A year of integrated care systems: reviewing the journey so far | Kings Fund
The aim of this study was to understand how Integrated Care Systems (ICSs) are developing, and identify emerging lessons for local systems and national policy-makers. 72 interviews were conducted with NHS and local government leaders and other stakeholders to examine progress in eight of the first ICSs.
Although ICSs have only been in operation for a year, the report found encouraging signs of progress. The evidence reported shows that partner organisations and their leaders are working more collaboratively to manage performance and finances across a system in a way that was not happening previously.
Evidence of tangible improvements in services and outcomes is limited to date, but this is to be expected given the brief time ICSs have been in existence. This must be a key priority for all ICSs going forward. The report found broad consensus that the ICS model has real potential to bring about improvements in health and care, and to place services on a sustainable footing.
What role are ambulance services playing in transforming health and care services in England? | NHS Confederation
This podcast – produced in partnership with the Association of Ambulance Chief Executives – explores their role in detail, providing perspectives from a panel of local and national ambulance service leaders.
The wide-ranging conversation, led by the NHS Confederation’s Phil McCarvill, discusses how ambulance services have adapted ways of working to meet the needs of the evolving health and social care landscape.
Shedding light on the unique position of these trusts, the 12-minute episode also considers the workforce opportunities and risks of transformation, approaches to partnership working, and why ambulance services must be firmly at the decision-making table.
NHS England |The Atlas of Shared Learning | September 2018 |Improvement in early detection and prompt treatment of sepsis across Weston Area Health NHS Trust
A case study on the improvement in early detection and prompt treatment of sepsis across Weston Area Health NHS Trust has been published on the atlas of shared learning. The Lead Nurse at the Trust identified unwarranted variation in detection of sepsis in the early stages and the prompt treatment of Weston Area Health Trust.
The Trust identified a way to strengthen the sepsis care pathway to not only save lives but to sustain improvements by using quality improvement methodology and integrating clinical governance.
Forty percent of cases relating to sepsis are severe and 50% of cases are related to septic shock (NICE, 2014). Sepsis is the biggest cause of maternal death in the UK (World Health Organisation, 2016) and costs the National Health Service (NHS) over an estimated £2.5 billion per year (Health Care Ombudsman, 2014). Successful management of sepsis requires prompt recognition, appropriate interventions to identify and control the micro-organisms and restore oxygen delivery to tissues, and appropriate escalation and decisive medical management within the first hour of red flag sepsis.
NHS England | September 2018 |Primary care quality assurance – South Nottinghamshire
A new case study on the Atlas of Shared Learning shows how a consistent quality assurance approach is being established by Nurses in a CCG team in Nottinghamshire. This arose as nurses within the Quality Team identified unwarranted variation within primary care practices in the broad areas of quality, safety, clinical effectiveness and patient experience, where there was no uniformed process to review effectiveness and safety across GP practices across the CCG area.
The implementation of a quality assurance and improvement framework enabled the CCG nurses to target resources and support towards GP practices that needed greater support to achieve effective and safe practice, which is driving improvements and enhancing safety within the practices.
NHS England: The Atlas of Shared Learning | September 2018 | Reducing sepsis at James Paget University Hospital
Nurses at James Paget University Hospital undertook a Trust audit which revealed that over two-thirds (68 per cent) of A&E patients and more than half (58 per cent) of inpatients were receiving the right, personalised treatment for sepsis within an hour of resuscitation, as recommended by NICE and Sepsis UK. However, there was scope for improvements to the care pathway, to adhere more closely to these recommendations.
In addition to the audit, the team also mapped processes and protocols to identify opportunities for development and any barriers preventing the Trust from achieving the highest standard. From this they found there was a need to recognise sepsis earlier in the care pathway and to initiate treatment as quickly as possible thereafter. The aim was to create a sepsis awareness culture and to streamline the sepsis pathway. In this way, staff would more readily identify sepsis and be clearer about how to respond (Source: NHS England) .
Measures to support the campaign included:
Setting up a sepsis group across wards at the Trust, to encourage partnership working and to approve ideas from front line staff (such as a sticker for A&E notes as a reminder to check for sepsis);
Supporting the Clinical Care Outreach Team and Hospital at Night Practitioners to administer antibiotics, to reduce the risk of delays;
Developing a sepsis pack with a step-by step guide, placed in designated sepsis drawers and bags;
Redesigning the observation chart to include a “sepsis recognition box”;
Distributing prompt cards which fit inside staff ID card holders;
Adapting the associated paperwork to ensure that staff can complete in less than 30 seconds;
Running short sepsis awareness sessions to accommodate shift patterns;
Encouraging sepsis huddles following ward rounds to ensure every patient has been assessed in line with sepsis recommendations.
RAND Europe| September 2018 | Independent evaluation of the Q Improvement Lab
RAND Europe has published its interim report on the evaluation of the second phase of the Q Initiative. The Q initiative is led by the Health Foundation and supported and co-funded by NHS England. It aims to connect people working in quality improvement across the healthcare system throughout the UK, to make it easier for them to share ideas, enhance their skills and thus bring about a change that benefits patients.
RAND Europe carried out an independent, embedded evaluation of Q during its first phase from spring 2015 to January 2016 (Garrod et al. 2016). Subsequently, RAND Europe was commissioned to provide an independent evaluation of Q, starting in 2016 and reporting in early 2020. This is the interim report of that evaluation, documenting progress towards two overarching evaluation aims:
To provide evidence and analysis to support strategic decision-making and inform the ongoing design and management of Q.
To assess the impact that Q has, primarily on members, but also on their organisations more widely and to understand how this contributes to improvement in health and care quality across the UK (Source: RAND).
NHS England | September 2018 | NHS opens international search for new innovations
NHS England is calling on the best innovators from across the world to apply to join two schemes that aim to ensure NHS patients benefit from new technology faster.
Two programmes that look to spread innovation across the NHS have opened for new applications as NHS England once again champions the spread of the latest and greatest new technology.
Through the Innovation Technology Payment (ITP) NHS England can directly fund a small group of proven innovations to help spread them at scale across the NHS.
The NHS Innovation Accelerator (NIA) provides tailored support to innovators with compelling evidence-based innovations, to enable their innovations to be taken up at pace across the NHS. Eligible innovations must address one or more of the following priorities: prevention and early diagnosis (cancer, cardiovascular disease), mental health, primary care (Source: NHS England).