System approaches to workforce challenges

A place to work: system approaches to workforce challenges in the NHS | NHS Providers

This briefing examines how trusts are working with their staff and local partners to enable the workforce to adapt to new ways of collaborative working.  It shares examples of how NHS trusts and foundation trusts have worked together and with partners across the wider system to develop joined-up workforce solutions, support the workforce with system transformation, tackle challenges in recruitment and retention, and address skills gaps.

Additional links: NHS Providers news release | NHS Providers blog

Leeds research could revolutionise vaccine development

University of Leeds | December  2019 |Leeds research could revolutionise vaccine development

A new approach to the polio vaccine has been developed by scientists at the University of Leeds, unlike traditional vaccines this approach uses harmless proteins called virus-like proteins (VLPs) rather than a live virus. The VLPs are created in the laboratory to imitate effects of a virus on the immune system. But they do not carry genetic material and are not infectious. 


Over the next couple of months, scientists will investigate the yield and quality of vaccine produced with the aim of  developing a production process that can be used by low-to-middle income countries.

The vaccine development programme has been led by Professors Nicola Stonehouse and Dave Rowlands from Leeds’ Faculty of Biological Sciences (Source: University of Leeds).

Full details are available in the University of Leeds press release 



Menopause and the workplace

NHS Employers | December  2019 | Menopause and the workplace

A blog post from NHS Employers focuses on menopause and the workplace.  The menopause is a natural part of ageing that usually occurs between 45 and 55 years of age as a woman’s estrogen levels decline.

Studies have shown that menopause symptoms can have a significant impact on attendance and performance in the workplace.


With our population now living longer, working longer, and with so many women working in the NHS, it’s vital that staff are supported to stay well and thrive in the workplace.

Menopause is not just a female issue, it’s an organisational issue.  All managers need to know about it and how they can support their staff.  Awareness on this topic is fundamental and reducing the stigma attached to it is vital so that more people will talk openly about it.

  • There are 3.5 million women over 50 in the workplace.
  • There are just under one million women working in the NHS (960,000)
  • In the UK, the average age for a woman to go through menopause is 51.
  • Around one in a 100 women experience menopause before age 40.
  • Three out of four women experience symptoms, one in four could experience serious symptoms (Source: NHS Employers)

There is also a video which provides an overview of the project, available from NHS Employers 

The blog post also signposts to a a number of related resources:

The Mid Yorkshire Hospitals NHS Trust has an informative menopause factsheet

Belfast Health and Social Care Trust  information leaflet 

Improving menopause support for staff at Sherwood Forest Hospital Foundation Trust

GPs recruited to take part in fractures project

Yorkshire & Humber AHSN | December 2019| GPs recruited to take part in fractures project

Yorkshire & Humber Academic Health Science Network is supporting an innovative new approach to reducing the risk of older people breaking bones and which could save the NHS over £35 million, across the North of England.

The bone health project team leading the project have now recruited GPs that care for a total of 160,000 people to take participate, which identifies patients at high risk of breaking bones, evaluates medications and treats those patients, where appropriate, with a bone-sparing agent to improve bone density.

Scaled up to the level of the North’s 16 million population, this would equal £35,163,642 in direct costs and £8,454,046 in residential costs – a total of £43,617,688 potential savings in health and social care.

The project has been developed and tested by the AHSN NENC and the Innovation Agency (AHSN for the North West Coast). Now all four AHSNs across the North including Yorkshire & Humber are implementing the project. The Northern AHSNs will be working in partnership with AMGEN, The Northern Health Science Alliance (NHSA) and Interface to deliver the approach to targeting fracture risk assessment and bone-sparing medication review at a primary care level (Source: AHSN).



Full details of the project are available from Yorkshire & Humber AHSN Network 



NHS warning as winter vomiting bug closes 1,000 hospital beds

NHS England | December  2019| NHS warning as winter vomiting bug closes 1,000 hospital beds

The NHS is calling on the public to heed advice and stay at home if they have norovirus to avoid passing it on, as hospitals in England have been forced to close more than 1,100 hospital beds over the last week.

Top medics are concerned about the spread of the winter vomiting bug this year and the impact it is having on hospitals and other services.

They are therefore urging those who catch the virus not to go back to work or school until at least 48 hours after symptoms pass, to avoid passing it on to others.

The latest data from Public Health England (PHE) surveillance showed that the number of positive norovirus laboratory reports during the two weeks in the middle of November (11th-24th) was 28% higher than the average for the last five.

