DOCSLIB.ORG

State of Healthcare 2007

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
State of Healthcare 2007 Inspecting Informing Improving State of Healthcare 2007 Improvements and challenges in services in England and Wales © 2007 Commission for Healthcare Audit and Inspection Items may be reproduced free of charge in any format or medium provided that they are not for commercial resale. This consent is subject to the material being reproduced accurately and provided that it is not used in a derogatory manner or misleading context. The material should be acknowledged as © 2007 Commission for Healthcare Audit and Inspection with the title of the document specified. Applications for reproduction should be made in writing to: Chief Executive, Commission for Healthcare Audit and Inspection, Finsbury Tower, 103-105 Bunhill Row, London, EC1Y 8TG ISBN 978 0 10 295155 4 Healthcare Commission State of Healthcare 2007 Improvements and challenges in services in England and Wales Ordered by the House of Commons to be printed on 4 December 2007. Presented to Parliament by the Secretary of State and by the Comptroller and Auditor General in pursuance of Section 128(2) and paragraph 10(4) of Schedule 6 of the Health and Social Care (Community Health and Standards) Act 2003. A copy of the report has also been provided to the Secretary of State for Wales and the Minister for Health and Social Services, National Assembly for Wales, pursuant to section 128(3) of the Health and Social Care (Community Health and Standards) Act 2003. HC 97 London: The Stationery Office £25.75 Contents Foreword 4 Summary 6 Introduction 16 1. Providing a positive experience for patients 24 2. Working to improve health and wellbeing 42 3. Meeting the needs of children and young people 62 4. Developing a culture of safety 80 5. Improving quality and effectiveness 100 Appendix 114 References 120 Index 130 Foreword Healthcare Commission State of Healthcare 2007 | 5 During 2007, the Healthcare Commission highlighted some instances of seriously poor practice and failures in service in healthcare. Are these a sign of more widespread problems in healthcare in England and Wales? The reality is complex. For example, in a 2007 report by the Commonwealth Fund, the UK was ranked first among six developed countries for its provision of healthcare, in relation to quality of care, access, effectiveness and efficiency. In 2007, we rated significantly more NHS organisations “excellent” for the quality of their services and their use of resources than in 2006. Basic standards in the NHS and the independent healthcare sector are also getting better. The overall health of the population also continues to improve. People are living longer and infant mortality is falling. Access to hospital services, including treatment for cancer, continues to improve as waiting times fall. The numbers of doctors and nurses working in the NHS increased during 2007. However, there are areas that need to improve. We found that although patients rated their overall quality of care highly, some aspects of their experience of healthcare fell short. For example, providers of services need to improve their planning of patients’ care to ensure that their services meet individuals’ needs. Primary care services and GPs are the bedrock of healthcare in England and Wales and the main point of contact for most people. Primary care trusts have a crucial role in promoting health at a local level and improving public health. In addition to providing services themselves, they plan and purchase services on behalf of the populations they serve. We identifi ed significant room for improvement in both areas. High-quality information about patients’ care is crucial for measuring how well healthcare providers are performing and highlighting where they need to improve. Where data was not available, for example on sexual health, we could not be confident about the performance of services. Information needs to be available on a comparative basis across the public and private healthcare sectors, and published in a way that patients can access and understand. In this report, we make six high-level recommendations to Government and those providing and purchasing healthcare. These focus on the need to: improve the planning and commissioning of services; improve access outside the waiting time targets; promote a culture of safety more effectively; improve healthcare for children and young people; demonstrate more sensitivity to the individual needs of patients and users of services; and use information better. We urge Government and commissioners and providers of healthcare, working with patients and the public, to act on our recommendations and take account of them in their future plans, so that improvements can continue to be made. Professor Sir Ian Kennedy Anna Walker CB Chair Chief Executive Summary Healthcare Commission State of Healthcare 2007 | 7 Our fourth State of Healthcare report sets out the main improvements in healthcare