Your ideas and suggestions

Ideas and suggestions submitted by HSJ readers to help you do your job more effectively, including best practice, service design and more.

Forecasting methods in healthcare planning

Current healthcare planning assumes that a combination of primary and community care initiatives and public health improvements will reduce the need for hospital beds, despite an increasingly elderly population.

Reduction of A&E attendances

A&E attendances

Initial liaison and discussion took place between Yorkshire Ambulance Service and the community matrons to look at ways of working together to ensure wherever possible patients can be managed at home, especially those with long term conditions and to try and reduce inappropriate 999 calls.

Access to maternity care

In 2006 an exciting opportunity arose which enabled some innovative thinking to become a reality and the award winning Hackney Maternity Helpline was born.

Adult spine services

New approaches in spine service at St Thomas’ Hospital have yielded impressive results.

Advanced practitioners

As part of a wider programme of workforce modernisation in the North West, NHS organisations identified the need to develop the advanced practitioner role in 2005.

AIDS prevention

The Newham and Tower Hamlets HIV/AIDS Prevention Partnership is a joint initiative funded by NHS Newham and NHS Tower Hamlets.

Alcohol screening and intervention

We began as academic ST4 GP registrars at Imperial College in August 2009.

Managing ankle fractures prior to surgery

Ankle fracture management

As clinicians we have an obligation to review our practice and strive to provide high quality care for all.

Appraising social value

Imagine two identical health programmes serving deprived areas. Both are hitting their outcome targets, but one is doing a whole lot more.

Asset management

Karen Conneely outlines the need for a single integrated asset register.

Provision of FHS administrative services are part of the role of primary care trusts and include maintaining contractor performer lists, paying primary care contractors, maintaining population databases and administrating screening programmes. Many PCTs u

Back office cost reductions

Providing FHS administrative services is part of primary care trusts’ role and includes maintaining contractor performer lists, paying primary care contractors, maintaining population databases and administrating screening programmes. Many PCTs use shared service arrangements to deliver these services.

Banding appeals

In the last year we have seen an increase in the number of banding appeals. Appeals arise when trusts and junior doctors are in dispute over hours worked and compensation due, under the New Deal rules for doctors.

Bank and agency quality improvement project

Bank and agency quality improvement project

NHS organisations must now rise to the challenge of improving patient care while safely reducing costs.

Five ways branding can save you money

Branding in the NHS

When times are tough branding might not seem a priority, but well thought out branding has the power to save an organisation money.

Californian GP commissioning

As details emerge from the health White Paper, Equity and Excellence: Liberating the NHS, about the coalition government’s plans to reform the NHS by handing general practitioners more commissioning power, one thing is certain: this reform is high risk and will need very careful implementation if it is to deliver ...

Capacity planning in rheumatology day units

A comparison of the administration regimens for two rheumatoid arthritis drugs across three hospital day units has highlighted an opportunity for substantial time savings for healthcare providers and patients.

Carbon reduction

The Carbon Reduction Commitment is a mandatory, auction-based emissions trading scheme, which came into effect on 1 April 2010.

Carbon reduction

Increasing hospital efficiencies is a pressing issue for trusts. In 2008, the Government passed the Climate Change Act, which aims to achieve an 80 per cent cut in CO2 emissions from 1990 levels by 2050.

Carbon reduction commitment

NHS energy use costs £400 million annually and results in around one million tonnes of carbon emissions.

Carbon Reduction Commitment

Dave Covell provides an update on the recently implemented Carbon Reduction Commitment scheme

Care of deteriorating patients

Salford Royal Foundation Trust signed up to Patient Safety First in 2008 and is one of the trusts to implement the reducing harm from deterioration intervention.

Career development

In the calls made for an increase in the quantity, quality and capability of clinical leaders there is a fundamental challenge. How to bridge the gap between clinical training and developing clinical leadership capacity for the future?

Career transition as a path to reform

The recently published white paper has thrown leaders and staff in our strategic health authorities and primary care trusts into uncertainty about their futures.

Carers and medical training

Michael Yousif looks at how carers’ experiences can be incorporated into psychiatric training

Changes in patient safety

After the crisis: the maintenance model of effective change

Childhood obesity

In some London boroughs a third of children leaving primary school at the age of 11 are overweight or obese. We know overweight children are much more likely to become obese adults, so this major public health problem must be tackled early. The government’s child obesity public service agreement target ...

