CBT could be beneficial for adults with ADHD

NIHR | August 2018 | Cognitive behavioural therapy could benefit adults with attention deficit hyperactivity disorder (ADHD)

NIHR have published a new signal which looks at Cognitive behavioural therapy (CBT) and its impact to improve the core symptoms of attention deficit hyperactivity disorder (ADHD) in adults, compared with a range of other treatments. 

The review included trials that compared cognitive behavioural therapy to other specific interventions or to a range of control conditions, including waiting list and no treatment. It also looked at cognitive behavioural therapy plus drug treatment, versus drug treatment alone.

The included trials were rated very low to moderate quality. They also used a variety of outcome measures, which made it difficult to compare the interventions.

Despite these limitations, the review provides evidence that reinforces current guidance and practice (Source: NIHR).
Read the full signal at NIHR 

Prescribing of over the counter medicines is changing

NHS England | August 2018 | Prescribing of over the counter medicines is changing

NHS England have produced a series of documents to support CCGs to implement recommendations and support discussions between patients and their healthcare professionals.

Quick Reference Guide for Healthcare Professionals: Items which should not routinely be prescribed in primary care

The Quick Reference Guide for Healthcare Professionals is a quick reference tools summarising the CCG guidance on Items which should not routinely be prescribed in primary care.

Interactive Quick Reference Guide for Healthcare Professionals: Items which should not routinely be prescribed in primary care

This an interactive, quick reference tool summarising the CCG guidance on Items which should not routinely be prescribed in primary care.


There are also a series of patient information leaflets, including easy read leaflets

Patient information leaflet ‘Prescribing of over the counter medicines is changing’

A patient information leaflet to support discussions between patients and healthcare professionals

See NHS England for full details 

Reducing emergency admissions

The Health Foundation | August 2018 | Reducing emergency admissions: unlocking the potential of people to better manage their long-term conditions

The Health Foundation has produced a briefing which looks at Patient Activation Measures scores, which assess four levels of knowledge, skill and confidence in self-management, for over 9,000 adults with long-term conditions.


  • This briefing summarises research that explores the link between how well patients feel able to manage their long-term conditions such as asthma, diabetes and depression and their use of health care.
  • The findings show the NHS could reduce avoidable health care use and improve people’s quality of life, if they were better supported to manage their long-term conditions.
  • The briefing points to solutions and calls for national policy makers and the local NHS to take action now, including by prioritising support for self-management in the NHS long-term plan.

Read the full press release from The Health Foundation here 

The full article has been published in BMJ Quality and Safety 


Objective To quantify the association between patient self-management capability measured using the Patient Activation Measure (PAM) and healthcare utilisation across a whole health economy.

Results 12 270 PAM questionnaires were returned from 9348 patients. In the adjusted analyses, compared with the least activated group, highly activated patients (level 4) had the lowest rate of contact with a general practitioner, emergency department attendances, emergency hospital admissions  and outpatient attendances. These patients also had the lowest relative rate (compared with the least activated) of ‘did not attends’ at the general practitioner, ‘did not attends’ at hospital outpatient appointments and self-referred attendance at emergency departments for conditions classified as minor severity, a significantly shorter average length of stay for overnight elective admissions, and a lower likelihood of 30- day emergency readmission, though this did not reach ignificance.

Conclusions Self-management capability is associated with lower healthcare utilisation and less wasteful use across primary and secondary care.

Full reference:

Barker ISteventon AWilliamson R, et al| 2018| Self-management capability in patients with long-term conditions is associated with reduced healthcare utilisation across a whole health economy: cross-sectional analysis of electronic health records |

The full article is available to read from BMJ Quality & Safety 

Towards a longevity dividend: Life expectancy and productivity across developed countries

International Longevity Centre | August 2018 | Towards a longevity dividend: Life expectancy and productivity across developed countries

A new international report from the International Longevity Centre explores the relationship between life expectancy and productivity in developed countries.

This paper explores the effects of life expectancy on productivity across developed countries since the 1970s. For this, the International Longevity Centre utilised the demographic and macroeconomic data collected by the OECD for 35 countries.


1 minute summary

  • Based on their analysis of OECD data they find life expectancy is positively associated with productivity. As life expectancy rises, this leads to increased output per hour worked, per worker and per capita
  • Using an instrumental variables approach, they find the relationship to be robust to different productivity measures, the inclusion of a range of explanatory and control variables and different instruments
  • In our analysis, life expectancy is a more powerful determinant of productivity than either the young or old age dependency ratios
  • When investigating the channels through which life expectancy boosts productivity, we find education to be more important than employment. In this context, rising life expectancy raises the returns to education
  • Overall, their analysis suggests that there may well be a longevity dividend, whereby improvements to health result in wider economic and productivity gains in developed countries
  • Improving health and raising life expectancy must therefore remain a key goal not only for a nation’s health and wellbeing but also for the wider economy
  • Public policy and economic forecasters should consider how best to take into account the potential fiscal benefit of better health and not neglect it in discussions of our long run sustainability (Source: International Longevity Centre )

    Full details from International Longevity Centre 

Healthcare sustainability project

Royal College of Physicians | August 2018 | Healthcare sustainability project launches new NHS impact animation

The RCP has launched a new animated video outlining the impact the NHS has on the environment, and how health professionals can incorporate sustainability in their work

The video has been  produced by the RCP’s healthcare sustainability project, highlights how NHS activity can impact environmental issues such as climate change, reduce air quality, and lead to long term conditions for patients including respiratory diseases and cancers.

