In this slideshow Dr Rebecca Rosen, Senior Fellow, Nuffield Trust, explores recent trends and strategic choices in the organisation of hospital services in Europe.
Dr Rosen spoke at the Nuffield Trust European Summit 2014, supported by KPMG.
The document discusses the NHS Digital Academy, which will be responsible for ensuring international excellence in training and education for clinical information officers and other digital health leaders. The Academy will support leaders from exemplar NHS trusts and complement existing workforce development programs. It will include distance learning, partnerships with international organizations, and experiential learning through digital health projects at exemplar sites. The document also briefly mentions the MyNHS data visualization and customization tool, as well as new domains for conditions like dementia and diabetes. Finally, it outlines plans to launch an online triage service for NHS 111.
Sandeepa Arora & George Stoye: Private health care provisionNuffield Trust
This document analyzes trends in public and private healthcare spending in England between 2003-2012. It finds that while the total number of hip and knee replacements remained stable, NHS-funded operations increased by a third, accounting for over half the rise. This suggests some patients switched from private to NHS care. Demographic changes only explain a small part of the increase. Evidence from individual providers also shows decreasing private volumes and numbers of privately-funded procedures, further indicating substitution from private to public funding.
Dr. Nav Chana, Dr. Junaid Bajwa, and Claire Oatway discussed solutions to improve primary care based on their experiences with the Primary Care Home model. Dr. Paul Grundy discussed transforming healthcare delivery through population health management and patient-centered care. The presentation proposed the Primary Care Home model, which focuses on personalized care, population health planning across primary, secondary and social care, and financial alignment based on community health needs. A panel then discussed questions about implementing this new primary care model.
This document discusses how community pharmacy can support the Sustainability and Transformation Plans (STPs) and Vanguard programs in the UK. It outlines several services community pharmacies provide that could help address demands on the NHS, including: 1) treating minor ailments to reduce strain on GPs and A&E, 2) providing emergency supplies of medication to avoid unnecessary visits to out-of-hours doctors or A&E, and 3) assisting with discharge from hospitals and admissions avoidance through medicine reviews. The document also discusses how community pharmacy can help in areas like anticoagulation monitoring and management of long-term conditions like COPD. It emphasizes the need for consistent commissioning of pharmacy services across regions to maximize the
This document discusses ways that community and hospital pharmacies can work together to implement recommendations from the NHS Five Year Forward View and Lord Carter Report to improve efficiency and save up to £5 billion. Specifically, it outlines how infrastructure functions like supply chain management, education, and advisory services could be delivered by community pharmacies. Potential areas of collaboration include having community pharmacies take over hospital outpatient dispensing, provide homecare services, dispense discharge medications, and help manage stock. Challenges and future developments are also discussed.
This document summarizes a presentation on achieving innovation at scale in the NHS. It was chaired by leaders in the NHS and medical fields. One presentation discussed the EPISCISSORS-60, a patented episiotomy scissors that provides a more accurate cut and has led to reductions in childbirth injuries across several UK hospitals. Another presentation discussed implementing the i-THRIVE model of care for child and adolescent mental health services, which focuses on a needs-based pathway with multi-agency involvement, community support, and shared decision making. A third presentation was about the digital health company AliveCor and its wireless electrocardiogram devices.
The document discusses the NHS Digital Academy, which will be responsible for ensuring international excellence in training and education for clinical information officers and other digital health leaders. The Academy will support leaders from exemplar NHS trusts and complement existing workforce development programs. It will include distance learning, partnerships with international organizations, and experiential learning through digital health projects at exemplar sites. The document also briefly mentions the MyNHS data visualization and customization tool, as well as new domains for conditions like dementia and diabetes. Finally, it outlines plans to launch an online triage service for NHS 111.
Sandeepa Arora & George Stoye: Private health care provisionNuffield Trust
This document analyzes trends in public and private healthcare spending in England between 2003-2012. It finds that while the total number of hip and knee replacements remained stable, NHS-funded operations increased by a third, accounting for over half the rise. This suggests some patients switched from private to NHS care. Demographic changes only explain a small part of the increase. Evidence from individual providers also shows decreasing private volumes and numbers of privately-funded procedures, further indicating substitution from private to public funding.
Dr. Nav Chana, Dr. Junaid Bajwa, and Claire Oatway discussed solutions to improve primary care based on their experiences with the Primary Care Home model. Dr. Paul Grundy discussed transforming healthcare delivery through population health management and patient-centered care. The presentation proposed the Primary Care Home model, which focuses on personalized care, population health planning across primary, secondary and social care, and financial alignment based on community health needs. A panel then discussed questions about implementing this new primary care model.
This document discusses how community pharmacy can support the Sustainability and Transformation Plans (STPs) and Vanguard programs in the UK. It outlines several services community pharmacies provide that could help address demands on the NHS, including: 1) treating minor ailments to reduce strain on GPs and A&E, 2) providing emergency supplies of medication to avoid unnecessary visits to out-of-hours doctors or A&E, and 3) assisting with discharge from hospitals and admissions avoidance through medicine reviews. The document also discusses how community pharmacy can help in areas like anticoagulation monitoring and management of long-term conditions like COPD. It emphasizes the need for consistent commissioning of pharmacy services across regions to maximize the
This document discusses ways that community and hospital pharmacies can work together to implement recommendations from the NHS Five Year Forward View and Lord Carter Report to improve efficiency and save up to £5 billion. Specifically, it outlines how infrastructure functions like supply chain management, education, and advisory services could be delivered by community pharmacies. Potential areas of collaboration include having community pharmacies take over hospital outpatient dispensing, provide homecare services, dispense discharge medications, and help manage stock. Challenges and future developments are also discussed.
