Health Management and Policy Alert

Untapped potential: district nursing services and the avoidance of unplanned admission to hospital

The Queen's Nursing Institute - 
This report describes how District Nurse Team Leaders have advanced skills in assessment, diagnosis and patient management which could be used to provide safe and effective care for people at home, preventing unnecessary hospital admissions. It argues that the NHS is failing to capitalise on the skills, knowledge and experience of District Nurses and instead is investing in new specialist teams of staff in the community, which may impact negatively on the continuity of care. At the same time, the number of District Nurses has fallen dramatically.

• Report
• The Queen's Nursing Institute - news

Crowding and its consequences

Royal College of Emergency Medicine - 

Against the backdrop of long ambulance delays experienced across the UK, high levels of crowding in emergency departments (EDs), and record-breaking numbers of patients experiencing the longest waits, this report examines crowding and its consequences. It finds that at least 4,519 patients have died as a result of crowding and twelve hour stays in EDs in England in 2020-2021. The report urges governments, NHS England and devolved equivalents, integrated care systems, and trusts to take a system wide approach to tackling the problem.

• Report
• Press release

State of the provider sector 2021

NHS Providers - 

This briefing sets out the results of NHS Providers' annual survey of trust leaders. It highlights concerns about winter and rising demand for services and staffing challenges, including shortages and burnout. The results emphasise the strong sense amongst NHS leaders that the health and care system is entering an unpredictable time in which colleagues will need to navigate seasonal winter pressures, Covid-19, workforce burnout and staff shortages.

• Briefing
• Press release

Delayed hospital handovers: impact assessment of patient harm

Association of Ambulance Chief Executives (AACE) - 

This report, based on a structured clinical review of handover delays at hospital emergency departments across England, finds that the proportion of patients who could be experiencing unacceptable levels of preventable harm is significant. Over eight in ten of those whose ‘handover’ (from ambulance clinician to hospital clinician) was delayed beyond 60 minutes were assessed as having potentially experienced some level of harm; 53 per cent low harm, 23 per cent moderate harm and 9 per cent (one patient in ten) could have been said to have experienced severe harm.

• Report
• Press release

Under pressure: NHS priorities this winter

NHS Confederation -
According to a poll of NHS leaders, the pressure on the NHS is now at unsustainable levels and patient safety and care are being put at risk by staff shortages. Leaders in England warn that the NHS has reached a tipping point, with nearly nine in 10 (88 per cent) saying the demands on their organisation are unsustainable. Almost the same number (87 per cent) also say that a lack of staffing in the NHS as a whole is putting patient safety and care at risk.

• Report
• NHS Confederation - news

The state of health care and adult social care in England 2020/21

Care Quality Commission (CQC) - 

The CQC’s annual assessment of the state of health and social care in England looks at the quality of care over the past year. This year’s is the first of these reports to cover a full year of the pandemic. Staffing pressures are being felt across all health and care settings. However, the impact is being seen most acutely in adult social care, where providers are competing for staff with the retail and hospitality industries. Data from information submitted to CQC by providers of residential care shows the vacancy rate rising month-on-month from 6 per cent in April to 10.2 per cent in September.

• Report
• Press release
• The King's Fund response

Comparing nations on timeliness and coordination of health care

Commonwealth Fund - 

Aging populations present major challenges to health care systems around the world. The 2021 Commonwealth Fund International Health Policy Survey, conducted among adults age 65 and older between March and June 2021, provides insights about how well U.S. seniors fare relative to older adults in ten other high-income countries (including the United Kingdom, France, Germany and the Netherlands).

• Survey results

Manifesto for recovery: the health and care system after Covid-19

NHS Confederation - 

This report sets out the views of healthcare leaders in England on the measures needed to ensure the NHS can meet the key challenges it faces, including addressing the backlog of care and health inequalities that have been exacerbated by Covid-19. It also explores how the health and care sector can sustain the beneficial changes that have resulted from the pandemic.

• Report

 

 

 

Building back inclusively: radical approaches to tackling the elective backlog

NHS Confederation - 

This briefing recommends radical, whole-system changes to tackle the elective backlog inclusively. Aimed at healthcare leaders overseeing elective recovery, as well as policymakers with the levers to effect change, it puts forward ten practical measures to manage the backlog.

• Briefing
• More detail

Building back inclusively: the evidence

NHS Confederation - 

This briefing provides analysis of August 2021 data and trends in waiting times, the impact on inequalities and what the NHS and patients can expect unless action is taken.

• Briefing