Publications from HOPE on the looming crises in healthcare

Mediation in healthcare

Ageing health workforce - Ageing patients

The findings of the 31st HOPE Exchange Programme and the broad topic of “Ageing health workforce and ageing patients” were extensively discussed in Berlin during HOSPAGE, a conference an evaluation meeting on 12 and 13 June 2012. The report illustrates the contents and findings of HOSPAGE; it goes through the debates and results and gives notice of the solutions and situations identified by the HOPE Exchange Participants.

Better health- A shared challenge for hospitals and primary health care

The Crisis, Hospitals and Healthcare

Chronic diseases, a clinical and managerial challenge


See http://www.hope.be/

epSOS – the European eHealth Project

epSOS aims to design, build and evaluate a service infrastructure that demonstrates cross-border interoperability between electronic health record systems in Europe.
A large scale pilot has entered into operational mode.

"Cross-border eHealth Services

epSOS attempts to offer seamless healthcare to European citizens. Key goals are to improve the quality and safety of healthcare for citizens when travelling to another European country. Moreover, it concentrates on developing a practical eHealth framework and ICT infrastructure that enables secure access to patient health information among different European healthcare systems. epSOS can make a significant contribution to patient safety by reducing the frequency of medical errors and by providing quick access to documentation as well as by increasing acessibility of ones prescribed medicine also abroad. In emergency situations, this documentation  provides the medical personnel with life-saving information and reduces the (sometimes needless) repetition of diagnostic procedures.

The technical, legal and organizational concepts developed within the framework of the project are subject to an extensive practical testing phase which will last until the end of the project."

See http://www.epsos.eu

Ageing health workforce - Ageing patients

A publication from HOPE - European Hospital and Healthcare Federation
Findings from a conference on the effects that aging is having on healthcare systems across Europe


http://www.hope.be/05eventsandpublications/docpublications/90_ageing/90_HOPE_Publication-Ageing_October_2012.pdf

Robo-pets can improve quality of life for dementia sufferers

Interaction with a robotic companion can help people with mid to late stage dementia become less anxious and also have a positive influence on their quality of life, according to new research.

The study investigated the effect of interacting with PARO — a robotic harp seal — fitted with artificial intelligence software and tactile sensors that allow it to respond to touch and sound. It can show emotions such as surprise, happiness and anger, can learn its own name and learns to respond to words that its owner uses frequently.
Read more at:

http://www.mtbeurope.info/news/2013/1306028.htm

GPs to be held accountable for any future 'Mid-Staffs', says health secretary

In Pulse:
"GP commissioners will be held accountable for the failure of hospital services in the case of another Mid Staffs-style scandal, health secretary Jeremy Hunt has said."

So not the secretary of State himself, CQC, Monitor, DH etc ...

Interesting comments under the article also

See http://www.pulsetoday.co.uk/commissioning/commissioning-topics/secondary-care/gps-to-be-held-accountable-for-any-future-mid-staffs-says-health-secretary/20003507.article#.UdbSpW3t46Y

Longer Lives map of health outcomes across England

Public Health England's Longer Lives interactive map highlights premature mortality across every local authority in England, giving people important information to help them improve their community’s health.

See http://longerlives.phe.org.uk/

Baby's life saved by 3D-printed tracheal splint

Doctors at the University of Michigan have saved the life of a 20-month-old baby with a collapsed trachea by printing a custom designed splint based on a CT scan of his trachea. With video.

See: www.mtbeurope.info/news/2013/1306003.htm

MTB Europe: Thirteen national science academies call on G8 to act on drug resistance threat

The national science academies of the G8 member states and five other science academies, are calling on the G8 governments to take action over two threats to human populations: drug-resistant infectious agents and sustainable development.

Infectious agents that are resistant to drugs represent one of the greatest threats to the human population worldwide. People are increasingly being infected with resistant pathogens, and more and more often the drugs used to treat them, such as antibiotics, are not working. The academies also warn that the number of multi-drug-resistant infections acquired in hospital settings is on the rise. 

