The King’s Fund responds to the latest NHS hospital performance data 
Commenting on the latest monthly NHS hospital performance data, Siva Anandaciva, Chief Analyst, The King’s Fund said: ‘Despite significant progress being made in reducing the number of people facing very long waits for planned hospital treatment, the overall waiting list has continued to grow to 6.5 million people1 and the NHS is still fighting battles on multiple fronts. The latest data2 shows 12,000 patients every day remained stuck in hospital despite being well enough to be discharged, in part due to overwhelming pressure on social care services.

Reconciling patients and professionals after poor experiences – BMJ 
When people in key public service roles feel pressurised, overwhelmed, or unfairly attacked for failings outside their control they can become defensive or self-justifying, or they counterattack.

Study finds ‘pad culture’ in hospital settings for dementia patients – Nursing Times 
Dementia  patients in acute hospital settings are at increased risk of developing incontinence during their hospital stay as a result of a widespread “pad culture”, according to a new study. The study looked at continence care across six acute wards in three hospitals in England.

Latest newsletter for nurses and nursing associates – NMC
Deborah Sturdy is the first Chief Nurse for Adult Social Care in England and has over 40 years of nursing experience in clinical practice, management, policy and research. She spoke to us about the new health and social care levy, how it’s helping nursing professionals to meet their continuing professional development (CPD), and why CPD is so important for nurses and nursing associates.

Latest newsletter for midwives – NMC
Paulette Lewis MBE is a highly experienced leader and director with a career in midwifery and nursing which has spanned over three decades. She holds many leadership roles including as a non-executive director, management consultant, Chair of the Croydon BME Forum and President of the Caribbean Nurses & Midwives Association (UK).

NMC launches consultation on English language requirements 
We’ve launched a new consultation giving people the chance to have their say on proposed changes to our English language requirements.

The National Consultant Information Programme (NCIP)
NCIP aims to support quality improvement by providing consultant surgeons access to their surgical outcomes data for key procedures across a range of metrics. Focusing on elective surgical specialties, the programme has already rolled out the tool to 70 trusts through urology, and is now rolling it  out to six HVLC and recovering supporting specialties: ENT, OMFS, neurosurgery, gynaecology, spinal and upper GI. More information on the NCIP page or by emailing ncip.implementation@nhs.net

Recent updates from GIRFT

• New metrics available for paediatric T&O surgery
  GIRFT data to help NHS teams improve the care and outcomes of children undergoing trauma and orthopaedic surgery has been added to the Model Health System. A new compartment of clinical metrics for trauma and orthopaedic surgery on patients under 17 is now available via the improvement tool, giving trusts and systems the opportunity to gauge their own performance and benchmark against their peers in a large range of areas, such as treatment for clubfoot, knee procedures, fracture care and hip conditions like developmental dysplasia. Learn more on our website.
• Study supports GIRFT’s work in endocrinology 
  New research has been published in support of GIRFT’s recommendation that patients who need surgery to remove their parathyroid gland should be directed to surgeons who perform the operation most often.
• Urology: the path to recovery
  GIRFT’s urology clinical leads, working  with NHSE teams, the  British Association of Urological Surgeons (BAUS) and the British Association of  Urological Nurses (BAUN), have delivered a strategic framework and manual for improving the quality of care, ensuring equity of access, patient experience and efficiency of urology  services. The framework focuses on ten key topics to help the specialty tackle the backlog in elective care and to support clinical teams in the recovery of urology services post pandemic. An accompanying manual provides  further  insight, detail and resources across these ten topics, drawing together information and guidance into a single document for clinicians, service managers and those planning future service delivery at trust and system level.
• Hand surgery
  Guidelines for operating outside of main theatres. Developed with The British Society for Surgery of the Hand (BSSH)
• Paediatric surgery
  Best practice pathway and guidance for acute abdominal pain and appendicectomy
• Orthopaedic surgery
  Mini delivery guide on the South Warwickshire Accelerated Transfer (SWAT) programme – reducing length of stay in elective arthroplasty through focused enhanced recovery.

BMJ Open Quality

• Limited waiting areas in outpatient clinics: an intervention to incorporate the effect of bridging times in blueprint schedules
• Cognitive impairment and frailty screening in older surgical patients: a rural tertiary care centre experience

BMJ Quality & Safety

• Value of a value culture survey for improving healthcare quality The article by Sorra and colleagues in this issue of BMJ Quality and Safety reflects a subtle but important shift in national efforts to enhance quality in healthcare. Since 2000 and the publication of To Err is Human , there has been widespread recognition of the need to address patient safety issues at a systems level.
• Indirect effects of the COVID-19 pandemic on people with type 2 diabetes: time to urgently move into a recovery phase While the direct risks of the COVID-19 on people with type 2 diabetes (T2D) are well established, the indirect effects of the COVID-19 response on their management are less well understood. It is estimated that 4.7 million people have diabetes in the UK with T2D accounting for 90% of all diabetes cases, with primary care being at the forefront of delivering diabetes care.
• Outsourcing care to the private sector: some reassuring evidence on patient outcomes Many countries have a mixed healthcare economy, with a private sector (either for profit or non-profit) making up a varying proportion of capacity, depending on the financing model. The outsourcing of routine elective care to the private sector by the National Health Service (NHS) in England has become well established over the last two decades.
• Adding value to the diagnostic process In 2010, Porter introduced the concept of value-based healthcare in an attempt to shift the focus from volume of services to value created for patients. Value was defined based on important health outcomes achieved for patients relative to costs, rather than being based on the input in terms of volume of delivered services.
• Development and pilot testing of survey items to assess the culture of value and efficiency in hospitals and medical offices
• Impact of COVID-19 restrictions on diabetes health checks and prescribing for people with type 2 diabetes: a UK-wide cohort study involving 618 161 people in primary care
• Outcomes for surgical procedures funded by the English health service but carried out in public versus independent hospitals: a database study
• Filling a gap in safety metrics: development of a patient-centred framework to identify and categorise patient-reported breakdowns related to the diagnostic process in ambulatory care

HSJ Roundup –  Full text available on request from the Hanley Library

‘Shifted to untrained staff’ leaves over half stroke units with too few nurses Fewer than half of stroke units in England have the recommended number of trained nurses — a drop of 10 percentage points in two years, a report has warned.

NHS systems ‘making it harder for patients to go private’, say independent providers The amount of NHS elective procedures carried out by the private sector in early 2022 was lower in eight of the 10 largest specialties than in a comparable period before the pandemic, an HSJ analysis reveals.

Bullying and harassment ‘normalised’ at trust put back in special measures An ambulance trust has been placed in special measures after the Care Quality Commission rated its leadership ‘inadequate’ and said staff felt unable to raise concerns without fear of reprisal

Mental Health Matters: A challenge to ICSs HSJ’s fortnightly briefing covering safety, quality, performance and finances in the mental health sector — contact me in confidence.

Huge variation in referrals to flagship ‘urgent response’ service Groundbreaking new data on community services appears to show enormous variation between areas in the number of referrals for a ‘two-hour urgent response’ being recorded.