Blog post by Steve Fairman, Managing Director of NHS Improving Quality

Today’s NHS is facing almost unprecedented challenges. Demand for services continues to grow while resources are under greater pressure than ever. It is clear that we can only square this circle by changing the way we do things. And that is exactly what NHS Improving Quality’s new White Paper offers.

Health Foundation directors were asked to write about what they think the key issues are facing the health service over the coming months and years. The result? A collection of blog posts discussing the challenges to achieving health care quality against a backdrop of constrained budgets and rising demand. But it’s not all doom and gloom: they also give their views on what can be done by those in health care practice and policy to maintain and improve quality for patients across the UK.

This guidance is designed to help ensure safe and efficient nurse staffing levels on hospital wards that provide overnight care for adult patients in England and is in response to concerns about standards of patient care following the Mid-Staffs inquiry. The guidance committee concluded that when each registered nurse is caring for more than 8 patients this is a signal to check that patients are not at risk of harm. At this point senior management and nursing managers should closely monitor red flag events, analyse safe nursing indicator data and take action if required. No action may be required if patient needs are being adequately met.

Finds enhanced recovery programmes have been adopted with some enthusiasm by the NHS as a means to achieving productivity gains and cost-savings. The evidence base to support such widespread implementation is limited, but does suggest possible benefits in terms of reducing length of hospital stay by 0.5–3.5 days compared with conventional care, without compromising postoperative complications, readmissions or patient outcomes. Enhanced recovery programmes are complex interventions and the most effective combination of elements requires further clarification.

Joint report from College of Emergency Medicine, the NHS Confederation, the Royal College of Surgeons and the Royal College of Paediatrics and Child Health that provides a synthesis of the key points raised in discussions at the summit. It sets out 13 recommendations for government, national bodies, commissioners, providers, professional bodies and clinicians to take forward at local, regional and national levels. Implementing these measures will help build an urgent and emergency care system that is resilient, fit for purpose and sustainable. Recommendations cover key areas such as access and alternatives, closer system collaboration, workforce, training, funding and technology.

Key recommendations include ensuring that out-of-hours GP services should be available in hospitals alongside emergency departments to try to stem the “overwhelming” number of patients seeking urgent care, leading doctors have said. There should also be other health and social care workers physically located in emergency departments to bridge the gap between GP, hospital and social care services in order to support vulnerable patients.

An independent review for the government has concluded that more NHS organisations should be encouraged to become public service mutuals. The review, led by Chris Ham, Chief Executive of The King’s Fund, found compelling evidence that NHS organisations with high levels of staff engagement – where staff are strongly committed to their work and involved in decision-making – deliver better quality care. While staff engagement levels have increased across the NHS in recent years, the review found significant variations between organisations. It calls on all NHS organisations to make staff engagement a key priority in order to improve care at a time of unprecedented financial and service pressures.

This article discuss the democratic leadership style which is created by a highly mobile, in-demand workforce. It looks at how leaders rise in this kind of environment and identifies 3 key traits of these people.

Explains the importance of trust and some strategies for building trust with in a team both in person and virtually.

The effect employee satisfaction has on productivity at work. Looks at engagement, retention, focus, general life satisfaction and positive energy at work.

 The NHS is poorly placed to deal with continuing austerity and could experience a funding crisis before the 2015 General Election, our latest study reveals. This research provides the most comprehensive look yet at how the finances of the hospitals and commissioning groups that make up the NHS in England have held up under austerity between 2010 and 2014.