Map of technology and data in health and care

The Kings Fund has published ‘Map of technology and data in health and care’.

This interactive map brings together case studies from across England and the rest of world, highlighting some of the places that are experimenting with and implementing new technologies to achieve better health outcomes or more efficient care.

The map is not a comprehensive listing of all such projects – it is limited to case studies featured in The King’s Fund publications and events, plus the NHS test bed sites set up to evaluate the real-world impact of new technologies.

Read more here

The Battle for Breath – the impact of lung disease in the UK

British Lung Foundation. Published online: June 2016

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Image source: BLF

The Battle for Breath examines the overall extent and impact of lung disease across the UK. It also takes a closer look at the impact of 15 major lung conditions.

The new report is a valuable resource for policymakers, researchers, health care providers and more.

It explains in detail our new findings, and the changes that need to be made to tackle them.

Key findings

  • Lung disease is one of the top three killer diseases in the UK
  • 115,000 people a year die from lung disease – 1 person every 5 minutes
  • Mortality figures are roughly the same as 10 years ago, yet heart disease has fallen 15%
  • 1 in 5 people in the UK have been diagnosed with a lung disease
  • Every day, 1,500 new people are diagnosed with a lung disease
blf stats

Image source: BLF

Read the full report here

Is beer good for the brain?

ScienceDaily. Published online: 1 June 2016

beer-1290633_960_720While most people will agree that excessive consumption of alcohol can have a detrimental effect on the brain, there is less agreement regarding the effects of light or moderate drinking. This includes concern and controversy surrounding the effects of drinking on the development of neurodegenerative diseases such as Alzheimer’s (AD). This study investigated the association between consumption of different alcoholic beverages — beer, wine, and spirits — and one of the neuropathological signs of Alzheimer’s disease, β-amyloid (Aβ) aggregation in the brain.

Researchers examined data from 125 males participating in the Helsinki sudden death autopsy series, who at the time of death were 35 to 70 years old. Consumption of alcohol, Aβ aggregation in the brain, and apolipoprotein E (APOE) genotype were assessed. Surviving relatives answered a questionnaire used to gather the drinking history of the deceased, and Aβ was observed by immunohistochemical staining of brain sections.

Read the full commentary here

Read the original research abstract here

Making evidence based medicine work for individual patients

McCartney, M. et al. BMJ. 2016. 353:i2452

A Google Scholar search using the term “evidence based medicine” identifies more than 1.8 million papers. Over more than two decades, evidence based medicine has rightfully become part of the fabric of modern clinical practice and has contributed to many advances in healthcare.

But many clinicians and patients have expressed dissatisfaction with the way evidence based medicine has been applied to individuals, especially in primary care.1 There is concern that guidelines intended to reduce variation and improve the quality of care have instead resulted in medicine becoming authoritarian and bureaucratic.2 Evidence generated from large populations has been distilled into large numbers of lengthy and technically complex guidelines. Guidelines in turn have been used to create financial incentive schemes such as the UK’s Quality and Outcomes Framework, whereby a substantial proportion of general practice income depends on achieving thresholds for drug therapy or surrogate outcomes in accordance with National Institute for Health and Care Excellence guidelines. Not only do these thresholds exceed the limits of the evidence for many people but they also encourage clinicians to ignore the need to elicit and respect the preferences and goals of patients.

Read the full article here

Related podcast:

 

Julian Treadwell, Neal Maskrey and Richard Lehman join us in the studio to argue that new models of evidence synthesis and shared decision making are needed to accelerate a move from guideline driven care to individualised care.

Deficit in NHS provider sector triples in a year to £2.45bn

BMJ. 2016. 353:i2904

Providers of NHS services have amassed a £2.45bn (€3.2bn; $3.6bn) deficit in the past year, and although the scale of deficit is not as bad as feared, it has still almost tripled from the previous year (£834m).

Health policy experts have described the figures as unprecedented and said that the figure meant that the NHS’s overall deficit was about three times as high as the previous year’s, despite additional funding for the NHS and major efforts to boost efficiencies.

