Sharing to improve: four case studies of data sharing in general practice | The Health Foundation
A new briefing from the Health Foundation, Sharing to improve: four case studies of data sharing in general practice, introduces approaches to collaborative data sharing that enable improvement in the quality of care. The four case studies in this briefing offer promising early indications that collaborative data sharing – in different configurations of general practice – has potential to make a meaningful contribution to improving the quality of care. Insights from these case studies show different methods of using data to improve care, and share practical learning from groups already experimenting with these efforts.
New research led by the Health Foundation looks at trends in emergency admissions over the past decade and reviews some of the interventions aimed at reducing them.
One in three patients admitted to hospital in England as an emergency in 2015/16 had five or more health conditions, such as heart disease, stroke, type 2 diabetes, dehydration, hip fracture or dementia. This is up from one in ten in 2006/07
The number of patients admitted urgently to hospital has increased by 42% over the past decade – that’s an average of 3.2% per annum. This far outstrips the total number of people who attend A&E departments, which is up by only 13%
Patients arriving at A&E are sicker than ever before, and more likely to need admission. This has grown for patients with multiple health conditions, as well as for older patients aged 85 or over, up by 58.9%
Hospitals are treating patients more quickly, with overnight stays for those with five or more conditions lasting 10.8 nights in 2015/16 compared with 15.8 days a decade previously. The number of these patients admitted to hospital but discharged on the same day have increased by 373% over the same period.
The briefing also identifies opportunities to reduce emergency admissions including:
Approximately 14% of all emergency admissions are for ‘ambulatory sensitive’ conditions – conditions such as asthma where timely and effective primary care could reduce the likelihood of admission
If older patients saw their regular GP two more times out of every ten consultations, this would be associated with a 6% decrease in admissions for ambulatory sensitive conditions
Around 26.5% of all unplanned A&E attendances in England (5.77 million per year) were preceded by the patient being unable to obtain a GP appointment that was convenient to them, however few of these A&E attendances will have resulted in an admission.
Quality Improvement Series | BMJ | Health Foundation
The BMJ, in partnership with and funded by the Health Foundation, are launching a joint series of papers exploring how to improve the quality of health care delivery. The quality improvement series will discuss the evidence for systematic quality improvement, provide knowledge and support to clinicians and ultimately will aim to help improve care for patients.
End of life care in England: a briefing paper | IPPR
This paper provides a brief summary of issues around end of life care including the impact of location on the quality and cost of care; analyses data on the current location and cost of end of life care in England; and appraises the current policy agenda in this area, suggesting key areas where improvements should be made.
NHS Improvement | May 2018| 12 million people to benefit from better joined up NHS and social care work
Over 12 million people will soon benefit from better joined up NHS and social care as four more areas, covering four and a half million extra people, are given more control to improve local services.
NHS England chief Simon Stevens and Ian Dalton, head of NHS Improvement, have called on the NHS to ‘supercharge’ integration as Gloucestershire, West Yorkshire and Harrogate, Suffolk and North East Essex and North Cumbria will join the ten areas already part of the integrated care development programme (NHS Improvement).
University College London Hospitals | May 2018 | Revolutionising healthcare with AI and data science: UCLH and The Alan Turing Institute announces breakthrough partnership today
University College London Hospitals Biomedical Research Centre and the Alan Turing Institute are working in partnership to improve healthcare through artificial intelligence (AI) and data science.
The Alan Turing Institute will use AI and machine learning techniques to enable analysis of large data sets which will identify bottlenecks and barriers, after identification these could be resolved to improve efficiency and reduce patient waiting times. (via UCLH).
Professor Marcel Levi, UCLH chief executive, said:
“With ever increasing numbers of patients and ongoing financial pressures, we need to try something different, something innovative, something longer-term. The partnership with the Alan Turing Institute provides an opportunity to work with the world’s leading data scientists to do just this.
“Imagine a scenario where patients present to A&E with abdomen pain – our standard response is to check bloods, order X-rays or scans and in probably about 80% of cases, discharge for home management. What, if through analysis of thousands of similar scenarios, we were able to identify patterns in the initial presentation of the 20% with serious conditions, such as intestinal perforation or severe infections? This could enable us to fast track them through to a scan and a swift diagnosis and could support clinical decision making to manage the 80% who need no further clinical input more effectively. Machines will never replace doctors, but the use of data, expertise and technology can radically change how we manage our services – for the better”.
Sir Alan Wilson, Institute CEO of the Alan Turing Institute, commented: “At the Turing we believe that data science and AI will revolutionise healthcare: not only through new technologies, as in the recent break-throughs in image recognition, but also through applying cutting-edge algorithms to the every-day problems facing the NHS such as A&E waiting times and other crucial services. We are very proud to be working with UCLH to begin a multi-year research partnership and driving the outputs of our research forward to deliver real impact across the whole NHS.”
NHS England | May 2018 | Paramedic’s brainwave eases A&E pressures by keeping “frequent callers’ away
A senior paramedic who noticed that a small number of patients used a lot of NHS resources and staff time came up with the idea to address their problems with an innovative programme. Rhian Monteith arranged a scheme where the frequent callers were able to meet for coffee and a chat. The scheme The High Intensity User programme was innovated by Rhian who collaborated with other teams to compile a list of 23 patients, many suffering from mental health problems or loneliness, who had visited A&E more than 700 times during the previous three months, mostly by ambulance. Through personal mentoring and one-to-one coaching, as well as getting them involved with community activities, the patients were encouraged to phone her rather than dial 999.
Rhian helped A&E attendances, 999 calls and hospital admissions drop by about 90 per cent among the group. The scheme was then scaled up to cover about 300 patients in Blackpool over the following three years, saving the NHS more than £2million. It has now been rolled out to around a fifth of the country with 36 local heath teams adopting the scheme. (Public Health England)