This document summarizes a presentation on achieving innovation at scale in the NHS. It was chaired by leaders in the NHS and medical fields. One presentation discussed the EPISCISSORS-60, a patented episiotomy scissors that provides a more accurate cut and has led to reductions in childbirth injuries across several UK hospitals. Another presentation discussed implementing the i-THRIVE model of care for child and adolescent mental health services, which focuses on a needs-based pathway with multi-agency involvement, community support, and shared decision making. A third presentation was about the digital health company AliveCor and its wireless electrocardiogram devices.
Has clinical commissioning found its voice? GP perspectives on their CCGsNuffield Trust
This slide deck presents the fourth and final year of results from an annual survey of GPs and practice managers in six CCGs across the country. The survey – conducted as part a joint project with The King’s Fund – explores how GP attitudes towards clinical commissioning have evolved since their launch in 2013.
The perfect health system - Dr Mark BritnellNuffield Trust
At the first keynote for the Nuffield Trust Health Policy Summit 2016, Mark Britnell gives an overview of key characteristics of effective health systems.
Reshaping the healthcare workforce - Candace imisonNuffield Trust
For the Nuffield Trust Health Policy Summit 2016, Candace Imison talks about what steps would be necessary to develop and reshape the health care workforce.
The document discusses plans for the Cheshire and Mersey Comprehensive Local Research Network (CLRN) and its transition to the North West Coast CLRN. It outlines objectives to double recruitment, increase commercial study participation, and reduce approval times. It also discusses merging over 100 networks into 15 Local Clinical Research Networks including the North West Coast CLRN covering Cheshire, Mersey, South Cumbria and Lancashire with an £18 million budget. The goal is to simplify structures while maximizing research delivery and protecting national priorities through close working with the Academic Health Science Network.
Greater Manchester's visionary approach to integrated care
Delivered by the Greater Manchester Health and Social Care Partnership
Day Two, Pop-up University 8, 16.00
The way forward for greater manchester academic health science network ahsnPM Society
The document discusses the relationship between the Manchester Academic Health Science Centre (MAHSC) and the Greater Manchester Academic Health Science Network (GM-AHSN). It outlines that MAHSC members host many of the key assets that support GM-AHSN's business plan and that GM-AHSN's domains will deliver implementation of NICE guidelines and technologies. It also describes MAHSC and GM-AHSN's areas of expertise, including systems biology, discovery assets, implementation science, and access to a large population. Finally, it discusses opportunities and challenges for partnership working with industry through case studies.
Evaluating the impact of choice on place of careNuffield Trust
This document examines the effect of patient choice and Independent Sector Treatment Centres (ISTCs) on treatment location in England from 2003 to 2011. It finds that while ISTCs increased the number of procedures conducted outside the NHS, their overall effect was small due to a limited number of sites. The distribution of referrals also became more concentrated at the GP practice level during this period.
Creating successful partnerships in yorkshire and humberPM Society
The document discusses creating successful partnerships in Yorkshire and Humber through the Yorkshire and Humber Academic Health Science Network (YH AHSN). It outlines the AHSN's large membership network and the challenges in the region including health variations and economic pressures. The AHSN's 2013/14 work programme focuses on improving population health, transforming health services, increasing wealth and research participation through various partnership initiatives. Key to success is emphasizing collaboration, adding value to existing organizations, and closing gaps between industry, higher education and the NHS.
The document summarizes the key themes of the NHS 5 Year Forward View plan. It outlines the plan's vision for new models of integrated care focused on populations of 50,000 people. The plan acknowledges an estimated annual funding gap of £30 billion by 2020/21 for the NHS and the need for efficiency savings and increased funding. It also emphasizes the importance of prevention, personalization, technology, and social determinants of health for a sustainable healthcare system.
The document discusses improving clinical quality in orthopaedic care within the NHS in England. It notes significant increases in joint replacement procedures and revisions in recent years. There is huge variation between trusts in outcomes like infection rates, readmission rates, and litigation costs. The GIRFT program aims to address this variation by collecting comprehensive data on trusts, identifying best practices, and supporting implementation of quality improvements to achieve better outcomes and cost savings. The document advocates for more centralized specialty services and clinical networks to improve quality and training.
This document provides an overview and summary of the planning guidance for the NHS in England for 2015/16. It outlines the key priorities and requirements for the coming year which include maintaining performance standards, implementing new models of care, improving prevention, workforce development, digital transformation, and driving efficiency. Local areas are encouraged to develop plans that align commissioner and provider budgets and activity in line with the priorities of the Five Year Forward View.
Moving forward with the greater manchester formularyPM Society
The document discusses the development and implementation of a joint formulary across Greater Manchester to standardize prescribing and reduce unwarranted variation.
Some key points:
- The GM joint formulary aims to create consistency in prescribing across primary and secondary care within the region to improve patient care and reduce costs.
- Developing the formulary required significant consultation, leadership support, and governance structures to align 12 CCGs and providers.
- Implementation includes developing formulary chapters, monitoring use at practice level, and establishing a "do not prescribe" list to prevent postcode prescribing variation.
- Future plans include the formulary being maintained by the CSU, expanding monitoring capabilities, and developing partnerships with industry within ethical frameworks
This document discusses opportunities for engagement within the new NHS system, including both product-specific engagement at the national level regarding research, pipelines, commissioning, value, price, and placement, as well as local implementation, priorities, problems, and prices. It also addresses challenges with medicines optimization, such as low medication adherence rates, insufficient patient information, preventable hospital admissions due to medicine side effects, unacceptable medication errors, and wastage. Finally, it proposes strategies for engagement, collaboration, improving outcomes, ensuring value, and leveraging information technology.
