Variability in COVID-19 in-hospital mortality rates between national health service trusts and regions in England: A national observational study for the Getting It Right First Time Programme

Healthcare chaplaincy in the National Health Service (NHS) has rapidly changed in the last few years. Research shows a decline of people belonging to traditional faith frameworks, and the non-religious patient demographic in the NHS has increased swiftly. This requires a different approach to healthcare chaplaincy. Where chaplaincy has originally been a Christian profession, this has expanded to a multi-faith context. Over the last five years, humanists with non-religious beliefs have entered the profession for the first time, creating multi-faith and belief teams. As this is a very new development, this article will focus on literature about humanists entering traditionally faith-based NHS chaplaincy teams within the last five years in England. This article addresses the question “what are the developments resulting from the inclusion of humanist chaplains in healthcare chaplaincy?” Topics arising from the literature are an acknowledgement of a changing healthcare chaplaincy field, worries about changing current practices and chaplaincy funding, the use of (Christian) language excluding non-religious people and challenging assumptions about those who identify as non-religious.

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A Culture Of Openness Is Associated With Lower Mortality Rates Among 137 English National Health Service Acute Trusts

Health Affairs ◽

10.1377/hlthaff.2018.05303 ◽

2019 ◽

Vol 38 (5) ◽

pp. 844-850 ◽

Cited By ~ 2

Author(s):

Veronica Toffolutti ◽

David Stuckler

Keyword(s):

National Health Service ◽

Health Service ◽

National Health ◽

Mortality Rates ◽

Lower Mortality ◽

English National Health ◽

English National Health Service

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Impact of the Manchester Glaucoma Enhanced Referral Scheme on NHS costs

BMJ Open Ophthalmology ◽

10.1136/bmjophth-2019-000278 ◽

2019 ◽

Vol 4 (1) ◽

pp. e000278 ◽

Cited By ~ 3

Author(s):

Hannah Forbes ◽

Matt Sutton ◽

David F Edgar ◽

John Lawrenson ◽

Anne Fiona Spencer ◽

...

Keyword(s):

National Health Service ◽

Health Service ◽

Observational Study ◽

Cost Analysis ◽

National Health ◽

False Positive ◽

Waiting Times ◽

Outpatient Visits ◽

Audit Data ◽

The Cost

ObjectivesGlaucoma filtering schemes such as the Manchester Glaucoma Enhanced Referral Scheme (GERS) aim to reduce the number of false positive cases referred to Hospital Eye Services. Such schemes can also have wider system benefits, as they may reduce waiting times for other patients. However, previous studies of the cost consequences and wider system benefits of glaucoma filtering schemes are inconclusive. We investigate the cost consequences of the Manchester GERS.DesignObservational study.MethodsA cost analysis from the perspective of the National Health Service (NHS) was conducted using audit data from the Manchester GERS.Results2405 patients passed through the Manchester GERS from April 2013 to November 2016. 53.3% were not referred on to Manchester Royal Eye Hospital (MREH). Assuming an average of 2.3 outpatient visits to MREH were avoided for each filtered patient, the scheme saved the NHS approximately £2.76 per patient passing through the scheme.ConclusionOur results indicate that glaucoma filtering schemes have the potential to reduce false positive referrals and costs to the NHS.

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Treatment with anthroposophic remedies to integrate conventional therapy: Observational study on 133 patients admitted to general medical division of an hospital operating with national health service

European Journal of Integrative Medicine ◽

10.1016/j.eujim.2010.09.192 ◽

2010 ◽

Vol 2 (4) ◽

pp. 263

Author(s):

E. Mariani ◽

G. Landoni ◽

C. Donarini ◽

G. Oriani ◽

G. Tancredi ◽

...

Keyword(s):

National Health Service ◽

Health Service ◽

Observational Study ◽

National Health ◽

Conventional Therapy ◽

Medical Division

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Hospitalization in fibromyalgia: a cohort-level observational study of in-patient procedures, costs and geographical variation in England

Rheumatology ◽

10.1093/rheumatology/kez499 ◽

2019 ◽

Vol 59 (8) ◽

pp. 2074-2084

Author(s):

Anushka Soni ◽

Stephanie Santos-Paulo ◽

Andrew Segerdahl ◽

M Kassim Javaid ◽

Rafael Pinedo-Villanueva ◽

...

Keyword(s):

National Health Service ◽

Health Service ◽

Observational Study ◽

National Health ◽

Inpatient Care ◽

Geographical Variation ◽

Diagnostic Code ◽

Weak Evidence ◽

Therapeutic Procedures ◽

Outpatient Settings

Abstract Objectives Fibromyalgia is a complex, debilitating, multifactorial condition that can be difficult to manage. Recommended treatments are usually delivered in outpatient settings; evidence suggests that significant inpatient care occurs. We describe the scale and cost of inpatient care with a primary diagnostic code of fibromyalgia within the English National Health Service. Methods We conducted a cohort-level observational study of all patients admitted to hospital due to a diagnosis of fibromyalgia, between 1 April 2014 and 31 March 2018 inclusive, in the National Health Service in England. We used data from Hospital Episode Statistics Admitted Patient Care to study: the age and sex of patients admitted, number and costs of admissions, length of stay, procedures undertaken, class and type of admission, and distribution of admissions across clinical commissioning groups. Results A total of 24 295 inpatient admissions, costing £20 220 576, occurred during the 4-year study period. Most patients were women (89%) with peak age of admission of between 45 and 55 years. Most admissions were elective (92%). A number of invasive therapeutic procedures took place, including a continuous i.v. infusion (35%). There was marked geographical variation in the prevalence and cost of inpatient fibromyalgia care delivered across the country, even after accounting for clinical commissioning group size. Conclusions Many patients are admitted for treatment of their fibromyalgia and given invasive procedures for which there is weak evidence, with significant variation in practice and cost across the country. This highlights the need to identify areas of resource use that can be rationalized and diverted to provide more effective, evidence-based treatment.

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What is the relationship between mortality alerts and other indicators of quality of care? A national cross-sectional study

Journal of Health Services Research & Policy ◽

10.1177/1355819619847689 ◽

2019 ◽

Vol 25 (1) ◽

pp. 13-21

Author(s):

Elizabeth Cecil ◽

Alex Bottle ◽

Aneez Esmail ◽

Charles Vincent ◽

Paul Aylin

Keyword(s):

National Health Service ◽

Health Service ◽

Hospital Mortality ◽

National Health ◽

Hospital Setting ◽

Cross Sectional Study ◽

Hospital Quality ◽

Sectional Study ◽

Cross Sectional ◽

Process Indicator

Objectives To assess whether mortality alerts, triggered by sustained higher than expected hospital mortality, are associated with other potential indicators of hospital quality relating to factors of hospital structure, clinical process and patient outcomes. Methods Cross-sectional study of National Health Service hospital trusts in England (2011–2013) using publicly available hospital measures reflecting organizational structure (mean acute bed occupancy, nurse/bed ratio, training satisfaction and proportion of trusts with low National Health Service Litigation Authority risk assessment or in financial deficit); process (mean proportion of eligible patients who receive percutaneous coronary intervention within 90 minutes) and outcomes (mean patient satisfaction scores, summary measures of hospital mortality and proportion of patients harmed). Mortality alerts were based on hospital administrative data. Results Mortality alerts were associated with structural indicators and outcome indicators of quality. There was insufficient data to detect an association between mortality alerts and the process indicator. Conclusions Mortality alerts appear to reflect aspects of quality within an English hospital setting, suggesting that there may be value in a mortality alerting system in highlighting poor hospital quality.

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