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

Delivering care under pressure

NHS reality check: Delivering care under pressure | Royal College of Physicians | OnMedica

Around three quarters of doctors (74%) say they are worried about the ability of their service to deliver safe patient care in the next 12 months due to pressures on the NHS, according to a survey carried out by the Royal College of Physicians (RCP).

The RCP launched a report today at its annual conference in which it detailed various concerns raised by the 2,101 doctors who responded to its survey.

The survey asked doctors about their experiences of delivering healthcare and their confidence in being able to raise concerns about patient care.

Focusing on their experiences of care over the past 12 months, 78% of doctors said demand for their service was rising and more than half (55%) of physicians believed patient safety had deteriorated.

More than a third (37%) said the quality of care had fallen while the majority (84%) had experienced staffing shortages in their team, while 82% believed the workforce was demoralised.

Read more on this at OnMedica

Full report: NHS reality check: Delivering care under pressure

New report from the national guardian for freedom to speak up

Dr Henrietta Hughes, national guardian for speaking up freely and safely in the NHS has published a new report, which outlines the progress made since her appointment in October 2016 | NHS Employers

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Image source: CQC

Over the last 100 days, Dr Hughes has set up the national office and established a national network of Freedom to Speak Up guardians. Key points include:

  • 201 NHS trusts now have an FTSU guardian in place
  • twelve trusts are in the process of making an appointment of an FTSU guardian
  • 21 trusts have yet to appoint to the role
  • online resources and training available for guardians (including eight training sessions being led by the National Guardian’s Office (NGO)
  • guardians are encouraged to join regional networks to share progress and provide neighbouring support
  • the NGO plans to issue good practice guidance.
Read the full report here

Pressure on NHS beds could risk patient safety

Pressure on beds in the NHS in England has become so acute that on any given day last winter, the equivalent of more than five extra hospitals’-worth of beds had to be brought into service to cope with surges in demand | Nuffield Trust

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Image source: Nuffield Trust

On the single busiest day last winter, an extra 4,390 beds had to be opened, equivalent to more than seven extra hospitals in one day.  And on average, over 95% of beds across English hospitals were occupied every day last winter, despite evidence that once bed occupancy rates exceed 85%-90%, there is an increasing risk of infection (see note 1). Given that pressures on the health service have not lessened over the last 12 months, Trusts will face similarly high bed occupancy rates this winter.

Read the full overview here

Read the full report here