in England and Wales during 2006/2007 and six key challenges for service providers. The Healthcare Commission is the Healthcare Commission has a statutory independent healthcare watchdog for duty to pay particular attention to children’s England. We assess and report on the needs. In view of our increasing work in this quality and safety of services provided area, and that of other organisations, we felt by the NHS and the independent sector, the time was right to report in detail on the to promote ongoing improvement in particular issues facing young patients and healthcare in England and Wales. This users of services. is our fourth annual State of Healthcare report. In it, we set out the findings of our Throughout this report, we have drawn recent assessment work, focusing on the mainly from our own findings. We have 2006/2007 financial year. Although the included relevant information produced by formal purpose of State of Healthcare 2007 other organisations where it is helpful to is to report to Parliament and the Welsh our analysis. Although our main focus is on Assembly Government, we hope that other 2006/2007, in some instances we have used audiences will find it informative and useful information from earlier or later periods as well. where it has added to our understanding. Our work as a regulator asks two The Commission has a more limited role in fundamental questions. Are the healthcare Wales than in England. As in previous years, organisations we inspect and regulate when preparing this year’s report we have getting the basics right in terms of quality worked closely with Healthcare Inspectorate and safety, and are they building on the Wales, which reviews NHS and independent basics to deliver real improvements? With healthcare providers in Wales, the Wales this in mind, in the pages that follow we Audit Office and other partners. focus on how organisations in England and Wales are performing in fi ve broad areas: Context • Providing a positive experience for Funding for the NHS rose from over £55 patients. billion in 2002/2003 to nearly £90 billion in 2007/2008, an increase of 7.2% a year • Working to improve health and wellbeing. in real terms. Levels of activity have risen • Meeting the needs of children and young substantially over the past 10 years, with people. the number of consultations in GP practices growing by around 70 million to almost • Developing a culture of safety in 290 million in 2006. The number of fi rst healthcare. outpatient appointments has risen by more • Improving quality and effectiveness. than one million since 2000/2001. The NHS workforce in England has grown by 27% in Our chapter on the health needs of the 10 years since 1996. children and young people is the only one that focuses on a particular group. The 8 | Summary During 2006/2007, the NHS in England saw hospitals. This view was supported by the major reconfigurations of its ambulance annual assessment of hospital cleanliness services and primary care trusts (PCTs), carried out by patient environment action with the number of PCTs halved. These teams, which awarded a higher percentage changes are expected to benefi t patients of inpatient facilities “excellent” or “good” and the public in the long term, but during in 2007. Most of the patients who took the year they presented challenges for the part in the survey (around 70%) reported NHS in terms of maintaining a high quality that doctors and nurses always washed of service for patients or cleaned their hands between touching patients, though there is still some room for Our annual assessment of NHS trusts improvement. in England for 2006/2007 showed improvements in both the quality of services Improving people’s access to treatment and offered by trusts, and in trusts’ use of reducing the length of time they have to wait their resources. Compared with results for for it has been a major focus of Government 2005/2006, a larger proportion of trusts policy in England. We have seen long- scored “excellent” for quality of services and term and yearly improvements in waiting a smaller proportion scored “weak”. times for diagnostic tests, for outpatient appointments and for planned admissions Our assessments of the independent sector to hospital. The vast majority of acute trusts in 2006/2007 also found improvements in continued to meet the standard requiring compliance with core national minimum them to see 98% of patients in A&E within standards. four hours. Providing a positive experience Although this is positive news, many trusts still need to pay more attention to for patients ‘hidden’ waiting times. These are waiting The vast majority of NHS trusts provide care times for areas that historically haven’t that patients and users of services regard been monitored or had clear targets as “good” or better than good. For example, set, or are partially or wholly excluded more than 90% of those who responded from the current 18-week waiting times to our survey of acute hospital inpatients target.
