Using pharmacists to help improve care for people with type 2 diabetes

drug-1674890_1280The Royal Pharmaceutical Society (RPS) has published Using pharmacists to help improve care for people with type 2 diabetes.  This document is aimed at policy makers and education/service commissioners within the NHS in England and makes recommendations for how pharmacists can play an increasing role in the prevention, early detection, care and support of people with type 2 diabetes.

To improve care for people with type 2 diabetes, the RPS are calling for:

  1. Pharmacists should work in collaboration with other healthcare professionals to play a greater role in prevention and detection services for type 2 Diabetes
  2. Pharmacists should play an active role in optimising medicines, improving the health, wellbeing and safety of people with type 2 diabetes across the NHS
  3. Pharmacists in specialist and generalist roles should be given access to the most up to date education and training to support people with multiple conditions
  4. NHS organisations need to establish and embed the role of consultant pharmacists in diabetes across the NHS should ensure improved outcomes in the management of people with type 2 diabetes, promote collaborative practice, multidisciplinary team working, quality improvement and research.

Full detail at Royal Pharmaceutical Society

See also: Pharmacists must be integrated into diabetes care | RPS press release

National Audit of Care at the End of Life

National Audit of Care at the End of Life | The Healthcare Quality Improvement Partnership 

The National Audit of Care at the End of Life (NACEL) is a comparative audit of the quality and outcomes of care in England and Wales experienced by the dying person and those important to them during the last admission leading to death. It looks at care in acute, community hospitals and mental health inpatient providers.

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Image source: http://www.hqip.org.uk

Around a quarter of a million people die in hospital each year in England and Wales and the audit results suggest 75% of bereaved people feel that this was the right place for the person important to them to die. This audit reviews how people’s preferences regarding care at the end of life are identified, discussed and implemented during their last admission in acute and community hospitals.

National Audit of Care at the End of Life (NACEL) 2019

National Maternity and Perinatal Audit

National Maternity and Perinatal Audit Organisational Report 2019 | The Healthcare Quality Improvement Partnership

The second organisational survey of the National Maternity and Perinatal Audit (NMPA) maps current service provision as of January 2019 across England, Scotland and Wales.  This report describes how services have changed since the last survey in January 2017, where service provision has improved and where further improvement is still needed in order to meet recommendations.

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Key findings include:

Services

  • Smoking cessation and weight management support is available at 72% and 45% of trusts and health boards respectively – no improvement since 2017.
  • A higher number of trusts and health boards participate in a perinatal mental health network – this has increased from 70% to 93% in England, from 43% to 79% in Scotland, and from 71% to 86% in Wales.
  • Access to community perinatal mental health teams increased from 72% to 91% of trusts and boards, and to specialist perinatal mental health midwives from 72% to 91% of 151 trusts and boards. Availability of psychiatrist clinics increased from 37% to 58% of maternity sites with an obstetric unit.
  • 83% of maternity sites with a neonatal unit provided transitional care – keeping mothers and babies together and avoiding unnecessary neonatal unit admission – and this has risen from 64% in 2017.
  • Maternity sites with a dedicated multi-disciplinary cardiac clinic increased from 18% to 25%, with a greater geographical spread in England and Scotland than in 2017.
  • Access to electronic maternity records improved for community midwives, with 66% of trusts and boards reporting access at any location and 90% at midwives’ community bases. But still only 19% reported that women could access their own electronic record, and the number of GPs with access decreased from 29% to 21%.

Staffing

  • While 87% of obstetric units reported gaps in their obstetric middle grade rotas, compared to 89% in 2017, the number that required locum cover remained the same at 83%.
  • 85% of sites reported that at least 95% of women had one-to-one midwifery care in established labour, compared to 84% in 2017. But only half (51%) of maternity sites reported that all women received one-to-one care in established labour, compared to 54% in 2017.

Full report available to download here

Additional link: RCOG press release

GP patient survey

NHS England and Ipsos MORI have published the latest results from the GP Patient Survey 2019.  The results show the majority of patients have had a good overall experience of their GP practice (83%)

  • The GP Patient Survey (GPPS) is an England-wide survey, providing GP practice level data about patients’ experiences of general practice.
  • Ipsos MORI administers the survey on behalf of NHS England.
  • This report sets out the national headline and summary findings for the 2019 GPPS publication.
  • 2,328,560 questionnaires were sent out nationally, and 770,512 were returned completed between 2nd January and 5th April 2019. This represents a response rate of 33.1%.
  • The questionnaire can be found here www.gp-patient.co.uk/surveysandreports

See also:

A summary of key headlines for GP practices

National infographic

 

 

National Audit of Dementia

National Audit of Dementia: care in general hospitals 2018-2019 – Round 4 audit report | The Healthcare Quality Improvement Partnership

This report presents the Round 4 results of the National Audit of Dementia.   Scores from each hospital are derived from key themes and are shown in comparison to the scores from Round 3.

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Image source: http://www.hqip.org.uk

There are several areas where improvement has been made: 96% of hospitals in England and Wales now have a system in place for more flexible family visiting; a large number (88%) of carers (and/or patients) receive a copy of the discharge plan; and more staff report being able to access finger food or snacks for patients with dementia.

Key areas for improvement include striving to ensure that more hospitals assess for delirium and that any member of staff involved in the care of people with dementia must have training relevant to their grade and include identification and management of delirium. This training should be recorded to provide assurance to the public and regulators.

