Coalition for collaborative care: action for long-term conditions

"The Coalition brings together a growing number of people and organisations. These include those wanting to introduce person-centred, collaborative care to their lives and work, as well as those responsible for NHS delivery and development at a national level."

Visit the Coalition for collaborative care website to find out more.

Costs of perinatal mental health problems

"Because the costs of perinatal mental health problems indicate the potential benefits of intervention, even a relatively modest improvement in outcomes as a result of better services would be sufficient to justify the additional spending on value for money grounds"

Costs of perinatal mental health problems
A Bauer, M Parsonage, M Knapp, V Iemmi, B Adelaja
London School of Economics and Political Science, Centre for Mental Health
October 2014

Read more here.

Simple Telehealth

"This website will help you to address your learning needs about Technology Enabled Care Services (TECs) whether you are a clinician, or commissioner or manager. Consider what competences and capabilities you or the teams you work with need."

Simple Telehealth (Digital Health SOT) 
NHS Stoke-on-Trent Clinical Commissioning Group
2014

Access the website here.

Implementation of multidimensional knowledge translation strategies to improve procedural pain in hospitalized children

"The overall aim of this study was to improve pain assessment and management over time.  Multifaceted, tailored KT [knowlegge management] interventions may be the first step in promoting optimal pain practices; however whether or not they are the answer to sustained improvement is unknown." 

Implementation of multidimensional knowledge translation strategies to improve procedural pain in hospitalized children
BJ Stevens, J Yamada, S Promislow, J Stinson, D Harrison, JC Victor
Implementation Science 2014, 9:120  doi:10.1186/s13012-014-0120-1

Read more here.

Manifestations and implications of uncertainty for improving healthcare systems

"Our analyses have implications for efforts to improve healthcare system performance and patient outcomes. Understanding differences in the ways that uncertainty is manifest in different clinical scenarios will lead to an improved understanding of the types of improvement efforts that will be most likely to be effective."

Manifestations and implications of uncertainty for improving healthcare systems: an analysis of observational and interventional studies grounded in complexity science
LK Leykum et al.
Implementation Science 2014, 9:165  doi:10.1186/s13012-014-0165-1

Read more here.

Commissioning for Value: Developing a More Systematic Approach to Commissioning in Calderdale

"This follow-up report describes progress in Calderdale one year on. The narrative highlights how the Right Care approach can support a CCG to build a sustainable health and social care economy. The CCG has made some of the smaller changes to reduce waste and is now on a journey to deliver large scale transformation across the health and social care system to meet current and future demand "

Commissioning for Value: Developing a More Systematic Approach to Commissioning in Calderdale - One Year On
Right Care Casebook Series
November 2014

Read more here.

Driving Local Change for effective and efficient eye care services

"This guidance brings together the learning from the CEE project and is accompanied by a suite of support tools to assist commissioners, local government partners, Local Eye Health Networks (LEHNs) and partnerships to plan and deliver eyecare services that maximise the best possible outcomes for their local communities."

Driving Local Change for effective and efficient eye care services: Sharing our learning from the Commissioning for Effective and Efficiency (CEE) project
UK Vision Strategy
November 2014

Read more here.

The reconfiguration of clinical services

"This paper aims to help those planning and implementing major clinical service reconfigurations ensure that change is as evidence-based as possible. It investigates the five key drivers – quality, workforce, cost, access and technology"

The reconfiguration of clinical services: What is the evidence?
C Imison, L Sonola, M Honeyman, S Ross
The King's Fund
November 2014

Read more here.

Antigen-specific active immunotherapy for ovarian cancer

"Antigen-specific active immunotherapy for ovarian cancer is not supported by sufficient good quality evidence. Consideration could be given to using it only within the context of a research or audit project.

Reducing or stopping antigen-specific active immunotherapy for ovarian cancer is likely to improve the quality of patient care by reducing exposure to unproven therapies and result in productivity savings."

Antigen-specific active immunotherapy for ovarian cancer (Quality and productivity collection examples)
The UK Cochrane Centre and NICE
November 2014

Read more here.

National training survey 2014: concerns about patient safety

"some doctors in training told us negative stories about their experiences of raising concerns at their workplace. In this report, we explore some of this information and outline the action that we intend to take."

National training survey 2014: concerns about patient safety
General Medical Council
November 2014

Read more here.

How does context influence collaborative decision-making for health services planning, delivery and evaluation?

"Collaboration among researchers (clinician, non-clinician) and decision makers (managers, policy-makers, clinicians), referred to as integrated knowledge translation (IKT), enhances the relevance and use of research, leading to improved decision-making, policies, practice, and health care outcomes. However IKT is not widely practiced due to numerous challenges. This research explored how context influenced IKT as a means of identifying how IKT could be strengthened."

How does context influence collaborative decision-making for health services planning, delivery and evaluation?

