Nuffield Trust | August 2019 | Paediatrics at a crossroads: what next?
The Nuffield Trust has published a guest blog post from Dr Guddi Singh entitled Paediatrics at a crossroads: what next? With many child health outcomes in the UK going in the wrong direction over the past decade, Dr Singh makes the case for social paediatrics (Source: The Nuffield Trust).
Parents with a child who had been admitted to hospital tended to rate their child’s overall experience highly, with over 80% of respondents rating their child’s experience as ‘8’, ‘9’ or ‘10’ (very good).
Only 52% of Community Mental Health Survey respondents rated their overall experience of NHS mental health services in the last 12 months as ‘8’, ‘9’ or ‘10’ (very good), and 10% rated their experience as ‘2’, ‘1’ or ‘0’ (very poor).
Adult inpatients’ overall experience has improved over time, with the proportion of survey respondents rating their experience as ‘8’, ‘9’ or ‘10’ (very good) increasing from 67% in 2012 to 73% in 2017. However, overall experience declined slightly to 71% in 2018.
The proportion of GP Patient Survey respondents who had a good overall experience (‘very good’ or ‘fairly good’) decreased from 88% in 2012 to 85% in 2017. In 2018, 84% of patients had a good overall experience and this declined slightly to 83% in 2019.*
Service users’ satisfaction with adult social care services has remained stable over time, with 65% of respondents ‘extremely or very satisfied’ in 2017-18.
Between 2012 and 2019, the proportion of patients who had a good overall experience (‘very good’ or ‘fairly good’) of NHS dental services increased from 83% to 85%.
Nuffield Trust | July 2019 | Why a “risk pool” must underpin a social care system
A new publication from the Nuffield Trust looks at the social care system, in the one-page document the think-tank explains why it thinks relying on individual funding options is unlikely to provide a viable basis for the system.
Nuffield Trust | June 2019 | Achieving a digital NHS: Lessons for national policy from the acute sector
With the creation of NHSX, which will unite digital leaders from NHS England, NHS Improvement, and the Department of Health and Social Care to lead on setting standards for technology use, championing and developing digital training and ensuring NHS systems can talk to each other across the health and care system, the Nuffield Trust wanted to know:
How national policy impacted on a trust’s approach to digitisation
How national policy was helping and hindering digital progress
What national policy could do differently to better support digitisation on the ground
To this end the Nuffield Trust spoke to 72 senior digital leaders in national organisations and NHS trusts as well as frontline health care professionals. Now the Nuffield Trust have published Achieving a digital NHS, which is based on discussion with 72 senior digital leaders in national organisations and NHS trusts as well as frontline health care professional national policy for digitisation, is working from the perspective of acute trusts. This report seeks to understand how national policy for digitisation is working from the perspective of acute trusts (Source: Nuffield Trust).
Nuffield Trust | May 2019 | Improving access out of hours: Evaluation of extended-hours primary care access hubs
The Nuffield Trust was commissioned by Barking, Havering and Redbridge CCGs to evaluate the impact of access programmes in these boroughs.
The schemes aimed to improve the quality of primary care services and to improve patients’ experience and outcomes over a two-year period.
The schemes involved:
improving public access to primary care by providing additional capacity outside of core hours
the development of a new integrated care hub for the management of people with complex care needs.
Most of the patients we interviewed told us that they had chosen to attend the hubs because they found it difficult to attend in-hours primary care services. Others said that they had wanted a speedy clinical assessment for themselves or their children.
Patients particularly liked the appointment-based system at the hubs and this was what they highlighted when distinguishing between the hubs and other services such as walk-in centres and A&E departments.
Since the hubs opened, there has been an increase in the use of A&E services across the boroughs. However, during our research the size of this increase appeared to be associated with hub attendance in that it was significantly lower in areas where hub attendance was highest by approximately 4.5%. This suggests that the presence of the hubs may have been diverting some people who would otherwise choose to attend A&E, or who may have been sent to A&E by NHS 111, away from this service.
However, from a commissioning perspective, such reductions in A&E attendance would not be enough to offset the local cost of providing the hub service.
During the study, a call centre had been introduced to improve the appointment booking process. By 2016, between 80% and 90% of patients attending the hubs were recorded as self-referrals, presumably because they had used the call centre. The number of referrals from NHS 111 had remained more stable and generally not increased as new hubs opened.
The hubs had adapted to lower demand on Sundays by reducing opening hours and staffing, thus ensuring that Sunday usage rates were comparable to usage rates on other days of the week.
Some staff working at the hubs raised concerns about their lack of access to patients’ medical records and their inability to refer patients on for further treatment. Both these areas require effective systems to be in place to avoid the potential of increased clinical risk.
Survey responses from staff working at the hubs revealed a largely positive attitude towards working at the hubs, with 59% of staff saying that working at the hubs was better than their other or previous work.
It is possible that the hub scheme may have had an effect on the locum market in the area: some staff not working at the hubs suggested that higher locum rates being paid to hub staff might reduce the availability of locums for in-hours work.
Nuffield Trust | May 2019 | What can the NHS learn from learning health systems?
The Nuffield Trust has produced a briefing:What can the NHS learn from learning health systems?
This briefing identifies opportunities for local organisations and systems to make better use of health data, and recommends ways that national policy could promote the collaboration and greater use of analytics which underpin the LHS concept. The Nuffield Trust focuses on lessons for the NHS – but many of the same actions could be taken across the wider health and care system.
Nuffield Trust | May 2019 | The gender pay gap in the English NHS: Analysis of some of the underlying causes
This briefing from the Nuffield Trus looks at differences in basic pay between men and women employed by the NHS in England, based on data from the NHS electronic staff record for one month. As well as drawing on previous analyses to describe the extent of overall pay differences by staff group, pay band, age and ethnicity, it also identifies factors that drive those differences.