Background Poor translation of clinical practice guidelines (CPGs) into clinical practice is a barrier to the provision of consistent and high-quality evidence-based care. The objective was to systematically review the roles and effectiveness of knowledge brokers (KBs) for translating CPGs in health-related settings.
Northamptonshire Healthcare NHS Foundation Trust (NHFT) have made significant improvements to their Workforce Race Equality Standard (WRES) indicators. They have done some great work to improve equality within their workforce. This is making a real difference in the working environment and the quality of care they provide.
South London and Maudsley NHS Foundation Trust has been rated Good overall by the Care Quality Commission.
The trust was rated Good for being effective, caring, responsive and well-led. It was rated Requires Improvement for being safe, following the inspection in April and May 2019. At a previous inspection the trust was also rated Good overall.
England's Chief Inspector of Hospitals has praised Shropshire Community Health NHS Trust following an inspection by the Care Quality Commission.
Shropshire Community Health NHS Trust was rated as Good overall following an inspection which took place between January and March this year.
This is an important judgement as it further clarifies what is an acceptable care setting. The appearance of the proposed service did not match with the residential area it was located within and was too big - there was a supported living service on the same site. This did not promote integration with the local community.
The child and adolescent mental health wards were rated Inadequate overall and for safe, responsive and well-led services, and Requires Improvement for caring and effective services.
The concerns primarily focused on West Lane Hospital, it was not delivering safe care. There were substantial and frequent staff shortages and staff did not adequately assess, monitor or manage risks to patients. When patients demonstrated higher levels of risk, staff did not follow processes and procedures to mitigate these through appropriate observation and engagement.
The Care Quality Commission (CQC) has rated the services provided by South West Yorkshire Partnership NHS Foundation Trust as Good following an inspection in May and June. This represents an improvement on their last inspection in March and April 2018 when the trust was rated as Requires Improvement.
The Care Quality Commission (CQC) has told North East London NHS Foundation Trust that it must make immediate improvements following its latest inspection.
The Care Quality Commission has rated the services provided by Lancashire Care NHS Foundation Trust as Requires Improvement following an inspection in May and June.
At this latest inspection, the trust was rated Requires Improvement for safe, effective, responsive and well-led and Good for caring. Overall the trust remains at Requires Improvement, no change from their last inspection in 2018.
Barnet, Enfield and Haringey Mental Health NHS Trust has been rated Good overall by the Care Quality Commission. Previously it was rated Requires Improvement.
The trust was rated Good for being effective, responsive, caring and well-led. It was rated Requires Improvement for being safe, following the inspection in June and July 2019.
The Care Quality Commission (CQC) has today published a report on Cumbria Partnership NHS Foundation Trust. The trust has been rated Requires Improvement following an inspection in May and June 2019.
A Pre-admission Suite (PAS) at a south London mental and community health trust has now closed, following a Care Quality Commission focused inspection in August 2019.
CQC undertook the inspection following concerns received about the length of
time patients stayed in Oxleas NHS Foundation Trust’s PAS and complaints from patients and relatives.
Driving improvement through technology’ includes examples from across health and social care. These range from apps that help people to take more control of their care, to digital systems for sharing care records.
Each has made positive changes to drive improvements for patients. In each case study we highlight how staff describe the journey of improvement as they experienced it.
Together their stories share some common themes. They show that one of the biggest aspects to supporting improvement across all hospitals was robust leadership. Another is meaningful engagement with staff.
In this update for 2018, we report on:
the increase in opioid prescribing across the UK
measures put in place following the Gosport Independent Panel report
our continuing concerns regarding lower schedule controlled drugs
the introduction of legislation for cannabis based medicinal products.
Our update shares the key issues raised by NHS England controlled drug accountable officers and their unaccounted-for losses of controlled drugs by NHS England area. We also give examples of issues raised and followed up through the local area networks.
The Care Quality Commission’s annual assessment of the state of health and social care in England shows that quality ratings have been maintained overall – but people’s experience of care is determined by whether they can access good care when they need it.
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.
