Effective board governance of safe care: a (theoretically underpinned) cross-sectioned examination of the breadth and depth of relationships through national quantitative surveys and in-depth qualitative case studies – Health Services and Delivery Research Volume: 4 Issue: 4
Recent high-profile reports into serious failings in the quality of hospital care in the NHS raise concerns over the ability of trust boards to discharge their duties effectively. This study aims to generate theoretically grounded empirical evidence on the associations between board governance, patient safety processes and patient-centred outcomes. The specific aims were as follows:

• to identify the types of governance activities undertaken by hospital trust boards in the English NHS with regard to ensuring safe care in their organisation;
• in foundation trusts, to explore the role of boards and boards of governors with regards to the oversight of patient safety in their organisation;
• to assess the association between particular hospital trust board oversight activities and patient safety processes and clinical outcomes;
• to identify the facilitators and barriers to developing effective hospital trust board governance of safe care; and
• to assess the impact of external commissioning arrangements and incentives on hospital trust board oversight of patient safety.

This  research is the first large-scale mixed-methods study of hospital board activity and behaviour related to the oversight of patient safety in the English NHS and the key findings should be used to influence the design of future governance arrangements as well as the training and support of board. Our finding that board governance/competencies appear to be linked to staff feeling safe to raise concerns about patient safety issues, and also their confidence that their organisation would address their concern, is worthy of further and more sustained exploration, particularly in the context of the current focus on improving whistleblowing policies in the NHS.

NICE standards could help bids to fund COPD rehab – Chartered Society of Physiotherapy
Official standards to ensure people with acute chronic obstructive pulmonary disease (COPD) receive timely rehabilitation could help physios to secure funding for their services, the CSP has said.

Delivering a healthier future – how CCGs are leading the way on prevention and early diagnosis – Academy of Fabulous NHS Stuff
With real-life projects that are already having an impact and truly demonstrate the positive difference that local clinically led commissioning can have for patients and communities, the case studies in this publication show that even in challenging times, CCGs are bringing together all the players in their local areas to drill down to the very essence of what populations want and need – and how it can be achieved.

Blue Sheets – quality – Academy of Fabulous NHS Stuff
Explains why the Clarke Ward team at  the Royal Hampshire County Hospital in Winchester had made a decision to restrict the use of blue sheets. It was a result of a quality improvement project that was able to demonstrate clearly that the blue sheets, if used as Incontinence pads, can increase the risk of moisture lesions.

Trust halts patient record system to tackle financial deficit – Health Service Journal
A hospital trust has put plans to develop an electronic patient record system on hold because of its “unforeseen” financial challenge, HSJ has learnt.  A memo sent by directors at East Cheshire Trust, seen by HSJ, has said the trust board decided work on the system could be “safely deferred or halted” while the trust focused on tackling its financial deficit, which is forecast to be at least £13.5m by the end of 2015-16.

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‘Off-framework’ ban extended to agency doctors – Health Service Journal
The ban on NHS trusts using “off-framework” staffing agencies will be extended to doctors from April. Since October, providers have been barred from using nursing agencies not on approved framework agreements, unless they obtain specific approval.

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NICE leak reaction: Trusts should use guidance says college president – Health Service Journal
All trusts should use the leaked NICE safe staffing guideline for accident and emergency to analyse their staffing levels and what action to take, the president of the Royal College of Emergency Medicine has said.

• Royal College of Emergency Medicine president says scale of A&E understaffing could be 50 per cent
• Dr Cliff Mann says trusts should use leaked NICE guideline to conduct gap analysis on nurse staffing levels
• CQC expects providers to use “any tool they deem appropriate” to ensure safe care

Carter to back new measure of nurse productivity – Health Service Journal
Lord Carter’s review of NHS productivity is to recommend that a new metric – “care hours per patient day” – should become the principal measure of hospitals’ use of nurses and healthcare assistants from April. Introducing the new metric is part of a plan – to be set out in Lord Carter’s final report, due shortly – for how he believes the NHS could save £2bn of the £5bn savings identified by the review, through better management of its workforce.

• Carter to call for new “principal” measure of nursing deployment to be introduced from April
• “Care hours per patient day” derived from nursing and healthcare assistant hours per inpatient
• Review expected to call for “national people strategy” to tackle absenteeism, bullying and turnover
• Will also back clampdown on use of executive headhunters

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Productivity of the English NHS
The University of York Centre for Health Economics has published Productivity of the English NHS: 2013/14 update (Research paper 126).  This report updates the time-series of NHS productivity to account for growth between 2012/13 and 2013/14.  Overall NHS input growth is low, at around 0.55%, and down from 2.36% on the previous year. This is mainly due to replacement of Primary Care Trusts by Clinical Commissioning Groups, following the 2012 Health & Social Care Act.  Productivity growth between 2012/13 and 2013/14 for the NHS was 2.07%. This represents a rise on the 0.36% estimate recorded for the previous financial year, and is the fourth consecutive period of positive year-on-year productivity growth.

Online survey on elective orthopaedic care
NHS England’s Sustainable Improvement Team and its partners are launching a short online survey which aims to highlight what is working well in reducing elective orthopaedic waiting times, as well as the enablers and barriers to success. The online survey is hoped to reach clinical directors and service managers within orthopaedics, commissioners of orthopaedic services, as well as other stakeholders working in this area.