Full details from RCP 

Related: Healthcare sustainability

Learning by doing: integrating health and care in Scotland

The King’s Fund | August 2018| The King’s Fund | Learning by doing: integrating health and care in Scotland

A new blog post on The King’s Fund summarises the experiences of integration authorities who are leading the integrated agenda in the 32 local authority areas of Scotland. The blog makes comparisons between Scotland and England, offering some reflections between the health and care systems. 

The full post is at The King’s Fund 


The Hospital Frailty Score

Nuffield Trust | August 2018 | The Hospital Frailty Score

A new tool from the Nuffield Trust has been developed to help providers and commissioners of care in England assess the needs of frail older people being cared for in hospital.


The Hospital Frailty Score is available to download from Nuffield Trust 

A guest blog at the Nuffield Trust website  from Professor Simon Conroy discusses the advantages of being able to identify older people at risk in hospitals, and how it could make a real difference.

Comprehensive geriatric assessment: needs assessment tool

GPs’ Mental Health

Mind | August 2018 |Two in five GPs have experienced mental health problems, finds survey

A survey conducted by the mental health charity MIND reports that 40 per cent of  GPs have experienced mental health problems such as anxiety and depression. Among the 1000 doctors who participated in the survey 84 per cent said they would look to family or friends for support; 77 per cent would consult their own doctor and 45 per cent would also speak to colleagues. 

Mind is urging Clinical Commissioning Groups (CCGs) and GP practices to ensure the whole primary care workforce receives appropriate support when needed and has workplace policies and procedures in place to better promote staff wellbeing (Source: Mind).

Mind’s survey results also includes the experiences of two GPs who talk about their own mental health.  Read the full release at Mind 

Read Dr Simon’s blog about being a GP and his experience of managing his own mental health at Mind 

RPS backs development of pharmacist independent prescribers

Royal Pharmaceutical Society | August 2018 |RPS backs development of pharmacist independent prescribers

The way health services are delivered is changing and there are more opportunities than ever before for Pharmacist Independent Prescribers (PIPs). 

Greater use of PIPs will increase patient access to medicines and support.  RPS believe all pharmacists in direct patient care roles should have access to independent prescriber training and be able to practise the skills they gain to enhance patient care.


RPS’ policy document on independent prescribing outlines their views.

Key recommendations include:

  • New models of care should enable PIPs to routinely use their skills and knowledge to benefit patient care
  • A clear pathway must be developed for pharmacists to become qualified Independent Prescribers

Pharmacist Independent Prescribers policy document is available here 

Diabetes epidemic predicted to increase rise in heart attacks and stroke

British Heart Foundation | August 2018 | Growing diabetes epidemic to trigger ‘sharp rise’ in heart attacks and strokes by 2035

Currently  in England, nearly 4 million people are living with diabetes. Extrapolation of data based on the increasing number of people with diabetes predicts that almost  39,000 people living with diabetes suffering a heart attack in 2035 – a rise of 9,000 compared to 2015 – and over 50,000 people suffering a stroke – a rise of 11,000.


BHF expect that to rise to over 5 million over the next 20 years, as a result of the population’s  worsening lifestyles and the UK’s growing obesity rates.  As well as the increased risk of heart attacks and stroke, this rise in diabetes cases will increase the number of people suffering from conditions including angina and heart failure. BHF forecasts this will put further pressure on the NHS with previous estimates suggesting the yearly cost of treating people with diabetes will be £16.9 billion by 2035, up from £9.8 billion in 2012.

BHF are underlining  urgent need for ‘bold action’ to tackle lifestyle factors, such as obesity and a poor diet, that are leading to spiraling rates of diabetes, as well as a greater focus within the health sector on earlier diagnosis.

Read the full news story at BHF 

In the news:

BBC News Rise in diabetes ‘to cause surge in heart disease and strokes’

Sky News Diabetes epidemic set to cause surge in heart attacks and strokes

Daily Mail  Britain’s diabetes time-bomb: Rise of Type 2 will cause heart attacks and strokes to soar over the coming years with 30% increase in serious illnesses linked to the condition

The Telegraph Obesity epidemic will fuel 30 per cent rise in heart attacks in 2035

Times Diabetes means big rise in heart attacks

The Guardian Diabetes epidemic ‘will lead to rise in heart attacks and strokes’