Meningitis Research Foundation | September 2018 |Spotting a seriously ill child The need for safety netting advice for parents when a sick child is sent home by a health professional
The Meningitis Research Foundation has released Spotting a seriously ill child a document that underlines the difficulties in recognising the early signs of meningitis and sepsis. The report includes a summary of personal accounts of over 100 parents whose children had meningitis but were sent home after their first visit to a health professional.
National clinical recommendations advise that parents and carers of children and young people presenting with early non-specific symptoms should be given ‘safety netting’ information before they are sent home that includes information on bacterial meningitis and sepsis, but the report shows this does not always happen.
The report finds that management of children with early stages of bacterial meningitis could be improved.
Employee Engagement in the NHS: A secondary data analysis of the NHS Healthy Workforce and Britain’s Healthiest Workplace surveys | RAND Corporation
This study examined the factors associated with engagement among NHS employees as part of a project with the Health Foundation.
Comparing the NHS to other sectors in the UK, the findings suggest that employee engagement in the NHS is lower than in some UK sectors, such as media and telecommunications and professional services, but better than in others, such as financial services and logistics.
The report suggests that a number of demographic factors are associated with levels of engagement, including gender and age.
Employees working in different NHS occupations report different levels of engagement. For instance, among employees in social care, admin and general management levels of engagement tend to be lower on average. In contrast, employees in medical and dental occupations, and nursing and healthcare assistants tend to report higher levels of engagement.
Approaches aimed at improving staff engagement will need to be targeted at specific groups.
It is important to keep making the business case for improved staff engagement to key policy makers and decision-makers in the service starting possibly with finance directors and chief executives.
Royal College of Physicians| October 2018 | Talking about dying: How to begin honest conversations about what lies ahead
A new report from the Royal College of Physicians (RCP) explores the reasons that doctors and other healthcare professionals find it hard to talk to patients about dying.
During their research, the RCP identified that the timely, honest conversations about their future that patients want are not happening. Yet, these proactive discussions are fundamental to effective clinical management plans, part of being a medical professional and align with the aspirations of the RCP’s Future Hospital Commission report.
This report seeks to offer advice and support for any doctor on holding conversations with patients much earlier after the diagnosis of a progressive or terminal condition, including frailty.
Ask the patient if they would like to have the conversation and how much information they would want.
All healthcare professionals reviewing patients with chronic conditions, patients with more than one serious medical problem or terminal illness, should initiate shared decision making including advance care planning in line with patient preferences.
Conversations about the future can and should be initiated at any point. The conversation is a process not a tick-box, and does not have to reach a conclusion at one sitting.
Be aware of the language you use with patients and those they have identified as being important to them, and try to involve all the relevant people in agreement with the patient. (Source: Royal College of Physicians)
At Spring Budget 2017, local government was provided with an additional £2 billion funding for adult social care. This funding was to be spent through the Improved Better Care Fund over the period 2017-18 to 2019-20.
The purpose of the grant is to:
meet adult social care needs
reduce pressures on NHS, including supporting more people to be discharged from hospital when ready
ensure that the local social care provider market is supported
As a condition of the funding, local authorities were required to report quarterly to MHCLG. This publication reports on data collected from local authorities outlining how the £1.01 billion allocated for 2017-18 has been used.
NHS Improvement | October 2018 | Nutrition and hydration collaborative
NHS Improvement ran a 180-day programme, with 25 volunteer trusts, to improve nutritional care by increasing the accuracy of nutritional screening and the appropriateness of nutritional interventions.
The overall aims of the collaborative were to support trusts to:
increase in the proportion of patients with an accurate nutritional screen
increase in the proportion of patients receiving appropriate nutritional interventions
introduce and increase the use quality improvement tools and techniques
In addition to these aims organisations could identify their own quality improvement focus if appropriate.
25 trusts volunteered to be part of the programme to drive quality improvements, each shared their good practice, what they have learnt about quality improvement and helpful techniques with each other.
