Primary Care Networks: an overview for general practice teams

Primary Care Commissioning | August 2019| Primary Care Networks an overview for general practice teams

Primary Care Commissioning has released a slide deck to provide an overview for general practice teams, it covers the following:  

  1. Practice contracts
  2.  Background to changes
  3.  Your PCN
  4. Changes to QOF
  5. IT
  6. Network services
  7. Workforce
  8.  Funding
  9. Full details from Primary Care Commissioning

It also signposts key documents for PCNs

Its available from the PCC

 

The General Practice Nurse Education Network

General Practice Nurse Education Network | August 2019 | The General Practice Nurse Education Network

This network is part of a number of initiatives arising from the General Practice Nursing 10 point plan. The General Practice Nurse Education Network  (GPNEN)  provides a repository of online resources to assist those nurses working in General Practice to have a “one-stop shop” when looking for continuing professional development initiative and support. adult-blood-care-1350560

It also works to provide a framework for GPN practice education roles within primary care. Provide guidance and resources to primary care about how the new Nursing and Midwifery Standards for student supervision and assessment are applied

It also provides information for student nurses and those new to General Practice Nursing (Source: GPNEN).

A range of resources are available from the GPNEN

Full details about the Network are available from the General Practice Nurse Education Network

Tackling loneliness

House of Commons Library | August 2019  |8514| 5|Tackling loneliness 

Tackling loneliness is a briefing from the House of Commons Library- it looks at research into the causes and impact of loneliness and possible intervention and also explains the Strategy and the steps taken so far by the Government; as well as briefly outlining the situation in Wales, Scotland and Northern Ireland (Source: House of Commons Library). 

researchbriefings.parliament.uk
Image source: researchbriefings.parliament.uk

See also:

Reading list 

Tackling loneliness (full report)

National Data Guardian 2018-19 report

National Data Guardian | August 2019 | National Data Guardian 2018-19 report

The National Data Guardian (NDG) has published a report reviewing the period between January 2018 to March 2019. 

National Data Guardian for Health and Care Progress Report January 2018-19 looks back over the work of Dame Fiona Caldicott as National Data Guardian for Health and Social Care in England. It also outlines the work that the Panel and  Dame Fiona Caldicott have carried out since January 2018 to uphold those principles.

assets.publishing.service.gov.uk
Image source: assets.publishing.service.gov.uk

She describes the progress made against the eight work priorities set in her 2017 report, and outlines the NDG’s new priorities for 2019 onwards – her first set of work commitments since the NDG role became statutory on 1st April 2019.

The National Data Guardian for Health and Care Progress Report: January 2018-March 2019

The Healthcare Safety Investigation Branch launch online feedback form

Healthcare Safety Investigation Branch | August 2019 | Online feedback form launched so you can ‘tell us what you think’

The Healthcare Safety Investigation Branch (HSIB) have launched an online feedback form so that anyone involved in their healthcare safety investigations can tell HSIB what they think.

  • National investigations in general
  • Specific national investigations
  • Maternity investigations
  • HSIB in general

Full details from HSIB

[NICE Guideline update] Preterm labour and birth

NICE| August 2019| Preterm labour and birth NICE guideline [NG25]

NICE has updated Preterm labour and birth guideline 

This guideline covers the care of women at increased risk of, or with symptoms and signs of, preterm labour (before 37 weeks), and women having a planned preterm birth. It aims to reduce the risks of preterm birth for the baby and describes treatments to prevent or delay early labour and birth.

In August 2019, NICE made new recommendations on prophylactic vaginal progesterone and prophylactic cervical cerclage for preterm labour and birth. For further details see update information (Source: NICE).

See NICE for full details

Cochrane: Incentives for smoking cessation

University of East Anglia | August 2019 | Incentives for smoking cessation

A study conducted by researchers from the University of East Anglia, the University of Oxford and University of Stirling has now been published on the Cochrane Library. This new review summarizes the results of 33  radomized controlled trials (RCTs) which included more than 21000 people in 8 countries. They looked at the long-term effect of  incentives such as vouchers, cash payments on smoking; all of the studies included had data on the participants for at least 6 months’ following the intervention.  Studies included in the review were from a range of settings such as workplaces, the community, clinics or institution- based.

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The research team also looked at studies of pregnant women who smoke separately, finding ten trials, nine based in the USA and one in the UK, covering 2571 pregnant women who smoke. 

 

Even after excluding low quality data from the review, the authors’ conclude that their certainty in the findings is high as those who were receiving rewards had a higher likelihood (approximately 50 per cent) of not starting smoking than those in the control groups.

The study’s lead author Dr Caitlin Notley, from UEA’s Norwich Medical School, said:

“We found that six months or more after the beginning of the trials, people receiving rewards were approximately 50 per cent more likely to have stopped smoking than those in the control groups.  In people not receiving incentives, approximately 7% had successfully quit for six months or longer, compared to approximately 10.5% of those receiving incentives. This is an important increase when we consider the enormous harms of smoking, and benefits of quitting, and suggests that incentives can be a useful part of a comprehensive approach to help people quit smoking. Another really important thing is that success rates continued beyond when the incentives had ended.

University of East Anglia Rewards incentivise people to stop smoking  [press release]

Cochrane Plain Language Summary

Background

Smoking is the leading cause of disease and death worldwide. Most smokers want to quit, but stopping smoking can be very challenging. Quitting smoking can greatly improve people’s health. Rewards, such as money or vouchers, can be used to encourage smokers to quit, and to reward them if they stay stopped. Such schemes can be run in workplaces, in clinics, and sometimes as community programmes.

