New RCM reports on staffing

The Royal College of Midwives has published two reports focusing on midwifery staffing

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Midwifery staffing is the focus of two new publications from the RCM.


They come at a time of rising demand due to a historically high birthrate, increasingly complex pregnancies and expectations that midwives will deliver more support and advice. Growing demand is combined with a decade-long midwifery shortage, a rapidly ageing workforce and fears of a fall in applications to study midwifery.

The reports are:

Development of a critical appraisal tool to assess the quality of cross-sectional studies

Downes, M.J. et al. BMJ Open. 6:e011458


Objectives: The aim of this study was to develop a critical appraisal (CA) tool that addressed study design and reporting quality as well as the risk of bias in cross-sectional studies (CSSs). In addition, the aim was to produce a help document to guide the non-expert user through the tool.

Conclusions: CA of the literature is a vital step in evidence synthesis and therefore evidence-based decision-making in a number of different disciplines. The AXIS tool is therefore unique and was developed in a way that it can be used across disciplines to aid the inclusion of CSSs in systematic reviews, guidelines and clinical decision-making.

Read the full abstract here

The effects of a high-intensity functional exercise group on clinical outcomes in hospitalised older adults

Raymond, M.J.M. et al. Age Ageing. Published online: December 7 2016


Objective: to investigate a high-intensity functional exercise (HIFE) group in hospitalised older adults.

Conclusion the results suggest that a HIFE group programme combined with individual physiotherapy may improve mobility to a similar extent to individual physiotherapy alone in hospitalised older adults. Providing physiotherapy in a group setting resulted in increased therapist efficiency. A high-intensity exercise group with individual physiotherapy may be an effective and efficient method to provide care to older inpatients.

Read the full abstract here

Rise in children hospitalised for self-harm

Nearly 19,000 children and young people in England and Wales were hospitalised for self-harm last year | NSPCC

This marks an increase of almost 2,400 (14%) in the past 3 years.

The worrying figures were obtained by NSPCC Freedom of Information Request (FOI) to NHS Trusts, and highlight the crisis many young people face as they struggle to cope with the pressures of modern day life.

Childline delivered over 18,471 counselling sessions about self-harm last year, making it one of the most common reasons for children and young people to reach out for support.

Information source: NSPCC

Read the full news story here

Read NSPCC advice for parents about why children and young people self-harm, how to spot the signs and what you can do to help here

New #bigdata tool to help predict dementia risk in older people

A machine learning method analyzing large amounts of health information has potential in assessing the risk of cognitively healthy older people for later dementia, according to research published in the Journal of Alzheimer’s Disease | ScienceDaily


The research team used data from the Cardiovascular Risk Factors, Aging and Dementia (CAIDE) study conducted in Eastern Finland. Study participants were cognitively normal individuals aged 65-79 years from the general Finnish population who underwent detailed health-related assessments, including memory and other cognitive tests. The dementia risk index performed well in identifying comprehensive profiles for predicting dementia development up to 10 years later. The main included predictors were cognition, vascular factors, age, subjective memory complaints and apolipoprotein E (APOE) genotype.

The researchers conclude that the risk index could be useful for identifying older individuals who are most at risk, and who may also benefit most from preventive interventions. They emphasize that the risk index is not meant for dementia diagnosis, but as a tool to help with making decisions about dementia prevention strategies, i.e. to whom these should be targeted, and what risk factors should be specifically addressed based on the visual risk profile.

Read the full overview here

Read the original research abstract here

Britain’s attitudes on obesity

Public Health England commissioned a set of questions on obesity as part of the British Social Attitudes (BSA) survey to inform its future work. | PHE


The findings of the first British Social Attitudes survey on obesity, commissioned by Public Health England (PHE), have been published.

PHE commissioned NatCen Social Research to include a set of questions in its BSA survey to understand the public’s view of obesity and related issues.

The paper, Attitudes to obesity, presents NatCen’s analysis of the results.

The primary findings show that people underestimate their weight and struggle to identify the point when someone becomes obese. Almost two thirds of adults are overweight or obese. All of this combined suggests being overweight or obese is normalised in society.

Download the full paper here


The family’s experience of the progression of dementia.

Trine H Clemmensen et. al. The family’s experience and perception of phases and roles in the progression of dementia: An explorative, interview-based study. Dementia. Published online ahead of print, December 6, 2016.


This paper examines how the relatives of a person with dementia experience challenges in everyday life. A model of phases is developed on the basis of interviews with 14 relatives from eight families. Data were subjected to a thematic content analysis, which found that the progression of dementia – from the perspective of the family – had three phases.

These phases involved small changes in everyday life, adaptations to everyday life, and the loss of everyday life. The analysis further identified the following two archetypes of relatives that develop throughout the progression of dementia: the protective relative and the decisive relative.

The study found that the two types of relatives experience different challenges during the three phases. It is important for health professionals to be familiar with these changes, when they evaluate whether the relatives of a person with dementia require help.

Full paper available here

Care quality measures

The Health Foundation and Nuffield Trust have published Quality at a cost: QualityWatch annual statement 2016.

This report looks at a range of care quality measures across the NHS in England. It highlights several areas of health care where standards have improved, but the authors point to slowing improvement in other areas, growing waiting times and continuing financial pressures.

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QualityWatch routinely monitors over 300 indicators spread across all domains of quality. This report considers a selection of areas from within this set, covering different stages of a patient’s experience of the health service, to give a picture of quality in 2016.

It looks across six main areas:

  • Public health
  • Primary care
  • Ambulances
  • Hospital care
  • Mental health
  • Condition-specific care (stroke and hip fracture)

The report observes that the pressure of austerity did not impact on quality measures straight away, but took a few years to be felt. Authors conclude that further ‘delayed decline’ could occur in other aspects of care quality, such as effectiveness of treatment or patient safety, given the extent of the challenges faced and ongoing austerity in health and social care spending.

End of life care for infants, children and young people

NICE has published new NICE guidance: End of life care for infants, children and young people with life-limiting conditions: planning and management (NG61).

This guideline covers the planning and management of end of life and palliative care in for infants, children and young people (aged 0–17 years) with life-limiting conditions. It aims to involve children, young people and their families in decisions about their care, and improve the support that is available to them throughout their lives.

Additional link: NICE news report

Pressure of 10-minute consultations undermining GP compassion, warns GMC

GPs are struggling to provide compassionate care to patients under the strict pressures of 10-minute consultations, a report published by the General Medical Council has warned. | GMC | GP online


Problems arising due to the professional isolation of doctors, fragmentation of care and poor communication are threatening the wellbeing of doctors, according to the GMC.

The Medical Professionalism Matters report, compiles feedback from more than 1,000 doctors who responded to polls online and at GMC events held to gauge the challenges facing the medical profession.

The report assessed issues relating to ethics, resilience, collaboration, compassion, scholarship and patient safety. Doctors said they did not believe their colleagues were any less compassionate than 20 years ago, but 44% felt that increasing time pressures and higher patient demand had undermined care.

Read more at GP Online or read the full GMC report