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News Article
Government dilutes public health priorities to deliver shorter NHS mandate
Patient Safety Learning posted a news article in News
The government has downgraded the importance of improving public health in its annual ‘mandate’ to the NHS. ‘The government’s 2023 mandate to NHS England’ is noticeably shorter at 18 pages than the previous document from March 2022. Speaking at the NHS ConfedExpo conference, health secretary Steve Barclay said: “For over a decade, governments have used the mandate to make asks of the system. Sometimes these asks have been excessive, with long documents with many pages full of tests and targets… But what we’ve done this year is make it short and clear… setting out our priorities: Cutting waiting lists; the three recovery plans; tech; and workforce". All the keystone targets for recovering the elective backlog, emergency care waits and cancer care remain in place. However, the latest mandate places significantly less emphasis on public health. For example, one of the five objectives in the 2022 mandate called for the service to “embed a population health management approach within local systems, stepping up action to prevent ill health and tackle health disparities”. It also makes no mention of any vaccination programme. Read full story (paywalled) Source: HSJ, 15 June 2023- Posted
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Content Article
This is the government’s formal response to the recommendations made by the Health and Social Care Committee in its Seventh report - Integrated care systems: autonomy and accountability, published on 30 March 2023. This document also sets out its response to the recommendations made in the Hewitt Review, which was commissioned by the government in November 2022 and published shortly after the committee’s report on 4 April 2023.- Posted
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Content Article
The government has published its mandate to NHS England. This mandate is intended to apply from 15 June 2023 until a new mandate is published. NHS England has a duty to seek to achieve the objectives in the mandate. The Secretary of State keeps progress against the mandate under review, setting out his views in an annual assessment which is laid in Parliament and published. The government will agree with NHS England how it should report on overall progress against the mandate to support the Secretary of State in keeping this under review. This will include reporting at agreed intervals on other delivery expectations listed beneath the objectives.- Posted
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News Article
We need to be ‘really thoughtful’ about intervening with ICSs
Patient Safety Learning posted a news article in News
NHS England needs to be ‘really thoughtful’ about how and when it intervenes as powers are devolved from the centre to integrated care systems, NHSE’s chief executive has said. Following her keynote speech at NHS ConfedExpo in Manchester today, Amanda Pritchard was asked about “her vision for the future” devolving powers to Integrated Care Systems (ICSs) as part of the NHS reforms and if “it changes the way leaders should behave”. Ms Pritchard admitted “earned autonomy” in relation to ICSs – a phrase she has previously used but has jarred with many local leaders – was “not quite the right phrase”. “It feels like we’re using yesterday’s language for today’s ways of working. I know it’s not quite the right word, but I can’t think of a better one at the moment,” she said. “What I am asking my own organisation to do, is make sure that we are really thoughtful about all of those different things that we do, and we are increasingly really intentional about which of those [tools] you can use in different circumstances [in regards to performance and accountability].” Read full story Source: HSJ, 14 June 2023 -
Content Article
Variation persists in the quality of board-level leadership of hospitals. The consequences of poor leadership can be catastrophic for patients. The year 2019 marks 50 years of public inquiries into healthcare failures in the UK. The aim of this article is to enhance our understanding of context-specific effectiveness of healthcare board practices, drawing on an empirical study of changes in hospital board leadership in England. The study suggests leadership behaviours that lay the conditions for better organisation performance. We locate our findings within the wider theoretical debates about corporate governance, responding to calls for theoretical pluralism and insights into the effects of discretionary effort on the part of board members. It concludes by proposing a framework for the ‘restless’ board from a multi-theoretic standpoint, and suggest a repertoire specifically for healthcare boards. This comprises a suite of board roles as conscience of the organisation, sensor, shock absorber, diplomat and coach, with accompanying dyadic behaviours to match particular organisation aims and priorities. The repertoire indicates the importance of a cluster of leadership practices to fulfil the purposes of healthcare boards in differing, complex and challenging contexts.- Posted
