News Bulletin for Tuesday 18th March

March 18, 2014 Daily News

Expert group: Leave Francis constitution amendments ’till later’ – HSJ
An expert group set up to review the future of the NHS Constitution has rejected the Francis report’s recommendation the document should be rewritten and has instead said the government should focus on making sure it was “publicised, embedded and applied”.

Hospital discharge delays ‘cost NHS £100m’ HSJ
Delays in discharging patients from hospital while they are waiting for social care to be arranged are costing the NHS in England about £100m each year, a documentary claims.

Adult Social Care review
In the first of a series of reports on the adult care system, the National Audit Office has highlighted the main risks and challenges as the system changes radically. Adult Social Care: an overview points out that government does not know if the limits of the capacity of the care system to continue to absorb pressures are being approached. It warns that major changes to the system to improve outcomes and reduce costs will be challenging to achieve.

Community engagement to improve health
NICE has produced a local government briefing on Community engagement to improve health. This briefing summarises NICE’s recommendations for local authorities and partner organisations on how community engagement approaches can be used to improve the planning and delivery of all services, including those that impact on health. It is particularly relevant to health and wellbeing boards.

Early access to medicines
The government has announced a new scheme which aims to give patients with life threatening or seriously debilitating conditions access to medicines that do not yet have a marketing authorisation.  Under the Early Access to Medicines Scheme, Medicines and Healthcare products Regulatory Agency (MHRA), will give a scientific opinion on a new medicine or indication that has demonstrated a positive risk/benefit balance.  The scheme will begin taking applications from companies from early April 2014.
Additional link: DH press release

Extension to new medicine service
NHS England has been considering the short term future of the new medicine service (NMS), in discussion with the Pharmaceutical Services Negotiating Committee.  It has been agreed that the NMS will be extended to run throughout 2014/15, subject to the outcome of the evaluation.  This decision was informed by initial findings from the evaluation. The final report is not expected to be published before May 2014.

The 5 most difficult conversations you’ll have at work…made easy – People Management Article
Article outlining approaches to 5 key HR conversations, from dealing with a bully to proving the value of the HR function.

Systematic review of the application of the plan–do–study–act method to improve quality in healthcare – BMJ Quality & Safety Article
Plan–do–study–act (PDSA) cycles provide a structure for iterative testing of changes to improve quality of systems. The method is widely accepted in healthcare improvement; however there is little overarching evaluation of how the method is applied. This paper proposes a theoretical framework for assessing the quality of application of PDSA cycles and explores the consistency with which the method has been applied in peer-reviewed literature against this framework.

Rethinking ‘quality’ in health care – Journal of Health Services Research & Policy
In England, the NHS is ‘organising itself around a single definition of quality: care that is effective, safe and provides as positive an experience as possible’ enshrined in the NHS Outcomes Framework, as a set of measurable indicators.

Building knowledge, asking questions – BMJ Quality & Safety April 2014
In his recent book Ignorance: how it drives science, Stewart Firestein states, ‘Knowledge is a big subject. Ignorance is bigger.’  Firestein’s book does not explore the ways of knowledge, but the mechanisms by which scientists work to develop and answer questions…which invariably lead to more questions. ‘Not knowing’ is a key driver of research and of quality improvement (QI). While research seeks to create new generalisable knowledge, QI often focuses on improving a specific aspect of healthcare delivery that is not consistently or appropriately implemented in a particular setting.

Surgical checklists: a systematic review of impacts and implementation – BMJ Quality & Safety April 2014
Surgical complications represent a significant cause of morbidity and mortality with the rate of major complications after inpatient surgery estimated at 3–17% in industrialised countries. The purpose of this review was to summarise experience with surgical checklist use and efficacy for improving patient safety.

Suffering in silence: a qualitative study of second victims of adverse events – BMJ Quality & Safety April 2014
The term ‘second victim’ refers to the healthcare professional who experiences emotional distress following an adverse event. This distress has been shown to be similar to that of the patient—the ‘first victim’. The aim of this study was to investigate how healthcare professionals are affected by their involvement in adverse events with emphasis on the organisational support they need and how well the organisation meets those needs.

Analysis of patients’ comments about hospitals in the NHS via Twitter, and comparison with patient surveys –  BMJ Quality & Safety April 2014
Twitter and other social media are increasingly used by patients to discuss their experiences of healthcare. Social media might provide a new way for health services to listen to the voices of patients and improve their services. Little is known about how patients are communicating with hospitals via this route, and whether there is any association with traditional measures of patient experience such as surveys.

Does pay for performance in hospitals save lives? –  BMJ Quality & Safety April 2014
Pay for performance is increasingly used as a way of improving the quality of medical care. We previously showed that a pay for performance scheme targeting a range of processes measures in hospitals in the North West of England was associated with a substantial reduction in mortality for pneumonia, myocardial infarction and heart failure equivalent to 890 fewer deaths (Sutton et al. Reduced Mortality with Hospital Pay for Performance in England. New England Journal of Medicine 2012;367:1821–28). This analysis only assessed mortality in the first 18 months after introduction of the scheme. We now report mortality outcomes at 42 months to see whether the effect was sustained.

Evaluation of quality of care using registry data: the interrelationship between length-of-stay, readmission and mortality and impact on hospital outcomes. – BMJ Quality & Safety April 2014
Hospital mortality, readmission and length of stay (LOS) are commonly used measures for quality of care, given availability in administrative data. However, these measures are interrelated. For example, a short LOS due to patient’s death should be interpreted differently than short LOS in survivors. And patients who died cannot be readmitted. In this study we aim to disentangle the relationship between mortality, readmission and LOS and propose a way to jointly report the three figures to facilitate insight and evaluation of quality of care.

Proposals to remove administrative burdens on CCGs and NHS England
The Department of Health has published proposals to amend current legislation to remove administrative burdens on clinical commissioning groups (CCGs) and NHS England. Explanatory Document to accompany draft Legislative Reform Order 2014: amending the National Health Service Act 2006 sets out details of the proposal to use a Legislative Reform Order (LRO) to amend the NHS Act 2006 to: enable 2 or more CCGs to form a joint committee when carrying out their functions; and enable CCGs and NHS England to jointly exercise CCG functions and form a joint committee when doing so.  The draft Order has been laid in parliament and is going through parliamentary procedures for approval.

News Bulletin for Monday 17th March

News Bulletin for Wednesday 19th March