For further detail and to download the report, click here

NHS health information available through Amazon’s Alexa

The NHS is collaborating with Amazon to provide reliable health information from the NHS website through voice-assisted technology | Department of Health and Social Care

Voice-assisted technology will help patients, especially the elderly, blind and those who cannot access the internet through traditional means, to get professional, NHS-verified health information in seconds, through simple voice commands.

Amazon’s algorithm uses information from the NHS website to provide answers to voice questions such as:

  • “Alexa, how do I treat a migraine?”
  • “Alexa, what are the symptoms of flu?”
  • “Alexa, what are the symptoms of chickenpox”

amazon-echo-dot-3597986_1280.pngThe technology has the potential to reduce the pressure on the NHS and GPs by providing information for common illnesses.

Voice search has been increasing rapidly. By 2020, half of all searches are expected to be made through voice-assisted technology.

NHSX will look at ways of making more NHS services available to all patients through digital technology. The announcement supports the commitment in the NHS Long Term Plan to make more NHS services available digitially.

Full story at Department of Health and Social Care

Towards mental health equality

Towards mental health equality: a manifesto for the next Prime Minister | The Mental Health Policy Group

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Image source: http://www.mentalhealth.org.uk

This manifesto sets out the following five key areas that the next Prime Minister must address in order to improve the lives of people with mental health problems and promote the mental health of the nation:

  1. Take action to prevent mental illness
  2. Create a cross-government plan for mental health and establish a ‘mental health in all policies’ approach across government
  3. Reform the Mental Health Act
  4. Ensure everyone can access the right mental health support, in the right place, at the right time
  5. Build a mental health workforce fit for the future

Full document: Towards mental health equality: a manifesto for the next prime minister

State of caring report 2019

This report is based on the results of the 2019 State of Caring Survey of over 7,500 people currently caring unpaid for family or friends.  It captures the impact that caring has on carers’ lives and evidences the policy recommendations that would improve this.

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Image source: http://www.carersuk.org

New research released by Carers UK, the leading membership charity for people caring unpaid for family and friends, shows unpaid carers are “bankrupting their future to pay for the present”.

As well as providing significant levels of care themselves, more than two thirds (68%) of carers are also using their own income or savings to cover the cost of care, equipment or products for the person they care for. As a result many are struggling financially and unable to save for their own retirement.

 

A survey of over 7,500 people currently caring unpaid for family or friends, the majority of whom provide well over 50 hours of care every week, reveals the huge personal and financial cost of caring for a loved one, with two in five carers (39%) saying they are struggling to make ends meet. Those who take on caring responsibilities often struggle to juggle a job as well, with many reducing hours, turning down promotions or leaving work altogether.

The financial pressure on carers is having a knock on effect on their futures, with more than half (53%) of all carers unable to save for retirement.

Full report: State of caring: a snapshot of unpaid care in the UK  | Carers UK

Additional link: Carers UK press release

Prehabilitation for people with cancer

Prehabilitation for people with cancer: principles and guidance for prehabilitation within the management and support of people with cancer | The Royal College of Anaesthetists, Macmillan Cancer Support, and the National Institute for Health Research (NIHR) Cancer and Nutrition Collaboration

This document calls for changes to the delivery of cancer care across the UK, with a greater focus on prehabilitation including nutrition, physical activity and psychological support.

What is prehabilitation?

Prehabilitation supports people living with cancer to prepare for treatment. It promotes healthy behaviours and prescribes exercise, nutrition and psychological interventions based on a person’s needs, to help them find their best way through.

When should it be implemented?

Prehabilitation should be implemented in the early stages of the patient pathway, ideally soon after diagnosis and well in advance of treatment for maximum benefit. It should be seen as part of the rehabilitation pathway, as a way to optimise a person’s health and wellbeing, maximising their resilience to treatment throughout the cancer journey.

What are the benefits?

Prehabilitation offers patients and care givers three main benefits:

  • Personal empowerment: A sense of control and purpose, which prepares people for treatment and improves their quality of life
  • Physical and psychological resilience: An opportunity to improve physiological function and psychological wellbeing, which offers resilience to the effects of cancer treatment, enhances the quality of recovery and helps people to live life as fully as they can
  • Long-term health: An opportunity to reflect on the role of healthy lifestyle practices after a cancer diagnosis, to promote positive health behaviour change.

Further detail at Macmillan Cancer Support

Full document: Prehabilitation for people with cancer: principles and guidance for prehabilitation within the management and support of people with cancer

Decent and accessible homes for older people

Inquiry into decent and accessible homes for older people  | The All Party Parliamentary Group (APPG) for Ageing and Older People 

This report aims to understand the detrimental impact of poor housing on older people’s physical, mental and social wellbeing and contains 13 recommendations that look at the impact of poor quality, inaccessible housing on health, issues in supported housing and the private rented sector and the importance of home improvement agencies.

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Recommendations:

  1. Review of the Decent Homes Standard to include accessibility criteria
  2. Energy efficiency as a national infrastructure priority
  3. Integrate housing issues into health and care strategies and health and care issues into housing strategies
  4. Legislate to ensure all new homes are built to lifetime standard
  5. Planning and housing strategies
  6. Restore funding for national and local housing advice services
  7. Investment in Home Improvement Agencies and handyperson schemes
  8. Increase funding of the Disabled Facilities Grant (DFG)
  9. Ensure Housing, Health and Wellbeing Grants work for older people
  10. Adopt a national strategy on supported and specialist housing
  11. Extend housing options available to older people
  12. Improve conditions for private renters
  13. Work to increase adaptations in homes and housing stock in the Private Rented Sector

Full report: Inquiry into decent and accessible homes for older people.