NHS Outcomes Framework Research Articles

The community rehabilitation response to COVID-19: innovative service delivery in community rehabilitation teams

International Journal of Therapy and RehabilitationVol. 27, No. 8 EditorialThe community rehabilitation response to COVID-19: innovative service delivery in community rehabilitation teamsNicole Lavin, Elizabeth FarrarNicole LavinCorresponding author: Nicole Lavin; E-mail Address: [email protected]University of Bradford, Bradford, UKSearch for more papers by this author, Elizabeth FarrarLiz Farrar Physiotherapy, Halifax, UKSearch for more papers by this authorNicole Lavin; Elizabeth FarrarPublished Online:1 Sep 2020https://doi.org/10.12968/ijtr.2020.0096AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Attend Anywhere. Our work. 2020. https://www.attendanywhere.com/our-work.html (accessed 17 August 2020) Google ScholarChartered Society of Physiotherapy. Rehabilitation and COVID-19. CSP policy statement. 2020a. hhttps://tinyurl.com/y4gq4m44 (accessed 17 August 2020) Google ScholarChartered Society of Physiotherapy. Community rehabilitation: live well for longer. 2020b. https://tinyurl.com/y3sdzg3v (accessed 17 August 2020) Google ScholarDepartment of Health and Social Care. Equity and excellence: liberating the NHS. 2010. https://www.gov.uk/government/publications/liberating-the-nhs-white-paper (accessed 17 August 2020) Google ScholarDepartment of Health and Social Care. NHS Outcomes Framework. Domain 2: health-related quality of life for people with long-term conditions. 2017. https://tinyurl.com/y4g8f3hh (accessed 17 August 2020) Google ScholarGreenhalgh T, Wherton J, Shaw S, Morrison C. Video Consultations for Covid-19. BMJ. 2020;368:m998. https://doi.org/10.1136/bmj.m998 Crossref, Google ScholarJackson M, Jones D, Dyson J, Macleod U. Facilitated group work for people with long-term conditions: a systematic review of benefits from studies of group-work interventions. Br J Gen Pract. 2019;69(682):e363–e372. https://doi.org/10.3399/bjgp19X702233 Crossref, Google ScholarLahelle AF, Oberg GK, Normann B. Group Dynamics in a group-based, individualised physiotherapy intervention for people with multiple sclerosis: a qualitative study. Physiother Res Int. 2020;25(3):e1829. https://doi.org/10.1002/pri.1829 Crossref, Google ScholarNHS England. Universal personalised care: implementing the comprehensive model. 2019a. https://tinyurl.com/yxg6outw (accessed 17 August 2020) Google ScholarNHS England. The NHS Long Term Plan. 2019b. https://www.longtermplan.nhs.uk/wp-content/uploads/2019/08/nhs-long-term-plan-version-1.2.pdf (accessed 17 August 2020) Google ScholarNHS England. After-care needs of inpatients recovering from COVID-19. 2020. https://www.england.nhs.uk/coronavirus/publication/after-care-needs-of-inpatients-recovering-from-covid-19/ (accessed 17 August 2020) Google ScholarPhillips M, Turner-Stokes L, Wade D, Walton K. Rehabilitation in the wake of COVID-19 – a phoenix from the ashes. 2020. www.bsrm.org.uk/downloads/covid-19bsrmissue1-published-27-4-2020.pdf (accessed 17 August 2020) Google ScholarSchuster R, Sigl S, Berger T, Laireiter A. Patients' experiences of web- and mobile-assisted group therapy for depression and implications of the group setting: qualitative follow-up study. JMIR Ment Health 2018;5(3):e49. https://doi.org/10.2196/mental.9613 Crossref, Google ScholarScriven H, Doherty DP, Ward EC. Evaluation of a multisite telehealth group model for persistent pain management for rural/remote participants. Rural Remote Health. 2019;19(1):4710. https://doi.org/10.22605/RRH4710 Google Scholar FiguresReferencesRelatedDetailsCited byExploring the delivery of community rehabilitation services for older people in an urban Canadian setting: Perspectives of service providers, managers and health system administrators30 November 2021 | Health & Social Care in the Community, Vol. 30, No. 5Getting infected with SARS-CoV-2Massimiliano Polastri28 February 2022 | International Journal of Therapy and Rehabilitation, Vol. 29, No. 2 2 August 2020Volume 27Issue 8ISSN (online): 1759-779X Metrics History Published online 1 September 2020 Published in print 2 August 2020 Information© MA Healthcare LimitedPDF download

