Patient-centred goals of care conversations

Improving communication between health care professionals and patients in the NHS in England
NHS England 12 July 2021

• Studies from around the world demonstrate that effective patient/clinician communication can improve patients’ experiences and health outcomes. This systematic review aimed to identify interventions that have previously demonstrated a positive difference to patient experience and clinical outcomes, while also reducing financial demands on the health system. The options identified needed to be interventions that policy makers, commissioners and service managers across the NHS could replicate accurately, with a reasonable return on their investment and at a manageable level of implementation risk. 
• This report recommends that NHS England & NHS Improvement initially invest in a single intervention: introducing patient-centred goals of care conversations with patients presenting in Acute Medical Units (AMUs) and Surgical Assessment Units (SAUs) who are at risk of dying in the next 12 months.
• These conversations – held within 48 hours of patient admission - involve providing patients with information about their condition and treatment options, and giving them the opportunity to have their values, goals, priorities and treatment preferences heard and respected by clinical staff. These values, priorities and preferences will then be captured in a single care planning document.

The COVID-19 Vaccine Communication Handbook & wiki

The COVID-19 Vaccine Communication Handbook & wiki
SciBeh 7 January 2021

• A practical guide (in wiki format) for improving vaccine communication and fighting misinformation. This project tracks behavioural science evidence and advice about COVID-19 vaccine uptake. 
• “This handbook is for journalists, doctors, nurses, policy makers, researchers, teachers, students, parents – in short, it’s for everyone who wants to know more about the COVID-19 vaccines, how to talk to others about them, how to challenge misinformation about the vaccines.”

Building common purpose: Learning on engagement and communications in integrated care systems

Building common purpose: Learning on engagement and communications in integrated care systems
NHS Confederation 15 December 2020

• “engagement and communications play a crucial role in supporting integrated care systems, and the partners that make them up, to achieve stronger relationships, more open and transparent ways of working, greater trust, more engaged staff and, ultimately, better outcomes for the public.”

Mobile technologies to support healthcare provider to healthcare provider communication and management of care.

Mobile technologies to support healthcare provider to healthcare provider communication and management of care.
Cochrane Database of Systematic Reviews 2020, Issue 8. Art. No.: CD012927. DOI: 10.1002/14651858.CD012927.pub2

• A systematic review of the evidence around the impact of mobile devices to communicate with other healthcare workers identified 19 studies. It concludes mobile technologies may reduce the time between presentation and management of the health condition when primary care providers or emergency physicians use them to consult with specialists, may increase the likelihood of receiving a clinical examination among participants with diabetes and those who required an ultrasound and may reduce referrals to secondary or tertiary care. Concern is raised about data‐sharing and privacy
• Mobile technologies may have little or no impact on healthcare workers' and participants' satisfaction, health status or well‐being.

Clinical Communications Procurement Framework

Clinical Communications Procurement Framework
NHS Digital 3 August 2020

• The Procurement Framework aims to support NHS organisations with dedicated clinical facing communication and tasks management tools, to accelerate the adoption of proven technologies and to phase out pagers by the end of 2021.
• Framework date and duration: 3 August 2020 to 3 August 2022. Possible further extension for 12 months.
• See also NHSX blog

Mobile phones for targeted communication withclients, patients and the public:implementation considerations

Mobile phones for targeted communication with clients, patients and the public: implementation considerations
Cochrane Norway/EPOC March 2020

• Questions for implementers when implementing mHealth strategies taken from a recent Cochrane Review of qualitative research explored how clients, patients, and the public view and experience targeted communication by mobile phone. Includes issues around access and content.
• Includes studies that had been published up to July 2017.This review is among a series of systematic reviews informing the WHO guidelines on digital interventions for health system strengthening (https://bit.ly/2U7BXT6 )

Summary here: Mobile phones for health workers in primary care: implementation considerations
Cochrane EPOC, March 2020

Improving the scrutiny of integrated care systems and sustainability and transformation partnerships: A guide to good practice

Improving the scrutiny of integrated care systems and sustainability and transformation partnerships: A guide to good practice
NHS Confederation 6 February 2020

• This guidance aims to help scrutiny leads and communications and engagement directors within ICSs and STPs to understand how they might work more effectively together to produce a relationship that works in the best interests of local partnerships and communities.

