Category Archives: Drivers

Key questions for the future of STPs and ICSs

What does this mean for libraries? 

This report is only concerned with the current situation regarding sustainability and transformation partnerships (STPs) and integrated care systems (ICSs), and doesn’t make recommendations. However, it shows that 14 of the 44 STPs have already progressed to become ICSs, and 49% of Trusts agree that ICSs should replace STPs, so it shows that the directions of travel is clearly towards ICSs.

MAP has already looked at the implications of ICSs for LKS in a policy briefing on Integrated Care Organisations.

Source: NHS Providers

Link to main document

Date of publication: August 2018

Summary of driver:

Summarises recent developments in system working, including the state of play of STPs and ICSs.

It also sets out the background to the focus on collaborative working, and looks at some of the models that are emerging. There is also a look at what factors make collaboration more successful.

 A useful infographic summarises the state of play of STPs and ICSs.

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Learning from deaths Guidance for NHS trusts on working with bereaved families and carers

What does this mean for libraries?

Library and knowledge services can support staff and members of the public by signposting  to the various reports that informed this document. LKS staff could work with other LKS sectors to signpost to local and national support for bereaved families and carers.

Source: NHS England on behalf of the National Quality Board (NQB).

Link to main document

Date of publication: July 2018 

Summary of driver:

The NHS is committed to creating a learning culture and using patient and public experience to drive improvements. The CQC’s report ‘Learning, Candour and Accountability’ concluded that the way trusts engage with families required significant improvement.

Personal insights and experiences have shaped the guidance and will benefit all those involved following a death. In particular, supporting staff and families after an unexpected, avoidable or traumatic death in NHS care. It has the potential to break down the ‘them and us’ culture that families and carers have experienced.

It is about improving communication and engagement with families and how the NHS learns from its mistakes. It consolidates existing guidance and provides a perspective from family members, who have experienced bereavement within the NHS.

It will help trusts and commissioners to identify where they can make improvements in how they engage with families and carers. It is also a source of information for families and carers so they know what to expect following the loss of their loved one while in a trust’s care.

This information should supplement organisations own information and resources for bereavement support for families and carers.

Guidance breakdown:

  • Guiding principles
  • Family involvement before a death
  • Immediate actions following a death
  • Case note reviews
  • Information and participation in an investigation
  • Access to independent advice, information and advocacy
  • Family and carer participation in trust training
  • Involving families in action planning an assurance processes
  • Action if a family is dissatisfied with an investigation or their involvement

How is the NHS performing? June 2018

A policy briefing is available for LKS staff to share in their organisations.  Produced by the JET Library at Mid Cheshire Hospitals NHS Foundation Trust.  Feel free to reproduce it (with acknowledgement).

What does this mean for libraries? With services under great pressure, there is a greater need for library and knowledge services to support effective and efficient healthcare. As well as making health care provision safer, K4H impact case studies demonstrate that LKS can help make cost savings, and can support health service transformation.

Source: King’s Fund

Link to main document

Date of publication: July 2018

Summary of driver:

This is the 26th quarterly report by the King’s Fund, and as well as looking back at what has happened over the past three months, considers the recently announced funding offer for the NHS.

  • Services remain under substantial pressure – there are 4.2m waiting for consultant-led care
  • There is little optimism that current A&E performance targets can be met
  • Some NHS organisations are spiralling further into deficit while others are seeing their surpluses bolstered by centrally-released funding
  • There are some positive signs of increased joint working between local providers and commissioners of care
  • The recent announcement of a five-year funding offer for the NHS provides an opportunity to make good on previous attempts to deliver out-of-hospital services, including social care
  • By March 2018 2,755 people had been waiting more than a year for treatment – the highest number since 2012/13
  • The time by which 92% of patients are seen after a referral is now 22 weeks; the highest since March 2009
  • GP referrals are growing at a slower rate than before but are still increasing
  • Hospital-bed occupancy is at its highest level for eight years
  • Emergency admissions in May 2018 were 5.6% higher than the year before
  • 44% of CCG finance leads are considering extending waiting lists or reducing activity for certain elective specialties
  • In March 2018 only 9 of 137 Trusts with major A&E departments me the 95% standard
  • The overall 95% standard has not been achieved since July 2015
  • By the end of the 2017/18 financial year the provider sector had a deficit of £960m
  • The commissioning sector had an underspend of £955m due to underspending in central NHS England budgets
  • Nearly two-fifths of CCGs are expecting to overspend their budgets next year
  • 80% of CCGs are considering extending the number of low-value treatments and prescriptions that will no longer be funded
  • 42% of Trust finance directors are expecting to end 2018/19 in deficit
  • 51% of finance directors and 21% of CCG finance leads feel patient care has worsened in their area over the past year
  • However, closer working through STPs and ICSs is starting to pay some dividends
  • Acute Trusts account for 87% of Trusts in deficit
  • The long-term NHS funding settlement, a Green Paper on social-care reform and a 10-year health and care workforce strategy – taken together – might provide the best opportunity in a decade for health and social-care services to both find some stability and use that stability as a base for more fundamental transformation and improvement.

The Topol Review: Preparing the healthcare workforce to deliver the digital future: Interim Report June 2018 – A Call For Evidence

What does this mean for libraries? 

The interim report specifically talks about the need for evidence to support the introduction of new healthcare technologies, and library staff can support the accessing and use of the evidence-base, as well as providing support to healthcare staff that wish to publish evidence.

There will be an increasing demand for knowledge resources on the topics covered by the review, to support the education of new as well as existing healthcare staff.

