New national data opt-out

A new national data opt-out will be introduced from March 2018 to give patients a clear choice on how their personally identifiable data is used for purposes beyond their individual care, as detailed in the government’s response to the national data guardian.

NHS Digital is developing the system now along with a suite of communications products for the workforce and patients to test.  

NHS targets super-sized chocolate bars in battle against obesity, diabetes and tooth-decay

Hospitals have been ordered to take super-size chocolate bars and “grab bags” of sugary snacks off the shelves in the latest step of the NHS plan to fight obesity, diabetes and tooth-decay.

NHS England chief executive Simon Stevens has announced a 250 calorie limit on confectionery sold in hospital canteens, stores, vending machines and other outlets.

Hospital chiefs will have to ensure that four out of five items purchased on their premises do not bust the limit, which is an eighth of a woman’s and a tenth of a man’s recommended daily intake, or lose out on funding ring-fenced for improving the health of staff, patients and their visitors.

Unhealthy sandwiches and drinks are also being targeted as the NHS, Europe’s largest employer, takes a lead in tackling the availability of unhealthy food and drinks that are fuelling an obesity crisis.

Choice in end of life care: government progress

How the National End of Life Care Programme Board is delivering personalisation and choice in care for people at or near the end of life.

One year on: the Government response to the review of choice in end of life care

This DH report sets out how the National End of Life Care Programme Board is delivering personalisation and choice in care for people at or near the end of life.

Digital leadership in London's NHS

For the first time, NHS providers in London have revealed the extent to which smartphones, the Internet and Bluetooth are improving patient care and look set to save the capital’s NHS millions each year.Guy’s and St Thomas’ NHS Foundation Trust expects to save £2.5 million each year by reducing missed appointments through an app called DrDoctor which gives patients much more say in selecting a date and time of their choice, resulting in “no show” rates falling by 40%.

Introducing self-catering to empower service users

The Woodberry Ward in East London NHS Foundation Trust, has introduced self-catering in response to complaints regarding the taste, quality and nutritional value of the food provided.

Alison O’Reilly, Senior Occupational Therapist and her team were behind the QI project. They researched how other trusts were providing self-catering services, and applied Plan Do Study Act (PDSA) cycles to make the changes. The project has allowed service users to live with more autonomy and the satisfaction rates of meals and the ward environment have also improved.

The hospital as a multi-product firm: the effect of hospital competition on value-added indicators of clinical quality

This paper from the Centre for Economic Performance examines the impact of the introduction of patient choice in elective surgical procedures on patient reported outcome measures (PROMs). It finds that by introducing competition via the mechanism of patient choice, there may have been a negative effect of clinical quality.

Maternity choice and personalisation pioneers

This updated set of FAQs provides guidance and information on the pioneers who are testing ways of improving choice and personalisation for women accessing maternity services.

RCM publishes new guidance for members and managers on women’s choice of midwife

The Royal College of Midwives (RCM) has published new guidance, Facilitating women’s choice of midwife: Practical approaches to managing with flexibility, to help midwives and their mangers to better meet the needs of responding to women’s wishes for a specific midwife to be present at their birth.

RCS responds to CCGs' plans to ration hip and knee surgery using Oxford score

Redditch and Bromsgrove, South Worcestershire, and Wyre Forest CCGs are planning to decrease the eligibility threshold for patients requiring hip and knee replacements. The CCGs are using a scoring system, the Oxford score, designed to assess patients’ illness to reduce hip operations by 12 per cent and knee replacements by 19 per cent. They suggest the restriction could lead to 353 fewer surgeries and savings of up to £2.1m a year.

Delivering high value health care

The King’s Fund has published the presentations from a conference held on 10 January 2017 on Delivering high value health care.

• International evidence and experience on reducing wasteful spending on health care
• Tackling overuse and underuse of health care services
• Right Care
• Stories from the hospital setting: KT framework to minimise opportunity loss
• Improving safety and reducing harm and error
• Patient safety improvement
• Helping patients choose wisely
• Five Year Forward View: a new relationship with patients

Market structure, patient choice and hospital quality for elective patients

This research from the Centre for Health Economics examines the change in the effect of market structure on hospital quality for elective procedures (hip and knee replacements, and coronary artery bypass grafts) following the 2006 loosening of restrictions on patient choice of hospital in England.

Choice in the Presence of Experts: The Role of General Practitioners in Patients' Hospital Care

This paper from the Institute for Fiscal Studies (IFS) 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 ameneties 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.

Treatments of low clinical value

As part of the “choosing wisely” campaign, the Academy of Medical Royal Colleges listed 40 treatments and procedures that have limited clinical value or impact.

The campaign calls for doctors and patients to have a fully informed conversation about the risks and benefits of treatments and procedures.

Discordance between patients' stated values and treatment preferences for end-of-life care: results of a multicentre survey

Background: Medical orders for the use of life-supports should be informed by patients' values and treatment preferences. The purpose of this study was to explore the internal consistency of patients' (or their family members') stated values, and the relationship between these values and expressed preferences. 

Conclusions: Decision-making regarding medical treatments at the EOL is inadequate. To reduce decisional conflict, patients and their families need more support to clarify their values and ensure that their preferences are grounded in adequate understanding of their illness and treatment options.

BMJ Support Palliat Care bmjspcare-2015-001056. Published Online First: 6 October 2016 

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Choice in end of life care: government response

This report details the 6 commitments that the government has made to the public to end variation in end of life care across the health system by 2020.

NHS e-Referral Service saves £10million in first year

The NHS e-Referral Service has saved the NHS £10million in its first year of operation, following redevelopment by NHS Digital.

The savings have mostly been achieved as a result of the service being built in-house by NHS Digital, in collaboration with software specialists BJSS. This has led to a 60% reduction in running costs compared to the Choose and Book system, which the NHS e-Referral Service replaced in June 2015.

Patient choice: support for CCGs

NHS England and NHS Improvement have co-developed a CCG choice, planning and improvement guide to assess how well choice is working in the services they commission.

The guide can be found here...

The Hospital At Home Model: Bringing Hospital-Level Care To The Patient

The Commonwealth Fund -
This case study is one in an ongoing series examining programmes that aim to improve outcomes and reduce the cost of care for patients with complex needs, who account for a large share of U.S. health care spending. This case study looks at an initiative that offers patients the option of receiving hospital-level care at home rather than in-hospital.

New National Commissioning Framework for Hearing Loss Services launched

A new guide to help organisations responsible for planning and commissioning local hearing services for deaf people and those with diminishing hearing is launched by NHS England.

The Commissioning Services for People with Hearing Loss – a Framework for Clinical Commissioning Groups establishes what effective commissioning looks like for CCGs by:

• Ensuring CCGS are supported when choosing good value services for their local populations
• The needs of local people are met by high quality integrated care
• Addressing access and outcome inequalities
• Improving patient choice when it comes to selecting services
• Contracting and monitoring outcomes and referrals from all providers to ensure consistency