How to build effective teams in general practice

How to build effective teams in general practice
Kings Fund 9 January 2020

• Insights from Kings Fund research, policy analysis and leadership practice.

Wessex Exchange Model - a GP-consultant exchange scheme

Wessex Exchange Model
NHS England

• The Wessex Exchange Model for workplace exchanges is a GP-consultant exchange scheme developed to try to overcome challenges with fragmented working in both directions across the primary care and secondary care interface. 
• Guidance documents are available which includes a full suite of templates for localities wishing to set up their own version of the Wessex Model.

People's perceptions and experiences of targeted digital communication

Clients’ perceptions and experiences of targeted digital communication accessible via mobile devices for reproductive, maternal, newborn, child, and adolescent health: a qualitative evidence synthesis
Cochrane Systematic Review 14 October 2019 https://doi.org/10.1002/14651858.CD013447

• This qualitative evidence synthesis (35 studies) explores clients' views and experiences of being communicated with by the health system through their mobile phone. The synthesis looked at communication about pregnancy, newborn, and child health, sexual health, and family planning.

See also:
Qualitative evidence synthesis informing our understanding of people's perceptions and experiences of targeted digital communication
Cochrane Editorial 23 October 2019 https://doi.org/10.1002/14651858.ED000141

Raising staff awareness of the NHS App

Raising staff awareness of the NHS App
NHS Digital October 2019

• A resource pack, including posters, images for social media, a presentation, web banners, and suggested copy for bulletins and newsletters, to help NHS communications teams raise staff awareness of the NHS App and be part of the campaign.

Communicating with MPs

Making perfect sense of health: Can the healthcare sector communicate more effectively with elected officials?
MHP Health October 2018

• Research, including 108 MPs from across the House of Commons, to understand the level of understanding of healthcare terminology found that there is confusion over the language used in healthcare. This has resulted in an erosion of confidence in how politicians scrutinise the system. 
• The report includes suggestions for better communication with MPs.

Integrated care: organisations, partnerships and system

Integrated care: organisations, partnerships and system
Health Select Committee 11 June 2018

• This inquiry report explores the development of new integrated ways of planning local health and care services (sustainability and transformation partnerships and integrated care systems) and delivering care (integrated care partnerships and accountable care organisations), which have arisen out of the NHS five year forward view. 
• The report supports the move away from a competitive landscape of autonomous providers towards more integrated, collaborative and placed-based care. However, it finds that understanding of these changes has been hampered by poor communication and states that the government and the NHS must improve how they communicate NHS reforms to the public. (Kings Fund summary)

King's Improvement Science - QI resources

King's Improvement Science

• Based on experience of five quality improvement projects at Guy's and St Thomas' NHS Foundation Trust, King's College London NHS Foundation Trust and South London and Maudsley NHS Foundation Trust this website presents tools and resources to help others undertake quality improvements projects in a better, more scientific way.
• King's Improvement Science (KIS) includes advice around planning, evaluation, and communication and stakeholder engagement.
• KIS is funded by King’s Health Partners organisations until the end of 2018.

Updated Code of Practice for Statistics

Code of Practice for Statistics
UK Statistics Authority updated 22 February 2018

• The Code provides producers of official statistics with the detailed practices they must commit to when producing and releasing official statistics. 
• The interactive website includes information for those who produce, use or communicate official statistics as well as a voluntary code for those who produce other statistics.

