Quality improvement updates - 29 November 2012

New policy guidance, tools and initiatives from across the UK. For more information about the quality improvement theme see Quality and Safety e-Bulletin: quality improvement. 

Some of the resources linked to are in PDF format - see how to access PDF files.

Entries are arranged under the following headings:

Audit, reviews, legislation

Care Quality Commission: CQC: Primary medical services pilot: Testing our current inspection methods with GP practices and other primary medical services (PDF 129.4KB). The pilot involved 42 providers of primary medical services from rural and urban areas, different PCT catchment areas and of differing sizes. The recommendations in this report are based on the CQC's current approach to monitoring whether providers continue to meet essential standards, but are likely to change in line with the new CQC strategy currently under consultation.

CQC: CQC takes action at Basildon and Thurrock University Hospitals NHS Foundation Trust after inspection reveals serious concerns. Following an unannounced inspection the CQC has issued two warnings demanding immediate improvement at Basildon and Thurrock University Hospitals NHS Foundation Trust prompted by a number of serious incidents involving the care of children at the trust.

CQC: Tune in to hear CQC on ‘The Wireless’. A series of programmes about CQC are due to air this month on Age UK’s digital and online radio station, ‘The Wireless’. The programmes feature interviews with CQC staff, including an inspector, an ‘Expert by experience’ and our Chief Executive, David Behan.

DH: International sexual violence services review. This report provides an overview of the models of sexual assault service provision. It aims to provide insight into the various models of service provision and funding in a number of developed and developing countries with a particular focus on the roles of government and the voluntary and community services sector.

Healthcare Quality Improvement Partnership (HQIP): HQIP improves its online national clinical audit information. A range of improvements to HQIP’s online national clinical audit information have just been launched. Both the Quality Accounts resource and NCAPOP publication schedule are updated as part of an ongoing programme to improve the way HQIP shares information with clinical audit colleagues.

HQIP: Myocardial Ischaemia National Audit Project MINAP) report 2012. The eleventh annual  MINAP report presenting analyses from all hospitals and ambulance services in England, Wales and Belfast. For the first time this includes data on primary PCI technique within 120 minutes of calling for help. “"Despite evidence that care could continue to improve, MINAP continues to report a year on  year fall in the percentage of patients with heart attack (both STEMI and nSTEMI) that die within 30 days of admission to hospital." 

HQIP: National heart failure audit April 2011 to March 2012. The fifth annual report of the National Heart Failure Audit, commissioned by HQIP as part of the NCAPOP, highlights the urgent need for more patients who are admitted to hospital with heart failure to receive specialist care on a cardiology ward. This recommended practice reduces deaths and improves access to treatments and specialist follow-up. Currently only half of all patients admitted to hospital with heart failure involved in the 2011/12 audit were treated on cardiology wards.

HQIP: National Joint Registry recognises hip replacement surgery success. The National Joint Registry has monitored the performance of hip replacement implants since 2003. Approaching its 10th anniversary, the NJR holds a rich data resource that can offer robust analysis of the performance of these implants and effectiveness of surgical technique. Hip replacement surgery, a technique first introduced by British surgeon Sir John Charnley, celebrates its fiftieth anniversary this November.
BBC Health: Charnley’s hip replacement technique turns 50.

HQIP: Department of Health re-commissions HQIP to lead on clinical audit. The Healthcare Quality Improvement Partnership has been re-awarded two Department of Health contracts. The first is to manage the National Clinical Audit and Patient Outcomes Programme (NCAPOP) and the Clinical Outcome Review Programme (CORP).  The second contract is to support local NHS organisations in England and Wales to carry out local clinical audits and maximise the local use of outputs from national audits. 

HQIP: HQIP to publish 2013/14 quality accounts list this year. The list of national clinical audits to be included in Quality Accounts (QA) 2013/14 will be available to clinical audit professionals at the end of December 2012.

Monitor: Costing Patient Care: Monitor's approach to costing and cost collection for price setting. This sets out Monitor's intentions on costing and cost collection for 2013, and the direction of policy for future years, to support Monitor’s future responsibility for price setting for NHS services. It is accompanied by draft Approved costing guidance. Feedback is required by 11 December 2012.