Load more

Recommended publications
  • The NHS in Wales: Structure and Services (Update)
    The NHS in Wales: Structure and services (update) Abstract This paper updates Research Paper 03/094 and provides briefing on the structure of the NHS in Wales following the restructuring in 2003, and further reforms announced by the First Minister in 2004. May 2005 Members’ Research Service / Gwasanaeth Ymchwil yr Aelodau Members’ Research Service: Enquiry Gwasanaeth Ymchwil yr Aelodau: Ymholiad The NHS in Wales: Structures and Services (update) Dan Stevenson / Steve Boyce May 2005 Paper number: 05/ 023 © Crown copyright 2005 Enquiry no: 04/2661/dps Date: 12 May 2004 This document has been prepared by the Members’ Research Service to provide Assembly Members and their staff with information and for no other purpose. Every effort has been made to ensure that the information is accurate, however, we cannot be held responsible for any inaccuracies found later in the original source material, provided that the original source is not the Members’ Research Service itself. This document does not constitute an expression of opinion by the National Assembly, the Welsh Assembly Government or any other of the Assembly’s constituent parts or connected bodies. Members’ Research Service: Enquiry Gwasanaeth Ymchwil yr Aelodau: Ymholiad Members’ Research Service: Enquiry Gwasanaeth Ymchwil yr Aelodau: Ymholiad Contents 1 Introduction .......................................................................................................... 1 2 Recent reforms of the NHS in Wales................................................................... 2 2.1 NHS reforms in Wales up to April 2003 ................................................................. 2 2.2 Main features of the 2003 NHS organisational reforms ......................................... 2 2.3 Background to the 2003 NHS reforms ................................................................... 3 2.4 Reforms announced by the First Minister on 30 November 2004........................... 4 3 The NHS in Wales: Commissioners and Providers of healthcare services ....
    [Show full text]
  • Three Essays on the Behavioral, Socioeconomic, and Geographic Determinants of Mortality: Evidence from the United Kingdom and International Comparisons
    University of Pennsylvania ScholarlyCommons Publicly Accessible Penn Dissertations 2016 Three Essays on the Behavioral, Socioeconomic, and Geographic Determinants of Mortality: Evidence From the United Kingdom and International Comparisons Laura Kelly University of Pennsylvania, [email protected] Follow this and additional works at: https://repository.upenn.edu/edissertations Part of the Demography, Population, and Ecology Commons, and the Epidemiology Commons Recommended Citation Kelly, Laura, "Three Essays on the Behavioral, Socioeconomic, and Geographic Determinants of Mortality: Evidence From the United Kingdom and International Comparisons" (2016). Publicly Accessible Penn Dissertations. 1806. https://repository.upenn.edu/edissertations/1806 This paper is posted at ScholarlyCommons. https://repository.upenn.edu/edissertations/1806 For more information, please contact [email protected]. Three Essays on the Behavioral, Socioeconomic, and Geographic Determinants of Mortality: Evidence From the United Kingdom and International Comparisons Abstract This dissertation contains three chapters covering the impact of behavioral, socioeconomic, and geographic determinants of health and mortality in high-income populations, with particular emphasis on the abnormally high mortality in Scotland, and the relative advantages of indirect and direct analyses in estimating national mortality. Chapter one identifies behavioral risk factors underlying mortality variation across small-areas in Great Britain, using the indirect estimation
    [Show full text]
  • The Four Health Systems of the United Kingdom: How Do They Compare?
    The four health systems of the United Kingdom: how do they compare? Gwyn Bevan, Marina Karanikolos, Jo Exley, Ellen Nolte, Sheelah Connolly and Nicholas Mays Source report April 2014 About this research This report is the fourth in a series dating back to 1999 which looks at how the publicly financed health care systems in the four countries of the UK have fared before and after devolution. The report was commissioned jointly by The Health Foundation and the Nuffield Trust. The research team was led by Nicholas Mays at the London School of Hygiene and Tropical Medicine. The research looks at how the four national health systems compare and how they have performed in terms of quality and productivity before and after devolution. The research also examines performance in North East England, which is acknowledged to be the region that is most comparable to Wales, Scotland and Northern Ireland in terms of socioeconomic and other indicators. This report, along with an accompanying summary report, data appendices, digital outputs and a short report on the history of devolution (to be published later in 2014), are available to download free of charge at www.nuffieldtrust.org.uk/compare-uk-health www.health.org.uk/compareUKhealth. Acknowledgements We are grateful: to government statisticians in the four countries for guidance on sources of data, highlighting problems of comparability and for checking the data we have used; for comments on the draft report from anonymous referees and from Vernon Bogdanor, Alec Morton and Laura Schang; and for guidance on national clinical audits from Nick Black and on nursing data from Jim Buchan.