This document discusses how the Healthcare Quality Improvement Partnership (HQIP) supports quality improvement through various programs and tools. HQIP manages the National Clinical Audit Programme which includes 34 national audits across different clinical areas. It also oversees other national programmes focused on specific topics like learning disabilities. HQIP helps align quality improvement programs with NICE guidance and standards. Tools like clinical audits and the Quality Standard Service Improvement Template help providers assess current practice against standards and plan improvements. NICE guidance and quality standards can support quality improvement when implemented using these resources.
1) The document discusses new models of care that are being developed and tested in the UK to address issues with the current fragmented healthcare system such as rising costs and inconsistent quality of care.
2) It outlines challenges facing the current hospital-centric model and describes new integrated models that aim to coordinate care across providers, settings, and sectors.
3) The presentation concludes by acknowledging that transitioning to new models of care will be difficult and take longer than expected but remains an important strategy to improve outcomes and value through the NHS Five Year Forward View.
NHS England and partners have published six Quick Guides to bring clarity on how best to work with the care sector. They can be accessed at www.nhs.uk/quickguides
Want to find out how the care sector can support local systems in the run up to winter? Want to break down barriers between health and care organisations? Want to find out how Leicester has achieved a 60% reduction in care home admission costs? Want to finally break down the myths around sharing patient information and assessments? Want to use other people's ideas and resources?
Webinar outcomes:
Introduction to the care homes quick guides
Two examples of models referenced in the guides:
- Angela Dempsey, Baker Tilly on the Quest4care tool
- Dawn Moody on MDT working and a model implemented in a CCG
Guest Speakers: Nicola Spencer and Emily Carter - NHS England
This document provides an orientation for delegates of the Highlands Ranch Community Association (HRCA). It outlines the mission, vision, governance structure, roles and responsibilities of the board of directors and delegates. Key points include: the HRCA's mission is to enhance property values through recreation and community events; the board of directors and various committees provide leadership and oversight of recreational amenities, development projects, and financial management; and delegates represent members within their district and have powers to vote on budgets and elect board members.
This document discusses the organizational structures of hospitals. It describes the classifications of healthcare as primary, secondary, and tertiary care. Hospitals are also classified as general, specialty, rehabilitation, long-term care, or nursing homes. Regulatory agencies oversee hospitals. The roles of the governing board, hospital administrator, and medical staff are outlined. Advances in technology have increased complexity and professional specialization within hospitals. Effective communication and leadership are needed to coordinate the diverse professionals and administrative functions within this complex organizational system.
Has clinical commissioning found its voice? GP perspectives on their CCGsNuffield Trust
This slide deck presents the fourth and final year of results from an annual survey of GPs and practice managers in six CCGs across the country. The survey – conducted as part a joint project with The King’s Fund – explores how GP attitudes towards clinical commissioning have evolved since their launch in 2013.
The perfect health system - Dr Mark BritnellNuffield Trust
At the first keynote for the Nuffield Trust Health Policy Summit 2016, Mark Britnell gives an overview of key characteristics of effective health systems.
Reshaping the healthcare workforce - Candace imisonNuffield Trust
For the Nuffield Trust Health Policy Summit 2016, Candace Imison talks about what steps would be necessary to develop and reshape the health care workforce.
The document discusses plans for the Cheshire and Mersey Comprehensive Local Research Network (CLRN) and its transition to the North West Coast CLRN. It outlines objectives to double recruitment, increase commercial study participation, and reduce approval times. It also discusses merging over 100 networks into 15 Local Clinical Research Networks including the North West Coast CLRN covering Cheshire, Mersey, South Cumbria and Lancashire with an £18 million budget. The goal is to simplify structures while maximizing research delivery and protecting national priorities through close working with the Academic Health Science Network.
Greater Manchester's visionary approach to integrated care
Delivered by the Greater Manchester Health and Social Care Partnership
Day Two, Pop-up University 8, 16.00
The way forward for greater manchester academic health science network ahsnPM Society
The document discusses the relationship between the Manchester Academic Health Science Centre (MAHSC) and the Greater Manchester Academic Health Science Network (GM-AHSN). It outlines that MAHSC members host many of the key assets that support GM-AHSN's business plan and that GM-AHSN's domains will deliver implementation of NICE guidelines and technologies. It also describes MAHSC and GM-AHSN's areas of expertise, including systems biology, discovery assets, implementation science, and access to a large population. Finally, it discusses opportunities and challenges for partnership working with industry through case studies.
Evaluating the impact of choice on place of careNuffield Trust
This document examines the effect of patient choice and Independent Sector Treatment Centres (ISTCs) on treatment location in England from 2003 to 2011. It finds that while ISTCs increased the number of procedures conducted outside the NHS, their overall effect was small due to a limited number of sites. The distribution of referrals also became more concentrated at the GP practice level during this period.
Creating successful partnerships in yorkshire and humberPM Society
The document discusses creating successful partnerships in Yorkshire and Humber through the Yorkshire and Humber Academic Health Science Network (YH AHSN). It outlines the AHSN's large membership network and the challenges in the region including health variations and economic pressures. The AHSN's 2013/14 work programme focuses on improving population health, transforming health services, increasing wealth and research participation through various partnership initiatives. Key to success is emphasizing collaboration, adding value to existing organizations, and closing gaps between industry, higher education and the NHS.