Chlamydia screening

As chlamydia continues to prove a problem among young people, some PCTs are turning to more innovative methods to relate to them.

Chlamydia screening guide

Getting value for money from your chlamydia screening campaign requires careful consideraton.

Chronic pain

Highlighted in the chief medical officer’s 2008 annual report was that some 7.8 million people are affected by pain and the numbers continue to rise.

Clinical dashboards

Good quality information is known to be a driver of performance among clinical teams and vital to ensuring the right services and best possible care is provided to patients.

Clinical human factors

Human factors are what shape our behaviour in the context of the systems of which we are a part.

Clinical leadership

There are countless definitions of leadership, but the majority concur that leadership is about working with people and organisations to achieve goals and to produce change. While overlapping with management, there is an enhanced focus on change, vision, inspiration and empowerment.

Internal coaching for leaders

Coaching for leaders

Public Service Management Wales is the leadership development arm of the Welsh Assembly Government, working with the full range of public services across Wales.

Commissioner-provider divide

Primary care trusts are facing some critical issues over the integrity of local services as they separate their commissioner and provider functions.

Linking commissioning to strategic priorities

Commissioning and strategic priorities

World class commissioning requires robust decision making by commissioners linked to the strategic priorities of the PCT. Pat Williams explains how Wolverhampton City PCT is achieving this.

Commissioning challenges

The coalition government is in a bit of a hole.

Commissioning for outcomes

The report from The Nuffield Trust and The King’s Fund Where next for commissioning in the English NHS? describes the Health Service as reaching a “fork in the road”.

Commissioning for outcomes

 The recent report from The Nuffield Trust/The King’s Fund Where next for commissioning in the English NHS? (Smith et al 2010) describes the Health Service as reaching a ‘fork in the road’.

Commitment to health outcomes

“The government believes that we need to…encourage behaviour change to help people build healthier lives”.

Community rehabilitation

Chase Park Rehabilitation Centre was developed in response to the needs of clients with slow stream community rehabilitation and complex care requirements.

Competion law and the health bill

The health sector needs to brace itself for a severe competitive shock, with the anticipated Health Services Bill expected to give Monitor the power to apply the Competition Act 1998 to the provision of health services and adult social care across England.

Competitive commissioning

Among the rapid changes facing the NHS at the moment is the increasing exposure of services to competition by commissioners in order to secure maximum value for money.

Computer game applications

An innovative, technology driven project at Alder Hey Children’s Foundation Trust is exploring the potential of computer games technology as a communication tool for children with palliative care needs.

Consultant development programme

Disenchantment is rife among established NHS consultants.

Contestability and choice

The urgent need to tackle the fiscal deficit may be the catalyst for an historic turning point in re-designing NHS services to suit personal needs.

Continuing care

Helping patients settle happily into the right long-term care setting is a key dimension of health and social care. Getting it wrong means needier patients, angry families, and spiralling costs.

COPD awareness

Chronic obstructive pulmonary disease is the UK’s fifth biggest killer, each year causing more deaths than breast, prostate and bowel cancer. However, 2.8 million people are undiagnosed and unaware they have the progressive, possibly terminal disease.

COPD service in East Surrey

COPD services

Dr Elango Vijaykumar and Dr Joe McGilligan describe how internal integration of existing resources and external support from a pharmaceutical company have provided a structure to improve the care of people with COPD.

Cost cutting

As rising demand for services begins to clash with increasingly tight financial constraints, the NHS must plan now for impending 2011 funding restrictions.

Cost savings and operational efficiency

The NHS currently faces a big challenge on the way in which it delivers healthcare to patients as a result of budget pressure.

Introducing a CQUIN framework to stroke units

CQUIN in stroke units

In the UK, an estimated 150,000 people have a stroke annually (1). Mortality and morbidity are high. 67,000 deaths occur annually (2) and many of those who survive are left with moderate or severe disabilities (3).

Critical care interventions

Colchester General Hospital signed up to Patient Safety First in 2008. One of the key interventions they have targeted is the ventilator care bundle, which is part of the critical care intervention that aims to reduce the incidence of ventilator-associated pneumonia.

Customer care

April 1 saw the introduction of a new unified system for complaints about health and social care. The new system is designed to be more streamlined and complainant focused with an emphasis on local resolution.

