This report focuses on two questions that are central to understanding how individuals and sectors think about health and are motivated to promote it | RAND
How can the commonly understood concepts of cultural identity (e.g., ethnic or religious; lesbian, gay, bisexual, transgender plus; military) and organizational culture be harnessed to develop a Culture of Health?
How can incentives be used to promote individual health and engage investors and leaders within organizations or governments to promote health and well-being broadly?
Establishing health as a shared value is an important but challenging step in promoting health and well-being.
The importance of both individual and community health and well-being needs to be acknowledged.
Data can support the development of shared values.
Stakeholders spoke of equity as requiring integration, collaboration, and thinking about health equity from a broader perspective than just health or resolving health disparities.
Equity is often addressed in silos, which impedes progress toward a unified goal of health equity for all.
Structural inequity among organizations serving different communities can pose a barrier to progress.
Seven areas across England are set to trail-blaze digital services for mental health patients, which will include innovative apps to improve care and online access to ‘real-time’ patient records. | NHS England
NHS England has announced funding for seven mental health trusts to enable them to pioneer digital services for mental health patients. It is intended that all key professionals involved in a patient’s care have access to real-time records – from triage and initial assessment, through to admissions or referrals, as well as transfer between services and follow up care.
The trusts will also develop remote, mobile and assistive technologies to empower patients to manage their conditions and enable family and carers to provide the best possible support.
The trusts will have up to £70m to invest in digital services – consisting £35m with additional match funding from themselves of £35m – in order to become ‘Global Digital Exemplars for Mental Health’ helping the organisations become world-leading in the use of IT, providing knowledge and expertise to the wider NHS in order to reduce time and costs for others.
This is all part of the NHS’ plan to harness technology to improve services and become more efficient.
Most NHS trusts feel that demands from regulators are still too high in number and provide poor value for money.
There were 76 responses to the NHS Providers survey of January 2017 (22 NHS trusts and 54 NHS foundation trusts). The overall burden of regulation is still seen by NHS trusts and foundation trusts to be excessive, impacting heavily on individual trusts and absorbing considerable time and resources at a time of stretched capacity.
The survey findings revealed:
56 per cent of trusts responding indicated that the regulatory system provides ‘poor’ or ‘very poor value’ for money for taxpayers.
55 per cent did not feel that the current reporting requirements of the regulators were proportionate to the levels of risk.
Two thirds of respondents (68 per cent) felt that the regulatory burden had increased over the last 12 months.
69 per cent of respondents stating they have experienced a rise in the number of ad hoc requests from regulators over the last 12 months.
44 per cent of respondents felt that there has been effective coordination between the regulators.
Almost half – 47 per cent – considered the advice received from national bodies to be either ‘very’ or ‘fairly consistent’.
Some 8,000 people a year who have an ischaemic stroke will benefit from a massive expansion in the number of hospitals offering mechanical thrombectomy – a procedure described by experts as a “game-changer”.
Currently, only a few hundred patients a year receive the treatment and just a handful of hospitals in England offer it, despite its proved effectiveness. NHS England is now working to assess the readiness of 24 neuroscience centres across the country which want to introduce the service.
It is expected the treatment, which uses a stent to remove blood clots from the brain, will be phased in later this year with an estimated 1,000 patients set to benefit in the first year of introduction.
NHS England will work with Health Education England and trusts to build on the expertise that is currently available in these specialised centres, developing the workforce and systems to enable an estimated 8,000 to receive this treatment in coming years.
Stroke experts say the procedure can produce remarkable results, with patients who would otherwise have ended up in a wheelchair instead able to walk out of hospital within 48 hours of treatment.
Over 700 more practices, covering up to 6m patients, are to have access to a clinical pharmacist through an NHS England initiative to expand the role in general practice. | GP Online
NHS England has approved bids to hire a further 219 pharmacists to work in GP practices. The pharmacists will help free up GP time by providing patient consultations and expertise on medicine-related issues to the practice.
The new roles will be co-funded by NHS England and will bring the total number of practices in England with access to a clinical pharamcist to 1,350.
The scheme, which was launched as part of the GP Forward View in April 2016, aims to recruit 1,500 pharmacists to work in practices by 2021 and is supported by over £100m investment.
The Older People’s Care in Acute Setting project content has been developed in partnership with British Geriatric Society and explores the pathway that people take through the acute hospital, beginning in A&E and assessment units, and moving through to inpatient wards and supported discharge teams | NHS Benchmarking
Three key messages have emerged from the 2016/17 project that impact on the quality of care delivered for older people;
the use of CGA is increasing;
readmission rates are rising;
delayed transfers of care continue to grow.
Further findings from the Older People’s Care in Acute Settings 2016 project (2015/16) data include:
40% of organisations have a dedicated geriatric team located in the A&E department. The average number of hours that these teams are available during the week is 9 hours, at weekends this reduces to 6 hours.
77% of trusts delivered Comprehensive Geriatric Assessments on the elderly care wards, and 42% delivered these assessments on other specialty wards.
The ratio of qualified to unqualified nursing staff on the care of the elderly wards was found to be 55% registered and 45% unregistered. The RCN recommends a ratio of 65:35 skill mix for “ideal, good quality care,” and 50:50 for “basically safe care” across the participants (Safe staffing on older people’s wards, RCN, 2012).
85% of trusts operate Early Supported Discharge schemes, and 77% of trusts have an Integrated Discharge team.
The average time for a continuing healthcare assessment to be undertaken is 10 days.
74% of organisations set estimated discharge dates within 24 hrs of admission.
83% of delayed transfers of care were attributable to people age 65 and over in 2015/16.
56% of patients admitted to the care of older people wards had been admitted to hospital within the previous 12 months.
14% of pay costs spent on bank & agency across the pathway.