    [Show full text]
  • Frontiers of Health Report V9.Indd
    Social Research Institute Frontiers of performance in the NHS II “Stop looking up to the Department... and start looking out to your local populations and patients” David Nicholson NHS Chief Executive About Ipsos MORI Ipsos MORI is the sum total of two successful research companies, Ipsos UK and MORI, which joined together in October 2005 to create the second largest research company in the UK. We offer a full range of quantitative and qualitative research services, as well as extensive international research capacity. The Ipsos MORI Social Research Institute works closely with national government, local public services and the not-for-profit sector. We help policy makers understand what works in terms of service delivery, and we provide robust evidence to bridge the gulf between the public and politicians — we also provide a host of background information for clients on key policy challenges. The NHS and Public Health research team is a leading provider of research on attitudes of public service users, staff and other stakeholders. The team works extensively with the Department of Health and many Trusts and Strategic Health Authorities on a wide range of issues, from communications approaches to patient satisfaction, using the full range of research techniques. 2 Ipsos MORI: Frontiers of performance in the NHS II Contents Foreword 2 Executive Summary 4 Introduction 6 How is performance measured in the NHS? 6 Structure of the report 9 Part 1 – PCTs 11 1. What factors are associated with positive patient ratings of PCTs? 12 A. The effect of objective performance measures 12 B. Local population factors 16 C.
    [Show full text]
  • Annual Report and Accounts 2007-08 Adobe PDF Document 559Kb
    Health Professions Council Annual report and accounts for the year ending 31 March 2008 HC 986 Health Professions Council Annual report and accounts 2007_08 Presented to Parliament pursuant to Articles 44(3) and 46(7) of the Health Professions Order 2001. Ordered by the House of Commons to be printed on 21 July 2008 HC 986 London: The Stationery Office £12.85 © Crown Copyright 2008 The text in this document (excluding the Royal Arms and other departmental or agency logos) may be reproduced free of charge in any format or medium providing it is reproduced accurately and not used in a misleading context. The material must be acknowledged as Crown copyright and the title of the document specified. Where we have identified any third party copyright material you will need to obtain permission from the copyright holders concerned. For any other use of this material please write to Office of Public Sector Information, Information Policy Team, Kew, Richmond, Surrey TW9 4DU or e-mail: [email protected] ISBN:978 010 295742 6 Contents Part one The Council 4 President’s statement 8 Chief Executive and Registrar’s report 9 Part two Statutory committee reports 10 Conduct and Competence Committee 10 Education and Training Committee 11 Health Committee 13 Investigating Committee 14 Non-statutory committee reports 15 Audit Committee 15 Communications Committee 16 Finance and Resources Committee 17 Part three Communications 18 Campaigns and media 18 The web 19 Events 20 Publications 22 Public affairs and stakeholder communications 23 Policy and standards
    [Show full text]
  • Same Difference a Comparison of International Health Systems England • U.S
    SAME DIFFERENCE A COMPARISON OF INTERNATIONAL HEALTH SYSTEMS ENGLAND • U.S. • GERMANY INTRODUCTION ........................................................................................................................01 HEALTHCARE IN ENGLAND, THE U.S. AND GERMANY ....................................................02 THE CHANGING ENVIRONMENT .................................................................................. 08 COMMISSIONING RESPONSES .................................................................................. 13 CASE STUDY: UK........................................................................................................ 15 CHANGING CARE MODELS: PROVIDERS .......................................................... 16 CASE STUDY: U.S. .............................................................................................20 CHANGING CARE MODELS: PRIMARY CARE ............................................22 TECHNOLOGY ..........................................................................................24 CASE STUDY: GERMANY .....................................................................26 CONCLUSION ..................................................................................28 UNDERSTANDING THE TERMS WE USE ...................................30 REFERENCES ............................................................................ 31 PRODUCED BY THE BDO CENTRE FOR GLOBAL HEALTHCARE EXCELLENCE & INNOVATION NOVEMBER 2016 A COMPARISON OF INTERNATIONAL HEALTH SYSTEMS | SAME DIFFERENCE 01 INTRODUCTION
    [Show full text]
  • Dental-Service-Spec-Prisons-2020.Pdf
    Service specification Dental service for prisons in England 2020 NHS England and NHS Improvement 1 NHS England and NHS Improvement Publishing Approval Reference: 001181 Contents 1. How to use this document ................................................................................... 3 2. The model ............................................................................................................ 4 3. Introduction .......................................................................................................... 7 4. Guiding principles ................................................................................................ 8 5. Core service delivery ......................................................................................... 11 5.1 Service vision .................................................................................................. 11 5.2 Days and hours of operation ........................................................................... 13 5.3 Service availability ....................................................................................... 13 5.4 Inclusion criteria .......................................................................................... 14 5.5 Exclusion criteria ......................................................................................... 14 5.6 Equivalence for services in prisons ............................................................. 14 5.7 Setting ........................................................................................................
