The C-Word: How we react to cancer today

Being diagnosed with cancer is now one of the most common life-changing events in people’s lives | Macmillan 

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Image source: Macmillan

There are more new cases of cancer each year than marriages in the UK, according to a new report from Macmillan Cancer Support.

The report, The C-Word: How we react to cancer today, reveals being diagnosed with cancer is one of the most common life-changing events in people’s lives. New analysis reveals:

  • Cancer is more common than new marriages: Latest figures show there are over 70,000 more new cases of cancer each year in UK than new marriages
  • Cancer is more common than women having their first child: Latest figures show there are almost 50,000 more new cases of cancer each in year in England and Wales than women giving birthto their first child
  • Cancer is as common as graduating: Latest figures show there are a similar number of undergraduate degrees awarded each year in the UK, compared with new cases of cancer.
  • Cancer affects many people at the “prime” of their life: More than 1.2 million people have been diagnosed with cancer under the age of 65 in the past 10 years, including more than 340,000 diagnosed in their 20s, 30s and 40s.

Full report here

New ambulance service standards

NHS England has announced a new set of performance targets for the ambulance service which will apply to all 999 calls for the first time.

  • National response targets to apply to every single 999 patient for the first time
  • Faster treatment for those needing it to save 250 lives a year
  • An end to “hidden waits” for millions of patients
  • Up to 750,000 more calls a year to get an immediate response
  • New standards to drive improved care for stroke and heart attack
  • World’s largest clinical ambulance trial updates decades-old system

The new targets will save lives and remove “hidden” and long waits suffered by millions of patients, including reducing lengthy waits for the frail and elderly. The new system is backed by the Association of Ambulance Chief Executives, the Royal College of Emergency Medicine, the Stroke Association and the British Heart Foundation amongst others.

Call handlers will change the way they assess cases and will have slightly more time to decide the most appropriate clinical response. As a result cardiac arrest patients can be identified quicker than ever before, with evidence showing this could save up to 250 lives every year.

Full story via NHS England

 

Dementia care in hospitals

National Audit of Dementia Care in General Hospitals 2016-2017: Third Round of Audit Report | HQIP

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

This report presents the results of the third round of the National Audit of Dementia (NAD) with collected data between April and November 2016.

The National Audit of Dementia (care in general hospitals) measures the performance of general hospitals against criteria relating to care delivery which are known to impact upon people with dementia while in hospital.

The previous (second) round of audit, (reporting in 2013), showed that while significant progress in the care provided to people with dementia in general hospitals had taken place, some aspects of care still needed to evolve.

The full report and findings are available to download here

How ward staff engage with the implementation of a patient safety intervention

A patient safety intervention was tested in a 33-ward randomised controlled trial | BMJ Open

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Objectives: No statistically significant difference between intervention and control wards was found. We conducted a process evaluation of the trial and our aim in this paper is to understand staff engagement across the 17 intervention wards.

Findings: First, there were palpable differences in the ways that the 17 ward teams engaged with the key components of the intervention. Five main engagement typologies were evident across the life course of the study: consistent, partial, increasing, decreasing and disengaged. Second, the intensity of support for the intervention at the level of the organisation does not predict the strength of engagement at the level of the individual ward team. Third, the standardisation of facilitative processes provided by the research team does not ensure that implementation standardisation of the intervention occurs by ward staff.

Conclusions: A dilution of the intervention occurred during the trial because wards engaged with Patient Reporting and Action for a Safe Environment (PRASE) in divergent ways, despite the standardisation of key components. Facilitative processes were not sufficiently adequate to enable intervention wards to successfully engage with PRASE components.

Full reference: Sheard, L. et al (2017) Exploring how ward staff engage with the implementation of a patient safety intervention: a UK-based qualitative process evaluation. BMJ Open. 7:e014558

NHS holds on to top spot in healthcare survey

Commonwealth Fund analysis of healthcare systems in 11 nations finds NHS is the best, safest and most affordable | The Guardian

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The NHS has been judged the best, safest and most affordable healthcare system out of 11 countries analysed and ranked by experts from the influential Commonwealth Fund health thinktank.

It is the second time in a row that the study, which is undertaken every three years, has found the UK to have the highest-rated health system.

The NHS has held on to the top spot despite the longest budget squeeze in its 69-year history, serious understaffing and the disruption caused by a radical restructuring of the service in England in 2013.

Its ranking is even more notable because the thinktank found the UK to put the fourth smallest amount of GDP into healthcare among the 11 nations. While the US spends 16.6% of its national income on health, the UK comes near the bottom, investing just 9.9%. Only New Zealand (9.4%), Norway (9.3%) and Australia (9%) put in less.

The UK emerged with the best healthcare system overall, just ahead of Australia, with the Netherlands a little further behind. A group of experts assessed them against 11 criteria designed to measure the effectiveness of different health systems.

Read the full news story here

Roll out of NHS Wi-Fi to GP surgeries begins

NHS Digital has begun roll out of NHS WiFi to GP surgeries in England and it should be completed by the end of the year.

