Leading foot health experts call for an end to avoidable amputations

The College of Podiatry is calling on healthcare commissioners to prioritise diabetic foot care and end avoidable amputations that can have a devastating impact on the lives of patients and their families and cost the NHS millions.

Complications from diabetic foot disease are costing the NHS in England more than a billion pounds a year.

The College of Podiatry has launched an online commissioners’ guide that exposes in detail the comparative rates of amputations across England. It is calling on commissioners to take action and help end the postcode lottery of avoidable amputations.

National Maternity and Perinatal Audit Clinical report 2017

The National Maternity and Perinatal Audit (NMPA) has published a major clinical report that identifies areas of good practice and opportunities for improvement in the care of women and babies in maternity services across Britain.

While the vast majority of women have a safe birth, and despite on-going improvements in the safety of maternity services, findings show that variation exists in a number of clinical processes and outcomes in maternity care. Some of the variation found will be due to differences in data quality, completeness and the risk profile of women being seen in different units.

Eight reasons why we need to think differently about cardiovascular disease in England

Despite significant success in reducing premature mortality from cardiovascular disease (CVD), it remains a major cause of death and disability in England.The British Heart Foundation looks at eight reasons why tackling undiagnosed medical risk factors, improving quality of care and reducing variation can change millions of lives.

A second class ending: Exploring the barriers and championing outstanding end of life care for people who are homeless

There is huge variation in the quality of care that people receive at the end of their life.  This report and the research it draws on make it clear that by working together, healthcare services and the wider system – such as housing, social services and the charity sector – have a vital role to play in improving the quality and co-ordination of care for homeless people as they reach the end of life.

NHS Standard Contract 2017/18 and 2018/19 Technical Guidance

This is the draft version of the NHS Standard Contract 2017-19 Technical Guidance, published to accompany NHS England’s statutory consultation in October 2017.

NHS England has also published for consultation, proposals for in-year National Variations to the NHS Standard Contract 2017/18 and 2018/19 (Full Length) and to the NHS Standard Contract 2017/18 and 2018/19 (Shorter Form). We have also published the associated Technical Guidance in draft form.

Preventing and managing stroke: NHS RightCare Pathway

As part of the ongoing commitment by NHS England to prevent stroke and improve treatment and outcomes, NHS RightCare has published the latest Pathway for Stroke. 

Developed with the Stroke Association, the pathway details interlocking components for an optimal system for prevention and management of stroke and the priority higher value interventions that local health economies should focus on to address variation, improve outcomes, reduce cost and contribute toward a sustainable NHS.      

Exclusive: Variation in surgery standards depending on time of day flagged

National Emergency Laparotomy Audit reveals widespread variation in standards of care for thousands of patients

Patients operated on at night and after midnight had higher chance of death than those treated during the day

Almost a quarter of hospitals missing key targets to get patients to operating theatres within two hours.

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

New liver disease atlas shows major variation across England

New data published by Public Health England (PHE) shows a wide variation of premature mortality rates from liver disease across England.

The atlas shows premature mortality rates – dying before the age of 75 – ranged from 3.9 per 100,000 in South Norfolk clinical commissioning group (CCG) to 30.1 per 100,000 in Blackpool CCG, a 7.7 fold difference.

The atlas paints a mixed picture, with 10 indicators showing improvements including a reduction of premature deaths and fewer alcohol-specific hospital admissions for under 18s. Nine of the indicators have become worse over time, including a doubling of hospital admission rates for cirrhosis from 54.8 per 100,000 to 108.4 per 100,000 people over the past decade.

NHS standard contract: guidance on the variations process (full-length and shorter-form contracts)

This document from NHS England contains guidance on the process to effect variations to a commissioning contract in the form of the NHS standard contract (full length or shorter-form) and is relevant to all commissioners and providers who are parties to an NHS standard contract.

The north-south NHS divide: how where you are not what you need dictates your care

This report, from the Medical Technology Group, outlines the findings of an examination of data from 209 CCGs to assess patient access to medical technology. It finds wide variation in access between the north and south of England and argues that CCG performance against access indicators should be made clearer to patients.