Read more at http://www.mtbeurope.info/news/2013/1306002.htm

King's Fund report on emergency and urgent care

The urgent and emergency care system is under pressure, and performance on a number of important indicators, including the four-hour wait for accident and emergency (A&E) and ambulance handover targets, worsened during the winter and early part of 2013.
This has prompted a review of emergency care led by NHS England Medical Director, Bruce Keogh, and an inquiry by the Health Select Committee. NHS England has also announced that its local area teams are drawing up A&E recovery plans.
While the focus of attention has been the pressures felt by A&E services, there is no single cause or solution to this problem: the pressures are caused by issues across the health care system.
The King's Fund has published a selection of their policy research and analysis in this area.
http://www.kingsfund.org.uk/projects/urgent-emergency-care

NHS what?

NHS Institute for Innovation and Improvement (www.institute.nhs.uk) closed on 31 March and the new organisation NHS Improving Quality started on 1 April. So yet another organisation and website shut down.

What does it mean -- the NHS 'is' improving quality, the institute for improving quality, the improving quality department?

NHS Improvement (www.improvement.nhs.uk) has also closed (so what was that?)
On the website it says: "Part of NHS Improvement's work have come to a close, while some continue with NHS Improving Quality."

Was that written by the same illiterate person who came up with NHS Improving Quality?


"NHS Improving Quality (NHS IQ) now exists to bring together the wealth of knowledge, expertise and experience of a number of former NHS improvement organisations.
NHS IQ is hosted by NHS England, previously known as the NHS Commissioning Board."
Yet another change of name AND website, before it had even officially formed (and it still hasn't made up its mind exactly what it is doing).

There is, however some logic to the new organisation:
"As well as continually looking at best practice from both across the NHS and around the world, NHS IQ draws on the experience of previous successful improvement programmes established by legacy organisations"

• National Cancer Action Team
• National End of Life Care Programme
• NHS Diabetes and Kidney Care
• NHS Improvement
• NHS Institute for Innovation and Improvement.

You can find the phoenix at this catchy URL:
http://www.england.nhs.uk/ourwork/qual-clin-lead/nhsiq/

Diabetes care "risks being overlooked" in new NHS organizations 

New NHS organisations that are responsible for improving the health and wellbeing of their local populations and reducing health inequalities risk overlooking the need to improve diabetes care in their local area, according to a new report by Diabetes UK.
The report, which was supported by Novo Nordisk (which has a commercial interest in diabetes care), reviewed 50 Health and Wellbeing Boards, the bodies meant to plan and coordinate health priorities for local areas, and found that too many of them did not recognise the priority and impact of the condition.

Barbara Young, Chief Executive of Diabetes UK, said, "Health and Wellbeing Boards will have huge influence over health in their local areas, and so they have a great opportunity to help tackle the rising tide of diabetes. Our analysis suggests that in some cases this is an opportunity that is being missed.

"The number of people with diabetes is rising at an alarming rate, but there is not enough priority given to preventing Type 2 diabetes. For those people who already have diabetes, the support they need to manage their condition is inconsistent and this is leading to devastating complications, premature death and massive costs to the NHS."

Read more: 

http://www.diabetes.org.uk/About_us/News_Landing_Page/Diabetes-care-risks-being-overlooked-in-new-NHS-organizations/

GPs fight back --
from Pulse:

LMC leaders launch publicity fightback to defend general practice

LMC leaders have launched a major campaign to promote general practice to patients in London, in order to counteract weeks of negative statements from politicians and media coverage about the profession.

Dr Michelle Drage, chief executive of Londonwide LMCs, says: ‘GPs are sick of being blamed for all of the issues in the NHS. This is a complex and interdependent system in which blame seems to be the name of the political game.
‘GPs’ workloads have doubled in recent years and much of this is made up of unnecessary paperwork. Despite this we continue to ensure that our patients get the care they need and we should be proud of what is achieved by London’s practices.