AR Gagliardi, F Webster, MC Brouwers, NN Baxter, A Finelli, S Gallinger
BMC Health Services Research 2014, 14:545  doi:10.1186/s12913-014-0545-x

Read more here.

A cost-utility analysis of a rehabilitation service for people living with and beyond cancer

"We conducted a wait-list control randomised trial of an outpatient rehabilitation service for people living with and beyond cancer, delivered in a hospice day care unit. We report the results of an economic evaluation undertaken using the trial data."

A cost-utility analysis of a rehabilitation service for people living with and beyond cancer
J Round, B Leurent, L Jones
BMC Health Services Research 2014, 14:558  doi:10.1186/s12913-014-0558-5

Read more here.

Bulletin for Clinical Commissioning Groups

The November edition of the Bulletin for CCGs, featuring news, strategic and operational issues has been released. Access it here.

Duration of participation in continuous quality improvement: a key factor explaining improved delivery of Type 2 diabetes services

"Type 2 diabetes service delivery could be improved through long term commitment to CQI, encouraging regular attendance (for example, through patient reminder systems) and improved recording and coordination of patient care in the complex service provider environments that are characteristic of non-remote areas. "

Duration of participation in continuous quality improvement: a key factor explaining improved delivery of Type 2 diabetes services
V Matthews et al.
BMC Health Services Research 2014, 14:578  doi:10.1186/s12913-014-0578-1

Read more here.

Assisting allied health in performance evaluation

"The findings of this review should inform the development of a standardised framework that can be used to measure and evaluate allied health performance"

Assisting allied health in performance evaluation: a systematic review
L Lizarondo, K Grimmer, S Kumar
BMC Health Services Research 2014, 14:572  doi:10.1186/s12913-014-0572-7

Read more here.

Managing hospital doctors and their practice

"The findings of this study have implications for management of clinicians in NHS secondary care that are perceived as ineffective and leading to disengagement and resistance to effective performance measurement, evaluation and improvement"

Managing hospital doctors and their practice: what can we learn about human resource management from non-healthcare organisations?
TM Trebble, N Heyworth, N Clarke, T Powell, PM Hockey
BMC Health Services Research 2014, 14:566  doi:10.1186/s12913-014-0566-5

Read more here.

Commission on hospital care for frail older people

"There is a myth that providing more and better care for frail older people in the community, increasing integration between health and social care services and pooling health and social care budgets will lead to significant, cashable financial savings in the acute hospital sector and across health economies. The commission found no evidence that these assumptions are true."

Commission on hospital care for frail older people: main report
Health Service Journal, Serco
November 2014

Read more here.

Commissioning supplement: Sorting the good ideas

"How the NHS is looking to CSUs to bring health and social care together, plus two CCGs show a new way for GPs to coordinate data"

Commissioning supplement: Sorting the good ideas
Health Service Journal Supplement, 14 November, 2014

Read more here.

The Next Generation of Incentives to Help Doctors Improve the Quality and Efficiency of Care (podcast)

"To improve decision-making at the health care provider level, policies that blend financial and non-financial incentives are being developed and tested. A new initiative called Incentives 2.0 is exploring this new type of payment reform."

The Next Generation of Incentives to Help Doctors Improve the Quality and Efficiency of Care
S Hausman
The Commonwealth Fund
Oct 2014

Access the podcast here.

Exploring CQC’s well-led domain: How can boards ensure a positive organisational culture?

"The paper has been written as a practical guide for board members in strengthening leadership and culture and in preparing for CQC inspections."

Exploring CQC’s well-led domain: How can boards ensure a positive organisational culture?
K Steward
The King's Fund
November 2014

Read more here.

Management of transient ischaemic attacks in the emergency department

"This educational intervention has improved patient safety and has been seen to be sustainable on the second improvement cycle."

Management of transient ischaemic attacks in the emergency department: a quality improvement project
S Wydall, A Gordon, M Sims
BMJ Quality Improvement Reports 2014;3: doi:10.1136/bmjquality.u205496.w2443

Read more here.

Improving the percentage of electronic discharge summaries completed within 24 hours of discharge

"EDSs are an important part of patient care and medical communication. It is therefore important that they are completed promptly. Our results show the five day EDS summary led to a mean 9.75% improvement in EDS completion rates, and the protected EDS hour a mean 4.5% improvement in EDS completion rates within 24 hours of patient discharge."

Improving the percentage of electronic discharge summaries completed within 24 hours of discharge
M Haycock, L Stuttaford, O Ruscombe-King, Z Barker, K Callaghan, T Davis
BMJ Quality Improvement Reports 2014;3: doi:10.1136/bmjquality.u205963.w2604

Read more here.

