CARE QUALITY COMMISSION

Survey of NHS staff 2009 (17th March 2010)
The Care Quality Commission (CQC) have published the 7th annual survey of NHS staff. it provides trusts with information about the views and experiences of employees that can help to improve the working lives of staff and the quality of care for patients.

The 2009 survey provides 40 key findings about working in the NHS. Of these, 26 show improvements from 2008, two have deteriorated and eight have remained unchanged. A further four key findings are new to the survey in 2009.
Results

Regulating for better care (17th March 2010)
This is the first edition in the CQCs new 'regulating for better care' series.

This series looks at high quality care and improvements in health and social care following action by CQC.

The first edition focuses on improvements made by Ambulance Trusts after infection prevention and control inspections by CQC.
Publication

COMMUNITIES

EVENT - Better together, building healthy communities in hard times (15th March 2010)
The Institute of Community Cohesion (iCoCo) and the Improvement and Development Agency (IDeA) are running an important one-day event aimed at supporting NHS practitioners and partners in promoting community cohesion in the current financial climate. The event, to be held on 19th May 2010, will be chaired by Sir John Egan.

The event will look at:

• tackling health inequalities through building social capital in the downturn
• implementing the Marmot Review (from both a Local Authority and Primary Care Trust perspective)
• building resilience and promoting healthy communities by adopting a lifecycle approach

Information

NHS

General Election - Guidance (11th March 2010)
Two letters have been produced to provide chief executives with information on handling the General Election period, once it starts. It includes links to previous guidance and advice.
Letter for Arms Length Bodies
Letter for NHS Trust AND PCT

The handbook to the NHS Constitution for England (8th March 2010)
This Handbook is designed to give NHS staff and patients all the information they need about the NHS Constitution for England. It outlines the roles we all have to play in protecting and developing the NHS and will help you understand our rights, pledges, values and responsibilities.
Document

Getting the most out of PROMs. Putting health outcomes at the heart of NHS decision-making (11th March 2010)
More than 100 years ago Florence Nightingale suggested a health-related outcome measure for her patients: relieved, unrelieved and dead. Despite the developments in medical technology since then, attempts to measure the positive outcomes of health care have been slow in coming. An important step forward was made in 2009 when the English NHS began collecting patient-reported outcome measures (PROMs) for four elective procedures.

The aim of this report, from the Kings Fund, is to provoke and encourage thinking about the wide range of ways in which PROMs data can be used to inform decisions. It draws on Bupa’s example to discuss how providers can use PROMs data to improve clinical performance. It also offers practical advice for commissioners in using PROMs data to assess value for money and decide how to purchase health care systems.
Report

Rising to the challenge: health priorities for government and the NHS (11th March 2010)
The document sets out what the NHS Confederation see as the major priorities facing the NHS, what they think NHS leaders can do now to help develop the system and enhance patient care, and what a new government will need to do post-election to facilitate this and create the necessary conditions for progress.
Document

The NHS Constitution for England (8th March 2010)
This Constitution establishes the principles and values of the NHS in England. It sets out rights to which patients, public and staff are entitled, and pledges which the NHS is committed to achieve, together with responsibilities which the public, patients and staff owe to one another to ensure that the NHS operates fairly and effectively. All NHS bodies and private and third sector providers supplying NHS services are required by law to take account of this Constitution in their decisions and actions.
Document

Guidance on the attribution of NHS non-commercial Research costs, Support costs and treatment costs (ReSeT Guidance) (15th March 2010)
This document clarifies the distinction between the three categories of costs associated with non-commercial research studies: Research Costs, NHS Support Costs and Treatment Costs. It is supported by two annexes – Annex A provides an exemplar set of common activities that have been attributed to the three specific cost categories and Annex B provides a list of Frequently Asked Questions (FAQs). The first section of the FAQs relates to FAQs that are generic across the United Kingdom and the second section to country specific questions. These Annexes will be updated on a regular basis and users need to ensure that they have the latest version (please refer to individual Health Department websites for their country specific FAQs).
Document

