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Content ArticleHealthcare service innovations are considered to play a pivotal role in improving organisational efficiency and responding effectively to healthcare needs. However, healthcare organisations often encounter difficulties in sustaining and sharing innovations. This qualitative study aimed to explore how healthcare innovators of process-based initiatives see and understand factors that either facilitated or obstructed the implementation of innovation. The authors found that even though the innovations studied were very varied, innovators often highlighted the significant role of the evidential base of success, the inter-personal and inter-organisational networks, and the inner and outer context.
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Content ArticleThis qualitative study in BMC Medicine aimed to improve understanding of the reality of making and sustaining improvements in complex healthcare systems. It focused on understanding the implications of complexity theory, introducing a framework known as Successful Healthcare Improvement From Translating Evidence in complex systems (SHIFT-Evidence). This approach is accompanied by a series of ‘simple rules’ that aim to make complexity navigable (whilst recognising that it will never be simple), providing actionable guidance to both practice and research. The authors concluded that the SHIFT-Evidence framework provides a tool to guide practice and research. The ‘simple rules’ have potential to provide a common platform for academics, practitioners, patients and policymakers to collaborate when intervening to achieve improvements in healthcare.
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Content ArticleDuring the Covid-19 pandemic there was a large-scale shift to remote consulting in UK general practice. In 2021, we saw a partial return to in-person consultations, which occurred in the context of extreme workload pressures due to backlogs, staff shortages and task shifting. This study in the British Journal of General Practice looked at media depictions of remote consultations in UK general practice at a time when general practice was under stress. The authors did a thematic analysis of national newspaper articles about remote GP consultations during two time periods: 13–26 May 2021, following an NHS England letter, and 14–27 October 2021, following a government-backed directive, both stipulating a return to in-person consulting. They found that newspaper coverage of remote consulting was strikingly negative and conclude that remote consultations have become associated in the media with poor practice. They recommend proactive dialogue between practitioners and the media to help minimise polarisation and improve perceptions around general practice.
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Content ArticleThe Voluntary Organisations Disability Group (VODG) has launched a commission on Covid-19, Disablism and Systemic Racism to explore how the worst impacts of Covid have fallen on Disabled people, particularly those from Black, Asian and minoritised ethnic groups. The Commission is examining the extent to systemic neglect of social care over many years has caused negative outcomes that have been worsened by confused approaches by the Government during the pandemic. This includes poor implementation of policy and conflicting guidance. The work will gather evidence, scrutinise the Department of Health and Social Care’s policies and responses to the pandemic, including ways in which systemic racism may have further worsened outcomes for disabled people of colour, and build solutions and support for transformative and sustainable change in social care, based on justice and human rights. The Commission is calling on Disabled people and people with long-term health conditions from Black, Asian and minoritised ethnic groups to share their views and experiences of the Covid-19 pandemic as part of its 'Call for Views and Experiences'. They are also keen to hear from families, carers and people who work in social care.
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Content ArticleCrisis resolution teams (CRTs) provide treatment at home to people experiencing mental health crises, as an alternative to hospital admission. This study in the International Journal of Mental Health Nursing aimed to measure whether CRTs adhere to a model of good practice, using one-day fidelity reviews of UK crisis teams. The authors found that despite a national mandate to implement the CRT model, there are wide variations in implementation in the UK and no teams in the sample achieved overall high fidelity.
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Content ArticleThis article explores the question of why change management was an issue in the NHS in the 1980s. It reports the results of a study which explored reasons for variability in the observed rate and pace of strategic service change in the NHS. The article introduces the metaphor of 'receptive' and 'non-receptive' contexts for change, as well as outlining eight 'signs and symptoms' of receptivity. It provides a logic and language which may enable a better understanding of the processes of change in the NHS.
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Content ArticleTo be effective, clinical governance should reach every level of a healthcare organisation—it requires structures and processes that integrate financial control, service performance and clinical quality in ways that will engage clinicians and generate service improvements. In this article for the BMJ, the authors argue that because clinicians are at the core of clinical work, they must be at the heart of clinical governance. They look at problems with the prevailing model of clinical governance and describe an alternative approach.