Improving Clinical Communications Between Primary and Secondary Care Clinicians

Improving Clinical Communications Between Primary and Secondary Care Clinicians: A review and recommendations for the Sussex and East Surrey STP
South East Clinical Senate,  10 January 2018

• This review looks at the current barriers and enablers to better clinical communications, reviews some of the pertinent literature, single centre experiences, and technologies that have been used, and provides a range of recommendations for how this agenda can be taken forward.
• Recommendations include
• Improving telephone communications - Enabling GP contact with specialists
• Enhancing secondary care access to GPs
• Use of Video links
• Shared access to Integrated Digital Care Records 
• Fostering improved relationships between GPs and consultant
• Contractual incentives and levers to support and encourage improvement In clinical communications.

Partnerships for improvement: ingredients for success

Partnerships for improvement: ingredients for success
Health Services Management Centre, University of Birmingham for Health Foundation, 6 September 2017

• This briefing summarises the main findings of a research report (see below) which looks at a range of current organisational partnerships, and draws tentative learning to help inform and guide both policymakers and providers.and what providers and policymakers can learn. 
• Most research has focused on the impact of structural mergers and acquisitions between health care providers. Studies show that realising financial or quality benefits from mergers of health care organisations is far from straightforward and often takes years to materialise. 
• Buddying schemes are popular across occupational sectors, but there is little academic research available on the effects or effectiveness of these more informal forms of partnership. The report examines five case studies to explore different forms of informal partnership and to understand the key ingredients for success for each.

Partnering for improvement: inter-organisational developments in the NHS

HSMC University of Birmingham September 2017

Impact of information and communication technology on interprofessional collaboration for chronic disease management: a systematic review

Impact of information and communication technology on interprofessional collaboration for chronic disease management: a systematic review
Journal of Health Services Research & Policy June 6, 2017

DOI: https://doi.org/10.1177/1355819617714292

• A systematic review of research examining the impact of technology on interprofessional collaboration in chronic disease management found six studies. Analysis concluded that success depends upon supporting the social relationships and organization in which the technology will be placed. 

Abstract
Objectives: Information and communication technology is often lauded as the key to enhancing communication among health care providers. However, its impact on interprofessional collaboration is unclear. The objective of this study was to determine the extent to which it improves communication and, subsequently, enhances interprofessional collaboration in chronic disease management.
Methods: A systematic review of academic literature using two electronic platforms: HealthSTAR and Web of Science (core collection and MEDLINE). To be eligible for inclusion in the review, articles needed to be peer-reviewed; accessible in English and focused on how technology supports, or might support, collaboration (through enhanced communication) in chronic disease management. Studies were assessed for quality and a narrative synthesis conducted.
Results: The searches identified 289 articles of which six were included in the final analysis (three used qualitative methods, two were descriptive and one used mixed methods). Various forms of information and communication technology were described including electronic health records, online communities/learning resources and telehealth/telecare. Three themes emerged from the studies that may provide insights into how communication that facilitates collaboration in chronic disease management might be enhanced: professional conflict, collective engagement and continuous learning.
Conclusions: The success of technology in enhancing collaboration for chronic disease management depends upon supporting the social relationships and organization in which the technology will be placed. Decision-makers should take into account and work toward balancing the impact of technology together with the professional and cultural characteristics of health care teams.

Organising care at the NHS front line

Organising care at the NHS front line
Kings Fund 3 May 2017

• This report looks at the reality of caring for acutely ill medical patients at the NHS front line and asks how care in hospitals can be improved.
• It comprises a series of essays by frontline clinicians, managers, quality improvement champions and patients, and provides vivid and frank detail about how clinical care is currently provided and how it could be improved. 
• Key points include the importance of collaboration and co-ordination to deliver the best possible outcomes, intensity of work, lack of contact with GPs, difficulties in communication within hospitals and ineffective information systems.
• The essays are introduced and summarised by Chris Ham and Don Berwick.

NHS staff awareness of STPs

Research into NHS staff awareness of STPs
BritainThinks April 2017

• This report presents findings from research into NHS staff awareness of STP work and practical tips on how best to discuss change with them.