QUALITY

The NHS Quality, Innovation, Productivity and Prevention challenge: an introduction for clinicians (11th March 2010)
This booklet has been published to support clinical teams and NHS organisations to meet the quality and productivity challenge and provides ways in which NHS clinicians can all get involved in shaping the response locally. It is important that clinicians start to discuss with colleagues how to continue to improve the quality of care provided, and do so more efficiently. Clinicians can listen to patients and work closely with managers to make sustainable improvements.
Booklet

FOUNDATION TRUSTS

Northern Governors Events 2010 (23rd February 2010)
The Audit Commission have announced two free seminars in the North of England for foundation trust and aspiring foundation trust governors. The dates are:

• 14th April 2010 - Newcastle
• 27th April 2010 - Warrington

Information

Quality accounts 2 (25th February 2010)

The Foundation Trust Network has launched a publication on the practical elements of producing quality accounts, including engagement and assurance.

Publication

HEALTHCARE

Revision of professional roles and quality improvement. A review of the evidence (26th February 2010)
This report, from the Health Foundation, considers the impact of professional role revision on quality of care and outcomes. It focuses on two types of changes to professional roles:

• Substitution – exchanging one type of professional for another.
• Supplementation – extending the range of service provision within one health delivery system.

This report focuses on the revision of roles between doctors and:

• advanced practice nurses such as nurse practitioners, specialist nurses, clinical nurses and practice nurses
• physician assistants pharmacists
• allied healthcare professionals such as physical therapists (referred to as physiotherapists in this review), speech and language therapists, dietitians and paramedics.

The report finds that there is no detrimental effect of revising or extending the roles of non-medical professionals, and in some cases there is a positive effect on the quality of patient care.
Report

MANAGEMENT

Report of the Advisory Group on assuring the quality of senior NHS managers (24th February 2010)
Following publication of the Next Stage Review report, the Department of Health asked Ian Dalton, Chief Executive of North East Strategic Health Authority, to chair an Advisory Group on Assuring the Quality of Senior NHS Managers.

The Advisory Group’s work to develop proposals to further raise the standards of senior NHS managers was supported by research undertaken by PricewaterhouseCoopers. This was commissioned, following a tendering exercise, to provide an independent evidence base to inform the group’s work.
Report

NHS

Robert Francis Inquiry report into Mid-Staffordshire NHS Foundation Trust (24th February 2010)
Robert Francis QC has today published his Inquiry report into Mid-Staffordshire NHS Foundation Trust. His Inquiry followed concerns about standards of care at the Trust, and an investigation and report published by the Healthcare Commission in March 2009. Robert Francis has heard evidence from patients, their relatives and staff to inform his report and the 18 recommendations he makes. The Department of Health and the Trust Board has accepted the recommendations of the Inquiry in full.
Report and other related documents

Working it out: employment for people with a mental health condition (3rd March 2010)
The link between employment and positive mental health is an issue of great importance for the NHS, both in terms of supporting service users to recover from mental health conditions and for improving staff productivity. Between 10 per cent and 16 per cent of people with a mental health condition, excluding depression, are in employment. However, between 86 and 90 per cent of this group want to work. Meaningful work is integral to recovery.


Employers who take steps to improve the management of mental health at work can help to improve staff productivity and save money. As the NHS enters a challenging period for future funding, reducing the costs of staff sickness absence and driving up productivity are critical. This Briefing outlines the key themes from recently launched government policies in this field and sets out actions for the NHS, as both an employer and service provider.
Briefing

The Heart of the Matter: patient and public engagement in today's NHS (22nd February 2010)

This report says that patient and public engagement (PPE) must become integral to the operation of every NHS organisation.

The heart of the matter: patient and public engagement in today's NHS asks questions about the future of PPE in an ever-changing NHS and sets out:

what good engagement looks like

the legal framework for PPE

the importance of having a culture of engagement

where the NHS has got to on PPE

how Local Involvement Networks (LINKs), membership schemes and working with local government contribute to PPE.

