A tough task ahead for the NHS in 2018/19

NHS Providers  | April 2018  | A tough task ahead for the NHS in 2018/19

Last year NHS Providers published Mission impossible? predicting that the task set for providers in 2017/18 was impossible to deliver. During the last year, trusts have treated more emergency patients than ever before. They are delivering 1.8% efficiency gains, which is nine times the UK whole economy average; and are on course to achieve more than £3bn in savings. 

Now NHS Providers have produced a new report, Tough Task: The NHS delivering for patients and staff in 2018/19, it is based on analysis of current data and survey data from trust leaders.   The report includes projected levels of demand and performance for next year,  forecasting that approximately 3.6 million emergency patients will not be treated within four hours and 560,000 patients needing elective care will not be seen within 18 weeks. It reports that the size of the task will add a significant extra burden onto an already hard pressed workforce.

road-3142580_1920Tough Task reveals widespread scepticism about the ability of the service to meet performance and financial targets in 2018/19.   It also reports a stark and worrying assessment of the challenges facing NHS trusts this coming financial year.
There is an emphasis on the tasks set out in the recent revised planning guidance: a long list of ‘must-dos’ for the NHS.  The report points to the lack of capacity in terms of beds and staff affecting hospitals, mental health, community and ambulance trusts, as health and social care services struggle to meet a steep and relentless rise in demand for treatment.

It raises concerns in three areas:

  • A & E
  • planned hospital treatment
  • Trust finances.

The authors conclude that patients’ experience of care is likely to decline below trusts’ and the NHS constitution’s acceptable standards (NHS Providers).

The interactive report can be accessed here  


The efficacy of Communities of practice

Communities of practice (CoPs) often develop organically through shared interests or are created as a means of sharing best practice, disseminating knowledge and experiences as well as developing professionally or personally. According to the RAND Corporation the impact of CoPs can be difficult to quantify and there is incomplete evidence about the value they add. For CoPs to support current ambitions to transform UK health and social care a deeper understanding of their operation and consequences was required. For this reason a scoping review was undertaken, it had two primary research questions:

  1. How do the CoPs operate and how can their work be explored in more depth?
  2. How, when and why can the knowledge generated within CoPs lead to improved work?startup-594090_1920

The review intended to gather data to determine the best approach to a full-scale evaluation of CoPs, as well as to provide immediate evidence to help the CoPs improve their effectiveness.

Some of the CoPs covered in this review include medicines safety; maternity; duty of candour; medicines optimisation; sepsis; acute deterioration; and delirium. CoPs members include NHS non-medical and medical staff from a range of professional groups, and academics. (RAND Corporation)
Key findings

If the knowledge necessary to resolve or explore  a problem is in the CoP there is the opportunity for change, but if this is not the case then the CoP must be adapted or modified to engage senior leadership, change national mandates or work with commissioners.

The report identified a number of future evaluation questions along with associated subsidiary questions. The key overarching questions are:

  • (How) is the momentum towards transformation sustained and what are the wider dependencies that are needed for this to happen?
  • (How) is progress and value-added measured?
  • (How) is the rhythm of learning sustained?
  • (How) are cultures and principles nurtured and sustained? (RAND Corporation)

The eBook can be read online  here

Alternatively it can be downloaded from the RAND website


The nursing workforce

The Health Committee has published its report into the nursing workforce. It says too little attention has been focused on retaining nurses which has resulted in more nurses leaving, than joining the nursing register. 

nursing workforce
Image source: publications. parliament.uk

The report calls for Health Education England to reverse cuts to nurses’ continuing professional development budgets. Funding allocated to trusts should be specifically ringfenced for CPD for nurses, and specific funding should also be made available to support CPD for nurses working in the community.

The Committee welcomed the introduction of the new role of Nursing Associate and the expansion of career opportunities this brings for Health Care Assistants. The government needs to ensure that these new Nursing Associates have a clear professional identity, which the public understands and recognises.

An interactive version of the full report is also available

The report’s  summary is here

Click here for the report’s conclusions and recommendations



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.

NHS England: assessment of performance 2016 to 2017

Annual assessment of NHS England against its mandate and business objectives for 2016 to 2017.

The Secretary of State for Health’s assessment report covers the extent to which NHS England met its mandate and business plan objectives, and fulfilled its duties to:

  • improve the quality of services
  • reduce inequalities
  • secure public involvement

Full report: Annual Assessment of the NHS Commissioning Board (known as NHS England) 2016 to 2017

RCGP strategic plan 2017-2020

Great doctors, great care sets out the College’s four main objectives for the next three years. It also defines 12 ‘values’, applicable to College members and employees, that will shape how we go about achieving these goals | RCGP

RCGP 2-17
Image source: RCGP

Four objectives

The College has identified four objectives that explain its purpose and what it is aiming to achieve over the next three years:

  • Shape the future of General Practice
  • Ensure GP education meets the changing needs of UK primary care
  • Grow and support a strong, engaged membership
  • Be the voice of the GP (influence)

Vision and values

The College has also identified 12 values, which can be summarised in four ‘core’ values:

  • Excellence
  • Teamwork
  • Leadership
  • Care

Read the full plan here

Regional Review Of Medical Education And Training In The South West Of England

The GMC has published a review of medical education and training in the south west of England | GMC

Image source: GMC

The General Medical Council (GMC) has published a review of medical education and training in the south west of England.

Overall, it found that medical students and doctors in training are learning in positive and supportive environments but training time becomes squeezed when doctors’ workloads increase. The GMC sets standards to protect education and expects local organisations to meet these.

The report follows a series of quality assurance visits across the region at medical schools and hospitals who train doctors and an assessment of Heath Education England working across the south west which oversees local postgraduate training.

Read the full overview here

Read the full report here