Yearly Archives: 2011

Predicting primary health care costs with measures of morbidity and multimorbidity

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This paper Keep it simple? Predicting primary health care costs with measures of morbidity and multimorbidity, published by the Centre for Health Economics at the University of York, investigates the relationship between patients’ primary care costs (consultations, tests and drugs) and their age, gender, deprivation and alternative measures of their morbidity and multimorbidity.

This information is required to set budgets for general practices to cover their expenditure on providing primary care services. It is also useful to examine whether practices’ expenditure decisions vary equitably with patient characteristics.

The study compared the ability of eight measures of patient morbidity and multimorbidity to predict f uture primary care costs using data on 86,100 individuals in 174 English practices. The measures were derived from four morbidity descriptive systems (17 chronic diseases in the Quality and Outcomes Framework (QOF), 17 chronic diseases in the Charlson scheme, 114 Expanded Diagnosis Clusters and 68 Adjusted Clinical Groups.

Brilleman, S.L., Gravelle, H. and Hollinghurst, S. et al (2011). Keep it simple? Predicting primary health care costs with measures of morbidity and multimorbidity. CHE Research Paper 72. York: Centre for Health Economics, University of York, December 2011.

Safeguarding adults at risk of harm: a legal guide for practitioners

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This guide produced by the Social Care Institute for Excellence is aimed primarily at practitioners working in various settings for organisations involved in safeguarding. But it may also be useful for volunteers, family. It aims to equip practitioners with information about how to assist and safeguard people. Knowing about the legal basis is fundamental, because the law defines the extent and limits of what can be done to help people and to enable people to keep themselves safe.

This guide is intended to serve as a pointer to the law and to how it can be used. It tries to explain the law in reasonably simple terms, so it is selective and does not set out full details of each area of law covered. When it comes to the law, further advice will often be needed, but an awareness of it can help practitioners ask the right sort of question and explore possible solutions.

Download Safeguarding adults at risk of harm: A legal guide for practitioners

See also the recent toolkit produced by the British Medical Association Safeguarding vulnerable adults – a toolkit for general practitioners.

Better Care Better Value indicators

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The Better Care Better Value indicators compiled by the NHS Institute for Innovation and Improvement identify potential areas for improvement in efficiency whilst improving quality. They can help to stimulate ideas on where commissioners should focus their attention in re-designing and shifting services away from the traditional setting of the hospital and out towards community based care.

The indicators can help commissioners and providers to inform planning, to inform views on the scale of potential efficiency savings in different aspects of care and to generate ideas on how to achieve these savings. The tool can prompt you to start thinking of “how” and “why” your organisation might differ from others and to support commissioning priorities for health communities.

Access the Better Care Better Value indicators at www.productivity.nhs.uk

The ‘Converting the potential into reality’ guides contain ten steps that commissioners and providers can take to use the Better Care Better Value indicators to maximum effect to improve quality and increase productivity.

Emergency bed use: what the numbers tell us

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This King’s Fund briefing examines whether reducing the use of hospital beds for emergency admissions could help the NHS as it needs to find £20 billion in productivity improvements by 2015 to avoid reducing quality and making significant cuts to services.

The briefing examines:

  • why we need to understand more about bed use for emergency admissions
  • what progress has been made in reducing bed use
  • how reducing bed use can lead to improved quality of care and patient experience, and
  • what the next steps should be.

Download the King’s Fund briefing

Data on the accident and emergency clinical quality indicators

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This is the fifth publication of data on the accident and emergency (A&E) clinical quality indicators, drawn from A&E data within provisional hospital episode statistics. The data relate to A&E attendances in August 2011 and draw on 1.3million detailed records of attendances at major A&E departments, single speciality A&E departments (eg dental A&Es), minor injury units and walk in centres in England.

This report sets out data coverage, data quality and performance information for the following five A&E indicators:

  • Left department before being seen for treatment rate
  • Re-attendance rate
  • Time to initial assessment
  • Time to treatment
  • Total time in A&E

Download the report from the Health and Social Care Information Centre website

Strategic housing for older people resource pack

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This resource pack jointly published by the Housing LIN and ADASS is intended to support local strategic commissioning, planning and investment decisions to help transform and improve the range of housing choices for older people.

