Waiting time prioritisation: Evidence from England

"Following initiatives in other OECD countries, the English NHS and other healthcare systems faced with increasing excess demand for elective surgery should put more emphasis in encouraging further prioritisation on the list and consider formal policies to enforce this."

Waiting time prioritisation: Evidence from England: CHE Research Paper 114
N Gutacker, R Cookson, L Siciliani
Centre for Health Economics
University of York
September 2015

Read more here.

Impact of referral templates on the quality of referrals

"In this study, the dissemination of referral templates coupled with intermittent surgery visits produced higher quality referrals."

Impact of referral templates on the quality of referrals from primary to secondary care: a cluster randomised trial
H Wahlberg, PC Valle, S Malm, A Ragnhild Broderstad
BMC Health Services Research, 2015, 15:353

Read more here.

Effectiveness of short stay programmes for breast cancer surgery

"We provided a detailed case description of how implementation costs can be determined. Notable differences in implementation costs between hospitals were observed."

A detailed report of the resource use and costs associated with implementation of a short stay programme for breast cancer surgery
SMC Ament, et al.
Implementation Science, 2015, 10:78

Read more here.

IDEAL: A framework for evaluations of surgical innovations

"IDEAL is a framework for evaluations of surgical innovations. First, there is an Idea or Innovation, which then undergoes Development and Exploration, and subsequently Assessment and Long-term Studies."

Find out more about the IDEAL Collaboration here.

Identification of promising strategies to sustain improvements in hospital practice

"Certain post-implementation strategies are valuable in sustaining implementation successes achieved after joining a quality improvement collaborative."

Identification of promising strategies to sustain improvements in hospital practice: a qualitative case study
SMC Ament, et al.
BMC Health Services Research, 2014, 14:641

Read more here.

Variations and inter-relationship in outcome from emergency admissions in England

"Hospital-level risk-standardised outcomes for emergency admissions across a range of specialties vary considerably and cross traditional speciality boundaries. This suggests that global institutional infra-structure and processes of care influence outcomes. "

Variations and inter-relationship in outcome from emergency admissions in England: a retrospective analysis of Hospital Episode Statistics from 2005-2010
PJ Holt, S Sinha, BA Ozdemir, A Karthikesalingam, JD Poloniecki, MM Thompson
BMC Health Services Research, 2014, 14:270

Read more here.

New commissioning guides from the National Surgical Commissioning Centre

The National Surgical Commissioning Centre has published the following two commissioning guides:

• Emergency surgery for the acute abdomen 
• Provision of general children's surgery

Commissioning the conditions for safer surgery

"The taskforce concluded that to achieve a continual reduction in harm, we must reduce variation in practice, promote learning from our mistakes and from improvement activities, and continue to promote organisational and professional responsibility."

Standardise, educate, harmonise: commissioning the conditions for safer surgery
NHS England Never Events Taskforce
February 2014

NICE Medtech Innovation Briefings

"Medtech Innovation Briefings provide a description of the medical technology, including its likely place in therapy, the costs of using the technology and a critical review of the strengths and weaknesses of the relevant published evidence."

Access the briefings here.

Variations in outcome and costs among NHS providers for common surgical procedures

"We identify variation in patient-reported outcomes (PROs) across hospitals, assess the relationship between the cost and outcomes among NHS hospitals for these procedures, and determine the extent to which variations in outcomes and costs are due to differences in hospital performance."

Variations in outcome and costs among NHS providers for common surgical procedures: econometric analyses of routinely collected data
A Street, N Gutacker, C Bojke, N Devlin, S Daidone
National Institute of Health Research
Health Services and Delivery Research, 2014, 2(1)

Read more here.

Variation in surgical-readmission rates and quality of hospital care

"Hospitals with high surgical volume and low surgical mortality have lower rates of surgical readmission than other hospitals."

Variation in surgical-readmission rates and quality of hospital care
TC Tsai, KE Joynt, J Orav, AA Gawande, AK Jha
New England Journal of Medicine, 2013, 369:1134-42

Read more here.

Comparison of strategies to reduce MRSA rates in surgical patients

"In surgical wards with relatively low MRSA prevalence, a combination of enhanced standard and MRSA-specific infection control approaches was required to reduce MRSA rates."

Comparison of strategies to reduce meticillin-resistant Staphylococcus aureus rates in surgical patients: a controlled multicentre intervention trial
AS Lee, et al.
BMJ Open, 2013, 3:e003126

Read more here.

Comparison of experiences of the surgical safety checklist in hospitals

"Consistent use, completion and fidelity of checklist deployment are not straightforward in any setting, but may be higher in the two UK hospitals compared with the hospital in a low-income country."

A qualitative study comparing experiences of the surgical safety checklist in hospitals in high-income and low-income countries
EL Aveling, P McCulloch, M Dixon-Woods
BMJ Open, 2013, 3:e003039

Read more here.

Nurse staffing ratios and hospital readmission

"Children with common conditions treated in hospitals in which nurses care for fewer patients each are significantly less likely to experience readmission between 15 and 30 days after discharge."

An observational study of nurse staffing ratios and hospital readmission among children admitted for common conditions
HL Tubbs-Cooley, JP Cimiotti, JH Silber, DM Sloane, LH Aiken
BMJ Quality and Safety, 2013, 22:735-742

Read more here.

Consultant treatment outcomes

"On this page there are links to information about individual consultants in a number of clinical areas. It includes results for a range of operations and treatments to help people make decisions about their care. The data show where the clinical outcomes for each consultant sit against the national average."

Access the data here.

National Surgical Commissioning Centre

"The National Surgical Commissioning Centre (NSCC) is a web-based source of practical information, guidance,  advice and support for commissioners of surgical services."

Resources include data tools, national commissioning guides, regional support, and standards and policy. Access the Centre here.

Clinical engagement in high-value commissioning

"Following concern from the Department of Health and Surgical Specialty Associations that there was unexplained variation in the rates of some elective surgical procedures between Primary Care Trusts and that PCTs were varying in their use of “thresholds” for funding these procedures, an engagement exercise was undertaken to bring together commissioners, surgeons and patient representatives to develop an evidence based approach to identifying variation and setting commissioning guidance which could be used nationally to reduce unexplained variation."

Clinical engagement in high-value commissioning: elective surgical procedures
N Beasley
Right Care Casebook Series
January 2013

Read more here.

Read a summary from the Commissioning Elf here.

Delay in discharge and its impact on unnecessary hospital bed occupancy

"Elderly patients experiencing acute surgical admission and discharge to community hospitals had prolonged length-of-stay due to significant delays associated with care of the elderly provision."

Delay in discharge and its impact on unnecessary hospital bed occupancy
Majeed MU, et al.
BMC Health Services Research, 2012, 12:410

Read more here.

Access all ages: assessing the impact of age on access to surgical treatment

"Where there are allegations of rationing of interventions according to age, as opposed to clinical need and potential benefit, these should be investigated by the commissioners of that service and escalated to the NHS Commissioning Board where appropriate."

Access all ages: assessing the impact of age on access to surgical treatment
Royal College of Surgeons of England
October 2012

Read more here.

Educating surgical patients to reduce the risk of venous thromboembolism

"A simple method of introducing patient education at pre-assessment clinic and as part of their discharge planning, for major elective surgery, is an effective system in improving patient understanding of VTE, its risk factors and the importance of prophylaxis."

Educating surgical patients to reduce the risk of venous thromboembolism: an audit of an effective strategy
H Sadideen, JM O'Callaghan, M Navidi, M Sayegh
Journal of the Royal Society of Medicine Short Reports, 2011, 2(12):97

Read more here.