Report

Protecting and Improving the NHS. (22nd February 2010)

This paper sets out the Liberal Democrats commitments to the NHS in three main areas:

• Protecting and improving the NHS
• More control over healthcare
• Quality care for all patients

Paper

Information

The impact of the NHS market. An overview of the literature (1st March 2010)

NHS ‘internal’ or ‘quasi’ market policies in England have aimed to promote competition among providers in the hope of replicating the benefits markets have been known to bring about in the private sector: decreases in cost, and increases in efficiency, quality, innovation, and provider responsiveness. This briefing, from CIVITAS, presents the results of a large-scale literature search on the effectiveness of these policies over the past 20 years.

Document

Free web seminar - Demand and Capacity (3rd March 2010)

Expert on Call is a monthly online seminar which is open to all NHS staff, provided by the NHS Institute for Innovation and Improvement, where leading thinkers in the NHS Institute and beyond share their insights from research or product development via Webex.

The next Expert on Call electronic seminar Mike Davidge, will talk about why variation in both the demand for services and their supply can cause havoc and outline some practical ways of dealing with this, and will be of interest to anyone at any level who is interested or engaged in quality improvement or wants to develop new ways of working which are effective and sustainable.

The seminar will take place on Thursday 18th March 2010.

Information

FINANCE

NHS reference costs 2009/10: collection guidance (17th February 2010)
This document outlines the mandatory requirements for the 2009-2010 reference costs collection. It updates and supersedes previous costing guidance. It should be read in conjunction with the latest version of the NHS costing manual.
Document

NHS Costing Manual 2009-2010 (17th February 2010)
This manual sets out the principles and practice of costing to be applied in the NHS. It is not just designed to support the production of the National Schedule of Reference Costs, and through this, the national tariff, but should also be used in developing and monitoring service and financial frameworks, as well as developments in and the monitoring and implementation of National Service Frameworks.
Manual

LEADERSHIP

National Leadership Council: Resources for Ambassadors (published 7th January 2010 new to website 16th February 2010)
National Leadership Council (NLC) members and associates have an important role as ambassadors for the NLC and for leadership within the NHS. In order to support this role, this toolkit provides the resources to help members and associates communicate the work of the NLC, and to be advocates for 'leadership for a purpose'.
Resources

NHS

Review of the Mary Seacole Scholarship Awards (11th February 2010)
This review provides a robust evaluation which demonstrates that the Mary Seacole Scholarship Awards remains fit for purpose and are achieving its intending goal which are to enhance the development of future leaders in the NHS and improve black and minority ethnic patient experience
Review

Access to health services for military veterans: priority treatment (9th February 2010)

This letter advises of the guidance in place to ensure that military veterans receive priority access to NHS secondary care, for any conditions which are likely to be related to their service subject to the clinical needs of all patients.
Information

Delivering same-sex accommodation: self declaration (8th February 2010)
This letter introduces the declaration process for all providers of NHS funded care. Monitor will be introducing similar reporting requirements for NHS Foundation Trusts. The accompanying information has been developed to help provider organisations to determine their position.
Information

Major trauma care in England (5th England 2010)
There is unacceptable variation in major trauma care in England depending upon where and when people are treated, according to a National Audit Office report published today. Care for patients who have suffered major trauma, for example following a road accident or a fall, has not significantly improved in the last 20 years despite numerous reports identifying poor practice, and services are not being delivered efficiently or effectively.
Report

Learning from the best: what the NHS needs to do to implement high quality care for all (15th February 2010)
A new Health Services Management Centre (HSMC) paper, written in conjunction with the NHS Institute for Innovation and Improvement, sets out how the NHS can learn from high performing health organisations in the delivery of quality. The paper draws on discussions at a two-day seminar which brought together NHS leaders and researchers to explore the evidence from a range of international and UK studies.

