Independent evaluation finds trainee nursing associates see role as career pathway

Health Education England | August 2018 | Independent evaluation finds trainee nursing associates see role as career pathway

Independent evaluation of the first cohort of nursing associate test sites has been published today shining a light on the clear career path from healthcare assistant to nursing associate. 

The evaluation draws on the first online survey of Trainee Nursing Associates (TNA), which received 1,030 responses. The recommendations in the report are based on learning points emerging in the first four to five months of the programme.

Key findings:

  • Around 8,000 applicants for 2,000 places showed there was considerable interest in the programme
  • Interviews revealed that the programme is seen by many TNAs as a stepping stone to becoming a registered nurse and as an opportunity to go to university that might otherwise not be possible because of their personal circumstances
  • In the first few months of the programme, TNAs are highly motivated and conscientious learners, keen to build on their experience of working in health and care settings
  • Challenges that HEE is addressing as the next cohort of TNAs begin their training include helping TNAs manage high workloads and ensuring they have sufficient time to devote to the different elements of the programme
  • The other challenge raised that HEE will work with partners to address was travel to and from placements and university (Source: HEE)

    The evaluation is available from HEE 

NHS action plan can prevent over 600 still births a year says NHS England

NHS England | July 2018 | NHS action plan can prevent over 600 still births a year says NHS England

An independent evaluation of nineteen NHS Trusts in England shows that stillbirths fell by a fifth at the maternity units where national guidance, known as the Saving Babies Lives Care Bundle, had been implemented. The best practice guidance is now being introduced across the country and has the potential if these findings were replicated, to prevent an estimated 600 stillbirths.

The report from researchers at the University of Manchester describes the results of a comprehensive evaluation involving nineteen NHS Trusts in England that have been implementing the Saving Babies’ Lives Care Bundle (SBLCB) since April 2015, which aims to reduce the incidence of stillbirth by implementing best practice in four aspects of maternity care. This report describes the degree of implementation, the clinical and service outcomes and the economic impact(s) following a maximum two year implementation period in these early adopter Trusts and crucially, whether implementation of SBLCB translates into fewer stillbirths.

Key successes

  • Increase in the detection of small babies – there was a 59 per cent increase detection attributed to better monitoring and scanning in pregnancy
  • Better awareness of a baby’s movement in pregnancy – with a high number of women attending hospital due to reduced movement.
  • Carbon monoxide testing for smoking in pregnancy was almost universal – Smoking is strongly associated with stillbirth. A 1 per cent increase in smoking rates increases the chances of stillbirth by 1.7 per cent. Alongside carbon monoxide monitoring there has been a decline in the number of women smoking, at time of booking.

University of Manchester Evaluation of the implementation of the Saving
Babies’ Lives Care Bundle in early adopter NHS Trusts in England 
NHS England news release NHS action plan can prevent over 600 still births a year says NHS England

Safeguarding health before retirement

University College London | July 2018 | Safeguarding health before retirement

Scientists at University College London (UCL) have identified five modifiable risk factors that influence health post-retirement. The have discovered five factors in a person’s 50s that had the most impact on their chances of becoming frail in their 70s, these are:

  • how active a person was (~6% of inactive people studied were frail while only ~3% of active people were frail)
  • their BMI category (4.5% of underweight people were frail, 2.7% of normal weight, 3.4% of overweight frail and 7.9% of the obese participants)
  • whether they smoked or not (5.4% of smokers were frail, 3.5% pf non-smokers and 2.8% of ex-smokers)
  • levels of a chemical in blood interleukin-6 which is associated with inflammation  (0.9% of those with the lowest levels were frail, compared with 3.5% of those with the highest)
  • level of a different chemical in blood called C-reactive protein- created in the liver as a response to inflammation -1.5% of those with the lowest levels were frail, compared with 4.1% of those with the highest.


Aside from social class and age, women were found to have a higher risk factor of being frail than men. Race, frailty in non-white participants was between 5.4- 8.9% vs 3.1% for white participants.  Living alone raised the factor to 5.5% compared to 2.9% for those married or cohabiting and frail.

Participants with a lower income were 3 times as likely to be frail than more affluent participants. With an ageing population, the research team anticipate that these inequalities in frailty will become more apparent, creating a large increase in older people who need high levels of care, particularly in the most disadvantaged communities (Source: UCL).

National Cancer Patient Experience Survey 2017

Quality Health & National Cancer Patient Experience Advisory Group | July 2018 | National Cancer Patient Experience Survey 2017

The results of its national cancer patient experience survey have recently been published. Commissioned and managed by NHS England, the survey provides information to drive local quality improvements; monitors national progress on cancer care;  assists commissioners and providers of cancer care; and helps  to inform the
work of the various charities and stakeholder groups supporting patients with cancer. 

The experience of cancer patients in England continues to be generally very positive. Asked to rate their care on a scale of zero (very poor) to 10 (very good), respondents gave an average rating of 8.8. On nearly half of the questions in the survey, over 80% of respondents gave positive responses.

patient experience
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•79% of respondents said that they were definitely involved as much as they wanted to be in decisions about their care and treatment
•91% of respondents said that they were given the name of a Clinical Nurse Specialist who would support them through their treatment
•86% of respondents said that it had been ‘quite easy’ or ‘very easy’ to contact their Clinical Nurse Specialist
•89% of respondents said that, overall, they were always treated with respect and dignity while they were in hospital
•94% of respondents said that hospital staff told them who to contact if they were worried about their condition or treatment after they left hospital
•60% of respondents said that they thought the GPs and nurses at their general practice definitely did everything they could to support them while they were having cancer treatment. (Source: Quality Health)

Unpaid carers: informal yet integral

Nuffield Trust | July 2018 |Unpaid carers: informal yet integral

A new post on the Nuffield Trust’s blog considers the role of carers, following the recent publication of the annual national carers’ survey, State of caring (2018). This report is conducted to provide illumine the adult social care sector understand more about how services are affecting lives. 