Read the rest of this article on Pulse

NHS England announces new technical guidance to improve patient care

NHS England has today published guidance for GP practices explaining how better use of anonymised patient information from general practice will help commissioners improve the quality, efficiency, and equity of health care services.
The GP Technical Specification and its associated guidance was developed in partnership with the British Medical Association and Royal College of General Practitioners. The document explains the process of how data from general practice will be collected, anonymised and used to improve patient care.

More info: http://www.england.nhs.uk/2013/05/29/nhs-england-annou-tech-guide/ 

New guidance from NHS England for clinical commissioners

Everyone Counts: Planning for Patients 2013/14 outlines the incentives and levers that will be used to improve services from April 2013, the first year of the new NHS, where improvement is driven by clinical commissioners.

The guidance is published alongside financial allocations to clinical commissioning groups and is accompanied by other documents intended to help local clinicians deliver more responsive health services, focused on improving outcomes for patients, addressing local priorities and meeting the rights people have under the NHS Constitution.

http://www.england.nhs.uk/everyonecounts/

King's fund report: Patient-centred leadership. Rediscovering our purpose

This report from the King's Fund summarises the main findings of the Francis Inquiry into the failings of care at Mid Staffordshire in relation to NHS leadership and culture.
It sets out what needs to be done to avoid similar failures in future, focusing on the role of three key 'lines of defence' against poor-quality care: frontline clinical teams, the boards leading NHS organisations, and national organisations responsible for overseeing the commissioning, regulation and provision of care.

Key findings

• The leadership of the NHS at a national level needs to create conditions in which local organisations have the freedom to deliver consistently high standards of care and where the needs of patients come first.
• The quality of care provided by NHS organisations should, first and foremost, be a corporate responsibility under the leadership of boards, who must lead by example by focusing on the quality and safety of care.
  Leaders need to value and support frontline staff and ensure the main focus is on patients and their care.
• Leadership development should give priority to supporting leaders at all levels to be patient-centred and to ensure that staff have the time and resources required to deliver high-quality care.
• Patient leaders should work alongside NHS leaders to support the transformation called for in the Francis Inquiry report.

See more information on the King's Fund website and download the report:
http://www.kingsfund.org.uk/publications/patient-centred-leadership

GP contract set to change as Hunt hands responsibility for out-of-hours care back to general practice

From Pulse: The GP contract is set to be rewritten as part of reforms to out-of-hours care which will see general practice handed back responsibility for the care of patients around the clock, health secretary Jeremy Hunt has revealed.

See the full article in Pulse magazine

Evaluation of the first year of the Inner North West London Integrated Care Pilot

The Inner North West London Integrated Care Pilot has been the subject of significant attention for people wanting to encourage new models of integrated care. The pilot, which started in July 2011, aims to: improve outcomes for patients; create access to better, more integrated care outside hospital; reduce unnecessary hospital admissions; and enable effective working of professionals across provider boundaries.

Staff share information using an IT tool which allows for the identification of patients needing intensive case management, while multidisciplinary groups of local care providers meet on a regular basis to review and plan people’s care.

Read more at:

http://www.nuffieldtrust.org.uk/publications/evaluation-first-year-inner-north-west-london-integrated-care-pilot

Patient and public involvement – the role of the FT governor

Hilary Brown, FTGA director and fellow at the Health Services Management Centre, University of Birmingham, shares her thoughts on the role of the FT governor in the context of patient and public involvement.
The Francis inquiry seminar on patient experience, held in November 2011, emphasised that patient needs must be put systematically at the centre of the way trusts are organised. ...

Read more here:
http://www.ftga.org.uk/news/patient-and-public-involvement-the-role-of-the-ft-governor

 

Changing of the guard: lessons for the new NHS from departing health leaders

Just prior to the new NHS structures going live in April 2013, the Nuffield Trust interviewed some of the most experienced NHS leaders to gather their lessons for the new generation of leaders.

