Age UK’s Personalised Integrated Care Programme: Evaluation Of Impact On Hospital Activity

Nuffield Trust | February 2019 | Age UK’s Personalised Integrated Care Programme: Evaluation Of Impact On Hospital Activity

Age UK commissioned the Nuffield Trust to conduct a detailed evaluation of a scheme providing personalised care for older people. Given the severe pressure on health and care services across England, could this scheme help local systems by reducing the numbers of people being admitted to hospital in an emergency? 

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Image source: nuffieldtrust.org.uk

Read the full piece from Nuffield Trust

Download the publication Age UK’s Personalised Integrated Care Programme

 

NICE Consultation: Chronic obstructive pulmonary disease in over 16s: diagnosis and management (2019 update)

NICE | February 2019| Chronic obstructive pulmonary disease in over 16s: diagnosis and management (2019 update) In development [GID-NG10128]

The consultation on Chronic obstructive pulmonary disease in over 16s: diagnosis and management (2019 update) is open, NICE is inviting people to review and comment on this draft guideline. The consultation closes on 5 March 2019 at 5pm

See NICE for full details

Cerebral palsy in adults

NICE guideline [NG119] | January 2019 |Cerebral palsy in adults

This guideline covers care and support for adults with cerebral palsy. It aims to improve health and wellbeing, promote access to services and support participation and independent living.

NICE has also produced guidelines on cerebral palsy in under 25s: assessment and management and spasticity in under 19s: management.

Full details from NICE 

Delivering effective governance and accountability for integrated health and care

NHS Clinical Commissioners | February 2019 | Delivering effective governance and accountability for integrated health and care

NHS Clinical Commissioners has released a new explainer for the NHS and local authorities outlines possible solutions for the governance and accountability challenges brought by the move to integrated health and care.

NHS organisations and local authorities are already working closely together to join up approaches to delivery and this will become even more important as the journey towards more integrated approaches to planning for health and care continues via ICSs, as set out in the NHS Long Term Plan earlier this year.

But we know from our members that there are several important differences in governance and accountability between the NHS and local authorities, which creates challenges when seeking to integrate systems and structures (Source: NHS Clinical Commissioners)

NHS Clinical Commissioners Download the explainer

Standing desks with a support package reduce time sitting at work

NIHR | January 2019 | Standing desks with a support package reduce time sitting at work

National Institute for Health Research reports how an office-based intervention involving a height-adjustable workstation and instruction package reduced the amount of time spent sitting for 146 NHS workers. Using a height- adjustable work station reduced time sat by between 60 to 90 minutes less per day at six and 12 months compared with the control group.

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Sitting for long periods is a risk factor for ill health even in people meeting recommended levels of physical activity. Reducing time sitting at work could have health and economic benefits, but the evidence is limited. This trial was fairly small, involving 146 NHS workers. No firm conclusions can be drawn as to whether reduced sitting time may translate into effects on musculoskeletal health, work performance or sickness absence. However, the results are promising and will be important if shown to be effective and cost-effective for individuals and their employers when implemented more widely.

A larger NIHR-funded study involving council workers is underway which may provide further evidence and cost data.

Read the full Signal here 

Full reference:

Edwardson, C. | 2018|Effectiveness of the Stand More AT (SMArT) Work intervention: cluster randomised controlled trial|BMJ|10.3310/signal-000717

Objectives

To evaluate the impact of a multicomponent intervention (Stand More AT (SMArT) Work) designed to reduce sitting time on short (three months), medium (six months), and longer term (12 months) changes in occupational, daily, and prolonged sitting, standing, and physical activity, and physical, psychological, and work related health.
Design

Cluster two arm randomised controlled trial. Setting National Health Service trust, England.

Participants

37 office clusters (146 participants) of desk based workers: 19 clusters (77 participants) were randomised to the intervention and 18 (69 participants) to control.

Interventions

The intervention group received a height adjustable workstation, a brief seminar with supporting leaflet, workstation instructions with sitting and standing targets, feedback on sitting and physical activity at three time points, posters, action planning and goal setting booklet, self monitoring and prompt tool, and coaching sessions (month 1 and every three months thereafter). The control group continued with usual practice.
Main outcome measures

The primary outcome was occupational sitting time (thigh worn accelerometer). Secondary outcomes were objectively measured daily sitting, prolonged sitting (≥30 minutes), and standing time, physical activity, musculoskeletal problems, self reported work related health (job performance, job satisfaction, work engagement, occupational fatigue, sickness presenteeism, and sickness absenteeism), cognitive function, and self reported psychological measures (mood and affective states, quality of life) assessed at 3, 6, and 12 months. Data were analysed using generalised estimating equation models, accounting for clustering.

Results

A significant difference between groups (in favour of the intervention group) was found in occupational sitting time at 12 months. Differences between groups (in favour of the intervention group compared with control) were observed for occupational sitting time at three months and six months and daily sitting time at six months  and 12 months. Group differences (in favour of the intervention group compared with control) were found for prolonged sitting time, standing time, job performance, work engagement, occupational fatigue, sickness presenteeism, daily anxiety, and quality of life. No differences were seen for sickness absenteeism.

The full paper has been published in the BMJ