Delivering general practice with too few GPs

This briefing presents some ideas on how general practice can continue to be provided as the shortage of GPs becomes chronic | The Nuffield Trust

This briefing combines findings from a workshop with research evidence and specific examples of innovative practice around the country in order to identify generalisable lessons from current innovators and to outline the ways in which national and local policy can support new ways of delivering general practice.

Key messages:

  • Keep it local
    The design and delivery of new forms of general practice should take place at borough and network level so that services can be tailored to local contexts and the needs of practices and local populations.
  • Invest substantially in change
    A significant proportion of the £4.5 billion committed to general practice and primary care by 2020/21 should be set aside and sustained over several years to invest in capital and running costs and staff development.
  • Maintain realistic expectations about the pace of change that can be expected from a workforce under intense pressure

  • Ensure that high quality data is generated, collected and analysed

Full briefing: Rosen R (2019) Delivering general practice with too few GPs. |  Nuffield Trust




Delivering general practice with too few GPs | The Nuffield Trust

Better care for patients and service users

This report demonstrates how – in difficult circumstances – trust leaders and staff are coming up with ideas and solutions to deliver better care | NHS Providers

This is the first in a new publication series to promote the work of NHS trusts and foundation trusts in improving care.  This briefing focuses on how trusts have responded to feedback from the Care Quality Commission in a positive and systematic way, encouraging ideas that have made a difference for patients and service users.

The report Providers deliver: better care for patients considers both the leadership approaches and frontline initiatives that underpin improvements in quality. Through 11 case study conversations, it considers some of the frontline work that has contributed to trusts’ improvements in CQC ratings, as well as exploring the role of trust leaders in providing an enabling, supportive environment in which this work has been possible.

Full report: Providers deliver: better care for patients 

See also: NHS Providers blog

National Pregnancy in Diabetes Audit

National Pregnancy in Diabetes (NPID) audit report 2018 | The Healthcare Quality Improvement Partnership


The National Pregnancy in Diabetes (NPID) audit measures the quality of antenatal care and pregnancy outcomes for women with pre-gestational diabetes.

This is the first year that a Quality Improvement Collaborative (QIC) has been incorporated into the NPID programme for 2018/19 with the aim of focusing on improvement activity.

Some of the key findings include:

  • Overall 7 out of 8 women were not well prepared for pregnancy
  • There has been an increase in the rate of admissions with hypoglycaemia for women with type 1 diabetes
  • Almost one in two babies had complications related to maternal diabetes which is mostly the result of large for gestational age (LGA) babies
  • Admissions to neonatal units are more common than in the general population.

Full report: National Pregnancy in Diabetes (NPID) Audit Report 2018

See also: NHS Digital resources

Pulmonary Embolism: Know the Score

This report highlights the quality of care of patients aged 16 and over who had a PE, who either presented to hospital or who developed a Pulmonary Embolism (PE) whilst as an inpatient for another condition | The National Confidential Enquiry into Patient Outcome and Death 

Despite advances in the ability to prevent, diagnose and treat acute pulmonary embolism (PE) it remains an important cause of morbidity and mortality. Estimates suggest that there are more than 25,000 hospital deaths in the UK each year from venous thromboembolism (VTE), and previous studies have shown that for every diagnosed case of a non-fatal PE there are 2.5 cases of fatal PE that were not diagnosed.

The study described in this report aimed to identify and explore remediable factors in the process of care for patients with a new diagnosis of PE.  The report is accompanied by additional resources including a recommendation checklist, infographic, slide set and commissioner’s guide.

Full detail at National Confidential Enquiry into Patient Outcome and Death

National Clinical Audit of Anxiety and Depression

This report presents the main findings of the National Clinical Audit of Anxiety and Depression carried out by the Royal College of Psychiatrists between 2017 and 2018. It focuses on inpatient services, where people are admitted to hospital and stay overnight for a period of time, run by NHS mental health trusts in England.

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To measure how services are doing, they are assessed on 13 standards that represent best practice. By measuring how services are doing and helping them to improve, the audit increases the chance that people who use inpatient services for depression and anxiety will have a good experience.

A full account of the audit findings is presented in a Technical Report. The Technical Report provides a comprehensive overview of the audit methodology and findings, including how individual NHS Trusts performed and comprehensive recommendations for action. It is aimed at senior clinicians, health policy makers, commissioners, audit leads, researchers, and other relevant stakeholders to help understand and improve these services.

Time to solve childhood obesity

Time to solve childhood obesity: an independent report by the Chief Medical Officer | The Department of Health and Social Care

The Chief Medical Officer calls for action across industry and the public sector to help the government reach its target of halving childhood obesity by 2030.  It sets out a range of recommendations for the government, which are supported by 10 principles, and builds on the work the government has already done.

Full report: Time to Solve Childhood Obesity. An Independent Report by the Chief  Medical Officer,  Professor Dame Sally Davies | 2019

Children and young people’s wellbeing

State of the nation 2019: children and young people’s wellbeing | The Department for Education

This report evaluates wellbeing in children and young people, including: statistics on the wellbeing of children and young people in England; wider indicators on their happiness with their relationships, self-reported health and experiences with school; and an in-depth analysis of psychological wellbeing in teenage girls.

Full report: State of the nation 2019: children and young people’s wellbeing

Additional link: DHSC press release

[NICE Guideline] Head injury: assessment and early management

NICE | October 2019 | Head injury: assessment and early management |NICE guideline CG176

NICE has published the results of its surveillance decision, it will update this guideline, with a focus on 3 areas:

  • Head CT scans in people on anticoagulant treatment (recommendation 1.4.12).
  • Diagnosis and management of post head injury hypopituitarism.
  • Management of indirect brain injuries (not caused by direct trauma in the head).


Full details are available from NICE 

[NICE Guideline] Respiratory Tract Infections (self-limiting) prescribing infections

NICE | October 2019| Respiratory Tract Infections (self-limiting) prescribing infections | Clinical guideline [CG69]

NICE has published the results of its surveillance decision, it will  withdraw this guideline and incorporate any relevant evidence into relevant antimicrobial prescribing guidelines on sinusitis, sore throat, otitis media and cough


updated the guideline CG69 Respiratory Tract Infections (self-limiting) prescribing infections 

Full details are available from NICE