Wellbeing and inclusion: how ambulance trusts are seeking improvements for staff

NHS Providers – August 2023

This long read explores how ambulance trusts are seeking to support and improve the wellbeing of their workforce.

Further information = Wellbeing and inclusion: how ambulance trusts are seeking improvements for staff

Policy guidance on recording patient safety events and levels of harm

NHS England – 15th August 2023

This guidance is for users of the new Learn from Patient Safety Events (LFPSE) service, to provide context and guidance on selection of appropriate categories when recording incidents. It focuses on which Event Type is appropriate for different circumstances, and how to select the most appropriate options for the Levels of Harm categorisation required within Patient Safety Incidents.

Policy guidance on recording patient safety events and levels of harm

£250 million to boost NHS capacity with 900 new beds

Dept Health and Social Care – 15th August 2023

• £250 million of government funding has been allocated to NHS hospitals to increase capacity as part of the Urgent and Emergency Care Recovery Plan
• Funding will create 900 beds in hospitals to treat patients more quickly, and cut waiting lists
• Part of plans to increase capacity and improve performance ahead of winter and deliver an additional 5,000 permanent beds

Nine hundred new hospital beds will be delivered across the NHS as part of £250 million government funding to help treat patients more quickly this winter, the Health and Social Care Secretary, Steve Barclay, has announced today.

The funding has been awarded to NHS trusts to relieve pressures and help cut waiting lists, one of the government’s top five priorities.

Further information – £250 million to boost NHS capacity with 900 new beds

GIRFT issues six measures to help improve acute hospital flow during winter

GIRFT – Aug 2023

Guidance setting out six vital steps acute hospitals should take to improve flow during the winter months is available to download, in a collaboration between Getting It Right First Time (GIRFT) and the Society for Acute Medicine (SAM). The detailed guidance has been developed based on the views of acute physicians currently working in a range of clinical settings across England, to help hospitals manage their acute medical take. The aim is that implementing these steps can improve patient care, safety and staff well-being.

The six steps cover the key priorities for improving flow, offering in-depth guidance and best practice to address:

1. Protecting Same Day Emergency Care (SDEC) capacity and function, by ensuring that SDEC units are never bedded, and avoiding using SDEC staff to cope with demand elsewhere in the hospital.
2. Best practice for ward rounds and handover, including advice for achieving twice daily review on AMUs, seven days a week.
3. Measures for pharmacy services which can help to facilitate discharge.
4. Ensuring availability of, and access to, diagnostics for teams in AMU, SDEC and the emergency department (ED).
5. A range of measures to optimise the workforce, making best use of all members of the multi-professional team.
6. Ensuring the provision of, and access to, Allied Health Professionals (AHPs) and acute frailty services.

The guidance also stresses that any interventions should be supported by the development of a local comprehensive strategy for achieving flow in acute medicine.

Useful links are provided to further reading and supporting documents, such as the Royal College of Physicians’ toolkits for effective handover and for delivering a 12-hour, 7-day consultant presence in Acute Medical Units.

The guide also links in with GIRFT’s recent collaboration with the British Geriatrics Society (BGS) aiming to support hospital teams to improve care of older people living with frailty – another piece of guidance in the ‘six steps’ series, called Six Steps to Better Care for Older People in Acute Hospitals.

Read the Guidance – Six to Help Fix: Acute Medicine guidance for improving in-hospital flow

Major conditions strategy: case for change and our strategic framework

Department of Health and Social Care – 14th august 2023

Following the Secretary of State for Health and Social Care’s commitment to publish a major conditions strategy, this government report sets out the case for change and strategic framework for the final strategy.

The final strategy will aim to improve outcomes and better meet the needs of our ageing population living with an increasing number of conditions. Tackling the groups of major conditions that drive ill health in England provides an important opportunity to improve the lives of millions of people. Reducing suffering from these conditions will move us towards our objective of increasing healthy life expectancy by 2035, help us to ease pressure on the health system and reduce the number of people out of work due to ill health.

