NHS Improvement, which supports trusts and independent providers of NHS services, said that it had deployed staff to the six biggest hospital sites affected by the collapse of the Carillion construction company, which declared insolvency on 15 January. Overall, the NHS was a “relatively small” customer of Carillion, said NHS Improvement, as 13 trusts use Carillion through a private finance initiative (PFI) provider for building maintenance, catering, cleaning, or facilities management. Three trusts also contract Carillion directly for some services, as do several smaller primary and community care properties. Two trusts also have sites under construction.
The Care Quality Commission suspended inspections of all general practices and urgent services such as NHS 111 or GP out-of-hours that have a “good” or “outstanding” rating for the rest of January, to help services manage intense pressures this winter. But re-inspections of services rated as “requires improvement” or “inadequate” will continue as scheduled, as will inspections to follow up specific concerns. The BMA welcomed the move and urged NHS England to consider suspending other bureaucratic tasks that divert GPs and other professionals from delivering frontline care. (Full story doi:10.1136/bmj.k137)
Poor access to general practice services is not associated with more emergency department visits, showed an analysis of linked primary and secondary care records of 819 590 patients registered with GPs in east London, which found that patients more frequently using emergency departments also saw GPs more often. “This analysis provides strong evidence …

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服药7天：2018年1月10日至16日

支持NHS服务的信托和独立提供商的NHS改进表示，已将工作人员部署到了受Carillion建筑公司倒闭影响的六个最大的医院地点，该公司于1月15日宣布破产。NHS Improvement表示，总体而言，NHS是Carillion的“相对较小”的客户，因为13家信托机构通过私人融资计划（PFI）提供商使用Carillion进行建筑维护，餐饮，清洁或设施管理。三个信托机构还直接与Carillion签订了某些服务合同，一些较小的初级和社区护理机构也是如此。两个信托也有正在建设中的站点。
护理质量委员会暂停了对所有常规做法和紧急服务（例如NHS 111或GP的非工作时间）的检查，这些服务在1月剩余时间中被评为“好”或“出色”，以帮助服务机构应对今年冬天的巨大压力。但是，对服务评级为“需要改进”或“不足”的服务的重新检查将如期进行，针对特定问题的检查也将如期进行。BMA对这一举动表示欢迎，并敦促NHS英格兰考虑中止其他官僚主义任务，使全科医生和其他专业人员无法进行前线护理。（全文doi：10.1136 / bmj.k137）
对全科医疗服务访问不畅并不意味着急诊就诊次数增加，对伦敦东部地区全科医生登记的819 590名初级和二级护理记录的关联分析显示，发现经常使用急诊科的患者也更看望全科医生。“这项分析提供了有力的证据……