Free access. Despite consensus that preventing patient safety events is important, measurement of safety events remains challenging. This is, in part, because they occur relatively infrequently and are not always preventable. There is also no consensus on the ‘best way‘ or the ‘best measure’ of patient safety. The purpose of all safety measures is to improve care and prevent safety events; this can be achieved by different means. If the overall goal of measuring patient safety is to capture the universe of safety events that occur, then broader measures encompassing large populations, such as those based on administrative data, may be preferable. Acknowledging the trade-off between comprehensiveness and accuracy, such measures may be better suited for surveillance and quality improvement (QI), rather than public reporting/reimbursement. Conversely, using measures for public reporting and pay-for-performance requires more narrowly focused measures that favour accuracy over comprehensiveness, such as those with restricted denominators or those based on medical record review.
Health systems invest in diabetes quality improvement (QI) programmes to reduce the gap between research evidence of optimal care and current care.1 Examples of commonly used QI strategies in diabetes include programmes to measure and report quality of care (ie, audit and feedback initiatives), implementation of clinician and patient education, and reminder systems. A recent systematic review of randomised trials of QI programmes indicates that they can successfully improve quality of diabetes care and patient outcomes.2 Changes in surrogate markers such as blood glucose control, blood pressure or cholesterol levels are used to measure QI intervention effectiveness.2
However, investments in QI strategies are only worthwhile if the programmes that effectively improve care are sustained after trial completion.3. To read the full article, log in using your NHS OpenAthens details.
Open access. Lean is commonly adopted in healthcare to increase quality of care and efficiency. Few studies of Lean involve staff-related outcomes, and few have a longitudinal design. Thus, the aim was to examine the extent to which changes over time in Lean maturity are associated with changes over time in care-giving, thriving and exhaustion, as perceived by staff, with a particular emphasis on the extent to which job demands and job resources, as perceived by staff, have a moderated mediation effect.
Open access. The Plan-Do-Study-Act (PDSA) method is widely used in quality improvement (QI) strategies. However, previous studies have indicated that methodological problems are frequent in PDSA-based QI projects. Furthermore, it has been difficult to establish an association between the use of PDSA and improvements in clinical practices and patient outcomes. The aim of this systematic review was to examine whether recently published PDSA-based QI projects show self-reported effects and are conducted according to key features of the method.
Clinical negligence claims are costly events, both in terms of the harm caused and the expense that results. Helen Vernon, Chief Executive of NHS Resolution, discusses the importance of generating and sharing insight from the harm that can result in clinical negligence claims.
This guideline covers identifying and managing depression in children and young people aged 5 to 18 years. Based on the stepped-care model, it aims to improve recognition and assessment and promote effective treatments for mild and moderate to severe depression.
Book review. Writing to Improve Healthcare, edited and authored by David P. Stevens, is a timely and important book that is designed to help quality improvers publish their quality improvement (QI) work. (Dr Stevens was the previous Editor-in-Chief of this journal, when it was called Quality & Safety in Healthcare.) The book is unique in that it applies a healthcare improvement perspective to the traditional manuscript preparation and publication process. This is useful for the novice writer and for authors accustomed to writing more traditional clinical research studies or writing for other biomedical fields. Indeed, while some prospective authors of QI work may not be first-time writers, this may be the …...To read the full article, log in using your MPFT NHS OpenAthens details. To read a copy of the book in this review, please contact the library
To offer a better experience to service users on their ward, the team at Horizon Centre in Wakefield have introduced new ways of collecting patient feedback in order to see what they’re doing well and where they could make improvements.
The steps between receiving a query or referral and allocating it to the right team is shown below. In this resource, we have referred to this as the 'access process'. Getting this process right can improve waiting times, patient flow and quality of care.
HealthTech Connect, a new online resource provided by NICE to help identify and support new health technologies as they move from inception to adoption in the UK health and care system was formally launched 29 April.
The prosecution follows an incident in May 2016 when Sophie Bennett, 19, took her own life in Lancaster Lodge in Richmond, west London.
By law, registered providers of health and social care services must take all reasonable steps and exercise all due diligence to ensure patients receive safe care and treatment.
