Urgent and emergency care: best practice

This CQC report offers practical examples of how leading emergency departments are meeting the challenges of managing capacity and demand, and managing risks to patient safety .

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This report from the Care Quality Commission details the good practice identified following the Commission’s work with consultants, clinical leads, senior nursing staff and managers from leading emergency departments in 17 NHS acute trusts.

This resource identifies:

  • strategies staff use to meet the challenge of increased demand and manage risks to patient safety
  • positive actions to address potential safety risks and to manage increased demand better
  • how working with others can manage patient flow and ensure patients get the care they need
  • that rising demand pressures in emergency departments are an issue for the whole hospital and local health economy.

Full report: Sharing best practice from clinical leaders in emergency departments

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National Audit of Inpatient Falls

The National Audit of Inpatient Falls (NAIF) is designed to capture data from acute, community and mental health hospitals relating to falls | Royal College of Physicians

This report provides:

  • aggregated national results for the organisational aspects of leadership responsibilities, policies and procedures, highlighting deficiencies and changes since 2015
  • aggregated national averages for the clinical audit items, focusing on change since 2015, particularly where little progress has been made overall, or where there is a large variation in what has been achieved
  • detailed results from all individual hospitals, enabling comparison with their own performance in 2015, their performance against the guidance standards and a comparison with other hospitals.

Full report:  NAIF audit report 2017

Nine in 10 GPs rated good or outstanding following CQC inspection

Care Quality Commission (CQC) report finds that at the end of its first inspection programme of general practices 4% were rated ‘outstanding’, 86% were ‘good’, 8% were ‘requires improvement’ and 2% were ‘inadequate’.

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

The state of care in general practice 2014 to 2017 presents findings from CQCs  programme of inspections of GP practices. This detailed analysis of the quality and safety of general medical practice in England has found that nearly 90% of general practices in England have been rated as ‘good’, making this the highest performing sector CQC regulates.

Full document: The state of care in general practice 2014 to 2017

Costs of inpatient falls in hospitals

This review provides an overview of the scale of inpatient falls and the benefits to the NHS if the rate of falls was reduced in hospitals.

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As part of NHS Improvements work to reduce harmful inpatient falls and improve patient safety, the review helps answer the following questions:

  • What is the incidence of inpatient falls in hospital in England?
  • What are the estimated costs hospitals incur as a result of inpatient falls?
  • What are the potential cost savings from reducing falls by implementing well-evidenced multidisciplinary interventions?
  • What are the potential savings to hospitals from taking these actions?

Full report: The incidence and costs of inpatient falls in hospitals

How ward staff engage with the implementation of a patient safety intervention

A patient safety intervention was tested in a 33-ward randomised controlled trial | BMJ Open

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Objectives: No statistically significant difference between intervention and control wards was found. We conducted a process evaluation of the trial and our aim in this paper is to understand staff engagement across the 17 intervention wards.

Findings: First, there were palpable differences in the ways that the 17 ward teams engaged with the key components of the intervention. Five main engagement typologies were evident across the life course of the study: consistent, partial, increasing, decreasing and disengaged. Second, the intensity of support for the intervention at the level of the organisation does not predict the strength of engagement at the level of the individual ward team. Third, the standardisation of facilitative processes provided by the research team does not ensure that implementation standardisation of the intervention occurs by ward staff.

Conclusions: A dilution of the intervention occurred during the trial because wards engaged with Patient Reporting and Action for a Safe Environment (PRASE) in divergent ways, despite the standardisation of key components. Facilitative processes were not sufficiently adequate to enable intervention wards to successfully engage with PRASE components.

Full reference: Sheard, L. et al (2017) Exploring how ward staff engage with the implementation of a patient safety intervention: a UK-based qualitative process evaluation. BMJ Open. 7:e014558

NHS holds on to top spot in healthcare survey

Commonwealth Fund analysis of healthcare systems in 11 nations finds NHS is the best, safest and most affordable | The Guardian

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The NHS has been judged the best, safest and most affordable healthcare system out of 11 countries analysed and ranked by experts from the influential Commonwealth Fund health thinktank.

It is the second time in a row that the study, which is undertaken every three years, has found the UK to have the highest-rated health system.

The NHS has held on to the top spot despite the longest budget squeeze in its 69-year history, serious understaffing and the disruption caused by a radical restructuring of the service in England in 2013.

Its ranking is even more notable because the thinktank found the UK to put the fourth smallest amount of GDP into healthcare among the 11 nations. While the US spends 16.6% of its national income on health, the UK comes near the bottom, investing just 9.9%. Only New Zealand (9.4%), Norway (9.3%) and Australia (9%) put in less.

The UK emerged with the best healthcare system overall, just ahead of Australia, with the Netherlands a little further behind. A group of experts assessed them against 11 criteria designed to measure the effectiveness of different health systems.

Read the full news story here

Improving quality and safety in healthcare

NHS Improvement has published a shared learning resource on Improving quality and safety in healthcare. 

This resource contains case studies from providers that have been rated ‘good’ for safety by the Care Quality Commission.  They offer practical guidance to developing and spreading good practice on the following:

Read more at NHS Improvement