Two reports recommend cultural and organisational changes in the NHS. The Messenger review into NHS leadership has concluded that tackling discrimination against disadvantaged groups should be the responsibility of all staff, not just leaders and specialist diversity teams. Claire Fuller’s review into integrating primary care argues that previously siloed teams and professionals need to be brought together to improve patients’ access to GP services. Meanwhile, however, the number patients forced to remain in hospital beds while awaiting a care plan continues to increase, with no resolution in sight.
All the NHS’s 1.5m staff in England should tackle discrimination against disadvantaged groups, according to a new review from Genl Sir Gordon Messenger and Dame Linda Pollard.
The review, which was commissioned last year by Sajid Javid, the health and social care secretary, says that NHS trusts will need fewer equality, diversity and inclusion (EDI) teams if action against discrimination becomes “the responsibility of all”.
It says that although good practice is by no means rare, there is “widespread evidence of considerable inequity in experience and opportunity for those with protected characteristics”. The only way to tackle this effectively, the review says, is to “mainstream it as the responsibility of all, to demand from everyone awareness of its realities and to sanction those that don’t meet expectations.”
The number of patients who are stuck in hospital, even though they are well enough to be discharged, has continued to increase in the past few months, HSJ has reported.
Statistics for April show that an average of 12,589 patients per day in NHS hospitals in England – 13% of all occupied beds – did not meet the “criteria to reside”. At 31 trusts, the proportion was 20% or more. The occupation of beds by patients who are well enough to leave hospital is partly responsible for the long waits in emergency care, as ward beds are taking longer to become available to accident and emergency patients.
The problem is caused by a lack of care plans for elderly patients once they leave hospital. Rory Deighton, acute lead at NHS Confederation, said targets to reduce delayed discharges “will not be met” unless the government “invests in domiciliary care wages,” amid high numbers of vacancies in the social care sector.
Northampton General Hospital NHS Trust has begun digitising its patient records, with the aim of enabling health care professionals to access patient information remotely. The project involves scanning more than 200,000 medical records into IMMJ System’s MediViewer, an electronic document management system (EDMS).
The software will enable clinicians to see a complete history for trust patients. The use of SmartIndexing technology classifies information in real time and will allow free text search through the record to locate key clinical documents.
The project is part of a 10-year digital transformation plan from University Hospitals Northamptonshire NHS Group, which includes Northampton and Kettering hospitals.
Rises in the cost of living are already having a negative impact of people’s health, health professionals have warned.
A report by the BBC says that people have been skipping meals or cutting back on medication, because of money worries. Dr Andrew Goddard, president of the Royal College of Physicians, told the organisation that some of his respiratory-medicine colleagues had heard of patients choosing to turn off oxygen supplies to save money.
The Royal College of Nursing general secretary, Pat Cullen, said that nurses themselves were affected, with many having to choose between heating and eating as well as “struggling to afford the petrol they need to drive to their patients’ homes.”
Previously siloed teams and professionals need to be brought together to provide more integrated care for primary care patients, according to a stocktake report by Dr Claire Fuller.
The report, Next steps for integrating primary care: Fuller stocktake report, says that the creation of multi-organisational and sector teams working in each community will “help individual PCNs and teams better manage demand and capacity, building resilience and sustainability.”
It notes that integrated care systems (ICSs) have an opportunity to use their scale and combined power to develop relationships between sectors. This integrated working, the report says, “offers the NHS a real opportunity to deliver more effective and sustainable change.”