GIRFT: national general surgery report

The report found that reducing unwarranted variations between hospitals in areas such as effective procedures, length of stay, infection rates and procurement costs will improve patient outcomes and help the NHS save £160 million in efficiencies each year.

Diabetes pathway

This diabetes pathway from NHS RightCare defines the core components of an optimal diabetes service for people with or at risk of developing Type 1 and Type 2 diabetes that delivers the better value in terms of outcomes and cost.

The pathway shows the core components of an optimal diabetes service, evidence of the opportunity to reduce variation and improve outcomes and the key evidence-based interventions which the system should focus on for greatest improvement, supported by practice examples from across the NHS.

Tackling variations in clinical care: Assessing the Getting It Right First Time (GIRFT) programme

The Getting It Right First Time (GIRFT) programme from the King's Fund aims to bring about higher-quality care in hospitals, at lower cost, by reducing unwanted variations in services and practices.

It uses national data to identify the variations and outcomes, shares that data with all those concerned with a service – not only clinicians, but also clinical and medical directors, managers and chief executives – and monitors the changes that are implemented.

The programme began with orthopaedics and is now being rolled out to 32 different surgical and medical specialisms across the English NHS. Through an informal assessment of the programme, this paper sets out what the programme is, why it is needed, what is different about it, what it has achieved, what challenges it faces and what potential it has. It also contains vignettes illustrating hospitals’ experiences of the programme.

The State of Care in NHS Acute Hospitals: 2014 to 2016

This report outlines the findings from CQC's first round of acute and specialist hospital trust inspects. It shows variation in the quality of hospital services but also highlights those hospital trusts that have been able to make practical changes to the way they deliver care and are seeing improvements to patient care as a result. The analysis shows variation both in the quality of care between hospitals and between individual core services within the same hospital.

See the Health Foundation's and the Patients' Association's Responses.

The shift to value-based healthcare

NHS England has published NHS Rightcare and the shift to value-based health. 

This Board Paper summarises NHS RightCare's approach to delivering value-based population healthcare in England, by: explaining the principles behind NHS RightCare's aim of increasing value, reducing unwarranted variation and delivering better population healthcare; detailing how NHS RightCare is addressing the challenges related to better value; and updating on the accelerated roll out across the NHS in England

National Diabetes Audit – 2015-2016: Report 1, Care Processes and Treatment Targets

The National Diabetes Audit 2015-16, published by NHS Digital in partnership with Diabetes UK, found that the percentage of patients with Type 1 diabetes achieving NICE-recommended treatment targets for glucose control, blood pressure and cholesterol varied from 11 per cent in some CCGs/LHBs to 34 per cent in others.

The 2nd Atlas of Variation in NHS Diagnostic Services in England

The 2017 diagnostics themed atlas has been published by Public Health England.  It covers imaging, screening, physiological diagnostics, and endocopy

Commissioning for Value STP packs

These packs published by RightCare contain data from the CCG Commissioning for Value Where to Look packs, published in October 2016, but collated at Sustainability and Transformation Plan (STP) footprint level. The information in these packs include headline opportunities, improvement opportunity tables and pathways on a page showing how CCGs in each STP differ from their peers.

New mesothelioma lung cancer data shows increase in 1 year survival despite regional variation in treatment

The second mesothelioma report, launched by RCP London, demonstrates improvement in the number of people diagnosed with malignant pleural mesothelioma (MPM) surviving for more than 1 year*.

Despite this improvement, overall survival rates still remain poor, with only 43% of patients still alive at one year from initial diagnosis. The report uses data from over 2,000 patients diagnosed with MPM in England during 2014, the largest dataset for mesothelioma in the UK.

Survey finds early physio for cardiac surgery patients varies across UK

A UK-wide survey of physios working at cardiothoracic centres has revealed wide variations in rehabilitation for cardiac patients following surgery.