People who inject drugs in the UK

Shooting Up: infections among people who inject drugs in the UK |  Public Health England

addict-2713598_1920This latest report provides an overview of infections among people who inject drugs in the UK.  It focuses on infections among people who inject psychoactive drugs.  The accompanying documents include a briefing for directors of public health, commissioners and service providers in England.


Full report: Shooting Up: infections among people who inject drugs in the UK, 2016: an update, November 2017

Substance misuse services

This briefing looks at the quality and safety of clinics offering residential services for people withdrawing from drugs or alcohol | Care Quality Commission (CQC)


The Care Quality Commission has published Substance misuse services: the quality and safety of residential detoxification. This briefing examines the quality and safety of clinics offering residential services for people withdrawing from drugs or alcohol.  It outlines concerns identified during CQC inspections and gives an example of good practice, as well as actions and recommendations.

The briefing reported a number of concerns. Many of the clinics were not:

  • assessing the risks to the safety of people prior to their admission following recognised national clinical guidance on treating people who are withdrawing from alcohol or drugs
  • storing, dispensing and handling medicines
  • appropriately carrying out full employment checks or sufficiently training their staff

The CQC also found that nearly three in four providers failed in at least one of the fundamental standards of care that everyone has the right to expect, whilst almost two-thirds of providers were not meeting the requirement for providing safe care and treatment.

Full briefing: Substance misuse services: the quality and safety of residential detoxification


‘Early warning signs’ that austerity will impact health outcomes

New report from the International Longevity Centre (ILC-UK) identifies early warning signs that austerity will affect health outcomes for decades to come.

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A team of researchers at ILC-UK has written ‘Public health in Europe during the austerity years’. Using a number of independent data sources, the report finds that progress on a number of key health indicators has stalled, including life expectancy and mortality rates. The report indicates that levels of subjective health have fallen among young people aged 15 – 24 across Europe, and in all age-groups in the UK.

Cuts to preventative medicine in England, such as tobacco control programmes and sexual health services, were highlighted as austerity measures which could impact the health of young people decades into the future.

Key findings include:

  • Improvements to life expectancy and mortality rates have slowed across Europe during austerity years (2009 – 13)
  • The UK has seen the greatest fall in subjective health, with people of all ages reporting a decline in their general health
  • As a result of increasing medical costs and declining personal income, a number of countries experienced rising unmet medical needs.

Full report: Public health in Europe during the austerity years

Online Mental Health Support For Young People

This report from the Education Policy Institute aims to provide insight into the efficacy of online counselling for children and young people. 

The report reviews the current literature on online counselling for children and young people. Through an analysis of local data it also assesses how young people respond to the Kooth model, an online counselling and emotional wellbeing platform, before setting out recommendations for further research.

The report  finds Kooth online counselling to be popular and effective in increasing access to care and providing choice. The anonymous nature of the service was found to be a big benefit for children and young people.

Full report: Online Mental Health Support for Young People

Urgent and emergency care: best practice

This CQC report offers practical examples of how leading emergency departments are meeting the challenges of managing capacity and demand, and managing risks to patient safety .

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This report from the Care Quality Commission details the good practice identified following the Commission’s work with consultants, clinical leads, senior nursing staff and managers from leading emergency departments in 17 NHS acute trusts.

This resource identifies:

  • strategies staff use to meet the challenge of increased demand and manage risks to patient safety
  • positive actions to address potential safety risks and to manage increased demand better
  • how working with others can manage patient flow and ensure patients get the care they need
  • that rising demand pressures in emergency departments are an issue for the whole hospital and local health economy.

Full report: Sharing best practice from clinical leaders in emergency departments

Diagnosis, management and monitoring of chronic asthma: New guidance

New ways to diagnose and manage asthma can improve care, says NICE in new guidance

This latest NICE guideline covers diagnosing, monitoring and managing asthma in adults, young people and children. It aims to improve the accuracy of diagnosis, help people to control their asthma and reduce the risk of asthma attacks.