Admiral Nursing: case management for families affected by dementia

The numbers of people with dementia are set to increase, however, people with dementia do not live in isolation and any intervention is required to support their family carers also Newbronner et al. 2013. Dementia UK offers specialist one-to-one support and expert advice in the form of Admiral Nursing AN, first piloted in 1991 and are the only group of qualified nurses in the UK who focus on working with families affected by dementia. Once a diagnosis of dementia has been made, interventions structured around a family-centred approach provide a framework to help unite families, whilst still recognising individual values. This type of collective approach can help reduce conflict and improve relationships within the family. AN has evolved from delivering an intervention specifically aimed at supporting family carers to one that supports the whole family through a case management approach Harrison Dening et al. 2017. Case management has a long and successful history in supporting people with long term conditions and people with a diagnosis of severe mental illness Challis et al. 2010. Case management is a relatively new concept in dementia with early UK research being inconclusive Iliffe et al. 2014, however, it is proving to be a successful model in Holland Van Mierlo et al. 2014: MacNeil Vroomen et al. 2016. The evidence base for AN, as with the majority of specialist nursing roles, is scant. So it became a priority of Dementia UK to develop the evidence base for AN whilst also supporting the nurses to develop the skills, tools, time and impetus to collect data about their service activity and outcomes which could build the evidence base for the model. Commissioners and employers need data that is relevant to their expected outcomes and, as the AN community grows, it is increasingly important to collect data consistently in order to identify and promote effective AN models. Whilst current evaluation methodology may focus on undergraduate and postgraduate nursing course curriculum; a wider appreciation of the importance of evaluation in practice is required Moule et al, 2016. This paper will present results of a service evaluation project; Getting Evidence into Admiral Nursing Services GEANS, a mixed methods approach to demonstrate the evidence for the AN case management approach in supporting families affected by dementia. GEANS is a national programme, funded by Dementia UK aimed to support a cohort of AN teams to evaluate their services and to demonstrate the outcomes and impact on families affected by dementia. GEANS is a co-produced evaluation framework and defines outcomes for Admiral Nursing with families and in supporting best practice in other professionals. Outcomes reflect the domains of the NHS Outcomes Framework for England and the Adult Social Care Outcomes Framework. Three themes focus data collection; 1. Improved quality of life for carers and people with dementia. 2. Positive experience for families of AN Services 3. Cost efficiencies in health and social care costs. The paper will be supported through presentation of a local service case study from the Midlands, United Kingdom.

Improving care and services: nurse-led echo valve clinics

British Journal of Cardiac NursingVol. 13, No. 8 CommentImproving care and services: nurse-led echo valve clinicsMaureen GardnerMaureen GardnerSearch for more papers by this authorMaureen GardnerPublished Online:2 Aug 2018https://doi.org/10.12968/bjca.2018.13.8.407AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References British Cardiovascular Society. Guidance on appropriate workload for consultant cardiologists. https://tinyurl.com/yb8l2zad (accessed 26 July 2018) Google ScholarBritish Heart Foundation. CVD Statistics—BHF UK Factsheet. London: BHF; 2018. Google ScholarChambers JB, Lloyd G, Rimington HM et al.. Multi-disciplinary valve clinics with devolved surveillance: a two-year audit. Br J Cardiol. 2011;18:231–232. https://doi.org/https://doi.org/10.5837/bjc.2011.004 Crossref, Google ScholarNHS Digital. Hospital Episode Statistics for England. Outpatient statistics, 2015–2016. London: NHS Digital; 2016. Google ScholarNHS Digital. NHS Outcomes Framework 2017/18 Indicator and Domain Summary Table. London: NHS Digital; 2017. Google ScholarThe Health and Social Care Information Centre. HES Analysis: Main specialty by attendance type. London: The Health and Social Care Information Centre; 2011. Google ScholarRoyal College of Physicians. 2014–15 census (UK consultants and higher specialty trainees). 2016. https://tinyurl.com/y7w5x4cn (accessed 26 July 2018) Google Scholar FiguresReferencesRelatedDetails 2 August 2018Volume 13Issue 8ISSN (online): 2052-2207 Metrics History Published online 2 August 2018 Published in print 2 August 2018 Information© MA Healthcare LimitedPDF download

The use of a validated pre-discharge questionnaire to improve the quality of patient experience of orthopaedic care

Patient experience is central to the delivery of excellent healthcare. As such it is enshrined within the 2015 NHS outcomes framework, a set of indicators against which quality in healthcare...

