Sunday, 25 April 2010

News and opinion in HSJ 15 April

HSJ 15 April issue:

  • Report from NQB on lack of quality information – suggests that organisations review what info is needed for decision-making and improving patient care and stop collecting data that isn’t useful. Data from secondary care tends to be good but very little on community services or primary care. Final version of the report is due in May.
  • Article on reaction to growing talk of the need to close hospitals – quotes recent McKinsey report which included a review of bed occupancy – suggests up to £700m spent on hospital procedures having limited clinical benefit – if patients receive more info on options, likely outcomes and risks, fewer tend to opt for surgery e.g. mastectomies (can drop by half) and prostatectomies (can drop by a quarter) – report also claims that up to 40% of patients in typical hospital at any one time don’t need to be there – due to delays in receiving tests/therapies; lack of more suitable care facilities in community. A Picker Institute study – a trial of shared decision making with pts in gynaecology – led to 40% reduction in treatment costs
  • Tackling foundation trusts and enabling them to fulfil their role as leaders – suggest there is a role for commissioners to “develop into the local driving force of service improvement, challenging providers to be more efficient and effective and to meet the needs of patients in the most clinically effective – and cost effective – way. Commissioners need different ways of assessing the needs of the populations, and effective methods to ensure needs are met and demand is managed. Above all, commissioners need to embrace the concept of being the patient’s friend."

Tuesday, 13 April 2010

Open access - costs and benefits

The April edition of CILIP Update reports on a new JISC report by Key Perspectives on scholarly communications – and finds that open access is likely to cost research-intensive HEIs more. However, the report also lists the benefits of open access to the HE sector: better accessibility of research information, savings from less duplication of research, reduction in plagiarism, facilitation of inter-disciplinary research. The last three of these are dependent on usage of open access publications and reaching a critical mass. The report also talks through scenarios of how open access might develop.

Monday, 12 April 2010

Fair share formula; care closer to home and prevention

Interesting articles in HSJ – 8/4/10:

  • Article on fair share formula for practice budgets – reports new allocation formula for determining target commissioning budget of each GP practice and some speculation that may be applied in 2011-12.
  • Article on moving care closer to home and focusing on prevention by Jennifer Taylor. Virtual wards concept to prevent emergency hospital admissions – uses predictive risk modelling to predict patients at risk of emergency hospital admission within next 12 months. Then given intensive preventive care to reduce risk. NHS East of England delivering care at home using a personal health planning tool, for patients with long term conditions. This allows patients to state what they need and allows pooling of services so care is more systematised – therefore less duplication.

Wednesday, 7 April 2010

RIF projects - West Midlands

West Midlands SHA has announced the recipients of the latest round of the Regional Innovation Fund at : http://www.westmidlands.nhs.uk/Default.aspx?id=337&tabid=139

Would be useful to have links to the project descriptions tho....

Next round opens later this month...

Tuesday, 30 March 2010

Bit of a while since I posted last...

Time to get organised again and get back to regular posting...

Just been reading "Better" by Atul Gawande, recommended by a speaker at the recent IFM Healthcare study day. Gawande is a surgeon and is known for writing about quality and improvement. In this book, he focuses on what he calls "three core requirements for success in medicine":
  • diligence - essentially about identifying and embedding best practice and avoiding errors. He talks through the attempts in various organisations to reduce hospital-acquired infections, including campaigns to promote handwashing. It seems the most successful attempts stemmed from wide-ranging campaigns which involved all staff submitting their ideas, implementation of some of these ideas and a comprehensive comms programme keeping everyone informed of progress. Another example is how more American troops are saved than ever before because the whole system of treating them was reviewed - this resulted in Forward Surgical Teams who are there to provide immediate care - their focus is damage control rather than repair. The next level of care is a Combat Support Hospital designed to care for patients for up to 3 days - any longer and they are transferred home - "the average time from battlefield to arrival in the US is now less than four days".
  • doing right - refers to ethics, dignity and respect. Gawande explores ethical dilemmas around examinations and considers the lack of evidence on issues such as the use of chaperones. "How each interaction is negotiated can determine whether a doctor is trusted, whether a patient is heard, whether the right diagnosis is made, the right treatment given". He also considers the malpractice system and litigation in the US which he points out, doesn't really address the fundamental issues of errors and negligence in a fair way and doesn't encourage dialogue.
  • ingenuity - reflection and innovation. Gawande considers how we measure performance and how we recognise and learn from excellence, using treatment centres for children with cystic fibrosis as an example, showing that some centres achieve an average life expectancy of 46 whereas others only 30.
An interesting read...enough to make me request "Complications" and "The Checklist Manifesto" at the library!

Friday, 7 November 2008

Various bits and pieces

Work has been so incredibly hectic lately that I've been neglecting my reading - have managed to skim-read a few things so am making a note here as I'll forget otherwise...

CILIP Gazette (31 Oct - 13 Nov) has a cover feature ("Digital services 'challenge' HE") which reports on a JISC survey of senior staff and the latest SCONUL stats which show "the proportion of digital journals to printed journals shifting from 25% to 75% in 8 years. Some 45% of all acquisitions expenditure now goes on electronic formats".

HSJ (16 Oct) reports that members of the Long Term Conditions Alliance will merge with a new patient representation body and expected to become part of National Voices, being developed by Chief Exec David Pink.

Strategic Content Alliance (Oct newsletter) reports on the UKRDS interim report (www.ukrds.ac.uk) - it'll be interesting to see how that's taken forward. http://sca.jiscinvolve.org/files/2008/10/sca_news_2008_october-final.pdf

Strategic Content Alliance (Sept newsletter) reports that the UK has "increased its share of published research in the world's most influential scientific journals" from a DIUS report.
http://sca.jiscinvolve.org/files/2008/09/sca_news_2008_september-final.pdf

The SCA Sept newsletter also mentions the emerging W3C POWDER protocol which allows metadata to be associated with multiple resources. "POWDER has been developed to create and use authoritative descriptions that identify online resources that meet specific criteria, such as those published under a specific licence or subject to a given code of conduct or suitable for children". http://www.w3.org/2007/powder/

Saturday, 1 November 2008

e-Health Insider: "New patient e-health 2.0 sites launched"

"Two new websites have been launched featuring a collection of real life health stories and personal experiences of illness and health.

The two sites, Healthtalkonline, and Youthhealthtalk, have replaced DIPEx, a site created by Dr Ann McPherson, an Oxford GP, and Dr Andrew Herxheimer, former editor of the Drug and Therapeutics Bulletin."

http://www.e-health-insider.com/news/4249/new_patient_e-health_2.0_sites_launched