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Content ArticleIn healthcare, there is a well-recognised gap between what we know should be done, and what is actually done. This article considers new models that look at the implementation of evidence-based practice in healthcare systems, particularly looking at the application of a conceptual model called 'sticky knowledge'.
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Content Article
This is part of our series of Patient Safety Spotlight interviews, where we talk to people working for patient safety about their role and what motivates them. Dan talks to us about how his experiences as a paediatrician and military doctor have influenced his view of patient safety. He also describes the increasing complexity in healthcare systems and highlights the need for the Government to commit policy and resources to building and sustaining the NHS workforce. -
Content Article“Crisis,” “collapse,” “catastrophe” — these are common descriptors from recent headlines about the NHS in the UK. In 2022, the NHS was supposed to begin its recovery from being perceived as a Covid-and-emergencies-only service during parts of 2020 and 2021. Throughout the year, however, doctors warned of a coming crisis in the winter of 2022 to 2023. The crisis duly arrived. In this New England Journal of Medicine article, David Hunter gives his perspective on the current state of the NHS.
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Content ArticleEach year, Carers UK carries out a survey of carers to understand the state of caring in the UK, and this is the largest State of Caring survey carried out by Carers UK to date. Over 8,500 carers and former carers shared their experiences.
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Content ArticleIn 2020, all NHS organisations were instructed to name a single executive board member as their senior responsible person for tackling health inequalities. Across the NHS, there should now be over 450 dedicated health equality named leads in healthcare organisations. This report published by the independent NHS Race & Health Observatory in collaboration with The King’s Fund sets out recommendations to help ensure senior NHS officials responsible for improving health inequalities are able to make a difference.
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Content ArticleThe poor treatment of autistic people and people with learning disabilities has been a long-standing problem for the NHS and care system. Although successive governments have focused on supporting autistic people and people with learning disabilities to live independent and fulfilled lives in the community, over 2,055 people remain in secure institutions where they are unable to live fulfilled lives and are often subject to unacceptable and inhumane treatment. This report by the Health and Social Care Select Committee chaired by Jeremy Hunt MP outlines the finding of the committee's Inquiry into the treatment of autistic people by health and care services.
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Content ArticleThe Prescribing Safety Assessment (PSA) is a 60-question exam required as part of UK medical training to progress from FY1 to FY2. This independent review into the PSA was commissioned by the Medical Schools Council (MSC) together with the British Pharmacological Society (BPS) in the summer of 2022. It suggests a strategic future direction for the PSA and addresses how the PSA has impacted prescribing assessment and practice for medical students and Foundation Year 1 (FY1) doctors. It is intended to support national decision making about the future of UK prescribing assessment in the context of the imminent introduction of the Medical Licensing Assessment (MLA).
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Content ArticleHealth Education England, Loughborough University and a range of partners have developed the new Human Factors Healthcare Learning Pathway in response to the NHS Patient Safety Syllabus 2021. It is the first ever system-wide Patient Safety Syllabus and is available as e-learning short courses that can be completed as a Learning Pathway (Levels 1-3) or individually. Fully accredited by the Chartered Institute of Ergonomics and Human Factors (CIEHF) and the CPD Certification Service, the Pathway offers a complete programme for health and social care staff to: develop competence and capability in Human Factors (Ergonomics) focus their knowledge on patient safety and staff wellbeing. Level 1 is available for free on the NHS Education for Scotland TURAS system and Health Education England's e-Learning for Healthcare platform Selected Level 2 modules are available to book on the Loughborough University Healthcare Learning Pathway webpage
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Content ArticleThe Royal College of Anaesthetists set up PatientsVoices@RCoA to help the College improve the delivery of safe, more effective, patient-centred care to enhance patients’ experience of anaesthesia and perioperative care. This plan by PatientsVoices@RCoA aims to set out a clear direction for our future work which ensures patients’ voices are clearly heard across all relevant activities, as the College delivers its strategic aims over the next five years.