Customer focus

In the wake of planned spending cuts and head count reductions across the public sector, Jo Causon examines how maintaining ‘customer’ focus can minimise the impact on frontline service provision in the NHS.

Data protection

Recent moves by the Department of Health to tighten up on data management mean that healthcare service providers must meet the international quality standard, ISO27001.

The parliamentary Science and Technology Committee completed its report into homeopathy in February 2010, concluding that it should not be provided on the NHS.

Decommissioning homeopathy

The parliamentary Science and Technology Committee completed its report into homeopathy in February 2010, concluding that it should not be provided on the NHS.

Dementia and quality of life

Only 13 per cent of people believe a person with dementia can have a good quality of life at all stages of their condition according to Alzheimer’s Society research released in April.

Dementia strategy

In the UK there are approximately 700,000 people with dementia. In 30 years, this number is expected to double.

Unsuitable or inadequate in-patient accommodation for people experiencing a mental illness will limit a service’s ability to help people recover.

Design around patients

Unsuitable or inadequate in-patient accommodation for people experiencing a mental illness will limit a service’s ability to help people recover.

Developing clinical leaders

The quality of management and leadership remains the single biggest factor as to whether or not organisations succeed, and nowhere more so than an institution as large as the NHS.

Directorate management teams

Most acute hospitals in the UK are subdivided into directorates with each directorate taking care of one or more specialities.

Distraction and patient safety

I believe that distraction is one of the most powerful factors in errors and harm to patients in a hospital. To improve patient safety we need to be alert and watch out for distraction so we do not miss a trick in patient care.

Doctors' views on the NHS IT programme

If politicians listened more to doctors about the use of IT in healthcare progress could be smoother, says Dr Tim Ringrose

Economic modelling

Economic modelling

Economic modelling can be used to support commissioning decisions by testing the cost and benefit impact of multiple care pathway scenarios.

Economic survival guide

The NHS thinks it is having a tough time financially. But this is just the beginning of a long-drawn out process of adjustment as the UK falls into an economic abyss.

E-learning and the hygiene code

Health and social care providers have worked steadily to improve standards, but many still have a long way to go. According to the Care Quality Commission one in five NHS trusts does not comply with at least one of the three standards relating to the hygiene code. Louise Pasterfield examines ...

Electronic patient records

In the third quarter of 2009 Newcastle upon Tyne Hospitals foundation trust plans to go live with its new electronic patient record.

Electronic prescribing

Picture the scene. A doctor is attending a Fitness to Practise hearing at the General Medical Council. She stands accused of making a prescribing error which has lost a patient his life. The doctor is now fighting for her career.

End of life care

End of life care

Yvonne Cartwright explains how a Sue Ryder Care rapid response service supported people in northBedfordshire to die at home

Endodontic clinical audit

Endodontic clinical audit 

Each year NHS Bradford and Airedale organises a peer review process for dentists in the area and following an evaluation of the 08/09 process a decision was made to base the 09/10 peer review on a clinical topic.

Assessing the English skills of overseas professionals

English language requirements

 Dr Mike Milanovic gives advice on getting English language requirements right in the medical sector

Equal pay

Any trust involved in the NHS equal pay litigation will need to act with far greater haste if they want to avoid costly appeal hearings.

E-rostering for medical staff


Recent media coverage highlights genuine concern from the BMA and other NHS representative bodies about the impact of threatened and actual cuts in NHS staffing levels.

The story of how the European Working Time Directive was implemented successfully at Sheffield Teaching Hospitals NHS Foundation Trust

European working time directive

The story of how the European working time directive was implemented successfully at Sheffield Teaching Hospitals Foundation Trust.

Excess inventory

Up to £200m excess stock could be held in acute trusts in England.

Financial benchmarking tools

It may not be possible for primary care trusts to become cost efficient overnight, but healthcare actuaries are developing financial diagnostic tools to identify readily achievable cost savings and focus scarce resources in overstretched budgets to achieve the greatest return.

Fly on the wall tool

Health and social care are labour-intensive service industries which are currently facing enormous change. Achieving staff engagement, excellent leadership and clinically focused organisations, particularly when 1.3 million NHS staff members are involved, calls for some radical rethinking of about how individuals learn and may achieve change in their working practices.

