Review by Monitor of the provision of walk-in centre services in England

This review examined the possible impact of closures of walk-in centres on patients, whether commissioning arrangements for walk-in centres are working well for patients.

HSCIC publishes new report to help shed light on A&E activity

Focus on Accident and Emergency, December 2013 aims to help inform the current debate by bringing together a broad range of statistical data and analyses. While the report reflects a changing, complex picture of overall attendance, it also shows striking consistencies in patterns of A&E activity over several years.

‘Avoidable’ emergency admissions on the rise

The report from the Care Quality Commission looks at the pressures on accident and emergency (A&E) services due to an increase of admissions for ‘avoidable’ conditions.

Challenging bureaucracy

In February 2013 the NHS Confederation was commissioned to complete a review of the bureaucratic burdens on providers of NHS care. This report sets the actions which should be taken to free the NHS from unnecessary bureaucracy to help ensure that healthcare staff spend as much time as possible delivering patient care.

Winter health check – 29th November 2013

This weekly summary offers an overview of the system and pulls together information on waiting times in A&E, ambulance response times, daily situation reports from the NHS, and information on flu rates.

New guidance published to support staffing decisions

The National Quality Board, has published new guidance to support providers and commissioners to make the right decisions about nursing, midwifery and care staffing capacity and capability

NHS England promises new and far reaching drive to improve patient safety

NHS England highlights the significant work it is leading to improve the safety of patients as part of a co-ordinated response to the Francis Report.  In the coming months NHS England will: launch patient safety collaborative programmes; create an NHS improvements fellows programme; make patient safety data more accessible; publish never events data; and re-launch the patient safety alerts system.

Report on seven-day NHS care

The Academy of Medical Royal Colleges (AoMRC) report on seven-day care argues that consultants need to be present all week round and that it is “ethically unjustifiable” to provide a lower standard of care at weekends compared to weekdays.

Volunteering in acute trusts in England

The King's Fund has produced a report on volunteering in acute trusts. Survey data analysis suggests that for the average trust, every pound invested in volunteering could yield around £11 in added value.

PROMs in England - April 2013 to June 2013

The Health and Social Care Information Centre has published provisional monthly patient reported outcome measures from April to June 2013.

NHS Outcomes Framework 2014 to 2015

This version of the framework includes a progress report and information about the development of the indicators.

NHS standard contract 2014/15

NHS England plans to issue the 2014/15 NHS standard contract via its website by the end of December.  Face to face training and webinars on the NHS standard contract and e-contract system will also be provided during January and February 2014.

NHS clinical and financial engagement best practice

The government has published a guide to promote collaborative working and understanding between NHS clinicians and finance professionals.

NHS Employers workforce survey results

A workforce survey by NHS Employers  reporting current reported trends in the labour market across the NHS, including information on pay awards and affordability along with recruitment, retention, workforce supply and service demand. 

Public Health England publishes cold weather plan

With winter fast approaching, the cold weather plan for England has been published by Public Health England (PHE).

Commissioning for value data packs

These packs from Public Health England are for use by the local health community and its partners, GP commissioners and leaders and CCG senior management teams and health and wellbeing boards. They will support local discussion about prioritisation and utilisation of resources

Lessons from Europe: assuring quality through regulation

With the Francis report proposing far-reaching changes to how quality in the NHS is assured and regulated, the final Lessons from Europe seminar examined what the NHS in England can learn from how European countries assure quality in a market-based environment.

Patients unsure how to raise concerns about poor medical care

A new report has found that many patients are unsure how to raise concerns about poor medical care and more needs to be done to help them

Adopt, improve or defend - An AID for QIPP

Commissioners in Wigan have embedded a systematic approach to achieve challenging QIPP targets by identifying and addressing variations in local healthcare. This has been achieved through a three-stage process. Savings of £18m were achieved in 2012-13. 

Closing the NHS funding gap: how to get better value health care for patients

Health services will need to change radically in order to secure the future of the NHS Monitor has warned. These changes will be needed if the health sector is to close a £30 billion funding gap while providing good quality services to patients that are free at the point of use and fit for the needs of patients in the 21st century.

