New framework to promote person-centred approaches in healthcare

Skills for Health, Health Education England and Skills for Care have announced a new Framework to support person-centred approaches for the health and social care workforce | Skills for Health

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Image source: Skills for Health

This approach, outlined in the Five Year Forward View, puts people, families and communities at the heart of health, care and wellbeing. It encourages people to speak with staff about what is important to them, helping to develop a shared understanding of what matters to them.

The new framework, commissioned by Health Education England, helps workers communicate meaningfully both verbally and non-verbally, tailoring the care and advice they give to suit peoples’ needs. It supports individuals to better manage their own health and wellbeing through bespoke care, planning and support. Where appropriate, the framework encourages shared decision making, outlining all reasonable options and ensuring that all information is personalised, accessible and useful.

 

Practical value in the NHS

The King’s Fund has previously highlighted the fact that addressing waste and variability in clinical work can create better value in the NHS. But what does value mean to people working in the NHS – and how it is being applied in practice? | The King’s Fund Blog

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‘Value’ sounds like a familiar concept but it can mean different things to different people. One definition of value in the health and care sector is ‘health outcomes per dollar spent’, so attempts to increase value can look at either improving quality or reducing cost.

In early July we held a roundtable discussion with health service providers to better understand their approach to value improvement – initial research for a new project intended to understand the practical barriers and challenges that frontline clinical, operational and managerial leaders have encountered in pursuing better value health care. Experts who attended – including a chairman, chief executive, chief nurse, deputy chief operating officer, change leader, and representatives of national bodies – agreed that the emphasis should be on patient care. Clinicians are more likely to engage in a programme that revolves around the quality of services, and better care is typically less wasteful, so as one participant put it, ‘if you focus on quality, money will fall out’ [spending will reduce]. Consultants will often drive through successful programmes with change management teams, but we also discussed the role of junior doctors, nurses and therapists, who frequently witness low-value care and understand how to fix it. We know that substantial changes in practice can be delivered as we have seen, for example, in generic prescribing, reduced length of stay and the move towards day case surgery.

Read the full blog post here

NHS accused of shrouding £500m of planned cuts in secrecy | @TheBMA @guardian

BMA says patients deserve to know the impact of savings in healthcare across England | The Guardian

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Image source: Roger Blackwell – Flickr // CC BY 2.0

Doctors’ leaders have accused NHS bosses of shrouding controversial plans for £500m of cuts to services across England in “totally unacceptable secrecy”. Patients deserve to know how hospitals being told to “think the unthinkable” as part of the savings drive will affect their access to healthcare, the British Medical Association (BMA) said on Friday.

The doctors’ union voiced its frustration after trying but failing to obtain details of the cuts that are being planned in the 13 areas affected by the “capped expenditure process” (CEP), despite the NHS’s duty as a public body to respond to freedom of information requests.

NHS bodies in just eight of the 13 areas replied, and none gave anything other than vague, general details about what cuts were under consideration.

Expert reaction to study looking at drinking alcohol and risk of diabetes

In new research published in Diabetologia scientists report that alcohol drinking frequency is associated with a reduced risk of diabetes and that consumption of alcohol over 3-4 days per week is associated with the lowest risk of diabetes | Science Media Centre

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Dr Graham Wheeler, Bayesian Medical Statistician, UCL, said:

“Whilst this large study has found an association between moderate weekly alcohol consumption and a reduced risk of diabetes, this alone does not prove a causal link.

“Establishing a biological mechanism for how this protective effect might work is key to understanding the findings of these types of study.

“In the Danish study, participants were asked to recall drinking habits only once.  So participants may under- or over-report their true alcohol consumption.  We also don’t know how their drinking habits changed as they were followed up.

“Researchers looked at the association between diabetes onset and lots of different categories of drinking behaviour, which increases the chance of claiming at least one association is statistically significant, when actually it isn’t.

“Whilst drinkers may want to raise a glass upon hearing this news, alcohol has been linked to the increased risk of alcoholic hepatitis, liver cirrhosis and several cancers.  Further research will help us piece together the complex relationship between alcohol consumption and diabetes.”

Read the full analysis here

NHS to build new cyber security centre

NHS Digital will go to tender for a new national cyber security system in response to critical internal review, that recommended strengthening cyber security |via HSJ

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The agency charged with protecting the NHS from cyber attacks is planning to build a new ‘security operations centre’. NHS Digital has published a request for information, seeking a “strategic partner” to improve its cyber security both internally and as part of its services across the NHS.

The partner would help build a security operations centre to bring together and improve many of NHS Digital’s “disparate” cyber services, including detecting threats, responding quickly and educating trusts.

The new system would provide a more advanced, data analytics driven threat intelligence service, designed to catch cyberattacks early.  Further details of the enhanced cybersecurity set up are expected later in the year, when NHS Digital goes out to tender.

The new centre is expected to be up and running by spring 2018.

Full story at HSJ

 

Children and teens let down by mental health inpatient services in England

Inpatient provision for children and young people with mental health problems. Emily Frith | Education Policy Institute | via OnMedica

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Image source: epi.org.uk

A report from the Education Policy Institute has found that 12% of  child mental health inpatient units failed to meet basic requirements for staff to patient ratios.