The document summarizes the key themes of the NHS 5 Year Forward View plan. It outlines the plan's vision for new models of integrated care focused on populations of 50,000 people. The plan acknowledges an estimated annual funding gap of £30 billion by 2020/21 for the NHS and the need for efficiency savings and increased funding. It also emphasizes the importance of prevention, personalization, technology, and social determinants of health for a sustainable healthcare system.
The document discusses improving clinical quality in orthopaedic care within the NHS in England. It notes significant increases in joint replacement procedures and revisions in recent years. There is huge variation between trusts in outcomes like infection rates, readmission rates, and litigation costs. The GIRFT program aims to address this variation by collecting comprehensive data on trusts, identifying best practices, and supporting implementation of quality improvements to achieve better outcomes and cost savings. The document advocates for more centralized specialty services and clinical networks to improve quality and training.
This document provides an overview and summary of the planning guidance for the NHS in England for 2015/16. It outlines the key priorities and requirements for the coming year which include maintaining performance standards, implementing new models of care, improving prevention, workforce development, digital transformation, and driving efficiency. Local areas are encouraged to develop plans that align commissioner and provider budgets and activity in line with the priorities of the Five Year Forward View.
Moving forward with the greater manchester formularyPM Society
The document discusses the development and implementation of a joint formulary across Greater Manchester to standardize prescribing and reduce unwarranted variation.
Some key points:
- The GM joint formulary aims to create consistency in prescribing across primary and secondary care within the region to improve patient care and reduce costs.
- Developing the formulary required significant consultation, leadership support, and governance structures to align 12 CCGs and providers.
- Implementation includes developing formulary chapters, monitoring use at practice level, and establishing a "do not prescribe" list to prevent postcode prescribing variation.
- Future plans include the formulary being maintained by the CSU, expanding monitoring capabilities, and developing partnerships with industry within ethical frameworks
This document discusses opportunities for engagement within the new NHS system, including both product-specific engagement at the national level regarding research, pipelines, commissioning, value, price, and placement, as well as local implementation, priorities, problems, and prices. It also addresses challenges with medicines optimization, such as low medication adherence rates, insufficient patient information, preventable hospital admissions due to medicine side effects, unacceptable medication errors, and wastage. Finally, it proposes strategies for engagement, collaboration, improving outcomes, ensuring value, and leveraging information technology.
This document discusses how the Healthcare Quality Improvement Partnership (HQIP) supports quality improvement through various programs and tools. HQIP manages the National Clinical Audit Programme which includes 34 national audits across different clinical areas. It also oversees other national programmes focused on specific topics like learning disabilities. HQIP helps align quality improvement programs with NICE guidance and standards. Tools like clinical audits and the Quality Standard Service Improvement Template help providers assess current practice against standards and plan improvements. NICE guidance and quality standards can support quality improvement when implemented using these resources.
1) The document discusses new models of care that are being developed and tested in the UK to address issues with the current fragmented healthcare system such as rising costs and inconsistent quality of care.
2) It outlines challenges facing the current hospital-centric model and describes new integrated models that aim to coordinate care across providers, settings, and sectors.
3) The presentation concludes by acknowledging that transitioning to new models of care will be difficult and take longer than expected but remains an important strategy to improve outcomes and value through the NHS Five Year Forward View.
NHS England and partners have published six Quick Guides to bring clarity on how best to work with the care sector. They can be accessed at www.nhs.uk/quickguides
Want to find out how the care sector can support local systems in the run up to winter? Want to break down barriers between health and care organisations? Want to find out how Leicester has achieved a 60% reduction in care home admission costs? Want to finally break down the myths around sharing patient information and assessments? Want to use other people's ideas and resources?
Webinar outcomes:
Introduction to the care homes quick guides
Two examples of models referenced in the guides:
- Angela Dempsey, Baker Tilly on the Quest4care tool
- Dawn Moody on MDT working and a model implemented in a CCG
Guest Speakers: Nicola Spencer and Emily Carter - NHS England
This document provides an orientation for delegates of the Highlands Ranch Community Association (HRCA). It outlines the mission, vision, governance structure, roles and responsibilities of the board of directors and delegates. Key points include: the HRCA's mission is to enhance property values through recreation and community events; the board of directors and various committees provide leadership and oversight of recreational amenities, development projects, and financial management; and delegates represent members within their district and have powers to vote on budgets and elect board members.
This document discusses the organizational structures of hospitals. It describes the classifications of healthcare as primary, secondary, and tertiary care. Hospitals are also classified as general, specialty, rehabilitation, long-term care, or nursing homes. Regulatory agencies oversee hospitals. The roles of the governing board, hospital administrator, and medical staff are outlined. Advances in technology have increased complexity and professional specialization within hospitals. Effective communication and leadership are needed to coordinate the diverse professionals and administrative functions within this complex organizational system.
Organizational Structure Of A Hospital[1]jawadorak
The organizational structure of a hospital facilitates efficient management by establishing lines of authority and accountability. Larger hospitals have more complex structures than smaller facilities. Hospital departments are generally grouped into administration services, informational services, therapeutic services, diagnostic services, and support services. Administration oversees budgets, policies and public relations. Informational services handle admissions, billing, records and technology. Therapeutic services provide treatment. Diagnostic services determine causes of illness or injury. Support services maintain supplies and the facility. Understanding the organizational chart helps navigate a hospital's departments and staff.
The document discusses the organizational structure of hospitals. It explains that hospital structure involves different levels of management and departments grouped by similarity of duties. Large hospitals tend to have complex structures while smaller hospitals have simpler structures. Common departmental groupings include administrative services, informational services, therapeutic services, diagnostic services, and support services. An example traditional organizational chart and symbolic pyramid structure are also provided.