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David Gilbert is a writer and health activist. He was the first patient director in the healthcare system. He is a mental health service user with 40 years of experience in healthcare, specialising in patient and public engagement and coproduction. He helped pioneer the concept of patient leadership and authored ‘The Patient Revolution - how we can heal the health care system’. He is the founder and director of InHealth Associates, a network of specialists that supports experiential practice and patient leadership. His monthly newsletter, Impatient, is now published on the HSJ website.- Posted
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The Health and Social Care Committee carried out an inquiry to consider how Integrated Care Systems will deliver joined up health and care services to meet the needs of local populations. They have now published the report, together with formal minutes relating to the report.- Posted
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- Integrated Care System (ICS)
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News Article
Covid inquiry prepares for first hearing after 220,000 deaths
Patient Safety Learning posted a news article in News
More than three years after Boris Johnson announced a nationwide lockdown, the Covid investigation will cover every aspect of the UK’s pandemic response. More than three years after the first lockdown began, two years after the last one ended, the public hearings are at last starting. Over the months that come the inquiry will have many questions to answer. Should we have locked down earlier? Should we have not locked down at all? Did we eat out to help restaurants out, or eat out to help the virus out? Could more have been done to protect care homes from infection? Should more have been done to protect residents from loneliness? Baroness Hallett, the judge presiding, said her chief role is “to determine whether [the] level of loss,” in the broadest sense of the word, “was inevitable or whether things could have been done better”. Read full story (paywalled) Source: The Times, 13 June 2023 -
News Article
Hitting elective target ‘not in NHS’s control’, Sunak warned
Patient Safety Learning posted a news article in News
The NHS Confederation chief says he will this week demand clarity about Rishi Sunak’s flagship waiting list reduction target, warning it may not be ‘the most sensible target [or] within the service’s control’. Matthew Taylor also reflected in an exclusive interview with HSJ about a “pretty bruising” recent planning round for 2023-24. Speaking ahead of the conference, which starts this week, he said he would ask Steve Barclay for “clarity” about “what exactly the government means when it talks about reducing waiting lists”. The prime minister’s waiting list pledge is one of his frequently-referenced five priorities, which when he set them out in January stated: “NHS waiting lists will fall and people will get the care they need more quickly.” But Mr Taylor said yesterday: “It’s a bit unclear to me… Does it mean the overall waiting list? Does it mean long waiters? And what about the other waiting lists that we don’t talk about [like psychiatric care for children]?” Read full story (paywalled) Source: HSJ, 13 June 2023- Posted
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Content Article
As the NHS approaches its 75th anniversary, writers close to it reflect on the numbers behind its problems, and what it will take to heal the wounds.- Posted
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Content Article
An NHS consultant who was sacked after whistleblowing says it was because he raised concerns that “normal birth” ideology was putting the lives of women and babies at risk. Martyn Pitman, a respected obstetrician and gynaecologist, became a whistleblower to prevent “avoidable disasters” in NHS maternity care, but it cost him his career. Pitman lost his job last month after more than 20 years as a consultant at Royal Hampshire County Hospital in Winchester. His bosses cited an “irretrievable breakdown in his relationship with management”. His dismissal caused outrage from hundreds of former patients and doctors’ leaders, who say it highlights an NHS culture of “punishing those who dare to speak out”.- Posted
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News Article
WHO treaty on future pandemics is being watered down, warn health leaders
Patient Safety Learning posted a news article in News
The World Health Organization’s new pandemic preparedness treaty is being watered down and stripped of the key stipulations needed to prevent another global health disaster, say leading international health experts and civil society groups. WHO’s 194 member states agreed in December 2021 to draw up a new convention to ensure that the world would be prepared for future global health threats and to prevent the “catastrophic failure” seen during the covid pandemic. The “zero draft” of the accord, published in February, had excited observers because its scope went beyond the closest existing legally binding framework, the International Health Regulations. That draft stipulated strong obligations for information sharing and the importance of having a strong health workforce and universal healthcare, among other requirements. The latest 42 page document, leaked during the World Health Assembly, has revealed that many passages that experts regard as key to improving global health have been weakened or made optional, meaning that they could be removed in the final draft. Read full story Source: BMJ, 31 May 2023- Posted
