Antibiotic prescribing and resistance

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Public Health England has published English surveillance programme for antimicrobial utilisation and resistance (ESPAUR) report 2016.

The ESPAUR report includes national data on antibiotic prescribing and resistance, and hospital antimicrobial stewardship implementation. It forms a standard against which antimicrobial use and antimicrobial resistance can be compared in successive years and a resource for commissioning and implementing antimicrobial stewardship policies in England.

Additional link: PHE press release

Commissioning and delivering seven day services

The NHS Confederation has published Commissioning and delivering enhanced seven-day NHS services.

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Image source: http://www.nhsconfed.org/

 

This paper aims to get behind the debate and explore the evidence for and against the extension to seven-day services.  It analyses what is already known about seven-day provision from the work of NHS national bodies, NHS organisations and others, and explores what the evidence already shows about the case for an enhanced seven-day NHS.

Funding child and adolescent mental health services

The Royal College of Psychiatrists has published information and an interactive map which highlights the variations on the planned spend on children and adolescent mental health services by CCGs across the country during the period 2016/2017.

The Government has pledged to invest in child and adolescent mental health services, with £119 million of NHS funding allocated to clinical commissioning groups for this financial year and another £140 million promised for 2017/18, with an additional £30 million for eating disorder services.

Click on the map below and see spend in your area:

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Image source: http://www.rcpsych.ac.uk/

The digital patient: transforming primary care?

 

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

This report from The Nuffield Trust reviews the evidence that exists on digital technology and its impact on patients in primary care and the NHS. It explores the impact of seven types of digital services offered by the NHS:

  1. Wearables and monitoring technology
  2. Online triage tools
  3. Online sources of health information and advice, targeted interventions and peer support
  4. Online appointment booking and other transactional services
  5. Remote consultations
  6. Online access to records and care plans
  7. Apps

The report finds that patient-facing technology is already showing promise that it can improve care for patients and reduce strain on the stretched health service – particularly for people with long-term conditions such as diabetes or COPD. However, this rapidly evolving market comes with risks. Many apps, tools and devices have not been officially evaluated, meaning that their effectiveness is unknown. In some cases, technology can increase demand for services, disengage staff and have the potential to disrupt the way that patients access care.

Moreover, the report warns that policy-makers and politicians should avoid assuming that self-care-enabling technology will produce significant savings, at least in the short term.

The report also presents a series of lessons and recommendations to NHS professionals, leaders and policy-makers about how best to harness the potential of technology and avoid the pitfalls.

See also: Why the NHS must tackle digital exclusion | Nuffield Trust

Half of hospital trusts miss reduced waiting targets

Via Health Service Journal

  • Trusts missing largely lower “reset” targets for elective treatment times
  • Performance means organisations could miss out on sustainability and transformation funding
  • Total waiting list approaches 4 million

More than half of England’s hospital trusts have missed their elective waiting time targets set by NHS Improvement.  HSJ analysis of the 18 week referral to treatment time data for the second quarter of 2016-17 shows 66 trusts missed targets set for them by the regulator.

The national target is for trusts to have no more than 8 per cent of their patients waiting more than 18 weeks for elective treatment – but in July NHS Improvement set different, usually lower, “reset” targetsthat trusts must hit to access sustainability and transformation funding.

Of the 120 trusts that signed up for reset targets from July, 42 missed them in each of the three months of quarter two. Another 24 missed in aggregate over the quarter

Homecare is failing people with dementia: Alzheimers Society

Only 2% of people affected by dementia say homecare workers have enough dementia training. |  Alzheimer’s Society

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An Alzheimer’s Society investigation has exposed a vicious cycle where a lack of dementia training for homecare workers results in intolerable stress for people with dementia, families and carers – and for the homecare workers themselves.

Poor quality homecare is leaving too many people with dementia spending the day in soiled clothing, going without food or water, or ending up in costly hospital or care home admissions when they could have stayed at home, where they want to be, for longer.

The investigation involved a survey of homecare workers with Unison, research into the sector with Skills for Care, Freedom of Information (FOI) requests to all local authorities in England, and a survey of over 1220 people affected by dementia to gather first-hand testimonies about homecare.

Key findings from the survey of over 1220 people affected by dementia include:

  • Only 2% of people affected by dementia say homecare workers ‘have enough dementia training
  • Half (49%) of people affected by dementia do not think that ‘homecare workers understand the specific needs of people with dementia’
  • More than a third (38%) of people affected by dementia do not think that ‘homecare workers know how to treat people with dementia with understanding and dignity

Read more via the Alzheimer’s Society

How is the NHS performing?

