Does improving quality save money?

A new report published by the Health Foundation ‘Does improving quality save money?’ provides evidence that suggests quality improvement could make an important contribution to addressing financial pressures but only if there is careful planning, leadership, expertise, perseverance, and not a little healthy scepticism. It also requires a sustained and relentless focus on high quality implementation.

The Health Foundation believes that managers and clinicians in the health service should be asking themselves the important question of how they can continue to improve quality while also cutting costs.

The research, carried out by a leading academic, shows that poor quality services are common and costly. It has been estimated that the costs to the NHS of hospital acquired infections are £1bn a year and adverse drug events are estimated to be between £0.5bn.

There is evidence that some solutions for poor quality are effective. There is strong evidence that simple clinical-level changes are effective in reducing adverse events, such as prophylaxis before surgery, but there is less evidence of the effectiveness of other proposed solutions.

When looking at organisational changes, the potential is greater for reducing waste and poor quality and making savings but so are the risks. This is probably due to the number of professions and organisational units that need to change.

The report’s author John Overtveit says, ‘To make it more financially advantageous for providers to increase quality, changes are needed in routine financing systems, in how performance is measured to include quality measures, and in expert support and information on how to make successful improvements’.

Research shows that improving quality can save money, though the current evidence is limited. The review found that many studies which reported savings did not assess the cost of the intervention, left out some costs, or did not use actual cost data from the service.

‘The report suggests that although the available evidence isn’t strong, improvement initiatives can reduce costs to service providers and improve quality. There is evidence that adapting patient safety practices and proven treatments have the potential to improve outcomes and save money. This requires careful planning, leadership, expertise, perseverance and a sustained and relentless focus on high quality skilful implementation.

At a local level, the evidence in the report suggests that clinicians and managers can increase their likelihood of success by: working together to meet the challenge, using tested improvements that are adapted to local circumstances, using reported experiential evidence; measuring and monitoring the improvement, including how much it has cost and how much it has saved; and above all by managing implementation skilfully.

At a national level, the evidence suggests that the Department of Health and Strategic Health Authorities could improve chances of success by providing NHS organisations with expert support, supporting the development of skills and addressing the barriers created by the financial and performance management systems.

Download the report Does improving quality save money? here.

Missed appointments cost NHS £575million annually says Dr Foster

According to Dr Foster Intelligence, around 6 million appointments per year are being missed at a cost, in terms of lost income, of almost £100 per appointment.

Read what Dr Foster says here.

Read a BBC news article based on the Dr Foster figures here.

“Efficient use of resources and good quality services go hand in hand” – new finance guide for doctors

The Audit Commission and Academy of Medical Royal Colleges have published A guide to finance for hospital doctors.

In the publication, they state that ”there are many examples where clinicians have led change and improved services, through taking greater responsibility for managing the money available to them. This is not about focusing on cost and cost alone, but how best money can be used to improve the quality of care, combining operational and clinical effectiveness. Efficient use of resources and good quality services go hand in hand.”

Healthcare Governance Review believes that the guide, whilst written for doctors, may be of interest to board members and managers.

Download A guide to finance for hospital doctors here.

BBC Radio Four investigates how the NHS can save money

The BBC Radio 4 Today programme wants to find out practical ideas as to how the NHS can save money from people with first hand experience of the health service.

The have devoted a section of their website to issues around saving money in the NHS. On the site you can listen to an interview with Kings Fund economist John Appleby and Roy Lilley, a former NHS trust chairman, where they discuss how the NHS can be more efficient.

If you work in the NHS, or for an organisation which works with the NHS, the programme wants to hear where you think savings could be made. They will treat your emails in confidence and will not publish any information that could lead to your identification without contacting you directly beforehand.

Access the Radio 4 site here.

NHS wastes £900m a year having nurses hunt for missing medical items

Over a third of the UK’s 300,000 nurses spend up to two hours on an average shift trying to locate vital medical items such as pumps, drip stands and dressings, reveals a survey of nurses commissioned by GS1 UK, the not for profit data standards organisation, and Nursing Times magazine.

According to GS1 UK, “This is equivalent to 40 hours per month, or a quarter of a working day spent looking for equipment that should be readily available to ensure effective patient care. It indicates that up to one week of a nurse’s salary is being wasted every month. For the NHS, this could mean that more than £900 million of salary expenditure each year is being spent looking for medical items.”

GS1 UK says that these medical items “could be found instantly” by using bar code scanning technology that has been in our supermarkets for over 30 years. Readers should note that whilst GS1 UK may be a not for profit organisation, it does exist to help its members (which include the companies that sell bar code technology) increase their profits!

Notwithstanding this point, the figures presented in their report are compelling and represent a tremendous barrier to providing safe, high quality patient care as well as beinga huge waste of NHS human and financial resources.

For further information, click here.