The post reviews carers’ dissatisfaction, the support that carers value and new learning from the survey’s results.


Carers UK | State of Caring 

Carers UK | press release 

State of caring 2018

Carers UK | July 2018 | State of caring (2018)

Carers UK has published its annual survey of over 7000 carers across the UK. The report highlights the immense strain carers are under and an underfunded social care system that is really taking its toll on families. Among its findings are 50 per cent of unpaid carers anticipate that their quality of life will worsen in the next year.  Only one-tenth of those caring unpaid for a relative or friend feel confident that the support they receive and rely upon will continue (Source: Carers UK).

State of caring
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The full report is available to download from Carers UK

Carers UK press release 


Dementia Training Standards Framework

Health Education England, Skills for Health & Skills for Care, | July 2018 |Dementia Training Standards Framework

Health Education England (HEE) have released the Dementia Training Standards Framework, the resource was previously known as Dementia Core Skills Education and Training Framework, its recent update and review include a number of additions regarding food, drink and oral health.

The framework is  an extraordinarily useful resource which details the essential skills and knowledge necessary across the health and social care spectrum. Three tiers are described:

  • Awareness, which everyone should have;
  • Basic skills which are relevant to all staff in settings where people with dementia are likely to appear and;
  • Leadership.

This framework will help ensure quality and consistency in dementia education and training if you are an organisation or an individual working in health, social care or housing.

The framework will allow the differentiation of high quality services, ensure personalised care and support for people living with dementia, and support organisations and individuals to meet requirements of regulators  (source: HEE).

You can access the framework here

Alternatively, the framework can be downloaded from the Skills for Health website

NHS visitor and migrant cost recovery programme

Department of Health and Social Care | August 2018 | NHS visitor and migrant cost recovery programme

The Department of Health and Social Care  has released guidance and documents for NHS organisations and frontline staff .

Migrants, visitors and former residents of the UK must pay for their care when they’re in England. In April 2015, changes were made to the way the NHS charges overseas visitors for healthcare. This is so that the NHS does not lose out on income for services these people receive.

This collection includes guidance and a range of resources, including template letters and posters, to help NHS organisations manage overseas visitors and recover the costs of healthcare where appropriate (Source: Department of Health and Social Care).

Full details at Department of Health and Social Care

There is also a resource –Overseas Visitors NHS Cost Recovery Programme– available from E-Learning for Healthcare here

NICE Guideline Community pharmacies: promoting health and wellbeing

NICE | August 2018 | Community pharmacies: promoting health and wellbeing

This guideline covers how community pharmacies can help maintain and improve people’s physical and mental health and wellbeing, including people with a long-term condition. It aims to encourage more people to use community pharmacies by integrating them within existing health and care pathways and ensuring they offer standard services and a consistent approach. It requires a collaborative approach from individual pharmacies and their representatives, local authorities and other commissioners (Source: NICE). 



This guideline includes recommendations on:

Who is it for?

  • Community pharmacies, local pharmaceutical committees and pharmacy organisations
  • Commissioners of health-promoting interventions including local authorities, clinical commissioning groups and NHS England
  • Local professional networks (hosted by NHS England)
  • Health and wellbeing boards

    For full details about the guideline see NICE

Medical rota gaps

British Medical Association | July 2018 | Medical rota gaps 

A new report that looks at the effects of rota gaps on doctors and patients has been released by  the British Medical Association (BMA). The report’s findings indicate that four-fifths of the doctors surveyed  (n=1000) noted that individuals are doing the work of multiple staff.  

The research was conducted by the BMA using a variety of research methods to collate feedback from doctors in secondary care. It aimed to gain a better understanding of the problems caused by rota gaps, to inform practical recommendations. A range of research methods were used to gather feedback from doctors across secondary care.

Some of the key findings include:

  • More than 80% of respondents to a survey said that individuals are encouraged to take on the workload of multiple staff
  • Over 68% of respondents had been asked to act up into more senior roles or cover for more junior colleagues
  • 65% of respondents said medical trainees are pressurised to take on extra shifts
  • More than a third (34.6%) of respondents reported that their employers had re-designed rotas to include fewer doctors, thereby obscuring the rota gap problem
Medical rota gaps
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The recommendations offer practical solutions that can be implemented locally and nationally intended to mitigate some of the negative effects that rota gaps can have on training, morale, work-life balance and quality of care.

The BMA’s report makes a number of recommendations, these include:

  • Trusts should minimise the impact of rota gaps by effective forward planning by rota coordinators/planners
  • Each hospital should appoint a junior doctor to be actively involved with rota design, planning and rostering
  • All trusts must ensure that the exception reporting system is supported with clear standardised processes for reporting excess hours worked, missed breaks or training opportunities
  • Government, NHS Improvement, NHS Confederations, NHS Employers and commissioners must support employers to place renewed focus on the health and wellbeing of permanent full and part-time staff.


In the news: OnMedica |Gaps in doctors’ rotas is putting patients at risk