The latest figures on the NHS’s performance

NHS Improvement| November 2018 | The latest figures on the NHS’s performance

The latest report from NHS Improvement, covering the period from the period between July and September, shows that hospitals admitted nearly 1,000 more emergency patients a day than in the same period last year, treating 5.52 million patients within the four-hour target.


Hospitals have also been able to discharge more patients from their services sooner, including reducing the number of beds occupied by patients who have been there for more than three weeks (classed as a ‘long-stay patients’), freeing up the equivalent of 2,470 beds in time for winter.

However, these achievements come as:

  • waiting times for planned treatment, such as routine non-urgent operations, have increased
  • vacancies for doctors and nurses still stand at over 100,000 despite some improvements
  • the provider sector’s deficit is forecast to be £558 million by the end of March
    (Source: NHS Improvement)

See also:

King’s Fund The King’s Fund responds to NHS Improvement’s report on the performance of the NHS provider sector 

New service will put crucial patient information in the hands of paramedics and mental health nurses

NHS Digital | November 2018 |New service will put crucial patient information in the hands of paramedics and mental health nurses

The National Record Locator Service is  a new service that will enable triage personnel such as mental health nurses and paramedics, who are called to a patient in distress, to find out whether a patient they are treating has a mental health crisis plan.


The service will enable triage personnel to transport the patient to a more appropriate care setting than A&E or offer alternative, community-based care as indicated in the crisis plan.

This will not only improve patient safety and mental health outcomes, but it will also reduce duplicate care costs (within A&E and mental health services) and improve staff safety (NHS Digital).

Full details from NHS Digital 

Bowel cancer waiting times figures revealed

University of Edinburgh | November 2018 |Bowel cancer waiting times figures revealed

Bowel cancer is the fourth most common cancer type, now researchers from the University of Edinburgh have shown that it takes 10% of  patients in England and Wales more than a year from recognising the symptoms to receiving treatment for their bowel cancer. They found that 10% of people with bowel cancer in Scotland waited more than 8 months to start treatment. 


This international study included anonymised medical data from 3000 patients and their doctors in Australia, and Canada alongside the UK. Among their findings people in Wales took the longest to contact their GP once they had a health concern. Patients in Wales also waited the longest time (168 days)  to commence treatment,  which contrasts with Denmark (77 days. Researchers found that men and women in Wales took the longest to contact their doctor once they had noticed a health concern or symptom (Source: University of EdinburghUniversity of Edinburgh).

Full details from University of Edinburgh 

Digital devices during family time could exacerbate bad behaviour

Science Daily | June 2018 | Digital devices during family time could exacerbate bad behavior

Children whose parents spend lots of time on their mobile devices or watching television were found to be more likely to whine, throw tantrums, display more hyperactivity, frustration and sulking. Researchers in the US  have labelled this parental behaviour as ‘technoference’ saying it could also impact on their child’s long-term behaviour (Science Daily).

the-prohibition-of-2460240_640.png Their study was published in June’s Pediatric Research. The researchers asked 337 parents to answer questionnaires during 2014-16. They were asked if devices interrupted their daily interactions with their children, and to indicate their frequency. Parents reported their child’s internalizing behaviour for instance through sulking, they also reported their externalizing behaviour such as anger of frustration. In addition they also noted their personal level of stress or depression and their child’s screen time and usage.  The researchers found for nearly all of the participants, at least one device intruded in the interactions between the parent and their child at some point in the day (Science Daily).

Read the news item from Science Daily 

Full reference: McDaniel, B.T., Radesky, J. S.| 2018 | Technoference: longitudinal associations between parent technology use, parenting stress, and child behavior problems| Pediatric Research| 2018| DOI: 10.1038/s41390-018-0052-6


Background and objectives

Heavy parent digital technology use has been associated with suboptimal parent–child interactions and internalizing/externalizing child behavior, but directionality of associations is unclear. This study aims to investigate longitudinal bidirectional associations between parent technology use and child behavior, and understand whether this is mediated by parenting stress.


Participants included 183 couples with a young child (age 0–5 years, mean = 3.0 years) who completed surveys at baseline, 1, 3 and 6 months. Cross-lagged structural equation models of parent technology interference during parent–child activities, parenting stress, and child externalizing and internalizing behavior were tested.


Controlling for potential confounders, we found that across all time points (1) greater child externalizing behavior predicted greater technology interference, via greater parenting stress; and (2) technology interference often predicted greater externalizing behavior. Although associations between child internalizing behavior and technology interference were relatively weaker, bidirectional associations were more consistent for child withdrawal behaviors.


Our results suggest bidirectional dynamics in which (a) parents, stressed by their child’s difficult behavior, may then withdraw from parent–child interactions with technology and (b) this higher technology use during parent–child interactions may influence externalizing and withdrawal behaviors over time.


In the news:

BBC News Would you hand over your mobile phone for a free meal?


Learning from Deaths [e-learning]

e- Learning for healthcare |  Learning from Deaths 

A new e- Learning course from Health Education England and Skills for Health aims to encourage a learning and quality improvement culture within the health and care sectors. It helps organisations remove barriers and enable a change in culture whereby all learning opportunities are taken. This in turn will result in improvements in care.