NICE is recommending objective tests, which include spirometry and FeNO, to help confirm a diagnosis of asthma. This, they suggest, can achieve more accurate diagnosis and therefore more effective treatment

The new guidelines released yesterday recommend:

  • GPs and PNs should use an objective test to diagnose asthma, not symptoms alone.
  • Patients should be treated immediately if they are acutely unwell at presentation and objective tests for asthma should be performed if the equipment is available.
  • Check for possible occupational asthma. Refer those with suspected occupational asthma to an occupational asthma specialist.
  • For children under five with suspected asthma, treat symptoms based on observation and clinical judgement, and review on a regular basis.
  • Offer a FeNO test to adults if a diagnosis of asthma is being considered. A FeNO level of 40 parts per billion (ppb) or more is a positive test.
  • Offer a short-acting beta agonist as a reliever treatment to adults with newly diagnosed asthma.
  • Offer a low dose of inhaled corticosteroid as the first-line maintenance treatment to adults.

Full Guideline: Asthma: diagnosis, monitoring and chronic asthma management

Community services: what do we know about quality?

Community services:  what do we know about quality? | The Health Foundation | Nuffield Trust 

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This QualityWatch report looks at trends in routinely collected national quality measures in 18 community trusts in England.  The report finds that a lack of routinely reported data and the absence of appropriate indicators present challenges to monitoring quality in this area.

Some of the key findings of the report were:

  • Care in community trusts was predominantly delivered by professionally qualified clinical staff such as community health nurses, allied health professionals and community health visitors.
  • These staff were roughly as satisfied with their jobs as staff in all NHS trusts, although they were less likely to recommend their trust as a place to work.
  • The median waiting time for an outpatient appointment was three days longer in the community than across all trusts in England.
  • Patients using services offered by community trusts would generally
    recommend them to a friend and were less likely to experience harm
    compared to those using services provided by non-community trusts.

Full report: Community services: what do we know about quality?

Related Nuffiled Trust blog: Why is it so hard to measure quality in community services?

Children and young people’s survey 2016

Latest CQC survey looks at the experiences of children, young people and their parents and carers attending hospital for treatment as an inpatient or day case.

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The Care Quality Commission (CQC) has published the findings of it’s national survey looking into children and young people’s experiences of inpatient and day case care. Just under 35,000 respondents, including over 11,000 children and young people, were able to speak up about their healthcare experience.

Overall children and young people’s experiences of inpatient and day case care were mostly positive. The majority of children and young people said they were well looked after while in hospital, staff were friendly and that they received answers to their questions. Most parents and carers reported positive experiences for how their child’s pain was managed and for receiving enough information about new medication.

The survey results suggest there is scope for improvement in a number of areas, including:

  • Children and young people having enough things to do whilst in hospital
  • Involving children and young people in decision making
  • Being treated on age appropriate wards

Full detail at Care Quality Commission


Marriage may lower the risk of developing dementia

Marriage may help stave off dementia, study finds | Journal of Neurology Neurosurgery & Psychiatry


Researchers combining the results of 15 studies including data on more than 800,000 participants have found  that lifelong singletons and widowers appear to have a heightened risk of developing dementia.

Analysis of the data showed that lifelong singletons were 42% more likely to develop dementia than those who were married, and widowers were 20% more likely to develop the condition. Part of this risk might be explained by poorer physical health among lifelong single people, suggest the researchers.  Marriage may help both partners to have healthier lifestyles, including exercising more, eating a healthy diet, and smoking and drinking less, all of which have been associated with lower risk of dementia. Couples may also have more opportunities for social engagement than single people – a factor that has been linked to better health and lower dementia risk, the researchers suggest.

Full reference: Sommerlad A, et al. | Marriage and risk of dementia: systematic review and meta-analysis of observational studies |  Journal of Neurology Neurosurgery & Psychiatry | published online 28 November 2017

Safer maternity care

Safer Maternity Care: Progress And Next Steps | Department of Health

This document reports on progress and next steps with implementation of the safer maternity care action plan, and sets out additional measures for further and quicker improvement, including:

  • improving rigour and quality of investigations into term stillbirths, neonatal and maternal deaths, and serious brain injuries, and learning from the investigations
  • more support for maternity and neonatal training
  • looking into giving coroners powers to conduct investigations into stillbirths
  • aiming to reduce the national rate of pre-term births from 8% to 6%
  • bringing forward from 2030 to 2025 the ambition to halve rates of stillbirths, neonatal and maternal deaths, and brain injuries occurring during or soon after birth
  • Report
  • Safer maternity care
  • Department of Health – publications