Changes in costs and effects after the implementation of disease management programs

"After one year we have found indications of improvements in level of integrated care for cardiovascular risk  patients and lifestyle indicators for all diseases, but in none of the diseases we have found indications of cost savings due to disease management programs. However, it is likely that it takes more time before the improvements in care lead to reductions in complications and hospitalizations."

Changes in costs and effects after the implementation of disease management programs in the Netherlands: variability and determinants
A Tsiachristas, J Murray Cramm, AP Nieboer, MPMH Rutten-van Mölken
Cost Effectiveness and Resource Allocation 2014, 12:17

Read more here.

Health Visiting Programme and 0-5 Commissioning of Public Health Services

"Local authorities know their communities and understand local need so can commission the most vital services to improve local children’s health and wellbeing. One of the benefits of councils commissioning health visitor services is that it offers opportunities to link with wider systems, such as housing, early years education providers and to enable the integration of children’s services." 

Factsheet on Health Visiting and commissioning of public health services for 0 to 5 year olds
Department of Health, Public Health England, NHS England
November 2014

Read more here.

Optimizing Safety with the Electronic Health Record (audio broadcast)

"As the implementation of electronic health records (EHR) increases across healthcare, so has awareness of new patient safety risks that the technology has either introduced or exposed.  The very same EHR being counted on to improve communication, safety, and continuity of care across multiple settings and providers turns out to have features that can have the opposite effect."

WIHI: Optimizing Safety with the Electronic Health Record: The Latest on Glitches and Fixes from the Frontlines (audio broadcast)
Institute for Healthcare Improvement
November 2014

Access the broadcast here.

Adult Social Care Outcomes Framework (ASCOF) 2015 to 2016

"The ASCOF measures how well care and support services achieve the outcomes that matter most to people. The Framework:

• supports councils to improve the quality of care and support services they provide
• gives a national overview of adult social care outcomes in 2013 to 2014
• looks at how the framework will be developed in future"

Adult Social Care Outcomes Framework (ASCOF) 2015 to 2016

Department of Health

November 2014

Read more here. 

Designing quality improvement initiatives: the action effect method

"The action effect method gives structure to the identification and articulation of programme theory, an important step of quality improvement initiative development. It provides a framework to guide execution and evaluation of an initiative, a focal point for other quality improvement methods and a communication tool to engage stakeholders."

Designing quality improvement initiatives: the action effect method, a structured approach to identifying and articulating programme theory

JE Reed, C McNicholas, T Woodcock, L Issen, D Bell
BMJ Quality and Safety 2014;23:1040-1048 doi:10.1136/bmjqs-2014-003103

Read more here.

Quantification of the Hawthorne effect in hand hygiene compliance monitoring

"Hand hygiene event rates were approximately threefold higher in hallways within eyesight of an auditor compared with when no auditor was visible and the increase occurred after the auditors’ arrival. This is consistent with the existence of a Hawthorne effect localised to areas where the auditor is visible and calls into question the accuracy of publicly reported hospital hand hygiene compliance rates."

Quantification of the Hawthorne effect in hand hygiene compliance monitoring using an electronic monitoring system: a retrospective cohort study
JA Srigley, CD Furness, GR Baker, M Gardam
BMJ Quality and Safety 2014;23:974-980 doi:10.1136/bmjqs-2014-003080

Read more here.

Outcomes in patients with heart failure treated in hospitals with varying admission rates

"Heart failure admission rates exhibited variability between institutions, and patients who presented to emergency departments with low admission rates experienced higher rates of subsequent adverse outcomes in a single-payer health system."

Outcomes in patients with heart failure treated in hospitals with varying admission rates: population-based cohort study
RS Bhatia, PC Austin, TA Stukel, MJ Schull, A Chong, JV Tu, DS Lee
BMJ Quality and Safety 2014;23:981-988 doi:10.1136/bmjqs-2014-002816

Read more here.

Patient Online support and resources

"This guide is intended for GPs, general practice staff, clinical commissioning groups (CCGs) and commissioning support units (CSUs) who are providing support to GP practices implementing Patient Online."

Patient Online support and resources
NHS England
November 2014

Read more here.

Personalised health and care 2020

"Better use of data and technology has the power to improve health, transform the quality and reduce the cost of health and care services."

Personalised health and care 2020: Using Data and Technology to Transform 
Outcomes for Patients and Citizens - A Framework for Action 
National Information Board
November 2014

Read more here.

Effect of a national primary care pay for performance scheme on emergency hospital admissions for ambulatory care sensitive conditions

"We found relative reductions in rates of emergency admissions for conditions incentivised under the Quality and Outcomes Framework scheme, particularly for coronary heart disease and stroke."

Effect of a national primary care pay for performance scheme on emergency hospital admissions for ambulatory care sensitive conditions: controlled longitudinal study
MJ Harrison, M Dusheiko, M Sutton, H Gravelle, T Doran, M Roland
BMJ 2014;349:g6423

Read more here.

