This briefing follows a March 2014 speech by the Secretary of State for Health at Virginia Mason Medical Center in Seattle. In his speech, Jeremy Hunt MP set out a new ambition to reduce avoidable harm to patients in the NHS.

The NHS is facing the biggest challenge in its history because of the squeeze on its budget, says its new boss.

In a speech on his first day as NHS England’s chief executive, Simon Stevens, will say the health service is enduring the most sustained “budget crunch in its 66-year history”.

He will warn navigating the next few years will require a huge effort.

And he will say only by “radically transforming services” will the NHS continue to thrive

It’s virtually impossible to like everyone you meet. It’s even more unlikely that you will get along with everyone at work. People have different personalities, biases, values, ambitions, and interests, all of which affect the chemistry of their relationships. And if you throw in the pressures of the workplace, it’s hardly surprising that tensions arise between colleagues and co-workers. But when members of a senior management team don’t get along, the negative impacts can cascade through an organization. Those conflicts have the potential to reduce productivity and morale for dozens or hundreds of people.

 We are faced with the need to make decisions every day.  Should we bring product A or B to market?  Which marketing strategy should we use?  Of the choices that we have available, who is the best person to hire or who would make the best partner? In each case, we try to rely on as many facts as we can so that we can make a reasonable estimation of the best path to follow.  At first glance, the approach of weighing the evidence rationally seems perfectly reasonable.  Yet, in so many instances, rational predictions fail.  Why is that? And what can we do about it?

Do you often feel reactive instead of proactive? Do people complain that decisions at the top take too long to percolate down to the frontlines? If so, you probably manage your organization and your direct reports through weekly meetings and email. You should instead consider “leader standard work.”

 The article discusses research on quality-improvement actions and strategies that employers use to encourage employees to care about quality outcomes and to make quality a cultural value in the organization. The researchers found that leadership emphasis, message credibility, peer involvement, and employee ownership are attributes which predict a corporate culture focused on quality. The discussion topics include making quality a leadership priority, delivering communications that appeal to workers, holding peers responsible for quality, and empowering workers to make quality decisions and to challenge directives that do not maintain or improve quality. INSET: THE FOUR ESSENTIALS OF QUALITY

This resource requires an OpenAthens account you can register here from an NHS connected computer (you can email us to request one) or call Evidence Services on 0151 285 4493.

As we move into 2014/15, the leadership challenge for NHS providers remains significant. Improving quality for patients at a time of growing financial constraint is an increasingly demanding goal for NHS trusts, one which we must take on at a time when the scrutiny applied to the NHS is rightly more intense than ever before. This Accountability Framework sets out how the TDA will work alongside NHS trusts to meet this challenge.

Additonal Information
Documents containing supporting guidance which provide further detail to help trusts understand the processes set out in the Accountability Framework.
http://www.ntda.nhs.uk/blog/2014/03/31/af2014/

“Local processes and professional and microsystem considerations played a significant role in adoption and implementation.”

Making sense of evidence in management decisions: the role of research-based knowledge on innovation adoption and implementation in health care
Y Kyratsis, R Ahmad, K Hatzaras, M Iwami, A Holmes
HS&DR, 2014, 6(2)

“Part of the reason why quality improvement is so hard to achieve may be that those involved in leading QI programmes need to deploy three different but interrelated types of improvement skills: technical, soft and learning skills.”

Skilled for improvement?
The Health Foundation
March 2014

“Recognising these different patterns should help identify at-risk diagnoses where quality of care can be improved in order to minimise the excess mortality associated with weekend admission.”