Monitor: Providers highlight commissioning and tendering as a major concern. Initial findings published today from Monitor’s Fair Playing Field review show the commissioning of patient services has been the most common concern raised so far by respondents. Providers of all types are concerned that commissioners are not tendering as much as they could, making it difficult for new providers to enter the market and develop new services. 
See: Fair Playing Field: Key issues.

Monitor: Monitor steps in on behalf of patients at Cambridge University Hospitals NHS Foundation Trust. Monitor has taken regulatory action at Cambridge University Hospitals NHS Foundation Trust to improve the quality and organisation of healthcare for patients.

National Audit Office (NAO): Review of the data systems for the Department of Health. Review of a sample of the data systems underpinning the input and impact indicators in the Department of Health's Business Plan, Common Areas of Spend and wider management information. 2011-12 is the first year in a rolling programme which will present a complete picture over the next three years.

Regulation and Quality Improvement Authority (RQIA): Independent review of the implementation of the Cardiovascular Service Framework, November 2012 (PDF 634.6KB). The framework was launched by DHSSPS in 2009 and sets out 45 standards for cardiovascular services in Northern Ireland. It was the first in a series of service specific frameworks to be developed and has facilitated service improvements and developments. The report makes ten recommendations for the implementation arrangements for future service frameworks. For each framework a regional lead officer should be identified to take forward the implementation process.

RQIA: Stage Two of the Review of the Implementation of the Northern Ireland Single Assessment Tool (PDF 890.4KB). RQIA has published stage two of its Northern Ireland Single Assessment Tool (NISAT) Review, which focused on the use by staff of the carer’s support and needs assessment tool within the Older People’s Programme of Care. It covers the training provided to staff in the use of the tool, the impact for staff in the implementation of the tool, the views and experiences of carers subject to assessment using the tool.

Scottish Government: Forensic paediatrics: a report by the Short Life Working Group. Short Life Working Group examined present service provision of medical examination to children who have been sexually abused and identified means by which the availability and sustainability of these medical services could be improved.

Scottish Government: Obesity Indicators 2012: monitoring progress for the prevention of obesity route map. This publication reports the latest results for the indicators selected to monitor progress of the Scottish Government’s Prevention of Obesity Route Map. This is the third time the Obesity Route Map indicators have been published. The data for most indicators have been updated to include 2011, although some are more or less recent than this.  

Guidance, innovation, tools

Agency for Healthcare Research and Quality (AHRQ): TeamSTEPPS® for Long-Term Care. This American tool can help nursing home staff define and create teams, and demonstrates the use of TeamSTEPPS tools to identify and raise communication issues affecting long-term care facilities. It was developed by AHRQ and DOD and created specifically for nursing homes, but can be adapted to other long-term care settings such as assisted living communities. TeamSTEPPS for Long Term Care includes new materials to demonstrate how to use communication tools in quality improvement projects.  It is available in DVD format and includes PowerPoint presentations, teaching modules, exercises, and video vignettes that can be used to train staff.

British Dietetic Association: Food counts: The nutrition and hydration digest: improving outcomes through food and beverage (PDF 2MB). Primarily written for those involved in food provision in care settings, particularly dietitians and caterers, this includes sections on menu design structure, different texture of food, cultural and therapeutic diets, dietary coding guidance, catering specifications and food service systems.
Press release: New Nutrition and Hydration Digest Launched.

British Medical Association (BMA): Armed forces: ethical decision making. This toolkit aims to help armed forces doctors fulfil their ethical obligations as medical doctors in the military context.

Care Inspectorate: Emergency relaxation of conditions of numbers. Policy for residential care homes for children and young people. Policy for residential care homes for children and young people. So that the immediate needs of children and young people who need to be looked after are met, and to reflect the emergency nature of these situations which cannot be covered by the normal variation procedures, the Care Inspectorate in Scotland may agree to specific requests from providers to exceed their registered number, subject to certain conditions.

Centre for Pharmacy Postgraduate Education: Business continuity management – a guide. CPPE have developed this guide to support pharmacy teams in understanding the requirements for their pharmacy and to make provisions for emergency planning. It will help the pharmacy team to complete a risk assessment for their place of work and develop and evaluate their own individual business continuity plans, taking into account their specific circumstances.