The document discusses the organization of hospitals. It defines a hospital as a social organization that brings together people with different skills and knowledge to provide patient care through a hierarchy. Hospitals have a matrix organizational structure with both vertical and horizontal lines of authority. This allows for decentralized decision-making while maintaining central control. The organizational chart is complex to accommodate different professional groups like doctors, nurses, and administrative staff. Formalization of roles and standardization of processes are important to integrate these groups toward the common goal of patient care.
Rebecca Rosen: Trends and drivers of change in primary careNuffield Trust
This document discusses trends and drivers of change in European primary care. It outlines that primary care serves as the first point of access to health services through generalist clinicians working in teams. The scope of primary care is expanding to include care coordination, specialist services, and new forms of access like e-consultations. There are multiple drivers of increasing demand, like aging populations and rising chronic disease prevalence. Primary care systems vary significantly across Europe in inputs like physician numbers and expenditures. The document examines political, economic, and policy trends shaping primary care reforms around integration, new payment models, and delivery innovations.
Primary care in Europe: can we make it fit for the future?Nuffield Trust
Primary care provides essential health services but current models are struggling to adapt to changing needs. New models are emerging in Europe to make primary care more comprehensive, coordinated, accessible and sustainable. These include larger group practices, multidisciplinary teams, and integrated community health centers. Redesigning primary care requires principles like continuity, early access to expertise, and payment systems that support coordination and population health.
Sue Hill (Chief Scientific Officer for England) The perfect storm hcs15NHShcs
The document discusses the challenges facing the UK healthcare system and outlines a vision for the future outlined in the NHS Five Year Forward View. It identifies three gaps - in health/wellbeing, funding/efficiency, and care/quality - that could undermine the future system if not addressed. The Forward View proposes new models of integrated care, greater investment in primary care, empowering patients, and preventative health. Realizing this vision will require diverse local solutions, aligned national leadership, a modern workforce, exploiting technology/data, accelerating innovation, and driving efficiency. Healthcare science professionals can help achieve better outcomes through prevention, earlier disease detection, and improved treatment options.
Keith Willet: Pharmacy's role in the urgent and emergency care review Nuffield Trust
The document discusses proposals from the Urgent and Emergency Care Review in the UK to reform urgent and emergency care services. It outlines plans to provide more responsive urgent care outside hospitals, treat non-life threatening issues close to home, and ensure serious issues are treated in specialized centers. It also discusses expanding the role of community pharmacies, improving NHS 111, and creating Urgent Care Networks to better coordinate care across providers. The goal is to provide the right care, in the right place, first time for urgent and emergency patients.
This document discusses proposals to reform urgent and emergency care in England. It outlines plans to provide more responsive urgent care outside hospitals. For serious/life-threatening needs, centers with expertise and facilities would be established. Current systems are described, including millions of pharmacy visits, NHS 111 calls, GP consultations, and A&E attendances annually. Reforms proposed include better self-care information, an enhanced NHS 111 service, improved use of summary care records, more same-day access to primary/community care, and ambulance services providing mobile treatment. Urgent care centers and networks connecting all services are also discussed. Payment reforms and addressing workforce and information sharing challenges are highlighted.
1115 aine carroll clinical leaders forum nhc integrated care turning healthca...investnethealthcare
This document summarizes a presentation on integrated care given at the National Healthcare Conference in 2015. It discusses different types of integrated care including horizontal, vertical, and within sectors. Integrated care aims to provide coordinated services across providers and settings to support patients. Barriers to integrated care include fragmentation, distrust, and lack of coordination between strategy and operations. National clinical programs in Ireland have led to improved outcomes for conditions like heart attacks, surgery, and stroke through more integrated models of care. However, challenges remain around resources, hierarchies, and fully implementing integrated approaches across the healthcare system.
Dr Judith Smith: Current state of NHS reformsNuffield Trust
The document summarizes the current state of NHS reforms in the UK. It describes the NHS under the previous Labour government, including increased spending, improved access and outcomes. It then outlines the efficiency challenges facing the NHS and key proposals in the new White Paper, including establishing independent commissioning bodies and transferring public health to local governments. It discusses the mixed reaction to the proposals and an announced "policy pause". It considers potential impacts and risks going forward, such as the challenges of transitioning to the new system while achieving major efficiency savings.
The document summarizes the current state of NHS reforms in the UK. It describes the NHS under the previous Labour government, including increased spending, improved access and outcomes. It then outlines the efficiency challenges facing the NHS and key proposals in the new White Paper, including establishing independent commissioning groups, an outcomes framework, and moving public health to local governments. It discusses mixed reactions to the proposals and an announced "policy pause" to further review the plans.
Mike Deegan: Solving the challenges facing hospitals Nuffield Trust
This document discusses challenges facing hospitals and a case study of achieving sustainable hospital services in Trafford. It summarizes the clinical model developed between Trafford General Hospital and Central Manchester Foundation Trust, which included consolidating services like acute medicine, orthopedics, and critical care onto a primary site. Key benefits included improved outcomes, reduced costs, and better staffing through unified services operating across sites. The acquisition model was deemed transferable to other contexts where strong commissioning support and regulatory approval exist for necessary service changes.
The EU Directive on cross-border healthcare aims to increase transparency in healthcare across EU countries. It will initially involve publishing information for all hospitals and hospital services, and then expand to include outpatient services. This will form an EU-wide standard for healthcare quality, guidelines, price lists, and other consumer information. Each member state must create easy-to-use websites providing this information by the end of 2013. The goal is to drive competition for better quality and value in healthcare through transparency and increased patient involvement in healthcare choices.