Funding innovation

Dr Kathy McLean looks at how healthcare providers can make best use of the £220m innovation funding to improve working practices and deliver quality of patient care

Future opportunities for PCTs

The formation of the GP consortia bodies is being seen as an opportunity to be grasped by the best of the PCT teams.

As a retired hospital doctor, my work in the NHS was a huge advantage when I started as an MP, because I already knew many consultants and GPs, as well as managers of all the local health trusts.

Getting to know your MP

As a retired hospital doctor, my work in the NHS was a huge advantage when I started as an MP, because I already knew many consultants and GPs, as well as managers of all the local health trusts.

GP surgery sustainability

Sustainability is increasingly becoming a key issue for the NHS. This case study of the sustainability audit of a small GP surgery shows how this is affecting primary care providers by looking at three critical areas.

GP-led services

GPs will increasingly call the shots about how and where money is spent in the local health economy, writes Conor Burke

Health and social care regulation

In the short time since the spring general election, the new coalition government has announced significant changes to the health and social care regulatory sector.

Health inequalities evaluation framework

In September 2008, NHS Westminster commissioned Shared Intelligence and Gillian Granville Associates to develop an evaluation framework. The purpose was to shape the development and delivery of the health inequalities and health promotion programmes, and build the local evidence base of effectiveness.

Health innovation and education

A recent policy reform by the Department of Health heralded a re-think on the way it promoted innovation and education for NHS staff.

Health politics

Politicians who get tangled up with healthcare usually end up regretting it. Ask Barack Obama. One day you have this dream of bringing medical coverage to 30 million of your unprotected fellow citizens. A year of drift, squabble and dodgy compromise later and your party is booted out in Massachusetts, ...

Evaluating Knowsley’s health trainers

Health trainers

Knowsley is a metropolitan borough on Merseyside with a population of just over 150,000 people.

Derbyshire PCT health trainers scheme

Health trainers

Since 2006 the NHS Health Trainer scheme has been working with the aim of supporting positive lifestyle changes in local communities.

Healthcare for people with learning disabilities

Recent years have seen a series of high profile reports criticising the NHS for offering inadequate healthcare to patients with learning disabilities.

Healthy eating

In the first initiative of its kind in the UK, social marketing techniques have been used to promote the sustained improvement of nutrition and healthy eating among hospital employees.

Healthy eating promotion

To increase consumption of fruit and vegetables, customer insight analysis was used to determine the best route for a mobile food store around Great Yarmouth and Waveney Primary Care Trust.

High-risk medications

The key intervention that Medway foundation trust has put into practice is the reducing harm from high-risk meds intervention. This aims to reduce harm from five high-risk medicines with a specific focus on insulin.

Home births

Women used to give birth at home: in 1900s over 99 per cent of babies were born at home. However, as GPs and obstetricians persuaded women that giving birth in hospital was safer than at home the rate dropped to 1 per cent in the 1980s. Today the home birth ...

Hospital capacity planning

Bedford Hospital Trust is a 450 bed district general hospital within NHS East of England.Over the last few years the trust has performed well against most operational targets but was operating in an environment of a recurrent financial deficit of £12m.

Human rights in mental health

A new human rights based leadership programme is being developed with investment from SCIE and the support of the National Mental health Development Unit and University of Central Lancashire.

Illness prevention

Since its redefinition in 1974 - before which it included local authority health departments - the NHS has never really taken on a significant preventative role. It is still focused on the treatment of acute illnesses.

Independent contractor performance

Central Lancashire has a large number of highly skilled independent contractors. However, when concerns are raised it is important that investigations are carried out in a fair and open environment.

Infection control

Patient Safety is about working together day in, day out, 365 days a year.  It requires hard work and commitment to the cause, with each individual playing a vital role in preventing errors being made.

Information governance

Information governance

Inspired and intrigued by a recent Health Informaticians’ debate, Amit Bhagwat delves into facets of information governance – those that are commonly understood within the health sector, those that are commonly misunderstood and others that are routinely missed.

Information management services

When it comes to deciding when is the right time to outsourcing information management and IT services support, there are several issues that must be carefully considered.

The new guide From the Ground Up is an invaluable toolkit for PCT service planners and estates managers wanting to develop sites and buildings to support the delivery of integrated care services.

