Cuts to social care funding represent urgent threat to the NHS, warn experts – BMJ
Successive cuts to local authority budgets are leading to serious gaps in social care availability to older people and are putting significant strain on the NHS, according to a new report by health think tanks the King’s Fund and the Nuffield Trust

Time for a turnaround on turnaround time –  MindMetre Research
This briefing contains an assessment of the importance and impact of improving laboratory test turnaround time in the acute care sector. The authors consider whether this is an area that should be better funded and prioritised?

Who knows best? Older people’s contribution to understanding and preventing avoidable hospital admissions –  University of Birmingham
The authors of this report interviewed 104 older people, exploring their experiences of emergency admissions. The research focused on whether the older people felt it was appropriate to be admitted to hospital and whether they thought anything could have prevented their admission. The findings of this study confirm the belief that older people have an important role to play in helping understand the nature of emergency admissions and to devise appropriate responses to their rising numbers. The report concludes that ignoring this expertise could be detrimental to ensuring older people get the appropriate care they need.

Trust heading for unexpected deficit after governance failings – Health Service Journal
Gloucestershire Hospitals Foundation Trust has revealed it is heading for a large unexpected deficit after “concerns” were raised within the trust about its financial position.

Checklist for signing off new care model revealed – Health Service Journal
Regulators are expected to require proposals for MCPs to pass three tests under a “joint assurance process” before becoming operational, according to governing body paper.

Why is diagnosing frailty important? – Professor Martin Vernon, NHS England
Professor Martin Vernon, National Clinical Director for Older People and Integrated Care at NHS England discusses the importance and potential in diagnosing frailty. ‘All the world’s a stage…and one man in his time plays many parts, his acts being seven ages’. Shakespeare elegantly captured life’s journey, describing human frailty in ways we can still resonate […]

More GPs needed to ‘keep NHS on its feet’ as 600 practices face closure – NHE
Primary medical care will be short-staffed and unsafe for patients unless more GPs are recruited to address the shortfall in the service, the Royal College of General Practitioners (RCGP) has said, as it warned that nearly 600 practices are currently at risk of closure. The RCGP estimates that the number of full-time equivalent GPs across…

Doctors risks of formal patient complaints and the challenge of predicting complaint behaviour – BMJ Quality & Safety current issue
Spittal et al recently presented the readers of this journal with a simple and reliable scoring system for predicting doctors’ risk of becoming the subject of patient complaints. Development of such measures can probably promote constructive use of complaint information, decrease patient dissatisfaction, prevent substandard care and target quality improvement interventions. Using patient complaints constructively, however, necessitates consideration of the manifold facets of patient complaints and behaviours related to making complaints. Patients may have rather different motivations and thresholds for complaining about healthcare delivery and it remains unclear to what degree complaint patterns and over-represented doctor categories provide a balanced reflection of substandard healthcare and quality problems. Furthermore, empirical data are limited about whether complaint risk is actually sensitive to quality improvement interventions and health provider changes (eg, exhortation to undertake continuing medical education, communication technique optimisation, shared decision-making, care upgrade or, ultimately, exclusion of health professionals).

Statistical analysis of differences in turnover times among operating theatres –
BMJ Quality & Safety current issue
Overdyk et al used remote video auditing with real-time feedback in a surgical suite. As part of their randomised trial clustered by theatre, they report less turnover times among ‘fast rooms’, those generally including three or greater cases per day. Successive turnover times between scheduled cases within theatres on the same date tend to be correlated (eg, caused by same surgeon, nurses and anaesthetist). This was shown in Dexter et al and Austin et al. Overdyk et al’s description of their statistical model seems not to describe consideration of correlations of turnover times within the same theatre on the same day. This can be rectified by including the theatre-day combination as a fixed or random effect. Alternatively, and typically, analyses take the simpler approach of batching (binning) by each day, week, 2-week or 4-week period, and then comparing the periods (eg, week) pairwise…

An embedded checklist in the Anesthesia Information Management System improves pre-anaesthetic induction setup: a randomised controlled trial in a simulation setting –
BMJ Quality & Safety current issue
Background: Anaesthesiologists work in a high stress, high consequence environment in which missed steps in preparation may lead to medical errors and potential patient harm. The pre-anaesthetic induction period has been identified as a time in which medical errors can occur. The Anesthesia Patient Safety Foundation has developed a Pre-Anesthetic Induction Patient Safety (PIPS) checklist. We conducted this study to test the effectiveness of this checklist, when embedded in our institutional Anesthesia Information Management System (AIMS), on resident performance in a simulated environment.

Conclusion: Required use of a pre-induction checklist improves anaesthesiology resident performance in a simulated environment. The PIPS checklist as an integrated part of a departmental AIMS warrant further investigation as a quality measure.

Real lives: listening to the voices of people who use social care –  The Richmond Group of Charities
In summer 2016, working in collaboration with the British Red Cross and Royal Voluntary Service, The Richmond Group of Charities commissioned The King’s Fund and the Nuffield Trust to undertake a series of interviews with individuals with experience of using social care services. The aim of this work was to complement and add value to a wider piece of research being undertaken by The King’s Fund and the Nuffield Trust to examine the future sustainability of the social care system, Social Care for Older People: Home Truths (published 15 September 2016). The personal experiences of people needing care and support and their carers outlined in Real Lives illustrate the key issues and challenges facing local authorities, policymakers and those who depend on services.

About the Public Health England Office for Data Release (ODR) and accessing data – 
Public Health England (PHE)
These documents contain details of the services offered by the PHE ODR and guidance on how to access PHE held data. PHE recognises the benefits of using data for the public good but also has a range of policies, protocols and processes in place to ensure the confidentiality of data is maintained at all times. The ODR is responsible for managing the release of explicitly identifiable or potentially identifiable data from PHE on behalf of the Information Asset Owner to an agreed process and within a formal structure.

Tackling bullying and harassment in the NHS – NHS Employers
In the first of a two-part series of podcasts listen to NHS experts and external specialists discuss bullying and harassment in the NHS.