Some of the technologies are some years away, but there are some such as wearable technologies (for example Fitbits) that are becoming commonplace and there may be an argument for library staff to become familiar with them, or to provide loanable devices so healthcare staff can try them out. Although in most NHS organisations the IT infrastructure is not always conducive to new technologies, where it is, library staff could argue the need to support initiatives such as Skype or other video communications (such as is being done at the Mid-Cheshire Hospitals NHS Trust), or other digital technologies.

At the moment, the interim review is seeking evidence to inform the final review, and once this is published the implications for libraries may become clearer but the overall thrust of the review is that new technologies will become more dominant in the NHS, and there is a case for library staff to be given the support to become more tech-savvy so they can support the wider workforce.

Source: Health Education England (HEE)

Link to main document

Date of publication: June 2018

Summary of driver: This is an interim report of a review commissioned by the Secretary of State for Health and Social Care to look at technological developments and how they impact on the future workforce.

In particular, the review will be looking three themes: genomics, digital medicine, and artificial intelligence (AI) and robotics. These are likely to change the roles of healthcare staff, and the report is concerned with the skills required to use these technologies, and which professions will be most impacted by the changes. It is also concerned with the education and training needs of current and future NHS staff.

The review proposes three key principles to govern the future workforce strategy. Firstly, patients should be empowered to use new technologies to be more actively involved and engaged in their care. Secondly, the introduction of any new technology needs to be supported by robust evidence. Thirdly, new technologies should free up more time for care and enhance the patient-clinician relationship.

Evidence and comments are being sought from those interested in workforce education and development, with a view to informing the Final Report which is planned to be presented in December 2018.

The Government’s Serious Violence Strategy: Policy Briefing

policy briefing is available for LKS staff to share in their organisations.  Produced by the JET Library at Mid Cheshire Hospitals NHS Foundation Trust.  Feel free to reproduce it (with acknowledgement).

What does this mean for libraries? 

Whilst this driver will be implemented at a national level, there are some things libraries can do to support it

  • The opportunity to deliver evidence and knowledge to teams experiencing issues with the impact of serious violence
  • Opportunity to link in with other sectors to raise awareness of the strategy

Source: HM Government

Link to main document 

Date of publication: April 2018

Summary of driver:  This document illustrates the Government’s approach to address the rise in serious violent crime in the UK. It outlines proposals with education, health, social services, housing, youth services and victim support in order to achieve this. The overarching message in this strategy is that tackling serious violence is not a law enforcement issue alone and it requires cross sector working involving a range of partners. In particular, it needs the support of communities thinking about what they can themselves do to help prevent violent crime happening in the first place and how they can support measures to get young people and young adults involved in positive activities.

Making sense of integrated care systems

Title: Making sense of integrated care systems, integrated care partnerships and accountable care organisations in the NHS in England

A policy briefing is available for LKS staff to share in their organisations.  Produced by the JET Library at Mid Cheshire Hospitals NHS Foundation Trust.  Feel free to reproduce it (with acknowledgement).

What does this mean for libraries? 

  • Share this resource with colleagues who are involved in the creation of integrated care systems, integrated care partnerships, accountable care systems and accountable care organisations.
  • There may be an opportunity to deliver evidence and knowledge to managers, commissioners and transformation teams as health care services undergo this change.
  • As organisational boundaries blur and take a ‘whole population’ approach, LKS may be required to adapt their service delivery models accordingly.
  • If healthcare moves away from a competitive structure and towards a collaborative one, there will be many opportunities relating to knowledge management that could support the sharing and dissemination of good practice, innovation and organisational knowledge.
  • LKS will have to consider how the negotiation and procurement of resources needs to adapt to reflect the changes in organisational structures.
  • There is a clear role for technology in supporting the emergence of integrated care systems and Accountable Care Organisations that presents an opportunity for digitally enabled LKS.

Source: King’s Fund

Link to main document 

Date of publication: February 2018

Summary of driver:  Crucially, this document indicates that the first wave of 10 “shadow accountable care systems” being supported by NHS England have been renamed Integrated Care Systems. This name describes more accurately the work being carried out. The long read outlines that integrated care is being tackled differently in different places and a variety of terms are being used. For the purpose of this document, the following are defined as being the main 3 approaches to integrated care:

  • Integrated care systems (ICSs)
  • Integrated care partnerships (ICPs)
  • Accountable care organisations (ACOs)

The document also outlines the new care models, provides an update on the 10 integrated care systems, discusses the controversy around ACOs and privatisation, future developments and concludes by providing support for the approach.

Leading change, adding value

Title: Leading change, adding value: A framework for nursing, midwifery and care staff

What does this mean for libraries? 

There are a number of commitments (page 13) which libraries could hook into and could directly support when delivering services to staff:

Commitment 7 We will lead and drive research to evidence the impact of what we do.
Commitment 8 We will have the right education, training and development to enhance our skills, knowledge and understanding.
Commitment 10 We will champion the use of technology and informatics to improve
practice, address unwarranted variations and enhance outcomes.

Source: Health Education England

Link to main document 

Date of publication: May 2016

Summary of driver:

This framework builds upon Compassion in Practice and outlines how nursing, midwifery and care staff will meet the challenge of delivering the “Triple Aim” of better outcomes, better experiences for people and better use of resources outlined in the Five Year Forward View.

The framework will help to close gaps in health & well-being, care and quality and funding and efficiency. On page 13 of the document, there are 10 aspirational commitments which can be implemented locally at any level.