The introduction of the National Learning from Deaths framework has led to a requirement for training to support organisations in a variety of areas, including: their mortality governance; how they launch and handle investigations; maintaining a robust quality improvement strategy; embedding safety culture into their organisations; and understanding the impact of human factors on staff performance and behaviour.

Course details:

The course  comprises six sessions and will take around 3.5 hours to complete:

  1. How to use this e-learning
  2. Culture and learning from deaths
  3. Engaging with families and carers
  4. Case record reviews and investigations
  5. Actions and improvements
  6. Trust Boards and the role of Non-Executive Directors
  7. Assessment

The course is suitable for anyone working in a health or care setting and supports the ‘ward-to-board’ responsibility of learning from deaths and serious incidents and includes learning which is relevant to all roles.




New plan announced by NHS Chief to tackle Type 2 diabetes epidemic

NHS England | November 2018 |Very low calorie diets part of NHS action to tackle growing obesity and Type 2 diabetes epidemic

NHS Chief executive Simon Stevens has announced that people recently diagnosed with Type 2 diabetes will be trialled as part of a new NHS long term plan, which will increase the focus on prevention as well as treatment.


As well as improving the health of patients,this will also save the NHS money that can be reinvested in frontline care. Currently, the health service in England spends around 10% of its budget on treating diabetes.

The scaling up of the NHS DPP scheme, the first in the world to become available country-wide, comes after it proved even more successful than planned with patients losing on average a kilogram more than expected.

The nine month programme helps people to:

  • achieve a healthy weight
  • improve overall nutrition
  • increase levels of physical activity

Online versions of the DPP, which involve wearable technologies and apps to help those at risk of Type 2 Diabetes, will also be provided for patients who find it difficult to attend sessions because of work or family commitments (Source: NHS England).

Full news release available from NHS England 

In the news:

BBC News Type 2 diabetes: NHS to offer 800-calorie diet treatment

ITV News Liquid diet to be prescribed to diabetes patients

Evening Standard Liquid diet for type 2 diabetes patients after trial puts condition into remission

Skin cancer rates in England higher than previously thought

Data from a newly established UK skin cancer database, the largest database of its kind in the world, has revealed that there are over 45,000 cutaneous squamous cell carcinomas (cSCC) every year in England, 350 per cent more than previous estimates suggested | JAMA Dermatology | via ScienceDaily


Developed by experts at Queen Mary University of London and Public Health England (PHE), and funded by the British Association of Dermatologists, the database fills in gaps in the recording of skin cancer, ensuring that accurate numbers for the three most common types of skin cancer: melanoma, basal cell carcinoma (BCC), and cutaneous squamous cell carcinoma (cSCC), are available for the whole of the UK.

These data are important as they enable researchers and policy makers to evaluate the effectiveness of prevention initiatives, screening, staging and treatments for what is a very common cancer. The study has been published in JAMA Dermatology.

Full story at ScienceDaily

Journal reference: Venables, Z. et al. |  Nationwide Incidence of Metastatic Cutaneous Squamous Cell Carcinoma in England |  JAMA Dermatology | published online November 28th 2018

Progress towards ending the HIV epidemic in the United Kingdom

Public Health England | November 2018 | Progress towards ending the HIV epidemic in the United Kingdom 2018 report 

Although there has been steady progression in implementing combination
prevention measures to end the HIV epidemic and the efforts are having a major
effect, there still remain opportunities for further improvements.  Public Health England (PHE) has published Progress towards ending the HIV epidemic in the United Kingdom, this report includes key  messages which have been drawn together to support efforts to reach those living with HIV who are undiagnosed and to maintain high treatment and care standards (Source: PHE).

The report includes key messages for:

  • Sexual health services
  • Local authorities
  • HIV care providers

As well as recommendations for the pubic

Progress towards ending the HIV epidemic in the United Kingdom 2018 report 

See also: HIV in the United Kingdom

In the media:

BBC News UK meets global HIV targets as diagnoses keep falling

The Telegraph An ‘alarm bell’: Experts warn HIV has hit a 10 year high in Europe ahead of 30th World Aids Day

Items which should not routinely be prescribed in primary care: an update and a consultation on further guidance for CCGs

NHS England | November 2018 | Items which should not routinely be prescribed in primary care: an update and a consultation on further guidance for CCGs

NHS England are running a national consultation on items which should not routinely be prescribed in primary care (for example GP practices, pharmacies, the dentist, and 
eye clinics.) The consultation involves 9 medicines and products. According to NHS England, research shows that some medicines can be replaced with other medicines that
work better, are safer or cost less money.


Overview Items which should not routinely be prescribed in primary care: an update and a consultation on further guidance for CCGs

Easy read version of the consultation document

Consultation document 

See also:

NHS Clinical Commissioners [press release]

Who cares? The implications of informal care and work for policymakers and employers

The Work Foundation | November 2018 | Who cares? The implications of informal care and work for policymakers and employers

Who cares? The implications of informal care and work for policymakers and employers, is a paper from The Work Foundation. It outlines some of the implications associated with the growing number of informal carers in the UK, the health and social care system’s increasingly unsustainable reliance on them, and what Government and employers can do about it. This is informed by the academic and grey literature, as well as a workshop we hosted in 20176, which was attended by over 30 expert stakeholders from government and non-government bodies, individual carers, carers charities, think tanks, and businesses (Source: The Work Foundation).

work foundation
Image source:

Download the full report

Executive summary