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Using NHS WiFi, patients will be able to access the internet free of charge in their GP’s waiting room, via their smart phone or tablet. It will enable patients to link in with local health clinics and services and is paving the way for future developments in digital patient care.

NHS WiFi will provide a secure, stable, and reliable WiFi capability, consistent across all NHS settings. It will allow patients and the public to download health apps, browse the internet and access health and care information.

Local Clinical Commissioning Groups (CCGs) are responsible for choosing a supplier that can provide an NHS WiFi compliant system which suits their needs, and working with them to implement it across their local NHS sites. The chosen system must be based on a set of policies and guidance defined by NHS Digital.

Guidance available via NHS Digital relates to implementing NHS WiFi in GP practices. Hospitals and secondary care will follow in 2018.

Further details available here

Are we living longer?

Health profile for England. A report combining Public Health England (PHE) data and knowledge on the health of the population in England in 2017.

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This report focuses on the question ‘are we living longer, and are the extra years spent in good or bad health?’.

It summarises and interprets current trends in health outcomes in England, in particular:

  • life expectancy
  • health life expectancy
  • morbidity
  • mortality

It explores the impact of risk factors on these health outcomes and considers how England compares with other developed countries. It summarises inequalities in outcomes and the impact of the social determinants of health.

The 7 chapters can be read alone or as a series:

  1. Life expectancy, healthy life expectancy and years lived in poor health
  2. Major causes of death and how they have changed
  3. Trends in morbidity and risk factors
  4. European comparisons
  5. Health inequalities
  6. Social determinants of health
  7. Emerging health protection issues

Full report available here

Big cuts planned to public health budgets

Plans to cut public health budgets by £85m this year ‘self-defeating’ | story via Kings Fund

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Public health services such as sexual health clinics and services reducing harm from smoking, alcohol and drugs are to be cut by £85m this year by local authorities, despite having their budgets severely reduced in recent times, new research has found.

In findings released by the King’s Fund which analysed Department of Communities and Local Government data, it was revealed that councils in England were planning to spend £3.4bn on public health services in 2017-18.

However, on a like-for-like basis excluding the impact of changes to how budgets are calculated over different years, councils will only spend £2.52bn on public health in 2017-18 compared to £2.60bn last year.

Once inflation is factored in, the King’s Fund experts also discovered that public health spending is more than 5% less in 2017-18 than it was four years ago, in 2013-14.

Full story at The Kings Fund

Related: Kings Fund blog: Chickens coming home to roost: local government public health budgets for 2017/18

 

Community hospitals and their services

The National Institute for Health Research has published Community hospitals and their services in the NHS: identifying transferable learning from international developments, scoping review, systematic review, country reports and case studies.

This study set out to understand better the role of different models of community hospital provision within the wider health economy and learn from experiences of other countries in order to inform the future development of community hospitals in England.

It concludes that at a time when emphasis is being placed on integrated and community-based care, community hospitals have the potential to assume a more strategic role in health-care delivery locally, providing care closer to people’s homes.

Related: Community hospitals: a traditional solution to help today’s NHS? | HSJ

Expert reaction from to two studies looking at coffee consumption and risk of death

Two studies publishing in the Annals of Internal Medicine assess the association between higher coffee consumption and reduced risk of death | Science Media Centre

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Dr Tim Chico, Reader in Cardiovascular Medicine / consultant cardiologist, University of Sheffield, said:

“These two studies followed many thousands of people for 16 years and compared death rates in coffee drinkers with non-coffee drinkers.  In keeping with previous studies, death rates were slightly lower in coffee drinkers than in non-coffee drinkers.

“The studies were well conducted and have the advantage of having observed thousands of people from many different countries and ethnic backgrounds, and the association between coffee drinking and mortality seems to be the same across all these populations.

“The authors of both studies are commendably cautious about whether or not coffee drinking is the cause of the reduced mortality in coffee drinkers, or whether there are other unknown differences between coffee drinkers and non-coffee drinkers that are the real cause for the differences observed.  Neither study seems to take into account the income of the people involved (although they do adjust for educational level) and since coffee isn’t cheap it is possible that non-coffee drinkers are less well off, which would be a potential explanation for some of the differences seen.

“What can we conclude from these studies?  The authors of both papers sensibly go no further than concluding that their results show that coffee drinking is not harmful.  I’m occasionally asked by patients whether they should drink coffee and these studies will help in advising them that coffee drinking is safe.

“The only way to be certain whether or not coffee might make people live longer is to force many thousands of people to drink it regularly, while preventing many thousands of otherwise similar people to never drink coffee.  A study like this is never going to take place, so we may never know the answer to this question.

“I don’t think this study should lead anyone to drink more coffee in search of a health benefit that might not actually exist.  It is useful to compare this to the proven benefits of physical activity.  A 20-min walk to a local coffee shop will definitely provide many health benefits, even if you don’t actually go in and buy anything.”