The resource pack jointly published by the Housing LIN and ADASS provides a framework and a basket of accompanying tools for councils, public and private sector developers and providers to develop their strategic market position and take the initiative in designing and building homes that older people want, including extra care housing. It can be used to influence local strategic commissioning, planning and investment decisions to help transform and improve the range of housing choices for older people.

The pack supports a variety of activities including:

  • how to develop an understanding of what future demand is likely to be for housing for older people
  • what does the market look like now and how should it look in the future
  • what are the key success factors in the service design process for extra care housing
  • how do you promote and market extra care housing

Strategic housing for older people resource pack (PDF – 13.12Mb)
Read more about the resource pack on the Housing LIN website

Hip fractures and dementia

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In this blog Professor Alistair Burns, National Clinical Director for Dementia for England, talks about fragility fractures and the association with dementia.

Key points

  • 40-50% people with hip fractures have some form of dementia or cognitive impairment
  • Rehabilitation is more of a challenge to people with dementia
  • As part of the routine checks for people who are admitted with a hip fracture, they will now have an assessment of their memory and their cognitive function on admission and after their operation
  • This enables a measure to be made on the presence of dementia or delirium
  • This should lead to better rehabilitation care and better outcomes for dementia sufferers and their carers.

Inquiry into how to improve dementia diagnosis rates in the UK

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The All-Party Parliamentary Group (APPG) on Dementia has launched its next inquiry which will focus on improving dementia diagnosis rates across the UK.

The inquiry will bring together more evidence and understanding about the current problems there are to improving diagnosis of dementia. It will also find good practice examples where services have been helpful to people with dementia getting an early diagnosis, and ensuring they have proper information and support afterwards, so that these examples can be shared.

The APPG is seeking evidence from people with dementia and their carers, health and social care providers and practitioners, and key stakeholder organisations and professional bodies.

You can share your views by completing an online questionnaire.

Alternatively you can email your evidence to appg@alzheimers.org.uk or post it to APPG Evidence, Sarah Tilsed, Alzheimer’s Society, Devon House, 58 St Katharine’s Way, London, E1W 1LB.

The deadline for submission of evidence is 2nd March 2012.

Improving dementia care in South West hospitals

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Hospitals in the South West are working to improve standards of care for patients with dementia.

A regional Expert Reference Group made up of clinical leads for dementia, patients and carers, the voluntary sector and service commissioners has developed a set of eight standards to drive improvement.

The standards are about understanding and meeting people’s individual needs, better assessment and discharge, making the hospital environment ‘dementia friendly’, education and training for staff, nutrition and hydration, working with carers families and volunteers, and care towards the end of life.

South West Standards for Dementia Care in Hospital

Alison Moon, NHS South of England (West) Champion for Dementia Care in Hospital and Chief Nurse at University Hospitals Bristol NHS Foundation trust, said:

“We know that a significant proportion of hospital patients will also have dementia, and that number is increasing. The biggest challenge is to ensure that compassionate, skilled staff have the time and resources they need to provide the best care, whether it is in hospital or the patient’s home. We all need to do better for people with dementia.”

Each general hospital in the South west has an action plan in place to improve care and in recent weeks teams of experts have been reviewing progress.

Alison said:

“We found that all general hospitals in the South West have made good progress with implementing the South West Standards for Dementia Care in Hospital, and in many we found examples of outstanding practice.

However, all hospitals face the challenge of spreading this good practice so that, wherever patients with memory problems or dementia are treated in the hospital, they are their carers receive excellent care. If we get care right for people with dementia, we’ll get it right for all patients”

Each hospital in the South West has a Clinical Lead for Dementia, to ensure that dementia care is a priority at all levels and in all settings. The review teams found that most hospitals have a growing number of ‘Dementia Champions’, hospital staff including porters, security staff, nurses, doctors, physiotherapists and managers who have special training, and focus on improving dementia care.

Better links between hospital and community services are helping to prevent unnecessary admissions to hospital, and to ensure people are discharged home as soon as possible. Special attention is being given to making wards more welcoming and less stressful for the confused patients, to ensure that they have enough o drink and that they have help at mealtimes if they need it.

Alison added:

“We have some way to go to be confident that all standards of care are consistently excellent. But we are sure that thee is a huge amount of work under way to provide the best care for patients with dementia, in the right place.”

Find out more about the South West Standards for Dementia Care in Hospital.