Planning for the Better Care Fund

"The Better Care Fund is an innovative idea for joining-up care services locally for the benefit of patients. However, the quality of early planning and preparations did not match the scale of ambition."

Planning for the Better Care Fund
National Audit Office
November 2014

Read more here.

Evidence for Success: The guide to getting evidence and using it

"This guide is for anyone who wants to use evidence to improve policy and practice, regardless of the level of experience they have in doing so. Therefore, it is intended that this guide will also be of value to a wide range of stakeholders including: 

• practitioners 
• service managers 
• funders and commissioners 
• policy makers and planners."

Evidence for Success: The guide to getting evidence and using it 
Knowledge Translation Network
August 2014

Read more here.

Next steps towards primary care co-commissioning

"This document aims to provide clarity and transparency around co-commissioning options, providing CCGs and area teams with the information and tools they need to choose and implement the right form of co-commissioning for their local health economy."

Next steps towards primary care co-commissioning

NHS England, NHS Clinical Commissioners

November 2014

Read more here. 

Decisions of Value

"Decisions of Value is a project led by the Academy of Medical Royal Colleges and the NHS Confederation that has spent six months studying what is influencing the decisions made in the NHS. It brings together a large amount of research to show how decisions impact on the value delivered and how this extends beyond Whitehall to the front line."

Decisions of Value: full report and findings
NHS Confederation, Academy of Medical Royal Colleges
October 2014

Read more here.

Associations between Perceived Chronic Care Quality, Perceived Patient Centeredness, and Illness Representations among Persons with Diabetes

"Chronic care quality as defined in the Chronic Care Model and consistency of chronic care with patient expectations (patient centeredness) was associated with illness representations favorable for good self-care management."

Associations between Perceived Chronic Care Quality, Perceived Patient Centeredness, and Illness Representations among Persons with Diabetes
J Thomas, NN Iyer, WB Collins
Journal for Healthcare Quality, 2014, 36: 50–59. doi: 10.1111/jhq.12077

Read more here.

Improving Medication Administration Safety

"Ultimately, these findings affirm that nurse adherence to safe practices reduces medication administration (MA) errors. Although MA errors account for a minority of overall adverse drug events, they are typically not intercepted by other members of the healthcare team. Integrating these findings into evidence-based staffing considerations, nursing education and clinical practice competency validation has the potential to improve the quality, cost, and outcomes of MA."

Improving Medication Administration Safety: Using Naïve Observation to Assess Practice and Guide Improvements in Process and Outcomes
N Donaldson, C Aydin, M Fridman, M Fole
Journal for Healthcare Quality, 2014, 36: 58–68. doi: 10.1111/jhq.12090

Read more here.

Commissioning and contracting for integrated care

"Many clinical commissioning groups (CCGs) have started to develop novel contracting and commissioning tools to drive more transformational and sustainable service integration. There is a range of contractual models being discussed and implemented across England. In this paper, we describe two broad frameworks that are currently being developed in five areas of the country to stimulate more integrated models of care – a prime contract and an alliance contract."

Commissioning and contracting for integrated care
R Addicott
The King's Fund
November 2014

Read more here.

Standards for food and drink in NHS hospitals

"The Panel recommends that all NHS hospitals should develop and maintain a food and 
drink strategy. This should include: 

• the nutrition and hydration needs of patients 
• healthier eating for the whole hospital community, especially staff 
• sustainable procurement of food and catering services" 

The Hospital Food Standards Panel’s report on standards for food and drink in NHS hospitals
Department of Health, Age UK
August 2014

Read more here.  

The efficient management of healthcare estates and facilities

"Guidance for NHS trusts, foundation trusts and other NHS organisations on achieving efficiency savings and reducing costs in NHS estates."

The efficient management of healthcare estates and facilities
Department of Health
November 2014

Access the guidance here.

Children's and adolescents' mental health and CAMHS

"There are serious and deeply ingrained problems with the commissioning and provision of Children’s and adolescents’ Mental Health Services. These run through the whole system from prevention and early intervention through to inpatient services for the most vulnerable young people."

Children's and adolescents' mental health and CAMHS: Third Report of Session 2014–15
House of Commons Health Committee
October 2014

Read more here.

How to commission better mental health and wellbeing services for young people

"In this guide, we will consider how commissioners can add value at each stage of the commissioning process to ensure that the most appropriate services are procured to address the mental health needs of young people aged 16–25."

How to commission better mental health and wellbeing services for young people
Right Here (Mental Health Foundation, Paul Hamlyn Foundation)
October 2014

Read more here.

How CCGs are driving integration for their patients and local populations

"Through a series of case studies – drawing on the work of CCGs across the country – a picture emerges of organisations committed to developing a more coordinated system. It is a system focused on wellbeing as well as illness, and one that places a premium on the needs and preferences of patients and carers. And while it may not be the sole solution to the NHS’s cost savings challenge, it is an important contributor."

