Are you pessimistic enough when planning?

Prediction about the future being so difficult, there is a good argument that nobody ever has an exact picture about risk.

Statistician George Box once said: “All models are wrong but some are useful.”

All models are wrong because they merely approximate the truth – this is why events such as flooding, accidents at nuclear reactors, and financial crises seem to happen much more often than they should.

The idea of a good risk model is not to be correct, but to be useful.  Read more

Are you planning beds using Bed Manager?

Vulnerable patients are getting stuck in hospital in England as delays discharging people hit record levels, figures show.

There were more than 160,000 days lost to delays in October – up a third since 2010 when record-keeping began.  read more here

Service redesign

Accessing a physiotherapist on the NHS usually involves seeing a GP and getting a referral.

But, in this week’s Scrubbing Up, Prof Karen Middleton, chief executive of the Chartered Society of Physiotherapy, says it would make much more sense – for both patients and the health service – if patients could have direct access to an NHS physio.  The full article is on the BBC website.

Harmonise local Public Health

This article on transport networks raises some interesting facsimiles with Social Services, Primary Care and Acute Care.  The perceived performance of each will certainly depend on the network as a whole.  An organisation wriggle room is closely linked to their openness for operation bleed across grey areas of service delivery.  

Resource planning

The latest right care maps show there is a significant range of geographical service performance across the NHS.  A good starting point for each location would be to get their capacity right.

Should we all be looking for marginal gains?

The concept of marginal gains has revolutionised some sports. Could the same approach also change important areas of everyday life, asks Matthew Syed.

The doctrine of marginal gains is all about small incremental improvements in any process adding up to a significant improvement when they are all added together.

The full article is on the BBC website Read more

NHS England Enforces Penalties

NHS England has stated that penalties for breaches outlined in the 2015/16 contract between commissioners and providers will be applied without exception. They have said that they will be taking action to ensure that CCGs understand the requirement to apply mandatory sanctions. In addition the financial penalties related to Referral to Treat (RTT) breaches are likely to increase by 25%.

Anthony Thompson of the Checklist Partnership stated that “both our CCG and provider clients are concerned by these changes. It has certainly focussed them on forecasting potential breaches before they actually occur. We have found that with advanced warning many potential breaches can be avoided.”

BBC launches NHS Winter Project

As the first cold snaps hit the UK the BBC is launching a project to check how the NHS is performing this winter.

Each week they will publish the percentage of patients seen within 4 hours, using publicly available NHS data. The results will be split by major and all A&E units and can be seen down to hospital level. There will also be commentary by Nick Triggle, Health Correspondent for BBC news, on each week’s figures.

From the data so far it has already been noted that many increases are linked to the increasing demand for A&E services, along with the growth in complex cases, requiring more care and, often, admission to hospital. Hospital admission recently hit 110,000, one of the highest figures recorded.

A further £300 million to support winter pressures.

The government have announced an additional £300 million for investment mainly in beds and staff to help manage the extra pressures on the health service this winter. This takes the total funds to some £700 million. CCGs, working with local providers, have been asked to bid for funds.

Unavailability of beds is seen as a key contributor to delays in A&E, where the Government’s target of 95% of patients treated within 4 hours has been missed for the past 16 months. And over 6,500 patients have waited on trollies for over 12 hours before being admitted to a hospital bed. Double the number for the same period last year.

The Deputy COO of a London Teaching Hospital recently stated “We knew things were going to be bad, but we need to know exactly how bad so that we can aim to fix the problem”.

Checklist Bed Manager provides detailed and accurate forecast of bed capacity and outcomes. For further information click here.

Increases of up to 136% in cancelled operations in the South West.

With the exception of one hospital in Torbay, all the hospitals in the South West have shown year on year increases in cancelled operations. The trusts have said that the operation were cancelled as no beds were available. The increases vary from 4% to 136% at the Royal Devon & Exeter Hospital, 156 operations in all. North Devon Healthcare cancelled 341 operations at the last minute, a 51% increase year on year.

As well as causing anxiety & risks to patients, cancelled operations cancelled on the day of admission are expensive. Trusts do not get paid for the original or the re-scheduled operation. These costs can run into tens of thousands of pounds.

The issue is becoming a political hot potato, with Labour blaming Government reforms. The conservatives say that, although emergency funding is being provided, there needs to be changes in the way the NHS operates to cope with these pressures.

One Deputy COO told Checklist “we knew we had a problem coming, but we could have handled it better if we had more warning of the scale”.

For further information see Checklist Bed Manager.