First ever NHS menopause passport launches in Birmingham

National Health Executive – 14th November

University Hospitals Birmingham (UHB) has launched the NHS’s the first ever menopause passport, as the trust looks to further support the women they employ as they approach the menopause.

The passport enables staff to request a lighter and less cumbersome work uniform, adjustments to their working schedules, and opportunities for fast-tracked advice and help. Along with that, the passport has already helped establish a menopause support group, staff-only Q&A sessions with the trust’s menopause expert, all of which is supported by a network of menopause champions.

With the Birmingham trust employing more than 18,000 women, and since the menopause affects every woman in a completely different and unique way, the passport will help ensure every staff member gets the tailored and specialised support they need.

More information – First ever NHS menopause passport launches in Birmingham

Understanding patient perspectives on improving GP referrals to secondary care through the use of specialist advice and guidance

Patients Association – September 2022

The Patients Association has been working with NHS England to look at how to improve GP referrals of patients to hospital. The goal was to look at ways specialists could support GPs so they could reduce the number of outpatient appointments patients have to attend, without compromising care.

Full Report – Understanding patient perspectives on improving GP referrals to secondary care through the use of specialist advice and guidance

Everything affects health: An update to our briefing ‘Mind the gap: what’s stopping change?’

NHS Confederation – 24th November

In this briefing, we have collected stories which describe how organisations from across Wales are working to reduce poverty, ill health and inequalities by breaking down barriers across health, social services, housing, benefits and welfare advice, transport, loneliness and isolation, climate change, air pollution and much more. Read on to learn about the stories behind the stats.

Cross-sector working in action: how organisations across Wales are working to reduce poverty, ill health and inequalities.

This set of case studies describes how organisations across Wales are working across borders and boundaries to help the most vulnerable people in our society. This cross-sector working should be supported and encouraged by the Welsh Government with a cross-government action plan.

Briefing – Everything affects health: An update to our briefing ‘Mind the gap: what’s stopping change?’

Clinical investigation booking systems failures

Healthcare Safety Investigation Branch – November 2022

This investigation explores the context and contributory factors to patients being lost to follow up due to administrative functions, and safety implications of patient communication being generated solely in English, and opportunities to address this risk.

Interim bulletin – Clinical investigation booking systems failures

NHS staffing shortages: Why do politicians struggle to give the NHS the staff it needs?

Kings Fund – 24 November 2022

The workforce crisis has been a prominent issue for years, but there has been little concerted action from governments to tackle the challenge.

For almost two decades now there has been no clear plan to address the crisis and the staffing gaps have continued to worsen, because, for whatever reason, the UK political system seems unable to respond properly to this very real public concern. Given this long-running gap in solutions from national politicians, The King’s Fund and Engage Britain commissioned Bill Morgan, a former Conservative special adviser, to explore what can get in the way of ministers taking meaningful, long-term action to address NHS workforce shortages.

The resulting report, NHS staffing shortages; why can’t politicians give the NHS the staff it needs?, focuses on the role of politicians in workforce planning and delivery. It sets out the scale of the workforce crisis and the impact that it has, and the causes – identified in the report as difficulties in workforce forecasting, a tendency to train too few staff in the UK, and the insufficiently strategic use of international migration to compensate. It also considers the political reasons around why it has historically been so hard to fix and considers three factors that could contribute to tackling the current shortages:

• transparency in workforce forecasts
• the establishment of an independent workforce-planning organisation
• accepting the NHS’s historical reliance on recruitment from outside the UK as explicit future policy and planning accordingly.

Full Report – NHS staffing shortages: Why do politicians struggle to give the NHS the staff it needs?

Accompanying long read from Sally Warren, Director of Policy at The King’s Fund

Commit, understand, act: our anti-racism strategy

NHS Confederation – 22 November 2022

Supporting healthcare organisations to eliminate racism and reduce health inequalities through commitment, understanding and action.

Full Publication –Commit, understand, act: our anti-racism strategy

Independent review of integrated care systems

Review will explore how best to cut through red tape and boost efficiency, financial accountability and autonomy, with fewer national targets | Department of Health and Social Care

The government has announced a new independent review into oversight of ICSs to reduce disparities and improve health outcomes across the country. The review will explore how to empower local leaders to focus on improving outcomes for their populations. This includes giving them greater control and making them more accountable for performance and spending, reducing the number of national targets, enhancing patient choice and making the healthcare system more transparent.

Further detail: Independent review of integrated care systems

Continuous flow models in urgent and emergency careAn inadequate response to the deep problems within the NHS?

BMJ 2022;379:o2751

Winter is not yet fully upon us and already emergency departments in the UK are struggling with unprecedented levels of overcrowding. Record numbers of patients are waiting for longer than 12 hours for an inpatient bed, with some spending days in the emergency department. Ambulances are unable to offload patients for want of space, impeding their ability to respond to the most urgent calls.1 So serious is the situation that it has been suggested as the main
cause of the spike in excess non-covid deaths seen over the summer. One possible solution currently attracting interest is the continuous flow model, first introduced in North America in the late 1990s.

Full editorial – Continuous flow models in urgent and emergency care

Nuffield Trust- Should emergency departments move patients to other wards even when there’s no bed space available?

Striving for high reliability in healthcare: a qualitative study of the implementation of a hospital safety programme

Rotteau L, Goldman J, Shojania KG, et al, Striving for high reliability in healthcare: a qualitative study of the implementation of a hospital safety programme, BMJ Quality & Safety 2022;31:867-877.

Healthcare leaders look to high-reliability organisations (HROs) for strategies to improve safety, despite questions about how to translate these strategies into practice. Weick and Sutcliffe describe five principles exhibited by HROs. Interventions aiming to foster these principles are common in healthcare; however, there have been few examinations of the perceptions of those who have planned or experienced these efforts.

Objective – This single-site qualitative study explores how healthcare professionals understand and enact the HRO principles in response to an HRO-inspired hospital-wide safety programme.

Methods – We interviewed 71 participants representing hospital executives, programme leadership, and staff and physicians from three clinical services. We observed and collected data from unit and hospital-wide quality and safety meetings and activities. We used thematic analysis to code and analyse the data.Results

Participants reported enactment of the HRO principles ‘preoccupation with failure’, ‘reluctance to simplify interpretations’ and ‘sensitivity to operations’, and described the programme as adding legitimacy, training, and support. However, the programme was more often targeted at, and taken up by, nurses compared with other groups. Participants were less able to identify interventions that supported the HRO principles ‘commitment to resilience’ and ‘deference to expertise’ and reported limited examples of changes in practices related to these principles. Moreover, we identified inconsistent, and even conflicting, understanding of concepts related to the HRO principles, often related to social and professional norms and practices. Finally, an individualised rather than systemic approach hindered collective actions underlying high reliability.

Conclusion – Our findings demonstrate that the safety programme supported some HRO principles more than others, and was targeted at, and perceived differently across professional groups leading to inconsistent understanding and enactments of the principles across the organisation. Combining HRO-inspired interventions with more targeted attention to each of the HRO principles could produce greater, more consistent high-reliability practices.

Striving for high reliability in healthcare: a qualitative study of the implementation of a hospital safety programme

Core20PLUS5 infographic – Reducing health inequalities for children and young people, NHS England (published/updated 18th November 2022)

NHS England – 18 November

Core20PLUS5 is a national NHS England approach to support the reduction of health inequalities at both national and system level. The approach defines a target population cohort and identifies ‘5’ focus clinical areas requiring accelerated improvement.

Core20PLUS5 infographic – Children and young people