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.