Safer maternity care

Safer Maternity Care: Progress And Next Steps | Department of Health

This document reports on progress and next steps with implementation of the safer maternity care action plan, and sets out additional measures for further and quicker improvement, including:

  • improving rigour and quality of investigations into term stillbirths, neonatal and maternal deaths, and serious brain injuries, and learning from the investigations
  • more support for maternity and neonatal training
  • looking into giving coroners powers to conduct investigations into stillbirths
  • aiming to reduce the national rate of pre-term births from 8% to 6%
  • bringing forward from 2030 to 2025 the ambition to halve rates of stillbirths, neonatal and maternal deaths, and brain injuries occurring during or soon after birth
  • Report
  • Safer maternity care
  • Department of Health – publications
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New models of care

The Health Foundation has published Some assembly required: implementing new models of care: lessons from the new care models programme.  This report draws on the experiences of those leading the vanguard sites of the new care models programme and sets out ten lessons for making improvements across local health and care services for those patients who are in most need of joined up care.  It emphasises the value of local co-creation and testing of new care models.

High-impact innovations for patient benefit

App that helps pregnant women monitor hypertension among new NHS innovations that will save lives and improve treatment | NHS England

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A wireless sensor that better detects breathing rate in hospital patients, an app to help pregnant women monitor hypertension and another that directs patients with minor injuries to treatment units with the shortest queues are among the latest innovations set to be spread across the NHS.

Eleven projects are being backed in the latest round of NHS England’s programme to develop and spread pioneering ideas, equipment and technology that have the potential to save lives as well as money.

Further detail of this latest round of the NHS Innovation Accelerator (NIA) programme  can be found at NHS England

 

 

Improving the care of people living with dementia admitted to hospitals

This review seeks to identify primary research and use its findings to develop explanations of what characteristics of dementia-friendly initiatives in hospitals make them work, in what circumstances, and why | BMJ 

Abstract

Objectives To identify features of programmes and approaches to make healthcare delivery in secondary healthcare settings more dementia-friendly, providing a context-relevant understanding of how interventions achieve outcomes for people living with dementia.

Design A realist review conducted in three phases: (1) stakeholder interviews and scoping of the literature to develop an initial programme theory for providing effective dementia care; (2) structured retrieval and extraction of evidence; and (3) analysis and synthesis to build and refine the programme theory.

Data sources PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, NHS Evidence, Scopus and grey literature.

Eligibility criteria Studies reporting interventions and approaches to make hospital environments more dementia-friendly. Studies not reporting patient outcomes or contributing to the programme theory were excluded.

Results Phase 1 combined findings from 15 stakeholder interviews and 22 publications to develop candidate programme theories. Phases 2 and 3 identified and synthesised evidence from 28 publications. Prominent context–mechanism–outcome configurations were identified to explain what supported dementia-friendly healthcare in acute settings. Staff capacity to understand the behaviours of people living with dementia as communication of an unmet need, combined with a recognition and valuing of their role in their care, prompted changes to care practices. Endorsement from senior management gave staff confidence and permission to adapt working practices to provide good dementia care. Key contextual factors were the availability of staff and an alignment of ward priorities to value person-centred care approaches. A preoccupation with risk generated responses that werelikely to restrict patient choice and increase their distress.

Conclusions This review suggests that strategies such as dementia awareness training alone will not improve dementia care or outcomes for patients with dementia. Instead, how staff are supported to implement learning and resources by senior team members with dementia expertise is a key component for improving care practices and patient outcomes.

Full reference: Handley M, Bunn F, Goodman C. | Dementia-friendly interventions to improve the care of people living with dementia admitted to hospitals: a realist review | BMJ Open 2017; 7:e015257

See also: Dementia care in hospital: training, leadership and culture change needed | The Mental Elf

Digital Technology and health

Patient Carers and Service User Vision | National Information Board | Department of Health

This policy paper examines how changes in digital technology can be used to improve patient, carer and service user experiences of health services. The document will allow people to understand why and how changes are being introduced and to see whether the planned improvements are really happening.

A systems approach to health and care design

A more holistic or ‘joined-up’  systems approach to health and social care provision could help  transform the way these essential services are delivered and address the needs of a changing patient population | Royal College of Physicians

The Royal Academy of Engineering, the Academy of Medical Sciences and the Royal College of Physicians have published Engineering better care: a systems approach to health and care design and continuous improvement.

This report explores how an engineering approach could be applied in health and social care to develop systems that meet the needs of patients, carers and NHS staff.  It presents a framework to support ongoing work in service design and improvement in health and care.  It found that more widespread application of a rigorous systems approach to health and care improvement, has the potential to have a transformative effect on health and care.

Full document: Engineering better care: a systems approach to health and care design and continuous improvement.

 

New model of Primary Care provision

New report from the Nuffield Trust evaluates an initiative called the Primary Care Home (PCH) model developed by the National Association of Primary Care (NAPC).

The primary care home model was developed by the National Association of Primary Care as a response to workforce challenges, rising demand and opportunities to shape transformation in local health and care systems across England.

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Image source: nuffieldtrust.org.uk

This report from the Nufield Trust suggests that the new models of primary care provision are showing early signs of success but will need more resources and support for these models to work well on a permanent basis.

The evaluation found that participating in the primary care home programme had strengthened inter-professional working between GPs and other health professionals while also stimulating new services and ways of working, tailored to the needs of different patient groups.

It was judged to be too early in the scheme’s development for the Nuffield Trust to quantify impacts on patient outcomes, patient experience or use of wider health services.

Full report: Primary Care Home. Evaluating a new model of primary care.

Related: New primary care model needs resources, say experts | OnMedica