139). This paper examines the change in the effect of market structure on hospital quality for elective procedures (hip and knee replacements, and coronary artery bypass grafts) following the 2006 loosening of restrictions on patient choice of hospital in England.
Improving whole system flow
The Health Foundation and the Advancing Quality Alliance have published The challenge and potential of whole system flow: improving the flow of people, information and resources across whole health and social care economies. This report outlines an organising framework and tested methods that local health and social care leaders can use to improve whole system flow. It draws on case studies and other examples of work from across the UK and internationally and describes steps that policymakers and regulators at a national level should take to create an environment that is conducive to change at this scale.
Service Integration
The Local Government Association in partnership with NHS Confederation, ADASS and NHS Clinical Commissioners has published Stepping up to the place: integration self-assessment tool. This tool is designed to support local health and care leaders through health and wellbeing boards to critically assess their ambitions, capabilities and capacities to integrate services to improve the health and wellbeing of local citizens and communities.
Guidance: Burden of Disease Study for England
12 October, 2016
Estimates of the main causes of death and disability, attributable risk factors and the effect of deprivation, modelled for England and its regions.
Patient flow in hospitals
The Nuffield Trust has published Understanding patient flow in hospitals. This briefing draws on theories about congestion in hospitals to look at why meeting the A&E four hour target has become more difficult, and what can be done about it. It looks at ongoing changes driving pressure on bed space, including mortality, the squeeze on bed space during years of austerity, rising numbers of patients with multiple conditions, and delayed discharges. It also looks at the solutions available and suggests
managers should focus in particular on the minority of long-staying patients who account for a majority of bed use.
State of health care and adult social care
The Care Quality Commission (CQC) has published The state of health care and adult social care in England 2015/16. This annual report provides an overview of health and social care in England looking at the trends, highlighting examples of good and outstanding care, and identifying factors that maintain high-quality care. It finds that most services provide people with good care, but variation exists. Some care services are closing, increasing pressure on other services including GPs and hospitals. The report highlights that the sustainability of the adult social care market is approaching a tipping point.
Social value priorities in health and care commissioning
Social Enterprise UK has published 12 Steps to embedding social value priorities in health and care commissioning. This report details the difference social value can make in health and care commissioning, and shares learning for other commissioning authorities to make the most of social value. It presents the initial findings from the Social Value Programme, a three-year programme bringing together local CCGs, local authorities, Health and Wellbeing Boards and the voluntary, community and social enterprise organisations in twelve areas across England.
News story: Getting patients quicker access to innovative healthcare
24 October, 2016
New recommendations set out how patients could get quicker access to innovative new diagnostic tools, treatments, and medical technologies.
Accountability for integrated care
The Health Foundation has published Simpler, clearer, more stable: integrated accountability for integrated care. This paper identifies the principles that should underpin a good accountability framework, and examines how the present arrangements for accountability across health and social care in England could be improved.
NHS Five Year Forward View: progress report
The King’s Fund has published NHS Five Year Forward View: two years on. This report reviews progress on the implementation of NHS Five Year Forward View. This progress report assesses what changes have already been made in the implementation of the Forward View and highlights what still needs to be done to align policies with the plan.
Prevalence of conditions across England
NHS Digital has published Quality and Outcomes Framework (QOF) - Prevalence, Achievements and Exceptions Report, England 2015-16. The report provides information on the prevalence of 21 conditions, including heart disease, hypertension, dementia, diabetes, and depression. It also identifies how the prevalence of these conditions has changed since the previous year. Prevalence data on these conditions can be broken down sub-nationally to regional and general practice level.
Supporting patients with multimorbidity
The Royal College of General Practitioners has published Responding to the needs of patients with multimorbidity: a vision for general practice. This report reviews how effectively the current health system serves patients living with multiple long-term conditions, and explores the experiences of these patients. It highlights the barriers that prevent the quality of their care improving such as lack of time and resources for GPs and provides recommendations to overcome these barriers. The report also recommends improving communication between primary and secondary care; increasing exposure of delivering care for those with multimorbidity in GP training; and developing improved decision making tools.
Reducing winter pressures on accident and emergency departments
The House of Commons health committee has published Winter pressure in accident and emergency departments Third Report of Session 2016–17. This report is calling on the Government to make sure that sufficient funding is available to support the infrastructure investment required to ensure that type 1 emergency departments are fit for purpose, and to review the real terms cuts to NHS capital budgets in the spending review. The Committee is also asking for NHS Improvement to consider the steps that it can take this winter to ensure that all A&E departments are properly staffed and for Health Education England to look again at the long term sustainability of staffing, including for paramedics, within major emergency departments and the ambulance service.