Study types

We conducted our most recent search for studies in July 2018.

General trials: We found 33 trials, covering more than 21,600 people, that tested different rewards schemes to help smokers to quit. Two studies included smokers from mental health clinics, two from primary care clinics, two from head‐and‐neck cancer treatment clinics, two from colleges or universities, and one in Thai villages. Twenty‐four of the trials were run in the USA. All the trials followed up participants for at least six months. Those who had quit were checked by testing their breath or bodily fluids. Rewards were cash payments, vouchers, or the return of money deposited by those taking part.

Pregnancy trials: We looked at studies in pregnant women separately. We found ten trials, nine based in the USA and one in the UK, covering 2571 pregnant women who smoked. Rewards were vouchers that were sometimes increased in value, depending on how long the woman had managed to stay quit.

Key results
General trials: Six months or more after the beginning of the trial, people receiving rewards were more likely to have stopped smoking than those in the control groups. Success rates continued beyond when the incentives had ended. Studies varied in the total amounts of rewards that were paid. There was no noticeable difference between trials paying smaller amounts (less than USD 100 (US dollars)) compared to those paying larger amounts (more than USD 700).

Pregnancy trials: Combining data from nine trials showed that women in the rewards groups were more likely to stop smoking than those in the control groups, both at the end of the pregnancy and after the birth of the baby.

Quality of the studies
Some of the studies did not provide enough data for us to fully assess their quality. Taking out the lowest‐quality trials from the analysis did not change the results. Our certainty in our main findings is high. Our certainty in our findings in pregnant women is moderate, as some studies were of lower quality.

The full review is available from the Cochrane Library 

Full reference:

Notley  C, Gentry  S, Livingstone‐Banks  J, Bauld  L, Perera  R, Hartmann‐Boyce  J. | 2019| Incentives for smoking cessation| Cochrane Database of Systematic Reviews | Issue 7. Art. No.: CD004307| DOI: 10.1002/14651858.CD004307.pub6.

Abstract 

Background

Financial incentives, monetary or vouchers, are widely used in an attempt to precipitate, reinforce and sustain behaviour change, including smoking cessation. They have been used in workplaces, in clinics and hospitals, and within community programmes.

Objectives

To determine the long‐term effect of incentives and contingency management programmes for smoking cessation.

Search methods

For this update, we searched the Cochrane Tobacco Addiction Group Specialised Register, clinicaltrials.gov, and the International Clinical Trials Registry Platform (ICTRP). The most recent searches were conducted in July 2018.

Selection criteria

We considered only randomised controlled trials, allocating individuals, workplaces, groups within workplaces, or communities to smoking cessation incentive schemes or control conditions. We included studies in a mixed‐population setting (e.g. community, work‐, clinic‐ or institution‐based), and also studies in pregnant smokers.

Data collection and analysis

We used standard Cochrane methods. The primary outcome measure in the mixed‐population studies was abstinence from smoking at longest follow‐up (at least six months from the start of the intervention). In the trials of pregnant women we used abstinence measured at the longest follow‐up, and at least to the end of the pregnancy. Where available, we pooled outcome data using a Mantel‐Haenzel random‐effects model, with results reported as risk ratios (RRs) and 95% confidence intervals (CIs), using adjusted estimates for cluster‐randomised trials. We analysed studies carried out in mixed populations separately from those carried out in pregnant populations.

Main results

Thirty‐three mixed‐population studies met our inclusion criteria, covering more than 21,600 participants; 16 of these are new to this version of the review. Studies were set in varying locations, including community settings, clinics or health centres, workplaces, and outpatient drug clinics. We judged eight studies to be at low risk of bias, and 10 to be at high risk of bias, with the rest at unclear risk. Twenty‐four of the trials were run in the USA, two in Thailand and one in the Phillipines. The rest were European. Incentives offered included cash payments or vouchers for goods and groceries, offered directly or collected and redeemable online. The pooled RR for quitting with incentives at longest follow‐up (six months or more) compared with controls was 1.49. Results were not sensitive to the exclusion of six studies where an incentive for cessation was offered at long‐term follow up, suggesting the impact of incentives continues for at least some time after incentives cease.

Although not always clearly reported, the total financial amount of incentives varied considerably between trials, from zero (self‐deposits), to a range of between USD 45 and USD 1185. There was no clear direction of effect between trials offering low or high total value of incentives, nor those encouraging redeemable self‐deposits.

We included 10 studies of 2571 pregnant women. We judged two studies to be at low risk of bias, one at high risk of bias, and seven at unclear risk. When pooled, the nine trials with usable data (eight conducted in the USA and one in the UK), delivered an RR at longest follow‐up (up to 24 weeks post‐partum) of 2.38, in favour of incentives.

Authors’ conclusions

Overall there is high‐certainty evidence that incentives improve smoking cessation rates at long‐term follow‐up in mixed population studies. The effectiveness of incentives appears to be sustained even when the last follow‐up occurs after the withdrawal of incentives. There is also moderate‐certainty evidence, limited by some concerns about risks of bias, that incentive schemes conducted among pregnant smokers improve smoking cessation rates, both at the end of pregnancy and post‐partum. Current and future research might explore more precisely differences between trials offering low or high cash incentives and self‐incentives (deposits), within a variety of smoking populations.