Investigation into NHS continuing healthcare funding

The National Audit Office has published a report charting the increasing demand for continuing healthcare (CHC), a package of care provided outside of hospital that is arranged and funded solely by the NHS for individuals with significant ongoing healthcare needs.

The report finds that the number of people assessed as eligible for CHC funding has been growing by an average of 6.4% a year over the last four years. In 2015/16, almost 160,000 people received, or were assessed as eligible for, CHC funding at a cost of £3.1 billion.

The High Intensity User Project at North East Essex CCG

North East Essex Clinical Commissioning Group (NEE CCG) has been undertaking an exciting piece of work ‘The High Intensity User (HIU)’ project, looking at frequent users of local health services and empowering those individuals to take ownership of their health and well-being whilst decreasing their dependency upon unscheduled care services.

The HIU Project builds on a previous pilot which considered a cohort of 3 patients. Evaluation of this pilot proved that following intervention, after the creation and initiation of a care plan, all activities for 2 out of 3 patients decreased to zero.

Electronic Palliative Care Co-ordination Systems (EPaCCS) National Data Project

Electronic Palliative Care Co-ordination Systems (EPaCCS) enable the recording and sharing of people’s care preferences and key details about end of life care.

Last year NEoLCIN undertook a study to better understand the impact of EPaCCS nationally, look at geographical variations in EPaCCS data, understand the potential challenges/barriers and opportunities associated with collating EPaCCS data. The study also explored the effectiveness of EPaCCS in achieving people’s preferences for care and supporting the co-ordination of care and advance care planning.

Multimorbidity – the biggest clinical challenge facing the NHS?

In this joint blog, Dawn Moody and David Bramley argue multimorbidity is 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.

The recent publication of the NICE guideline on multimorbidity offers clear direction in this complex area. It uses a tailored approach to put people at the heart of decisions about their care and helps professionals and commissioners to offer their best advice and support.  Here are six practical top tips to help make the most of the guideline in clinical practice:

National Oesophago-Gastric Cancer Audit 2016

This HQIP report aims to give an overall picture of the care provided to patients with OG cancer or oesophageal HGD by NHS services. It provides information on the:

• Management of patients with HGD of the oesophagus
• Routes to diagnosis for OG cancer patients, and their staging investigations
• Treatment planning for OG cancer patients
• Patterns of curative surgery, admissions to intensive care,and short-term outcomes
• Use of radiotherapy in palliative treatment
• Longer term survival after diagnosis with OG cancer.

Sustainability and Transformation Plans: what we know so far

Sustainability and Transformation Plans (STPs) – the 44 regionally specific blueprints for improving health and social care services and finances for the coming five years – are taking shape, and final versions are expected to be submitted in the coming weeks. With this in mind, the Nuffield Trust and the Healthcare Financial Management Association recently held a workshop for STP leaders that was designed to help those involved in STP ‘footprints’ to develop their plans. We have drawn together insights from the workshop, from members of our learning networks for hospital CEOs and CCG accountable officers, and from a series of conversations with other STP leads. We have also reviewed a number of draft plans.

MODEM: modelling outcome and cost impacts of interventions for dementia: Advance Care Planning

Advance care planning involves people thinking and talking about how they would like to be cared for in the future. Anybody can develop an advance care plan. However people usually plan ahead because they have a condition, such as dementia, that means that they may not be able to make their own decisions or clearly communicate their wishes in the future. It is completely voluntary; people do not have to have a discussion or develop a written plan if they do not want to.

Sustainability and transformation plans (STPs) explained

Sustainability and transformation plans (STPs) were announced in the NHS planning guidance published in December 2015. NHS organisations in different parts of the country have been asked to come together to develop ‘place-based plans’ for the future of health and care services in their area. Draft plans were submitted in June 2016, and final plans are expected to be completed in October. 

But what do STPs really mean? And what will they mean for the NHS?

Guidance to support health and social care commissioners in joint market shaping

The Institute of Public Care has developed tools and guidance to help local commissioners understand market shaping.

These include a database of market position statements and general guidance on market shaping.
The guidance was developed at the request of the Department of Health, Local Government Association and the Association of Directors of Adult Social Service, working with the Care Provider Alliance. One of the six resources aimed at health and social care commissioners explores the importance of developing a place-based approach to shaping the care market.

Guidance on anticoagulant care

The interdisciplinary group for stroke prevention in atrial fibrillation (iSPAF), part of the London stroke clinical network, has just published guidance on anticoagulant care, which describes the components of an...

Better care fund: updated operating guidance

NHS England has published updated operating guidance on the better care fund (BCF).
The guidance sets out the legislation underpinning the BCF, the accountability arrangements and funding, the reporting and monitoring requirements for 2016/17, and the role of the BCF support team in supporting delivery.

Raising awareness of end of life care

Case study from Shrewsbury and Telford Hospital NHS Trust on raising awareness if end of life. The Trust recruited an end of life care facilitator who:

• created individual end of life care plans for patients in collaboration with other health services across Shropshire
• delivered training on the plan to 1500 staff
• implemented the swan scheme

Also see NHS Employers end of life care training top tips.

Compassion in Dying launches free website for advance care planning

Compassion in Dying has launched a free website to help people plan ahead for their future treatment and care.  It includes information on living wills, advance decisions and lasting power of attorney.

Government commits to high quality end of life care

The government has made 6 commitments to the public to end variation in end of life care across the health system by 2020. These are:

• honest discussions between care professionals and dying people
• dying people making informed choices about their care
• personalised care plans for all
• the discussion of personalised care plans with care professionals
• the involvement of family and carers in dying people’s care
• a main contact so dying people know who to contact at any time of day

See also Our Commitment to you for end of life care: The Government Response to the Review of Choice in End of Life Care

Evaluation of the Care Assistant Development Programme: Learning from early implementation – SCIE evaluation report for HC-One

HC-One’s Care Assistant Development Programme (CADP) aims to develop senior carers into nursing assistants, trained up to assist with medication and care planning. The Programme enables newly-trained nursing assistants to support registered nurses and improves the quality of care provided to residents.

This report presents the findings from SCIE’s independent evaluation – commissioned by HC-One – of the early implementation of the Programme.