Patient survey highlights variation in benefit from common NHS operations

The Health and Social Care Information Centre (HSCIC) has published an interactive map showing the level of health benefit patients feel they gain from four common NHS operations under different providers. For the first time the map presents the annual results of the Patient Reported Outcome Measures (PROMs) programme. 

Lincolnshire Joint Strategic Needs Assessment 2013 Update Report Published

The Lincolnshire Joint Strategic Needs Assessment (JSNA) 2013 Overview Update Report has just been published on the LRO. This document provides an update of this overarching Joint Strategic Needs Assessment for the health and wellbeing of the Lincolnshire population. 

Local price setting and contracting practices for NHS services

Monitor has published a new research paper which assesses just how effective local contracts have been in delivering more for patients, with the focus being on national price setting.

NHS won’t meet £20bn improvement target

The NHS will struggle to meet its target of delivering £20bn in productivity improvements by 2015 according to the latest quarterly monitoring report from the King’s Fund. 

Patients are at the centre of new ward inspection regime

NHS England has published findings from its patient-led inspections of hospitals.

Quality and safety in the NHS

This study of NHS cultures and behaviours found that the quality of care in the English NHS is too often compromised by a lack of clearly defined goals, too much regulation and highly variable staff support

Consultation on the 2014/15 national tariff

New rules will come into force next year allowing local experiments in ways of paying for NHS-funded services to develop new models of care for patients.

Monitor clarifies process on awarding foundation trust status

Monitor has reaffirmed that it will not grant foundation trust status to any further NHS trusts until it receives robust assurance from the Care Quality Commission (CQC) that applicants are providing a good quality of care for patients.

Monitor has also updated Applying for NHS foundation trust status: Guide for applicants

New EU Directive on public procurement

This briefing provides an overview of key aspects of the new EU public procurement Directive and its implications for the health service

Predicting hospital admission: an observational study

This study aimed to test the performance of new variants of models to identify people at risk of an emergency hospital admission.

NHS written complaints figures released

NHS organisations received more than 162,000 written complaints during 2012/13, the equivalent of over 3,000 complaints a week, according to figures released by the Health and Social Care Information Centre.

‘Care left undone’ during nursing shifts: associations with workload and perceived quality of care

This report aims to examine the nature and prevalence of care left undone by nurses in English National Health Service hospitals and to assess whether the number of missed care episodes is associated with nurse staffing levels and nurse ratings of the quality of nursing care and patient safety environment

Tool for measuring adverse events

This tool provides an easy-to-use method for accurately identifying adverse events and measuring the rate of adverse events over time. This paper provides step-by-step instructions for using the tool to accurately identify adverse events and measure the rate of adverse events over time.

Commissioning children’s palliative care: a guide for CCGs

This document describes the population of children who need palliative care; the services and professionals who provide it; and recommendations for the commissioning of children’s palliative care.

The Shared Learning collection

The Shared Learning collection on the NICE website is a portfolio of quality-assured examples of implementation of NICE guidance and the use of quality standards to change local practice

NHS England puts patient data to better use

NHS England is introducing a modern information service on behalf of the NHS called care.data. The service will use information from a patients’ medical record to improve the way that healthcare is delivered for all.

Finance managers recommend changes to NHS payments system

NHS finance managers acknowledge the benefits of payment by results (PBR) the current system governing payments, but argue that the current system is in need of reform. The findings are explained in a joint briefing by the Healthcare Finance Managers’ Association and the King’s Fund.

Variations to NHS standard contracts

NHS England has published technical guidance on the process through which commissioners can effect local variations to electronic and paper contracts

Performance data for surgeons published

Surgery-specific data has been published on the NHS Choices website.

Keogh review of hospital care

More networking to share good practice and real-time patient feedback beyond the friends and family test area among the recommendations of Sir Bruce Keogh’s report on quality and standards of care at the 14 hospital trusts identified as below the line.