The NHS is responding by launching a new social media campaign to help people avoid catching the bug if possible, and recognise and deal with the symptoms of norovirus at home if they are unlucky enough to get infected.

Health bosses are also encouraging those who need it to seek help from the free, 24/7 NHS 111 phone and online service rather than going to hospital or their GP, where they risk infecting others (Source: NHS England).


BMJ: Maternal diabetes during pregnancy and early onset of cardiovascular disease in offspring: population based cohort study with 40 years of follow-up

BMJ | November 2019 | Maternal diabetes during pregnancy and early onset of cardiovascular disease in offspring: population based cohort study with 40 years of follow-up| 67| l6398

A study that looked at the associations between maternal diabetes (diagnosed prior to or during pregnancy) and early onset cardiovascular disease (CVD) in offspring during their first four decades of life adds to the evidence around non-genetic intergenerational connections between maternal illness and risk factors for CVD among offspring. The experts who authored the study looked at data from more than 2 million births in Denmark between 1977 and 2016. 


The findings from this population based study indicate that the children of mothers with diabetes, especially mothers with CVD history or diabetic complications, had increased rates of early-onset CVD throughout the early decades of life. If the associations are causal, then preventing and treating diabetes in women of childbearing age could have a significant impact on the reduction of CVD incidence in the next generation.

The authors argue that their findings highlight the importance of effective strategies for screening and preventing diabetes in women of childbearing age (Source: BMJ).



Read the full Opinion from BMJ

Yongfu, Y. et al | 2019|  Maternal diabetes during pregnancy and early onset of cardiovascular disease in offspring: population based cohort study with 40 years of follow-up|


Objective To evaluate the associations between maternal diabetes diagnosed before or during pregnancy and early onset cardiovascular disease (CVD) in offspring during their first four decades of life.

Design Population based cohort study.

Setting Danish national health registries.

Participants All 2 432 000 liveborn children without congenital heart disease in Denmark during 1977-2016. Follow-up began at birth and continued until first time diagnosis of CVD, death, emigration, or 31 December 2016, whichever came first.

Exposures for observational studies Pregestational diabetes, including type 1 diabetes (n=22 055) and type 2 diabetes (n=6537), and gestational diabetes (n=26 272).

Main outcome measures The primary outcome was early onset CVD (excluding congenital heart diseases) defined by hospital diagnosis. Associations between maternal diabetes and risks of early onset CVD in offspring were studied. Cox regression was used to assess whether a maternal history of CVD or maternal diabetic complications affected these associations. Adjustments were made for calendar year, sex, singleton status, maternal factors (parity, age, smoking, education, cohabitation, residence at childbirth, history of CVD before childbirth), and paternal history of CVD before childbirth. The cumulative incidence was averaged across all individuals, and factors were adjusted while treating deaths from causes other than CVD as competing events.


Results During up to 40 years of follow-up, 1153 offspring of mothers with diabetes and 91 311 offspring of mothers who did not have diabetes were diagnosed with CVD. Offspring of mothers with diabetes had a 29% increased overall rate of early onset CVD ; cumulative incidence among offspring unexposed to maternal diabetes at 40 years of age 13.07%, difference in cumulative incidence between exposed and unexposed offspring 4.72% . The sibship design yielded results similar to those of the unpaired design based on the whole cohort. Both pregestational diabetes and gestational diabetes were associated with increased rates of CVD in offspring. We also observed varied increased rates of specific early onset CVDs, particularly heart failure, hypertensive disease, deep vein thrombosis, and pulmonary embolism. Increased rates of CVD were seen in different age groups from childhood to early adulthood until age 40 years. The increased rates were more pronounced among offspring of mothers with diabetic complications. A higher incidence of early onset CVD in offspring of mothers with diabetes and comorbid CVD was associated with the added influence of comorbid CVD but not due to the interaction between diabetes and CVD on the multiplicative scale.


Conclusions Children of mothers with diabetes, especially those mothers with a history of CVD or diabetic complications, have increased rates of early onset CVD from childhood to early adulthood. If maternal diabetes does have a causal association with increased CVD rate in offspring, the prevention, screening, and treatment of diabetes in women of childbearing age could help to reduce the risk of CVD in the next generation.

Offspring of mothers with diabetes, especially those mothers with a history of CVD or diabetic complications, have increased rates of early onset CVD from childhood to early adulthood

The article is available in full from The BMJ