December 2016
Health Management and Innovation Update December 2016
Hello and welcome to the December issue of HMIU. We start with a reminder about Red:Green Bed
Days, as highlighted in the Corporate Brief on 5 th December with some additional
resources/information:
ECIP Quick Guide – Red and Green Days (Dr Ian Sturgess)
The Red:Green Bed day is a visual management system to assist in the identification of wasted time
in a patients journey. It is most applicable to in-patient wards in both acute and community
settings. This post from the Academy of Fabulous NHS Stuff explains in a clear and concise way how
it works, and from this we can see how it could be applied here at WSFT.
If you can access You Tube, this video explains how it works:
https://www.youtube.com/watch?v=Dc-b6GclTq4
Application of Red:Green Days
This is how it was applied at Mid Cheshire Hospital NHS Foundation Trust which delivers acute
services across three sites employing 3,200 staff and has around 540 beds, so reasonably
comparable to WSFT.
Unblocking the beds: one hospital’s efforts to get older patients home
A personal account of attempts at Ipswich Hospital to improve patient flow using Red:Green Days –
article from The Guardian 02.02.16
If you would like more information or an evidence search on the impact of Red:Green days
please contact the Library to request a search [email protected]
Sustainable Transformation Plans
Deliver Personal Care
Deliver Safe Care
Deliver Joined Up Care
Support a Healthy Life
Support Ageing Well
Support All Our Staff
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December 2016
Sustainable Transformation Plans
Our regular round-up of the latest evidence and opinion on STPs:
Doctors report lack of STP engagement
According to a BMA survey, almost two thirds of doctors report seeing no clinical or public
engagement on STPs.
STPs and NHS providers’ plans for major workforce changes will be subject to checks on
safety
Health economies and NHS providers’ plans for major workforce changes will be subject to NHS
Improvement checks on safety, its chief executive has said. HSJ report 06.12.16.
Some STPs are becoming ‘integrated organisations’ says Stevens
A small number of the most advanced STPs will soon become “integrated organisations” combining
providers and commissioners, while others will be able to take control of staff working across their
region. HSJ Report 07.12.16.
Global Digital Exemplars (GDEs)
The digital patient: transforming primary care?
This report argues that digital technology for patients and staff in primary care holds great potential for
the NHS but that the impact of this new digital capability is far from certain. It reviews the evidence on
digital technology and its impact on patients and finds that patient-facing technology is already
showing promise, particularly for people with long-term conditions. The report warns that policymakers and politicians should avoid assuming that self-care enabling technology will produce
significant savings, at least in the short term. (Nuffield Trust, November 2016) Press release
Multimorbidity – the biggest clinical challenge facing the NHS?
Around one in four of us have two or more long-term conditions (LTCs), often known as
‘multimorbidity’ and this rises to two thirds of people aged 65 years or over. In this joint
blog, Dawn Moody and David Bramley argue multimorbidity is therefore becoming the
norm. They take a look at the adverse impact this can have upon individual quality of life
and examine its association with higher mortality, adverse drug events and greater
use unplanned care. (NHS England, November 2016)
NICE Guidelines (in development - Sept 2016)
Responding to the needs of patients with multimorbidity: a vision for general practice
This report reviews how effectively the current health system serves patients living with multiple longterm conditions, and explores the experiences of these patients. It highlights the barriers that prevent
the quality of their care improving - such as lack of time and resources for GPs - and provides
recommendations to overcome these barriers. The report also recommends improving communication
between primary and secondary care; increasing exposure of delivering care for those with
multimorbidity in GP training; and developing improved decision making tools. (Royal College of GPs,
November 2016)
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December 2016
Choice in the presence of experts: the role of general practitioners in patients' hospital care
This paper presents an analysis of patients' hospital choice for elective medical procedures when their
choice set is pre-selected by a GP. The study found that patients defer to GPs when assessing
hospital quality and tangible attributes such as hospital amenities and that GPs, in turn, as patients'
agents present choice options based on quality, but as agents of health authorities also consider their
financial implications. (Institute of Fiscal Studies, October 2016)
The challenge and potential of whole system flow
Improving the flow of patients, service users, information and resources within and
between health and social care organisations can have a crucial role to play in
coordinating care around the needs of patients and service users, and driving up service
quality and productivity. This report outlines an organising framework and tested methods
that local health and social care leaders can use to improve whole system flow. It draws
on case studies and other examples of work in this area from across the UK and
internationally.
State of the NHS Provider sector
NHS Providers has produced, for the first time, a view of how the sector is performing, identifying the
challenges it faces and the successes we should be celebrating while also setting out what more
support is needed. This is intended to be a regular publication. (NHS Providers, November 2016)
How is the NHS performing? Quarterly monitoring report: November 2016
The King’s Fund’s latest quarterly monitoring report finds that big rises in demand for health care
mean the NHS is heading into winter with its finances under pressure and performance against
several key indicators at their worst level for more than a decade. For the first time, the report
includes analysis of demand and activity in general practice and similarly finds an increase in patient
contacts. The report highlights the impact of social care budget cuts on delayed discharges and
problems in
co-ordinating care. (The King’s Fund, November 2016)
Financial sustainability of the NHS
In 2015-16, NHS commissioners, NHS trusts and NHS foundation trusts reported a combined deficit of £1.85
billion, a greater than three-fold increase in the deficit position of £574 million reported in 2014-15. According to
this report, the financial performance of NHS bodies worsened considerably in 2015-16 and this trend is not
sustainable. (National Audit Office, November 2016) Summary report
The financial sustainability of the NHS in England
This briefing provides background on the current funding settlement for the NHS in England, the financial and
operational performance of the health service, and measures being taken to ensure its future sustainability,
including Sustainability of Transformation Plans. The briefing also provides background on the Department of
Health’s Annual Report and Accounts for 2015/16 and ongoing Select Committee scrutiny of NHS funding.