    [Show full text]
  • Accessing Healthcare in Other Countries of the European Economic Area by the S2 (E112) Route
    Accessing Healthcare in England If you are registered with a general practitioner in Scotland then you are entitled to free NHS care arranged by NHS Scotland. Generally that care will be provided as close to home as possible and within your own NHS Board area but care may be provided elsewhere in NHS Scotland if that is clinically necessary. NHS England runs a different financial system involving internal charging between “providers” (NHS Trusts) and “commissioners” (NHS Primary Care Trusts) for health care services. Residents of Scotland who are registered with a GP in Scotland will always be entitled to emergency care anywhere in the UK but are not automatically entitled to access elective (planned) NHS care in England as NHS providers will expect to invoice NHS Scotland for providing that service. Before providing elective services to patients registered within NHS Scotland, a provider Trust is therefore required to obtain advance financial consent from the relevant NHS Scotland Board. Where a patient wishes to access routine healthcare in England for social reasons such as studying or working in England or staying with relatives for a period longer than a normal holiday then we would strongly recommend that the patient registers with a local general practitioner in England which will entitle them to access their routine NHS care including community services from NHS England. Where it is necessary for clinical reasons to refer a patient to a specialist service in England because that service is not available in NHS Scotland then this is usually funded through national agreements managed by NHS National Services Division in Edinburgh.
    [Show full text]
  • Quality in the New Health System ‐ Maintaining and Improving Quality from April 2013
    Quality in the new health system ‐ Maintaining and improving quality from April 2013 A draft report from the National Quality Board Final Report, January 2013 3 Contents Foreword 1. Introduction 6 2. Our common purpose 13 – improving quality and delivering better outcomes 3. Our shared values and behaviours 21 – putting patients and service users first 4. Our distinct roles and responsibilities for quality 25 5. How we will work together to maintain quality 51 – spotting the early signs of failure – judging when there has been a quality failure – responding when things go wrong 6. Making it happen 57 4 Foreword The Health and Social Care Act 2012 is fundamentally changing the way the NHS, public health and care system in England is organised and run. Over the past two years, there has been much debate about these changes. This debate has often been emotive, polarised and technical in nature, and the focus on quality has tended to be implicit rather than explicit. Yet improving the quality of care for patients and service users is the driving force behind these changes and is what unites us around a common purpose. The NHS is organising itself around a single definition of quality: care that is effective, safe and provides as positive an experience as possible. This simple, yet powerful definition that arose out of the NHS Next Stage Review has now been enshrined in legislation. It lies at the heart of the first ever NHS Outcomes Framework and continues to help unite the ambitions and motivations of staff with the hopes of patients and the expectations of the public.