The effects of the NHS reforms on quality of care

The Health and Social Care Act 2012 (HSCA2012) has altered the operational and business environment in which NHS trusts in England operate. The Shelford group is one of the leading multi-specialty NHS trusts in England. The aim of this study was to assess the impact of HSCA2012 on the quality of care provided by the group. Annual quality of accounts produced by each of the Shelford group trusts for financial years (FYs) 2012–13, 2013–14 and FY 2014-15 were reviewed. The key performance indicators (KPIs) for each organisation were collected and classified in line with NHS Quality and Outcomes Framework (QOF). KPIs for the period just prior to enactment of HSCA2012 (FY2012–13) were compared with the corresponding values for the period after the enactment of HSCA2012. The benchmarking model used in the study was validated against the Hospital Intelligent Monitoring Report used by the Care Quality Commission. The clinical services provided by the group increased year on year by 7.5%, 6.4% and 4% respectively. In the FY2014–15, the group collectively provided 14 735 000 patient care episodes There was no significant difference in the value of the KPIs before and after enactment of HSCA2012 along the six domains defined by the QOF. Good correlation was observed between the benchmarking method used in the study compared with the HIMR (r2 = 0.86). The quality of care provided by the group did not change following enactment of HSCA2012.

The prevention and management of pressure ulcers: summary of updated NICE guidance.

Journal of Wound CareVol. 24, No. 4 EducationThe prevention and management of pressure ulcers: summary of updated NICE guidanceL. Cooper, C. Vellodi, G. Stansby, L. AvitalL. Cooper1Department of Plastic Surgery, Royal Free HospitalSearch for more papers by this author, C. Vellodi2Department of Acute Medicine and Medicine for the Elderly, Barnet and Chase Farm Hospitals NHS Trust, LondonSearch for more papers by this author, G. Stansby3Department of Vascular Surgery, Freeman Hospital, Newcastle upon Tyne. On behalf of the Guideline Development GroupSearch for more papers by this author, L. Avital4National Clinical Guideline Centre, Royal College of Physicians London.Search for more papers by this authorL. Cooper; C. Vellodi; G. Stansby; L. AvitalPublished Online:8 Apr 2015https://doi.org/10.12968/jowc.2015.24.4.179AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References 1 Dealey, C., Posnett, J., Walker, A. The cost of pressure ulcers in the United Kingdom. J Wound Care 2012; 21: 6, 261–262. Link, Google Scholar2 Moore, Z., Johanssen, E., Van Etten, M. A review of PU prevalence and incidence across Scandinavia, Iceland and Ireland (Part I). J Wound Care 2013; 22: 7, 364–368 Link, Google Scholar3 Grey, J.E., Harding, K.G., Enoch, S. Pressure Ulcers. Br Med J 2006; 332: 472–425. Crossref, Medline, Google Scholar4 Graves, N., Birrell, F,. Whitby, M. Effect of Pressure Ulcers on Length of Hospital Stay. Infect Control Hosp Epidemiol 2005; 26: 3, 293–297. Crossref, Medline, Google Scholar5 Bennett, G., Dealey, C., Posnett, J. The cost of pressure ulcers in the UK. Age Ageing 2004; 33: 3, 230–235. Crossref, Medline, Google Scholar6 The NHS Outcomes Framework 2014/15, Department of Health 2013. www.gov.uk/government/publications/nhs-outcomes-framework-2014-to-2015 (Accessed June 2014). Google Scholar7 Johansen, E., Moore, Z,. van Etten, M., Strapp, H. Pressure ulcer risk assessment and prevention: what difference does a risk scale make? A comparison between Norway and Ireland. J Wound Care 2014; 23: 7, 369–370. Link, Google Scholar8 Pressure ulcers: prevention and management of pressure ulcers. (2014) National Institute for Health and Care Excellence. www.guidance.nice.org.uk/CG179 (accessed 22/06/2014). Google Scholar9 European Pressure Ulcer Advisory Panel and National Pressure Ulcer Advisory Panel. Treatment of pressure ulcers: Quick Reference Guide. Washington DC: National Pressure Ulcer Advisory Panel; 2009. www.epuap.org/guidelines/Final_Quick_Treatment.pdf. (accessed 19/1/2015). Google Scholar10 NICE Guidelines Manual. (2012) www.nice.org.uk/article/pmg6/chapter/1%20introduction (accessed 31/10/2014). Google Scholar11 Pressure ulcers overview. NICE Pathways 2014. pathways.nice.org.uk/pathways/pressure-ulcers (accessed 22/06/2014). Google Scholar12 Pressure ulcer prevention, treatment and care. NICE Information for the public 2014. www.publications.nice.org.uk/pressure-ulcer-prevention-treatment-and-care-ifp179 (Accessed June 2014). Google Scholar FiguresReferencesRelatedDetailsCited ByDevelopment of customized support for the prevention of Pressure Ulcer (PU) using multi-materials printingJournal of Physics: Conference Series, Vol. 1969, No. 1Pressure injury prevalence and predictors among older adults in the first 36 hours of hospitalisation8 August 2019 | Journal of Clinical Nursing, Vol. 28, No. 21-22Development and validation of the pressure ulcer management self‐efficacy scale for nurses21 April 2019 | Journal of Clinical Nursing, Vol. 28, No. 17-18Pressure heel ulcers in patients with type 2 diabetes: Is it T.I.M.E. to customise wound bed preparation according to different heel areas?17 April 2018 | International Wound Journal, Vol. 15, No. 5Support surfaces for treating pressure ulcers11 October 2018 | Cochrane Database of Systematic Reviews, Vol. 2018, No. 10References and Further Reading3 September 2018Large‐Scale Hospital Mattress Switch‐Out Leads to Reduction Hospital‐Acquired Pressure Ulcers: Operationalization of a Multidisciplinary Task Force8 March 2018 | Worldviews on Evidence-Based Nursing, Vol. 15, No. 3Pressure injuries in intensive care: What is new?Intensive and Critical Care Nursing, Vol. 45Pressure ulcers in critically ill patients – Preventable by non-sedation? A substudy of the NONSEDA-trialIntensive and Critical Care Nursing, Vol. 44Secondary Assessment of Life-Threatening Conditions of Older Patients9 September 2017Cicatrização de úlceras por pressão com extrato Plenusdermax® de Calendula officinalis L.Revista Brasileira de Enfermagem, Vol. 69, No. 2Spinal cord injury5 March 2016Spinal cord injury5 March 2016 2 April 2015Volume 24Issue 4ISSN (print): 0969-0700ISSN (online): 2052-2916 Metrics History Published online 8 April 2015 Published in print 2 April 2015 Information© MA Healthcare LimitedPDF download

