70,000 more toddlers to get their first dental check-up as NHS England targets childhood dental health

NHS England | May 2018 | 70,000 more toddlers to get their first dental check-up as NHS England targets childhood dental health

According to the latest data examined by NHS England,  children as young as one year old are having decayed teeth extracted. A new awareness programme has been launched to support 24,000 dentists across England to see more children from a young age in order to address this early decay.  NHS England is asking dentists to check the oral health of an additional 70,000 pre-school children to support young families maintaining good dental health (NHS England). 

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Full details are available from NHS England

Related:

British Society of Paediatric Dentistry  Dental Check by One 

Tackling the nursing shortage

The Open University | May 2018 | The Open University: Tackling the nursing shortage

Tackling the nursing shortage, the  new publication from The Open University considers the financial impact of temporary staffing to address the shortage, which the report describes this as “an expensive, short-term approach to plugging the gaps – [as] it costs the NHS nearly £1.5 billion a year.”  It also outlines many of the factors driving the shortage, suggesting that new routes into the profession, like apprenticeships, can help to plug the gap and future-proof the nursing workforce in the long-term (Open University).

The Open University
Image source: open.ac.uk

Using data obtained by The Open University under the Freedom of Information Act, the report calculates that if the hours  currently worked by temporary staff were instead covered by permanent nurses, the NHS could save as much as £560 million a year. This funding could otherwise be used to pay for continuing professional development or improved services.  

The report can be downloaded from The Open University 

In the media:

The Telegraph Nurse shortages cost the NHS up to £2.4 billion last year

The Independent NHS spending £1.5bn a year on temporary nurses as staff leave in droves, study reveals

Leading healthcare professor Don Berwick says NHS could be world number one if it integrates care

NHS England | May 2018| Leading healthcare professor Don Berwick says NHS could be world number one if it integrates care

A former advisor to Barack Obama Professor Don Berwick argues that the NHS  “I think the NHS probably has a better chance to truly integrate care than almost any other health care system in the world.”

Prof Berwick said improving health through social determinants like housing and lifestyle would be key to its success.  Now an advisor to The King’s Fund,  he also said the fragmented nature of the NHS could be addressed  if all local health and care organisations, worked in partnership and pooled resources, a movement which is underway.  Prof Berwick also underlined the importance of finding time to build relationships, acknowledging the pressure the NHS already faces:

“Right now the NHS is under enormous pressure. You’re going to have to find the time.

“There’s no reason the NHS can’t have the best care in the world, why you can’t take an appropriate proportion of your efforts and move them upstream to the causes of illness and use social determinants to prevent illness. There’s no reason why you have to waste money; you have limited resources and you can use those resources increasingly wisely.” (Source: NHS England)

 

The full, unedited piece can be read at NHS England 

 

The hardest hit: addressing the crisis in alcohol treatment services.

Alcohol Concern & Alcohol Research UK|May 2018 |The hardest hit: Addressing the crisis in alcohol treatment services

The report highlights how severe funding cuts, rapid re-tendering cycles, loss of qualified staff and lack of political support are impacting on some of the most vulnerable people in society. It also highlights the  need for action to ensure that treatment services do not enter a cycle of disinvestment, staff depletion, and reduced capacity.

alcohol concern
Image source: alcoholconcern.org

Key findings from the report show:

  • Only 12% of respondents felt that resources were sufficient in their area;
  • Respondents reported cuts of between 10% and 58%, with one treatment provider saying local areas were ‘paring back to a skeleton service’;
  • 59% of respondents felt that aspects of services in their area had worsened in the last three years, with particular threats to community detox and residential rehabilitation facilities;
  • 62% of respondents said that in their area appropriate care is not available for people with both a mental health and an alcohol problem, with many told they must resolve their alcohol problems before they can access mental health services;
  • Only 7% described the quality of engagement between JobCentre Plus and local alcohol services as ‘good’.

