Doing away with disjointed care

This article suggests that devolution is urgently required so that regional clinical teams can respond with agility to the needs of individuals and places | via HSJ  | 25th June 2020

The covid-19 crisis has demonstrated two things: that the UK has some of the most dedicated and skilled clinicians and carers in the world; and the system within which they work is overly centralised, disjointed, underfunded and difficult to manage.

A new report, published by ResPublica, calls for the radical devolution and reform of the UK’s health and social care system, as a vital step towards improving the health and wellbeing of the whole population.

Devolution is urgently required so that regional clinical teams can respond with agility to the needs of individuals and places, unencumbered by centralised bureaucracy. Once devolved, then a more responsive acute medical service can be complemented by actions that address the biggest driver of ill health: a person’s life circumstances.

Full article: Doing away with disjointed care | HSJ

Related: How to Improve the Health and Wellbeing of the Population: Devolution and Reform of Health and Social Care | ResPublica | 25th June 2020

Improving care by using patient feedback

Improving care by using patient feedback | The National Institute for Health Research (NIHR)

This themed review features nine new research studies about using patient experience data in the NHS which show what organisations are doing now and what could be done better. The evidence ranges from hospital wards to general practice to mental health settings. There are also insights into new ways of mining and analysing big data, using online feedback and approaches to involving patients in making sense of feedback and driving improvements.

Full document: Improving care by using patient feedback

Improving mental health services

Improving mental health services in systems of integrated and accountable care: emerging lessons and priorities | The Royal College of Psychiatrists

This report aims to better understand the priorities and lessons for improving mental health services in established and emerging Integrated Care Systems (ICSs) and makes recommendations that reflect the opportunities and challenges in doing so. It is recognised that further lessons and priorities will emerge as more ICSs are established across the country.

Better care for patients and service users

This report demonstrates how – in difficult circumstances – trust leaders and staff are coming up with ideas and solutions to deliver better care | NHS Providers

This is the first in a new publication series to promote the work of NHS trusts and foundation trusts in improving care.  This briefing focuses on how trusts have responded to feedback from the Care Quality Commission in a positive and systematic way, encouraging ideas that have made a difference for patients and service users.

The report Providers deliver: better care for patients considers both the leadership approaches and frontline initiatives that underpin improvements in quality. Through 11 case study conversations, it considers some of the frontline work that has contributed to trusts’ improvements in CQC ratings, as well as exploring the role of trust leaders in providing an enabling, supportive environment in which this work has been possible.

Full report: Providers deliver: better care for patients 

See also: NHS Providers blog

Mental Healthcare in Young People and Young Adults

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This review looks in detail at the mental healthcare provided to young people from the unique perspective of the overlap between physical and mental healthcare, the quality of physical and mental healthcare provided and how patients with mental health conditions use healthcare services. The overarching aim of this study was to identify areas of care that can be improved for all patients aged between 11 and 25 years.

The review is divided into three reports and can be downloaded here

Investing in health and care data analytics

Untapped potential: Investing in health and care data analytics | The Health Foundation


This new report from the Health Foundation highlights key reasons why there should be more investment in analytical capability. The report calls for action and investment across the system so the NHS has the right people with the right tools to interpret and create value from its data. This could result in an NHS that can make faster progress on improving outcomes for patients.

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Key points
  • The NHS generates a huge amount of data. Making better use of this growing mountain of information has the potential to improve care and how services are run.
  • Yet the NHS is failing to make the most of its data because there aren’t enough people with the right analytical skills to make sense of the information that is being collected.
  • More investment is needed in skilled analysts to unlock the full potential of NHS data to benefit patients.


Nine key reasons why there should be more investment in analytical capability:

  • Clinicians can use the insights generated by skilled analysts to improve diagnosis and disease management.
  • National and local NHS leaders can evaluate innovations and new models of care to find out if expected changes and benefits were realised.
  • Board members of local NHS organisations and systems can use analysis to inform changes to service delivery in complex organisations and care systems.
  • Local NHS leaders can improve the way they manage, monitor and improve care quality day-to-day.
  • Senior NHS decision makers can better measure and evaluate improvements and respond effectively to national incentives and regulation.
  • Managers can make complex decisions about allocating limited resources and setting priorities for care.
  • Local NHS leaders will gain a better understanding of how patients flow through the system.
  • New digital tools can be developed and new data interpreted so clinicians and managers can better collaborate and use their insights to improve care.
  • Patients and the public will be able to better use and understand health care data.