It consists of frank reflections from 12 former or soon-to-depart hospital, primary care trust (PCT) and strategic health authority (SHA) chief executives, along with health regulators, that offer insights into the challenges they faced during the last decade or more in the NHS.


http://www.nuffieldtrust.org.uk/publications/changing-of-the-guard

Putting Patients First: The NHS England Business Plan for 2013/14 – 2015/16

NHS England’s business plan for 2013/14 – 2015/16, called Putting Patients First, explains how its commitment to transparency and increasing patients’ voice are fundamental to improving patient care.
The plan describes an 11 point scorecard which NHS England will introduce for measuring performance of key priorities, focused on receiving direct feedback from patients, their families and NHS staff.
This supports the cultural change needed to put people at the centre of the NHS, a key theme in the report by Robert Francis QC, by making sure that patients’ voices are heard and used to deliver better services.
This plan builds on Everyone Counts: Planning for Patients 2013/14, our earlier planning guidance for commissioners which was published in December 2012.
There is also a summary document available - Putting Patients First: The summary NHS England business plan for 2013/14 – 2015/16 and an ‘easy read’ version.


NHS England video
http://youtu.be/m8ao5YGF4R8

EC says patients should be given access to their health data — by 2015-2020

European Commission Digital Agenda for Europe

Action 75: Give Europeans secure online access to their medical health data and achieve widespread telemedicine deployment

"Undertake pilot actions to equip Europeans with secure online access to their medical health data by 2015 and to achieve by 2020 widespread deployment of telemedicine services

What is the problem? Sustainability of healthcare systems is at stake

Increasing demands from patients, a rising spread of chronic diseases, the impact of an ageing population, together with scarcer human and financial resources are putting sustainability of healthcare systems at risk.

Why is EU action needed? Patients' empowerment and deployment of telemedicine services are key to ensuring the sustainability of healthcare systems

Patients' access to their healthcare data increases empowerment, participation and responsibility, makes relationships with healthcare services more effective and enables mobility. As active players, patients gain in autonomy, quality and safety of care, and can improve their lifestyles.

Telemedicine services are crucial to taking better care of chronic diseases patients, including elderly patients and of people in remote areas and to respond to the shortage of healthcare professionals and lack of financial resources.

DAE action 75 will also contribute to the delivery of the European Innovation Partnership in the field of active and healthy ageing, proposed under the Innovation Union flagship."

For more information see: http://ec.europa.eu/digital-agenda/en/pillar-vii-ict-enabled-benefits-eu-society/action-75-give-europeans-secure-online-access-their

Monitor and NHS England call for views on how the NHS payment system can do more for patients

Health sector regulator Monitor and NHS England are working together to reform the way NHS services are paid for.
Hospitals are currently paid through the Payment by Results system, which has been in operation for nearly a decade and has delivered benefits. However feedback from the health sector is that the current system is not sufficiently patient focused, not always based on good quality information, and can act as a barrier to delivering integrated care.
For more see: http://www.england.nhs.uk/2013/05/13/tariffs-consultation/

Pan European telehealth project to develop 'cookbook' of co-ordinated care

Royal Philips Electronics and its consortium partners have announced the launch of the Advancing Care Coordination and Telehealth Deployment (ACT) program in five European countries. This will explore the organizational and structural processes needed to successfully implement chronic disease management services on a large scale.

See http://www.mtbeurope.info/news/2013/1304033.htm

European telecare project going beyond Whole System Demonstrators:
Advancing Care Coordination and Telehealth 

The Advancing Care Coordination & Telehealth Deployment (ACT) Programme brings together a pan-European consortium of leading companies, universities, hospitals and healthcare authorities. Initiated in February 2013, the 2.5-year programme will define best practices in care coordination and telehealth. The objective of this EU co-funded project is to overcome the structural and organizational barriers of the deployment of coordinated care.

