The state of the NHS provider sector: November 2016 – NHS Providers
This survey of NHS trust chairs and chief executives has revealed rising concerns over the growing NHS workforce gap. 172 NHS leaders responded to the survey and only 27 per cent of these respondents reported confidence in having the right staff numbers, quality and skill mix to deliver high-quality care. The report provides examples of where trusts are improving quality of care and increasing productivity despite financial constraints and growing demand. The report highlights that trusts are able to deliver when given achievable tasks but warns that the sustainability of services is at risk.

Pediatric emergency department return visits: a proactive approach to quality improvement. Ostrow, O., Shim, A., Azmat, S., Chartier, L. – BMJ Quality & Safety
Routine monitoring and investigation of ED RVs provides a proactive approach to seeking improvement opportunities. With a better understanding of specific patient and visit-level factors associated with RVs, future system-level quality improvement initiatives can be targeted.

A ‘paperless wall-mounted surgical safety checklist with migrated leadership can improve compliance and team engagementOng, A. P. C., Devcich, D. A., Hannam, J., Lee, T., Merry, A. F., Mitchell, S. J. – BMJ Quality & Safety
Improvements in team engagement and compliance with administering checklist items followed introduction of migrated leadership of checklist administration and a wall-mounted checklist. This paradigm change was relatively simple and inexpensive.

Displaying radiation exposure and cost information at order entry for outpatient diagnostic imaging: a strategy to inform clinician orderingKruger, J. F., Chen, A. H., Rybkin, A., Leeds, K., Guzman, D., Vittinghoff, E., Goldman, L. E. – BMJ Quality & Safety
Displaying radiation exposure and cost information at order entry may improve clinician awareness about diagnostic imaging safety risks and costs. More clinicians reported the radiation information influenced their clinical practice.

The Healthcare Complaints Analysis Tool: development and reliability testing of a method for service monitoring and organisational learning – Gillespie, A., Reader, T. W – BMJ Quality & Safety
HCAT is not only the first reliable tool for coding complaints, it is the first tool to measure the severity of complaints. It facilitates service monitoring and organisational learning and it enables future research examining whether healthcare complaints are a leading indicator of poor service outcomes. HCAT is freely available to download and use.

Does integrated care reduce hospital activity for patients with chronic diseases? An umbrella review of systematic reviews. – BMJ Open
This summary of 50 reviews investigating integrated care interventions found that most reported statistically significant improvements in outcomes (e.g. emergency admissions, length of stay), but that interventions rarely demonstrated unequivocally positive effects

NMC announces new OSCE test centre
The Nursing and Midwifery Council (NMC) has announced the opening of a new UK centre for testing the competence of nurses and midwives trained outside of the European Economic Area.

NHS trusts urged to use private care to beat winter crisis – NHE 
Leaked documents show that trusts are being instructed to transfer patients to the private sector as part of a bid to cope with unprecedented demand this winter, leading the BMA to warn that the NHS is now facing “unmanageable pressures”. The NHS England and NHS Improvement memo, seen by the Daily Telegraph, instructs trusts…

Market structure, patient choice and hospital quality for elective patients – Centre for Health Economics (CHE)
This paper examines the change in the effect of market structure on hospital quality for elective procedures following changes in 2006 to encourage greater patient choice of hospital in England. The study finds that post-2006, hospital quality was reduced as the probability of emergency readmission was increased for hip and knee replacement patients.

BMA warns over ‘unprecedented’ sharing of medical records in new Bill – NHE
The Digital Economy Bill could pose an “unprecedented” risk to the confidentiality  of patients’ medical records, the BMA has warned. In a briefing ahead of a Parliamentary discussion of the Bill yesterday, the doctors’ union warned that Part 5, Clause 29 “would appear to permit an unprecedented and…

HSJ roundup: (contact the library for further details on any of these HSJ articles)

• Details of new waiting targets for trusts 
  NHS trusts will have to report how quickly they are treating patients experiencing mental health crisis in A&E or hospital wards from April as part of new NHS England standards.
• NHS staff ‘quitting to stack shelves’, warns provider chief
  Staff in lower pay bands are leaving the NHS to stack supermarket shelves and work in care homes because the service is keeping wages down despite private sector salary increases, a senior figure has warned.
• Keeping trusts’ deficit under £1bn would be ‘extraordinary’  
  Keeping the provider sector deficit under £1bn in 2016-17 would be “an extraordinary achievement”, the chief executive of NHS Providers has said, despite trusts being set a target of £580m.
• Trust seeks to terminate £200m contract 
  Nottingham University Hospitals Trust will look to terminate a five year, £200m estates and facilities contract with Carillion amid concerns over poor standards.
• Trusts create joint executive board  
  A single executive management team has been appointed to run two acute foundation trusts.
• ‘Ominous’ social care warning from leading STP  
  Health leaders in Greater Manchester have warned that social care funding problems threaten to jeopardise the delivery of their regional plan – despite their £450m transformation fund.
• Private providers back on course to land £1.2bn deal  
  A major £1.2bn procurement for cancer and end of life care which was “paused” because of the collapse of another similar large contract involving the same lead advisers has finally been given the go ahead by NHS England.