Leading local partnerships: How CCGs are driving integration for their patients and local populations
NHS Clinical Commissioners
October 2014

Read more here.

Is general practice in crisis?

"This briefing provides an evidence-based overview of the current state of general practice in England, and offers some potential solutions. It examines demand for GP services, the GP workforce, funding, and standards of access and quality of care. It then presents four ideas to help solve the problems facing general practice – and the wider NHS."

Is general practice in crisis?
M Dayan, S Arora, R Rosen, N Curry
Nuffield Trust
November 2014

Read more here.

Health leaders' survey 2

"Ahead of the 2015 election, we will be regularly surveying a panel of 100 health and social care leaders for their views on a range of issues, including the state of the NHS and social care system and what they believe should be the priority areas for reform during the next Parliament."

Health leaders' survey two: the state of general practice
Nuffield Trust

Read more here.

Intravenous fluid prescribing: Improving prescribing practices

"as a result of improved documentation and consideration given to fluid prescriptions, we were able to increase the percentage of maintenance IV fluid prescriptions that conformed to NICE guidelines."

Intravenous fluid prescribing: Improving prescribing practices and documentation in line with NICE CG174 guidance
BMJ Quality Improvement Reports 2014;3: doi:10.1136/bmjquality.u205899.w2409

LT Sansom, L Duggleby

Read more here.

NICE quality standard 73: Fertility problems

"This quality standard covers the assessment and treatment of fertility problems in:

• people with explained or unexplained infertility
• people preparing for cancer treatment who may wish to preserve their fertility."

NICE quality standard 73: Fertility problems
NICE
October 2014

Read more here.

Framework for responding to CQC inspections of GP practices

"From October 2014, the CQC will begin to roll out their new inspection regime to inspect and rate every GP practice in England by April 2016. Practices will be inspected across five key questions, considering the extent to which they are safe, effective, responsive, caring and well-led. They will be rated in one of four categories; outstanding; good; requires improvement; or inadequate."

Framework for responding to CQC inspections of GP practices
October 2014
Commissioning Operations, NHS England

Read more here.

Care Act 2014: statutory guidance for implementation

"The guidance associated with the Care Act set out how the Act will work in practice when the first phase of the reforms comes into effect next year."

Care Act 2014: statutory guidance for implementation
Department of Health
October 2014

Read more here.

Improving the value of diabetes care in Slough

"The Commissioning for Value Insight pack for Slough CCG identified that diabetes presented an opportunity for both quality improvement and financial savings. These opportunities were indicated by higher numbers of non-elective admissions compared with similar CCGs and also higher prescribing costs for conditions resulting from complications in cases of diabetes that were not well controlled."

Slough CCG: Improving the value of diabetes care in Slough (Right Care casebook)
N Nanda, R Sultana
October 2014

Read more here.

IMatter: validation of the NHS Scotland Employee Engagement Index

"Employee engagement is a fundamental component of quality healthcare. In order to provide empirical data of engagement in NHS Scotland an Employee Engagement Index was co-constructed with staff. `iMatter? consists of 25 Likert questions developed iteratively from the literature and a series of validation events with NHS Scotland staff. The aim of this study was to test the face, content and construct validity of iMatter."

IMatter: validation of the NHS Scotland Employee Engagement Index
A Snowden, E MacArthur
BMC Health Services Research 2014, 14:535  doi:10.1186/s12913-014-0535-z

Read more here.

The impact of nurse-led annual telephone follow-up of patients with inflammatory bowel disease

"Inflammatory bowel diseases (IBD) are characterised by periods of disease activity and period with disease in remission. In Denmark all patients are seen in hospital settings. The aim of this study was to introduce a nurse-led phone service for stable patients replacing annual visits."

The impact of nurse-led annual telephone follow-up of patients with inflammatory bowel disease

P Bager
BMJ Quality Improvement Reports 2014;3: doi:10.1136/bmjquality.u206365.w2574

Read more here. 

Ward round documentation in a major trauma centre: can we improve patient safety?

"We show that our new system of note keeping for use during ward rounds in a major trauma centre improves both the quality and consistency of ward round entries. It consolidates each member of the team’s knowledge about each patient, and contributes to effective handover. "

Ward round documentation in a major trauma centre: can we improve patient safety?
G Green, A Aframian, J Bernard
BMJ Quality Improvement Reports 2014;3: doi:10.1136/bmjquality.u206189.w2537

Read more here. 

Improving incident reporting among junior doctors

"This project highlights the fact that using a focussed reporting period and/or specific clinical themes as an education tool can benefit a hospital by promoting awareness of incidents and by increasing incident reporting rates. This can only assist in improving hospital systems, and ultimately increase patient safety."