The ACT programme addresses a primary challenge facing healthcare systems in EU member states: the ageing population and the related burden of chronic disease. By specifically investigating four key drivers, influencing the effective deployment of Coordinated Care & TeleHealth services and generating 'best practice' examples, ACT provides the foundation to help overcome organisational and structural issues in patient stratification, patient and staff engagement, optimisation of organisational structures, and efficacy and efficiency.

 www.act-program.eu

Affiliate Members

The ACT programme is open and willing to share our ambition and results. If you, as a European Healthcare regions, are interested in our activities and results we would like to welcome you as an affiliate member of the programme. For further information, please contact the project coordinator.

Why might you want to be an ACT programme affiliate member?

Engagement as observer in the ACT programme would enable your healthcare region to:

• Access to programme results and participation in project meetings
• Learn from the others' good practice and experiences
• Provide opportunities for collaboration leading to efficiently (re-) design and validate innovative care services and expand the services to larger population - with the same level of investment
• Enlarge your visibility at international level
• Enable local industry to see a larger market, beyond the 'local border'
• Engage political/industrial support

Engagement as evaluation site in the ACT programme would enable, in addition, your healthcare region to:

• Access to the ACT evaluation engine and fully participate in the evaluation process and best practice selection
• Get evidence and benchmarking of your solution under the review of the key international experts
• Combine evidence with all the evaluation sites

Contact
 http://www2.med.auth.gr/act/contact.php

IBM's thought leadership piece on the value of analytics in healthcare

The global healthcare industry is experiencing fundamental transformation as it moves from a volume-based business to a value-based business. With increasing demands from consumers for enhanced healthcare quality and increased value, healthcare providers and payers are under pressure to deliver better outcomes.  ...

http://www-935.ibm.com/services/us/gbs/thoughtleadership/ibv-healthcare-analytics.html

Kent Surrey Sussex Academic Health Science Network  receives designation



Kent Surrey Sussex Academic Health Science Network is delighted to share with you news that Sir Ian Carruthers has congratulated us on our designation. He has asked us to pass on his thanks to everyone who has been involved in developing our proposals.



This gives us the go-ahead to us to build on the momentum of recent months.
We look forward to working with you to transform health and healthcare, and put innovation at the heart of everything we do - improving patient outcomes and contributing to economic growth.

Website: http://www.kssahsn.net

Tim Kelsey, National Director for Patients and Information, NHS England, outlined the Insights Dashboard which will be formally launched for the NHS in November 2013

From NHS England Board Paper (available here)
 

http://www.england.nhs.uk

Prioritising patients in every decision we make

The purpose of this paper is to update the Board on progress made in the development of the Insight Dashboard and proposed next steps.

Key Issues and Recommendations:

The Board is committed to: promoting and upholding the values, rights and pledges enshrined within the

NHS Constitution;

putting patients and the public at the heart of everything it does;

promoting and embedding a truly customer focused culture within the NHS;

andensuring that patient and public voice is not just heard, but actively used to

inform commissioning decisions taken by the Board and CCGs.

The Board is therefore creating an Insight Dashboard, which brings together a range of regularly updated views, feedback and comment from patients and the public about the NHS. The Insight Dashboard will be web based and publicly available, demonstrating the Board’s commitment to both transparency and active patient and public participation in shaping health services.

Actions Required by Board Members:

To note progress in the development of the Insight Dashboard (which will bedemonstrated at the Board meeting).

To agree proposed next steps in taking the dashboard forward.

2.Prioritising patients in every decision we make

The Insight Dashboard

Context

1. NHS England is committed to prioritising patients in every decision it makes. This will require regular and updated insight into what patients and the public think about NHS services, so that both CCGs and NHS England can ensure their commissioning plans are informed by patient and public views.

2. NHS England is also committed to transparency of information, to enable the active participation of patients in decisions regarding their own healthcare and of the public in decisions about the nature of the NHS services they use. Once developed and tested, the Insight Dashboard will be a publicly available

tool to enhance both transparency and participation; it will be a rich source of information to help people understand what their fellow patients and citizens are saying about health services.