Do variations in hospital mortality patterns after weekend admission reflect reduced quality of care or different patient cohorts? A population-based study
O Perez Concha, B Gallego, K Hillman, GP Delaney, E Coiera,
BMJ Quality & Safety, 2014, 23:215-222

This paper sets out the Government’s response to the five recommendations directed to the Department of Health. The response can be divided into two sections:

• Recommendations relating to the NMC’s ability to conduct Fitness to Practice Proceedings
• Transposition of the Mutual Recognition of Professional Qualifications (MRPQ) Directive and the NMC’s ability to apply appropriate language controls to applicants

The article presents the author’s perspective on transformational management, noting that the transformation truths discovered by Liz Clairborne apparel company’s business teams include the idea that transformation is an era and not a short-lived moment or event in a company’s history. The management topics include sustaining a vision, building a brand, and reorganizing teams.

This resource requires an OpenAthens account you can register here from an NHS connected computer (you can email us to request one) or call Evidence Services on 0151 285 4493.

The Learning Communities Initiative aimed to explore the use of organisational techniques such as learning communities and communities of practice. It set out to work with selected improvement groups in the NHS to help them learn collectively about proven improvement methods (‘improvement science’) and to examine how the learning process – and hence the enhancement of quality – could be better deployed in future improvement initiatives.

The four improvement groups proved very different in terms of their characteristics, cultures and processes, and the extent to which they achieved their improvement tasks. This report presents a detailed picture of the four contrasting improvement stories – which, in effect, proved to be a natural experiment – and analyses the reasons why there were such significant differences in what they achieved and how.

Aims to provide a toolkit that will enable a consistent approach, to be adopted across the NHS, for combating inflationary pressures.

NHS Providers are being advised by the Department of Health to resist blanket inflationary price increases from suppliers; an approach supported by both the Trust Development Authority (TDA) and Monitor. The NHS has been facing inflationary pressures well above the norm and increasingly NHS Providers are not receiving uplifts in budgets to cover such price increases. Our goal, as a minimum, is to ensure non-pay expenditure is inflation-free until at least the end of 2015-16, to keep a balanced budget and to continue to provide a quality service for patients by protecting the front-line.

This guidance has been developed with the support of a number of NHS Providers and includes some examples of best practice they have implemented to tackle these financial pressures. It is not intended to be a comprehensive guide to supplier management, but does provide some basic processes and templates to support
those NHS Providers who are embarking on implementing supplier management in their organisation.

Across the country, hospitals and primary and community care organisations are working together to look at ways of delivering safe and effective care over seven days a week. This helps address the link between poorer outcomes for patients and the reduced levels of service provision at the weekend.

This new publication summarises service improvement achievements and potential challenges. While significant progress has been made we need to strive to find new and innovative solutions that are both clinically and financially sustainable to change delivery of diagnostic and scientific services to meet the needs of service users.

A new coalition of people and organisations across the health, social care and voluntary sectors has been launched to make person-centred coordinated care for people with long term conditions a reality.

The Coalition for Collaborative Care is using an approach called the House of Care to improve care and support planning for the 15 million people in England who have a long term condition. That means improving the relationship that people have in their day-to-day interaction with the NHS and social care so their care and support is organised around what matters to them.

There are many social enterprises throughout the North West, with several being set up during the NHS transition, when Primary Care Trusts (PCTs) were closed down and services transferred to other organisations.They helped to ensure that the provision of certain services were sustained and even extended. This overview is intended to give a snapshot of such organisations, including  Bolton Community Practice Community Interest Company (CIC), Spiral Health CIC, Future Directions CIC and One to One Midwives.

Guidance from the Whistleblowing Helpline containing a number of recommendations, aiming to help make whistleblowing an important part of improving the quality of service user support and patient safety.

Report from Dr Foster Intelligence that calls on NHS England and the Health and Social Care Information Centre to improve the consistency and accuracy of data recording to improve monitoring of patient care.

The report note that calculating adjusted mortality ratios that take account of whether or not patients were admitted for palliation or treatment at the end of life are extremely useful to clinicians and managers of health services.

The ability to provide such information has been undermined in recent years by growing variation in clinical coding practices and a lack of rigour in the coding definitions. This report summarises the changes in coding practices in recent years.