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Content ArticleThe Patients Association's Patient Partnership Week brought together patients, carers and healthcare professionals to talk about patient partnership.
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Content ArticleIn this editorial. Peter Walsh reflects on 20 years as Chief Executive of Action against Medical Accidents (AVMA) as he retires from the role. AvMA also marks its 40th anniversary this year, and Peter examines the organisation's unique role in focusing on patient safety and justice for patients. He highlights that healthcare systems and patient safety practice still have a long way to go in offering fairness and support to families affected by avoidable harm in healthcare, and argues that focusing on patients and their families must be a top priority when looking at system safety. He highlights the vital role that AvMA has played in bringing Duty of Candour into law in the countries of the UK, and argues that legal action is an important right that must be retained for patients and families who have come to harm as a result of medical error. He also talks about AvMA's recent development of a Harmed Care Pathway in collaboration with the Harmed Patients Alliance, which outlines the specific set of needs that should form part of a package of care for harmed patients and families.
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Content ArticleThe National Centre for Social Research’s (NatCen’s) British Social Attitudes (BSA) survey has been conducted annually since 1983. Each year the survey asks people what it's like to live in Britain and what they think about how Britain is run, including measuring levels of public satisfaction with the health and care services. The most recent survey was carried out between 7 September and 30 October 2022 and asked a nationally representative sample (across England, Scotland and Wales) of 3,362 people about their satisfaction with the National Health Service (NHS) and social care services overall, and 1,187 people about their satisfaction with specific NHS services, as well as their views on NHS funding. This report highlights the key findings of the survey, which was jointly sponsored this year by The King's Fund and the Nuffield Trust.
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Content ArticleHow does the public view the state of the health and care service? After political turmoil in Westminster, do people think the Government has the policies to set the NHS on the right course? With the health service under so much strain, do people remain committed to its founding principles? This long read by The Health Foundation presents its analysis of public perceptions research conducted with Ipsos that tracks the public’s views on health and social care in the UK every six months. The survey was conducted via Ipsos’ UK KnowledgePanel between 24 and 30 November 2022, with 2,063 people aged 16 and older across the UK.
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Content Article
NRAS - SMILE-RA e-learning for patients
Patient-Safety-Learning posted an article in Patient engagement
SMILE (Self-Management Individualised Learning Environment) is an e-learning experience for people with rheumatoid arthritis (RA) who want to learn more about RA, its treatments and how to become good at self-managing. Each module is on a particular theme or subject and takes between 20 mins and half an hour to complete. -
Content ArticleThis article in BMJ Quality & Safety looks at letters of compliment from patients to NHS staff, recognising their role in identifying and encouraging high quality healthcare. The authors examined compliment letters from patients and identified: why patients wrote them which activities they complimented which members of staff the feedback was aimed at. The study found that 77% of letters complimented staff on their relationship with the patient, 50% on clinical work and 30% on management. Many letters commented on staff going above and beyond their role to help patients and most letters had the joint aims of acknowledging and promoting good practice. The authors conclude that by acknowledging, rewarding and promoting positive practice, compliment letters can contribute to healthcare services by promoting positive behaviours and giving staff social recognition.
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Content ArticleA Learning Health System (LHS) is a model of how routinely collected health data can be used to improve care, creating ‘virtuous cycles’ between data and improvement. This requires the active involvement of health service stakeholders, including patients themselves. However, to date, research has explored patients being ‘data donors’ rather than considering patients as active contributors. This study in the journal Health Expectations aimed to understand how patients should be actively involved in a LHS.
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Content ArticleYou're still entitled to free NHS care if you choose to pay for additional private care. This guidance from the NHS outlines how receiving both private care might affect treatment on the NHS. It looks at the following points: What does 'as clear a separation as possible' mean? Receiving private and NHS care at the same time What treatments can my doctor tell me about? What if I have complications?
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Content ArticlePatient (or lived experience) leadership involves people affected by life-changing illness, injury or disability becoming equal partners in NHS decision-making. This expert briefing by patient leadership champion David Gilbert highlights the most significant developments in the field of patient leadership.