The Care Quality Commission’s Chief Executive, Ian Trenholm and Dr Paul Lelliott, Deputy Chief Inspector (Mental Health) will give evidence to the UK Parliament Human Rights Committee in early June.
The Care Quality Commission (CQC) is calling for an independent review of every person who is being held in segregation in mental health wards for children and young people and wards for people with a learning disability or autism. These reviews should examine the quality of care, the safeguards to protect the person and the plans for discharge.
This report provides examples of the local changes that have been made to services so far and highlights the extensive work which is happening nationally in response to common themes raised through LeDeR reviews across the country.
The NHS has today announced that an additional £5 million will fund reviews to improve care for people with a learning disability and committed to renewed national action to tackle serious conditions.
The world’s first programme to review the deaths of everyone with a learning disability is being expanded to speed up the spread of best practice.
Thousands more reviews will be carried out over the next 12 months, driving local improvements to help save and improve lives.
Performance measurement (PM) and management for quality have become ubiquitous in 21st-century healthcare. Numerous entities have independently developed measures for assessing mortality, quality of chronic-disease care, access and patient satisfaction. Consequently, measures have mushroomed; for example, the National Clearinghouse for Quality Measures houses nearly 1100 active measures.1 Despite this proliferation, those whose performance is being measured have had little input in measure development.
Although many studies of quality improvement (QI) education programmes report improvement in learners’ knowledge and confidence, the impact on learners’ future engagement in QI activities is largely unknown and few studies report project measures beyond completion of the programme.. To read the full article, log in using your NHS OpenAthens details.
England’s Chief Inspector of Hospitals has rated the services run by Mersey Care NHS Foundation Trust as Good, following an inspection by the Care Quality Commission.
CQC carried out an inspection at the trust during October and December 2018, overall the trust has maintained its rating of Good. In respect of safe, effectiveness, responsiveness and caring, the trust has been rated as Good. In respect of well led the trust have been rated as Outstanding. This is an improvement on their last inspection, March 2017, when safety was rated as Requires Improvement.
There was a strong recovery ethos throughout service delivery. Staff shared a clear definition of recovery and supported clients to achieve their goals. Staff were hard working, caring and committed to delivering a good quality service.
Staff supported clients to engage in their local community. Dedicated workers helped clients’ engagement with community services and worked to bridge the gap in support after treatment and promote independence and self-care in clients.
Staff used effective systems to identify and manage client risk. Safety was a priority in all teams. The whole team was engaged in reviewing and improving safety and safeguarding systems. There were effective systems in place to ensure that safeguarding concerns were identified, managed and reviewed.
The Care Quality Commission has rated LANCuk Heywood, an assessment and treatment service for children and adults with Attention Deficit Hyperactivity Disorder and Autism, as Requires Improvement following an inspection in January 2019.
Researchers at the University of York have shown that costly external NHS hospital inspections are not associated with improvements in quality of care.
UHDB is celebrating a year of embarking on an improvement practice this month. On 12 April 2018, we were chosen as one of seven trusts nationally to take part in a programme which draws on learning from an American hospital to enable staff in a new improvement method which delivers results that patients will see and feel.
North Staffordshire Combined Healthcare NHS Trust provides a range of inpatient and community mental health services to adults, older people and children. Between 4 December 2018 and 23 January 2019, a team of CQC inspectors visited the trust.
Following the trust’s previous inspection, in 2017, the trust was rated as Good overall.
The Care Quality Commission has rated the care being provided by MOSAIC to be Outstanding after an inspection in January 2019.
MOSAIC is a substance misuse service operated by Stockport Metropolitan Borough Council and provides support and treatment for people with drug and alcohol issues, as well as support for young people whose parents misuse substances.
The local authority area data profiles bring together data to give an indication of how different services work together, providing a picture of the health and social care system in each local authority area.
The Procurement team, based at Shrewsbury Business Park, is a finalist in the Financial or Procurement Initiative of the Year category of the Health Service Journal’s Value Awards 2019, which recognise excellent use of resources and also seek out examples of demonstrable improvement in outcomes.
They have been nominated for their ‘Lean Methodology Journey’ – which saw them making savings of £1.8million in the 2017/18 financial year. The overall winner will be announced in May.