To address the issue, the report sets out several key recommendations, including:

  • The Government must develop and implement a National Alcohol Strategy, with treatment at the heart of a broader suite of interventions to reduce alcohol harm.
  • The Government must urgently plug the gap in treatment funding and reduce health inequalities arising from local funding structures. The report contains recommendations for how this might work.
  • There must be a national review of commissioning of alcohol services, and the balance of staffing in the alcohol field.

    Source: Alcohol Concern 

A press release can be read here

The full report is available from Alcohol Concern 

NHS staff prizes to be won

NHS70 | NHS70 Staff Prize Draw

The NHS is turning 70 on 5 July 2018. Our #NHS70 celebrations aim to recognise the contribution that NHS staff make to patient care. As a thank you to our extraordinary NHS staff – the everyday heroes who are always there to care for us – we have over 400 tickets to give away to some amazing sporting. 

  • Wimbledon Championships – 35 pairs of tickets, on 5 July 2018, the NHS birthday itself!
  • Rugby League Challenge Cup and Super League Grand Final, London (Wembley) and Old Trafford (Manchester) – 50 pairs of tickets including a unique ‘money can’t buy’ VIP experience for a family of four at the Super League Grand Final – ONLY available to be won by a member of NHS staff, on 25 August 2018.

Full details including entry details and a full list of prizes can be found at NHS70

Stopping over medication of people with a learning disability, autism or both (STOMP) case studies published

NHS England | Publications | April 2018 

STOMP (Stopping over medication of people with a learning disability, autism or both) is an initiative which aims to encourage patients to have regular check ups, ensure doctors and health professionals involve people, families and support staff in decisions about medication, inform everyone about non-drug therapies and practical ways of supporting people. Now NHS England has produced five case studies which are relevant to people with a learning disability, autism or both and their families.

The case studies can be read by clicking the links below

A bright future for Graham 

 

Further details about STOMP can be found at NHS England 

 

A new national approach to large-scale change?

Developing new models of care in the PACS vanguards: a new national approach to large-scale change? | The Kings Fundlight-bulbs-1125016_1920This independent report was commissioned by NHS England as part of a package of support provided to primary and acute care system (PACS) vanguard sites by The King’s Fund. The PACS model is an attempt to bring about closer working between GPs, hospitals, community health professionals, social care and others.

The report offers a unique set of first-hand perspectives into the experience of those leading a major programme at the national level and those living it at the local level. The insights shared will be invaluable to those constructing future national support programmes intended to facilitate transformation in local health and care systems. The lessons learned will also be highly relevant to those involved in the ongoing implementation of PACS and similar models.

Full report: Developing new models of care in the PACS vanguards: a new national approach to large-scale change?

See also: An international perspective on developing new models of care in the PACS vanguards

 

Cyber-attack on the NHS

Cyber-attack on the NHS | The Public Accounts Committee

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This report finds that the Department of Health and Social Care and its arm’s-length bodies were unprepared for the relatively unsophisticated WannaCry attack of May 2017.  It finds that people across the NHS did not know how best to communicate with the Department and other NHS organisations.

The attack caused widespread disruption to health services, with more than a third of  NHS trusts affected. The NHS had to cancel almost 20,000 hospital appointments and  operations, and patients were diverted from the five accident and emergency departments that were unable to treat them.

The report finds that lessons have been learned but there is still a lot of work to do to improve cyber-security.  The Committee has set a June deadline for the Department to provide an update on costed plans for vital security investment.

