No difference in patient mortality for weekend vs weekday admissions to psychiatric hospitals

NIHR. Published online: 20 April 2016

Interim findings from a NIHR HS&DR study, published in The Lancet, have found that there is no significant difference in risk of mortality for patients admitted to a psychiatric hospital at the weekend versus during the week.

Whilst previous studies have indicated that risk of mortality is higher for patients admitted to acute hospitals at the weekend less is known about variations in clinical outcomes among patients admitted to psychiatric hospitals.

The main study is being led by Professor Len Bowers from South London and Maudsley NHS Foundation Trust and is evaluating ‘seclusion and intensive psychiatric care’. As part of the research the team have investigated the variations in clinical outcomes for patients admitted to a psychiatric hospital at the weekend.

The results identified that patients admitted at the weekend had shorter admissions and increased risk of readmission but no significant difference in risk of inpatient mortality. This finding contrasts with previous studies in acute hospitals where weekend admission is typically associated with increased likelihood of inpatient mortality, and highlights a need to consider variations in demand when implementing health-care services across a 7 day week.

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Caldicott: ‘Considerable’ public support for data sharing

Santry, C. HSJ. Published online: 21 April 2016

There is “considerable” public support for sharing anonymised health data with third parties, according to the unpublished findings of national data guardian Dame Fiona Caldicott.

Dame Fiona was commissioned last September by health secretary Jeremy Hunt to propose a set of data security standards for health and social care organisations, and advise on the wording of a new consent and opt-out model for sharing patient information.

Her recommendations were originally expected to be published in February, but this has been delayed until after the EU referendum on 23 June, Dame Fiona revealed on Wednesday.

Speaking at the UK e-Health Week conference in London, she said her research had found “considerable” public support for the use of patients’ anonymised information, despite low levels of understanding about data use and sharing.

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Improving management of type 2 diabetes in South Asian patients: a systematic review of intervention studies

Bhurji, N. et al. BMJ Open. 2016. 6:e008986


Objectives: Optimal control of type 2 diabetes is challenging in many patient populations including in South Asian patients. We systematically reviewed studies on the effect of diabetes management interventions targeted at South Asian patients with type 2 diabetes on glycaemic control.

Design: Systematic review of MEDLINE, EMBASE and CINAHL databases for randomised controlled trials (RCTs) and pre-post-test studies (January 1990 to February 2014). Studies were stratified by where interventions were conducted (South Asia vs Western countries).

Participants: Patients originating from Pakistan, Bangladesh or India with type 2 diabetes.

Primary outcome: Change in glycated haemoglobin (HbA1c). Secondary end points included change in blood pressure, lipid levels, anthropomorphics and knowledge.

Results: 23 studies (15 RCTs) met criteria for analysis with 7 from Western countries (n=2532) and 16 from South Asia (n=1081). Interventions in Western countries included translated diabetes education, additional clinical care, written materials, visual aids, and bilingual community-based peers and/or health professionals. Interventions conducted in South Asia included yoga, meditation or exercise, community-based peers, health professionals and dietary education (cooking exercises). Among RCTs in India (5 trials; n=390), 4 demonstrated significant reductions in HbA1c in the intervention group compared with usual care (yoga and exercise interventions). Among the 4 RCTs conducted in Europe (n=2161), only 1 study, an education intervention of 113 patients, reported a significant reduction in HbA1c with the intervention. Lipids, blood pressure and knowledge improved in both groups with studies from India more often reporting reductions in body mass index and waist circumference.

Conclusions: Overall, there was little improvement in HbA1c level in diabetes management interventions targeted at South Asians living in Europe compared with usual care, although other outcomes did improve. The smaller studies in India demonstrated significant improvements in glycaemic and other end points. Novel strategies are needed to improve glycaemic control in South Asians living outside of India.

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Improving access to mental health services

The National Audit Office has published Mental health services: preparations for improving access. This report looks at the preparations the Department of Health, NHS England and other arm’s-length bodies are making for improving access to mental health services. It is the first output in what we expect to be a long-term programme of work on mental health in the coming years, covering both the health system’s progress in improving support for people with mental health problems and how mental health issues are tackled more widely across government.

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Related link: NHS Clinical Commissioners

Investment in General Practice

NHS England announces multi-billion plan designed to improve patient care and access, and invest in new ways of providing primary care.

NHS England has published General practice: forward view. The plan sets out details of increased levels of investment in primary care, with an extra £2.4 billion a year for general practice services by 2020/21.  The plan also contains specific, practical and funded steps to strengthen workforce, drive efficiencies in workload, modernise infrastructure and technology, and redesign in the way primary care is offered to patients.

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Taking aspirin could increase cancer survival by 20%

Study prompts call for more research into aspirin as an additional cancer treatment – ScienceDaily, 20 April 2016

Patients receiving cancer treatment could increase their chance of survival by up to 20% and help stop their cancer from spreading by taking a low-dose of aspirin, new research suggests.

In a systematic review of the available scientific literature a team from Cardiff University’s School of Medicine found a significant reduction in mortality and cancer spread by patients who took a low-level dose of aspirin in addition to their cancer treatment (average study follow-up length over 5 years).

The review looked at all of the available data including five randomised trials and forty two observational studies of colorectal, breast and prostate cancers.

As a result of the review, the team say their study highlights the need for randomised trials to establish the evidence needed to support low-dose aspirin as an effective additional treatment of cancer.

B0006253 Aspirin crystals
Image of aspirin crystals. Source: Annie Cavanagh, Wellcome Images.//CC BY-NC-ND 4.0

Professor Elwood added: “While there is a desperate need for more detailed research to verify our review and to obtain evidence on less common cancers, we’d urge patients diagnosed with cancer to speak to their doctor about our findings so they can make an informed decision as to whether or not they should take a low-dose aspirin as part of their cancer treatment.”

Full reference: Elwood, P. et al. Aspirin in the Treatment of Cancer: Reductions in Metastatic Spread and in Mortality: A Systematic Review and Meta-Analyses of Published Studies. PLOS ONE, 2016; 11 (4):

Commissioning better cancer services

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NHS England has published guidance to support commissioners and strategic clinical networks to ensure every person affected by cancer will have access to a recovery package and follow-up pathways by 2020, as set out in the cancer strategy.

The guidance includes checklists for developing service specifications, practical examples and templates to use and adapt locally.

Full reference: Implementing the Cancer Taskforce Recommendations: Commissioning person centred care for people affected by cancer