There has been an increasing interest in the concept of value-based health care and how resources are allocated to improve outcomes. However, measuring outcomes in mental health services is often complex and fraught with difficulty, with professionals and service users often having very different perspectives on the nature of mental illness and the role of services in addressing it.
The streamlining programme’s aim is for BOB [Buckinghamshire, Oxfordshire and Berkshire West] as a healthcare system, is to work collaboratively to achieve improvements in quality, staff health, wellbeing and make financial savings by realising the potential value of the healthcare workforce deployed across the region. Six NHS trusts, four key HR workstreams, over 24 managers all producing a maze with multiple processes to support their recruitment and staff experience.
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We have seen variation in how trusts are implementing the new guidance. While awareness of the guidance is high, some trusts are finding it more difficult than others to make the changes they need.
There is some, limited evidence that suggests the guidance is better suited to acute trusts than mental health or community trusts.
One in 4 adults experiences a mental health condition in any given year, and mental health conditions are the largest single cause of disability in the UK. This report considers how NICE’s evidence-based guidance can contribute to improvements in the care of people with mental health conditions.
Performance measurement (PM) and management for quality have become ubiquitous in 21st-century healthcare. Numerous entities have independently developed measures for assessing mortality, quality of chronic-disease care, access and patient satisfaction. Consequently, measures have mushroomed; for example, the National Clearinghouse for Quality Measures houses nearly 1100 active measures.1 Despite this proliferation, those whose performance is being measured have had little input in measure development. Research consistently shows when performance measurement systems are implemented by leadership divorced of the evidence-based motivational component that induces goal commitment and facilitates behaviour change, these do not accelerate performance improvement.2 3. To read the full article, log in using your NHS OpenAthens details.
Open access. Although widely recommended as an effective approach to quality improvement (QI), the Plan–Do–Study–Act (PDSA) cycle method can be challenging to use, and low fidelity of published accounts of the method has been reported. There is little evidence on the fidelity of PDSA cycles used by front-line teams, nor how to support and improve the method’s use. Data collected from 39 front-line improvement teams provided an opportunity to retrospectively investigate PDSA cycle use and how strategies were modified to help improve this over time.
Free access. Over the past decade, quality improvement (QI) has gone from a secret skill expected only among trained staff in the quality office to a core competency for all health professionals.1–3 This expectation has generated new curricula which have introduced QI to a new generation of learners, but has also created some challenges for health professions educators.4–7 Identifying knowledgeable teachers, defining core content and securing time in the curriculum represent recurring issues, while emerging discussions now centre on how best to evaluate educational efforts in QI. It is here that we find ourselves at an impasse.
On Thursday 14th March, MPs are to hold a general debate on NICE appraisal processes for treatments for rare diseases. Liz Twist MP will begin the proceedings.
The Care Quality Commission (CQC) is calling for people to speak up about their experiences of care, as new research* shows that almost 7 million people in England who have accessed health or social care services, in the last five years have had concerns about their care, but never raised them**. Of these, over half (58%) expressed regret about not doing so.
Today we have published an updated version of our joint working protocol.
This sets out how we works with councils, and updates a version signed in 2011.
Working with councils help us regulate health and adult social care in England. This in turn which promotes high quality care and drives improvement. Our working relationship involves sharing information and taking coordinated action over health or adult social care providers.
Open access. The positive deviance approach seeks to identify and learn from those who demonstrate exceptional performance. This study sought to explore how multidisciplinary teams deliver exceptionally safe care on medical wards for older people.
This guideline covers diagnosing and managing chronic obstructive pulmonary disease (COPD) in people aged 16 and older, which includes emphysema and chronic bronchitis. It aims to help people with COPD to receive a diagnosis earlier so that they can benefit from treatments to reduce symptoms, improve quality of life and keep them healthy for longer.
Health inspectors say there has been a “significant improvement” in how public sector organisations work together to provide services for older people who need care in Stoke-on-Trent.
The Care Quality Commission (CQC) has revisited the city to look at how well older people – and specifically those over 65 – can move through the health and social care system following an initial inspection in September 2017.
