Substance misuse in older people

Our invisible addicts | The Royal College of Psychiatrists 

This report presents up-to-date evidence on the extent of substance-related health problems amongst older people and the services required to deal with the complexity of such problems which often involve co-morbid mental and physical health problems, polypharmacy and psychosocial adversity.

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Image source: http://www.rcpsych.ac.uk

The document seeks to build on the progress made over the past six years and to emphasise that including older people with substance problems in national policies is imperative and that there is a need for organisational reform to tackle this issue.

The authors consider and advocate the further development of a clinical workforce with the appropriate knowledge, skills and attitudes to provide identification, assessment, treatment, and assist in recovery and referral for substance misuse in an older population.

Included within the report are chapters on the following areas:

  • Public health and substance misuse in older people
  • Assessment of substance misuse
  • Treatment
  • Service delivery and development
  • Education and training
  • Ethical and legal considerations for older people with substance misuse

Full report: Our Invisible Addicts (2nd edition) 

Evaluating weight management interventions

Evidence-based guidance to support the evaluation of weight management interventions | Public Health England

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This document is an update of the ‘Standard Evaluation Framework (SEF) for weight management interventions’, (2009) which was originally published by the National Obesity Observatory, and is now widely used across England.

It has been updated as a result of feedback from practitioners in the field following a consultation exercise, and to provide support for the Weight management: guidance for commissioners and providers collection.

The document contains a list of ‘essential’ and ‘desirable’ criteria for data required for a comprehensive and robust evaluation. Essential criteria are the minimum data and information recommended to perform a basic evaluation of a weight management intervention. Desirable criteria are additional data that would improve the quality of an evaluation; and enhance understanding about what has been achieved and the processes that have taken place during the intervention.

Full document: Standard evaluation framework for weight management interventions

Improving the experiences of people who use services

This briefing looks at what the vanguards have been doing to improve the way people experience and interact with health and care services, and shares the lessons that other organisations and partnerships can take from the vanguards’ experiences | NHS Providers

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This final briefing in the Learning from the new care models series highlights how the vanguards are improving the experiences of people using services and their families.

The briefing looks at the work of the vanguards in the following areas:

  • Coordinating care around peoples’ needs
  • Ensuring people receive high-quality care wherever they are
  • Specialist care closer to home
  • Reducing the need to travel
  • Directing people to the right care, faster
  • Supporting people to manage long-term conditions
  • Supporting people to develop self-confidence
  • Tailoring care for people with the greatest needs
  • Making access to urgent care as simple as possible
  • Promoting health and wellbeing among people and communities
  • Helping people connect
  • Supporting carers to stay well
  • Working with people to design services that work for them

Full briefing:
Learning from the vanguards: improving the experiences of people who use services

Review of children and young people’s mental health services

This report describes the findings of our independent review of the system of services that support children and young people’s mental health | Care Quality Commission (CQC)

This CQC report indicates that many children and young people experiencing mental health problems don’t get the kind of care they deserve; the system is complicated, with no easy or clear way to get help or support.

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

The report makes a number of recommendations to organisations responsible for making sure that the problems with mental health services are dealt with, including:

  • The Secretary of State for Health and Social Care should make sure there is joint action across government to make children and young people’s mental health a national priority, working with ministers in health, social care, education, housing and local government
  • Local organisations must work together to deliver a clear ‘local offer’ of the care and support available to children and young people
  • Government, employers and schools should make sure that everyone that works, volunteers or cares for children and young people are trained to encourage good mental health and offer basic mental health support
  • Ofsted should look at what schools are doing to support children and young people’s mental health when they inspect

Full report: Are we listening? A review of children and young people’s mental health services

See also:

How is the NHS performing?

This report aims to take stock of what has happened within the NHS over the past quarter. 

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The report finds that more patients are facing long waits for hospital treatment, with those experiencing the longest waits often most in need of treatment. With demand for services continuing to rise, the authors suggest it is very unlikely that meeting waiting time targets will become more achievable.

The report also finds that:

  • nearly two-thirds (63 per cent) of finance directors felt that patient care has worsened in their local area in the past year. Just 4 per cent said it had improved
  • more than half (52 per cent) of trust finance directors said they expected their organisation to end 2017/18 in deficit. A third (32 per cent) were fairly or very concerned about meeting financial targets agreed with national NHS bodies
  • demand for services continues to soar – admissions from A&E jumped by 6.8 per cent in January 2018 compared to January 2017, reaching 389,649
  • more positively, progress on reducing delayed discharges from hospitals has continued to improve, with 145,3180 total days delayed in December 2017, the lowest total since September 2015.

Full report: How is the NHS performing? March 2018 quarterly monitoring report

See also:

Calorie reduction programme

Steps to cut people’s excessive calorie intake have been unveiled by Public Health England (PHE), as part of the government’s strategy to cut childhood and adult obesity.

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This report sets out the evidence on children’s calorie consumption and the details of the calorie reduction programme.

In terms of the evidence the report includes details of:

  • recommendations around calorie intakes, sources of calories and reported levels of intake
  • calculated estimates for daily energy intakes and excess calories consumed by children and adults
  • evidence on reformulation and portion size reduction; and public perceptions and attitudes to calories
  • estimated health economic benefits of a calorie reduction programme

For the calorie reduction programme, the reports sets out:

  • the overall ambition and structure of the programme
  • the food categories included
  • suggested mechanisms for action
  • timeline and next steps for PHE

Full report: Calorie reduction: the scope and ambition for action

Additional link: PHE news story

Workload in general practice

Ensuring patient safety through control of workload and demand management in general practice | The British Medical Association (BMA)

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General practice in England has seen consultation rates soar by nearly 14 per cent between 2007 and 2014, while the 12 months between 2016-17 saw the total number of full-time equivalent GPs fall by 3.4 per cent.

The BMA suggest that this increase in workload is because of growing patient need (complex multi-morbidity) as well as a result of the widespread recruitment and retention crisis and a lack of long-term investment in general practice. It is argued that the issue of GP workload must be addressed urgently.

This document seeks to address the current challenges in primary care.  It sets out a strategy aimed at improving safety and quality of patient care by recommending the development of agreed workload limits at a local level supported by national guidance.

Full document: Workload Control in General Practice. Ensuring Patient Safety Through Demand Management