Integrated care services

The new guide From the Ground Up is an invaluable toolkit for PCT service planners and estates managers wanting to develop sites and buildings to support the delivery of integrated care services.

Interim managers

Interim managers

The term interim manager means different things to different people. Within the industry, an interim manager is a senior professional, typically used at short notice for high impact roles. They are often overqualified for the assignment, meaning they have the potential to offer seamless delivery and full accountability. They ...

International recruitment

With a shortage of healthcare staff in the UK, overseas-trained professionals play a vital role in the NHS.

Internet security

A new generation of internet applications is making it easier for healthcare organisations to tap into the power of the internet to lower costs and improve productivity.

Job search tips

Taking the time to refine your CV for each application and then properly preparing for the interview will go a long way in securing you the job that you deserve.

Joint commissioning

Commissioning Support for London Accelerated Development Programme 2009

Joint commissioning in London

Joint commissioning in London

Consumers of health and social care increasingly demand high quality care, expect choice, personalised services and seamless provision.

Joint ventures in the health sector

The detail of the white paper Equality and Excellence: Liberating the NHS and its impact and meaning has yet to emerge.

Joint working with the pharmaceutical industry

Steve Williamson, Sean McGrath and Abbie Pound explore the importance of collaborative working between healthcare providers and the pharmaceutical industry - facilitated by medical education agencies - and what this might mean for patient care

Leadership and management training

The quality of management and leadership remains the single biggest factor as to whether organisations succeed or not.

Leadership development

For a cluster of primary care trusts on Teesside (Hartlepool, Middlesbrough, Redcar and Cleveland and Stockton on Tees Teaching PCT), developing their strategy for 2008/13 and preparing for world class commissioning assessment led to a change in their thinking about the nature of leadership and leadership development in their organisations.

Leadership for change

Martin Seligman, the leading figure in the positive psychology movement, has described Appreciative Inquiry (AI) as the most significant and powerful organisational intervention currently available.

Leadership in patient safety

Sharon Beamish is chief executive of George Eliot Hospital is the deputy director of nursing at George Eliot Hospital

Leadership lessons

Chris Roebuck reports on the views from the NHS Employers conference

Lean in mental health

Cambridgeshire and Peterborough Foundation Trust forecast a saving of £16 million and a 100 per cent increase in clinical time spent with patients.

Lean in radiology

Using lean to make an ongoing difference, achieve targets and improve staff morale

Lean strategy in the NHS

With growing financial pressures in health care, successful efforts to improve operational efficiency are becoming increasingly important. We present seven critical success factors in the successful implementation of lean in health care, identified through a review of the literature and two case studies. Consideration of these critical success factors may ...

Lean thinking in the NHS

Despite having been in the service improvement business for years, I choose now to finally really get my head around “lean thinking” as inspired by Taiichi Ohno’s work on the Toyota production system.

Legal consortium panels

Procurement in the NHS recently came under scrutiny following the publication of the PCT Procurement Guide for Health Services. As the coalition government begins to cut spending throughout the public sector, trusts must seriously consider procuring legal services in a sustainable manner that provides value for money.

LINks and the retendering process

Advice for local involvement networks and their hosts as they prepare for the end of their three year contracts

Improving local authority and PCT partnerships

Local authority and PCT partnerships

We know that better partnerships will identify and address need in an improved way and will save resources.

Local breastfeeding support

Commissioning Local Breastfeeding Support Services, published in October last year by the Department of Health and Department for Children, Schools and Families, aims to assist commissioners and primary care trusts in “providing coherent services that will promote breastfeeding and reduce inequalities”, as set out in Healthy Lives, Brighter Futures – ...

Local mental health services' links with universities

Each Thursday evening in the drama studios at York St John University, Out of Character, a theatre company made up of people who use mental health services, students and staff, meets to rehearse. Next door, theatre students and staff run a course that provides a broad introduction to theatre.

Low clinical priority procedures

This article describes how a primary care trust’s low clinical priority procedures were implemented by a clinical health psychologist working across primary and acute settings.

Making the most of clinical leaders

Whichever way you look at it, ensuring a supply of high quality clinical leaders is a top priority.

