Practical value in the NHS

The King’s Fund has previously highlighted the fact that addressing waste and variability in clinical work can create better value in the NHS. But what does value mean to people working in the NHS – and how it is being applied in practice? | The King’s Fund Blog

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‘Value’ sounds like a familiar concept but it can mean different things to different people. One definition of value in the health and care sector is ‘health outcomes per dollar spent’, so attempts to increase value can look at either improving quality or reducing cost.

In early July we held a roundtable discussion with health service providers to better understand their approach to value improvement – initial research for a new project intended to understand the practical barriers and challenges that frontline clinical, operational and managerial leaders have encountered in pursuing better value health care. Experts who attended – including a chairman, chief executive, chief nurse, deputy chief operating officer, change leader, and representatives of national bodies – agreed that the emphasis should be on patient care. Clinicians are more likely to engage in a programme that revolves around the quality of services, and better care is typically less wasteful, so as one participant put it, ‘if you focus on quality, money will fall out’ [spending will reduce]. Consultants will often drive through successful programmes with change management teams, but we also discussed the role of junior doctors, nurses and therapists, who frequently witness low-value care and understand how to fix it. We know that substantial changes in practice can be delivered as we have seen, for example, in generic prescribing, reduced length of stay and the move towards day case surgery.

Read the full blog post here

Quality improvement in mental health

Quality improvement in mental health | The King’s Fund

This report explores the potential opportunities arising from the application of quality improvement approaches in the mental health sector and identifies relevant learning from organisations that have already adopted these approaches.

The authors were specifically interested in understanding how and why some mental health organisations have embraced quality improvement strategies and what has enabled them to do so. It explores what changes are needed from senior leaders to cultivate a quality improvement ethos within their organisation.    

Key findings

  • Embracing quality improvement requires a change in the traditional approach to leadership at all levels of an organisation, so that those closest to problems (staff and patients) can devise the best solutions and implement them.
  • Doing quality improvement at scale requires an appropriate organisational infrastructure, both to support frontline teams and to ensure that learning spreads and is taken up across the organisation.
  • Tools and approaches used in the acute hospital sector can be adapted for use in mental health care, including in community settings.
  • Success is most likely when there is fidelity to the chosen improvement method, and a sustained commitment over time.
  • The strong emphasis on co-production and service user involvement in mental health can be harnessed as a powerful asset in quality improvement work.

Download the full report: Quality improvement in mental health

Health Education England: annual report

Annual report and accounts for Health Education England for 2016 to 2017.

The fourth HEE Annual report  outlines the achievements over the last year: outlining
how HEE continue to help improve the quality of care for patients by focussing on and investing in the education and training of the workforce which delivers that care,
now and in the future.

This vision of higher quality care is articulated in the Five Year Forward View (5YFV), which HEE co-created and now helps deliver nationally, regionally and locally through Local Workforce Action Boards (LWABs).

LWABs are where the workforce issues of Sustainability and Transformation Plans are worked through together with HEE’s partners; making sure the right conversations happen with the right people at the right time.

Involving staff with quality improvement initiatives

NHS Employers has published Staff involvement, quality improvement and staff engagement:  the missing links.

This briefing aims to help managers and leaders understand more about how involving staff with quality improvement initiatives can have a significant impact on staff engagement levels.

Involving staff in quality improvement decision-making, planning and delivery has always been a good idea. However, at a time of unprecedented pressures and financial challenges it is an issue of the highest importance.

This new briefing explores the benefits, approaches and working examples of how organisations are involving staff with their quality improvement activities.

Read more about staff engagement initiatives across the NHS here.

Tackling variations in clinical care: Assessing the Getting It Right First Time (GIRFT) programme

The Getting It Right First Time (GIRFT) programme aims to bring about higher-quality care in hospitals, at lower cost, by reducing unwanted variations in services and practices | The King’s Fund

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Image source: The King’s Fund

It uses national data to identify the variations and outcomes, shares that data with all those concerned with a service – not only clinicians, but also clinical and medical directors, managers and chief executives – and monitors the changes that are implemented.

The programme began with orthopaedics and is now being rolled out to 32 different surgical and medical specialisms across the English NHS. Through an informal assessment of the programme, this paper sets out what the programme is, why it is needed, what is different about it, what it has achieved, what challenges it faces and what potential it has. It also contains vignettes illustrating hospitals’ experiences of the programme.

CQC seeking views on their next phase of regulation

The CQC is consulting on a further set of proposals which will help shape the next phase of regulation of health and social care in England.

light-bulb-1002783_1920For the next eight weeks, anyone with an interest is encouraged to have their say.

The proposals include:

  • Changes to the regulation of primary medical services such as GPs and dentists and adult social care services such as care homes and home-care services.
  • This includes the frequency and intensity of inspections and how the CQC monitor, provide and gather intelligence.
  • Improvements to the structure of registration and the definition of ‘registered providers’.
  • Further information on how the CQC will monitor, inspect and rate new models of care and large or complex providers.

Take part in the new consultation

Changes affecting the NHS

NHS Confederation has published What comes into force in April 2017?

This briefing summarises new measures, requirements and legislative changes coming into force this month that will affect NHS organisations, staff, patients and service users across England. It covers arm’s length bodies, charges, e-prescribing, finance, general practice, innovation, integration, personal health budgets, quality, reconfiguration and workforce.