Knowledge @lert for Thursday 4th May

May 3, 2017 CCG Daily News Uncategorized

Organising care at the NHS front line – The King’s Fund
What are the challenges facing frontline clinicians today and what could they do to improve the quality of care? Our report presents a range of views from clinicians, managers, quality improvement champions and patients.

Shifting attention to acute medical wards would benefit staff and patients – King’s Fund Blog, David Oliver
Organising care at the NHS front line, a report from The King’s Fund, focuses on the logistical barriers to delivering the best care for acutely ill medical patients. Its starting point is the lived experiences of clinical staff based on acute medical units, and general medical and geriatric inpatient wards. These clinical areas are in the eye of a perfect storm, created by rising emergency attendances, falling bed numbers and more patients stranded in hospital due to increasingly inadequate community health and social care capacity. Acute care staff are often the ‘shock absorbers’ for these system problems – the one place that can never say no, yet often feeling unable to influence solutions outside the hospital walls. Their own morale, retention and engagement can suffer, perpetuating a vicious circle. But are some of the solutions in their own gift?

QualityWatch – focus on: emergency hospital care for children and young people – Nuffield Trust
Analysing Hospital Episode Statistics from 2006/07 to 2015/16, this report looks at the use and quality of emergency hospital services for children and young people aged up to 24. It shows changes in patterns of use over time and provides the basis for discussions about the quality of care for children and young people.

Nurse staffing levels and NHS pay policy – The Health Foundation
The Health Foundation has published In short supply: pay policy and nurse numbers: workforce profile and trends in the English NHS. This briefing examines the current position with regard to nurse numbers and staffing standards, and the future of NHS pay policy. It highlights that the lack of a coherent workforce strategy which is integrated with funding plans and service delivery models is one of the Achilles heels of the NHS.

Brexit and health and social care – The House of Commons Health Committee
The House of Commons Health Committee has published Brexit and health and social care – people and process. This report is intended to be the first phase of an inquiry examining how the UK’s withdrawal from the European Union will affect the provision of health and social care in the UK. It addresses the immediate issues faced by people, whether they are workers in health and social care or patients who rely on reciprocal healthcare arrangements.

Apprenticeship update and resources – NHS Employers
The latest update on apprenticeships provides a range of information on degree apprenticeships, the new minimum wage rates and a response to frequently asked questions.

Safer pregnancy campaign – The Royal College of Midwives
The Royal College of Midwives has endorsed a new campaign called Always ask which is designed to empower pregnant women to overcome fears of asking health professionals questions. The campaign is designed to reduce the number of women who have serious pregnancy complications, or a loss that could have been prevented.

Commissioning diabetes care – NHS Clinical Commissioners
NHS Clinical Commissioners has published Excellence in commissioning diabetes care. This report provides examples of where clinically led commissioning is changing the way diabetes care is commissioned and improving people’s lives. The document draws out lessons from those involved in the projects and includes tips on commissioning excellent diabetes care.

Innovations to improve care for older people – The Health Foundation
The Health Foundation has published details of four projects funded through the Innovation for Improvement programme. The projects are using new and interesting approaches to improve care for older people and include people managing their own risk of getting a pressure ulcer; remote assessment using smart glasses; extending primary care teams; and continence promotion in care homes.

Homeless hospital discharge project – Housing LIN
Housing LIN has published Cornwall Hospital Discharge Partnership Project. This case study describes a county-wide multi-agency approach to establish a homeless discharge project in Cornwall. The project aimed to reduce the number of delayed discharges due to housing need, reduce the number of patients discharged to no fixed address or inappropriate housing, and improve the health and reduce inequality for the homeless.

Future of HIV services in England – The Kings Fund
The Kings Fund has published The future of HIV services in England: shaping the response to changing needs. This report explores the challenges and opportunities facing HIV services in four areas in England, and makes recommendations on future development to those in national and local leadership roles.

Safe space in healthcare safety investigations – The Department of Health
The Department of Health has published Providing a ‘safe space’ in healthcare safety investigations:summary of consultation responses and next steps. This report summarises consultation responses on creating a balanced ‘safe space’ to allow NHS staff to speak up about incidents without the fear of being punished. The main conclusion of the review was that the ‘safe space’ proposal would be of most use for the Healthcare Safety Investigation Branch

Access to general practice – The House of Commons Public Accounts Committee
The House of Commons Public Accounts Committee has published Access to general practice: progress review. This follow-up report finds that the Department of Health and NHS England now have objectives to improve and extend access to general practice and have made some effort to understand the demand for extended access. However, the committee notes that extended hours are being introduced without an understanding of the level of access currently being provided, or how to get the best from existing resources.

NIHR Signals
The National Institute for Health Research regularly publishes signals. Signals are summaries of recently published research and intended to provide decision makers in health and social care organisations with evidence they can use.

National Institute for Clinical Excellence (NICE)

NICE surveillance reports
NICE has published the following surveillance reports:

Fever in under 5s: assessment and initial management (CG160) – surveillance decision: NICE will not update the guideline at this time.
Intravenous fluid therapy in adults in hospital (CG174) – surveillance decision: NICE will not update the guideline at this time.
Metastatic malignant disease of unknown primary origin in adults: diagnosis and management (CG104) – surveillance decision: NICE will not update the guideline at this time.
Acute kidney injury: prevention, detection and management (CG169) – surveillance decision: NICE will not update the guideline at this time.
Chronic kidney disease (stage 4 or 5): management of hyperphosphataemia (CG157)
Chronic kidney disease in adults: assessment and management (CG182)
Chronic kidney disease: managing anaemia (NG8)

Surveillance decision: NICE propose that consideration be given to combining the 3 guidelines to ensure that recommendations on the management of chronic kidney disease are accessible from one guideline. NICE plans an update of all 3 guidelines.

NICE quality standard: osteoporosis
NICE has published Osteoporosis (QS149). This quality standard covers managing osteoporosis in adults (aged 18 and over), including assessing risk and preventing fragility fractures. It describes high-quality care in priority areas for improvement. This quality standard has been incorporated into the NICE pathways on osteoporosis, medicines optimisation and multimorbidity.

NICE consultations