Managing costs may seem like a daunting task, but adopting some simple measures will reap serious long-term rewards, says Debjani Duncan

Managing costs

Managing costs may seem like a daunting task, but adopting some simple measures will reap serious long-term rewards, says Debjani Duncan

Manchester Academic Health Science Centre

Manchester Academic Health Science Centre (MAHSC) is one of the five AHSCs in England designated by Department of Health in March 2009. The designation recognises excellence in research, innovation, education and patient services which combine to provide a strong capacity for translational medicine.

Maternal mortality in Africa

The high rate of maternal mortality in Africa is a worldwide concern. The global targets of Millennium Development Goal (MDG) no 5 are to reduce maternal mortality by three-quarters and achieve universal access to reproductive health by 2015.

Medical student training

The transition from medical student to doctor is one that is often made with much trepidation. While medical schools work hard to equip students with the necessary skills, the role undertaken by employers is playing an increasingly significant part in this process.

Medication errors

Mark Thomson considers the role of newly available technologies in tackling patient safety

Reducing medicine waste

Medicine waste

Waste medicines is a big, expensive problem.

Medicines management

Medicines management

A review in 2007 by the Healthcare Commission into effective medicines management showed that 92% of mental health service users contacted had taken medicines.

Melanoma diagnosis

Rates of melanoma are increasing faster than any other common cancer and getting the diagnosis right is a real challenge for GPs.

Mental health business intelligence

Dr Alex Horne examines why high quality business intelligence is critical to meeting the unique set of challenges being faced by mental health trusts

Mental health in further education

The healthy further education steering group was launched in 2008 to meet the health needs of those studying and working in the further education sector.

Mental health response to disasters

Following disasters, UK survivors’ psychosocial needs are looked after by local authorities, possibly supplemented, since 2005, by a multi-agency “humanitarian assistance centre”. These centres come under the remit of the humanitarian assistance unit at the Department of Culture, Media, and Sport. People with acute mental health problems are treated by ...

Mental health review tribunals

Health and social care managers now face new rules on the disclosure of information in mental health review tribunals.

Mental health roadmap

The primary aim of world class commissioning is to improve the skills of primary care trusts to make them more effective commissioners. The 11 WCC competencies focus on the key areas required of PCTs, but some areas are inevitably more developed than others.

Modular wards

Construction in healthcare is a precision business. Its role is to support the industry’s primary function – to deliver the best available healthcare services to patients. New developments and continual refurbishment are all important in handling the demands on patient care, but can often present a number challenges, not least ...

Multi-source feedback

The communication of effective and constructive feedback has long been a thorny issue in many an organisation, and not least the NHS.

Shaping the future of neurological care

Neurological care

The Neurological Alliance is chairing the main day of the HSJ’s conference, Delivering Patient Centred Neurological Services, in London this week.Clare Moonan and Katie Smith, chief executives of the Neurological Alliance, say that the Alliance has been a key partner in shaping this unique event which has a central theme ...


Gwam Rajiah looks at the issues confronting neurophysiology departments around the UK

Intermediate Care Ambulance Transfer

New ambulance transfer service

A good example of successful integration of public and private resourcing of the NHS is the new Intermediate Care Ambulance Transfer Service introduced for hospitals in central London in April.

NHS asset management

Karen Conneely outlines the need for a single integrated asset register.

NHS bullying

Dr Malcolm Lewis, Senior Lectuerer in Health Service Management at UCLAN, gives his opinion on the issue of workplace bullying within the NHS and reflects on the ‘depressing picture’ his research reveals (DAWN, 2010).

NHS careers

NHS Careers, the careers information service for the NHS in England, has recently celebrated its 10th anniversary. Launched in 1999 by the Department of Health to help fill nursing and midwifery vacancies, NHS Careers has evolved into a service supporting more than 350 different careers in the NHS via a ...

NHS Choices in the Big Society

Andrew Lansley’s “information revolution” looks like it will be a boost for NHS Choices. Has the time come for it to fully play a role in improving health?

NHS governance

In the latest Apprentice series candidate James McQuillan was taken to task for writing in his CV that he would bring “ignorance” to the boardroom. While his choice of words was poor we knew what he meant - his outsider status would bring a new perspective to Sir Alan Sugar’s ...

NHS Leadership

The NHS struggles to measure one of the most important factors driving trust performance – leadership.

NHS marketing

In Hounslow a focused marketing campaign has helped ensure strong take-up rates of services at the area’s polyclinic.

