A study examined the extent and nature of alcohol health worker (AHW) provision in England (specialist hospital staff who worked with patients who drank at levels that had or could impact on their health). It said that provision had greatly increased, but was variable and precarious, and there was a need both for a review of the AHW function and for more outcomes research to build on the evidence base.
Source: Sarah Baker and Charlie Lloyd, A National Study of Acute Care Alcohol Health Workers, Alcohol Research UK
A report examined postnatal care planning in the United Kingdom. It said that over one-third (40 per cent) of women were discharged from hospital before they were ready after giving birth, that women did not receive the recommended level of postnatal care, and that women and babies were affected by poor continuity of care. The report made recommendations regarding commissioning, the planning and implementation of maternity care pathways, and increased staffing levels.
Source: Postnatal Care Planning, Royal College of Midwives
An article examined the extent to which hospital environmental sustainability had been studied and the key issues that emerged for policy, practice, and research. It said that there was a large variability in the evidence base according to topic, with more research on topics such as hospital buildings, or devices and technologies, and less evidence on the clinical, psychological, and social factors that influenced issues such as the use of resources, or travel to or from hospital. The article concluded that there remained significant gaps in the evidence base, although hospitals were increasingly carrying out assessments of environmental impacts and natural resource use, and rising costs and climate change mitigation measures were likely to stimulate further research.
Source: Forbes McGain and Chris Naylor, 'Environmental sustainability in hospitals ï¿½ a systematic review and research agenda', Journal of Health Services Research and Policy, Volume 19 Number 4
An article examined a case study of a public healthcare enterprise, the Queen Elizabeth Hospital in Greenwich, England. It said that the hospital, which was developed under the private finance initiative, became the first to be placed 'in administration', and considered the impact of changes in legislation and policy on the hospital.
Source: Jane Lethbridge, 'Public enterprises in the healthcare sector ï¿½ a case study of Queen Elizabeth Hospital, Greenwich, England', Journal of Economic Policy Reform, Volume 17 Number 3
A paper examined the extent to which a higher supply of nursing/care home beds, or lower prices, might reduce hospital bed blocking (when hospital patients could not be discharged to a nursing or care home because no place was available). It said that delayed discharges responded to the availability of beds but the effect was modest, with a 10 per cent increase in beds found to reduce delayed discharges by about 4-7 per cent. The paper also described strong evidence of spillover effects across local authorities, where spare capacity in neighbouring authorities reduced delays, and with higher levels of delays in local authorities with higher prices for long term care.
Source: James Gaughan, Hugh Gravelle, and Luigi Siciliani, Testing the Bed-Blocking Hypothesis: Does higher supply of nursing and care homes reduce delayed hospital discharges?, Research Paper 102, Centre for Health Economics (University of York)
A report said that patients undergoing operations in private hospitals might be put at risk from issues such as inadequate equipment, lack of intensive care beds, unsafe staffing arrangements, and poor medical record-keeping. It said that around 6,000 patients a year were transferred to National Health Service hospitals from the private sector and, between October 2010 and April 2014, 802 patients died unexpectedly in private hospitals. The report made a range of recommendations to increase available information (including information for patients), and to improve governance, formal reporting, and regulation requirements in the private hospital sector. It also recommended that the Department for Health should review the nature and cost of the transfers from private to National Health Service hospitals each year.
Source: Colin Leys and Brian Toft, Patient Safety in Private Hospitals ï¿½ the Known and the Unknown Risks, Centre for Health and the Public Interest
A report examined the standard of patient nutrition and hydration in hospitals in the United Kingdom. It recommended that the government should develop and maintain a food and drink strategy, and introduce a set of standards across National Health Service hospitals.
Source: The Hospital Food Standards Panel's Report on Standards for Food and Drink in NHS Hospitals, Department of Health/Age UK
An article examined factors and interventions in primary care that impacted on levels of unscheduled secondary care. It said that there were a range of related patient factors (such as age, prevalence of chronic disease, and socio-economic status), and that patients who saw the same family doctor every time they attended the surgery were less likely to require emergency care. Other factors included: ease of access to family doctor surgeries and primary care providers; the distance between home and the emergency department; and patients' other available options for accessing emergency care.
Source: Alyson Huntley, Daniel Lasserson, Lesley Wye, Richard Morris, Kath Checkland, Helen England, Chris Salisbury, and Sarah Purdy, 'Which features of primary care affect unscheduled secondary care use? A systematic review', BMJ Open, Volume 4 Issue 5
The regulator for National Health Service foundation trusts said that there was no systematic evidence of poorer quality of clinical services in small hospitals (often described as district general hospitals), compared to larger ones, and only a limited effect of size on financial performance. However, it said that this was likely to become more relevant as a result of ongoing policy change.
Source: Facing the Future: Smaller acute providers, Monitor
A report by a committee of MPs said that many hospitals found it difficult to cope with increasing levels of demand for accident and emergency services. It said that financial incentives were not aligned across the system, which meant that attempts to ensure patients were treated at the primary care level were not yet working. It noted the lack of specialist emergency care consultants, the slow introduction of round-the-clock consultant cover in hospitals, and a lack of quality performance data, and said that accountability and responsibility for introducing the required change remained unclear. The report made recommendations, including the consideration of better pay and conditions for consultants in more challenging hospitals, and to review the funding system.
Source: Emergency Admissions to Hospital, Forty-sixth Report (Session 201314), HC 885, House of Commons Public Accounts Select Committee, TSO
A study examined the response of acute hospital trusts in England to the report of the Mid Staffordshire NHS Foundation Trust Public Inquiry (Francis Report), published in 2013. The research asked how hospital trusts had responded to the key themes in the report, and about the challenges of changing the quality and culture of care. The report said that there were 'profound tensions' between the need to meet financial performance requirements and the prioritization of quality of care. Trusts had reported greater pressures from regulators and commissioners and the requirements for data provision were onerous for some.
Source: Ruth Thorlby, Judith Smith, Sally Williams, and Mark Dayan, The Francis Report: One year on – the response of acute trusts in England, Nuffield Trust
A report evaluated the Shrewsbury Safer Nights scheme, a multiagency co-ordinated treatment response designed to reduce the impact of the night time economy (NTE) on health services in Shrewsbury (a town in England) over the Christmas and new year period, through providing a temporary St John Ambulance minor injuries treatment unit within the town centre. The report concluded that local partners had successfully worked together to deliver a co-ordinated response, negating the need for attendance at accident and emergency departments, while supporting the police and staff within the NTE. Although the scheme did not have a quantifiable impact on accident and emergency department attendances, it was reported to reduce the pressure on the ambulance service. The report made recommendations for the further development of the scheme.
Source: Katie Hardcastle, Karen Hughes, and Zara Quigg, Perceptions and Impact of the Shrewsbury Safer Nights Minor Injury Unit, Centre for Public Health (Liverpool John Moores University)