Chief inspector of hospitals announces inspection plans

CQC’s new chief inspector of hospitals, Professor Sir Mike Richards is introducing radical changes to the way hospitals in England are inspected.

First results from NHS Friends and Family test published

New data from the NHS Friends and Family survey, which asks patients whether they would recommend A&E and inpatient wards to their nearest and dearest based on their own experience, has been released.

NHS England and the HSCIC launch a consultation on hospital data to raise standards and improve patient safety

The HSCIC has published NHS Hospital Data and Datasets: A Consultation for views on what information should be extracted from hospitals in future in order to raise standards, improve safety, and reduce inequalities in patient care.

New research explores association between nurse staffing levels and quality of care

Research published online in BMJ Quality and Safety, finds that ward nurses say they are forced to ration care, and not do or complete certain aspects because of time constraints.

New proposals to ensure care and compassion in the NHS and in social care

All healthcare assistants and social care support workers should undergo the same basic training, based on the best practice that already exists in the system, and must get a standard

‘Certificate of Fundamental Care’ before they can care for people unsupervised, according independent Cavendish Review,

King’s Fund on state of health and social care

The report finds that for the final quarter of 2012/13, nearly 6% of patients waited four hours or longer in A&E, the highest level since 2004.

Health workforce information review

This report sets out findings and recommendations from a review of the arrangements for handling health workforce data and intelligence. A supporting document provides links to best practice and toolkits on information governance.

Acheiving value in health systems – HFMA Right Care briefing

This briefing describes how Right Care’s approach supports the delivery of reform and improvement in a robust and systematic way, ensuring that the effort of the organisation and its partners is focused on transforming the right services to deliver improvements to patients while saving money

Putting patients at the heart of care

This briefing from the NHS Confederation highlights the experiences of some of the independent sector organisations that have looked hard at the total package of care they provide to ensure they continue to meet the changing needs and demands of their patients.

New website highlights variation in avoidable death

The figures are part of Longer Lives, a new Public Health England (PHE) website which allows local people to see easily how their areas perform on early deaths from the major four killers, like heart disease and cancer, and how this varies across the country

Social media for chief executives: the essential guide

The figures are part of Longer Lives, a new Public Health England (PHE) website which allows local people to see easily how their areas perform on early deaths from the major four killers, like heart disease and cancer, and how this varies across the country.

Clinical commissioning hub

This hub brings together information to support the commissioning of secondary care services across medical specialties.  It also reinforces the promotion of patient experience and education and training in commissioning decisions.

Proposals for the 2014/15 national tariff

Monitor and NHS England have published three documents on proposals for the 2014/15 national tariff.

CQC launches consultation on the future of inspection and regulation

The Care Quality Commission (CQC) has published plans to change the way health and social care is regulated.  This consultation focuses on hospital care.

Your choices: consultant choice

NHS England will begin the staged publication of mortality rates for individual hospital consultants in ten specialties.  The data – covering around 3,500 consultants – will appear on the NHS Choices website and will cover a range of operations and procedures.

Approved Costing Guidance

Costing services accurately has the potential to deliver higher quality care to patients and better value for the NHS, both through better prices and improved information for clinicians and other decision makers at health care providers.  The Approved Costing Guidance sets out Monitor’s approach to costing and we are encouraging providers of NHS-funded services to adopt this approach.

King’s Fund on state of health and social care

The report finds that for the final quarter of 2012/13, nearly 6% of patients waited four hours or longer in A&E, the highest level since 2004.

Health workforce information review

This report sets out findings and recommendations from a review of the arrangements for handling health workforce data and intelligence. A supporting document provides links to best practice and toolkits on information governance.

Acheiving value in health systems – HFMA Right Care briefing

This briefing describes how Right Care’s approach supports the delivery of reform and improvement in a robust and systematic way, ensuring that the effort of the organisation and its partners is focused on transforming the right services to deliver improvements to patients while saving money.

Putting patients at the heart of care

This briefing from the NHS Confederation highlights the experiences of some of the independent sector organisations that have looked hard at the total package of care they provide to ensure they continue to meet the changing needs and demands of their patients.