Full report: Untapped potential: Investing in health and care data analytics | The Health Foundation


Help shape services and support for people with sight loss

Barnsley Clinical Commissioning Group | March 2019 | Help shape services and support for people with sight loss 

Barnsley’s Vision Strategy group is asking about the experiences of Barnsley residents who have sight loss, from the point of diagnosis to on-going support and services. 

The Vision Strategy group is made up of representatives from people with sight loss, Barnsley Council, Education Inclusion Services, HealthWatch, Charities, NHS Barnsley Hospital, Barnsley Clinical Commissioning Group, South West Yorkshire Foundation NHS Partnership Trust, Royal National Institute of Blind People (RNIB) and local opticians.

The group is working together to develop ways to prevent sight loss, promote local eye health services and develop services for Barnsley people who have sight loss.

It plans to work with people with sight loss to look at what can be done within the resources available. They want to help people engage in what is already available locally, help support new community projects and look at developing services.

Information from completed questionnaires will be used to identify areas to focus on at an engagement event on Saturday 11 May, 12.30 to 3.30pm at Barnsley Town Hall (Source: Barnsley Clinical Commissioning Group)

Further details are available from Barnsley CCG 

Implementing the NHS Long Term Plan

The NHS Long Term Plan included suggested legislative changes to help implement the Plan easier and faster.  NHS England Strategy & Innovation Directorate and NHS Improvement Strategy Directorate are now setting these out in further detail and invite views on the proposals.

The proposals outline eight groups of suggested legislative changes in the NHS Long-Term Plan, with feedback invited by April 25 2019. These include proposed changes to both the Competition and Markets Authority (CMA) and NHS Improvement’s roles in respect of competition. These proposals are based on feedback from patients, clinicians, NHS leaders and partner organisations, as well as national professional and representative bodies.

Full document: Implementing the NHS Long Term Plan: Proposals for possible changes to legislation

See also:

Procuring for effective wound management [Shared Atlas of Learning Case Study]

NHS England | November 2018 |Procuring for effective wound management

A case study on the NHS England’s Shared Atlas features an innovation from a nursing team who introduced a centralised procurement system,  generating savings of £45,000 which has been reinvested in services.

The nursing team for the Wound and Lymphedema service at the East London Wound Healing Centre identified significant unwarranted variation in the supply and use of wound care products across their service, with variation in a standardised approach to dressing choice and in some instances the most optimal dressing was not being utilised.


This innovation led to:

Better outcomes – Enabling clinicians to directly order on a patient needs-based approach has improved care and outcomes, helping to identify patients with complex needs and triggering specialist interventions. Standardising wound care based upon best practice will also improve outcomes for patients.

Better experience – The supply system has reduced delays in treatment for patients and keeping track of ordering trends has highlighted training needs and targeted support to some teams and providers. The new system has resulted in effective and efficient access to dressings for patients and improved patient care.

Better use of resources – The scheme has operated within the original budget despite an 18% increase in population. Savings of £45,000 have also been reinvested in services. Total wound care spend per patient in Tower Hamlets is significantly below the national average without compromise on quality of service provision. The procurement system has done this by reducing over-ordering and the associated risk of dressings going unused. The scheme has generated cash savings of £82k that has been reinvested back into services such a wound care projects or interventions.

Read the full case study at NHS England 


Increasing continuity of care in General Practice

The Health Foundation is supporting five large-scale GP practices and federations to carry out targeted improvement work to increase continuity of care in their practices.

The Increasing Continuity of Care in General Practice programme will explore what continuity of care will look like, considering relationships between GPs and patients, and also examining whether better information and management practices can help increase continuity with the aim of bringing benefits to both staff and patients.


This programme is inspired by recent Health Foundation research which demonstrated that patients with ambulatory care sensitive conditions who see the same GP a greater proportion of the time have fewer unplanned hospital admissions. The programme has been developed with the advice and support of the Royal College of General Practitioners.

Each project will run for up to two years and each project team will receive up to £250,000 of funding to support the implementation, evaluation and dissemination of findings from their work.

Full story at The Health Foundation