Key messages from Chris Ham's paper, include: the need for an integrated approach, with quality as the business strategy; alignment across organisations - the emphasis being whole system thinking and working; and stable and sustainable leadership, which is dispersed throughout organisations and which emphasises strong clinical leadership.
Paper

AUDIT

Annual audit letters 2008/09 (29th January 2010)
The Audit Commission publish annual audit letters to enhance the openness and transparency of the audit process, for which they have overall responsibility. Annual audit letters summarise key matters arising from the yearly audit in clear language for executives and stakeholders.
Audit letters

CARE/CARERS

Integrated care pilots expansion (2nd February 2010)
Following successes in the original 16 ICPs the programme has been expanded to encourage and facilitate the sharing of knowledge amongst a wider range of stakeholders nationally and identify further innovative initiatives. The Department of Health are now inviting sites to send us their completed self-assessment forms in order to join the expanded community. Further guidance on the submission process is detailed within the tool documentation.
Documents

NHS

Clarification of Complaints Regulations 2009 (28th January 2010)
New regulations for handling NHS and adult social care complaints came into effect on 1 April 2009 - however, some local provider websites are still referencing the 2004 regulations. Additionally, clarification has been provided on the legislative position around complaints being handled by PALS, and cases where legal proceedings are being taken.
Document

NHS reference costs 2008-09 (28th January 2010)
These documents provide details of how, and on what, almost £48 billion of NHS expenditure was used in the 2008-09 financial year.

As in previous years, the main purpose is to provide a basis for comparison within (and outside) the NHS between organisations, and down to the level of individual treatments.
Documents

NHS reference costs 2008-2009: Appendix DBRC Organisation Specific Reference Cost Data (28th January 2010)
This page contains the reference costs 2008-09 organisation level data that underpins the national averages. To reduce file sizes these have been zipped and are in csv format, a guidance sheet demonstrating how to upload these files into Microsoft Access is also supplied. This method of publication replaces the data DVD publication used in previous years.
Document

PATIENT EXPERIENCE

Does the experience of staff working in the NHS link to the patient experience of care? An analysis of links between the 2007 acute trust inpatient and NHS staff surveys (2nd February 2010)
This report links the results of the 2007 acute inpatient and staff surveys using a series of statistical analyses intended to highlight the most important relationships between the two surveys.
Report

NHS

The standard NHS contracts for acute hospital, mental health, community and ambulance services and supporting guidance (18th January 2010)
The NHS standard contracts for Mental Health and Learning Disability, Ambulance Services, Acute Hospital and Community Services are published today.

The contracts support the NHS Operating Framework for 20010-2011: The contracts should be read in conjunction with the Principles and Rules for Co-operation and Competition and the PCT Procurement Guide.
Documents

Funding and Performance of Healthcare Systems in the Four Countries of the UK Before and After Devolution (20th January 2010)
Political devolution means there are now four National Health Services in the United Kingdom. The health services of England, Scotland, Wales and Northern Ireland are all funded by the UK taxpayer, but have developed different systems of governance and different methods of providing healthcare.

Funding and Performance of Healthcare Systems in the Four Countries of the UK Before and After Devolution examines the impact of this by studying key performance indicators for the NHS in England, Scotland, Wales and Northern Ireland at three time points – 1996/7, 2002/3 and 2006/7. The report also undertakes a completely new comparison of NHS performance in the English regions and the devolved countries. This is the first time such an analysis has been conducted.
Report

The operating framework for the NHS in England 2010/11 (4th January 2010)
This briefing details the key points of the operating framework, the white paper and the Pre-Budget Report.
Briefing

NHS European Office: policy priorities 2010 (5th January 2010)
The NHS European Office has published its policy priorities for 2010. The work of the European Office covers a wide range of EU policy and legislative proposals of key relevance to the NHS; as a provider and commissioner of healthcare, as an employer and as a business.

This document outlines the main policy areas on which the European Office will be working throughout the calendar year.
Document

The new EU Remedies Directive: proven procurement is of the essence (13th January 2010)
New EU rules which improve access to rapid and effective review procedures for suppliers who allege that public authorities have breached procurement rules have taken effect in the UK.

The EU Remedies Directive amends the UK Public Contract Regulations and will affect all procurement contracts commenced after 20 December 2009.