Acheiving value in health systems – HFMA Right Care briefing

This briefing describes how Right Care’s approach supports the delivery of reform and improvement in a robust and systematic way, ensuring that the effort of the organisation and its partners is focused on transforming the right services to deliver improvements to patients while saving money.

New website highlights variation in avoidable death

The figures are part of Longer Lives, a new Public Health England (PHE) website which allows local people to see easily how their areas perform on early deaths from the major four killers, like heart disease and cancer, and how this varies across the country.

Social media for chief executives: the essential guide

This briefing explores how using social media platforms can help NHS chief executives develop a collaborative leadership style that helps get results in the complex system of health and social care.

Clinical commissioning hub

This hub brings together information to support the commissioning of secondary care services across medical specialties.  It also reinforces the promotion of patient experience and education and training in commissioning decisions.

Proposals for the 2014/15 national tariff

Monitor and NHS England have published three documents on proposals for the 2014/15 national tariff.

CQC launches consultation on the future of inspection and regulation

The Care Quality Commission (CQC) has published plans to change the way health and social care is regulated.  This consultation focuses on hospital care.

Your choices: consultant choice

NHS England will begin the staged publication of mortality rates for individual hospital consultants in ten specialties.  The data – covering around 3,500 consultants – will appear on the NHS Choices website and will cover a range of operations and procedures.

Approved Costing Guidance

Costing services accurately has the potential to deliver higher quality care to patients and better value for the NHS, both through better prices and improved information for clinicians and other decision makers at health care providers.  The Approved Costing Guidance sets out Monitor’s approach to costing and we are encouraging providers of NHS-funded services to adopt this approach

NHS launch plan to help hospital and A&E departments keep waiting times in check

Plans to strengthen performance in urgent and emergency care are being put in place across the country to help hospital A&E departments meet demand and tackle waiting time pressures

Hospital mortality review data

NHS England has published detailed data about the first four of the 14 hospitals involved in the review of mortality data.

NHS launch plan to help hospital and A&E departments keep waiting times in check

Plans to strengthen performance in urgent and emergency care are being put in place across the country to help hospital A&E departments meet demand and tackle waiting time pressures.

NHS premises assurance model

The NHS Premises Assurance Model (Pam) is a management tool that provides NHS organisations with nationally consistent approach to evaluating NHS premises performance against a set of common indicators.

Guide to hospital data for non-executive directors

The NHS Confederation has published a briefing for non-executive directors (NEDs) interested in improving their understanding of NHS data and how it can be used to determine what is going on in their hospital. It looks at elective hospital admissions, waiting times and patient experience.  See also The non-executive directors’ guide to hospital data part one: Activity, pathways and datasets 

The regulation and oversight of NHS trusts and NHS foundation trusts

A Joint statement on changes to regulation and oversight of NHS trusts and NHS foundation trusts proposed in response to the Francis report.

Model Core Constitution

The Model Core Constitution has been updated.  It reflects provisions of the Health and Social Care Act 2012 which are relevant to NHS foundation trusts' constitutions and which are now in force. Aspirant foundation trust should use this version.

First year's findings about harm-free patient care published

The Health and Social Care Information Centre (HSCIC) has released its first publication based on the NHS Safety Thermometer tool, which reports an increase in the percentage of assessed patients who received harm-free car

The accountability framework for NHS trust boards

This framework sets out how the NHS Trust Development Authority will work with NHS trusts on a day-to-day basis, how it will assess their progress and how it will provide the development support each organisation need

Study of medical leadership models

From the Health Services Management Centre at the University of Birmingham and the King’s Fund this report provides a comprehensive and up-to-date picture of the state of medical leadership in NHS trusts today.

Healthcare groups: an alternative to merger-mania?

There is a growing consensus that acute NHS trusts in particular, are about to enter a new phase of organisational consolidation.  This NHS confederation briefing summarises key learning from those who have already had involvement in developing healthcare groups and considers what might be done to take the concept further.