DH: Distributing Quit kits in 2013. Following the success of this year’s Quit Kit campaign, the Department would like to invite pharmacies across England to distribute Quit Kits to smokers between January and March 2013. The campaign will be supported by a national advertising campaign encouraging smokers to visit their nearest participating pharmacy to pick up a Quit Kit. The Quit Kit is a box of practical tools and advice to help smokers quit smoking, and has been developed by experts, smokers and ex-smokers.

DH: Public health outcomes framework data tool. This first set of baselines published from the interactive data tool will allow local authorities to assess their own outcomes against the various indicators, with the intention of expanding the number of indicators and range of equalities breakdowns presented as the data becomes available. Appendix A, C and D from part 1, and the summary technical specifications from part 2 of the 'Public health outcomes framework' itself have also been updated.
DH: Public Health Outcomes Framework gets technical refresh.

MIND: Crisis Care. Mind has launched an online tool to help commissioners and service users to understand crisis care services for mental health in their area by hosting the FOI data from their local trust. The charity is also sending a detailed briefing to all Clinical Commissioning Groups (CCGs) in England outlining where services are struggling and how they can improve.
Briefing: Mental health crisis care: commissioning excellence (PDF 319KB).
RCN: RCN comments on MIND research.

National electronic Library for Medicines (NeLM): A guide to responding to requests for information about medicines management or use, made under the Freedom of Information Act 2000 (updated October 2012). This guide has been put together by East and South East England Specialist Pharmacy Services.  

National End of Life Care Programme (NEoLCP): Find your 1%: helping GPs to support people to live and die well. This resource pack has been developed to be a practical tool to help GPs identify those patients who may be in their last year of life and talk to them about their preferences. It contains information on: identifying people at the end of life; having end of life care conversations; putting plans in place; managing and co-ordinating care; and space for GPs to include local information such as the telephone numbers of hospices, palliative care teams and pharmacies which stock palliative care drugs.

NHS Commissioning Board: Single model for Strategic Clinical Networks will reduce variation in care. “The primary purpose of these networks, which will work alongside local and operational delivery networks, is for clinicians to gather and share insight into treating conditions that are complex and offer treatment across a number of settings". The new model set to be in place by April 2013 brings together management support and clinical leadership for mental health, dementia, neurological conditions, maternity and children, cancer and cardiovascular services.

NHS Confederation: NHS Outcomes Framework 2013/14 mind map. This mind map brings together on one page all the indicators for each of the five domains in the NHS Outcomes Framework 2013/14. The Framework was published alongside the NHS Commissioning Board Mandate on 12 November 2012.

NHS Improvement: Adult Survivorship: from concept to innovation (PDF 2.1MB). The National Cancer Survivorship Initiative (NCSI) is a partnership between the Department of Health, Macmillan Cancer Support and NHS Improvement. As part of this initiative, NHS Improvement is testing approaches to care and support that ensures that we are moving to a position of not only supporting recovery from their disease, but also their future health and wellbeing through sustaining that recovery. During the last few years a proof of principle has been established which if transferable from the test sites to other organisations will begin the process of spread across the NHS and provide national risk stratified effective pathways for breast, colorectal and prostate cancers.

NHS Kidney Care: How-to guide: ‘Tray’ approach makes home conversions for dialysis easier and more cost effective. NHS Kidney Care has published this guide to a new approach for home dialysis.

NICE: Advice from NICE aims to improve commissioning of hip fracture services. NICE has issued a guide to support the integrated commissioning of high-quality, evidence-based services for people who have fractured their hip. Specifically the guide provides advice on the commissioning of services for people with fragility fracture of the hip or fracture of the hip due to osteoporosis or osteopenia, including services for the ongoing secondary prevention of further hip fracture/fragility fractures.

Public Health Wales: Alcohol Awareness Toolkit. To promote Alcohol Awareness Week 2012 (19-23 November), Public Health Wales has launched a new video about the effectiveness of alcohol brief interventions and developed a toolkit in partnership with Alcohol Concern Cymru to support organisations and workplaces to get involved and promote key messages.

