Transforming Urgent and Emergency Care and the Vanguard Initiative: Learning from Evaluation of the Southern Cluster

Urgent and Emergency Care (UEC) vanguards aim to improve the quality, efficiency and effectiveness of UEC services so that patients receive the most appropriate care at the right time and in the right place, and so that unnecessary admissions to accident and emergency (A&E) and hospitals are reduced. The Southern Cluster comprises three such UEC vanguards. RAND Europe's evaluation examined the impacts of the vanguards, the processes underpinning delivery (and associated enablers and challenges), and implications for future policy and practice.

The evaluation used a multi-method approach, including theories of change, document review, workshops, interviews, surveys and data dashboards. Rand's report makes recommendations concerning: (i) UEC health and care workforce capacity-building, (ii) local-national coordination around UEC transformation, (iii) collaboration across localities and professions, (iv) support for an end-to-end UEC pathway with mutually reinforcing activities, (v) cost and outcome data, (vi) an interoperable data infrastructure, and (vii) capacity for evaluation and learning.

Changes to the National Patient Reported Outcomes Measures programme

NHS England undertook a consultation on the national Patient Reported Outcomes Measures (PROMs) programme in 2016. As a result of the findings of that consultation, NHS England has now taken the decision to discontinue the mandatory varicose vein surgery and groin-hernia surgery national PROM collections.

NHS England will continue with hip and knee surgery PROM collections and are working with NHS Digital to make the national data on them easier to use and to provide a range of automated outputs that are tailored to the needs of trusts, CCGs and other users.

Commissioning for Quality and Innovation: Enhanced supportive care data tool

This updated version of the tool, from NHS England, should be used to collect baseline data and return data relevant to each quarter's payment trigger within the Enhanced supportive care (for advanced cancer patients) commissioning for quality and innovation national goal.

Healthcare Informatics

New guidance from the Royal College of Ophthalmologists.

Healthcare involves the collection and generation of huge amounts of information which is subsequently managed, utilised and shared. Healthcare informatics is the science of ensuring that this processing of information is efficient and safe for the benefit of patients. With the current rapid improvements in information technology, it is the duty of healthcare providers to harness this technology to maximise efficiency, safety and quality of patient care, as well as to help drive healthcare innovation.

This document intends to provide a glossary and basic introduction to the multiple facets of healthcare informatics and provides references for further reading.

Changes to cancer waiting times system and dataset

NHS England is planning changes to the cancer waiting times (CWT) system and dataset, which will come into effect from April 2018.

The changes are part of a programme of work to implement the new 28 day faster diagnosis standard by 2020. The CWT system enables CCGs to monitor and manage pathways of care for cancer patients. An information standards notice published on 28 September sets out the forthcoming changes, and an updated guidance document for CWT standards will be published later this year.

Costing newsletter: September 2017

Latest news from NHS Improvement's costing transformation programme. In this edition

• news about cost collections in 2018 - a big step towards a single national cost collection
• the national PLICS portal is ready to launch
• call for volunteers to review the 2018 acute standards and collection guidance
• your chance to have a say on mandating patient-level costing
• your opportunity to be a 2018 'early implementer'

Monitoring e.coli

NHS Improvement has published two resources to help meet the ambition to reduce healthcare associated Gram-negative bloodstream infection by 50% by 2021.

The first is a tool to enable providers and CCGs to understand the number of deaths associated with E. coli bloodstream infections and the savings that can be made if infection rates are reduced.

Using published data from Public Health England on healthcare acquired E.coli infection rates, we've also produced a map to display NHS providers and clinical commissioning groups (CCGs) with the highest and lowest infection rates in 2016/17.

This letter sets out the additional data collection required to help reduce healthcare associated Gram-negative infections. You will now need to submit data on Klebsiella species and Pseudomonas aeruginosa in addition to the E.Coli data..

Workplace health needs assessment

A health needs assessment can be a useful and simple way to gather anonymous information about the health of a company’s workforce, and also provide a baseline of data against which to track progress. This document provides practical advice for employers on workplace health and a tool for carrying out workplace health needs assessments.

New quality of life measure for recovering cancer patients

In a world leading move, quality of life for cancer patients will be tracked as part of ambitious plans by NHS England to radically improve care and support for people once treatment ends.

The new ‘quality of life metric’, which is the first of its kind, will use questionnaires to measure how effective this support is and the data will be made available on My NHS – helping patients, the public, clinicians and health service providers see how well their local after cancer care support is doing.

NHS England will invest in artificial intelligence, says Stevens

NHS England is to invest more in artificial intelligence over the next 12 months and will roll out new regional patient data schemes, chief executive Simon Stevens has said.

