NHS inpatient satisfaction falls for first time in six years

Adult inpatient survey 2018 | Care Quality Commission (CQC)

The results of the latest inpatient survey show what over 75,000 adults who stayed in hospital for at least one night in July last year said about the care they received. The survey covered the quality of information and communication with staff, whether they were given enough privacy, the amount of support given to help them eat and drink, and their discharge arrangements. The results are provided for England as a whole and by NHS trust.

feedback-3676922_1920Across the majority of questions asked in the survey there has been no improvement since it was last carried out, and this year’s results show an increase in those reporting lengthy delays, greater dissatisfaction with the amount of information provided when leaving hospital, and those who felt a lack of involvement in their care.

Most results for the 2018 Adult Inpatient Survey have slightly declined since last year or remained static.

Positive findings:

  • Relationships with the medical and nursing staff are usually positive although there is a small decline compared to last year. For example, patients reported that overall, doctors and nurses answered their questions in a way they understood.
  • Trust in doctor and nurse is high, although declining slightly compared to last year.
  • Fundamental needs of most patients are being met in terms of food, hydration and rest.
  • The proportion of patients reporting being given enough privacy when being examined or treated continues to be very high.

However, this year’s results indicate that there are many areas in need of improvement:

  • Patients are reporting poorer experience when it comes to the integration of their care.
  • Patients are reporting that they are waiting too long at admission and longer than previous years at discharge.
  • At the time of being discharged, significant numbers of patients were unsure about their situation. This includes not being given appropriate information about their care after leaving the hospital, and not receiving enough notice.
  • Significant numbers of patients reported not being sufficiently involved in decisions regarding their care and treatment.

Certain groups of patients consistently reported poorer experiences of their time in hospital, including

  • Patients with a mental health condition
  • Younger patients (aged 16 to 35)
  • Patients who were admitted in an emergency

Full report: Adult inpatient survey 2018

CQC press release: Confidence and trust in hospital staff high but overall improvements in people’s inpatient experience have stalled

See also:

 

The changing age profile of people accessing drug treatment

This report from the Advisory Council on the Misuse of Drugs (ACMD) aims to describe the changing age profile of people accessing drug treatment. It provides an overview of the challenges faced by the ageing cohort in the UK, explains why current service regimens are not meeting the needs of this group and makes recommendations for practise and policy.

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The past decade has seen a shift in the age profile of those seeking treatment for drug use. An ageing cohort, who have survived lengthy histories of heavy drug use, now account for an increasing portion of the treatment group in the UK and Europe.

This report from the Advisory Council on the Misuse of Drugs (ACMD) explores the specific issues for older people with a drug problem focusing on those who have had a drug problem for an extended period of time. It describes the health and social care needs of this population, and identifies effective services responses and best practice.

Full document: Ageing cohort of drug users

New approach to leadership development, diversity and supporting CEOs required – new NHS Confederation report

NHS Confederation | June 2019 | New approach to leadership development, diversity and supporting CEOs required – new NHS Confederation report

A new report from the NHS Confederation outlines the views of new NHS chief executives on the changes in leadership approach and culture that they believe will be required if the NHS is to meet the ambitions of the Long Term Plan.

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Image source: nhsconfed.org

Nine NHS trust chief executives were interviewed, they make a number of observations about the future of leadership in the NHS, including:

  • They support the need to move beyond working in isolation as leaders of single organisations to being part of a health economy. Many have taken on wider roles as system leaders and they recognise the need to have a dual responsibility for the performance of their local systems for the benefit of their local communities, as well as of course for their own organisations.
  • Talent management has not been a notable feature within the NHS in recent years, but this is starting to be addressed by NHS England/Improvement. The chief executives want to see a different approach to identifying and supporting leaders and recognise the need for proactive talent management to secure the next generation of leaders, with the right skills, mind-sets and from diverse backgrounds. This should include providing opportunities for leaders to work across different organisations.
  • They want to see more support when things go wrong and a commitment to make sure that chief executives are not forced out when they are doing a difficult and challenging job – with leaders given the opportunity to learn from their mistakes.
  • These chief executives also want to see more progress on developing inclusive cultures and organisations – they recognise the strong link that exists between inclusive and diverse working environments and better outcomes for patients and staff.

NHS Confederation  The best job in the world?

 

 

 

 

Cochrane: Which inhaled corticosteroid and inhalation device has least impact on growth in children with asthma?

Cochrane | June 2019 | Which inhaled corticosteroid and inhalation device has least impact on growth in children with asthma?

A new review from Cochrane has reviewed the evidence on which inhaled corticosteroid (ICS) has the least impact on the growth of children with asthma. The  review studied the data from six trials involving 1199 children aged from 4 to 12 years with mild-to-moderate persistent asthma.  This review did not include children with persistent asthma treated with other ICS besides beclomethasone, budesonide and fluticasone, or ICS combined with medications called long acting beta2-agonists (LABA).

