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The State Of The NHS Provider Sector: November 2016

The largest ever survey of NHS trust chairs and chief executives has revealed rising concern over the growing NHS “workforce gap”.

Image source: NHS Providers

Only one in four trust leaders (27%) are confident they have the right staff numbers, quality and skill mix to deliver high quality healthcare for patients and service users. Fewer still (22%) are confident about having the right staffing levels in six months’ time. These findings show that, for many trust leaders, worries over staffing are becoming even greater and more urgent than those over funding.

Read the full overview here

Read the full report here

Market Structure, Patient Choice and Hospital Quality for Elective Patients

Moscelli, G. et al. (2016) CHE Research Paper 139

Image source: CHE

This paper examines the change in the effect of market structure on hospital quality for elective procedures (hip and knee replacements, and coronary artery bypass grafts) following the 2006 loosening of restrictions on patient choice of hospital in England.

We allow for time-varying endogeneity due to the effect of unobserved patient characteristics on patient choice of hospital using Two Stage Residual Inclusion. We find that the change in the effect of market structure due to the 2006 choice reforms was to reduce quality by increasing the probability of a post-operative emergency readmission for hip and knee replacement patients. There was no effect of the choice reform on hospital quality for coronary bypass patients. We find no evidence of self-selection of patients into hospitals, suggesting that a rich set of patient-level covariates controls for differences in casemix.

Read the full paper here

Stroke care: Only 20% of acute hospitals are meeting the standard for weekend nurse staffing levels.

National Report England, Wales and Northern Ireland. Prepared by Royal College of Physicians, Care Quality Improvement Department (CQID) on behalf of the Intercollegiate Stroke Working Party

Image source: HQIP

Other headline results from the 2016 acute organisational audit include:

  • Lack of essential psychology provision: Very few hospitals (6%) achieve the standard of one whole time equivalent (WTE) qualified clinical psychologist for every 30 stroke unit beds
  • Number of hospital sites with unfilled consultant vacancies rises by 14%.
  • There continues to be a reassuring increase in many areas of acute stroke organisation:
    – All hospitals now have a designated stroke unit
    –  7-day access to occupational and physiotherapy has increased to 31% and 40% of hospitals, however only    6% can provide speech and language therapy 7-days a week
    – 99% and 68% of hospitals are able to given their patients access to thrombolysis 24 hours a day, 7 days a    week and intra-arterial (thrombectomy) treatment on-site or by referral off-site respectively
    – 81% of hospitals have specialist early supported discharge (ESD) available to them meaning that patients     can return home sooner and receive specialist post-acute care

Read the overview here

Read the full report here

Clinical academic roles: Some reflections on the benefits, the challenges and the next steps

Parker, R. BMJ Evidence-Based Nursing Blog. Published online: 27 November 2016


Clinical academics make an invaluable contribution to healthcare yet it is estimated that only 0.1% of the Nursing, Midwifery and Allied Health Professional (NMAHP) workforce are currently in these roles. The absence of a clear clinical academic pathway has been a barrier to NMAHP pursuing these roles (Coombs et al., 2012). Earlier this month the Association of UK University Hospitals released guidance on transforming healthcare through clinical academic roles in NMAHP.

The guide provides a practical resource to develop and sustain NMAPH clinical academic roles. It is aimed at healthcare provider organisations and anyone interested in fostering clinical academic roles for NMAHP. In each section, a ‘what’, ‘why’ and ‘how’ format is used accompanied by case study examples.

Read the full blog post here



Perceived causes of differential attainment in UK postgraduate medical training

Woolf, K. et al. (2016) BMJ Open. 6:e013429

booksObjectives: Explore trainee doctors’ experiences of postgraduate training and perceptions of fairness in relation to ethnicity and country of primary medical qualification.


Conclusions: BME UKGs and IMGs can face additional difficulties in training which may impede learning and performance. Non-stigmatising interventions should focus on trainee–trainer relationships at work and organisational changes to improve trainees’ ability to seek social support outside work.

Read the full abstract and article here

NHS trust helps staff improve their confidence in conversational English

Barking, Havering and Redbridge University Hospitals NHS Trust have partnered with Creative English to develop and deliver a learning programme for their international staff, designed to improve confidence in conversational English.

talk-1246935_960_720The trust serves a large and diverse population, ranging from the elderly population of the East End of London, to those who have newly arrived from Eastern Europe with potentially few or no English language skills. This coupled with the changing demographic of staff increased the potential for difficulties in conversation between patients and staff.

Using scenarios inspired by hospital situations, the programme enabled staff to understand and practice the language they need in their day to day work in a relaxed and fun atmosphere.

Read the case study to find out about the programme and the benefits to both staff and patients.