Integration of cardiac monitoring with video to enable service transformation

The future of digital care will be significantly enhanced by the integration and interoperation of systems and services. Collaboration between clinicians and service providers will allow combined services to be shaped such that the whole is greater than the sum of the parts. In future services need to enable people to continue with their lives whilst being supported, rapidly and appropriately when required. We present the results of a project to use an innovative cardiac event loop recorder (ELR) and screening service in cooperation with the use of video consultations. The ELR service detects and records abnormal ECG traces. The connected consultant can choose to receive a PDF of any abnormal trace within seconds or have the trace pre-screened by a cardiac physiologist. The consultant can then initiate a video call to the person and discuss the event. The patient might then attend a consultation in person. The goal is to significantly improve the detection of abnormal events and offer immediacy of support and diagnosis i.e. quality improvement by early diagnosis and potential cost saving in the immediate term by reducing surveillance appointments and in the long term by reducing burden of disease e.g. stroke reduction by earlier AF detection This approach facilitates two modes of care delivery that are innovative: The first is the capture of infrequent events. An example case involved a 66-year-old hypertensive female who suffered from 2 years history of palpitations and had been treated for anxiety and ventricular ectopic beats. Physical examination was normal. Echocardiography showed structurally normal heart. Her electrocardiogram showed normal sinus rhythm with normal PR and QT segments Since several 24 hours Holter monitoring episodes had proved to be unsuccessful in the past it was decided to monitor the patient with the smart event ELR. The patient was equipped with a one-channel smart ELR that was used over a period of 2 weeks of continuous monitoring. The recorder was programmed to automatically send both manually triggered cardiac events as well as automatically triggered events for atrial fibrillation (AF). For the latter, the automatic AF detection algorithm had been activated. All events were automatically transferred using GPRS (tele-ECG option) and in virtually real time. International Digital Health and Care Congress, The King’s Fund, London, September 10-12 2014. International Journal of Integrated Care – Volume 14, 01 November – URN:NBN:NL:UI:10-1-116508– http://www.ijic.org/ Over the course of the next days the recorder sent in ECGs, which showed clear evidence of paroxysmal atrial fibrillation (PAF) as a cause of her intermittent palpitation. During these episodes, she felt unwell with erratic heart rate and light-headedness. The episodes lasted between 30 seconds and up to 2 minutes, confirming the diagnosis of PAF. For patients with long-term conditions that include cardiovascular disease the approach offers a pro-active and supportive way to manage people in their own homes. Both approaches address several of the NHS Outcomes Framework domains, specifically: • reducing premature mortality. • ensuring people feel supported to manage their condition. • reducing the amount of time spent in hospital. • improving people’s experience of outpatient care. • improving hospital’s responsiveness to patient’s needs. During the presentation there will be a live demonstration of the cardiac monitoring and the video service.