Major conditions strategy: case for change and our strategic framework

Best practice timed diagnostic cancer pathways: practical guidance for clinicians to maximise use of NHS Cancer pathways for the benefit of patients

GIRFT – July 2023

GIRFT and the NHS England Cancer Programme have co-produced this guide, outlining how cancer alliances and constituent organisations can implement NHSE’s best practice timed pathways for cancer, with insights from the relevant GIRFT national clinical leads. The guide summarises the key guidance documents available to NHS colleagues, with links provided.

Access the Guide – Best Practice Timed Diagnostic Cancer pathways

Dementia Care in General Hospitals Round 5 Audit 2022 (NAD)

HQIP – 10th Aug 2023

The National Audit of Dementia (NAD) has published its latest report, which presents the results of the fifth round of audit data. For the first time, the audit has been undertaken prospectively (which will enable hospitals to take earlier action to improve patient care and experience), however, this has demonstrated that many hospitals still have no ready mechanism to identify people with dementia once admitted.

One notable improvement is delirium screening (dementia is the biggest risk factor for developing delirium). Screening for delirium has improved from 58% in round 4 to 87% in the current audit. In addition, a high number of pain assessments are also being undertaken within 24 hours of admission (85%). Although encouraging, the report highlights that 61% of these assessments were based only on a question about pain – an approach that can be unreliable in patients with dementia.

While this report acknowledges that our health services have experienced an extraordinarily difficult and challenging time (and, despite this, there are areas where progress has been made), it does shine a light on a need for more training. It states that is encouraging that many staff have received Tier 1 dementia training (median 86%), but suggests that a much higher proportion of ward-based patient facing staff should have received Tier 2 dementia training (median 45%). The report also finds that only 58% of hospitals are able to report the proportion of staff who have received training. As such, it recommends that any member of staff involved in the direct care of people with dementia should have Tier 2 training, and this training should be recorded to provide assurance to the public and regulators.

Read the Report – Dementia Care in General Hospitals Round 5 Audit 2022 (NAD)

Diagnostic imaging reporting turnaround times

NHS England – August 2023

Turnaround time (TAT) in imaging is the interval between an imaging examination and a verified report being made available to the referring clinician. Keeping TATs as short as possible is essential for the timely diagnosis and treatment of patients. Developed in consultation with and supported by The Royal College of Radiologists and The Society of Radiographers, this document sets out national turnaround time (TAT) guidance in England for imaging reporting TATs across clinical pathways, including the maximum timeframe within which all imaging must be reported

More information – Diagnostic imaging reporting turnaround times

Operational Pressures Escalation Levels (OPEL) Framework 2023/24

NHS England – August 2023

This framework aims to provide a unified, systematic and structured approach to detection and assessment of acute hospital urgent and emergency care (UEC) operating pressures; provide a consistent framework for the proportional representation of each acute trust hospital’s OPEL score toward the corresponding integrated care system (ICS), NHS England regions, and NHS England nationally; provide guidance to acute hospital trusts, ICS and NHS England regions that supports an effective, integrated and coordinated response to acute trust operational pressures and provide guidance on the alignment of, and interaction between, the OPEL Framework 2023/24 and the national Emergency Preparedness, Resilience and Response (EPRR) framework.

The OPEL Framework 2023/24 replaces all previous versions of the NHS OPEL Framework.

Operational Pressures Escalation Levels (OPEL) Framework 2023/24

The Ombudsman’s Annual report and accounts 2022 to 2023 – Parliamentary and Health Service Ombudsman

Parliamentary and Health Service Ombudsman – July 2023

Our 2022-2023 Annual report and Accounts give details of our performance over the past 12 months, including financial reports and statistical information about the complaints we receive. We lay our annual reports before Parliament each year.

Read the report – The Ombudsman’s Annual report and accounts 2022 to 2023