Missing data has risked GPs’ patient care

Missing patient data that was mistakenly held in storage for years has led to around 1,700 cases of potential harm caused to GPs’ patients, according to a report published today by the National Audit Office (NAO) | OnMedica

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The NAO’s Investigation: clinical correspondence handling at NHS Shared Business Services report details the watchdog’s investigation into how NHS Shared Business Services (NHS SBS) – an agency contracted by the government to run some back-office operations in the NHS – handled unprocessed clinical correspondence.

Significant amounts of important data on patients including test results and diagnoses were delayed mistakenly between 2011 and 2016 by the NHS Shared Business Services agency before they were delivered to hospitals and GP surgeries.

This data, which included copies of test or screening results, and communications about planned treatment following appointments with other healthcare providers, was sent by hospitals and other GPs to practices where the patient had moved away or was unknown, so needed to be redirected.

Emergency medicine: what keeps me, what might lose me?

EDs are currently under intense pressure due to increased patient demand. There are major issues with retention of senior personnel, making the specialty a less attractive choice for junior doctors | Emergency Medicine Journal

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This study aims to explore what attracted EM consultants to their career and keeps them there. It is hoped this can inform recruitment strategies to increase the popularity of EM to medical students and junior doctors, many of whom have very limited EM exposure.

Methods: Semistructured interviews were conducted with 10 consultants from Welsh EDs using a narrative approach.

Results: Three main themes emerged that influenced the career choice of the consultants interviewed: (1) early exposure to positive EM role models; (2) non-hierarchical team structure; (3) suitability of EM for flexible working. The main reason for consultants leaving was the pressure of work impacting on patient care.

Conclusion: The study findings suggest that EM consultants in post are positive about their careers despite the high volume of consultant attrition. This study reinforces the need for dedicated undergraduate EM placements to stimulate interest and encourage medical student EM aspirations. Consultants identified that improving the physical working environment, including organisation, would increase their effectiveness and the attractiveness of EM as a long-term career.

Full reference: James, F. & Gerrard, F. (2017) Emergency medicine: what keeps me, what might lose me? A narrative study of consultant views in Wales. Emergency Medicine Journal. 34:436-440

Podcast: The Evidence Manifesto – it’s time to fix the E in EBM

A response to systematic bias, wastage, error, and fraud in research underpinning patient care | BMJ

Informed decision making requires clinicians and patients to identify and integrate relevant evidence. But with the questionable integrity of much of today’s evidence, the lack of research answering questions that matter to patients, and the lack of evidence to inform shared decision how are they expected to do this?

Too many research studies are poorly designed or executed. Too much of the resulting research evidence is withheld or disseminated piecemeal. As the volume of clinical research activity has grown the quality of evidence has often worsened, which has compromised the ability of all health professionals to provide affordable, effective, high value care for patients.”

Carl Heneghan, director for the Centre for Evidence Based Medicine, and Fiona Godlee, editor in chief of The BMJ set out the 9 points of the Evidence manifesto, which tries to set a road map for strengthening the evidence base.

1) Expand the role of patients, health professionals and policy makers in research
2) Increase the systematic use of existing evidence
3) Make research evidence relevant, replicable and accessible to end users.
4) Reduce questionable research practices, bias, and conflicts of interests
5) Ensure drug and device regulation is robust, transparent and independent
6) Produce better usable clinical guidelines.
7) Support innovation, quality improvement, and safety through the better use of real world data.
8) Educate professionals, policy makers and the public in evidence-based healthcare to make informed choices.
9) Encourage the next generation of leaders in evidence-based medicine.

Video: What on earth is a vanguard?

Cutting through modern-day NHS jargon is no mean feat, but one up-and-coming TV broadcaster has succeeded where the Jeremy Paxmans of this world have failed… meet Healthwatch Harriet | NHS England

The tenacious 10-year-old has turned her sights on the NHS England new care models programme. In her new video, she meets new care models programme director Louise Watson, chair of Tower Hamlets CCG Sir Sam Etherington, and Hertfordshire County Council’s director of health and community services Iain MacBeath and asks them: “What on earth is a vanguard?”

Read the full news story here

Department of Health group accounting manual 2017 to 2018

Mandatory annual reports and accounts guidance for DH group bodies.

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The Department of Health group accounting manual (GAM) includes mandatory accounting guidance for DH group bodies (including clinical commissioning groups, NHS trusts, NHS foundation trusts and arm’s length bodies) completing statutory annual reports and accounts for 2017 to 2018.

The GAM is approved by the HM Treasury Financial Reporting Advisory Board. It is based on the 2017 to 2018 Treasury financial reporting manual, adapted for the NHS.

There will be additional guidance updates to the GAM later in the year, which must be treated as having the same status as the GAM itself. The additional guidance will be contained in a single document, which will be updated as further issues arise.

Involving people in health and care guidance

The two sets of guidance, and a wealth of web based resources and best practice, together supersede the original ‘Transforming Participation in Health and Care’ guidance, which was published in 2013 | NHS England

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In response to user feedback, elements of the original guidance have been retained and new features introduced, including a greater focus on people with the greatest health needs, and information on the practicalities of involvement.

The links between individual and collective involvement in health are clear; people who have advanced knowledge, skills and confidence to manage their own health are more likely to get involved at a group/community level in having a say about health and health services. Equally, those who have been involved in the commissioning process (planning, buying and monitoring) health services are more likely to be informed about health and health services; they will therefore be better placed to manage their own health and be involved about decisions relating to their care and treatment.

The future of commissioning

NHS Providers has launched a new publication series “Provider Voices” which promotes the views of leaders from a range of trusts and other parts of the service on some of the key issues facing the NHS.

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The first report Where next for commissioning? includes eight interviews that address concerns including the role of Sustainability and Transformation Partnerships (STPs) and accountable care systems (ACSs), the challenge of integrating health and care commissioning, and the future of the purchaser-provider split.

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