Improving incident reporting among junior doctors
E Hotton, L Jordan, C Peden
BMJ Quality Improvement Reports 2014;3: doi:10.1136/bmjquality.u202381.w2481

Read more here.

Improving phlebotomy handover to doctors

"Implementation of a hospital-standardised phlebotomy handover folder dramatically improved the communication and handover between phlebotomists and doctors allowing for medical teams to take prompt action on unbled patients. This intervention will help improve patient safety, reduce delays in management/discharge and reduce the number of jobs handed over to evening on-call teams."

Improving phlebotomy handover to doctors: a quality improvement project
G Shouls, Z Jarrar, J Wickenden
BMJ Quality Improvement Reports 2014;3: doi:10.1136/bmjquality.u204813.w2033

Read more here.

Measuring success in health care value-based purchasing programs

"Based on the findings from the environmental scan, literature review, and technical expert panels discussions, we provide a set of recommendations for consideration that could serve to advance the design, implementation, monitoring, and evaluation of value based purchasing programs to generate critically needed knowledge to guide policy making."

Measuring success in health care value-based purchasing programs: summary and recommendations
CL Damberg, ME Sorbero, SL Lovejoy, G Martsolf, L Raaen, D Mandel
RAND Corporation

Read more here.

Community mental health survey 2014

"While there were some positive findings, particularly for questions asking about contact with staff, survey results show that improvements are needed across many other areas asked about in the questionnaire. This includes:

communication and information.
reviewing care.
involvement in decisions.
support and understanding with other areas of life."

Community mental health survey 2014
Care Quality Commission

Read more here.

Cause for concern: QualityWatch annual statement 2014

"The past year has seen an increasing number of signs that historic improvements in quality are not being sustained in some areas, or have even reversed. Stress signals we first identified in 2013 are now becoming even stronger and apparent in a wider range of services."

Cause for concern: QualityWatch annual statement 2014
The Health Foundation, Nuffield Trust
October 2014

Read more here.

The state of health care and adult social care in England 2013/14

"We found wide variation in care between trusts, between hospital sites, between hospital services and within each service."

The state of health care and adult social care in England 2013/14
Care Quality Commission
October 2014.

Read more here.

Healthier Lives online tool: Diabetes, Hypertension, NHS Health Check

This newly released tool/map shows the quality and levels of care provided across England with comparisons against the national average. It currently contains statistics for diabetes, high blood pressure and NHS Health Checks.

Healthier Lives: Diabetes, Hypertension and NHS Health Check online tool
Public Health England
October 2014

Access the tool here.

Protecting resources, promoting value: a doctor’s guide to cutting waste in clinical care

"This report provides a framework for a way in which doctors can think critically about waste from a clinical perspective and provides examples of doctors improving the value of health care by reducing waste."

Protecting resources, promoting value: a doctor’s guide to cutting waste in clinical care
Academy of Medical Royal Colleges
November 2014

Read more here.

What is the evidence on the economic impacts of integrated care?

"There is evidence of cost–effectiveness of selected integrated care approaches but the evidence base remains weak. Eight of the nineteen studies reported on cost–effectiveness."

What is the evidence on the economic impacts of integrated care?
E Nolte, E Pitchforth
European Observatory on Health Systems and Policies
World Health Organization
2014

Read more here.

Delivering High Value Care Pathways

"In this scenario we examine a typical long term condition pathway, comparing a sub-optimal but typical scenario against an ideal pathway. At each stage we have modelled the costs of care, both financial to the commissioner but also the impact and cost on the patient, family and their contribution to society. We show how the Right Care methodology can help clinicians and commissioners to improve the value of the care pathway."

Delivering High Value Care Pathways – Paul Adams – a commissioning scenario
A typical Long-Term Conditions story and how the NHS Right Care approach can help to achieve better value
NHS Right Care
August 2014

Read more here.

Five Year Forward View

"The NHS has dramatically improved over the past fifteen years. Cancer and cardiac outcomes are better; waits are shorter; patient satisfaction much higher. Progress has continued even during global recession and austerity thanks to protected funding and the commitment of NHS staff. But quality of care can be variable, preventable illness is widespread, health inequalities deep-rooted." 

Five Year Forward View
NHS
October 2014

Read more here.

People in control of their own health and care

"The idea that people should have a stronger voice in decisions about their health and care, and that services should better reflect their needs and preferences, has been a policy goal of politicians and senior policy-makers in health for at least 20 years. Patients want it, and the evidence shows that when they are involved, decisions are better, health and health outcomes improve, and resources are allocated more efficiently."

People in control of their own health and care: The state of involvement
C Foot et al.
The King's Fund
November 2014

Read more here.