RCN: Diabetes resource. This popular resource has been re-structured and re-launched in readiness to complement a new learning area that is due to be published by the RCN Learning Zone in January 2013. The Diabetes resource directs you to key sources of information and quality resources for diabetes care across the four UK countries, which are useful to health care practitioners, people with diabetes and their families and carers. It is equally useful to those who are very new to diabetes and to those who are more experienced who wish to check out information on a particular aspect of diabetes and its management or, for example, practitioners who are working in different practice areas who need to find out more when caring for patients who also have diabetes.

Royal College of General Practitioners (RCGP): TARGET antibiotics toolkit. The TARGET antibiotics toolkit has been created to aid clinicians and commissioners use antibiotics responsibly and meet (UK) Care Quality Commission requirements. It has been developed by the Royal College of General Practitioners, the (UK) Health Protection Agency and The Antimicrobial Stewardship in Primary Care collaboration of professional societies including GPs, pharmacists, microbiologists, clinicians, guidance developers and other stakeholders.

Scottish Government: A framework for the delivery of palliative care for children and young people in Scotland. The Framework sets out a safe, effective and person centred approach to palliative care for children and young people. It is supported by guidance for services and provides a self assessment tool.

Scottish Government: National risk framework to support the assessment of children and young people. The document sets out a framework and a set of tools to support practitioners working with children and young people to assess their risks from harm and abuse. It is based on the Getting It Right for Every Child approach to well-being and uses the National Practice Model as its basis.

Scottish Government: Mental health strategy for Scotland: 2012-2015. This has been published with corrections. It sets out a range of key commitments across the full spectrum of mental health improvement, services and recovery. S

Shared Intelligence: Evaluation of the Equality Delivery System (EDS) for the NHS. The EDS is a tool kit that can help NHS organisations improve the services they provide for their local communities, consider health inequalities in their locality and provide better working environments, free of discrimination, for those who work in the NHS. The evaluation, undertaken between January and August 2012, focused on the implementation of the EDS across NHS organisations in England.
NHS Commissioning Board: Evaluation of the first year of the Equality Delivery System. 

Social Care Institute for Excellence (SCIE): SCIE Report 62: Managing the transfer of responsibilities under the Deprivation of Liberty Safeguards: a resource for local authorities and healthcare commissioners. This report is intended to help people plan for the changes to the Deprivation of Liberty Safeguards, which comes into force from 1 April 2013. It describes the changes to the identity of the supervisory body in health settings and offers guidance on how local authorities, hospitals, primary care trusts (PCTs) and Clinical Commissioning Groups (CCGs) can work together to ensure that the rights of vulnerable patients are protected.

UK Vision Strategy: Briefing on public health indicator: Preventing avoidable sight loss: a public health priority.  All the leading patient groups and professional bodies strongly support this first ever national eye health indicator. The Government will measure the rate of preventable sight loss by measuring the numbers of all people who are certified sight impaired (partially sighted) or severely sight impaired (blind) and the numbers of these who have lost their sight from one of the three major causes of preventable sight loss: glaucoma, age-related macular degeneration and diabetic retinopathy. 

SCIE Social Care TV: Transition from children’s to adults’ services. Two new films from SCIE focus on transition from children’s to adults’ services for young people with mental health problems. In the first film, four young people from different parts of the country share their experiences of transition. The second film shows a pilot scheme developed by Sheffield Health and Social Care Trust to address the difficulties that young people face and to try to ensure that they do not lose contact with mental health services at the time of transition.

West Midlands Public health Observatory: Older People's Health and Wellbeing Atlas. This updated Atlas can be used to identify deficits in the health and care of older people and to highlight large variations between local authorities across England. Annex A lists the indicators updated in this version of the Atlas. With the inclusion of these updated indicators over 100 indicators relevant to the health and wellbeing of older people are presented at local authority level.

Practice examples and case studies

Care Quality Commission (CQC) case studies: CQC takes urgent action in response to anonymous feedback. "Sometimes when we receive information it prompts us to take immediate action. When we received the feedback below, sent to us anonymously by a member of the public via our website, that’s exactly what happened."