Drinking 10 drinks a week reduces life expectancy by up to 2 years

Cambridge University | April 2018 | Drinking more than five pints a week could shorten your life, study finds

The latest edition of The Lancet includes research from Cambridge University that has been funded by NIHR, the British Heart Foundation and other partners. Dr  Angela Wood the lead author of the study said: “Alcohol consumption is associated with a slightly lower risk of non-fatal heart attacks but this must be balanced against the higher risk associated with other serious – and potentially fatal – cardiovascular diseases.”
The authors of the study found that an increased intake of alcohol  is associated with a higher risk of stroke, fatal aneurysm, heart failure and death (via Cambridge University).
bottles-2357645_1920The researchers found that intake of 10 or more alcoholic drinks per week was linked with one to two years shorter life expectancy.  For those drinking 18 or more drinks per week  life expectancy was around four to five years shorter. For this reason the authors  say their findings challenge the belief that moderate drinking is beneficial to cardiovascular health, and support the UK’s recently lowered guidelines on alcohol consumption. 

Summary

Background

Low-risk limits recommended for alcohol consumption vary substantially across different national guidelines. To define thresholds associated with lowest risk for all-cause mortality and cardiovascular disease, we studied individual-participant data from 599 912 current drinkers without previous cardiovascular disease.

Methods

We did a combined analysis of individual-participant data from three large-scale data sources in 19 high-income countries (the Emerging Risk Factors Collaboration, EPIC-CVD, and the UK Biobank). We characterised dose–response associations and calculated hazard ratios (HRs) per 100 g per week of alcohol (12·5 units per week) across 83 prospective studies, adjusting at least for study or centre, age, sex, smoking, and diabetes. To be eligible for the analysis, participants had to have information recorded about their alcohol consumption amount and status (ie, non-drinker vs current drinker), plus age, sex, history of diabetes and smoking status, at least 1 year of follow-up after baseline, and no baseline history of cardiovascular disease. The main analyses focused on current drinkers, whose baseline alcohol consumption was categorised into eight predefined groups according to the amount in grams consumed per week. We assessed alcohol consumption in relation to all-cause mortality, total cardiovascular disease, and several cardiovascular disease subtypes. We corrected HRs for estimated long-term variability in alcohol consumption using 152 640 serial alcohol assessments obtained some years apart (median interval 5·6 years [5th–95th percentile 1·04–13·5]) from 71 011 participants from 37 studies.

Findings

In the 599 912 current drinkers included in the analysis, we recorded 40 310 deaths and 39 018 incident cardiovascular disease events during 5·4 million person-years of follow-up. For all-cause mortality, we recorded a positive and curvilinear association with the level of alcohol consumption, with the minimum mortality risk around or below 100 g per week. Alcohol consumption was roughly linearly associated with a higher risk of stroke (HR per 100 g per week higher consumption 1·14, 95% CI, 1·10–1·17), coronary disease excluding myocardial infarction (1·06, 1·00–1·11), heart failure (1·09, 1·03–1·15), fatal hypertensive disease (1·24, 1·15–1·33); and fatal aortic aneurysm (1·15, 1·03–1·28). By contrast, increased alcohol consumption was log-linearly associated with a lower risk of myocardial infarction (HR 0·94, 0·91–0·97). In comparison to those who reported drinking  greater than 0–less than or equal to 100 g per week, those who reported drinking more than 100– less than or equal to 200 g per week,  more than 200– less than or equal to 350 g per week, or  greater than 350 g per week had lower life expectancy at age 40 years of approximately 6 months, 1–2 years, or 4–5 years, respectively.

Interpretation

In current drinkers of alcohol in high-income countries, the threshold for lowest risk of all-cause mortality was about 100 g/week. For cardiovascular disease subtypes other than myocardial infarction, there were no clear risk thresholds below which lower alcohol consumption stopped being associated with lower disease risk. These data support limits for alcohol consumption that are lower than those recommended in most current guidelines.

The full article may be downloaded from The Lancet 

Full reference:
Wood, A, M., M et al. |Risk thresholds for alcohol consumption: combined analysis of individual-participant data for 599 912 current drinkers in 83 prospective studies |The Lancet | Vol. 391| Issue 10129 | P. 1513 – 1523 | DOI: https://doi.org/10.1016/S0140-6736(18)30134-X

 

In the media:

BBC News  Regular excess drinking can take years off your life, study finds