Category Archives: Policy Briefing

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.
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Leadership in today’s NHS: delivering the impossible

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? 

Opportunity to support the increasing demand for knowledge resources related to sustainable leadership.

Source: King’s Fund

Link to main document 

Date of publication: July 2018

Summary of driver:

This report is based on a survey of NHS trusts and foundation trusts carried out by NHS Providers in 2017. Consisting of qualitative interviews and a roundtable event with frontline leaders and national stakeholders, the survey showed that leadership vacancies are widespread and that a culture of blaming individuals for failure is making leadership roles less attractive. The report also highlights the widespread challenges in meeting financial and performance targets as demands on services continue to increase. The challenges facing leaders of NHS trusts have changed and there is now a greater emphasis placed on working collaboratively as part of more integrated health and care systems.

 

The NHS 10-year plan: how should the extra funding be spent?

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?

Whilst only suggestions from the King’s Fund, some of the points made are aims that have been stated before, and if implemented would have implications for LKS.

The integration of health and social care may mean new groups of staff to support, especially around social care staff who have not traditionally been served by NHS libraries. Whilst it make take many years to fully integrate health and social care, in some areas, the introduction of Integrated Care Organisations and Accountable Care Organisations may mean this happens much faster.

The suggested expansion of new roles such as physician and nurse associates may mean more staff undertaking courses whilst working, and nurse associates in particular may need more support for their learning locally. A re-balancing of staff towards primary and community care has implications for the way LKS support remote users that may find it difficult to access LKS in person.

The King’s Fund suggests more capacity among local leaders and less reliance on external regulators. LKS already support leadership education and development, but this may become more important in the future.

Various ways of tackling waste are mentioned, such as reducing the use of procedures of limited value, and tackling variations in practice. LKS are ideally placed to ensure that the evidence base of healthcare is used to provide consistent and effective care.

Source: King’s Fund

Link to main document

Date of publication: July 2018

Summary of driver:

The King’s Fund has outlined the priorities it believes should be at the heart of the NHS plan that the Government has asked the NHS to create, to show how it will use the extra funding it recently announced will be spent.

  • The centrepiece of the new plan should be a commitment to bring about measurable improvements in population health and to reduce health inequalities
  • This depends on making further progress in integrating health and social care
  • There should be a focus on: older people with frailty, people with complex needs and children
  • Reforming the NHS from within needs much more emphasis, drawing on the intrinsic motivation of staff. This depends on building capability among leaders and staff as less reliance is placed on external interventions from regulators
  • The Government must increase funding for the social care and public-health services provided and commissioned by local authorities
  • The NHS and Government must work together to produce a comprehensive workforce plan and bring forward proposals to make social-care funding sustainable
  • The Government’s new funding translates to an average annual increase of 3.4%
  • Productivity in the NHS has grown by around 1.4% a year since 2009 and the Government wants this kept up for the next five years
  • The OECD estimates that about a fifth of spending on health care makes no or minimal contribution to health outcomes this includes:
    • Adverse events
    • People who are in hospital because no appropriate alternatives are available
    • Administrative costs
  • Ways of tackling waste include:
    • More generic prescribing
    • Tackling variations in practice
    • Reducing overuse of antibiotics and procedures of limited value
    • Reducing the transaction costs of the internal market
    • Reducing the number of national bodes
    • Reduce over-reliance on inspection and regulation
  • There should be more use of social prescribing for things such as volunteering, arts activities, cookery, gardening etc
  • Alternative solutions to those offered by the public sector are needed – these could come from charities
  • The aim should be to work towards a single health and social-care system – a move to free personal care would cost an additional £14bn by 2030/31
  • There is a need to train, retain and retrain staff
  • Physician and nursing associate roles should be expanded and more use made of apprentices
  • The workforce should be re-balanced to more primary and community staff
  • Integrated care systems (ICSs) should be established in law as NHS bodies held to account on goals for improving population health
  • Peer-to-peer connections should be enabled through learning networks, improvement collaboratives and communities of practice

Reducing Emergency Admissions – House of Commons Public Accounts Committee

Optional wording for policy briefings ONLY: 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? 

Whilst this document will be implemented at a national level, there are some things libraries can do to support it including, providing evidence and knowledge around the main themes of reducing emergency admissions/data collection.

Link to main document 

Date of publication: May 2018

Summary of driver:

Emergency admissions to hospitals continue to rise, despite the NHS’s efforts to reduce them. Statistics show that nearly 1.5 million people could have avoided emergency admissions in 2016–17 if hospitals, GPs, community services and social care had worked together more effectively.