Delivery of local health and care services
PricewaterhouseCoopers (pwc) has published Redrawing the health and social care architecture. This report also calls for health and social care to be brought under one department, away from the current system where social care sits with the Department for Communities and Local Government (DCLG). The report frames a vision in which the system remains a national service, where standards and majority of the funding is determined at a national level. However increasingly this balance of power should be devolved so local areas have greater responsibility and accountability.
Maternity transformation programme
NHS England has announced details of the seven local areas who will be taking forward the recommendations set out in its report Better Births. The Early Adopter sites will test a range of new and innovative ways of working to help transform maternity services such as: using small teams of midwives to offer greater continuity of care to women; creating single points of access to a wider range of maternity services; making better use of electronic records to provide more joined up care; improving postnatal care and providing better personalised care planning.
Guidance: Improving health through the home: a checklist for local plans and policies
10 November, 2016
How to review local plans to make sure they consider home and housing circumstances, and their effect on health.
Clinical oncology workforce
The Royal College of Radiologists has published Clinical oncology UK workforce census 2015 report.
This report provides information on the numbers, distribution and activities of all clinical oncologist in the UK. It also provides information on changing workforce and working patterns. The report highlights that a high-quality cancer care can only be achieved with sufficient numbers of oncologists and is calling on Government and NHS bodies to undertake rational, joint planning of the oncology workforce.
The King’s Fund - How to involve and co-produce with patients and communities
Bringing together national leaders and local innovations from across the country, this event demonstrated how you can implement the six principles which set out the basis of good person-centred, community-focused care. View the presentations here.
The King’s Fund - Policy changes to implement the NHS five year forward view: a progress report
Two years on from the publication of the NHS five year forward view, our new report assesses what progress has already been made and what still needs to be done to align policies with the plan. In his blog, Tom Buckley considers the significant challenges that lie ahead in implementing the Forward View, and shares his view on whether there is hope for sustainability and transformation in the NHS.
The King’s Fund - Integrated Care Summit 2016 – Presentations
Showcasing learning from national and international accountable care systems, as well as other emerging new care models, the summit explored more systemic and integrated approaches to improving population health.
Commissioning and delivering seven day services
The NHS Confederation has published Commissioning and delivering enhanced seven-day NHS services. This paper aims to get behind the debate and explore the evidence for and against the extension to seven-day services. It analyses what is already known about seven-day provision from the work of NHS national bodies, NHS organisations and others, and explores what the evidence already shows about the case for an enhanced seven-day NHS.
Improving local population - Urgent and emergency care pilot reports
As part of their plans to explore how they might comment on the quality of care across a local health and care system, the Care Quality Commissions has published reports of two pilots which explore what this could look like for urgent and emergency care. The reports focus on urgent and emergency care systems in South Warwickshire and in Airedale, Wharfedale, Craven & Bradford. In both areas the CQC looked at the contribution of the services that support people with urgent and emergency care needs, including NHS 111, A&E departments, ambulance services, GP practices, GP out of hours-services and care homes and how well they worked together for the benefit of the local population. health and delivering accountable care
Pathology services capacity
Cancer Research UK has published Testing times to come? An evaluation of pathology capacity across the UK. This report highlights lack of capacity for pathology services as a result of the increasing number of patient samples that need to be tested. The report recommends that action is taken now to address current and future workforce shortfalls. It also recommends the Royal College of Pathologists should update their guidance and look at ways to attract staff to train in pathology.
NHS Indicators
The House of Commons Library has published NHS indicators: England, December 2016. The briefing provides a summary of data on demand and performance for NHS services in England. It covers areas such as A&E, waiting lists, delayed transfers of care, staffing levels, and demand for hospital services.
Measuring health outcomes
The Office of Health Economics has published Important aspects of health not captured by EQ-5D: views of the UK general public. The EQ-5D is a standardised instrument designed for use as a generic measure of health outcome. This report sets out the views of the UK general public about aspects of health that they consider to be important but do not perceive as being captured by the five EQ-5D dimensions.
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Writing Club
We hold lunchtime meetings on a range of topics for clinicians who are interested in Writing for Publication.
Further details can be found here or email us to be added to the mailing list
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Resources used:
Daily Health Bulletin
Department of Health
The Health Foundation
Healthcare UK
The King's Fund
King's Fund Blog
NHS Confederation
NHS England
NHS Partners Network
Public Health England
Royal College of General Practitioners
Royal College of Physicians
UK Trade & Investment
The World Health Organisation
Links checked: 19/12/2016
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