    [Show full text]
  • Investigating What the UK Can Learn from the French Model of Healthcare Funding
    Investigating what the UK can learn from the French model of healthcare funding November 2018 Thomas Mills The UK is reaching a healthcare funding crisis. The population is ageing and there is strong demand for a process of modernisation.1 But the finances to ameliorate these problems are not available. The UK funding model cannot keep up with the financial demands of quality universal healthcare.2 Yet the system remains without serious proposals for reform. This report seeks to understand the ways in which healthcare in the UK is failing and how the method of funding may be responsible. The weaknesses of the oft-referenced US model should not stand as confirmation of the pre- eminence of the government-controlled system. The shortcomings of the American structure should serve only as a warning against shifting the majority of funding responsibility to the private sector. This comparison obscures the fact that an abundance of European nations have rejected the notion that universal healthcare must be funded through taxation. A significant number of countries with universal healthcare avoid using direct, unhypothecated taxation as their core funding mechanism. This includes Germany, Switzerland, the Netherlands and France. And given its similarities to the UK in foundational principles and domestic appreciation for the respective system, as well as its relative strengths, France shall be the nation under review. After exploring the key mechanisms, analysis will turn to the merits and drawbacks of the model. This will aid in assessing whether elements of the French healthcare funding system are suitable and effective enough to implement in the UK.
    [Show full text]
  • Imagine, a World Without DIS-EASE Is It Possible?
    Imagine, A World Without DIS-EASE – Is It Possible? Mark S. Grenon Imagine, A World Without DIS-EASE Is It Possible? Mark S. Grenon Volume One Copyright © 2018 Mark S. Grenon All rights reserved. ISBN-13: 978-1727749144 ISBN-10:1727749146 Imagine, A World Without DIS-EASE – Is It Possible? Mark S. Grenon In LOVING Memory of Bishop David “Maverick” Glover for his help and dedication to creating “a world without dis-ease”! Imagine, A World Without DIS-EASE – Is It Possible? Mark S. Grenon 100% of the proceeds from this book will be donated to the Genesis II Church of Health and Healing to support its workers and support official G2 Projects around the world to help create, “a world without dis-ease.” REAL SCIENCE: We at the Genesis II Church of Health and Healing have been involved in one of the most comprehensive, worldwide, cross cultural, broad spectrum, voluntary, human health studies of this world for the past 8 years. If you include Jim Humble and his studies in Africa, it has been almost 20 years. 95% of the world's diseases have been CURED with the Genesis II Church Protocols! No monies were received from any pharmaceutical/medical companies wanting a certain result. The people of this world who have followed the G2C protocols have not been paid in any way, but they have “self-dosed” themselves voluntarily. “Self-Care” is what is being taught and encouraged by the Genesis II Church worldwide and it is working incredibly well. Every person on this earth has the God-given right to control their own health and not rely on the pharmaceutical/medical industry.
    [Show full text]
  • NHS Long Term Plan (Pdf)
    Long-Term Plan Long-Term Plan Long-Term The NHS Long Term Plan Plan Long-Term Plan #NHSLongTermPlan www.longtermplan.nhs.uk [email protected] www.longtermplan.nhs.uk #NHSLongTermPlan January 2019 The NHS Long Term Plan 3 Contents THE NHS LONG TERM PLAN – OVERVIEW AND SUMMARY 6 CHAPTER 1: A NEW SERVICE MODEL FOR THE 21ST CENTURY 11 1. We will boost ‘out-of-hospital’ care, and finally dissolve the historic divide 13 between primary and community health services A new NHS offer of urgent community response and recovery support 14 Primary care networks of local GP practices and community teams 14 Guaranteed NHS support to people living in care homes 15 Supporting people to age well 16 2. The NHS will reduce pressure on emergency hospital services 18 Pre-hospital urgent care 19 Reforms to hospital emergency care – Same Day Emergency Care 21 Cutting delays in patients being able to go home 23 3. People will get more control over their own health and more personalised 24 care when they need it 4. Digitally-enabled primary and outpatient care will go mainstream 25 across the NHS 5. Local NHS organisations will increasingly focus on population health – 29 moving to Integrated Care Systems everywhere CHAPTER 2: MORE NHS ACTION ON PREVENTION AND HEALTH INEQUALITIES 33 Smoking 34 Obesity 36 Alcohol 38 Air pollution 38 Antimicrobial resistance 39 Stronger NHS action on health inequalities 39 CHAPTER 3: FURTHER PROGRESS ON CARE QUALITY AND OUTCOMES 44 A strong start in life for children and young people 45 Maternity and neonatal services 46 Children
    [Show full text]