This document discusses predictive risk modeling and its applications in integrated care. It provides examples of how predictive risk modeling works, including:
- Developing predictive risk models using pseudonymized patient data to identify individuals at high risk of future health events.
- Evaluating model performance by measuring how well it predicts actual outcomes, with trade-offs between correctly identifying more actual cases versus incorrectly predicting cases.
- Examples of UK projects that use predictive risk modeling to stratify patient populations and target case management or other interventions to high-risk groups, with the aim of improving outcomes and reducing health care costs.
This document summarizes the partnership between the National Institute for Health Research (NIHR) and industry to support clinical research and innovation in the UK. Key points:
- NIHR invests over £1 billion annually in research infrastructure including clinical trials facilities to support industry partnerships and clinical research.
- In 2015/16 this infrastructure supported over 11,000 studies, recruited over 320,000 patients, and resulted in over 1,300 collaborations and 576 partnerships with industry worth £149.7 million.
- Examples are provided of NIHR funding programs that support translational research and adoption of novel technologies, helping to bridge the "valley of death" between research and commercialization.
1) Telenursing in the Intensive Care Unit (ICU) involves using telecommunication technologies to remotely monitor critically ill patients and support bedside healthcare teams.
2) The number of patients requiring critical care is increasing due to an aging population and advanced treatments, yet resources are decreasing. Tele-ICU aims to address these challenges by providing remote monitoring and expertise from ICU specialists.
3) Studies have found tele-ICU can reduce ICU and hospital length of stays and mortality while increasing compliance with best practices. Tele-ICU nurses monitor patients, collaborate with bedside staff, and ensure best practices are followed to increase patient safety.
This document discusses health technology assessment (HTA) and commissioning in the English NHS, with a focus on general practitioners (GPs). It provides background on HTA, which evaluates the clinical effectiveness and cost-effectiveness of health interventions. It also discusses key elements of the 2010 NHS reform plan and the history of GP commissioning in England since the 1990s, including GP fundholding schemes that gave GPs budgets to purchase some services. Evaluation found GPs were able to improve primary care and develop alternatives to hospital care, but faced challenges shifting resources from hospitals.
This document discusses a partnership between UCB, a biopharmaceutical company, and the NHS to improve epilepsy services. It outlines UCB's role in research and development for neurological conditions. The objective is to provide data tools and best practices to help the NHS analyze needs, develop services, and implement new commissioning models for epilepsy care. This includes using simulation tools to model pathways and costs with different service configurations. Opportunities for UCB and Epilepsy Action to work together are also discussed to jointly drive improvements in epilepsy healthcare.
The document summarizes the vision for integrating Chelsea & Westminster Hospital NHS Foundation Trust and West Middlesex University Hospital NHS Trust to create a larger healthcare provider and teaching hospital. Key points include:
- The new organization would have over 1,000 beds and £500 million in revenue, becoming one of the largest providers in London.
- West Middlesex would focus on elective care and lower complexity services while Chelsea & Westminster would focus on specialist tertiary care.
- The integration is intended to improve quality, access, staff opportunities, and financial sustainability through increased scale and efficiencies.
- Consultation is underway and the goal is to establish the new organization in July 2015 pending regulatory approvals.
Nwc academic health science network event slide deck3GDR
The document discusses celebrating partnerships in health and innovation in the North West Coast region of England. It summarizes that partnerships are bringing together organizations for wider collaboration, establishing regional health and economic projects, and promoting the region for joint working and business. It outlines the vision of the North West Coast Academic Health Science Network to reduce health inequalities, improve economic growth, and build partnerships across the region through a focus on residents, infrastructure, and sharing best practices.
This document discusses innovation in health and e-health. It notes that populations are aging and chronic conditions are increasing, putting demands on healthcare systems and professionals. It describes Odense University Hospital as a major Danish healthcare center that receives 10% of the country's healthcare budget. The hospital's innovation focuses on buildings, processes, and systems like infrastructure, communication platforms, shared care systems, robots, and cross-sectoral collaboration. It discusses telemedicine and using a MAST model for assessing telemedicine applications across multiple domains. The document emphasizes staying patient-focused, collaborating locally and globally, developing and testing new technologies, and ensuring recruitment and expansion of competencies to serve future hospitals.
Holly Holder & Ian Blunt: Integrated care pilot evaluationNuffield Trust
The document evaluates the first year of the Inner North West London Integrated Care Pilot (ICP), which aims to improve coordination of care for older adults and those with diabetes. It finds that the ICP made substantial progress establishing governance structures and engaging organizations across health and social care. However, most patients did not experience changes in year one and it was too early to see impacts on health services or outcomes. The evaluation highlights the complexity of implementing large-scale transformation and that longer-term evaluation is needed to assess changes in care and health impacts.
Similar to Rebecca Rosen: Trends in the organisation of hospital services (20)
This document discusses the potential impacts of automation on healthcare employment and discusses alternative views beyond job loss. It notes that automation may lead to reconfiguring of healthcare work rather than outright job loss. Examples of existing technologies that have automated tasks in healthcare like pharmacy automation and emerging technologies like decision support systems and personal health tracking are provided. The document advocates that automation could lead to a virtuous cycle in healthcare if it allows workers to focus on tasks that require human skills and judgment.
Evaluation of the Integrated Care and Support Pioneers ProgrammeNuffield Trust
This document summarizes the findings of evaluations of the Integrated Care and Support Pioneers Programme in the UK. The evaluations found that while Pioneers aspired to comprehensive system change, their activities focused more narrowly on initiatives like risk stratification and care coordination teams. Progress was difficult to measure against indicators and Pioneers faced challenges from financial pressures and competing priorities. The evaluations concluded that further integration will be challenging under increasing demands on the health system.