Hand hygiene compliance for patient safety

Published evidence suggests that healthcare associated infections (HCAIs) are avoidable and infection prevention and control (IPC) strategies provide cost-effective solutions. The NHS Outcomes Framework ( Department of Health, 2010 ) Domain 5 recognises that patient safety is of paramount importance in terms of quality of care and to delivering better health outcomes. Preventing HCAIs is necessary in reducing the severity of harm and is a key performance indicator. It is vital that NHS organisations ask themselves how they can help to improve the safety of patients. The seven steps to patient safety ( National Patient Safety Agency, 2004 ) is a guide to good practice, which covers building a safer culture and managing, reporting and learning from patient safety incidents. This article highlights how improving hand hygiene compliance can improve patient care, prevents HCAIs and is fundamentality a patient safety prerequisite.

Informing the NHS Outcomes Framework: evaluating meaningful health outcomes for children with neurodisability using multiple methods including systematic review, qualitative research, Delphi survey and consensus meeting

BackgroundThe identification of suitable outcome measures will improve the evaluation of integrated NHS care for the large number of children affected by neurodisability, and has the potential to encourage the provision of more appropriate and effective health care. This research sought to appraise the potential of patient-reported outcome measures (PROMs) for children and young people with neurodisability.AimThis research aimed (i) to identify key outcomes of health care for children with neurodisability, beyond morbidity and mortality, from the perspectives of children, parents and professionals; (ii) to critically appraise existing generic multidimensional PROMs; and (iii) to examine whether or not the key outcomes might be measured by existing PROMs. We also sought agreement on a definition of neurodisability.MethodsData were gathered in three main ways, (i) a systematic review identified eligible generic multidimensional PROMs and peer-reviewed studies evaluating psychometric performance using English-language questionnaires. Studies were appraised for methodological quality and psychometric performance was appraised using standard criteria. (ii) Focus groups and interviews with children and young people with neurodisability, and separately with parents, sought to identify important outcomes of NHS care, and their feedback on example PROM questionnaires. (iii) An online Delphi survey was conducted with a multidisciplinary sample of health professionals to seek agreement on appropriate NHS outcomes. In addition, we convened a consensus meeting with a small nominal group of young people, parents and professionals; the group sought agreement on a core set of important health outcomes.ResultsFrom the systematic review, we identified 126 papers that reported eligible evidence regarding the psychometric performance of 25 PROMs. Evidence of psychometric robustness was more favourable for a small number of PROMs: KIDSCREEN (generic), DISABKIDS (chronic-generic) and Child Health Utility 9D (preference-based measure). The Pediatric Quality of Life Inventory and KINDL offer both self-report and a proxy report version for a range of age bands, but evidence of their psychometric performance was weaker. Evidence was lacking in one or more respects for all candidate PROMs, in both general populations and those with neurodisability. Proxy reporting was found generally to be poorly correlated with self-report. Focus groups and interviews included 54 children and young people, and 53 parents. The more important health outcomes were felt to be communication, emotional well-being, pain, mobility, independence/self-care, worry/mental health, social activities and sleep. In addition, parents of children with intellectual impairment identified behaviour, toileting and safety as important outcomes. Participants suggested problems with the face validity of example PROM questionnaires for measuring NHS care. In the Delphi survey, 276 clinicians from a wide range of professions contributed to at least one of four rounds. Professionals rated pain, hearing, seeing, sleep, toileting, mobility and communication as key goals for the NHS but also identified treating neurological symptoms as important. Professionals in the Delphi survey and parents working with the research team agreed a proposed definition for neurodisability. The consensus meeting confirmed overlap between the outcomes identified as important by young people, parents and professionals, but not complete agreement.ConclusionsThere was agreement between young people, parents and professionals regarding a core suite of more important health outcomes: communication, emotional well-being, pain, mobility, independence/self-care, worry/mental health, social activities and sleep. In addition, behaviour, toileting and safety were identified as important by parents. This research suggests that it would be appropriate to measure these constructs using PROMs to assess health care. None of the candidate PROMs in the review adequately captures all of the identified constructs, and there is inadequate evidence that candidate PROMs are psychometrically robust for use across children with neurodisability. Further consultation with young people, families and professionals is warranted to support the use of PROMs to measure NHS outcomes. Research to test potential PROMs with different age groups and conditions would be valuable.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

The role of subcutaneous infusion in integrated, patient-centred palliative care.