How is the NHS performing? October 2014

"Our latest survey of finance directors reveals the highest level of pessimism about the financial position of health organisations since we began surveying in the autumn of 2011. For the first time since we began our quarterly survey, no one expressed any degree of optimism about the financial state of their local health economies over the next year."

How is the NHS performing?: Quarterly Monitoring Report
J Appleby, J Thompson, J Jabbal
The King's Fund
October 2014

Read more here.

Better Care and Better Value for Hip and Knee Replacement

"Robert Kaplan from the Harvard Business School explains the Time-Driven Activity-Based Costing (TDABC), a powerful way to capture and analyze every step and cost of the joint replacement process. IHI has been working with some 32 hip and knee replacement providers over the past year on TDABC and subsequent improvements as part of the IHI Joint Replacement Learning Community. We learn about them and their exciting work on this episode of WIHI."

WIHI: Better Care and Better Value for Hip and Knee Replacement (audio broadcast)
RS Kaplan, K Luther, C Abbott, J Rosengrant
Institute for Healthcare Improvement
October 2014

Listen to the recording here.

Getting Started in Video Ethnography (toolkit)

"Kaiser Permanente's Care Management Institute has developed a replicable method for using video ethnography to learn from patient and staff experiences by capturing interviews and observations on videotape, analyzing the footage to identify improvement opportunities, and highlighting them in short videos that reflect the heart of patient experiences."

Toolkit: Getting Started in Video Ethnography - A Catalyst for Guiding and Motivating Quality Improvement
Kaiser Permanente, Care Management Institute
2010

Read more here.

Innovation in Health Care Leadership

"A growing demand for transparency has brought innovation in many areas of health care. In a video roundtable, three expert panels discuss the benefits and the challenges of these innovations, examining transparency in provider-driven quality data, in pricing, and in medical records."

Innovation in Health Care Leadership
D Blumenthal, et al.
New England Journal Medicine 2014; 371:e26 DOI: 10.1056/NEJMp1410441

Access the video here.

The experience of engaging with mental health services among young people who hear voices and their families

"Whilst the survey showed that some young people and their families had more positive experiences, many expressed dissatisfaction. To fulfil the needs of young people and their families, mental health services would benefit from developing alternative approaches to voice hearing and running support groups that could form part of a ‘normalising’ and ‘holistic care’ package."

The experience of engaging with mental health services among young people who hear voices and their families: a mixed methods exploratory study
P Kapur, D Hayes, R Waddingham, S Hillman, J Deighton, N Midgley
BMC Health Services Research 2014, 14:527

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Effect of telemedicine follow-up care of leg and foot ulcers

"The available evidence is too weak to make conclusions about the effectiveness of telemedicine follow-up care of patients with leg and foot ulcers. Larger and more rigorous studies are needed to enable strong conclusions and clinical recommendations to be made."

Effect of telemedicine follow-up care of leg and foot ulcers: a systematic review
LV Nordheim, M Tveit Haavind, MM Iversen
BMC Health Services Research 2014, 14:565

Read more here.

Liver Disease Profiles

"The liver disease profiles provide an invaluable resource relating to one of the main causes of premature mortality nationally; a disease whose mortality rates are increasing in England, while decreasing in most EU countries. The local authority profiles will support the development of Joint Strategic Needs Assessments and work of Health and Wellbeing Boards presenting local key statistics and highlighting questions to ask locally about current action to prevent liver disease."

Liver Disease Profiles
Public Health England

Access the profiles here.

Positive deviance: a different approach to achieving patient safety

"The focus on error detection and its management has not produced the expected gains in patient safety, primarily because these methods are not well suited to a complex adaptive system such as healthcare. Behaviours that produce errors are variations on the same processes that produce success, so focusing on successful practices may be a more effective tactic."

Positive deviance: a different approach to achieving patient safety
R Lawton, N Taylor, R Clay-Williams, J Braithwaite
BMJ Quality and Safety, 4 July 2014 doi:10.1136/bmjqs-2014-003115

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Relational coordination amongst health professionals involved in insulin initiation for people with type 2 diabetes in general practice

"Given the need for coordination between specialist and generalist care for the task of insulin initiation, this study's results suggest the need to build relationships and communication between specialist and generalist health professional groups and the potential for DNE?s to play a boundary spanner role in this process."

Relational coordination amongst health professionals involved in insulin initiation for people with type 2 diabetes in general practice: an exploratory survey
J Manski-Nankervis, I Blackberry, D Young, D O’Neal, E Patterson, J Furler
BMC Health Services Research 2014, 14:515  doi:10.1186/s12913-014-0515-3

Read more here.

Service user involvement: impact and participation: a survey of service user and staff perspectives

"The findings have shown that there is a high level of participation in service user involvement activity and a general endorsement that involvement has a positive impact. The percentage of service users and professionals who reported positive outcomes from activities they have been involved with was high, regardless of the type of activity they had experienced and their level of engagement in user involvement work."