The document discusses lessons learned from the Southwark and Lambeth Integrated Care (SLIC) program in London. Key points:
- SLIC aimed to reduce hospital admissions and care home placements for older adults through risk stratification, holistic assessments, and care management.
- Success required agreement on the problem, dedicated teams, funding shifts to support community care, and leadership development.
- Future programs need a strong business case, co-design with citizens, and a dedicated "engine room" team to drive local transformation.
Effectiveness of the current dominant approach to integrated care in the NHSNuffield Trust
Jonathan Stokes of the Greater Manchester Primary Care Patient Safety Translational Research Centre presents a systematic review of case management in integrated care.
Providing actionable healthcare analytics at scale: Understanding improvement...Nuffield Trust
This document discusses measurement for quality improvement. It explains that measurement in improvement aims to provide a basis for action to improve processes and outcomes, rather than just estimating parameters. Improvement measures should be simple, specific, and available in real-time. Statistical process control methods are important to separate normal variation from changes resulting from interventions. Examples are provided of run charts measuring improvements in recording BMI for mental health patients and compliance with care bundles. The document advocates making the theories behind improvement efforts more explicit.
Ramani Moonesinghe, Associate National Clinical Director for Elective Care at NHS England, discusses the use of data for monitoring care quality at various levels within the system.
This document discusses using statistical process control (CUSUM) charts to monitor mortality rates at the level of individual general practitioners and health authorities. It describes how CUSUM charts could potentially have detected Harold Shipman, a GP who murdered over 200 patients, by spotting outliers in the routine mortality data. The document also discusses challenges in risk adjusting outcomes to account for differences in patient characteristics and casemix between providers. Accurately adjusting for factors like age, comorbidities, and emergency status is important for fair comparisons but difficult using only administrative data.
Martin Utley, Director of the Clinical Operational Research Unit at University College London, reflects upon his involvement in the launch of specific tools to monitor care quality for paediatric cardiac surgery.
Evaluating new models of care: Improvement Analytics UnitNuffield Trust
Martin Caunt, Improvement Analytics Unit Project Director and NHS England and Adam Steventon, Director of Data Analytics at The Health Foundation share insights into how they have approached evaluating new models of care.
Lisa Annaly, Head of Provider Analytics at the Care Quality Commission, discusses lessons learned from the CQC as they have worked to monitor care quality over time.
- Real-time monitoring of healthcare services requires defining both a reporting window and data window to accurately capture demand, activity, and wait times.
- Using only a reporting window (e.g. a single month) to request data can result in invalid or misleading performance metrics, as it does not account for patients with long wait times.
- Defining a larger data window that includes all patients requested before the end of the reporting window and reported after the start avoids this problem, but requires a counterintuitive data request.
- Without properly defining both windows, real-time monitoring can provide an inaccurate picture of service performance and falsely suggest the need for more resources.
Monitoring quality of care: making the most of dataNuffield Trust
Chris Sherlaw-Johnson, Senior Research Analyst at the Nuffield Trust, introduced the Monitoring quality of care conference and gives an overview of some of the approaches that we've been using at the Trust to identify where care quality has been improving, especially for frail and older people.
Providing actionable healthcare analytics at scale: Insights from the Nationa...Nuffield Trust
Christopher Boulton, Falls and Fragility Fracture Audit Programme Manager at the Royal College of Physicians and Rob Wakeman, Clinical Lead for Orthopaedic Surgery at the National Hip Fracture Database talk about what they have learned by analysing the national hip fracture database.
Providing actionable healthcare analytics at scale: A perspective from stroke...Nuffield Trust
Benjamin Bray, Research Director and the Sentinel Stroke National Audit Programme, presents at the Monitoring quality of care conference about stroke care analytics.
New Models of General Practice: Practical and policy lessonsNuffield Trust
Nuffield Trust policy researchers Rebecca Rosen and Stephanie Kumpunen present findings from our upcoming report on large scale general practice models.
Dr. Tan's Balance Method.pdf (From Academy of Oriental Medicine at Austin)GeorgeKieling1
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Academy of Oriental Medicine at Austin
Academy of Oriental Medicine at Austin
Academy of Oriental Medicine at Austin
About AOMA: The Academy of Oriental Medicine at Austin offers a masters-level graduate program in acupuncture and Oriental medicine, preparing its students for careers as skilled, professional practitioners. AOMA is known for its internationally recognized faculty, award-winning student clinical internship program, and herbal medicine program. Since its founding in 1993, AOMA has grown rapidly in size and reputation, drawing students from around the nation and faculty from around the world. AOMA also conducts more than 20,000 patient visits annually in its student and professional clinics. AOMA collaborates with Western healthcare institutions including the Seton Family of Hospitals, and gives back to the community through partnerships with nonprofit organizations and by providing free and reduced price treatments to people who cannot afford them. The Academy of Oriental Medicine at Austin is located at 2700 West Anderson Lane. AOMA also serves patients and retail customers at its south Austin location, 4701 West Gate Blvd. For more information see www.aoma.edu or call 512-492-303434.
- Video recording of this lecture in English language: https://youtu.be/Pt1nA32sdHQ
- Video recording of this lecture in Arabic language: https://youtu.be/uFdc9F0rlP0
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Nano-gold for Cancer Therapy chemistry investigatory projectSIVAVINAYAKPK
chemistry investigatory project
The development of nanogold-based cancer therapy could revolutionize oncology by providing a more targeted, less invasive treatment option. This project contributes to the growing body of research aimed at harnessing nanotechnology for medical applications, paving the way for future clinical trials and potential commercial applications.
