Chris Gregory, head of clinical systems for LGSS Local Health and Care Shared Service explains how mobile solutions are transforming the work of community-based health teams | NHE
As the IT provider to Northamptonshire Healthcare NHS FT, LGSS has been involved in delivering mobile working solutions to a number of community-based health teams, including health visitors and district nurses, and for providing similar solutions in local government.
The trend towards delivering care closer to home to meet both patient aspirations, and the need to deliver savings through the reduction of estate, means that increasing levels of flexible working are being demanded across the NHS. If done successfully, mobile working can help to deliver the type of service that patients tell us they would like from their health service.
As with many IT services we’ve had a few attempts at delivering practical mobile working solutions, each based on and constrained by the technology available at the time. Prior to our latest deployment, we asked staff what they needed from a mobile device. Overwhelmingly, those who responded wanted:
A small form factor: There is plenty of other equipment a district nurse needs to carry so devices need to be small, as light as possible and certainly no more awkward to carry than the files of paper notes previously used
Sufficient battery life to get through an entire working day
A fast start-up: Ensuring that as little of the precious contact time with the patient was spent waiting for the technology
Versatility: Multiple means of inputting data, suggesting the need for both touchscreen and keyboard input
Being healthy is the best start to pregnancy for a woman and child | NIHR
Preparing for pregnancy can focus attention on health, such as eating a healthy balanced diet or losing excess weight, as well as avoiding risks from smoking, alcohol and drug use. Ensuring the best care for long-term physical and mental health conditions is important for a healthy pregnancy, as well as addressing complex social needs.
Getting the best start in life for children is a UK policy priority, focused on preventing problems and early intervention to improve outcomes. NIHR research evidence into modifiable factors to influence health before, during and after pregnancy is growing and helping to inform policy and practice.
This themed review brings together NIHR research on different aspects of health before, during and after pregnancy. It features:
46 published studies
28 ongoing studies or interim results
Questions for clinicians, commissioners, public health professionals and others
Productivity, Technology and the NHS, looks at the NHS in England approach to productivity improvement half-way through the implementation of NHS Engand’s ‘Five Year Forward View | Newchurch
A core component of NHS England’s Five Year Forward View (5YFV), which underpinned the subsequent financial settlement agreed with the Government, was that NHS productivity would improve by 2.4% a year for each of the five years up to 2020/21. The 5YFV went further suggesting that its implementation could even result in sustained improvements of 3% a year in the longer term, a proposition which must have assumed sustained improvement in workforce productivity, given that staff costs make up some 70% of NHS expenditure. This proposition always looked ambitious and subsequent analyses of the NHS’s long-term productivity performance have served to underline the size of the challenge. However the Carter Review, published 12 months ago, underlined the scale of the potential improvements that could be made in the NHS’s dominant acute sector.
A key contributor to achieving the rate of productivity improvement underpinning the 5FYV, reinforced by Carter’s conclusions, was the adoption of new digital technologies. This faith in the impact of digital technology is despite the evidence of the last 20 years that would cast considerable doubt as to the productivity impact of the digital technologies programmes that the NHS in England and its predecessors have implemented.
An analysis of current performance and future plans at the national, Sustainability and Transformation Plan and trust level suggests that the NHS as a system gives little priority to productivity improvement. Furthermore current plans for the development and implementation of digital technologies are unlikely to have any significant impact on productivity, certainly within the lifetime of the 5YFV.
The latest figures show coverage at 75.5 per cent – up slightly from 75.4 per cent the year before | Public Health Matters Blog
It’s great to see that for the first time in five years there’s been an increase in the number of eligible women taking up the offer to be screened for breast cancer, with levels remaining above the NHS Cancer Screening Programmes’ minimum standard of 70%.
Breast screening aims to reduce deaths from breast cancer by finding and treating cancers that are too small to be felt. The aim is to treat them early when there is a greater chance of a cure.
Deciding whether to have screening is a choice and it is important that women are sufficiently informed to decide for themselves. This is because there are risks as well as benefits, and over the last few years it’s been hard to miss the ongoing debate about the pros and cons.