Although NHS England and partners are making some progress in reducing the impact of emergency admissions for patients and hospitals, work still needs to be done around the impact on reducing the numbers of admissions that could have been avoided. Improved data collection would make  NHS England aware if its efforts to reduce emergency admissions are helping or potentially harming patients.

The document concludes that NHS England needs to deliver on its five-year plan to move care into the community and out of hospitals.

 

Innovative Models of General Practice

Optional wording for policy briefings: 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? 

This report would be of interest to library staff supporting General Practice, Community Services and Clinical Commissioning Groups. Library staff may be involved in:

  • Providing evidence to enable service and quality improvement.
  • Negotiating access to resources and services if practices merge or grow in size.
  • Conversations about how care is provided, facilitating access to evidence to underpin these discussions.
  • Ensuring equitable access to high quality resources exploiting collaborative purchasing opportunities as available.

Source: King’s Fund

Link to main document 

Date of publication: June 2018

Summary of driver:

The paper considers innovative models of general practice being delivered in  the UK and internationally:

  • Team-based working;
  • Digital innovations;
  • Community-centred approaches;
  • Segmentation;
  • New roles in general practice;
  • Whole-system redesign.

Case studies and lessons learnt are provided for each model. The report suggests that the following features will be important for future designs:

  • Building and maintaining strong relationships;
  • A shift from reactive to proactive care;
  • Using technology;
  • General practice working within a wider health system;
  • Supporting general practice to change.

The report concludes by making recommendations to general practice, system leaders and commissioners and policy makers.

A Fork in the Road: next steps for social-care funding reform

Optional wording for policy briefings ONLY: 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? 

This report would be of interest to library staff supporting social care organisations. It discusses a range of approaches to reforming funding for social care. Library staff who are providing services for social care providers should share this resource.

Source: King’s Fund

Link to main document 

Date of publication: May 2018

Summary of driver:

This paper outlines a number of options for the potential reform of funding for social care. It does not make recommendations, but considers each option provided, discussing the advantages and disadvantages of each and comparing them to each other. The models considered are:

  • Maintaining the current system (at 2015/16 levels) and keeping pace with projected demand pressures until 2030/31;
  • Restoring the quality and access that existed in 2009/10;
  • A ‘cap and floor’ model, similar to the Conservative Party proposals at the 2017 general election;
  • Free personal care (FPC), similar to the model in Scotland.

 

Spending on and Availability of Health Care Resources: Policy Briefing

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 health care spending at lower levels than other countries, it is imperative that the best use is made of resources, and library and knowledge services should have a key role in ensuring health care practice and commissioning is evidence-based and effective.

Unfortunately, the potential understaffing identified in this report may make it more difficult for health care staff to always make effective use of the evidence base. Library and knowledge staff can support this by providing value-added and time-saving services such as evidence searches, current awareness alerts, point of care tools and more.

Source: King’s Fund

Link to main document

Date of publication: May 2018

Summary of driver:

  • The King’s Fund compared health spending in the UK to other OECD countries (excluding the U.S.)
  • The UK has 2.8 doctors per 1,000 population – below the OECD average of 3.6
  • The UK has 7.9 nurses per 1,000 population – also fewer than average. Germany has 13.3 and Switzerland 18
  • The UK has 2.6 beds per 1,000 population compared to an average of 4.4. This is similar to Canada and New Zealand but far below Germany and Austria
  • The UK has fewer residential beds for long-term care than average. We are just ahead of Spain and just behind Canada. The Netherlands and Switzerland have the most
  • We have the fewest CT scanners per 1,000,000 population. Australia and Denmark are top
  • We also have the fewest MRI scanners per 1,000,000 population
  • Spending on drugs – outside drugs in hospital – makes up about a sixth of spending
  • We spend £500 per person per year – below the average amount but this might be due to more efficient purchasing
  • Some companies finance their health service via taxation – the Beveridge model. These include the UK, Australia, Canada and New Zealand
  • Others have compulsory health insurance, the Bismarck model e.g. Germany and France
  • Since 2008 most countries have tried to contain health expenditure to some extent
  • Social care spending is now included in our health spending meaning the spending as a percentage of GDP has gone up from 8.7% to 9.8%
  • This is about average. Germany, France and Sweden spend about 11%
  • There are around 100,000 vacancies for clinical staff in the English NHS
  • Nearly half of nurses do not think there are enough staff to let them do their job properly
  • The UK is one of the best systems in the world at using cheaper, generic medicines
  • Thanks to more efficient use the number of hospital beds has halved in the last 30 years
  • BUT more than 90% of hospital beds are now occupied, higher than the recommended 85% level
  • Budgets for adult social care fell by 8% in real terms between 2009/10 and 2015/16