Cancer remains one of the leading causes of death worldwide, prompting the need for innovative treatment methods. Nanotechnology offers promising new approaches, including the use of gold nanoparticles (nanogold) for targeted cancer therapy. Nanogold particles possess unique physical and chemical properties that make them suitable for drug delivery, imaging, and photothermal therapy.
“Psychiatry and the Humanities”: An Innovative Course at the University of Mo...Université de Montréal
“Psychiatry and the Humanities”: An Innovative Course at the University of Montreal Expanding the medical model to embrace the humanities. Link: https://www.psychiatrictimes.com/view/-psychiatry-and-the-humanities-an-innovative-course-at-the-university-of-montreal
5-hydroxytryptamine or 5-HT or Serotonin is a neurotransmitter that serves a range of roles in the human body. It is sometimes referred to as the happy chemical since it promotes overall well-being and happiness.
It is mostly found in the brain, intestines, and blood platelets.
5-HT is utilised to transport messages between nerve cells, is known to be involved in smooth muscle contraction, and adds to overall well-being and pleasure, among other benefits. 5-HT regulates the body's sleep-wake cycles and internal clock by acting as a precursor to melatonin.
It is hypothesised to regulate hunger, emotions, motor, cognitive, and autonomic processes.
Discover the benefits of homeopathic medicine for irregular periods with our guide on 5 common remedies. Learn how these natural treatments can help regulate menstrual cycles and improve overall menstrual health.
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STUDIES IN SUPPORT OF SPECIAL POPULATIONS: GERIATRICS E7shruti jagirdar
Unit 4: MRA 103T Regulatory affairs
This guideline is directed principally toward new Molecular Entities that are
likely to have significant use in the elderly, either because the disease intended
to be treated is characteristically a disease of aging ( e.g., Alzheimer's disease) or
because the population to be treated is known to include substantial numbers of
geriatric patients (e.g., hypertension).
Spontaneous Bacterial Peritonitis - Pathogenesis , Clinical Features & Manage...Jim Jacob Roy
In this presentation , SBP ( spontaneous bacterial peritonitis ) , which is a common complication in patients with cirrhosis and ascites is described in detail.
The reference for this presentation is Sleisenger and Fordtran's Gastrointestinal and Liver Disease Textbook ( 11th edition ).
TEST BANK For Brunner and Suddarth's Textbook of Medical-Surgical Nursing, 14...Donc Test
TEST BANK For Brunner and Suddarth's Textbook of Medical-Surgical Nursing, 14th Edition (Hinkle, 2017) Verified Chapter's 1 - 73 Complete.pdf
TEST BANK For Brunner and Suddarth's Textbook of Medical-Surgical Nursing, 14th Edition (Hinkle, 2017) Verified Chapter's 1 - 73 Complete.pdf
TEST BANK For Brunner and Suddarth's Textbook of Medical-Surgical Nursing, 14th Edition (Hinkle, 2017) Verified Chapter's 1 - 73 Complete.pdf
Gene therapy can be broadly defined as the transfer of genetic material to cure a disease or at least to improve the clinical status of a patient.
One of the basic concepts of gene therapy is to transform viruses into genetic shuttles, which will deliver the gene of interest into the target cells.
Safe methods have been devised to do this, using several viral and non-viral vectors.
In the future, this technique may allow doctors to treat a disorder by inserting a gene into a patient's cells instead of using drugs or surgery.
The biggest hurdle faced by medical research in gene therapy is the availability of effective gene-carrying vectors that meet all of the following criteria:
Protection of transgene or genetic cargo from degradative action of systemic and endonucleases,
Delivery of genetic material to the target site, i.e., either cell cytoplasm or nucleus,
Low potential of triggering unwanted immune responses or genotoxicity,
Economical and feasible availability for patients .
Viruses are naturally evolved vehicles that efficiently transfer their genes into host cells.
Choice of viral vector is dependent on gene transfer efficiency, capacity to carry foreign genes, toxicity, stability, immune responses towards viral antigens and potential viral recombination.
There are a wide variety of vectors used to deliver DNA or oligo nucleotides into mammalian cells, either in vitro or in vivo.
The most common vector system based on retroviruses, adenoviruses, herpes simplex viruses, adeno associated viruses.
The biomechanics of running involves the study of the mechanical principles underlying running movements. It includes the analysis of the running gait cycle, which consists of the stance phase (foot contact to push-off) and the swing phase (foot lift-off to next contact). Key aspects include kinematics (joint angles and movements, stride length and frequency) and kinetics (forces involved in running, including ground reaction and muscle forces). Understanding these factors helps in improving running performance, optimizing technique, and preventing injuries.
Comment that disability services and long term care are wrapped into healht care/hospital systems
Re networks and integation , comment on links to disability services and long term care
Link strategic funding to Carolines’
Three key sets of interests –
Governments and funders managing national health budgets trying to manage the amount of money swallowed up by the hospital sector
Then there are patients and the public with their health care needs. THese are becoming increasingly complex as the populations of Europe age and develop more chronic conditions and co-morbidities. But patient demands are also changing - with growing expectations about timeliness, convenience and Courtesy and a growing knoweldge and about sense of entitlement to the lates high tech treatments
Then there are the hospitals themselves – trying to balance their books; ensure quality and safety; grow their market share and build their reputation in order to attract patienst
So during the course of the day, we want to think about how the strategic development of the hospital will be shaped by these other stakeholder interests.
Increasingly difficult to solve hospital problems just by addressing the needs of the hospital just by focusing on the hospital alone.
We’re seeing lots of responses.