NHS targets vs patient needs

Government targets have led to real changes in the quality of NHS services, but national indicators are not sufficient to tell us whether performance against them actually affects the health of the local population.

NHS workforce planning

Workforce planning is often described as more of an art than a science. Yet workforce planners are increasingly seeking out and deploying sophisticated scientific methods.

Nuisance and disturbance on NHS premises

According to the NHS Security Management Service there were 54,758 reported physical assaults against NHS staff in England in 2008/2009.

Nursing standards

In September 2010 the Nursing and Midwifery Council launched their standards for pre-registration nursing education.


Liverpool, like many UK cities, has seen a significant rise in obesity in recent years. In the city, an estimated 40 per cent of the adult population is overweight and 20 per cent obese. It is estimated that obesity results in over 130,000 sick days every year in Liverpool.

Obesity challenge

As the obesity epidemic continues to gain weight, Liverpool tackles the problem head on.

Open innovation in healthcare

The concept of open innovation (OI); in which organisations collaborate on research has the potential to contribute to improvements in the quality and safety of healthcare. It is increasingly recognised in the NHS, but how can trusts get involved?

Operating theatre management

In 2007 we examined initiatives to improve throughput of operating theatres in a large teaching hospital, with 52 operating theatres each running at an estimated cost of £4800 per day, and performing 50-60,000 operations per year.

Organ donation

Recent important Department of Health guidance on organ donation gives boards in England and Wales an excellent opportunity to receive up to date progress on donation activity in their trusts and to review how they can support a drive to further boost rates.

Out of hours care

This report summarises the methodology and the outcome of a pilot project designed to reduce the number of elderly patients admitted to hospital from nursing homes. It suggests that enhanced out of hours care by GPs can improve the experience of patients (and their relatives) and reduce costs by limiting ...

How patients find the outpatient experience

Outpatient experience

The Picker Institute Europe coordinated the national outpatients survey for the Care Quality Commission in 2009. This is a summary of the key findings.

The H1N1 pandemic never reached the intensity feared, but the emergency response set in place has strengthened partnership working.

Partnership working and the flu pandemic

The H1N1 pandemic never reached the intensity feared, but the emergency response set in place has strengthened partnership working.

Patient access to medical records

There has been a consensus for some years that medical records belong to the patient rather than the clinician.

Treating patients in appropriate care settings

Patient data management system

Following Brighton and Hove Integrated Care Service’s (BICS) first year in operation, the not-for-profit organisation had a comprehensive understanding of its core values and recognised the need to implement a tailor-made patient data management system.

Patient data safety

The NHS organisations are frequently in the firing line for allowing information breaches of sensitive personal data. The Information Commissioners Office has said that nearly a third of reported breaches involve NHS trusts and related bodies.

Patient engagement

The NHS needs a strategy for shared decision-making with patients, here we set out why, for whom, and some evidence for what works.

The Patient Experience Network

Patient experience

In a Department of Health Statement on May 17, Health Secretary Andrew Lansley said: “Knowledge of patient experience is essential for understanding how best to improve care. I don’t intend to be locked away in an ivory tower. That’s why in addition to my other duties I will routinely read ...

Patient experience

Philip Darbyshire considers the patient experience and how healthcare professional can empathise.

Patient experience

It’s official. The NHS has discovered “the patient experience” and it has moved from a position of inconsequential “soft data”, usually relegated to the “touchy-feely” domain, to being a hard reality at executive and policy levels.

Patient level costing

Patient level costing

PLC data is a critical tool for trusts looking to optimise their performance and ensure best use of available funding and resources.

Patient level costing at Southampton

Southampton University Hospitals Trust provides local hospital services to some 500,000 people living in Southampton and South Hampshire, and specialist services such as neurosciences, cardiac services and children’s intensive care to more than three million people in central southern England and the Channel Islands.

Patient privacy and dignity

5 Boroughs Partnership Trust is taking a lead in ensuring that service users, carers and their relatives are given information about the facilities they can expect on wards. This takes the form of an information folder containing an information leaflet, ward-specific fact sheet and DVD.

Patient safety

The University Hospitals of Leicester trust was one of the first large acute trusts to sign up to Patient Safety First in June 2008.

Patient safety interventions

Avril Lowery explains how Gateshead Health Foundation Trust has taken the guiding principle of Patient Safety First, to make patient safety the trust’s number one priority, and applied it to their own environment, creating an internal campaign that works for them.

