Accountable care

Accountable care: policy fad or step forward on the journey towards integrated care? | Nicola Walsh |The Kings Fund

Accountable care is under discussion almost everywhere in the NHS. Groups of NHS providers (sometimes with the local commissioner) are exploring how they can work more closely together to take on the responsibility for the health and care of a given population within a given budget. Currently, we are seeing emerging accountable care arrangements adopting various forms according to local needs and preferences: in some areas the focus is on creating a single organisation; in others, organisations are keen to use the words ‘system’ or ‘partnership’ – to reinforce the notion of working together.

In this Kings Fund blog, Nicola Walsh looks in more detail at Accountable Care Systems and partnerships.

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Quality improvement

Making the case for quality improvement: lessons for NHS boards and leaders | The King’s Fund | The Health Foundation

This briefing outlines the following ten lessons for NHS leaders which provide a starting point for those seeking to embed quality improvement in their work:

  • Make quality improvement a leadership priority for boards.
  • Share responsibility for quality improvement with leaders at all levels.
  • Don’t look for magic bullets or quick fixes.
  • Develop the skills and capabilities for improvement.
  • Have a consistent and coherent approach to quality improvement.
  • Use data effectively.
  • Focus on relationships and culture.
  • Enable and support frontline staff to engage in quality improvement.
  • Involve patients, service users and carers.
  • Work as a system.

The briefing makes the case for quality improvement to be at the heart of local plans for redesigning NHS services.

Full report available here

Sustainability and transformation plans in London

Sustainability and transformation plans in London: an independent analysis of the October 2016 STPs | The Kings Fund | Nuffield Trust

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This report looks at the five Sustainability and Transformation Plans in London, their contents and common themes.  The authors, from The King’s Fund and the Nuffield Trust, assess the main issues and risks to be addressed across the plans. They make a small number of recommendations for the future of the STP process in London, focusing specifically on the role of London-wide action in taking forward the plans.  The report includes a brief update on progress since March 2017.

Download the full report here

NHS standards and performance: is prioritisation the answer?

The Kings Fund June 2017 quarterly monitoring report (QMR) showed that NHS performance on key access targets over the financial year 2016/17 continued to deteriorate. In this new blog James Thompson asks whether a combination of increased funding, incentives and pressure from the centre will be enough to get A&E waiting time targets back on track.

NHS Estates

The Kings Fund has published NHS Estates: Review of the Evidence

This report sets out the findings of an evidence review in relation to estates strategy, commissioned by the Department of Health.  It includes evidence on the approach to developing a strategy, and the different components required for an effective strategy. It also identifies the skills and capability involved in estates strategy development, and provides examples of some of the models for estates development that have been used in the NHS and elsewhere in the public sector (both in the United Kingdom and abroad).

The report can be downloaded here

Mental health and new care models

GPs need to prioritise mental health more, say experts. | Mental health and new models of care | Kings Fund | OnMedica

While some of the vanguard sites developing new care models report promising early results from adopting a whole-person approach, the full opportunities to improve care through integrated approaches to mental health have not yet been realised.
This Kings Fund report draws on recent research with vanguard sites in England, conducted in partnership with the Royal College of Psychiatrists. The report found that where new models of care have been used to remove the barriers between mental health and other parts of the health system, local professionals saw this as being highly valuable in improving care for patients and service users. But there remains much to be done to fully embed mental health into integrated care teams, primary care, urgent and emergency care pathways, and in work on population health.

The main vehicle for rolling out what vanguards are trying to achieve are England’s sustainability and transformation plans (STPs) and there are concerns, said the authors, that some STPs had limited content on mental health.

‘It is vital that STP leaders are encouraged to make mental health a central part of their plans, and that they are able to take heed of the emerging lessons from vanguard sites,’ says the report.

More mental health support is needed in GP surgeries, said the authors. They recommend strengthening mental health capabilities in the primary and community health workforce by improving the confidence, competence and skills of GPs, integrated care teams and others.

Compassionate leadership in health care

Caring to change:  How compassionate leadership can stimulate innovation in health care | Kings Fund

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This paper looks at compassion as a core cultural value of the NHS and how compassionate leadership results in a working environment that encourages people to find new and improved ways of doing things.  It describes four key elements of a culture for innovative, high-quality and continually improving care and what they mean for patients, staff and the wider organisation: inspiring vision and strategy; positive inclusion and participation; enthusiastic team and cross-boundary working; and support and autonomy for staff to innovate. It also presents case studies of how compassionate leadership has led to innovation. This work was supported by the Health Foundation.

Download the full report here

Related Kings Fund blog: Compassionate leadership – more important than ever in today’s NHS