The role of board-level clinical leaders in quality improvement

CLAHRC researcher Dr Lorelei Jones has been invited to deliver a seminar on the role of clinical leaders on NHS boards in quality improvement (QI).

The Health Services Research Centre is a leading authority on health care management and has invited Lorelei as part of their prestigious events series.

The poster below gives an overview of what she will be covering.

Dr Jones is part of our iQUASER study looking at how NHS boards implement QUASER – a dialogical tool for senior hospital leaders to develop and implement QI strategies across their organisation.

Lorelei will be presenting some results from her extensive fieldwork among NHS boards for this research, which involved interviewing board members, observing meetings and scrutinising papers and documents.

Introducing innovation in the NHS – what is your experience?

Still time to tell us your experience of how innovation is adopted in the NHS

We need your views; complete the DECIDE Survey by September 30th

Decisions in health Care to Introduce or Diffuse Innovations using Evidence (or DECIDE) – is a major study investigating the role of evidence in decisions to introduce innovation.

We are seeking the views of people working in the NHS.

We want to know

  • what different types of evidence are used when making decisions to adopt or diffuse innovations in the NHS?
  • what is your experience of decision-making in the NHS when it comes to spreading innovation?

Taking part in this survey is voluntary. No personal details will be asked of you in this survey, and published reports about this survey will not contain any personal details

The survey should take no more than 10 minutes to complete.

We need your views on how innovation spreads in the NHS

We need your views; complete the DECIDE Survey

Decisions in health Care to Introduce or Diffuse Innovations using Evidence (or DECIDE) is a two year study funded by the Health Foundation to investigate the role of evidence in decisions to introduce innovation. This survey is asking for your views about different types of evidence that are used when making decisions to adopt or diffuse innovations in the NHS.

Innovation in the NHS can take many different forms. It usually involves developing a new idea to meet a health care need. Often innovation may be related to clinical or administrative processes, but it may also involve the development of new medical technologies or clinical tools.

Examples of health care innovations might be information systems, surgical equipment, new drugs and new therapeutic uses for drugs or medical devices. An innovation does not have to be completely novel – for example, you can adopt a service development that is being done elsewhere and it is still an innovation in your organisation and in your local context.

We are interested in your experience of decision-making in the NHS and the kinds of evidence that you prioritise in your decision-making when deciding whether or not to adopt an innovation.

Taking part in this survey is voluntary. No personal details will be asked of you in this survey, and published reports about this survey will not contain any personal details

The survey should take no more than 10 minutes to complete.

Is screening for HIV in primary care cost-effective?

Our recently published research on the cost-effectiveness of screening for HIV in primary care has caused a great deal of interest and widespread media coverage.

We have produced a BITE sized summary of the paper with the headline findings and links to further information of interest.

The research, published in The Lancet HIV, represents the first time a model to explore the cost effectiveness of screening for HIV in primary care has been applied to the UK.

Our data provide the most reliable analyses to date and justify the investment needed to deliver HIV screening in primary care in the 74 localities considered to have high HIV prevalence – essentially most UK metropolitan areas.

Researcher and practicing GP Dr Werner Leber from Queen Mary University London said:
“We’ve shown that HIV screening in UK primary care is cost effective and potentially cost saving, which is contrary to widespread belief. This is an important finding given today’s austerity. Financial pressures, particularly within local authority’s public health budgets, mean that the costs of HIV testing are under intense scrutiny, and in some areas investment in testing has fallen.”

GP-based testing for HIV is cost-effective in areas of high prevalence and should be rolled out in 74 local authorities

New CLAHRC research published in The Lancet HIV has found that offering HIV testing to people on registration with a new GP in areas of high prevalence of the disease is cost-effective and will save lives.

Researchers based at the London School of Hygiene & Tropical Medicine and Queen Mary University of London (QMUL) carried out the study in areas with high prevalence of HIV – involving 86,000 people from 40 GP surgeries.

The promising results prompted CLAHRC researchers to call for a roll-out of HIV screening to all 74 high HIV prevalence local authorities in England (those with more than two diagnosed HIV infections per 1,000 adults).

HIV treatment is expensive, particularly when diagnosis is late. Early diagnosis means earlier intervention and treatment, saving the NHS money.

Building on earlier research from a trial in Hackney – a socioeconomically deprived inner London borough with an HIV prevalence rate of 8 per 1000 adults – the trial involved 40 general practices where they tested the effect of rapid fingerprick HIV testing as part of the standard health check during registration. They found it led to a four-fold higher HIV diagnosis rate.

Using a mathematical model that includes all the costs associated with HIV testing and treatment, the team now show that primary care HIV screening in high prevalence settings becomes cost-effective in 33 years (according to National Institute for Health and Care Excellence [NICE] criteria).

The CLAHRC North Thames study was carried out in partnership with NHS City and Hackney and involved University College London, Homerton University Hospital NHS Foundation Trust, University of Warwick, and University of British Columbia.

Dr Werner Leber from QMUL said: “We’ve shown that HIV screening in UK primary care is cost effective and potentially cost saving, which is contrary to widespread belief. This is an important finding given today’s austerity. Financial pressures, particularly within local authority’s public health budgets, mean that the costs of HIV testing are under intense scrutiny, and in some areas investment in testing has fallen.”

Read the full paper

Rebecca F Baggaley, Michael A Irvine, Werner Leber, Valentina Cambiano, Jose Figueroa, Heather McMullen, Jane Anderson, Andreia C Santos, Fern Terris-Prestholt, Alec Miners, T. Déirdre Hollingsworth, Chris J Griffiths.

Cost-effectiveness of screening for HIV in primary care: a health economics modelling analysis.

The Lancet HIV. DOI:10.1016/S2352-3018(17)30123-6

Changing general surgery procedures could improve care for patients and save the NHS millions

The Getting it Right First Time (GIRFT) programme has completed a review of general surgery and stated that the NHS could see a significant reduction in the amount of people unnecessarily admitted for emergency general surgery if more acute hospitals introduced consultant-led surgical assessments at their ‘front door’.

Analysis by the GIRFT team shows this change could lead to up to 30% fewer general surgery emergency admissions a year where no operation is delivered, and could cut the NHS’s annual cost for this (£361million) by £108m.

CLAHRC North Thames is evaluating the planned changes to orthopaedics, to identify lessons to inform future efforts to improve the organisation and delivery of services.