Food Foundation | September 2018 | Affordability of the UK’s Eatwell Guide
A report from the Food Foundation compares the cost of the Eatwell Guide with disposable income to estimate the proportion of income which would need to be allocated to food to afford the Eatwell Guide. The think tank finds that low income families are unable to afford the cost of following the government’s guidelines.
Researchers calculated that the fifth of UK households that earn less than £15,860 a year would have to spend an average of 42 per cent of their income after rent on food to eat a healthy and balanced diet making it unfeasible for many. They estimated that a household of four (two adults and two children aged 10 and 15) would need to spend £103.17 per week to be able to follow the Eatwell Guide.
According to their figures almost half (47 per cent) of UK households – about 14 million – did not spend enough money on food to meet the dietary recommendations. The proportion rises to 60 per cent for single-parent families, while less than a fifth of unemployed people spend enough to meet Eatwell’s definition of a healthy and balanced diet.
The UK Government’s Eatwell Guide outlines a diet that meets population nutrient needs.
However, there are several indicators that low income households in the UK may be struggling to follow the Eatwell Guide, including differential nutrient intakes and diets, increasing food bank usage, and higher childhood obesity statistics in deprived areas. This analysis assesses how affordable the Eatwell Guide is for households by income decile. We compared the cost of following the Eatwell Guide, calculated from existing research, to household expenditure data from the 2015/16 Living Costs and Food Survey and to disposable income data from the 2015/16 Family Resources Survey. We found that 26.9% of households would need to spend more than a quarter of their disposable income after housing costs to meet the Eatwell Guide costs, and more than half of these households contain at least one child. For households with children in the bottom two deciles, earning less than £15,860, 42% of after-housing disposable income would have to be spent to meet the Eatwell Guide costs. The results point to the need to ensure the incomes and resources of low-income households are adequate for purchasing a healthy diet, and to take measures to support these households in affording the foods contained within the Eatwell Guide.
Incisive Health | August 2018 | An international comparison of long-term care funding and outcomes: insights for the social care green paper
A new report from Incisive Heath in partnership with Age UK makes clear that governments can take very different approaches to organising and funding help for older people, and that indeed they do. No doubt to the disappointment of policymakers, the authors did not find a ‘magic bullet’ solution – every country is facing some problems. Moreover, cultural preferences also partially determine the ‘best’ approach for different societies.
How does England compare ask the authors? Rather badly, is the honest answer. We arguably get the worst of many of the different elements the report looks at, partly because no government is yet to really grip the issues (Source: Incisive Health).
Nursing Standard & The Health Foundation | September 2018 | Why as many as one in four nursing students could be dropping out of their degrees
Almost a quarter of nursing students (24 per cent) drop out of their courses prior to graduation finds a new study from the Nursing Standard and The Health Foundation. Their findings show that over 16,000 UK nursing students who began three-year degrees that were due to finish in 2017, 4,027 left their courses early, or suspended their studies.
Further analysis of this data gives an average attrition rate of 24% in the UK. The RCN suggest reasons for this rate of attrition as bad experiences on clinical placements, financial difficulties and academic pressures all impacting on the decision to leave or put studying on hold (Source: Nursing Standard & The Health Foundation).
Centre for Health Economics | August 2018 | Paying for Efficiency: incentivising same day discharges in the English NHS
The University of York’s Centre for Health Economics studied a pay-for-efficiency scheme that encourages hospitals to admit and discharge patients on the same calendar day where clinically appropriate. Since 2010, hospitals in the English NHS receive a higher price for patients treated as same-day discharge than for overnight stays, despite the former being less costly. The Centre for Health Economics analyses administrative data for patients treated for 191 conditions for which same-day discharge is clinically appropriate — of which 32 are incentivised — during 2006-2014. Using interrupted time series, differences-in-differences and synthetic control methods, we find that the policy generally had a positive effect on planned conditions with a statistically significant effect in about a third of conditions. The results are more mixed for emergency conditions. The median elasticity (across all 32 conditions) is 0.09 but above one for six conditions. Condition-specific design features explain some, but not all, of the differential responses (Source: Centre for Health Economics)
Read the full report from the Centre for Health Economics here
A new study from University of Missouri-Columbia examined how patterns between student, teacher and parent reporting could be used to create a fuller picture of the child’s mental health. The researchers completed profile analyses of 643 school aged children (between the ages of 6 and 12). They found that while almost a third (30 per cent) of children in the study reported feeling mildly to severely depressed, parents and teachers often failed to recognize the child’s depression. Although the team found that teachers and parents were more skilled at identifying other symptoms that might predict long-term risk for depression, such as social problems and inattention. This could be crucial, as Herman found that the children showing severe signs of depression were six times more likely to have skill deficits than their peers.