How is the NHS performing?  Quarterly Monitoring Report | November 2016 | The Kings Fund

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

The King’s Fund has published How is the NHS performing? November 2016.

This quarterly monitoring report combines publicly available data on selected NHS performance measures with views from NHS finance directors and clinical commissioning group finance leads. The report now also includes views from general practitioners and practice managers, and unpublished activity data.

Additional link: King’s Fund press release

Freedom to speak up in primary care

Freedom to speak up in primary care: guidance to primary care providers on supporting whistleblowing in the NHS | NHS England

kick-off-879382_1280This guidance aims to make it easier for all staff providing NHS primary care services to raise their concerns so that action can be taken and improvements made.

It details the principles and actions to apply in primary care when raising concerns about the delivery of primary care services to patients.

The guidance comes after Sir Robert Francis recommended that the principles outlined in his Freedom to Speak Up report be adapted for primary care, where smaller work settings can present challenges around anonymity and conflicts with employers.

Improving the Care of people with long term conditions

The Royal Pharmaceutical Society is launching a new campaign to improve the care of people with long term conditions through the better use of pharmacists.

An average 1 in 3 people across Great Britain have at least one long term condition. Caring for them accounts for around 50% of GP appointments and approximately 70% of the health and social care budget across the country.

As the third largest health profession in the UK, the Royal Pharmaceutical Society argues that the skills and expertise of pharmacists must be maximised within the multidisciplinary team to provide the best care for patients.

The RPS has published policy documents that focus on how the role of the pharmacist can be enhanced to prevent, identify, treat and support people with long term conditions, as part of a multidisciplinary approach.

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Image source: http://www.rpharms.com/

Genetic Risk, Adherence to a Healthy Lifestyle, and Coronary Disease

Khera, A.V. et al. NEJM. Published online: 13 November 2016

https://wellcomeimages.org/indexplus/result.html?_IXMAXHITS_=1&_IXACTION_=query&_IXFIRST_=12&_IXSR_=R6BynY4lzgm&_IXSS_=_IXMAXHITS_%3d250%26_IXFPFX_%3dtemplates%252ft%26_IXFIRST_%3d1%26c%3d%2522historical%2bimages%2522%2bOR%2b%2522contemporary%2bimages%2522%2bOR%2b%2522corporate%2bimages%2522%2bOR%2b%2522contemporary%2bclinical%2bimages%2522%26%252asform%3dwellcome%252dimages%26%2524%253dsi%3dtext%26_IXACTION_%3dquery%26i_pre%3d%26IXTO%3d%26t%3d%26_IXINITSR_%3dy%26i_num%3d%26%2524%253dsort%3dsort%2bsortexpr%2bimage_sort%26w%3d%26%2524%253ds%3dhealthy%2bdigital%26IXFROM%3d%26_IXSUBMIT_%3dSubmit%26_IXshc%3dy%26%2524%2b%2528%2528with%2bwi_sfgu%2bis%2bY%2529%2band%2bnot%2b%2528%2522contemporary%2bclinical%2bimages%2522%2bindex%2bwi_collection%2bor%2b%2522corporate%2bimages%2522%2bindex%2bwi_collection%2529%2529%2band%2bnot%2bwith%2bsys_deleted%3d%252e%26_IXrescount%3d39&_IXSPFX_=templates%2ft&_IXFPFX_=templates%2ft
Image source: Bill McConkey – Wellcome Images // CC BY-NC-ND 4.0

Background: Both genetic and lifestyle factors contribute to individual-level risk of coronary artery disease. The extent to which increased genetic risk can be offset by a healthy lifestyle is unknown.

Methods: Using a polygenic score of DNA sequence polymorphisms, we quantified genetic risk for coronary artery disease in three prospective cohorts — 7814 participants in the Atherosclerosis Risk in Communities (ARIC) study, 21,222 in the Women’s Genome Health Study (WGHS), and 22,389 in the Malmö Diet and Cancer Study (MDCS) — and in 4260 participants in the cross-sectional BioImage Study for whom genotype and covariate data were available. We also determined adherence to a healthy lifestyle among the participants using a scoring system consisting of four factors: no current smoking, no obesity, regular physical activity, and a healthy diet.

Conclusions: Across four studies involving 55,685 participants, genetic and lifestyle factors were independently associated with susceptibility to coronary artery disease. Among participants at high genetic risk, a favorable lifestyle was associated with a nearly 50% lower relative risk of coronary artery disease than was an unfavorable lifestyle.

Read the full article here