Three-fold variation in overall length of NHS stay following admission for hip fracture

This analysis in the latest National Hip Fracture Database report shows that the overall length of NHS stay for hip fracture across 180 hospitals ranges from 12.4 to 44.5 days – more than a three-fold variation

Clinical audit: statutory and mandatory requirements

This framework sets out how the NHS Trust Development Authority will work with NHS trusts on a day-to-day basis, how it will assess their progress and how it will provide the development support each organisation needs.

Health statistics notes and guidance: patient experience

These documents provide technical information, notes and guidance relating to the patient experience overall measure

Raising standards, putting people first: CQC strategy for 2013 to 2016

This strategy document outlines changes to the way that CQC will inspect and regulate services to make sure they provide people with safe, effective, compassionate and high-quality care, and to encourage them to make improvements.

Quality accounts resource 2010-14

The Healthcare Quality Improvement Partnership (HQIP) has updated its quality accounts tool to include information on the NHS outcomes framework.

Quality Governance: How does a board know that its organisation is working effectively to improve patient care?

This guidance from Monitor is designed for use across all types of NHS providers, including existing and aspirant NHS foundation trusts in the acute, specialist, ambulance, community and mental health sectors.

Using NICE guidance and quality standards to improve practice

This guide suggests what an organisation can put in place, and what staff can do to use NICE evidence-based guidance and quality standards to improve practice.  It also explains ways to assess the extent to which your organisation is implementing NICE guidance and using quality standards, and how to address any gaps if you find out it is not. 

Applying for NHS Foundation Trust Status: Guide for Applicants (April 2013)

The version of the Guide for Applicants published on 5 April 2013 contained a error regarding the statutory consultation process for Foundation Trust applications. The Guide was corrected and re-published on 12 April 2013.

Compassion in Practice implementation plans

NHS England has published its implementation plans for Compassion in Practice: ·

Summary Implementation Plans ·

Action area 1: helping people to stay independent, maximising well-being and improving health outcomes ·

Action area 2: working with people to provide a positive experience of care 

Action area 3: delivering high quality care and measuring impact ·

Action area 4: building and strengthening leadership ·

Action area 5: ensuring we have the right staff, with the right skills, in the right place ·

Area 6: supporting Positive Staff Experience

Improving the allocation of health resources in England

The paper from the King’s Fund explores how the health resource allocation process and the formula on which it is based have changed over time, and how it will work from April 2013.

Atlas of variation for liver disease

The NHS Atlas of Variation in Healthcare for People with Liver Disease reveals widespread variation in the prevalence of risk factors for liver disease across the NHS.

GMC publishes updated core guidance for all UK doctors

Every doctor in the UK will have to show they meet the professional standards set out in the updated guidance, Good Medical Practice from the General Medical Council.

Debt up and productivity down in NHS trusts

This report from Nuffield Trust examining patterns of spending and labour productivity, finds that the proportion of trusts in deficit has risen over the past four years, that there has been little improvement in hospital productivity

NHS standard contract deeds of variation now available

Providers are required to vary all contracts, which will run on beyond 31 March 2013 in order to incorporate policy requirements for the coming commissioning year. For the year 2013/14 these policy requirements are those set out in Everyone Counts: Planning for Patients 2013/14 and supporting guidance

Confirmation of payment by results arrangements for 2013/14/Collection of Reference Costs

The Department of Health has confirmed arrangements for payment by results (PbR) in 2013/14. And has issued final guidance for the collection of 2012/13 reference costs from 24 June to 26 July 2013.

The new provider licence

Monitor’s new provider licence has now been finalised and published, and is the new main tool that will regulate providers of NHS services. Foundation trusts will be licensed from April 2013, and other eligible NHS providers from April 2014

Maternity, child health, child and adolescent mental health services data sets

These data sets from the NHS Information Centre will provide comparative, mother and child-centric data that will be used to improve clinical quality and service efficiency. All NHS funded providers of these services in England should commence data collection from April 2013.