NHS Confederation: A primary care approach to mental health and wellbeing: case study report on Sandwell. This report presents a detailed case study of the journey Sandwell’s health commissioners (now Sandwell and West Birmingham Clinical Commissioning Group) went through to respond to a number of important health inequalities within its local population. It focuses on how its health service commissioners responded to specific health inequalities to develop a primary care-led approach to improving mental health and wellbeing.

SCIE: Call for evidence and practice: joint and integrated working between health and social care. SCIE is looking for case study examples of good practice in joint and integrated working between health and social care services - in particular case study examples of joint and integrated working models between health and social care in services for older people, mental health services and services for older people with mental health difficulties. Examples submitted may be selected to be featured in a new SCIE Digital Resource about Joint and Integrated Care.

Reports, commentary, statistics

2020Health: Orphan medicines: special treatment required? This report was prompted by concerns that patients and their clinicians are not always able to access medicines for those with rare diseases. Ongoing reforms to the NHS and the development of a strategy for rare disease offer an opportunity to consider access to medicines for those with orphan or ultra-orphan conditions. This report provides an analysis of the complex framework that influences patients’ access to orphan drugs, focusing on the role of R&D, regulatory and payer/commissioner decisions, and the links between decision making along the pathway to access. It makes suggestions for better decision making and how to improve access to such drugs more widely.

Care Inspectorate: Childcare statistics 2011. This presents statistics on the provision and use of day care of children and childminding services registered with the Care Inspectorate in Scotland as at 31 December 2011.

Centre for Mental Health & NHS Confederation: Liaison psychiatry in the modern NHS. This report sets out the findings of a study commissioned by the NHS Confederation Mental Health Network on behalf of Strategic Health Authority (SHA) Mental Health Leads. It seeks to identify how liaison psychiatry can most effectively contribute to the Quality, Innovation, Productivity and Prevention (QIPP) challenge of improving health outcomes while at the same time reducing health care costs.

Commonwealth Fund: International Profiles of Health Care Systems: Australia, Canada, Denmark, England, France, Germany, Japan, Iceland, Italy, the Netherlands, New Zealand, Norway, Sweden, Switzerland, and the United States. This publication presents overviews of the healthcare systems of 15 countries. Each overview covers insurance, financing, organization, quality of care, health disparities, efficiency, care coordination, use of evidence-based practice, cost containment, and recent reforms. Summary tables provide data on key health system characteristics and performance indicators.

DH: Dementia challenge progress report published. This progress report gives an update on the first 7 months of the Prime Minister’s Dementia Challenge. The report outlines the aims, achievements and ambitions of the challenge’s 3 champion groups.

DH: Improving health and care: the role of the outcomes frameworks. ‘Improving health and care: the role of the outcomes frameworks’ sets out how the 3 outcomes frameworks, Adult Social Care, the NHS and Public Health, work together to achieve the desired outcomes for the health and care system. This supporting account should be read alongside the individual outcomes frameworks, which for the first time, have been refreshed and published simultaneously.
Individual outcomes frameworks

DH: Adult Social Care Outcomes Framework 2013-14. The Adult Social Care Outcomes Framework (ASCOF) for 2013-14 has been launched by the Secretary of State. The framework has been strengthened with new measures and has been further aligned with the NHS Outcomes Framework and the Public Health Outcomes Framework, supporting all parts of the health and care system to work together to support people to live better for longer.
RCN: Adult social care report is ‘a warning shot’.

DH: Food businesses pledge to increase fruit and veg. More fruit and veg will be added to ready meals and supermarket fruit and veg sections will be expanded as part of a new drive to encourage people to get their 5-a-day. The move comes as part of the latest Public Health Responsibility Deal pledge that aims to encourage action across the food industry to help increase the amount of fruit and vegetables – including fresh, frozen, canned, dried as well as juices – used in pre-prepared food, such as ready meals.

DH: A simple guide to Payment by Results (PbR). This simple guide provides an introduction for newcomers to PbR, from NHS health professionals, managers and administrators, to people engaged in academic study and interested members of the public both in the UK and abroad. It replaces the version released in August 2011.

DH: Winterbourne View hospital good practice project: 'What does good look like?' This letter from Care and Support Minister Norman Lamb introduces a good practice project which will work with local authorities to find out 'what good looks like'.

