One of the world’s leading experts on nursing and safe staffing has questioned current NHS policies towards nurses and suggested some could even put patients at greater risk.
Evidence shows minimum nurse to patient ratios work, says global expert
Linda Aiken says there is no evidence the UK has a staffing policy on nursing
Substituting nurses for non-nurse roles increases poor outcomes claim
Linda Aiken, director of the Centre for Health Outcomes and Policy Research at Pennsylvania University in the United States, told HSJ evidence on safe nurse staffing ratios was clear and proved “they do work”.
She said the NHS’s plan to create a nursing assistant role at band 4 was “crazy”, as evidence in the US showed this actually increased mortality and poorer outcomes.
The Lancet: Volume 386, No. 10005, p1739–1746, 31 October 2015
Long working hours might increase the risk of cardiovascular disease, but prospective evidence is scarce, imprecise, and mostly limited to coronary heart disease. We aimed to assess long working hours as a risk factor for incident coronary heart disease and stroke.
Employees who work long hours have a higher risk of stroke than those working standard hours; the association with coronary heart disease is weaker. These findings suggest that more attention should be paid to the management of vascular risk factors in individuals who work long hours.
The International Agency for Research on Cancer (IARC), the cancer agency of the World Health Organization (WHO), has evaluated the carcinogenicity of the consumption of red meat and processed meat.
Researchers classified the consumption of red meat as probably carcinogenic to humans, based on limited evidence that the consumption of red meat causes cancer in humans and strong mechanistic evidence supporting a carcinogenic effect. Processed meat was classified as carcinogenic to humans.
The WHO did stress that meat also had health benefits. Cancer Research UK said this was a reason to cut down rather than give up red and processed meats.
The different internet networks used by the NHS and social care are a barrier to providing integrated care, according to the Local Government Association.
Speaking at a recent event on developing local digital roadmaps, Mark Golledge, programme manager for health and care informatics at the LGA, said that “network infrastructure” is one of the main challenges faced by organisations looking to share information across care boundaries.
NHS services in England and Scotland use the secure N3 network to share information online, whereas social care services tend to use the Public Services Network.
There are plans to create a combined Health and Social Care Network, but according to the Health and Social Care Information Centre this won’t be in place until 2016-17. The NHS contract for N3, which is run by BT, is due to end some point in 2017.
Despite the large number of new medicines entering the market every year, few offer important clinical advantages for patients. Huseyin Naci, Alexander Carter, and Elias Mossialos explain the reasons for this innovation deficit and offer some solutions
“Many in the pharmaceutical sector suggest that the industry is in crisis. Industry analysts fret that financial rewards are no longer sufficient for companies to maintain the investment needed to develop clinically useful drugs.1Despite these concerns, regulators in the US and Europe granted marketing authorisations to a record number of new medicines in 2014. However, the majority of new medicines offer few clinical advantages over existing alternatives. We discuss how both government and drug company practices contribute to the ongoing innovation deficit in the sector.” Carry on reading via Why the drug development pipeline is not delivering better medicines | The BMJ.
Cancer Research UK has issued a press release summarising stages of cancer diagnosis for different areas of England. The analysis looked at available data on 10 types of cancer across 25 areas of England in 2012 and 2013, and whether the disease was diagnosed early (at stage 1 or 2) or later (at stage 3 or 4). The results found that people’s chances of being diagnosed early could also depend on which cancer they have, with areas that were among the best for diagnosing one type of cancer early not always doing as well when it came to other types of the disease.
The Lancet Psychiatry: Volume 2, No. 11, p1013–1027, November 2015
Meng-Chuan Lai and Simon Baron-Cohen discusses the identification of autism spectrum conditions in adulthood with Lancet Psychiatry Editor Niall Boyce and Senior Editor Hannah Cagney.
Autism spectrum conditions comprise a set of early-onset neurodevelopmental syndromes with a prevalence of 1% across all ages. First diagnosis in adulthood has finally become recognised as an important clinical issue due to the increasing awareness of autism, broadening of diagnostic criteria, and the introduction of the spectrum concept. Thus, the idea of a lost generation of people who were previously excluded from a diagnosis of classic autism has arisen. Making a first diagnosis of autism spectrum conditions in adults can be challenging for practical reasons (eg, no person to provide a developmental history), developmental reasons (eg, the acquisition of learnt or camouflaging strategies), and clinical reasons (eg, high frequency of co-occurring disorders). The diagnostic process includes referral, screening, interviews with informants and patients, and functional assessments. In delineating differential diagnoses, true comorbidities, and overlapping behaviour with other psychiatric diagnoses, particular attention should be paid to anxiety, depression, obsessive-compulsive disorder, psychosis, personality disorders, and other neurodevelopmental disorders. Possible misdiagnosis, especially in women, should be explored. The creation of supportive, accepting, and autism-friendly social and physical environments is important and requires a coordinated effort across agencies and needs support from government policies.
Given the number of effective treatments for type II diabetes, which have good evidence about safety and efficacy, should any new drugs for the condition be subject to a higher regulatory bar?
In this podcast, Huseyin Naci from the London School of Economics, John Yudkin from Univerity College London, and Ben Goldacre from the University of Oxford, explain why they believe the current process is inadequate, and suggest some ways in which it could be improved.