This quality standard covers the recognition, assessment, care and treatment of mental health problems in women during pregnancy and the postnatal period (up to 1 year after childbirth). It also includes providing pre-conception support and advice for women with an existing mental health problem who might become pregnant, and the organisation of mental health services needed in pregnancy and the postnatal period.
Managing demand for planned health care is described in this report as a “wicked problem” – demand for healthcare is outpacing capacity to meet it.
Health economies have tried various approaches to managing demand; referral management centres, expanded roles, direct access amongst others. But the evidence base has been mixed, of variable quality and sometimes conflicting findings.
This synthesis of evidence sets out to understand what works but with a particular focus on context, to understand what works, in what settings and why.
PERFORMANCE: Older people’s mental health wards across Sussex require improvement, according to the Care Quality Commission. Please contact the library to receive a copy of this article - http://bit.ly/1Xyazai
Monitor requires all NHS foundation trusts to produce reports on the quality of care as part of their annual reports. Quality reports help trusts to improve public accountability for the quality of care they provide.
The Care Quality Commission (CQC) today publishes the findings of a short-notice, focussed inspection of Southern Health NHS Foundation Trust, conducted over four days in January 2016.
In May 2016, a new recommendation was added on providing information about olanzapine when choosing antipsychotic medication for children and young people with a first episode of psychosis.
Our 2016 to 2021 strategy sets out an ambitious vision: a more targeted, responsive and collaborative approach to regulation so more people get high-quality care.
Published today, the Care Quality Commission’s five year strategy, includes a greater focus on using the voices of patients, service users and their families, along with other information, to target inspections.
CQC is responsible for monitoring, inspecting and regulating health and social care in England. The new strategy sets out how CQC will combine learning from inspections with better use of intelligence from the public and others to focus inspections more tightly on where people may be at risk of poor care.
The National Guardian Office has published a document to explain where a local guardian sits in an organisation and the principles which underpin their role to help to improve the culture around raising concerns.
The document, entitled Freedom to speak Up Guardians - Purpose and key principles of the role includes principle examples.
The National Institute for Health and Care Excellence (NICE) has issued new guidelines on what is known as harmful sexual behaviour. As well as sexting (sending sexually explicit pictures or messages via smartphone) it also includes other age inappropriate sexual behaviour such as watching extreme pornography or making inappropriate remarks.
Northumberland, Tyne and Wear NHS Foundation Trust and East London NHS Foundation Trust have become the first two NHS mental health trusts in England to be awarded overall ratings of outstanding, as detailed in inspection reports published today (Thursday 1 September).
The Mental Health Five Year Forward View Dashboard, published in October 2016, is a response to the recommendation in the Five Year Forward View for Mental Health that NHS England create a tool “that will identify metrics for monitoring key performance and outcomes data and that that will allow us to hold national and local bodies to account for implementing this strategy.”
It includes a suite of metrics based on the proposals in the Implementation Plan and is structured around the core elements of the mental health programme
Presentation from NHS Transformathon. This session will show how, as a nation, Scotland is seeking to achieve large scale improvement in health and care through a combination of programme-specific activities and supporting development of sustainable QI cultures within health and care organisations. They’ll do this by sharing their experience of using a range of activities to support cultural change including the Building a QI Infrastructure Programme and Board development activities. They will also share their learning and outcomes from a specific example in the care of people living with frailty and delirium.
Adherence to medicines has been identified as a key issue by the Royal Pharmaceutical Society of Great Britain,1 the WHO2 and, most recently, by the UK Academy of Medical Sciences.3 Estimates of adherence vary widely but are often reported to be as low as 50%.4 When a patient does not take their prescribed medicines as intended, they may not derive the expected outcomes. As well as implications for the individual patient, this can result in increased costs associated with patient hospitalisations or avoidable escalation in other costs of care.3 It may also result in unused medicines, the cost of which is estimated at £300 million per year in England alone.3 To read the full article, log in using your NHS OpenAthens details
Prescribing errors occur in up to 15% of UK inpatient medication orders. However, junior doctors report insufficient feedback on errors. A barrier preventing feedback is that individual prescribers often cannot be clearly identified on prescribing documentation. To read the full article, log in using your NHS OpenAthens details
CQC is carrying out a review of how NHS trusts identify, report, investigate and learn from deaths of people using their services.
This follows a request from the Secretary of State for Health, which was part of the Government’s response to a report into the deaths of people with a learning disability or mental health problem in contact with Southern Health Foundation NHS foundation Trust.
CQC’s review will consider the quality of practice in relation to identifying, reporting and investigating the death of any person in contact with a health service managed by an NHS trust; whether the person is in hospital, receiving care in a community setting or living in their own home. The review will pay particular attention to how NHS trusts investigate and learn from deaths of people with a learning disability or mental health problem.
NICE has updated its guidelines pages to explain how they should be used in offering patients and service users the best care.
The new wording explains that guidelines should be taken fully into account but that the patient, or person receiving care, should be at the heart of decision-making. It also emphasises the importance of a clinician’s expertise and judgement.