Children’s Commissioner | October 2018 | A Crying Shame A report by the Office of the Children’s Commissioner into vulnerable babies in England
This report from the Children’s Commissioner looks at how many babies might be vulnerable to severe harm and presents the facts about the sort of risks even very young children are being exposed to. A Crying Shame suggests there are 15,800 babies under the age of 1 considered by local authorities to be vulnerable or highly vulnerable and at risk of harm, but still living at home. The report comes as many local authorities are struggling with unprecedented financial pressures that are putting increasing strain on children’s social services (Source: Children’s Commissioner).
Alice Miles, the Children’s Commissioner’s Director of Strategy and author of the report, said:
“This analysis suggests there are many thousands of babies living in households carrying very high risks, many of whom may not even be known to social services. We know infants are especially vulnerable to being harmed by parental abuse or neglect. With local authorities under such pressure financially, and troubled families funding coming to an end in 2020, it’s vital that ministers make the protection of vulnerable children a priority in policy and funding. The country is rightly shocked and outraged when serious case reviews reveal the circumstances in which young children live and sometimes die; however, sadly these are the tip of the iceberg.”
Department of Health and Social Care | October 2018 |NHS to reuse more medical equipment
As part of the NHS plan to reduce waste, medical equipment such as nearly-new crutches and wheelchairs currently left unused in patients’ homes are going to be reused, where it is safe to do so. Health Minister Steve Barclay is encouraging NHS staff to accept unwanted equipment that patients no longer need and reuse it.
Some hospitals are already re purposing equipment through innovative schemes:
Mid Essex Hospital Services NHS Trust – runs a scheme to reuse returned walking aids, such as frames and crutches. Returned items are examined, decontaminated and reused or recycled. Last year 21% of crutches and 61% of frames were returned. This saw over 2,000 pieces of equipment reused and generated savings of over £25,000
Airedale NHS Foundation Trust – a project run by the trust and shared across local areas has seen over 800 wheelchairs recycled by the charities for use overseas, including in Eastern Europe, Africa, Asia and the Pacific
University Hospitals Coventry and Warwickshire NHS Trust – a scheme to change the types of container it used for ‘sharps’, moving from disposable containers to long-span bins which last for 10 years, helping to save around £20,000 per year
Health Minister Steve Barclay said:
“There are some great examples of hospitals already reusing vital medical equipment ‒ such as wheelchairs and walking aids ‒ and we want to see more of this across the country. In too many instances, however, medical equipment is being used once and then thrown away at a time when the public is increasingly aware of the impact of waste on the environment.
Patients should be able to return the countless pairs of perfectly good crutches sitting unused in the corner of living rooms across the country and know they will be put to good use helping others, either in the NHS or elsewhere through charity donations.” (Source: Department of Health and Social Care)
This policy paper outlines what is needed to enable the health and care system to make the best use of technology to support preventative, predictive and personalised care | Department of Health and Social Care
This document proposes a modern technology architecture and a set of guiding principles that will together be the foundation for a new generation of digital services designed to meet the needs of all users – for the workforce and for patients and people who use care services.
The vision sets out how digital services and IT systems will need to meet a clear set of open standards to ensure they can talk to each other and be replaced when better technologies become available. A focus on putting user needs first and setting standards at the centre will enable local organisations to manage their use of technology and spread and support innovation wherever it comes from.
The paper concludes: “By harnessing the power of technology and creating an environment to enable innovation, we can manage the growing demand for services and create the secure and sustainable future for the NHS and social care system that we all want to see”.
Sustainability and transformation partnerships in London: an independent review | Kings Fund
This report, commissioned by the Mayor of London, reviews the progress made over the past year by the capital’s five sustainability and transformation partnerships (STPs), new bodies established to implement local plans for the future of health and care services. It argues that the capital’s complex and cluttered health and care system is hampering plans to improve Londoners’ health.
The review finds evidence of improvements in services for patients in boroughs and neighbourhoods across London which are often supported by the partnerships, but that London’s STPs are less advanced than those in many other parts of England.
The analysis found that the partnerships have spent much of the past year trying to overcome the problems associated with the nationwide introduction of STPs, which was undermined by a lack of engagement with the public and saw them unfairly labelled as vehicles for cuts and privatisation.
As a result, London’s STP leaders have spent much of their time over the past 12 months focusing on the internal workings of the partnerships, building relationships with their partners and addressing gaps in staff and public engagement.