Patient safety interventions

The University Hospitals of Leicester trust was one of the first large acute trusts to sign up to Patient Safety First in June 2008. Representatives from the hospital heard about the campaign from networking events they had attended and since they had recently introduced a new patient safety strategy, ...

Patient safety strategy

Sarah Woolley explains how Heart of England Foundation Trust has put the Patient Safety First campaign into action.

PCT membership schemes

NHS Leicestershire County and Rutland have developed a membership scheme which they believe is unique in its approach.

Perioperative care 

Over 90 per cent of acute trusts are signed up to Patient Safety First and are actively making changes within their organisations’ to reduce avoidable harm and avoidable death.

Pharmacy regulation

The General Pharmaceutical Council (GPhC), the new independent regulator for pharmacists, pharmacy technicians and pharmacy premises, launched on 27 September 2010. The establishment of the GPhC will lead to changes to the way in which the profession is regulated.

Age neutral workforce planning is currently highly relevant to the NHS, as an employer.

Planning an age neutral workforce

Age neutral workforce planning is currently highly relevant to the NHS, as an employer.


GPs will increasingly call the shots about how and where money is spent in the local health economy, says Conor Burke

Practice based commissioning

With the success of practice based commissioning high on the agenda of the Department of Health and the pivotal role PBC plays in underpinning world class commissioning, it is important for PCT provider arms to understand the potential impact of giving GP practices commissioning power.

Practice leaders programme

The practice leaders programme was conceived early last year by the primary care task force of NHS Education South Central.

Predictive modelling and quality healthcare

No matter which part of the NHS you are in, you will face the same fundamental challenge: to deliver outstanding healthcare while staying within financial boundaries which are finite and shrinking. Tough decisions need to be made.

Prescribing efficiency

GPs in the NHS are the gate keepers of an annual prescription spend of £8.3b in 2007/08.  The paradigm is that GPs decide who should receive medication and more importantly, which type of medication is the most appropriate for a patient.

Private equity in healthcare  

Over the last two years the number of private equity investments in the UK has fallen by over 50 per cent, due mainly to an absence of debt and the high returns required by investors.

Engaging public and partner organisations

Public and partner organisations

NHS Oxfordshire has an ambitious vision for improving the health of its county.

Public health workforce development

Towards the Best Together is NHS East of England’s 10 year vision, developed through consultation with clinicians, other NHS staff, patients and the public, for the NHS and the region’s population of 5.6 million.  It is based on an ambition to deliver the best health service in England.

Public involvement

5 Boroughs Partnership Trust is the first trust in the North West to use a “diary room” style booth with a video camera, where people can sit and give their views on the trust and mental health.

QIPP challenges

QIPP is a cornerstone of the government’s drive to make the NHS take a more preventative and patient-centred approach.

Quality improvement and cost reduction

Classic strategies for major corporate turnaround have always included, among others, quality improvement and cost reduction.

Quality through CQUIN

St Andrew’s Healthcare is a major provider of mental health inpatient services.

Randomised control trials

Randomised controlled trials often encounter problems in meeting recruitment targets, but insights from a recent successful trial can help future recruitment efforts.

Re-basing PMS contracts

NHS Kensington and Chelsea’s director of primary care shares key learning about the PCT’s negotiating framework.

Redundant equipment

If you have old hospital equipment to dispose of, the question is what to do next. While in the past, hospital managers paid to recycle surplus items or returned them to manufacturers to refurbish and sell on, there is now an emphasis on reusing equipment.

Referral pathways

We present a model for streamlining the paediatric grommet referral pathway and follow-up that we have been piloting at St George’s Hospital.

Reporting on incidents

The length of reports into critical incidents could be a barrier to communicating the valuable lessons buried inside them.

Representation in disciplinary hearings

The Court of Appeal has ruled that doctors and dentists employed by NHS bodies in England are entitled to legal representation at disciplinary hearings. The court says the right also extends to representation in capability and ill-health proceedings.

Resolving NHS complaints

Complaints about treatment and care are inevitable, but involving the Independent Complaints Advocacy Service in the process can help make a real difference to all concerned.

Safeguarding children

If NHS organisations are serious about improving safeguarding practice, they must invest in developing the leadership skills of frontline staff.