Under pressure – a long hard winter for our health service

Nuffield Trust Newsletter: February 2018

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As the cold weather continues, the Nuffield Trust reflects on how the health and social care sectors have been coping with extra pressure this winter in a series of blogs.

Meeting the demands of winter and beyond:

The resilience of those working in the NHS and social care is being tested to its limits this winter. With the current cold snap postponing any early end to the pressure on services,  Assistant Director of Policy, Ruth Thorlby, looks back at how health and social care have been surviving this season’s extra pressures, and where action is needed now in advance of next winter.

What do winter pressures mean for paediatric care?

Children make extensive use of the NHS, yet adult care tends to dominate the winter pressures debate. Clinical Fellow Dr Susannah Pye looks at how pressures on services impact on patients like 9-month-old Ollie.

Winter pressures data: where are the blind spots?

Clinical Fellow Dr Becks Fisher says the pressures reported in hospitals are painfully felt in the community too, but we don’t have comprehensive data to show what this means in practice.

NHS 111: understanding the impact on urgent and emergency care

NHS 111 has been criticised for directing a high proportion of patients to A&E, which may add to pressures felt during winter. But are callers to NHS 111 less likely to visit A&E if they speak to a doctor or nurse?

Two projects aiming to relieve pressure on busy services

Two improvement projects supported by the Health Foundation have been thinking differently about ways of reducing pressure on stretched services – pressures which often become most visible and acute during winter.

The Health Foundation Newsletter is available here

Successfully Scaling Innovation in the NHS

In Against the Odds: Successfully scaling innovation in the NHS, the Innovation Unit and The Health Foundation identity 10  different UK innovations.  The authors look at various case studies to explore how these insights build on, and challenge, existing wisdom in the NHS.

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Image source: http://www.innovationunit.org

The key findings of the report include:

  • The ‘adopters’ of innovation need greater recognition and support. The current system primarily rewards innovators, but those taking up innovations often need time, space and resources to implement and adapt an innovation in their own setting.
  • It needs to be easier for innovators to set up dedicated organisations or groups to drive innovation at scale. Scaling innovation can be a full-time job, and difficult to do alongside front-line service delivery. Dedicated organisations are often needed to consciously and strategically drive scaling efforts, including when innovators ‘spin out’ from the NHS.
  • System leaders need to take more holistic and sophisticated approaches to scaling. Targets and tariffs are not a magic bullet for scaling; while they can help, they don’t create the intrinsic and sustained commitment required to replicate new ideas at scale. Different approaches are needed, including articulating national and local health care priorities in ways that create strategic opportunities for innovators, and using commissioning frameworks to enable, rather than hinder, the sustainable spread of innovations.

 

The full report can be found here

What does the Autumn Budget mean for the NHS and social care?

In the budget this week, the Chancellor committed around £2 billion extra for the NHS next year. Nigel Edwards of the Nuffield Trust said this will bring respite for patients and staff, but is only around half of what’s needed.

In a Q&A about the budget, Tom Moberly, The BMJ’s UK editor, met with John Appleby (Nuffield Trust), Anita Charlesworth (Health Foundation) and Siva Anandaciva (King’s Fund) to discuss what it all means for the NHS and social care. You can watch the discussion below:

See also: Autumn Budget 2017: what it means for health and social care | The Kings Fund | Nuffield Trust | The Health Foundation

 

 

Quality improvement

Making the case for quality improvement: lessons for NHS boards and leaders | The King’s Fund | The Health Foundation

This briefing outlines the following ten lessons for NHS leaders which provide a starting point for those seeking to embed quality improvement in their work:

  • Make quality improvement a leadership priority for boards.
  • Share responsibility for quality improvement with leaders at all levels.
  • Don’t look for magic bullets or quick fixes.
  • Develop the skills and capabilities for improvement.
  • Have a consistent and coherent approach to quality improvement.
  • Use data effectively.
  • Focus on relationships and culture.
  • Enable and support frontline staff to engage in quality improvement.
  • Involve patients, service users and carers.
  • Work as a system.

The briefing makes the case for quality improvement to be at the heart of local plans for redesigning NHS services.

Full report available here

Improving quality of care through partnerships and collaboration

Partnerships for improvement: ingredients for success | The Health Foundation

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The idea of partnerships and collaboration across organisational boundaries is at the heart of NHS reforms in England. This briefing from the Health Foundation looks at what makes successful partnerships between providers at an organisational level, providing a snapshot of some of the key ingredients needed for successful partnerships.

The report looks at a range of current organisational partnerships focusing on five different partnering arrangements. It also includes interviews with national leaders, and draws learning to help inform and guide policymakers and providers.

The report finds that partnering does have potential benefits, but these are not easy or quick to achieve. To have a meaningful impact on the quality of care, the right form of partnering needs to be used in the right context and it needs to be accompanied by the right set of enabling factors – as described by the report.

Full briefing: Partnerships for improvement: ingredients for success

Related: Health Foundation blog: Is together always better? How good are NHS organisations and the wider system at achieving the potential benefits of partnering?

What makes us healthy?

The Health Foundation has published What makes us healthy?

This infographic is part of a new series of infographics and accompanying blogs and commentaries to describe and explain the social determinants of health in an accessible and engaging way. This infographic shows the extent to which health is primarily shaped by factors outside the direct influence of healthcare and invites people to look at this bigger picture.

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Image source: http://www.health.org.uk

Hospital performance

The NHS Combined Performance Summary is a monthly release of data on key performance metrics for the NHS. Here are some of the most important aspects relating to quality. The Health Foundation has issued a statement about this month’s data release, which can be read here.

For more in-depth analysis of the data over time, visit the QualityWatch indicators.

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Image source: http://www.qualitywatch.org.uk/