The figures, published on 20 May,1 show that for 2015-16 around two thirds (65%), or 157 of 240 NHS provider organisations, reported a deficit, most of which were acute care trusts. As well as acute care trusts, the figures are for ambulance, mental healthcare, and community care trusts.

NHS Improvement, the body responsible for overseeing foundation trusts, NHS trusts, and independent providers of NHS services, said that the figures showed that overall the NHS provider sector was £461m worse off than planned. It said that providers had risen to the challenge of record breaking demand for services but that more work was needed to continue improving services for patients and increasing efficiencies in 2016-17.

Analysis of providers’ operational and financial performance showed that they saw a record 21 million emergency patients last year, while the sector as a whole made £2.9bn in efficiency savings between April 2015 and March 2016. Nevertheless, NHS providers came under continuing pressure from further increases in demand for care, problems discharging medically fit patients, and high costs, particularly of agency staff. The sector spent £3.64bn on agency and contract staff in 2015-16. Consequently, many providers missed the national waiting time standard for emergency care and other operational performance measures in the last three months of 2015-16.

Halfway through 2015-16 the sector reported a deficit of £1.6bn and then predicted an end of year loss of £2.8bn, so today’s figures were not quite as high as feared.

Read the full article here

New rules on the packaging of tobacco and advertising e -cigarettes

https://www.flickr.com/photos/87735223@N02/25470325872/in/photolist-ENJ5vw-oQMp8A-tmCTC1-gVFs9c-bcgFMZ-hyh7pf-eqp1NG-r35THN-hKZ4GL-hKZKoX-du786C-CwNiuo-eiM8To-qUC8CG-nZENU5-qUBYLd-qCgSV6-FyevPH-nLeuLw-qvDBar-GkBF7P-pR1h7e-rsoRgG-hKZLxv-qSpB2b-mmT5dw-qUGRdk-qCfoFz-jEAf3V-icHgDY-k6VEhD-mF7SWi-qUGKZe-iiKkuw-pgpx7F-qoc441-qC8hzj-pXVvPn-fF831J-pjKNTa-odhndM-fn3ykJ-p2kCRk-ei1Xxy-iiN7D7-qC7YZE-q6PZZi-GtvKc6-fmNo7n-hqW2Fw

image source: Lindsay Fox Flickr – // CC BY-NC 2.0

The Department of Health has published two new guidance documents in relation to the changes of laws to the packaging and branding of tobacco products and the advertising of e-cigarettes:

  • Tobacco Packaging Guidance: This guidance provides an overview of new rules on the packaging of tobacco (and herbal products for smoking) for retail, which came into force on 20 May 2016.

What do patients and the public know about clinical practice guidelines and what do they want from them? A qualitative study

Fearns, N. et al. BMC Health Services Research. Published: 24 February 2016

Background: Guideline producers are increasingly producing versions of guidelines for the public. The aim of this study was to explore what patients and the public understand about the purpose and production of clinical guidelines, and what they want from clinical guidelines to support their healthcare decisions.

Methods: Participants were purposively selected to represent a range of the likely users of patient versions of guidelines, including individuals with health conditions (diabetes and depression), general members of the public, health communication professionals and a group of young people. Participants were asked about their awareness and understanding of clinical guidelines and presented with scenario recommendations, or draft materials from patient guidelines to prompt discussion. Each discussion was facilitated by one or two researchers. All focus groups were recorded and transcribed prior to analysis. Data were analysed using framework analysis.

Results: We ran nine focus groups involving 62 individuals, supplemented by four interviews with people experiencing homelessness. Eight groups were held in Scotland, one in England. The four interviews were held in Scotland. The framework analysis yielded five themes: access and awareness; what patients want to know; properties of guidelines; presenting evidence; and format. Awareness of guidelines was low. Participants emphasised the need for information that enables them to choose between treatment options, including harms. They would like help with this from healthcare professionals, especially general practitioners. Participants differed in their support for the inclusion of numerical information and graphs.

Conclusions: Members of the public want information to help them choose between treatments, including information on harms, particularly to support shared decisions with health professionals. Presenting numerical information is a challenge and layered approaches that present information in stages may be helpful. Ignoring the themes identified in this study is likely to lead to materials that fail to support public and patient healthcare decision making.

Read the full article here