On the one hand, breast screening has been shown to saves lives by detecting the disease earlier, but it can also detect small slow growing cancers that don’t need treating – the so-called ‘over diagnosed’ cancers.
Across the UK, there is a growing culture of overuse of medical intervention, with variation in the use of certain treatments across the country | Choosing Wisely UK
For example, the prescribing of antibiotics can vary by as much as two and a half times between one part of the country and another.
Common examples of overused medicines are antibiotics for common colds or other non-bacterial infections or prescriptions given for mild depression when alternative options such as exercise could be explored first.
Nearly 70 percent of prescription opioid medications kept in homes with children are not stored safely, a new study finds | ScienceDaily
In a national survey of 681 adults who used opioid pain relievers in the past year and had children ages 17 and younger living with them, only 31 percent reported safely storing them away from their children. Among those homes with children seven to 17 years old, just 12 percent reported safe storage.
The researchers defined safe storage as keeping the medication in a locked or latched place for homes with younger children and a locked place for homes with older children.
Smoking cessation services are being hit as cash-strapped local authorities and Clinical Commissioning Groups (CCGs) look to save money | OnMedica
Evidence obtained under the Freedom of Information Act by The Observer reveals that an increasing number of CCGs have been instructing GPs to stop providing the services with many CCGs arguing it is no longer their responsibility as local authorities are now responsible for public health.
Local authorities hold a £2.8 billion ring-fenced public health budget but, as the grants have been pared back in other areas, councils have pulled their funding for stop smoking services.
Hospital services in nearly two-thirds of England could be cut or scaled back, BBC analysis of local plans shows.
The BBC analysis found:
Plans to reduce the number of hospital sites in Leicester, Leicestershire and Rutland from three to two
In the Black Country a £700m funding gap means one hospital may have to be closed
Maternity and children’s services being “centralised” on to one site in Lincolnshire
A warning in West Yorkshire and Harrogate that having five hyper-acute stroke services may “no longer be viable”
The downgrading of two out of three A&Es in Mid and South Essex, with only one retaining specialist emergency care
In South West London, proposals to reduce the number of major hospitals from five to four
Plans in Nottinghamshire to significantly downsize City Hospital and reduce the number of beds across Nottingham by 200
In Cambridgeshire and Peterborough, consideration being given to centralising specialised orthopaedic trauma services at two local hospitals
Overall, a third of the 44 plans look to reduce the number of hospitals providing emergency care, while in another third of areas they have said they will consider moving non-emergency care to fewer sites.
Effective support can make a considerable difference to the relatives of people who are dying; helping to allay fears, reducing stress and anxiety, and minimising suffering in bereavement.
Clear communication around practical considerations (death certificate, funeral arrangements, information around autopsy, etc) and psychosocial support (normalising grief, cultural and spiritual considerations) is key.
Doctors need to familiarise themselves with local systems and protocols. Written communication in addition to verbal is beneficial.
All doctors, irrespective of their specialty or the setting in which they work, will care for patients who die. Around half of all deaths occur in hospitals.1 Evidence suggests that the quality of communication around this process is poorer in hospitals than in other settings, according to responses from relatives who have experienced bereavement.2 Over half of NHS complaints concern care of the dying.3
This article discusses how to best support relatives and carers at the end of a patient’s life. While the focus is on the hospital setting, the principles are applicable to community and care home settings. In this article, “relative” encompasses family members, care givers, and those close to the patient. The article presumes throughout that the patient has given consent for information to be shared with relatives (Box 1).
The Nuffield Trust’s “London Quality Standards” report evaluates recently introduced standards to improve acute and emergency care in London hospitals | Dementia and Elderly Care News
London-wide experiments with Seven Day Services Standards are soon to feature in STPs elsewhere in the UK. These standards specify various minimum requirements, including regular consultant review during out-of-hours and at the weekends.
This study found little evidence of benefits for patients. Threats to impose weekend working standards might be counter-productive, say the authors.
“We saw some deficiencies in hospitals’ ability to manage complex changes, and evidence of a deep disconnect between frontline staff and top managers. The use of reconfiguration as a ‘stick’ to drive the standards de-motivated staff, and eventually came to be seen as an empty threat”.