Tag Archives: Patient Experience

Right care: wrong answers

Dropkin, G. Journal of Public Health, https://doi.org/10.1093/pubmed/fdx136

Published: 03 November 2017

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Background

NHS RightCare is an NHS England programme describing itself as ‘a proven approach that delivers better patient outcomes’. It identifies opportunities for savings and quality improvements, comparing each Clinical Commissioning Group (CCG) with the ‘Best 5’ of a fixed set of ‘Similar 10’ CCGs chosen using equally weighted demographic and deprivation indicators. This article tests whether these indicators are sufficient and equal weighting is appropriate, and evaluates significance.

Methods

Robust public data on lung, colorectal, and breast cancer mortality is modelled using the indicators and incidence. Peers chosen using the preferred models are compared with the Similar 10. Confidence intervals are obtained for comparator group averages. RightCare significance is simulated.

Results

Preferred models have unequally weighted covariates. Incidence is the strongest predictor of lung cancer mortality. The ‘Similar 10’ are inappropriate comparators. RightCare significance ignores variability of comparator outcomes, causing 12% Type I errors. Whilst RightCare shows 1842 annual avoidable lung cancer deaths in 80 CCGs, only 168 deaths in 8 CCGs appear exceptional using appropriate peers and CIs.

Conclusion

CCGs cannot expect to match the average performance of the RightCare ‘Best 5’. Until the methodology is examined with data of known quality, claims that RightCare is a ‘proven approach’ are unsubstantiated.

 

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Diabetes 2015: Care in Crisis: a survey highlighting the views of people with diabetes and how that relates to the reality of today’s NHS

By InDependent Diabetes Trust (2015)

This report outlines the results of a survey of over 15,000 people with diabetes and found that 40 per cent of those surveyed believe that the NHS has “worsened” since the reforms. It also found that 37 per cent were not given appropriate advice and information about diet and exercise at the time of diagnosis. It calls on the government to introduce a specialist diabetes organisation which would work with the clinical community to drive improvements in care and stresses that CCGs should be more strongly encouraged to follow NICE commissioning guidance for diabetes education courses.

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Making sense and making use if patient experience data

By Membership Engagement Services (2015)

This report looks at patient experience data: how and what is being collected; how it is being used for improvements and how patients are being involved. It offers findings for further discussion and suggests next steps, and highlights case studies of where this is happening on the ground and the impact it is having.

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Heads, hands and heart: asset-based approaches in health care: a review of the conceptual evidence and case studies of asset-based approaches in health, care and well-being

By The Health Foundation (2015)

This report summarises the theory and evidence behind asset-based approaches in health care and wellbeing and gives details of six case studies, describing these approaches in action. It sets out some of the opportunities and challenges in adopting asset-based approaches for improving health and wellbeing and explores some of the key principles for developing health assets and the evidence and mechanisms of impact on health outcomes of asset-based projects in the UK.

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Hidden citizens: how can we identify the most lonely older adults?

By Campaign to End Loneliness (2015)

In 2013, the Campaign to End Loneliness consulted over 100 frontline service providers about what they needed to improve their support. Nearly half said they wanted a tool or information that could help them to identify people experiencing – or at risk of – loneliness. This report explores what was already known in both research and practice about identifying people experiencing loneliness. It looked at current approaches to identifying loneliness and searched for insights into how services can improve their outreach and support.

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Examining new options and opportunities for providers of NHS care: The Dalton Review

By The Dalton Review (2014)

Sir David Dalton has conducted a review for the government on new options for providers of NHS care. The Salford Royal NHS Foundation Trust Chief Executive considered issues such as whether local or non-geographical networks of hospitals and services could be brought together under a single leadership team. The review also explores how high-performing NHS organisations might lend their support to providers in difficulty.

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Whitehall monitor: deep impact? how government departments measured their impact, 2010-15

By Institute for Government (2015)

This report looks at one element of the Coalition’s performance measurement regime: impact indicators. These, part of each department’s business plans (which set out the actions each department would take), were designed ‘to help the public to judge whether our policies and reforms are having the effect they want’. This publication pulls together all the available data on the indicators and how they’ve moved over the parliament.

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