Final list of mortality indicator outliers announced

Sir Bruce Keogh has announced an investigation into hospitals that are persistent outliers on mortality indicators.  The list includes ULHT.

Diagnostics waiting times and activity – November 2012

The Department of Health has published data on waiting times and activity for 15 key diagnostic tests for the month of November 2012.

New data on emergency readmissions

The NHS Information Centre has published new data on emergency readmissions.

NHS safety thermometer 2013/14: CQUIN guidance

This guidance explains how the NHS Safety Thermometer tool can be used to achieve CQUIN goals for 2013/14. It outlines a step-by-step process to aid an understanding of data, and how to use it to set improvement goals and measure improvement over time.

Review of urgent and emergency services in England

The NHS Commissioning Board is to review the model of urgent and emergency services in England.  The review, will set out proposals for the best way of organising care to meet the needs of patients.

Payment by Results update eleven – January 2013

The DoH has published its eleventh Payment by Results (PbR) update. It includes information on PbR in 2013/14 and best practice tariffs.

Briefing on the new NHS standard e-contract

The new NHS standard contract has been launched and will be available for the first time as an e-contract.

Study of the use of contracts in commissioning

This report commissioning by the policy research unit at the Department of Health presents findings from research into how commissioners negotiate, specify, monitor and manage contracts. 

Changes to quality accounts reporting arrangements for 2012/13

Amendments made to the National Health Service (Quality Accounts) Regulations 2010, change the reporting requirements for quality accounts being published in June this year.

New tools and resources to support NHS reconfiguration

The NHS Confederation has published resources to help NHS leaders communicate and engage with staff, patients, the public and stakeholders about changes to local services

NHS TDA publishes Planning & Technical Guidance for 2013/14

Toward High Quality, Sustainable Services: Planning Guidance for NHS Trust Boards for 2013/14 sets out the expectations for what NHS Trusts will deliver in the coming year and how the NHS Trust Development Authority will support them to achieve high quality and sustainable care for the patient and communities they serve

Any Qualified Provider (AQP)

The Department of Health has published the updated versions of the Choice of Any Qualified Provider (AQP) implementation packs. These packs contain example service specifications, prices and other information to support commissioners to commission services using the AQP route.

Best practice tariffs and their impact

The Audit Commission has published an assessment of the impact of best practice tariffs (BPTs). It looks at their influence on day case surgery, fragility hip fractures and acute stroke and how implementation can be improved. 

Malnutrition toolkit for commissioners and providers

This toolkit contains guidance for commissioners and providers on defining the relevant, measurable outcomes related to nutritional care within services in order to gain value for money. 

Testing the new licensing system for providers of NHS-funded care

From April 2013, a new licensing system for most providers of NHS funded services is expected to be established. This is a briefing on the simulation event held to test the licence in a set of fictitious scenarios was held.

The Quarter: quarter 2 2012/13

David Flory’s quarterly report for Q2 (July to September) 2012/13 provides a summary of the NHS financial position and performance against the national priorities set out in the NHS Operating Framework 2012/1

Payment by Results 2013-14 road test package

The road test exercise provides an opportunity for providers to test out the new tariff and to comment on the draft 2013-14 Payment by Results (PbR) guidance and PbR code of conduct. 

Progress in making NHS efficiency savings

The National Audit Office reports that the NHS made a substantial amount of efficiency savings in 2011-12. 

2012/13 reference costs

Draft guidance for the collection of 2012/13 reference costs from NHS trusts and NHS foundation trusts in July 2013 has been published for comment and feedback.

Everyone Counts: Planning for Patients 2013/14

The NHS Commissioning new planning guidance for 2013/14 outlines the incentives and levers that will be used to improve services from April 2013, the first year of the new NHS where improvement is driven by clinical commissioners

Some additional planning documents are also available.

Developing operational delivery networks

The NHS Commissioning Board have announced the introduction Operational delivery networks (ODNs) will cover areas such as neonatal intensive care, adult critical care, burns and trauma and are focused on coordinating patient pathways between providers over a wide area to ensure access to specialist support and expertise.