Background

3. The February board paper introduced the concept of an Insight Dashboard which would utilise data from a variety of sources to provide a triangulated view of:

the experiences people have of NHS services and care; and views/conversations people hold or are having about the NHS.

4. A web-based beta dashboard has now been developed and will be tested over the next few months to ascertain the usefulness of measures included the presentational format of the data and to gain views on whether additional work needs to be undertaken to make this a meaningful tool for the public to utilise effectively.

5. A summary of data sets currently included in the dashboard, appear below:

Experiences of NHS services and care

Whether patients would recommend services to friends and family (currently available for trusts in the Midlands and East and available for all trusts in England from July);

Comments that patients are making about the NHS (from NHS Choices, which includes comments patients make through other routes, such as Patient Opinion);

What patients are complaining about (from the annual complaints return);

How satisfied patients are with NHS services (from the inpatientsurvey); and

Whether staff would recommend services to friends and family (from the NHS annual staff survey. An additional monthly data flow from a sample of NHS staff will be available as soon as possible during

2013/14).

Views/conversations about the NHS

Trending topics in healthcare;

Key themes the public engaged with about the NHS on social media;

How satisfied citizens are with NHS services; and Public perceptions of the NHS brand.

6. A number of data feeds contained (supplied by YouGov) within the dashboard are new and have not been seen before. These are as follows:

Daily perception data on key measures including satisfaction,

recommendation, general impression and corporate reputation;

Weekly survey data (sample size approx. 2,000 people per month) on which NHS services have been used, how satisfied people were with services and reasons for satisfaction/dissatisfaction; and

Monthly staff satisfaction data - this data will cover both satisfaction in their place of work and views on the NHS

7. The Insight Dashboard will provide a never before seen view of experiences and views about the NHS from patients, the public and NHS staff.

Proposed next steps in developing the Insight Dashboard

8. As mentioned previously, a beta (test) dashboard has now been developed which is likely to require further refinement. A procurement process will be required to secure a partner going forward to further develop and update the Insight Dashboard. The proposed next steps (which have taken into consideration the likely timescales for procurement) are as follows:

Testing within NHS England (May

9. It is proposed that the dashboard is made available to staff within NHS England to provide feedback on the tool and suggestions for further refinement. A series of workshops will be arranged to demonstrate the tool to key groups of staff working within NHS England.

Publication and stakeholder engagement (August - November)

10. It is proposed that the Insight Dashboard is made publicly available in August with an open invitation to a wide range of stakeholders to test and comment on it. This will include patients and the public (both directly and via voluntary sector organisations that advocate on their behalf); other parts of the NHS

and arm’s length bodies intermediaries and other organisations in the media, research and independent sectors. An August publication will also enable the national friends and family test data to be included for the first time.

Insight Dashboard formal launch (November)

11. A finalised Insight Dashboard can then be formally launched alongside the Integrated Customer Service Platform, which will replace NHS Choices in the autumn. This will ensure it has a high profile presence and is easily accessible by users of this service (currently nearly 20 million visits a month to

NHS Choices).operating in the health sector; information  

Maintaining interest in the dashboard

12. As a number of data sets within the dashboard contain much rich data but are annual, it is proposed that on a weekly basis a different area/topic is put in the spotlight. By providing weekly changes to the main focus dashboard, it is more likely to retain interest from users. The three main annual data sets

which contain a wide variety of data and will be treated like this are as follows:

Patient survey data;

Complaints data; and

Staff survey data

13. As new, more real time data flows become available (such as patient and public feedback through the Integrated Customer Service Platform) these will be incorporated into the dashboard and included in the rotating spotlight areas. Where possible, data captured in this way in real time will be immediately fed into the dashboard so that it is constantly updated.

Conclusion

14. The Board is asked to note the contents of this paper, including the live demonstration of the Insight Dashboard and to discuss and agree these proposed next steps.

Tim Kelsey

National Director for Patients and Information

April 2013

NHS England website: