Treatments and technologies matter, but patients most want to be seen as people

Patient stories are a raw and compelling new kind of online feedback. They can prompt rapid improvements in services – if the NHS is willing to embrace them | The Guardian Healthcare Network

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People have always shared their experiences of healthcare, usually privately, with family, neighbours or workmates. But online, patients and carers are increasingly willing to share accounts of their health service encounters with the wider world, often in intimate detail. There are websites devoted to collecting and publicising patient ratings and reviews of healthcare professionals, services, diagnoses and treatments.

The stories of patients and carers are becoming an unavoidable part of modern healthcare. In the US, people searching online for information about local services are more likely to read patient comments than official clinical outcome measures or patient experience metrics. In the UK, staff routinely read online patient feedback and share it on social media. NHS regulators have even started to think in terms of monitoring and analysing patient stories to provide an “early warning” for when things might be going wrong.

Read the full news story here

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The social barriers to an active society are being ignored

The simplicity of exhorting people to “be more active” belies how complicated it can be to put this into practice. Increasing physical activity requires individuals to do things differently | The Conversation

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Can individuals alone make the changes that are required? Public health campaigns imply that they can, focusing on how to live a healthier, more active life. But do the roots of inactivity really lie only in the behaviour, decisions and motivations of individuals? Or are there wider factors which need to be recognised and addressed?

Plenty of evidence suggests that external influences are also important, and there is mileage in ensuring that these elements are integrated into addressing individual behaviour.

Consider, for example, the challenge of raising physical activity levels among older people. This is a priority for public health given the predicted 89.3% increase in the numbers of older adults to 9.9m in the UK by 2039. According to Sport England, 54% of those aged 75 and above are doing less than 30 minutes of physical activity a week.

Full blog post here

Women and leadership – (still) more to do

Despite the advances of recent years, two recent reports, Women in finance and Women on boards: 50:50 by 2020, once again draw attention to the problems women still face in obtaining senior leadership positions within the NHS and outside it | The King’s Fund

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Women in finance is about fairness, equality and inclusion for women and men. It is predicated on a desire for gender parity and a balanced workforce because, as the evidence makes clear, this improves culture, behaviour, outcomes, profitability and productivity. However, the current situation in the financial services sector is quite different; more women than men start out in financial services but many women fail to move up the management scale. This leaves almost all the top jobs in the hands of men. The main reason for this, it appears, is organisational culture.

One study conducted in 2016 across a wide range of employment sectors found that unsupportive workplace cultures still present the most significant barrier to career progress for women. Amazingly this was the case for female respondents in the 20-29 age group as well as for older respondents. Gender inequality and discrimination were reported, as were difficult colleagues and managers, bullying, undervalued work, and women feeling that they have to over-perform simply because they are female. Recommendations following this study included building closer relationships between men and women in the workplace, and the provision of opportunities to discuss gender issues experienced within the organisational culture.

Jeremy Hunt outlines new government’s NHS priorities at #Confed17

After being introduced by Niall Dickson as ‘something of a survivor,’ Jeremy Hunt took to the stage on day two of Confed17 to give his thanks and praise to the NHS, its staff and its leaders, and to set out some of the new government’s priorities for the NHS | NHS Confederation

Thanking NHS leaders for ‘stepping up to the plate’ in what he described as one of the most difficult jobs in the world, Mr Hunt went on to thank NHS staff and stated that the support and welfare of staff is a central government priority. Other immediate priorities he highlighted are:

  • The status of EU nationals in health and care system.
  • Staff retention levels
  • Mental health support
  • Workforce shortages and gaps

Looking ahead for the next 12 months, the government’s priorities include:

  • Continuing progress to turn around performance
  • Achieving financial balance
  • Continued focus on transforming mental health
  • Continued focus on safety improvements

Read the full overview here

Adult smoking habits in the UK: 2016

Cigarette smoking among adults including the proportion of people who smoke including demographic breakdowns, changes over time, and e-cigarettes. | Office for National Statistics

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Main points

  • In 2016, of all adult survey respondents in the UK, 15.8% smoked which equates to around 7.6 million in the population.
  • Of the constituent countries, 15.5% of adults in England smoked; for Wales, this figure was 16.9%; Scotland, 17.7% and Northern Ireland, 18.1%.
  • In the UK, 17.7% of men were current smokers which was significantly higher in comparison with 14.1% of women.
  • Those aged 18 to 24 in the UK experienced the largest decline in smoking prevalence of 6.5 percentage points since 2010.
  • Among current smokers in Great Britain, men smoked 12.0 cigarettes each day on average whereas women smoked 11.0 cigarettes each day on average; these are some of the lowest levels observed since 1974.
  • In Great Britain, 5.6% of respondents in 2016 stated they currently used an e-cigarette in 2016, which equates to approximately 2.9 million people in the population.

Access the full document: Adult smoking habits in the UK: 2016

Brexit health alliance formed to safeguard healthcare interests

A new alliance has been established as the voice of the NHS during Brexit negotiations to safeguard the interests of patients as the UK leaves the EU. | Story via OnMedica

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A new alliance of health organisations has been formed to safeguard the interests of patients, and the healthcare and health research, as the UK prepares to begin Brexit negotiations with the EU.

The Brexit Health Alliance brings together NHS, medical research, industry, patients and public health organisations, and it will be co-chaired by Sir Hugh Taylor, the former permanent secretary of the Department of Health, and Niall Dickson, the chief executive of the NHS Confederation.

The Alliance will seek to make sure that issues such as healthcare research, access to technologies and treatment of patients are given the prominence and attention they deserve in the Brexit negotiations, and it will argue that it is in the interests of both Europe and the UK to maintain co-operation in research and in handling public health issues.

The Alliance will urge the UK government to make sure there is a commitment to medical research and providing alternative funding to the loss of funding from the EU, and also to ensure that UK citizens’ right to receive healthcare in EU countries is preserved.

Full story at OnMedica

Fresh thinking about the evidence needed for a healthier UK

The Health Foundation is working with Dr Harry Rutter from the London School of Hygiene and Tropical Medicine to develop a new model of evidence that will inform public health research, policy and practice. 

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As part of this work Dr Rutter and co-authors from the Health Foundation have published a new Viewpoint paper – The need for a complex systems model of evidence for public health – in The Lancet, which outlines the need for new approaches to designing and evaluating population-level interventions to improve health.

Key points

  • We are faced with many big health challenges in our society. Their complex nature is an ongoing problem for public health research and policy.
  • Such challenges often involve multiple factors operating over many decades in systems that adapt as changes occur. For example, the distribution of obesity in a population might be impacted by changes to food, employment, transport or economic systems.
  • The traditional linear model of research is not suited to tackling these challenges. This is because it focuses largely on changes in individuals, not the population as a whole, and because it tends to look at isolated interventions rather than the contexts in which they take place.
  • There is growing recognition that we need a new evidence model that looks at public health problems, and our potential responses, in terms of a complex systems approach.

Full reference: Rutter, H. et al.  The need for a complex systems model of evidence for public health The Lancet, 13 June 2017

Related: Building a new system for the generation and use of public health evidence