The change is in response to conversations NICE has been having with people – including GPs. The new wording reflects NICE’s broader responsibilities within health and social care.
The independent Expert Advisory Group (EAG) report, advising the Secretary of State for Health on the creation of the Healthcare Safety Investigation Branch (HSIB), makes the case that there is room for improvement for investigation capability throughout the NHS.
The EAG’s advice is that HSIB should be an exemplar for the whole health system on how to undertake learning-oriented safety investigations, helping those in the system improve rather than taking on the majority of investigations itself.
Hospital board members are asked to consider large amounts of quality and safety data with a duty to act on signals of poor performance. However, in order to do so it is necessary to distinguish signals from noise (chance). This article investigates whether data in English National Health Service (NHS) acute care hospital board papers are presented in a way that helps board members consider the role of chance in their decisions. You can request a copy of this article by replying to this email. Please ensure you are clear which article you requesting.
NHS Improvement has launched its single oversight framework consultation.
The framework sets out how the regulator will identify where trusts may benefit from, or require, support in key areas of performance.
We say the new framework is significant for all providers and marks a shift in the regulator's approach
The ‘5 whys’ technique is one of the most widely taught approaches to root-cause analysis (RCA) in healthcare. Its use is promoted by the WHO,1 the English National Health Service,2 the Institute for Healthcare Improvement,3 the Joint Commission4 and many other organisations in the field of healthcare quality and safety. Like most such tools, though, its popularity is not the result of any evidence that it is effective.5–8 Instead, it probably owes its place in the curriculum and practice of RCA to a combination of pedigree, simplicity and pedagogy...........To read the full article, log in using your NHS OpenAthens details.
Barnet, Enfield and Haringey Mental Health NHS Trust (BEH) is embarking on a new era in their quality improvement journey.
BEH is teaming up with Haelo, the Innovation and Improvement Science Centre founded at Salford Royal NHS Foundation Trust, (SRFT) as part of their world-renowned quality improvement programme.
Birmingham and Solihull Mental Health NHS Foundation Trust (BSMHFT) has achieved outstanding results for this year for PLACE assessments (Patient Led Assessments of the Care Environment).
Overall organisational scores exceeded the national average in all six categories, which assess how care environments support patients’ care in areas such as: cleanliness; food and hydration; privacy, dignity and wellbeing; the condition, appearance and maintenance of the dementia and disability environment.
Participation to the survey is open to all health and social care providers, is a 12 month subscription and will cost between £2,000-£4,000 dependent on the number of complaints you receive per annum.
Open access. Quality and safety in healthcare, as an academic discipline, has made significant progress over recent decades, and there is now an active and established community of researchers and practitioners. However, work has predominantly focused on physical health, despite broader controversy regarding the attention paid to, and significance attributed to, mental health. Work from both communities is required in order to ensure that quality and safety is actively embedded within mental health research and practice and that the academic discipline of quality and safety accurately represents the scientific knowledge that has been accumulated within the mental health community.
Improvements in health services require a range of technical skills, but like all complex organisational tasks they also rely on the personal skills and attitudes of the staff carrying out the changes. That much is axiomatic.1 2 3 Less certain, but surely potentially helpful to front-line staff undertaking improvement initiatives, is ascertaining just what might be the right sets of skills needed for different kinds of improvement tasks in varying circumstances.4 To read the full article, log in using your NHS OpenAthens details.
Although the Commission has improved as an organisation, it needs to overcome some persistent issues with the timeliness of some of its regulation activities if it is to sustain further improvement.
Open access. South West London and St George's Mental Health NHS Trust developed a system of weekend new patient reviews by higher trainees to provide senior medical input 7 days a week. To evaluate the effectiveness of these reviews, the notes for all patients admitted over 3 months were examined. The mean length of stay for patients before and after the introduction of the weekend new patient reviews were compared via unpaired t-test.
Despite concerns about the degree of compassion in contemporary healthcare, there is a dearth of evidence for health service managers about how to promote compassionate healthcare. This paper reports on the implementation of the Creating Learning Environments for Compassionate Care (CLECC) intervention by four hospital ward nursing teams. CLECC is a workplace educational intervention focused on developing sustainable leadership and work-team practices designed to support team relational capacity and compassionate care delivery. To read the full article, log in using your NHS OpenAthens details.
Open access. Editorial. Alongside concern about avoidable mortality, one of the key findings of the public enquiry into failings at Mid Staffordshire NHS Foundation Trust,1 which ran Stafford Hospital in England, was the lack of compassion in care delivery. Sir Robert Francis, who led the enquiry, laid the blame for the compassion deficit at the door nursing and support staff. He recommended, among other things, that people should work as care assistants prior to nurse training and that values-based recruitment should be used to ensure that the ‘right’ people are recruited to be nurses. However, there has been little evidence to support these propositions. For example Snowden et al 2 found that nursing students who had previous care jobs scored no higher for emotional intelligence than those without prior experience.
Open access. Although previous research suggests that different kinds of patient feedback are used in different ways to help improve the quality of hospital care, there have been no studies of the ways in which hospital boards of directors use feedback for this purpose.