Funding system failing people with continuing healthcare needs

Report suggests the Government must take steps to improve the complex process for obtaining funding which is beset with delays and poor-quality assessments. | Public Accounts Committee

NHS continuing healthcare (CHC) funding is intended to help some of the most vulnerable people in society, who have significant healthcare needs. This report finds that too often people’s care is compromised because no one makes them aware of the funding available, or helps them to navigate the hugely complicated process for accessing funding. Those people that are assessed spend too long waiting to find out if they are eligible for funding, and to receive the essential care that they need.

This report from the Public Accounts Committee finds that the Department of Health and NHS England recognise that the system is not working as well as it should but are not doing enough to ensure CCGs are meeting their responsibilities, or to address the variation between areas in accessing essential funding.

Full report: NHS continuing healthcare funding: Thirteenth Report of Session 2017–19

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Artificial Intelligence in the NHS

This report illustrates the areas where artificial intelligence (AI) could help the NHS become more efficient and deliver better outcomes for patients. | Reform

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The report from Reform suggests that AI has the potential to:

  • help address the health and wellbeing gap by predicting which individuals or groups of individuals are at risk of illness and allow the NHS to target treatment more effectively towards them
  • give all health professionals and patients access to cutting edge diagnostics and treatment tailored to individual need, helping to reduce the care and quality gap
  • help address the efficiency and funding gap by automating tasks, triaging patients to the most appropriate services and allowing them to self-care

The report makes 16 recommendations, and also highlights the main barriers to the implementation of this technology, suggesting some potential solutions.

Full report: Thinking on its own: AI in the NHS

 

Implementing Better Births: Continuity of Carer

This guidance sets out how local maternity systems can improve their services so that women experience continuity in the clinicians providing their maternity care | NHS England

Continuity of care and relationship between care giver and receiver has been proven to lead to better outcomes and safety for the woman and baby, as well as offering a more positive and personal experience. It was also the single biggest request of women using maternity  services heard during the 2016 National Maternity Review report, ‘Better Births’.

This guidance outlines four main principles that will need to underpin the provision of continuity of carer models across the country:

1. Provide for consistency of the midwife and/or obstetrician who cares for a woman throughout the antenatal, intrapartum and postnatal periods.

2. Include a named midwife who takes on responsibility for co-ordinating a woman’s care throughout the antenatal, intrapartum and postnatal periods.

3. Enable the woman to develop an ongoing relationship of trust with her midwife

4. Where possible be implemented in both the hospital and community settings.

Full document: Implementing Better Births: Continuity of Carer

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Image Source: http://www.england.nhs.uk

 

New approach to NHS clinical assessment could save thousands of lives

NHS England is asking every hospital trust to adopt the Royal College of Physicians’ new clinical assessment system, The National Early Warning
Score (NEWS) 

The National Early Warning Score (NEWS) has been produced by the Royal College of Physicians and is backed by the Royal College for Emergency Medicine, NHS Improvement, the Association of Ambulance Chairs and Sir Bruce Keogh, National Medical Director for NHS England.

The system was developed by the Royal College of Physicians with the aim of creating a standardised approach to clinical assessment across the country.

It is estimated that the NEWS is now being used in over 70% of trusts but NHS England is setting the goal of having the system in place across every acute and ambulance setting by 2019.

Having the NEWS adopted as the standard system will mean NHS staff who move between trusts are using a consistent set of measures for diagnosing patients.

Full story at NHS England

£4 billion needed next year to stop NHS care deteriorating

Analysis from the Health Foundation, The King’s Fund and the Nuffield Trust suggests the government must find at least £4 billion more for the NHS in the Budget to stop patient care deteriorating next year.

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The briefing calls on the government to recognise the immediate funding pressures facing the sector in 2018/19, which will see NHS funding growth fall to its lowest level in this parliament.

The publication also urges the government to act to close the growing funding gaps facing the health and care system, which it says are now having a clear impact on access to care.

 

The report calls for a credible medium-term strategy to better match the resources for the health and care service with the demands it faces, and proposes a new independent body to be established to identify the long-term health care needs of the population and the staffing and funding required to meet these needs.

Full briefing: The Autumn Budget:  Joint statement on health and social care

Related press release from The Health Foundation

Common evidence gaps in point-of-care diagnostic test evaluation

The authors used Oxford Diagnostic Horizon Scan Programme reports to determine the sequence and timing of evidence for new point-of-care diagnostic tests and to identify common evidence gaps in this process | BMJ Open

We extracted data from 500 primary studies. Most diagnostic technologies underwent clinical performance (ie, ability to detect a clinical condition) assessment (71.2%), with very few progressing to comparative clinical effectiveness (10.0%) and a cost-effectiveness evaluation (8.6%), even in the more established and frequently reported clinical domains, such as cardiovascular disease. The median time to complete an evaluation cycle was 9 years (IQR 5.5–12.5 years). The sequence of evidence generation was typically haphazard and some diagnostic tests appear to be implemented in routine care without completing essential evaluation stages such as clinical effectiveness.

Evidence generation for new point-of-care diagnostic tests is slow and tends to focus on accuracy, and overlooks other test attributes such as impact, implementation and cost-effectiveness. Evaluation of this dynamic cycle and feeding back data from clinical effectiveness to refine analytical and clinical performance are key to improve the efficiency of point-of-care diagnostic test development and impact on clinically relevant outcomes. While the ‘road map’ for the steps needed to generate evidence are reasonably well delineated, we provide evidence on the complexity, length and variability of the actual process that many diagnostic technologies undergo.

Full reference: Verbakel, J.Y. T et al. (2017) Common evidence gaps in point-of-care diagnostic test evaluation: a review of horizon scan reports. BMJ Open 7:e015760.

Updated confidentiality guidance comes into force for doctors

From 25th April 2017 all doctors practising medicine in the UK will be expected to follow revised, expanded and restructured ethical guidance on confidentiality | GMC

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Image source: GMC

Confidentiality: good practice in handling patient information has been updated following an extensive consultation exercise, and is now more explicit than previously published guidance about working with patients. It now clarifies:

  • The circumstances in which doctors can rely on implied consent to share patient information for direct care.
  • The importance of sharing information for direct care, recognising the multi-disciplinary and multi-agency context doctors work in.
  • The significant role that those close to a patient can play in providing support and care, and the importance of acknowledging that role.
  • The public protection responsibilities of doctors, including when to make disclosures in the public interest.

The full guidance is available here