(House of Commons Library, November 2016)
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December 2016
Winter pressure in accident and emergency departments
This report concludes that the government urgently needs to address the underfunding of adult social care to
relieve pressure on A&E departments. It finds that for major emergency departments in 2015, only 88 per cent of
patients were admitted, transferred or discharged within four hours, short of the 95 per cent standard set by the
government. It also finds that the current level of variation in meeting the four hour waiting time standard is also
due to differences in the way that trusts manage flows within hospitals. (House of Commons, Health Select
Committee, November 2016)
Doctors should nap during night shifts, conference hears
Researchers at a conference on the effect of sleep on fitness to work discussed how sleep
deprivation can affect patient safety and doctors’ training. Abi Rimmer reports junior doctors working
night shifts should be allowed to take regular short naps, says Jim Horne, a sleep neuroscientist and
emeritus professor of psychophysiology at Loughborough University. (BMJ, November 2016)
(Sign in using your Athens ID)
Realising the value: ten actions to put people and communities at the heart of
health and wellbeing
This is the final report of the Realising the value programme, an 18-month programme
funded by NHS England in support of the NHS Five Year Forward View vision to develop
a new relationship with people and communities. The report sets out ten key actions on
what should be done and how people need to work differently to put people and
communities at the heart of health and wellbeing. (NESTA, November 2016
A seat at the table: the views of people living with HIV
The King’s Fund is committed to listening to people with lived experience of our health care system.
We have been reviewing HIV services in England to develop policy and planning recommendations
for the next 5 to 10 years. It is common practice for our reviews to involve a broad range of
stakeholders. It is less common – but no less important – for us to directly involve people with lived
experiences in the design of our research and in influencing how services may need to change.
This article asks three people living with HIV why the experiences of patients should be used to
develop policy and planning recommendations.
The frontline battle: an inquiry into the impact of alcohol on emergency services
The report reveals the full extent of the pressures and dangers that alcohol related problems place on emergency
services. It discusses the impact on staff, the impact on service provisions and the effect on time and resources.
It makes recommendations to reduce the demand on emergency services including greater partnership working,
price limits on alcohol and greater public education on alcohol harm. Press release
Realising the value: ten key actions to put people and communities at the heart of health
and wellbeing
This is the final report of the Realising the Value programme, an 18-month programme funded by NHS England
in support of the NHS five year forward view vision to develop a new relationship with people and communities.
The report sets out ten key actions on what should be done and how people need to work differently to put
people and communities at the heart of health and wellbeing.
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December 2016
Integrated care for older people with frailty: innovative approaches in practice
A joint report from the Royal College of GPs and the British Geriatrics Society showcases
how GPs and geriatricians are collaborating to design and lead innovative schemes to
improve the provision of integrated care for older people with frailty. It highlights 13 case
studies from across the UK, ranging from schemes to help older people remain active
and independent, to those providing better services in the community, to those supporting
patients in hospital. (RCGP & BGS, November 2016) Press Release
Individual care plans reduce falls and broken hips in New Zealand hospitals
New Zealand is believed to be the first country in the world to achieve a national reduction in the
number of in-hospital falls that result in a broken hip, a paper published in the New Zealand Medical
Journal shows. (BMJ, 2016;355:i6490, December 2016) Note: You will need your Athens ID to
access the full article at https://www.ncbi.nlm.nih.gov/pubmed/27906924
Improving staff engagement through the workforce development strategy
This case study from Kettering General Hospitals shares their experiences of how they've
improved their staff engagement levels through the implementation of a workforce
development strategy. The strategy focuses on eight key objectives and is based on
findings from the NHS Staff Survey and is aligned to the trust's wider five year
organisational strategy. (NHS Employers, November 2016)
Improving confidence in conversational English
This case study discusses how Barking, Havering and Redbridge University Hospitals NHS Trust
partnered with Creative English to develop and deliver a learning programme for their international
staff, designed to improve confidence in conversational English. (NHS Employers, November 2016)
Plymouth Hospitals NHS Trust: gaining Workplace Wellbeing Charter accreditation
This case study shares Plymouth Hospitals NHS Trust experience of gaining the Workplace
Wellbeing Charter accreditation. The charter helped the trust identify if their wellbeing offer had any
gaps and also make improvements. It also provided an opportunity to celebrate the success of
initiatives that were working well. (NHS Employers, November 2016)
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© West Suffolk NHS Foundation Trust December 2016. All rights reserved.
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