The NHS European Office have published this briefing to raise awareness amongst NHS managers involved in procurement of the key changes to the rules and to highlight new provisions in the law which public authorities can use to protect themselves from challenge.
Briefing

Controlling public spending: The NHS in a period of tight funding (7th January 2010)
Policy Exchange research, which included a roundtable discussion with a number of senior academics and business leaders with expertise in the NHS, considers some of the options for the NHS in a period of tight funding. They believe that in order to protect the NHS into the future the next Government needs to make bold decisions on:
Performance related pay
Reducing variations in clinical practice
GP fundholding
Decommissioning services
Transformational change project
Report

CARE/CARERS

Training materials for the revised National Framework for NHS Continuing Healthcare and NHS funded Nursing Care (10th December 2009)
These slides have been developed to support local training. Individual groups of slides can be used for training on specific issues. Speaker notes are attached.

The slides are for general advice and training and should not be taken as a full and authoritative statement of the law and policy.
Slides

HEALTH SERVICES

Fracture prevention services: an economic evaluation (15th December 2009)
This economic evaluation models the costs and benefits from establishing a fracture liaison service, to reduce the risk of secondary fractures.
Report

INFECTION CONTROL

The Health and Social Care Act 2008: Code of Practice for health and adult social care on the prevention and control of infections and related guidance (16th December 1998)
The Code of Practice, which comes into force on 1 April 2010 for the NHS and October 2010 for all other registered providers, sets out the criteria against which a registered provider will be assessed by the Care Quality Commission. It also provides guidance on how the provider can meet the registration requirement relating to healthcare associated infections set out in the regulations.
Guidance

MRSA objective for 2010-11 (11th December 2009)
Following a recommendation from the National Quality Board, from April 2010, NHS organisations will be set an objective for reducing MRSA infections, relative to the median, with the best-performers setting their objectives locally.

The MRSA objective reflects a zero tolerance approach to preventable infections and the aim of reducing variation in performance on MRSA bloodstream infections.
Publication

NHS

Directions to NHS bodies concerning the cost of telephone calls 2009 (22nd December 2009)
These Directions came into force on 21st December 2009.
Directions

The NHS operating framework for England for 2010/11 (16th December 2009)
The operating framework for the NHS for 2010/11 sets out the priorities for the NHS for the year ahead to enable them to begin their planning.

For the third year in a row, the national priorities in the operating framework remain the same, providing important stability. The five priorities continue to be:

• improving cleanliness and reducing healthcare associated infections;
• improving access through achievement of the 18-week referral to treatment pledge and improving access (including at evenings and weekends) to GP services;
• keeping adults and children well, improving their health and reducing health inequalities;
• improving patient experience, staff satisfaction, and engagement; and
• preparing to respond in a state of emergency such as an outbreak of pandemic flu, learning from our experience of swine flu.

Framework

NHS 2010-2015: from good to great. Preventative, people-centred, productive (10th December 2009)
Secretary of State Andy Burnham introduces a five-year plan to reshape the NHS to meet the challenge of delivering high quality health care in a tough financial environment. The report describes practical measures to meet the demands of an aging population and the increased prevalence of lifestyle diseases. The vision is for an NHS that is organised around patients whether at home, in a community setting or in hospital. There will be a renewed focus on prevention with the ambition of delivering cost-effective high quality care across the service.
Command Paper

The Human Factor (November 2009)
The National Health Service needs to save £15 billion to £20 billion over the next few years.

This paper argues that these savings could be achieved through radical patient-centred service redesign and more effective approaches to public behaviour change. However, these approaches are difficult to develop within the existing health service.
Paper

Conservative Draft Manifesto 2010. Chapter One: Our reform plan for the NHS (4th January 2009)
The Conservative party have set out their plans for healthcare if they win the election. Some of the main points are:

• NHS providers to become Foundation Trusts
• Patients to be in charge of own health records with ability to choose which providers they share them with
• GPs' to hold patients' budgets and commission are on their behalf
• Link GPs' pay to quality of results they deliver
• Create an independent NHS board to allocate resources to different parts of the country
• Turn the Department of Health into a Department of Public Health
• Provide separate public health funding to local authorities

Document