Nearly a quarter (24%) of units struggle to employ permanent staff – up from 17% since 2014/15. Temporary bank and agency staff make up 19% of child mental health inpatient pay costs.

Staff shortages affect the quality of patient care, so a sustained focus on recruitment of skilled staff to work in child and adolescent mental health services is needed, recommends the report.

The report also found:

  • inpatient mental health services for young people on average fail to meet 7% of minimum quality of care standards
  • The issue of bed shortages can mean that children with mental health problems are admitted to adult wards
  • Eating disorders were the most common reason for a young person being admitted to hospital in 2015/16
  • Young people are being left in hospital for longer than necessary due to a lack of community services with the trend getting worse – the number of delayed discharge days in December 2016 – February 2017 42% higher than in the same period the previous year

Full story at OnMedica

Download full report: Inpatient provision for children and young people with mental health problems.

Rising popularity of e-cigarettes linked to higher quit rate

Findings from US observational study suggest E-cigarettes appear to have helped to increase smoking cessation at the population level.| OnMedica |BMJ

Researchers have looked at whether the increase in the use of e-cigarettes in the US was associated with a change in overall smoking cessation rate.

They drew on responses to five population surveys from 2001 to 2015. E-cigarette users were identified from the most recent survey (2014-15) and smoking cessation rates were obtained from those who said they had smoked cigarettes in the preceding 12 months. Rates from this most recent survey were then compared to those of four earlier surveys.

Of 161,054 respondents to the 2014-15 survey, 22,548 were current smokers and 2,136 recent quitters. More than a third (38%) of current smokers and nearly half (49%) of recent quitters said they had tried e-cigarettes.

E-cigarette users were more likely than non-users to make a quit attempt (65% vs 40%) and more likely to succeed in quitting for at least three months (8.2% vs 4.8%).

The overall population quit rate for 2014-15 was significantly higher (5.6%) than that for 2010-11 (4.5%), and higher than those for all other survey years.

The 1.1 percentage point difference might appear small, but it represents approximately 350,000 additional US smokers who quit in 2014-15, emphasise the researchers.

Full story at OnMedica

Full reference: Shu-Hong Zhu et al.  E-cigarette use and associated changes in population smoking cessation: evidence from US current population surveys  BMJ 2017; 358 (Published 26 July 2017)

Related BMJ editorial: Rise in e-cigarette use linked to increase in smoking cessation rates

Costs of inpatient falls in hospitals

This review provides an overview of the scale of inpatient falls and the benefits to the NHS if the rate of falls was reduced in hospitals.

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As part of NHS Improvements work to reduce harmful inpatient falls and improve patient safety, the review helps answer the following questions:

  • What is the incidence of inpatient falls in hospital in England?
  • What are the estimated costs hospitals incur as a result of inpatient falls?
  • What are the potential cost savings from reducing falls by implementing well-evidenced multidisciplinary interventions?
  • What are the potential savings to hospitals from taking these actions?

Full report: The incidence and costs of inpatient falls in hospitals

Buying time promotes happiness

Research suggest that using money to buy time can protect people from the  detrimental effects of time pressure on life satisfaction. | story via OnMedica

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Using money to free-up time rather than spending it on material goods is linked to increased happiness, according to new research published in the Proceedings of the National Academy of Sciences.

In an experiment, psychologists at the University of British Columbia in Canada said that individuals reported greater happiness if they used £30  to save time – such as by paying for household chores to be done – rather than spending the money on books, clothes or wine.

More than 6,000 adults in the US, Canada, Denmark and the Netherlands were asked questions about how much money they spent on buying time. The researchers found that fewer than a third of individuals spent money to buy themselves time each month. Those who did reported greater life satisfaction than the others.

Psychologists say stress over lack of time causes lower wellbeing and contributes to anxiety and insomnia.

Full story at OnMedica

Full reference: Whillans, A. V. et al. Buying time promotes happiness| Proceedings of the National Academy of Sciences | 2017 published ahead of print July 24, 2017

NHS staff have become shock absorbers of an NHS under chronic strain

‘Behind Closed Doors’ argues that the hard truths learned through the Francis Inquiry are in danger of being forgotten in the light of unprecedented, continuing, and seemingly endless service pressures | The Point of Care Foundation

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Image source: The Point of Care Foundation

The Point of Care Foundation calls on organisations to prioritise staff experience and strengthen efforts to protect staff from stress and burnout, because the way staff feel at work affects the way they care for patients.

The briefing presents evidence on current pressures and staff experience:

  • From 2004-16, the number of attendances at A&E increased by 18%, from 12.7 million to 15 million.
  • Only one in two staff feel their NHS employer values them and their work.
  • 2% for health and social care staff suffer work-related stress anxiety and depression in the NHS compared to around 1.2% of the overall British workforce

The Point of Care Foundation wants to see every patient treated with kindness, dignity and respect all of the time, but in an environment in which staff themselves don’t feel cared about, it is hard to deliver personalised care.  A positive staff experience is fundamental if staff are expected to be at their best with patients.

Read the full report here