The NHS Outcomes Framework (Department of Health (DH), 2010) set out the UK Government's plans to reform the NHS to focus more on patient outcomes.

The Warwick Patient Experiences Framework: patient-based evidence in clinical guidelines

This paper presents the development of the Warwick Patient Experiences Framework (WaPEF) and describes how it informed the development of the NICE Guidance and Quality Standard, 'Patient experience in adult NHS services: improving the experience of care for people using adult NHS services'. The WaPEF was developed using a thematic qualitative overview that utilized a systematic review approach. Search strategies were developed, inclusion and exclusion criteria developed and data extracted from papers. The WaPEF identifies seven key generic themes that are important to a high-quality patient experience: patient as active participant, responsiveness of services, an individualized approach, lived experience, continuity of care and relationships, communication, information and support. The WaPEF is the first patient experiences framework with an explicit link to an underpinning patient evidence base, linking themes and sub-themes with specific references. The WaPEF informed the structure and content of the NICE Patient Experiences Guidance. The guidance, published in February 2012, will form a key part of the NHS Outcomes Framework in the UK for the future evaluation of health and social care. The proposed framework could be adapted to other country contexts and settings.

Pharmacy Management National Forum told progress is being made on medicines optimisation

Pharmacy Management organises the UK National Forum in collaboration with NHS England, the Royal Pharmaceutical Society and the College of Mental Health Pharmacy. It brings together delegates from all sectors...

P242 What is the pre-admission NHS-consultation behaviour of adults with community-acquired pneumonia?

IntroductionUnder 75 mortality from respiratory disease is highlighted as a target in the NHS Outcomes Framework. Community-acquired pneumonia (CAP) cases are likely to form a considerable proportion of such deaths....

Commissioning a patient-centred kidney service across the care pathway

Journal of Renal NursingVol. 5, No. 4 practiceCommissioning a patient-centred kidney service across the care pathwayFiona LoudFiona LoudSearch for more papers by this authorFiona LoudPublished Online:29 Sep 2013https://doi.org/10.12968/jorn.2013.5.4.199AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View articleReferencesDavison SN, Jhangri GS, Johnson JA (2006) Cross-sectional validity of a modified Edmonton symptom assessment system in dialysis patients: A simple assessment of symptom burden Kidney Int 69(9): 1621–5 Crossref, Google ScholarDepartment of Health (2012) The NHS Outcomes Framework 2013/14. http://tinyurl.com/dyfwwfj (accessed 18 July 2013) Google ScholarGibbons E, Fitzpatrick (2010) A Structured Review of Patient-Reported Outcome Measures for People with Chronic Kidney Disease. http://tinyurl.com/npkdncs (accessed 3 July 2013) Google ScholarKidney Alliance (2011) Update on Dialysis Away from Base. http://tinyurl.com/puac75n (accessed 11 July 2013) Google ScholarKidney Alliance (2012) Commissioning of Specialist Renal Services. http://tinyurl.com/p3c38tw (accessed 11 July 2013) Google ScholarNHS Atlas of Variation (2012) Kidney disease. http://tinyurl.com/9957h6g (accessed 11 July 2013) Google ScholarNHS England (2013a) The Way Forward: Clinical Senates. http://tinyurl.com/pt59o5f (accessed 11 July 2013) Google ScholarNHS England (2013b) National Programmes of Care and Clinical Reference Groups. Renal Dialysis. http://tinyurl.com/q5ngopp (accessed 11 July 2013) Google ScholarNHS Shared Decision Making (2012) Decision aid. http://tinyurl.com/cnf9hah (accessed 11 July 2013) Google ScholarRoyal College of Nursing (2012) Clinical Senates and Strategic Clinical Networks. http://tinyurl.com/d7yl79v (accessed 11 July 2013) Google ScholarSpecialised Healthcare Alliance (2013) Specialised services. http://tinyurl.com/ovaxgo7 (accessed 11 July 2013) Google Scholar FiguresReferencesRelatedDetails 1 July 2013Volume 5Issue 4ISSN (print): 2041-1448ISSN (online): 2052-2894 Metrics History Published online 29 September 2013 Published in print 1 July 2013 Information© MA Healthcare LimitedKeywordsdialysiscommissioningtransplantationpolicyPDF download

Some challenges of providing information on surgical outcomes

In the recent Everyone Counts document, NHS England describes its role in helping commissioners to deliver innovation and increase productivity, as well as facilitating patient choice and empowering local clinicians to improve the outcomes of care. To achieve this, their board will oversee the expansion of publicly available information on the outcomes of healthcare. The NHS Outcomes Framework will be an important element of this, and commissioners and providers will be expected to make improvements across its various indicators.