DH: Public health functions to be exercised by the NHS Commissioning Board. This agreement sets out how the NHS Commissioning Board is accountable for the successful delivery of specified public health programmes, and arrangements for expert support from Public Health England. It provides service specifications which include the public health evidence and advice needed to support effective commissioning.

Department of Health, Social Services and Public Safety (DHSSPS): Health survey Northern Ireland: First results from the 2011/12 survey. This Departmental survey runs every year on a continuous basis. The survey covers a range of health topics that are important to the lives of people in Northern Ireland today. The topics included in the 2011/12 survey include general health, vaccinations, diet & nutrition, availability of food, obesity, smoking, drinking, physical activity, mental health, carers, sexual health, breast screening and cervical smear testing.
News: Key findings.

Health and Social Care Information Centre (HSCIC): Infant feeding survey 2010. The report provides estimates on the incidence, prevalence and duration of breastfeeding among mothers in the first eight to ten months after their baby is born.  "Mums are breastfeeding their babies for longer, with one in three still breastfeeding in some capacity at six months." Covering the UK, information is also available for each nation.
News: More mums are breastfeeding their infants for longer, new figures show.

Health Foundation: Pathway peer review to improve quality. In this thought paper, Professor Barry McCormick explores a novel approach to improving quality. He argues that pathway peer review offers a high-quality and complementary addition to the market regulation of the NHS. It utilises the benefits of professional insight and self-regulation in what is argued to be a cost-effective way. There is an accompanying research report from the Centre for Health Service Economics & Organisation.
CHSEO: Quality of NHS care and external pathway peer review. 

Health Foundation newsletter: Measuring quality: a complicated task. "How should we measure quality of care? We know what quality care should look like. It needs to be safe, effective, person-centred, timely, efficient and equitable. This sounds obvious, but in practice each of these areas is very complex and presents its own challenges when it comes to measurement."

Hospitals in Pursuit of Excellence (HPOE): Palliative care services: solutions for better patient care and today’s health care delivery challenges. This American report looks at palliative care specifically in the US, but findings may be of interest to an international audience. It aims to clarify the benefits and opportunities of providing high quality palliative care services, including: improvements in patient-centred care; the prevention of adverse events; better outcomes; fewer readmissions; and shorter hospital stays.

HSCIC: Hospital prescribing – England 2011. This report compares expenditure between primary and secondary care in total and for selected areas, including medicines positively appraised by NICE. The specific area covered this year is AIDS/HIV.

HSCIC: General Pharmaceutical Services in England 2002-03 to 2011-12. This publication shows information about services provided by community pharmacies and appliance contractors in England in contract with Primary Care Trusts (PCTs) to dispense NHS prescriptions between 2002-2003 and 2011-12.

HSCIC: Provisional Monthly Patient Reported Outcome Measures (PROMs) in England - April to June 2012. "There were 58,867 eligible hospital episodes and 44,533 pre-operative questionnaires returned so far - a headline participation rate of 75.7 per cent, (69.9 per cent for 2010-11)."

HSCIC: Provisional Accident & Emergency Quality Indicators for England. Experimental Statistics by provider for July 2012. This report, generated from Hospital Episode Statistics (HES) A&E data, 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. 

Joseph Rowntree Foundation (JRF): Monitoring poverty and social exclusion 2012. The report examines the impacts of the current Government’s policies on poverty and exclusion. It also examines welfare reform: who will be affected and what the impacts will be. Monitoring poverty and social exclusion 2012 is an essential resource for policy-makers and researchers who need to understand the challenges of tackling poverty in the future.

King’s Fund: Time to think differently. This major new programme of work explores how the funding and delivery of health and social care must be transformed to meet the challenges of the future. This requires new thinking and radical change.

King's Fund: Future trends overview. This overview summarises some of the most significant trends and drivers that will potentially affect health and social care services over the next 20 years. It also discusses the implications of these in order to provide an evidence base for future debate and thinking. It is aimed at policy-makers and health and social care leaders engaging in long-term, strategic thinking about how services need to change.