Lead researcher Keith Herman, professor in the MU College of Education said: “The gold standard for identifying children who might be at risk for developing depression later in life is to ask the children themselves,” Herman said. “However, even if a child doesn’t say they feel depressed, certain outward behaviors might provide clues to the state of the child’s mental health. It’s important for teachers and parents to catch these behaviors early to prevent long-term problems that occur with depression.” (Source: Science Daily)
Full reference: Herman, K. C. et al |2018| Using latent profile and transition analyses to understand patterns of informant ratings of child depressive symptoms| Journal of School Psychology| P.69, 84-99| https://doi.org/10.1016/j.jsp.2018.05.004
The present study examined the latent profiles of child, parent, and teacher ratings of child depressive symptoms in a developmental sample of children from Hawaii at two time points (2nd and 3rd grade). The study attempted to identify patterns of agreement and discrepancy among raters and correlates of these patterns to test a new theory for understanding rating disagreements as Divergent Operations. Three profiles best described the ratings at both time points: Child-Only High Depression, Child-Only Mild Depression, and Normative (non-depressed). Second and third grade measures of child social skills, externalizing symptoms, attention problems, and language and academic competence confirmed the distinctiveness of these classes which provides support for a Divergent Operations perspective. Latent transition analyses suggested that depressive symptoms were relatively transient for each class. Implications regarding the measurement and identification of child depressive symptoms across development and the meaning and use of discrepant ratings are discussed.
NHS Confederation | August 2018| What does ‘involvement’ really mean? An expert service user panel discussion
The Mental Health Network have created a new podcast which examines the current state of service-user involvment in the mental health sector, outlines opportunities for improvement and considers a vision for service-user involvement within a long-term strategy for the NHS.
NHS England | August 2018 | Rapid Access Diagnostic Clinic for vague symptoms at Guy’ and St Thomas’
At Guy’ and St Thomas’ a new Rapid Access Diagnostic Clinic (RADC) was implemented to help speed up cancer diagnosis, as well as finding more cancers at grade one and two, in patients presenting with vague symptoms. It was rolled out to the six other CCGs across South London earlier this year.
The RADC provides a diagnostic service to patients who have presented to their GP or at the Accident and Emergency Department with vague but worrying ‘red flag’ symptoms. It follows a model of fast patient triage; coordinated access to diagnostic tests; second follow up appointment or telephone consultation resulting in rapid specialist referral or patient discharge.
Although it is too early to say that the RADC has definitely improved patient outcomes the early findings are promising:
570 patients completed their RADC journey during its first 16 months of operation
300 (58.82%) patients diagnosed with a serious benign condition including cirrhosis of the liver, multiple sclerosis, tuberculosis, heart failure, emphysema and Crohn’s disease
44 (8.6% of all patients) diagnosed with cancer;
11 of these 44 (25%) cancers were diagnosed at grade 1 or 2
93% of patients rated their care as very good.
Patients with cancer and other serious conditions are diagnosed quickly, referred for appropriate treatment and start treatment much more quickly
Patients who have traditionally struggled to get a diagnosis, now have a diagnosis for their condition
Patients are being diagnosed in a clinic where appropriate advice and support can be given rather than at A&E
Patients feel listened to and that their symptoms are being taken seriously, leading to high levels of patient satisfaction
Many patients are quickly reassured that they do not have cancer, as well as receiving a prompt referral to the appropriate specialist
Very high patient satisfaction levels [93%  rated their care as very good].