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News Article
Ministers have been accused of failing to grasp the “tidal wave” of mental ill health blighting children’s lives, after research found that only a quarter of English primaries will be able to offer vital school-based support by the end of next year. With almost one in five pupils aged 7 to 16 now thought to have a mental health disorder, specialist support teams were set up to work with children in schools, addressing early symptoms and reducing pressure on overstretched NHS services. According to new figures shared exclusively with the Guardian, however, pupils in almost three-quarters (73.4%) of primary schools in England will have had no access to the new mental health support teams (MHSTs) by the end of 2024. The research follows reports that a quarter of a million children in the UK with mental health problems have been denied help by the NHS, with some trusts failing to offer treatment to 60% of those referred by GPs. Read full story Source: The Guardian, 9 June 2023- Posted
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- Children and Young People
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News Article
All NHS board members to get equality objectives
Patient Safety Learning posted a news article in News
Trusts and systems must draw up plans to improve the diversity of their executive and senior leadership teams over the next 12 months, and evidence progress against them by summer 2025, NHS England has announced. A new equality, diversity and inclusion (EDI) improvement plan also says every board and executive team member will have EDI objectives they will be assessed against during annual appraisals by spring 2024. The targets form part of six “high impact actions,” each with set targets that aim to address the “widely known intersectional impacts of discrimination and bias” within the NHS. Read full story (paywalled) Source: HSJ, 8 June 2023- Posted
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Content Article
This framework supports the health and disability sector to mitigate and respond to healthcare harm in Aotearoa New Zealand. Healthcare harm as defined in this framework can be a physical, psychological, social, spiritual injury or experience that occurs during the provision of care. In Aotearoa New Zealand, harm also occurs and endures due to the impacts of imperialism, colonisation and racism. In te ao Māori, harms are conceived as diminishing of the tapu and mana of people, their environments and their spiritual connection. The framework was developed by the National Collaborative for Restorative Initiatives in Health in partnership with a diverse range of stakeholders over an 18-month period. The recommendations in the framework aim to enhance the overall health and wellbeing of consumers and providers of healthcare, while accounting for the unique features of the health system context.- Posted
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The publication of a new single, shared improvement approach, ‘NHS Impact’, is an exciting milestone. It reflects recognition, at the highest level in the English NHS, that improvement principles need to be part of the mainstream approach to the challenges facing the sector. Penny Pereira, Q’s Managing Director, considers the new approach, its potential impact and what it means for members and others working to improve health and care in England and beyond.- Posted
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News Article
Kettering General Hospital chief apologises over children's care
Patient Safety Learning posted a news article in News
A chief executive whose hospital has been accused of failing children has admitted it has not always "got it right" and apologised at a meeting. The care regulator has warned Kettering General Hospital (KGH) over its children's and young people's services and rated them inadequate. Dozens of parents with children who died or became seriously ill have contacted the BBC with concerns. Deborah Needham told a board meeting she was "here to listen" to worries. In April it was revealed inspectors from the Care Quality Commission (CQC) raised concerns over sepsis treatment, staff numbers, dirt levels and not having an "open culture" where concerns could be raised without fear, following an inspection in December. The CQC had inspected the Northamptonshire hospital's paediatric assessment unit, Skylark ward, and the neonatal unit after hearing concerns of safety. Read full story Source: BBC News, 9 June 2023- Posted
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Content Article
Good patient communication strategies are an essential prerequisite for developing an effective NHS patient safety culture and the NHS needs to improve on its efforts, writes John Tingle in an article for the British Journal of Nursing.- Posted
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- Organisational culture
- Communication
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News Article
Ministers failing to reform ‘restrictive’ primary care rules
Patient Safety Learning posted a news article in News