Integrated Cancer System: a perspective on developing an integrated system for cancer services in London.

This article explores the potential for integrated cancer systems to improve the quality of care and deliver cost efficiencies and improve outcomes for cancer patients. Currently, patients in the UK still have poorer survival rates than comparable countries such as Canada, Sweden, Norway and Australia. Improving the quality of cancer services is a key policy objective and cancer is a priority outcome measure in both the NHS and Public Health Outcomes Framework. Evidence suggests that better integrated delivery has the potential to improve the quality and reduce the cost of healthcare, and ultimately improve health outcomes. One of the key themes from the Model of Care for Cancer Services (1) was that cancer services should be commissioned along pathways and that provider networks should be established to deliver care. London has two integrated cancer systems; one covering north central and east London (London Cancer) and the other covering west and south London (London Cancer Alliance). There a number of areas in cancer care that the current model of service provision has failed to adequately address and which have the potential to improve significantly though implementation of integrated services. These include improving early diagnosis, reducing inequalities in access to treatment and outcomes and maximising research and training across the system. Important drivers for the integration of cancer services are strong clinical leadership, shared informatics systems, focusing on quality of services and improving patient experience. Emerging needs of integrated cancer in London are around strengthening the involvement of primary care, public health and the third sector; working to develop sufficient capacity and expertise in primary care and collaborating more closely with commissioners to develop integrated systems.

Oxford Scores as a Triage Tool for Lower Limb Arthroplasty Lead to Discrimination and Health Inequalities

The NHS Outcomes Framework 2011/12 from the Department of Health states that reducing health inequalities and promoting equality is central if the NHS is to deliver health outcomes that are among the best in the world. Assessment of patient reported outcome measures (PROMS) was introduced across the NHS in April 2009 both for hip and knee replacement surgery. PROMs are applied before and after certain elective health interventions funded by the NHS. In addition to the established use in assessment of outcomes, it has been suggested that preoperative instruments might be used to assess whether referrals for elective procedures are appropriate and also to identify inequalities in heathcare. For hip and knee replacement surgery, Oxford hip and knee scores are used as the measure of pain and disability.

New Arrangements for The National End of Life Care Programme and Recent Publications

On 1 April 2013, a new improvement body, NHS Improving Quality, was established. It is hosted by the NHS Commissioning Board and brings together the combined knowledge and experience of a number of NHS improvement organisations: As a consequence, the National End of Life Care Programme (NEoLCP) ceased to exist in its current form from 31 March 2013. Some elements of NEoLCP work were due to finish by that time, while others have been transferred to the new organisation. Key end-of-life care (EoLC) priorities will continue to be supported and implemented within the NHS. Both Electronic Palliative Care Co-ordination Systems (EPaCCS) (NEoLCP, 2013a) and Transforming End of Life Care in Acute Hospitals (NEoLCP, 2012) will continue as work programmes, while the National End of Life Care Intelligence Network will continue to operate as part of Public Health England, from April 2013. For enquiries relating to the transition, please visit the ‘about us’ section of the NEoLCP website: http://www.endoflifecare.nhs.uk/about-us.aspx NHS Improving Quality aims to reshape the means by which improvement occurs in health care and support the NHS Outcomes Framework and the NHS Commissioning Board’s five domains (Department of Health, 2012) ( Table 1 ). (The NHS Outcomes Framework sets out the outcomes and corresponding indicators that will be used to monitor improvements in health outcomes.)The NEoLCP team has always been committed to ensuring dissemination of information to clinicians and all its partners and stakeholders. In recent weeks it has launched a number of key reports and publications (discussed below) in order to share data, research findings and …

