Cardiovascular disease prevention

Public Health England’s Action plan for cardiovascular disease prevention, 2017 to 2018 has been launched on World Heart Day (29 Sept).

With cardiovascular disease (CVD) causing 26% of all deaths and costing the UK healthcare system over £8 billion a year, it is felt more can be done to prevent many thousands of avoidable deaths and ill health. As well as highlighting some of PHE’s programmes and resources, the plan includes some  CVD initiatives planned for 2017 /18.

This includes work looking at a new return on investment tool, air pollution, sugar reduction and the NHS Health Check programmes. The plan is aimed at those involved in the commissioning and provision of services for CVD and its prevention such as clinicians, local authorities, service commissioners, public health specialists, the third sector and PHE staff.

The action plan can be downloaded here

Campaign materials for World Heart Day can be downloaded here

 

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NHS staff shortages are compromising patient care

New report from the Royal College of Nursing calls for urgent review of Nurse staffing levels to ensure patient safety this winter. 

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Image source: http://www.rcn.org.uk

The Royal College of Nursing (RCN) has today published a report, Safe and Effective Staffing: Nursing Against the Odds which shows the results of a recent staff survey. The survey, carried out in May 2017  reveals more than half (55%) say shifts did not have the level of nurses planned, and that shortages were compromising patient care (53% ).

Nursing staff in all four UK countries were asked about staffing levels on their most recent shift and the quality of care provided. More than a third (36%) report having to leave elements of patient care undone due to a lack of time, while two thirds (65%) work an unpaid extra hour on average.

Seven in 10 nurses (71%) in England said their last daytime shift exceeded NICE guidelines, which states that more than eight patients to one nurse should act as a ‘red flag’. A quarter (26%) reported shifts with 14 or more patients per nurse.

The respondents also reported that:

  • patients are no longer afforded enough dignity, even dying alone;
  • colleagues have burned out and have become sick themselves, unable to come to work;
  • staff leave work “sobbing” at the impact of shortages on patient care;
  • many question their future in nursing and contemplate leaving the profession;
  • they struggle to give their children and families enough support after shifts that can exceed 12 hours.

Full report: Safe and Effective Staffing: Nursing Against the Odds

Royal College of Nursing: Urgent action needed to tackle staffing crisis

Related:

Number of NHS beds more than halved over the past 30 years

The number of NHS beds has fallen by half in 30 years, and plans for further cutbacks are “unrealistic” | The Kings Fund

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A study from The Kings Fund has found that bed numbers – including general and acute, mental illness, learning disability, maternity and day-only beds –  have dropped from 299,000 to 142,000 since 1987.  Hospitals in England now have the least number of beds for their population compared with any other country in the European Union, with just 2.3 per 1,000 people.

The report explains that this decline is in part due to factors such as an increase in care being delivered outside hospitals. It also highlights the impact of medical innovation including an increase in day-case surgery, which has also had an impact by reducing the time that many patients spend in hospital.

The report however warns that there are signs of a growing shortage of beds. In 2016/17, overnight general and acute bed occupancy averaged 90.3 per cent, and regularly exceeded 95 per cent in winter, well above the level many consider safe. The authors state that in this context, proposals put forward in some sustainability and transformation plans to deliver significant reductions in the number of beds are unrealistic.

Full report: NHS hospital bed numbers: past, present, future

A systems approach to health and care design

A more holistic or ‘joined-up’  systems approach to health and social care provision could help  transform the way these essential services are delivered and address the needs of a changing patient population | Royal College of Physicians

The Royal Academy of Engineering, the Academy of Medical Sciences and the Royal College of Physicians have published Engineering better care: a systems approach to health and care design and continuous improvement.

This report explores how an engineering approach could be applied in health and social care to develop systems that meet the needs of patients, carers and NHS staff.  It presents a framework to support ongoing work in service design and improvement in health and care.  It found that more widespread application of a rigorous systems approach to health and care improvement, has the potential to have a transformative effect on health and care.

Full document: Engineering better care: a systems approach to health and care design and continuous improvement.

 

Owls May Shed Light on Age-Related Hearing Loss Prevention

Researchers have found that barn owls have what they call “ageless ears,” which could potentially help with identifying new treatment options for hearing-impaired humans. | story via The Hearing Journal

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In a study published in Proceedings of Biological  Science, researchers measured the auditory sensitivity of seven barn owls ranging from less than 2 years old to 23 years old by training them to fly to a perch to receive a food reward in response to an auditory cue. Young and old owls both responded to the varying levels of auditory cues, and the oldest owl at 23 years old heard just as well as the younger owls.

​According to Georg Klump, one of the study authors “birds can repair their ears like humans can repair a wound”.  “Humans cannot re-grow the sensory cells of the ears but birds can do this.” Work is underway to investigate the differences between birds and mammals, which commonly lose their hearing at old age. ​

Full reference: Krumm, B. et al. Barn owls have ageless ears Proc Biol Sci. 2017 Sep 27;284

Triaging patients using ‘telephone first’ approach may increase GP workload

Study finds wide variation among practices in how the ‘telephone first’ system impacted GPs – but showed overall it was associated with increased workload | GP Online | BMJ

A telephone first approach in general practice is likely to increase overall GP workload and there is ‘no evidence’ that using the scheme saves money, researchers have found.

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The study, published in the British Medical Journal (BMJ) analysed data from 147 GP practices in England using the approach and compared them with a 10% random sample of other practices in England. They also reviewed responses to patient satisfaction surveys.

The researchers found adoption of the approach led to fewer face-to-face consultations – from a mean of 13 to nine per day per 1,000 patients – and more telephone calls – from a mean of three to 12 per day per 1,000 patients.

They concluded that these results suggest that much of the work of a GP can be managed on the telephone,  but almost half of the patients triaged needed to be seen in person – effectively doubling the length of time for a GP to deal with their problem.

Patient responses to the scheme were also mixed, with some welcoming that they could be seen more quickly in telephone first practices, and others finding it more difficult communicating over the phone.

The scheme also led to an increase in emergency admissions, which the researchers warned could increase overall costs to the health system.

Full story at GP Online

Research paper: Newbould J. et al. Evaluation of telephone first approach to demand management in English general practice: observational study  BMJ 2017

Adult and older adult mental health services 2012-2016

Adult and older adult mental health services 2012-2016: An analysis of Mental Health NHS Benchmarking Network data for England and Wales | Centre for Mental Health

The number of acute inpatient beds for adults with mental health problems in England and Wales fell by 15% between 2012/13 and 2015/16 while specialist community mental health services also reduced by about 6%, according to a new briefing published today by Centre for Mental Health.

The briefing, Adult and older adult mental health services 2012-2016, analyses data collected by the NHS Benchmarking Network since 2012/13 up to the publication of the Five Year Forward View for Mental Health.

The briefing finds that while psychiatric acute inpatient beds for adults fell by 15% between 2012 and 2016, and staffing levels fell by 20%, the number of people admitted and the time they stayed in hospital did not change. This means that bed occupancy levels have risen to an average of 94%.

During the same time, community mental health service provision fell slightly: the number of people on community team caseloads reduced by 6%, staffing levels fell by 4% and contacts reduced by 7%. By contrast access to psychological therapies rose rapidly, reaching some 900,000 people a year by 2015/16.

Full report:  Adult and older adult mental health services 2012-2016