Service user involvement: impact and participation: a survey of service user and staff perspectives
E Omeni, M Barnes, D MacDonald, M Crawford, D Rose
BMC Health Services Research 2014, 14:491  doi:10.1186/s12913-014-0491-7

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A systematic review of hospital experiences of people with intellectual disability

"Our review of eligible papers revealed that despite 20 years of research and government initiatives, people with intellectual disability continue to have poor hospital experiences. The need for research to identify and investigate care at specific points of encounter across a hospital journey (such as admission, diagnostic testing, placement on a ward, and discharge) as well as to include people with a diversity of disabilities is discussed in terms of potential to influence policy and practice across health and disability sectors."

A systematic review of hospital experiences of people with intellectual disability

T Iacono, C Bigby, C Unsworth, J Douglas, P Fitzpatrick
BMC Health Services Research 2014, 14:505  doi:10.1186/s12913-014-0505-5

Read more here.

“No decision about me without me” in the context of cancer multidisciplinary team meetings

"Methods for ensuring that patients are actively integrated into the MDT processes are required to ensure patients have an informed choice regarding engagement, and to ensure recommendations are based on the best available patient-based and clinical evidence."

“No decision about me without me” in the context of cancer multidisciplinary team meetings: a qualitative interview study

C Taylor, J Finnegan-John, JSA Green
BMC Health Services Research 2014, 14:488  doi:10.1186/s12913-014-0488-2

Read more here.

Improving the follow-up of microbiology results

"Our intervention, the Pink Book of Results, provides a simple, cost effective system to follow-up microbiology results for discharged patients. It has been extremely well received by paediatric A&E staff and is now rolled out across the general paediatric ward and special care baby unit."

Improving the follow-up of microbiology results: the origins of the Pink Book
Henry Boyle, Charlie Hunt, Catherine McIlroy, Imran Qureshi
BMJ Quality Improvement Reports 2014;3: doi:10.1136/bmjquality.u721.w504

Read more here.

Optimising calcium monitoring post thyroid and parathyroid surgery

"Implementing five simple interventions has been shown to greatly improve the monitoring of calcium post-operatively, and ultimately improve patient safety at the Royal Devon & Exeter Hospital."

Optimising calcium monitoring post thyroid and parathyroid surgery
E Rayner, N Williams, J Dunn
BMJ Quality Improvement Reports 2014;3: doi:10.1136/bmjquality.u204844.w2048

Read more here.

Improving the compliance of extended venous thromboembolism prophylaxis following cancer resections

"Visual reminder is a simple yet effective tool to improve awareness among junior doctors on the importance of extended venous thromboembolism prophylaxis in cancer patients."

A persuasive intervention: improving the compliance of extended venous thromboembolism prophylaxis following cancer resections in a tertiary colorectal and hepatobiliary unit
YP Yong, A Karangizi, A Banerjea
BMJ Quality Improvement Reports 2014;3: doi:10.1136/bmjquality.u202594.w2216

Read more here.

Improving the accuracy and turn-around time of controlled drug prescribing for patients being discharged home for end-of-life care

"Re-audit after a pilot period showed a significant improvement in both error rate and dispensing time of these medications. This then allowed for better use of staff time within the pharmacy department, and a smoother and safer discharge for our patients going home for end of life care."

Improving the accuracy and turn-around time of controlled drug prescribing for patients being discharged home for end-of-life care

S Daniel, J Patel, D Benson
BMJ Quality Improvement Reports 2014;3: doi:10.1136/bmjquality.u203589.w1595

Read more here.

Implementing the NICE guideline on gallstone disease

"The guideline may have resource implications at a local level as a result of variation in clinical practice across the country. Therefore, we encourage organisations to evaluate their own practices against the recommendations in the NICE guideline and assess costs and savings locally. "

Costing statement: Gallstone disease: Implementing the NICE guideline on gallstone disease (CG188)
NICE
October 2014

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Multiple sclerosis: costing statement (NICE)

"This costing statement considers the cost implications of the recommendations made in Multiple sclerosis: management of multiple sclerosis in primary and secondary care"

Costing statement: Multiple sclerosis: management of multiple sclerosis in primary and secondary care
NICE
October 2014

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Implementing the NICE guideline on acute heart failure

"Implementation of the guideline should lead to improved management of acute heart failure and may lead to the following savings and benefits..."

Costing statement: Acute heart failure: Implementing the NICE guideline on acute heart failure (CG187)
NICE
October 2014

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A pharmacist-led ulcerative colitis review service

"This case study describes a pharmacist-led ulcerative colitis review service which was commissioned by Bushloe End surgery in Leicester."

A pharmacist-led ulcerative colitis review service: Improving medicines adherence in general practice: Quality and productivity collection
Bushloe End surgery
NICE
October 2014

Read more here.