Long length of stay reviews
This case study shows how Royal Preston Hospital, part of Lancashire Teaching Hospitals NHS Foundation Trust, implemented the ECIST long length of stay reviews to achieve a reduction in the number of patients with a length of stay greater than 20 days.

Home to the unknown: getting hospital discharge right – British Red Cross
This research explored patients’ unplanned stays in hospital and what it was like for them after they had returned home. More specifically, the research sought to reveal: patients’ experiences of being discharged from hospital; hospital systems and healthcare professionals’ experiences and perceptions of the discharge process; and what it was like for people returning home from hospital feeling more or less prepared. As a result, it aimed to explore the impact of discharge on recovery and wellbeing and to identify opportunities to improve systems, communication and support.

Closing the gap: key areas for action on the health and care workforce – The King’s Fund
Staffing is the make-or-break issue for the NHS in England. In this joint report with the Nuffield Trust and the Health Foundation, we set out the policy actions that need to be at the heart of the workforce implementation plan due to be published later this year.

Exploring variations in the opportunity cost cost-effectiveness threshold by clinical area: results from a feasibility study in England – Office of Health Economics
This research paper provides empirical evidence on the relationship between health outcomes and health expenditures in England. Results suggest that setting a cost-effectiveness criterion for NICE may not be capable of being synthesised using scientific methods alone, but involve political judgements.

Clinical oncology workforce census
The Royal College of Radiologists has published Clinical oncology: UK workforce census report 2018.  This report provides information on the number, distribution and working patterns of consultant-grade oncologists employed in NHS cancer centres.  It also forecasts workforce numbers and working patterns and estimates the extent to which future workforce supply and demand for cancer treatments are aligned.  The report is intended to inform local and national oncology workforce training, planning and policy.

Visualising patient journeys
The Nuffield Trust has published an explainer A 10-year story: visualising patient journeys.  This article explains an approach to visualising individual patients’ contacts with health services through charts.  It looks at what the charts are and when they are most useful.  The approach is now expanding into tools with the potential to enhance patient care.

Developing People Improving Care  
NHS Improvement has added these guides to their Developing People – Improving Care webpage.

Our Fabulous NHS – Academy of Fabulous Stuff 
***Get involved*** –  share your fab stuff!

• Introduction of award winning pharmacy service on emergency department
  A new, exciting service is being rolled out at Lancashire Teaching Hospitals NHS Foundation Trust which will enable patients to receive their medication reviewed and optimised much earlier in their admission. A dedicated pharmacy team will be based within the emergency department at Royal Preston Hospital. Lancashire Teaching Hospitals are one of few nationally that have fully integrated a team of pharmacy professionals into the emergency department. This innovative service will allow patients to be seen by the emergency department pharmacy team at the front door.

• ED Competencies at Whipps Cross Hospital
  We have put together a developmental pathway for nurses in the ED. Recruitment was at an all time low in August 2018 and more needed to be done to ensure that a good retention strategy was in place. A 6 Year strategy was designed. Taking a staff nurse through a 6 year programme covering all elements of ED Nursing, from RCN ED Competencies, trauma competencies, local competencies for professional development, all augmented with training days to augment learning. The programme then takes staff through quality improvement through a Champion/Link Nurse programme, focussing on their passions and giving them tools for improvement. The Nurse then moves onto Level 2 (Band 6 marker) which is about advanced skill levels in the ED/Trauma, how to run areas effectively and leadership. The Nurses have mandatory training days and at level 2, an in-house leadership training morning looks at the basics of leadership fundamentals and how to run a safe and high quality environment.