Open access. The growing interest in hospital users’ complaints appears to be consistent with recent changes in health care, which considers the patient’s voice a valuable information source to improve health care. Based on the assumption that the clinicians’ lived experience is an essential element of health care and to neglect it may have serious consequences, this study aimed to explore how physicians experience hospital users’ complaints and the associated mediation process.
As part of its work to improve staff engagement scores on the NHS Staff Survey, Lincolnshire Community Health NHS Trust has taken inspiration from the London Underground to develop a staff engagement tube map.
The case study looks at how the trust aimed to improve its Care Quality Commission rating and NHS Staff Survey score by focused on getting three areas right.
Middle-aged and older adults requiring skilled home healthcare (‘home health’) services following hospital discharge are at high risk of experiencing suboptimal outcomes. Information management (IM) needed to organise and communicate care plans is critical to ensure safety. Little is known about IM during this transition. A U.S. study.. To read the full article, log in using your NHS OpenAthens details.
Despite widespread use of quality indicators, it remains unclear to what extent they can reliably distinguish hospitals on true differences in performance. Rankability measures what part of variation in performance reflects ‘true’ hospital differences in outcomes versus random noise.. To read the full article, log in using your NHS OpenAthens details.
Free access. All healthcare systems show variation in the quality of care provided, whether that means access to primary care services,1 ambulance response times,2 Accident & Emergency waiting times3 or treatment processes and outcomes.4–6 Monitoring this variation in quality can serve multiple purposes: informing patients about where best to seek care;7 allowing clinicians to compare their performance with that of their peers and thus identify targets for local-level quality improvement efforts, and supporting the development of national policy. Though, what all these have in common is a trust in the reliability of the data to adequately reflect healthcare quality—sometimes a questionable assumption.
In BMJ Quality and Safety, Hofstede et al 8 have addressed a common situation where providers (such as hospitals, general practices or community teams) are ranked according to their performance on a quality indicator.
NHS Digital has produced and published the Innovation Scorecard quarterly as an official statistic since January 2013 on behalf of the Office of Life Sciences. It can be used by local NHS organisations to monitor progress in implementing NICE Technology Appraisal recommendations.
We produce the scorecard using a range of data sources. No central data collection is involved.
Junior doctors have the highest rates of prescribing errors, yet no study has set out to understand the differences between completely novice prescribers (Foundation year one (FY1) doctors) and those who have gained some experience (Foundation year two (FY2) doctors). The objective of this study was to uncover the causes of prescribing errors made by FY2 doctors and compare them with previously collected data of the causes of errors made by FY1 doctors.. To read the full article, log in using your NHS OpenAthens details.
Open access. Evidence is mounting that patient-reported experience can provide a valuable indicator of the quality of healthcare services. However, little is known about the relationship between the experiences of people with severe mental illness and the quality of care they receive. We conducted a study to examine the relationship between patient-reported experience and the quality of care provided to people with schizophrenia.
We've added 10 new Be Aware updates following your suggestions:
Musculoskeletal ; Osteoporosis ; Nutrition and obesity ; Falls ; HR ; Research Methods ; Information Governance ; Bladder, bowel and pelvic healthcare ; Rheumatology ; Medicines and healthcare products regulatory agency (circulated email)
Professor Steve Field, Chief Inspector of Primary Medical Services and Integrated Care, said: “Our review of health and social care services in the county found that older people had varied experiences of health and social care services. There were variations in what was available to them depending on where they lived, which meant that people’s experiences of care and the support they received were inconsistent.
West London NHS Trust has been rated Good overall by the Care Quality Commission.
The trust, which was formerly known as West London Mental Health Trust, was rated Outstanding for being caring, Good for being effective, responsive and well-led, and Requires Improvement for being safe, during the inspection which took place on dates between August and October 2018.
West London NHS Trust provides mental health and an increasing range of community healthcare services in west London and Berkshire.
The Chief Inspector of Hospitals has told Avon and Wiltshire Mental Health Partnership NHS Trust that it must make further improvements following its latest inspection by the Care Quality Commission.
