Some Implications of Seven Day Hospital Services Explored

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

lqs

Image source: Nuffield trust

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”.

Read the full blog post here

Read the full report here

Advertisements

Can vitamin D really stop you getting cold and flu?

New study claims that Vitamin D can reduce the risk of colds and influenza. A new study, published in the British Medical Journal found that daily pills of the vitamin reduced infections by 12%

health-621354_1280

Objectives To assess the overall effect of vitamin D supplementation on risk of acute respiratory tract infection, and to identify factors modifying this effect.

Design Systematic review and meta-analysis of individual participant data (IPD) from randomised controlled trials.

Results 25 eligible randomised controlled trials (total 11 321 participants, aged 0 to 95 years) were identified. Vitamin D supplementation reduced the risk of acute respiratory tract infection among all participants.  In subgroup analysis, protective effects were seen in those receiving daily or weekly vitamin D without additional bolus doses but not in those receiving one or more bolus doses.  Vitamin D did not influence the proportion of participants experiencing at least one serious adverse event. The body of evidence contributing to these analyses was assessed as being of high quality.

Conclusions Vitamin D supplementation was safe and it protected against acute respiratory tract infection overall. Patients who were very vitamin D deficient and those not receiving bolus doses experienced the most benefit.

Full reference: Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data  | Published 15 February 2017 | BMJ 2017;356:i6583

See also: BBC News: Vitamin D pills ‘could stop colds or flu’

Saving Sustainability and Transformation Plans

Saving STPs: achieving meaningful health and social care reform | Reform

Current ambitions for NHS reform rest on Sustainability and Transformation Plans (STPs). These aim to bring local leaders together to create cohesive systems of care that are proactive, not reactive, with a focus on prevention and care being delivered in the community rather than in hospitals. They also aim for health and social care systems to properly exploit technology. All this will save time and money and deliver better quality care.

In their current form, however, STPs are not going to work. This paper identifies the three key barriers to success and sets out the five changes that need to be made if the plans are to succeed.

Recommendations:

  • STPs should design their own local health outcomes for which every organisation in the STP is accountable.
  • STPs should take a ‘one-system, one-budget’ approach. NHS, social care and public health budgets should be merged across the STP and commissioned by a single body.
  • Commissioners need to regularly evaluate whether providers are delivering on outcomes. Where these are consistently not delivered, services should be decommissioned and broken up to allow smaller providers to bid. Contracts should come up for renewal at regular intervals.
  • NHS Improvement should publish guidance clarifying how current legislation surrounding competition applies in the context of STPs.
  • STP footprints should have elected leaders who are held to account by the public.

Full report available here

 

Technology-based tools and services for people with dementia and carers

Klara Lorenz et al. Technology-based tools and services for people with dementia and carers: Mapping technology onto the dementia care pathway. Published in Dementia, February 2017

satellite-34882_1280

This paper provides an overview of the role of technology in dementia care, treatment and support by mapping existing technologies – by function, target user and disease progression.

Technologies identified are classified into seven functions: memory support, treatment, safety and security, training, care delivery, social interaction and other. Different groups of potential users are distinguished: people with mild cognitive impairment and early stages of dementia, people with moderate to severe dementia and unpaid carers and health- and social care professionals. We also identified the care settings, in which the technologies are used (or for which the technologies are developed): at home in the community and in institutional care settings.

The evidence has been drawn from a rapid review of the literature, expert interviews and web and social media searches. The largest number of technologies identified aim to enhance the safety and security of people with dementia living in the community. These devices are often passive monitors, such as smoke detectors. Other safety interventions, such as panic buttons, require active intervention.

The second largest number of interventions aims to enhance people’s memory and includes global positioning systems devices and voice prompts. These technologies mostly target people in the early stages of dementia. A third group focusing on treatment and care delivery emerged from the literature. These interventions focus on technology-aided reminiscence or therapeutic aspects of care for people with dementia and their carers.

While the review found a range of technologies available for people with dementia and carers there is very little evidence of widespread practical application. Instead, it appears that stakeholders frequently rely on everyday technologies re-purposed to meet their needs.

Public involvement in health research

The National Institute for Health Research has launched a campaign urging patients and the public to get involved in health and social care research.

survey-1594962_1280

The #twosides campaign highlights ways for people who aren’t medical or academic professionals to play a part in shaping research, for example through suggesting research questions, reviewing research applications,
joining a study team or being a study participant.

Additional link: NIHR press release

Footballers may be at heightened risk of brain trauma linked to dementia

Repeated headers during a footballer’s professional career may be linked to long-term brain damage, according to a small study by UK scientists. | BBC | OnMedica

yard-football-957791_1280

The researchers, from the Queen Square Brain Bank in London, base their findings on 14 retired footballers with dementia, who were referred to the Old Age Psychiatry Service in Swansea between 1980 and 2010.

Evidence of chronic traumatic encephalopathy (CTE) was found in four out of the six whose brains were examined after death. All six also had signs of Alzheimer’s disease.

Lead author Dr Helen Ling explained “This is the first time CTE has been confirmed in a group of retired footballers, Our findings…suggest a potential link between playing football and the development of degenerative brain pathologies in later life.”

But she cautioned: “However, it is important to note that we only studied a small number of retired footballers with dementia and that we still do not know how common dementia is among footballers.”

The association between CTE and Alzheimer’s disease isn’t clear, she said. “Previous studies have shown that the risk of Alzheimer’s disease is increased in people with previous head injuries. On the other hand, the risk of dementia is also increased with age and we don’t know if these footballers would have developed Alzheimer’s disease anyway if they hadn’t played football.

“The most pressing research question is therefore to find out if dementia is more common in footballers than in the normal population.”

Read more via  OnMedica | BBC

Full reference: Ling H, et al. Mixed pathologies including chronic traumatic encephalopathy account for dementia in retired association football (soccer) players. Acta Neuropathologica, 2017. DOI: 10.1007/s00401-017-1680-3

New healthcare social media toolkit – helping you connect

Social media is a powerful tool: helping organisations and its people to raise awareness, share information, engage with existing audiences and reach out to new ones | Skills for Health

social-media-toolkit

Image source: Skills for Health

To help you make the most of the opportunities social media can provide, we have launched a comprehensive social media toolkit packed full of sector-specific insight, advice and best practice on how to use social media effectively.

Whether you are completely new to social media or want to make sure your existing social presence is fit for purpose and operates at its full potential, the toolkit will instruct and educate your organisation and employees on how to use these platforms effectively and efficiently.

Read the full overview here

The full toolkit if available here