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Clinical Quality

BGS Clinical Quality Steering Group (CQSG) work with NHS Benchmarking to develop PREM for Older People in Hospital

Tools such as the National Audit In-patient Survey and the Family and Friends Test provide users with the opportunity to give feedback but are unlikely to capture the experiences of older people adequately.  Dr Jackie Morris and Dr Fiona Thomson were charged with designing a Patient Reported Experience Measure (PREM) specifically for older people in hospital. Fiona Thomson is a Consultant Geriatrician from Hull and Dr Jackie Morris is a retired Consultant Physician, Vice President of the Patients Association and an Honorary Research Associate at University College London, both are members of the BGS Clinical Quality Steering Group. 

Members of the CQSG were aware of excellent work done by NHS Benchmarking (NHS BM) in relation to the National Audit of Intermediate Care (NAIC) and the data collection for their newer topic of Older People’s Care in Acute Settings. The NAIC included a validated PREM questionnaire but although it had the advantage of being readily available, not all questions were relevant to the acute setting. 

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The National COPD Audit is moving to continuous, prospective data collection in February 2017

As of February 2017, the National COPD audit will be moving to continuous collection of clinical data, so aligning with other National Audits such as Stroke. Data will be entered via a new web-tool to enable real-time reporting, a process that has proved a key driver of Quality Improvement in in other National Audits such as stroke and myocardial infarction. A much-reduced COPD dataset will be used and a consultation on the content will be held soon. One or more of the indicators may form the basis of a COPD Best Practice Tariff expected to be introduced in 2017. Participation in the COPD Audit will be a requisite of Trust Quality Accounts and a cross-sectional spot audit of COPD care organisation and resourcing will also be undertaken later in 2017, one Section of which will be devoted to COPD Improvement plans made since the 2014 audit round.

The COPD Audit Programme is commissioned by the Healthcare Quality Improvement Partnership (HQIP) as part of the National Clinical Audit and Patient Outcomes Programme (NCAPOP) and continues to be led by the Royal College of Physicians, in association with the British Thoracic Society, the British Lung Foundation, the Royal College of General Practitioners, and the Primary Care Respiratory Society UK.

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Moving patients to create bed capacity

Published in the Journal of the Royal Society of Medicine Vol 109(5) 172-173
Authors: Jim George and Iain Wilkinson, Cumberland Infirmary, Carlisle CA2 7HK

Bed crises are now commonplace in our acute hospitals. Patients regularly wait in crowded emergency departments, breaching the four-hour target because of lack of available acute medical inpatient beds. There has been a year on year increase in emergency medical admissions and hospitals have consistently high bed occupancies. A common short-term solution to the problem is to ‘board out’ patients from medical wards to surgical wards or even temporarily to day units to facilitate patients to be transferred out of the emergency department. However such non-clinical patient moves can be harmful. They predominantly affect older, frailer patients, and increase the risk of falls, delirium, medication errors and extend length of stay. Furthermore, they may disrupt arrangements for a complex discharge at a crucial time.

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