NEW Lessons Learned Bulletin – March 2016. The Deteriorating Patient (Only available via the Trust Intranet)

NEW on the Library website – The Deteriorating Patient Information Resource Portal Links to the latest guidance and pathways, research articles, video clips and evidence based resources. http://www.sonhslks.com/the-deteriorating-patient.html

Health and care bodies reveal the map that will transform healthcare in England – NHS England
National health and care bodies in England have published details of the 44 ‘footprint’ areas that will bring local health and care leaders, organisations and communities together to develop local blueprints for improved health, care and finances over the next five years, delivering the NHS Five Year Forward View.

Senior leaders who will be leading this work have also been confirmed today, with broadly equal representation from clinical commissioning groups and from hospitals and other providers of care, as well as some key figures from local authorities, recognising the need for local systems to work in partnership.

Sustainability and financial performance of acute hospital trusts
The Public Accounts Committee has published Sustainability and financial performance of acute hospital trusts.  The Committee concludes the financial performance of NHS trusts and NHS foundation trusts has deteriorated sharply and this trend is not sustainable.  It highlights the “long-term damage” to trusts’ finances caused by unrealistic government efficiency targets, and describes the data used to estimate trusts’ potential cost savings targets as “seriously flawed”.  It concludes the current system for paying providers “is not fit-for-purpose as it does not incentivise the right behaviors needed for joined-up healthcare services”.

Quality improvement training in medical education
The Academy of Medical Royal Colleges has published Quality improvement – training for better outcomes.  The report provides recommendations for embedding quality improvement training in medical education and highlights the importance of making quality improvement part of the mindset of all health and social care staff. It calls on employers in particular, to provide protected time and resources for doctors to put their quality improvement training into practice.

The Value and Contribution of Nursing to Public Health in the UK – Royal College of Nursing
This report shows the difference individual nurses and their teams can make if they are given the time, support and authority to do so.  It finds nursing expertise is highly valued, but barriers to nurses’ involvement in services include a lack of training among some nurses and a lack of knowledge among some commissioners of where nurses could contribute.  Commissioners state nurses are well placed to give public health messages and are often seen as more approachable than some other health care practitioners.

Comparing the cost-effectiveness and clinical effectiveness of a new community in-reach rehabilitation service with the cost-effectiveness and clinical effectiveness of an established hospital-based rehabilitation service for older people: a pragmatic randomised controlled trial with microcost and qualitative analysis – the Community In-reach Rehabilitation And Care Transition (CIRACT) study. –  Health Services and Delivery Research, Vol:4, Iss:7
Older people represent a significant proportion of patients admitted to hospital as a medical emergency. Compared with the care of younger patients, their care is more challenging, their stay in hospital is much longer, their risk of hospital-acquired problems is much higher and their 28-day readmission rate is much greater.  This study compares the clinical effectiveness, microcosts and cost-effectiveness of a Community In-reach Rehabilitation And Care Transition (CIRACT) service with the traditional hospital-based rehabilitation (THB-Rehab) service in patients aged ≥ 70 years.

Preparing for Home: a before-and-after study to investigate the effects of a neonatal discharge package aimed at increasing parental knowledge, understanding and confidence in caring for their preterm infant before and after discharge from hospital,  – Health Services and Delivery Research, Vol:4, Iss:10
Improved survival and shorter length of stay (LOS) for preterm infants, together with poorly organised discharge planning in some neonatal units, leaves many parents ill prepared to take their babies home, with increased use of out-of-hours services. Despite the importance accorded to family-orientated neonatal care by the Department of Health and the National Institute for Health and Care Excellence, few neonatal units offer structured, family-orientated discharge planning.

End-of-life care and physician-assisted dying: reflections and recommendations –  British Medical Association (BMA)
This project, launched in November 2014, aimed to examine both the public and medical professionals’ attitudes on aspects of end-of-life care and physician-assisted dying. While recognising the many excellent examples of end-of-life care provision, this research highlights the variability in the quality of care between and within geographical areas and between different medical conditions. The report outlines the main challenges to providing good end-of-life care and the ways we can address them. It highlights three overarching themes which have come out of the research: the need to ensure the provision of consistently high-quality end-of-life care; the need for ongoing education, training and support for doctors; and the central role of families and those close to the patient.

Independent sector providers
The NHS Partners Network has produced an infographic to highlight the varied and important contribution that independent sector providers make to supporting NHS patients.

NHS accepts HSJ call for gender equality on boards – Health Service Journal
The NHS has embraced a target to achieve gender balanced boards.  This week senior figures from across the service gave it their backing.  Ed Smith, NHS Improvement chair and the health service’s gender diversity champion, said: “I accept that challenge and will work hard to drive that ambition through the NHS. Now let’s get to work.”

New CQUIN guidance to support the wellbeing of NHS staff – NHS Employers
Guidance released to help and inform organisations of the new Commissioning for Quality and Innovation to improve staff health and wellbeing.

NICE shared learning

NICE has published the following shared learning case studies:

• Hospital Transfer Pathway (Red Bag Pathway) – Sutton CCG
• Service Evaluation for Group Clinics for New Patients with newly Diagnosed Coeliac Disease  – Sheffield Teaching Hospitals
• Therapy Support Workers in Critical Care: Improving physical and cognitive rehabilitation – Nottingham University Hospitals
• Improving the uptake of Hepatitis B screening and vaccination in at-risk groups attending the sexual health service – University Hospitals Birmingham NHS Foundation Trust

NICE consultations

• Diabetes in adults QS (update): Quality Standard consultation. Closing date for consultation 12 April 2016
• Tuberculosis: Topic engagement. Closing date for consultation 22 March 2016
• Mental health problems in people with learning disabilities: Draft guidance consultation. Closing date for consultation 20 April 2016
• Mental health problems with learning disability: Topic engagement. Closing date for consultation 20th April 2016

Statistics

• Quality Outcomes Framework (QOF) Recorded Dementia Diagnoses – February 2016
• Disability-Free Life Expectancy by Upper Tier Local Authority: England 2012-14
• Healthy Life Expectancy at birth by Upper Tier Local Authority and Area Deprivation: England: 2012 to 2014
• Combined Performance Summary –  January 2016
• Hospital Activity Data –  January 2016