To obtain this article please copy and paste the post into an email and send it to libraryw@uhcw.nhs.uk with the subject line, Please obtain this article.

Specialised services quality dashboards

These dashboards are designed to provide assurance on the quality of care by collecting information about outcomes from healthcare providers. The dashboards are a key tool in monitoring the quality of services, enabling comparison between service providers and supporting improvements over time in the outcomes of services commissioned by NHS England.

• Women and children's health
• Trauma care
• Mental health services

Equality and diversity mapping exercise 2017

NHS Employers is working with NHS England to gather information from trusts to:

• understand what the capacity is within NHS organisations to deliver against the various equality and diversity standards and mandates across England
• identify key trends, developments, issues and gaps
• assess how we can better support you to meet your requirements under the Equality Act 2010.

Seven day hospital services: autumn 2017 survey (clinical standard 2 only)

The spring 2017 survey showed that providers are making progress towards meeting all four priority clinical standards for seven day hospital services.

As clinical standard 2 remains the most challenging to implement, for the autumn 2017 survey we'll only measure you on this standard. The data collection will run between 20 September and 18 October 2017 and the submission deadline is midnight, Wednesday 29 November 2017.

Hipsprint reaches 5,000 hip fracture records

Hipsprint, the CSP’s national audit of hip fracture rehabilitation, is designed to provide invaluable insight into the rehabilitation of people after fracturing their hips. It was launched on 1 May and will be running to 31 October. The first phase will remain open for members to enter data on new patients until 31 July.

The research aims to map each patient's rehab journey over a 120-day period. It will now move into the community phase, tracking patients' experiences after leaving hospital.

Collecting outcomes to promote value-based healthcare

This case study describes how the University Hospital of Coventry and Warwickshire NHS Trust (UHCW) has started to collect, measure and use health outcomes for patients receiving prostate cancer care. The project is part of a wider programme of work currently underway in the trust to promote value-based healthcare.

UHCW Research: Rachel Mayman and Catherine Mitchell

Using inherent and elective behavior to improve hand hygiene monitoring in health care

Am J Infect Control. 2017 Jun 16. pii: S0196-6553(17)30288-2. doi: 10.1016/j.ajic.2017.03.032. [Epub ahead of print]

This study established a method for collecting hand hygiene (HH) performance data based on behavioral drivers (inherent or elective) that can be used by infection preventionists (IPs) to improve practice. Further, we explored the influence that task and setting has on HH behavior. A significant effect was found between task and setting that has implications for improving the usefulness of HH measurement, with positive feedback reported regarding the new measurement method.

UHCW Research: Dawson C, Wells F and, Prevc K

New time-saving data collection system

NHS Improvement has developed an innovative, automated data collection system which will save the NHS thousands of hours each year.

The simple system, which works with all NHS applications, places a server on to your systems that automatically “pulls” data from your databases, removing the need for you to export and upload the data manually. All of the winter sit rep data that you'd normally upload manually on a daily basis, will be automatically uploaded to our databases. 

We know the current manual system of uploading the winter sitrep data can take up to 45 mins per day so this new proecss will save you valuable time. Through our Emergency Care Improvement Programme (ECIP), we've already successfully implemented the system in more than 40 trusts.
The system will also be used to populate an emergency care dashboard, giving you deep insight into how patients flow through your emergency department and where there maybe bottlenecks. 

Help us shape the data collection process on cancer waiting times

Implementing the new cancer waiting time standard is a key aim of the cancer improvement programme we're developing with NHS England.

As part of this, NHS Digital's Burden Advice and Assessment Service (BAAS) team is evaluating an application to collect data for this programme.

This consultation seeks views from your operational leads working in and across cancer services on the changes to the dataset and submission process proposed for implementation from April 2018.

Contributing surgeons and centres must validate their cataract audit data on the NOD audit website before 1 June 2017

From the Royal College of Ophthalmologists:

Following the analysis of the first prospective audit data collected on cataract operations from 1 September 2015 to 31 August 2016, contributing surgeons and centres will be able to view their data on the NOD audit website prior to inclusion in the Audit annual report and the Clinical Outcomes Publication.

The NOD team encourages all contributing surgeons and centres to check their data by 1 June 2017, ahead of the report publication. Please inform as many of your colleagues as possible to check their individual data on the NOD audit website.

Resources to support delivery of ‘Reducing the impact of serious infection’ CQUIN

NHS Improvement and Public Health England have developed resources to support providers and commissioners in the delivery of the national ‘Reducing the impact of serious infections (Antimicrobial Resistance and Sepsis)’ CQUIN.

The resources include a series of FAQs, tools for data collections and baseline data, and are available via the NHS Improvement website or on the CQUIN webpage.