The government has failed to change ‘restrictive’ legislation which would enable primary care reform – despite repeated announcements – a pharmacy leader has said. Currently, pharmacy technicians cannot take on dispensing tasks without supervision from a pharmacist but the government promised in 2019 to look at how legislation can be updated to allow pharmacy technicians to take more of a role in dispensing, as part of the current five-year Community Pharmacy Contractual Framework, which ends next year. The government has repeatedly announced and reannounced over the past five years that it wants to remove restrictions to give community pharmacy an expanded role. But in a new report shared exclusively with HSJ, the Company Chemists’ Association – the trade body with members including Asda, Boots, Lloyds Pharmacy and Superdrug – highlights that government has failed to make progress. Read full story (paywalled) Source: HSJ, 7 June 2023- Posted
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Content Article
The Women's Health Strategy for England was developed and published in 2022 in response to the growing recognition of the unique health needs and challenges faced by women in England (and the U.K.) and was brought forward to address longstanding gaps in women's healthcare and to promote better health outcomes for women across the country. This Forbes article looks at why women’s health should be included in every government’s agenda. The author speaks to Professor Dame Lesley Regan, Women's Health Ambassador for England about the progress of the strategy and Dr. Ranee Thakar, President of the Royal College of Obstetricians and Gynaecologists about the need to ensure underrepresented groups are included in the strategy.- Posted
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Content Article
In this article for the BMJ, John R Drew, an improvement and culture consultant and Meghana Pandit, chief medical officer at Oxford University NHS Foundation Trust, argue that quality improvement (QI) should be a core tenet of how healthcare organisations are run. They highlight that some of the conditions and assumptions required for QI are at odds with prevailing management practices, with staff feeling more valued and respected while going through the QI process. They discuss the following subjects and questions: QI as the basis of management When do QI and good management coalesce? So is QI just good management? How can we help leaders get on this path?- Posted
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- Quality improvement
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Content Article
Huge issues are facing the UK’s medical workforce: angst among staff, battles for training opportunities, a lack of basic amenities, discrimination, shortages of posts, roles with no career progression, and a failure to support workers asking for pay reviews. In this BMJ opinion piece, Partha Kar says we need fresh leadership to lead basic changes with support from the royal colleges and unions, and other external organisations need to step up now.- Posted
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News Article
ICSs most ‘off target’ on recovery named by NHS England
Patient Safety Learning posted a news article in News
Seven integrated care systems and one ambulance trust have been placed in ‘intensive support’ because of their performance against urgent and emergency care metrics. NHS England launched the new intervention regime for emergency care earlier this year to measure progress against the urgent and emergency care recovery plan. The most troubled systems and organisations are now placed in a first “tier” and will receive central support from NHSE. Other systems requiring support from NHSE regional teams are placed in a secondary tier. This tiered approach is already in place for cancer and elective performance. Support will include help with analytical and delivery capacity, “buddying” with leading systems and “targeted executive leadership”. Read full story (paywalled) Source: HSJ, 7 June 2023- Posted
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- Integrated Care System (ICS)
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Content Article
Analysis, commentary and insight on patient flow from leaders across the healthcare sector. Please note you will need to submit your details to be able to download the report.- Posted
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News Article
The mayor of London is independently reviewing NHS England plans to reconfigure children’s cancer services in the capital, which were triggered when the commissioner finally accepted the current arrangements are unsafe. In a letter to NHSE London director Caroline Clarke, Sadiq Khan’s health adviser said the mayor would apply his six tests for major reconfigurations to both the options proposed for the “principal treatment centre” for paediatric cancer in south London. NHSE London is currently running a process to decide the principal treatment centre's location. An earlier assessment put the bid from the Evelina Hospital, part of Guy’s and St Thomas’ Foundation Trust, ahead of the other bidder, St George’s University Hospitals FT. Read full story (paywalled) Source: HSJ, 5 June 2023- Posted
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- Organisation / service factors
- Cancer
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