National Cancer Intelligence Network (NCIN): Overview of ovarian cancer in England: incidence, mortality and survival (PDF 2.2MB). According to this report the rates of women dying from ovarian cancer in England has fallen from 11.2 women in every 100,000 (3,820 cases) in 2001 to 8.8 per 100,000 (3,453 cases) in 2010 – a drop of around 20 per cent. "The most notable drop in deaths over the last 10 years has been among women aged 40-69 years old."
News: Death rates from ovarian cancer have fallen by 20 per cent in last decade. 

National End of Life Care Programme (NEoLCP): EPaCCS: making the case for change.  Locality registers, now known as Electronic Palliative Care Co-ordination Systems (EPaCCS) were identified in the 2008 End of Life Care Strategy as a mechanism for enabling care co-ordination across teams and organisations. This report examines the progress made to date using EPaCCS, including early findings from the South West SHA Locality Register pilot, which showed that the vast majority of people on the register were able to die outside of hospital, and in their preferred place of care. It also examines how they contribute to the patient choice and Quality, Improvement, Productivity and Prevention (QIPP) agendas, as well as improvements in patient safety through co-ordinated communication in standardised formats, which reduced the risk of inappropriate interventions.

NHS Commissioning Board: Bulletin for proposed CCGs – issue 23, 9 November 2012. 
See also: Issue 24, 27 November 2012.

NHS Confederation Community Health Services Forum: NHS continuing healthcare. NHS continuing healthcare (CHC) is care and support provided to adults aged 18 or over, that is arranged and funded solely by the NHS, and is therefore free at the point of delivery. It covers health, personal care and accommodation (if that is part of the overall need). It may take the form of a care home placement or a package of care and support in the individual’s own home or elsewhere. From 1 April 2013, the legal requirements on primary care trusts to undertake the assessment process for CHC will transfer to clinical commissioning groups (CCGs).

NHS Confederation: Ambulance Service Network annual review 2011/12. This review summarises the work and achievements of the Ambulance Service Network in 2011/12 and outlines the network's priorities for 2012/13.

Organisation for Economic Co-operation and Development (OECD): Health at a glance: Europe 2012. This publication presents a set of key indicators of health status, determinants of health, health care resources and activities, quality of care, health expenditure and financing in 35 European countries, including the 27 European Union member states, 5 candidate countries and 3 EFTA countries. The selection of indicators is based on the European Community Health Indicators (ECHI) shortlist, a set of indicators that has been developed to guide the reporting of health statistics in the European Union. It is supplemented by additional indicators on health expenditure and quality of care, building on the OECD expertise in these areas.

Policy Research Unit (PRU): Exploring the early workings of emerging Clinical Commissioning Groups: final report (PDF 3.5MB). This report presents the findings from a study of developing Clinical Commissioning Groups (CCGs) in England. It explores the early experiences of emerging CCGs as they set themselves up as ‘pathfinders’ and moved towards authorisation, investigating the factors that had affected their development and looking at lessons for the future. The specific research questions addressed in this report cover: the experiences of pathfinder CCGs over the past year; factors which have affected progress and development; and approaches taken to being a membership organisation, developing external relationships, and commissioning and
Executive summary (PDF 215KB)
Press release (PDF 458KB)

Schizophrenia Commission: The abandoned illness. In a year-long inquiry, the commission scoped the state of care and outcomes for people living with the condition in England. It "revealed a dysfunctional system that does not deliver the quality of treatment needed for recovery". And asks Is this tolerable in the 21st century? 
BBC: ‘Catastrophic failings’ in schizophrenia care.

Scottish Government: The Same as you? Consultation responses. Responses to the consultation on the learning disability policy.

Scottish Government: Home care services, Scotland, 2012. This Statistics Release presents the latest national figures for Home Care Services provided or purchased by local authorities in Scotland.

ScotPHO: Scotland and European Health for All (HfA) Database 2012. Update of trends to 2010. Following a demand for Scottish data to be included in the World Health Organization's European Health for All (HfA) Database, ScotPHO added Scottish data to a download of the European database and published the first Scotland and European HfA Database in 2006. This was followed by updates in 2007, 2009 and 2012. Provides data against 501 health and health realted indicators.