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While the review indicates that the drug molecule and delivery device may impact the effect size of ICS on growth in children with persistent asthma; the evidence was found to range from very low to moderate, mainly because of small numbers of trials and people, low quality of some included trials, and the possible influence of industry funding on reporting of trial results.

The full review is available from Cochrane

 

Health charities call for £1 billion a year to reverse cuts to public health funding

Two leading health charities say that the government must make a clear and urgent commitment to restoring £1 billion of real-terms per head cuts to the public health grant which enables local authorities to deliver vital preventive services that protect and improve health.money-2724241_1920

The Health Foundation and The King’s Fund say that government cannot continue to put off decisions on public health funding and must signal its intention to restoring cuts and ensuring there are no further reductions in funding.

The two organisations say that cuts to the public health grant made since 2015/16 are having a major impact on local services – such as sexual health clinics, stop smoking support and children’s health visitors – which play a key role in improving and maintaining the population’s health. They also argue that cuts to the grant undermine the ability of Directors of Public Health to influence wider public services that affect people’s health – including housing and transport. They say that failing to act now would be a false economy, placing further pressure on the NHS and wider public services.

Analysis by the Health Foundation shows that the grant, which currently amounts to £3.1 billion a year, is now £850 million lower in real terms than initial allocations in 2015/16.

Full article at The Kings Fund

See also: Invest in public health now, or store up problems for the future | The Health Foundation

Liverpool research: The impact of persistent poverty on children and young people

University of Liverpool| June 2019| Persistent poverty affects one in five UK children

Researchers at the University of Liverpool working alongside experts from University College London, have analysed data from the Millennium Cohort Study- data from 10652 children born between 2000 and 2002 who have been tracked throughout childhood- to help to determine whether specific patterns of exposure to poverty have different effects on adolescent physical and mental health.  

The findings of the study indicate that children in persistent poverty had a 3 times higher risk of mental ill health, a 1.5 times greater risk of obesity, and nearly double the risk of longstanding illness than children who had never been poor.
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For the purposes of this study poverty was defined as less than 60% of average household income) was measured at 9 months, and at 3, 5, 7, 11 and 14 years of age.Mental health was measured using a recognised questionnaire; physical health was measured by obesity (BMI); and parents were asked to report any longstanding illness when their child was 14 (Source: The BMJ).

(Source: University of Liverpool

Persistent poverty affects one in five UK children

The article is available from  Archives of Disease in Childhood
Full reference: Lai, E. T. C., et al | 2019|Poverty dynamics and health in late childhood in the UK: evidence from the Millennium Cohort Study | Archives of Disease in Childhood |

Abstract

Objective To assess the prevalence of different trajectories of exposure to child poverty and their association with three indicators of adolescent physical and mental health in UK children.

Methods We analysed data on 10 652 children from a large, prospective, nationally representative sample in the UK Millennium Cohort Study. The outcomes were mental health, measured by the Strengths and Difficulties Questionnaire (SDQ), physical health, measured by obesity and any longstanding illness, at age 14. The exposure was relative poverty (less than 60% of median of equivalised household income), measured at 9 months, 3, 5, 7, 11 and 14 years. Poverty trajectories were characterised using latent class analysis. ORs and 95% CIs were estimated using multivariable logistic regression, adjusted for maternal education and ethnicity.

Results Four poverty trajectories were identified: never in poverty (62.4%), poverty in early childhood (13.4%), poverty in late childhood (5.0%) and persistent poverty (19.4%). Compared with children who never experienced poverty, those in persistent poverty were at increased risk of mental health problems, obesity and longstanding illness. Poverty in early childhood was related to higher risk of obesity than that in late childhood, while the opposite is observed for mental health problems and longstanding illness.

Conclusions Persistent poverty affects one in five children in the UK. Any exposure to poverty was associated with worse physical and mental health outcomes. Policies that reduce child poverty and its consequences are likely to improve health in adolescence.

 

‘Care for young carers’ offer in GP surgeries

NHS England has outlined a series of practical plans and actions designed to help young carers who may be ‘hidden’, unpaid and under the age of sixteen.

Family doctors across the country can now volunteer to offer a new package of services for children and young adults who perform an informal caring role for a family member.  This includes priority appointments for carers, home visits, additional mental health checks, and ‘double appointments’ for the carer and those they provide care for.

Research from Barnardo’s and Carers Trust has highlighted a host of challenges young people face in juggling their caring role with their education and own health, with up to 40% experiencing mental health problems.

The measures, backed by Carers UK, Carers Trust, CQC and the Children’s Society, mean GP practices may offer more tailored services for carers in their community, based on national proposals and assessed against six ‘Quality Markers’, to ensure carers in every community across the country are being offered high quality support by their local practice.

It is estimated that up to one in five secondary school pupils provides some level of care for a parent or sibling.

Full story at NHS England