Commissioning for values is as important as commissioning for outcomes

Richard Shircore FRSPH, Professional Adviser in Public Health to the Burnham Health Protection Trust and Shirley Shaw, the Trust's Operational Manager, consider how simply focusing on commissioning for outputs or outcomes fails to understand the crucial importance of values in effective, acceptable and sustainable public healthIntroductionThose working in health and social welfare have become accustomed to the language of results based commissioning. Contracts are written containing all number of specific output measures required of the provider, whether it be waiting times for an outpatient appointment, number of persons quitting smoking, or prescribed weight loss over a given period. The rationale for such an approach often refers to the need for commissioners to get 'value for money for the public purse'. From a managerial perspective such an approach has also been justified as an example of how to demonstrate the efficiency of the organization in delivering relevant end results.The current situationRecently the target driven outputs of commissioning have come in for considerable criticism. The argument being that the focusing on outputs and targets has led to professionals focusing solely on contract criteria and losing sight of the bigger picture. Of equal concern is that the use of targets and outputs has resulted in complex organizations being assessed on a very narrow band of criteria.In response to this criticism the Department of Health (DH) has refined the language of commissioning by introducing the broader notion of outcomes as opposed to simply outputs. The details of this approach are contained in a policy document, NHS Outcomes Framework 2012.1, 2 This redefinition seeks to define success more broadly by looking at outcomes and processes and what these mean in more practical terms. The Outcomes Framework focuses on three key aspects of service delivery: efficacy, the potential to do good; effectiveness, the level necessary for competent service delivery; and efficiency, measured by a cost benefit analysis. Outcomes based commissioning is defined under five headings which reflect service priorities:* Prevention of premature death* Helping people recover from episodes of ill-health* Enhancing the quality of life for those with long-term conditions* Ensuring a positive experience of care* Caring for people in a safe environmentWhat is the purpose of commissioning?This question was raised by the Trustees of the Burnham Health Promotion Trust (BHPT).i The BHPT is an endowed charity located in Burnham, South Bucks, and the Trust commissions a wide range of local programmes from the clinical to social, internal to the external and in partnership with other commissioners.With the expected loss of NHS and Local Authority service funding to local agencies and the likely pressure on the Trust to make up any shortfall in statutory funding, the need to understand local expectations of commissioning was all too apparent. The Trustees were keen to know what type of commissioned activity was felt necessary by partners and service users in order to generate the greatest health gain. To seek answers to this question Health Impact Assessments (HIAs)ii were carried out on four different types of commissioned activity:* Out and About Club - externally commissioned for an 'at risk' population (e.g. isolated pensioners with mobility restrictions)* Citizen Advice Bureau - externally commissioned for the general publica local service provided from local medical centre* Burnham Dance Project - internally commissioned for the local general public-aimed to increase physical mobility* Intergenerational Project - internally commissioned for specific populations - bringing together pupils from a primary school with residents in an old people's homeThe outcomePrior to this study the Trust viewed commissioning as simply paying money to get something done; a way of budgeting and managing money. …

Neurology policy roundup 2012

British Journal of Neuroscience NursingVol. 8, No. 6 PolicyNeurology policy roundup 2012Sue ThomasSue ThomasSearch for more papers by this authorSue ThomasPublished Online:27 Sep 2013https://doi.org/10.12968/bjnn.2012.8.6.352AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Department of Health (2005) National Service Framework for long term conditions. DH, London Google Scholar Department of Health (2011) NHS Outcomes Framework 2012/13. DH, London Google Scholar Department of Health (2012a) Developing the long-term conditions outcomes strategy. http://bit.ly/RDIHDH (accessed 6 December 2012) Google Scholar Department of Health (2012a) Report recommends which specialised services should be commissioned nationally. www.dh.gov.uk/health/2012/09/cagreport (accessed 6 December 2012) Google Scholar National Audit Office (2011) Services for People with Neurological Conditions. NAO, London Google Scholar Neurological Alliance, MHP Health Mandate (2012) Intelligent Outcomes Applying the Health and Social Care Reforms to Improve Outcomes for People with Neurological Conditions. http://bit.ly/SfpeqH (accessed 6 December 2012) Google Scholar NHS Commissioning Board (2012) The Way Forward: Strategic Clinical Networks. NHS CB Google Scholar Public Accounts Committee (2012) Services for People with Neurological Conditions. http://bit.ly/YDOVXs (accessed 6 December 2012) Google Scholar Thomas S (2012) A framework for improving neurology services. Br J Neurosci Nurs 8(5): 302–3 Link, Google Scholar FiguresReferencesRelatedDetailsCited byHealth Policy in 2015: what are the levers for neurology?27 April 2015 | British Journal of Neuroscience Nursing, Vol. 11, No. 2 1 December 2012Volume 8Issue 6ISSN (print): 1747-0307ISSN (online): 2052-2800 Metrics History Published online 27 September 2013 Published in print 1 December 2012 Information© MA Healthcare LimitedPDF download