The Secretary of State for Health and Social Care asked us to work with NHS Improvement to look at issues in NHS trusts that contribute to Never Events taking place.
Open access. Identifying characteristics associated with struggling healthcare organisations may help inform improvement. Thus, we systematically reviewed the literature to: (1) Identify organisational factors associated with struggling healthcare organisations and (2) Summarise these factors into actionable domains.
Open access. Using outcome measures to advance healthcare continues to be of widespread interest. The goal is to summarize the results of studies which use outcome measures from clinical registries to implement and monitor QI initiatives. The second objective is to identify a) facilitators and/or barriers that contribute to the realization of QI efforts, and b) how outcomes are being used as a catalyst to change outcomes over time.
We'd like to hear your suggestions for new book alert topics. Simply reply to this email with 'Book Alert Topic' and your suggestions. You can also view and sign-up to our current new book alerts here: http://library.sssft.nhs.uk/librarykeepuptodate
In a national report published today, the Care Quality Commission (CQC) found that too many people are being injured or suffering unnecessary harm because NHS staff are not supported by sufficient training, and because the complexity of the current patient safety system makes it difficult for staff to ensure that safety is an integral part of everything they do.
The commitment includes a proposal for some of the most important types of avoidable harm to patients to be halved over the next five years in areas such as medication errors and Never Events, alongside developing a ‘just culture’ for the NHS where frontline staff are supported to speak up when errors occur.
A new resource on CQC’s website, which will see pages added as new topics are addressed, explores the use of technology in care, looking at the benefits of innovation and updating previously published information on surveillance.
Open access. Embracing practice-based quality improvement (QI) represents one way for clinicians to improve the care they provide to patients while also improving their own professional satisfaction. But engaging in care redesign is challenging for clinicians. In this article, we describe our experience over the last 7 years transforming the care delivered in our large primary care practice. We reflect on our journey and offer 10 tips to healthcare leaders seeking to advance a culture of improvement.
Open access. Several countries have national policies and programmes requiring hospitals to use quality and safety (QS) indicators. To present an overview of these indicators, hospital-wide QS (HWQS) dashboards are designed. There is little evidence how these dashboards are developed. The challenges faced to develop these dashboards in Dutch hospitals were retrospectively studied.
Open access. To quantify the association between patient self-management capability measured using the Patient Activation Measure (PAM) and healthcare utilisation across a whole health economy.
Open access. To provide a description of the Imperial College Mortality Surveillance System and subsequent investigations by the Care Quality Commission (CQC) in National Health Service (NHS) hospitals receiving mortality alerts.
To investigate the association between alerts from a national hospital mortality surveillance system and subsequent trends in relative risk of mortality.. To read the full article, log in using your NHS OpenAthens details.
Editorial. Alerts have become a routine part of our daily lives—from the apps on our phones to an increasing number of ‘wearables’ (eg, fitness trackers) and household devices. Within healthcare, frontline clinicians have become all too familiar with a barrage of alerts and alarms from electronic medical records and medical devices.
Somewhat less familiar to most clinicians, however, are the alerts received by institutions from regulators and other regional or national bodies monitoring healthcare performance. After the Bristol inquiry in 2001 in the UK,1 research showed that given the available data Bristol could have been detected as an outlier and that it was not simply a matter of the low volume of cases.2 3 Had the cumulative excess mortality been monitored using these routinely collected data, then an alarm could have given for Bristol after the publication of the 1991 Cardiac Surgical Register and could have saved children’s lives.4 Similar assertions have been made about detecting problems at Mid Staffordshire National Health Service Foundation Trust—that excessively high hospital standardised mortality ratios (SMRs) pre-dated the eventual recognition of exceptionally substandard care subsequently confirmed by other means.5 6. To read the full article, log in using your NHS OpenAthens details.
To obtain an overview of existing evidence regarding quality criteria, instruments and requirements for nursing documentation.. To read the full article, log in using your NHS Athens details. To access full-text: click “Log in/Register” (top right hand side). Click ‘Institutional Login’ then select 'OpenAthens Federation', then ‘NHS England’. Enter your Athens details to view the article.