This report finds that too many people approaching death are forced to spend long periods of time in hospital due to a lack of social care or alternative support options in their community. This in turn leads to increased hospital admissions and higher costs for an NHS under financial pressures.
With March marking a year since the first wave of vanguards were announced, a new animation (see below) and suite of factsheets shine a light on what the sites are up to and what’s in store for patients and communities across the country.
Launched on Thursday (25 February), the resources explain the aims and objectives of the country’s 50 health and care vanguards.
Aimed at health and care staff, patients and the public, the resources also showcase some of the innovative work happening across the country that’s making a difference to people’s lives.
The factsheets explore the five types of care models the vanguards fall under:
Acute care collaboration vanguard sites – linking local hospitals together to improve their clinical and financial viability.
Urgent and emergency care – new approaches to improve the coordination of services and reduce pressure on A&E departments.
Enhanced health in care homes – offering older people better, joined up health, care and rehabilitation services.
Multi-specialty community providers – moving specialist care out of hospitals into the community.
Integrated primary and acute care systems – joining up GP, hospital, community and mental health services.
Public Health England’s chief economist has published the first in a series of four blogs looking at health economics and the case for investing in prevention initiatives. The blog focuses on four key questions: does prevention save the health service money; are public health initiatives really providing the best value for money; and how can we better incentivise local authorities, NHS commissioners and health care providers to invest more in prevention and early intervention.
The new system, which was recommended following the Mid Staffs hospital scandal, aims to improve public protection by making sure that the UK’s 655,000 nurses and midwives are up to date in their training and skills and that they continue to remain fit to practise throughout their career.
Furthermore, they have to deliver five written reflections based on four themes in a new code of professional standards; have evidence of feedback from others including patients, relatives and colleagues and have third-party confirmation of continuing fitness to practise. This is likely to be from a line manager. As part of the process, they will also have to declare that they have professional indemnity insurance and that they are of good health and character.
By Sarah Chapman for the Evidently Cochrane Blog // February 12, 2016
There is new evidence on how tailoring a discharge plan to the individual compares with a routine process of discharging people from hospital, from a Cochrane review comparing these approaches.
Discharge planning: routine or personalized?
The review broadly defines the aims of discharge planning as these:
Reduce hospital length of stay
Reduce unplanned readmission to hospital
Improve the co-ordination of services following discharge
The Cochrane review has just been updated and includes 30 randomized controlled trials (5 from the UK) with almost 12,000 people. Older patients with a medical condition were recruited in 21 trials and data from these were pooled. The remaining trials involved people with a mix of medical and surgical conditions, patients from psychiatric hospitals and others admitted to hospital following a fall.
Here’s what they found:
A personalized discharge plan probably brings about a small reduction (just under a day) in the length of hospital stay for older people with a medical condition
A personalized discharge plan probably reduces the risk of readmission to hospital at three months follow-up for older people with a medical condition (about 3 fewer in every 100 people)
For elderly patients with a medical condition, there was little or no difference between groups for mortality
Discharge planning may lead to increased satisfaction for patients and healthcare professionals
It is uncertain whether discharge planning reduces readmission rates for patients admitted to hospital following a fall
It is uncertain whether there is any difference in the cost of care when discharge planning is implemented with patients who have a medical condition
Maternity services in England must become safer, more personalised, kinder, professional and more family-friendly. That’s the vision of the National Maternity Review, which today (Tuesday) publishes its recommendations for how services should change over the next five years.
The NHS England commissioned review – led by independent experts and chaired by Baroness Julia Cumberlege – sets out wide-ranging proposals designed to make care safer and give women greater control and more choices.
The framework highlights seven key priorities to drive improvement and ensure women and babies receive excellent care wherever they live. To make care more personal and family friendly, the report says that the following is needed:
Continuity of carer
Better postnatal and perinatal mental health care
A payment system
Working across boundaries
The report also recommends that NHS England seeks volunteer localities to act as early adopters to test the model of care set out in the report determine which flexibilities are required, and identify the most viable solutions for the long term.
This paper argues that the NHS in England cannot meet the health care needs of the population without a sustained and comprehensive commitment to quality improvement as its principal strategy.
Despite a succession of well-meaning policy initiatives over the past two decades, the paper argues that the NHS in England has lacked a coherent approach to improving quality of care. It describes key features of a quality improvement strategy and the role of organisations at different levels in realising it, offering 10 design principles to guide its development. A quality improvement strategy of this kind has never been implemented at such a scale and the challenge in doing so is immense – yet the paper argues that the NHS has no real alternative.