Transforming elective care services: Ophthalmology / Diabetes / Dermatology
NHS England has published three handbooks which describe what local health and care systems can do to transform services at pace, why this is necessary and how the impact of this transformation can be measured.  Practical guidance for implementing and adopting a range of interventions locally is included to help ensure patients see the right person, in the right place, first time.  The three handbooks are:

• Transforming elective care services: ophthalmology
• Transforming elective care services: diabetes
• Transforming elective care services: dermatology

Driving improvements through development programme  – NHS Employers 
This case study from Blackpool Teaching Hospitals describes how a leadership and development programme for newly-appointed senior doctors has increased their skills and knowledge and had a positive impact on patient care. The programme, which has been running successfully since its introduction in 2015, is now part of mandatory training for all new specialty and associate specialist (SAS) doctors and consultants.

Note: Today’s Grand Round (1-2pm SDGH Education Centre, video link to Ormskirk Education Centre) is “Developing Medical Leadership” presented by Dr Haslett, Associate Dean, HENW. All welcome.

Workforce Race Equality Standard
NHS England has published NHS Workforce Race Equality Standard: 2018 data analysis report for NHS Trusts.  This report presents three years’ of Workforce Race Equality Standard (WRES) data against all nine WRES indicators of workplace experience and opportunity. It shows trends over time regarding the level of progress made by NHS trusts across the country, as well as highlighting those areas where further concerted support and action is required.

Black and minority ethnic staff at senior levels
NHS England has published A Model Employer: Increasing black and minority ethnic representation at senior levels across the NHS.  This document outlines the ambitions set by NHS England and NHS Improvement and reflected in the Long Term Plan, for each NHS organisation to set its own target for BME representation across its leadership team and broader workforce. The strategy will provide accelerated, intensive support to local NHS organisations on increasing the recruitment of BME staff at senior levels.

General practice case studies

• Redesigning the annual patient review process across two practices – Robin Lane Medical Centre and Manor Park Surgery, Yorkshire and Humber
• Releasing two GP sessions a week for more appropriate appointments – Seven Dials Medical Practice, South East
• Working collaboratively to develop more efficient processes – Newham, London
• GP practices free up 3,000 extra patient appointments through Primary Care Network – Luton

Mortality in the UK
The House of Commons has published a briefing paper Mortality in the UK.  This paper examines data on the following measures of mortality in the UK: number of deaths, crude death rate, age-standardised mortality rate and period life expectancy.

13-24 year olds with cancer in England: incidence, mortality and survival – Teenage Cancer Trust 
This report examines the latest trends in the incidence, mortality and five-year survival rates for cancer among young people. This is the first time a detailed analysis has been conducted of cancer rates of the 13 to 24-year age group and shows an encouraging increase in survival rates.

Improving junior doctors’ access to educational opportunities – NHS Employers
This case study describes how Salford Royal NHS Foundation Trust used rota re-design to make improvements around the delivery of education and training within core medical training (CMT). The trust engaged its junior doctors to understand what was needed to accommodate the new three-year curriculum requirements which has replaced the current two-year CMT programme.

Public Health England research
Public Health England has published Public Health England research 2017 to 2018: annual review.  This report profiles research carried out by PHE which was supported by funding from the public and other sectors.

Statistics

• Appointments in General Practice – November 2018
• Direct access audiology waiting times – November 2018
• Learning Disability Services Monthly Statistics – Provisional – December 2018, MHSDS: October 2018 Final)
• Substance misuse treatment in secure settings: 2017 to 2018

Our Fabulous NHS – Academy of Fabulous Stuff 
***Get involved*** –  share your fab stuff!

• Spreading and sustaining red2green in Sheffield Teaching Hospitals NHS Trust Sheffield Teaching Hospitals (STH) is the secondary adult care provider, with over 2000 beds and 15000 staff. Similar to other health systems, Sheffield is under pressure to improve the quality of healthcare at the same or reduced cost, and improve the flow of patients. The Service Improvement team at STH is responding by helping build improvement capability at the front line of a care and supporting this with coaches trained by the UKs only Microsystem Coaching Academy (MCA). Ward based improvement work started with four Respiratory wards (Respiratory Change Room), their success in reducing length of stay and mortality gave the MCA the confidence to test our first learning collaborative in 2015, engaging 12 further wards across the trust.
• GHFT – Falls Prevention – reducing falls by 20% within 5 surgical wards.  Hospital falls and subsequent harm with increased morbidity are a common and preventable event in secondary care. Cost of falls has been calculated to be in the region of £634 million a year.
• GHFT- Improving funduscopic examination in adult patients who are discharged from the Emergency Department with a diagnosis of headache. Patients presenting to the Emergency Department with a headache must have potentially life-threatening causes, such as raised intracranial pressure, excluded. Funduscopic examination (looking at the retina with an ophthalmoscope or a retinal camera) can reveal papilloedema (swollen optic discs on the retina) indicating raised intracranial pressure. However, there are many barriers to performing fundoscopy.
• GHFT – ICUsteps: Developing a support group for patients following critical illness in Gloucestershire Critical illness results in extended physical and psychological ill health and poor quality of life. Follow up services have been shown to improve awareness of long term effects of recovery and improve self confidence. There is currently no follow up service available in Gloucestershire.
• GHFT – Introduction of a scalp cooling service for patients at risk from chemotherapy induced hair loss at GHNHSFT Chemotherapy induced hair loss is a common side effect of cancer treatment that can have a traumatic and distressing impact on some patients. Scalp cooling can prevent chemotherapy induced hair loss in some patients receiving certain chemotherapy regimens.