The team at the RADC have seen:
Patients quickly diagnosed and appropriately referred for treatment
Increased uptake in GP referrals
Early stage cancers diagnosed in patients who ordinarily might be missed due to vague symptoms
Over time, the team expect to see a reduction in A&E presentations and repeated presentations to their GP of patients with certain cancers such as GI cancers (Source: NHS England)
BMA, Royal College of General Practitioners & NHS England | August 2018 |GP career support pack
A new document from BMA, Royal College of General Practitioners & NHS England- GP career support pack- sets out the various types of support available to general practitioner’s at all stages of their career, whether in their first five years, mid-career, nearing retirement or after taking a career break (Source: NHS England).
Local Government Agency | August 2018| Helping to support and transform the lives of people affected by drug and alcohol problems
Research suggests that those most susceptible to developing problematic substance misuse problems are from ‘vulnerable groups’ such as children in care, persistent absentees or excludees from school, young offenders, the homeless and children affected by parental substance misuse. So providing well-funded, targeted and effective substance misuse services is vital.
It is the responsibility of local government to commission these and in the process, help prevent abuse in the first place and enable people to beat addiction and sustain their recovery.
The causes of substance misuse and the solutions for tackling it are multi-factorial.
It requires close working with partners, imagination and hard work. However, when we get it right it can have a tremendous impact.
As the case studies in this report show, lives are being turned around (Source: Local Government Agency).
UCL | August 218 |UCL research indicates that arteries youths who smoke and drink are already starting to harden
New research from University College London (UCL) shows that smoking and drinking even infrequently and at lower levels (than in adult studies) as a youth , is linked to loss of arterial elasticity (arterial stiffening) (via UCL).
The study used analysed data from more than 1,200 adolescents from Children of the 90s, the Avon Longitudinal Study of Parents and Children (ALSPAC), during a five-year period between 2004 and 2008.
“We found that in this large contemporary British cohort, drinking and smoking in adolescence, even at lower levels compared to those reported in adult studies, is associated with arterial stiffening and atherosclerosis progression,” said senior author, Professor John Deanfield (UCL Institute of Cardiovascular Science).
Interestingly the research team also discovered “that if teenagers stopped smoking and drinking during adolescence, their arteries returned to normal suggesting that there are opportunities to preserve arterial health from a young age.”
Dr Mariettta Charakida who was part of the team involved in the research said: “The age at which participants started drinking alcohol was not associated with arterial health, suggesting that duration of exposure might not be that important at this young age,” added Dr Charakida. “In addition, no beneficial effect of low alcohol consumption was found with regards to arterial health.”
To determine the impact of smoking and alcohol exposure during adolescence on arterial stiffness at 17 years.
Methods and results
Smoking and alcohol use were assessed by questionnaires at 13, 15, and 17 years in 1266 participants (425 males and 841 females) from the ALSPAC study. Smoking status (smokers and non-smoker) and intensity (‘high’ more than or equal to 100, ‘moderate’ 20–99, and ‘low or never’ less than 20 cigarettes in lifetime) were ascertained. Participants were classified by frequency (low or high) and intensity of drinking [light (LI less than 2), medium (MI 3–9), and heavy (HI more than 10 drinks on a typical drinking day)]. Carotid to femoral pulse wave velocity (PWV) was assessed at 17 years [mean ± standard deviation and/or mean difference (95% confidence intervals)]. Current smokers had higher PWV compared with non-smokers (P = 0.003). Higher smoking exposure was associated with higher PWV compared with non-smokers. Participants who stopped smoking had similar PWV to never smokers (P = 0.160). High-intensity drinkers had increased PWV. There was an additive effect of smoking intensity and alcohol intensity, so that ‘high’ smokers who were also HI drinkers had higher PWV compared with never-smokers and LI drinkers [mean adjusted increase 0.603.
Smoking exposure even at low levels and intensity of alcohol use were associated individually and together with increased arterial stiffness. Public health strategies need to prevent adoption of these habits in adolescence to preserve or restore arterial health.