NHS staff and parents to gain access to crucial child health information

NHS Digital | April 2019 | NHS staff and parents to gain access to crucial child health information

A new live service which enable access to important child health information at the point of care for health professionals has been launched by the NHS.

The service, the National Events Management Service, securely publishes information on key health interventions for children. Parents and health professionals can securely receive information digitally and use it to inform decisions on care and treatment, the service is the result of collaboration between NHS Digital and NHS England with IT suppliers.

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The service shows which preventative interventions a child has received; improving the speed of diagnosis and treatment by giving health visitors and parents access to the same information sources at the same time.

The service has initially launched in North East London in partnership with North East London Foundation Trust (NELFT) and their health visiting and child health services. IT suppliers which already support the Trust have connected their products to the new service.

Full details from  NHS Digital

 

Estimating the potential impact of the UK government’s sugar reduction programme on child and adult health: modelling study

Amies-Cull, B., Briggs, A. D. M.Scarborough, P. | 2019|  Estimating the potential impact of the UK government’s sugar reduction programme on child and adult health: modelling study | 

New research has estimated the potential impact of the UK government’s sugar reduction programme on child and adult obesity, associated health benefits, and healthcare costs. The study used data from over 1500 participants in the National Diet and Nutrition Survey (waves 5 and 6) who had completed at least three (food) diary days, lived in England, and were between the ages of 4 and 80.

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Abstract

Objective To estimate the impact of the UK government’s sugar reduction programme on child and adult obesity, adult disease burden, and healthcare costs.

Design Modelling study.

Setting Simulated scenario based on National Diet and Nutrition Survey waves 5 and 6, England.

Participants 1508 survey respondents were used to model weight change among the population of England aged 4-80 years.

Main outcome measures Calorie change, weight change, and body mass index change were estimated for children and adults. Impact on non-communicable disease incidence, quality adjusted life years, and healthcare costs were estimated for adults. Changes to disease burden were modelled with the PRIMEtime-CE Model, based on the 2014 population in England aged 18-80.

Results If the sugar reduction programme was achieved in its entirety and resulted in the planned sugar reduction, then the calorie reduction was estimated to be 25 kcal/day (1 kcal=4.18 kJ=0.00418 MJ) for 4-10 year olds , 25 kcal/day (24 to 28) for 11-18 year olds, and 19 kcal/day (17 to 20) for adults. The reduction in obesity could represent 5.5% of the baseline obese population of 4-10 year olds, 2.2% of obese 11-18 year olds, and 5.5% of obese 19-80 year olds. A modelled 51 729 quality adjusted life years (95% uncertainty interval 45 768 to 57 242) were saved over 10 years, including 154 550 (132 623 to 174 604) cases of diabetes and relating to a net healthcare saving of £285.8m (€332.5m, $373.5m; £249.7m to £319.8m).

Conclusions The UK government’s sugar reduction programme could reduce the burden of obesity and obesity related disease, provided that reductions in sugar levels and portion sizes do not prompt unanticipated changes in eating patterns or product formulation.

 

The full article is available to read at BMJ 

See also:

BMJ Opniioin  Sugar reduction—a bold contribution to addressing preventable illness

Teenage mothers and young fathers: support framework

Public Health England | April 2019 |Teenage mothers and young fathers: support framework

Public Health England’s (PHE) framework for supporting teenage mothers and young fathers- Teenage mothers and young fathers: support frameworkhas been updated.

Commissioners and service providers can use this framework as a multi-agency self-assessment tool to review local services, identify gaps in provision and look at the likely impact and effectiveness of each aspect of local support for young parents.

The teenage parent outcomes modelling tool should be read alongside this framework because it brings together data and evidence about factors that affect outcomes for teenage parents and their children.

The teenage pregnancy narrative reports bring together key data and information for local authorities to help inform commissioning decisions to reduce unplanned teenage conceptions and improve outcomes for young parents.
The document is available from PHE

Diet and colorectal cancer in UK Biobank: a prospective study

Bradbury, K.E.,  Murphy, N., Key, T. | 2019| Diet and colorectal cancer in UK Biobank: a prospective study|  International Journal of Epidemiology| dyz064| https://doi.org/10.1093/ije/dyz064

A research team behind a study into diet and the impact of diet on colorectal cancer used data from the UK Biobank research project in conjunction with  questionnaires to learn about the dietary habits of men and women aged between 40- 69 years and their potential risk of developing colorectal cancer. 
At follow up five years later the participants who had consumed (on average) 76g of red meat, compared to 21g, had a higher risk of developing cancer than other participants.

Participants who ate red meat on four or more occasions a week had a fifth increased risk of developing colorectal cancer compared with subjects who ate red meat twice weekly. 
Subjects who consumed the most wholegrains had a 14% lower risk of developing  colorectal cancer.
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Key Messages
  • Previous studies have found an increased risk of colorectal cancer in those with high intakes of red and processed meat. Most previous studies collected information on dietary intakes during the 1990s or earlier and patterns in meat consumption have since changed.
  • In addition, few studies have used re-measured intakes to reduce the impact of measurement error, and to quantify the amount of red and processed meat that is associated with an increased risk. Measurement error generally biases the associations towards the null value; the associations observed in previous studies that did not re-measure intakes may be underestimated.
  • Our study found that people who were consuming red and processed meat four or more times per week, had a 20% increased risk of colorectal cancer compared with those who were consuming red and processed meat less than twice a week.

Abstract

Background

Most of the previous studies on diet and colorectal cancer were based on diets consumed during the 1990s.

Methods

We used Cox-regression models to estimate adjusted hazard ratios for colorectal cancer by dietary factors in the UK Biobank study. Men and women aged 40–69 years at recruitment (2006–10) reported their diet on a short food-frequency questionnaire (n = 475 581). Dietary intakes were re-measured in a large sub-sample (n = 175 402) who completed an online 24-hour dietary assessment during follow-up. Trends in risk across the baseline categories were calculated by assigning re-measured intakes to allow for measurement error and changes in intake over time.

Results

During an average of 5.7 years of follow-up, 2609 cases of colorectal cancer occurred. Participants who reported consuming an average of 76 g/day of red and processed meat compared with 21 g/day had a 20% higher risk of colorectal cancer. Participants in the highest fifth of intake of fibre from bread and breakfast cereals had a 14% lower risk of colorectal cancer. Alcohol was associated with an 8% higher risk per 10 g/day higher intake. Fish, poultry, cheese, fruit, vegetables, tea and coffee were not associated with colorectal-cancer risk.

Conclusions

Consumption of red and processed meat at an average level of 76 g/d that meets the current UK government recommendation (less than or equal to 90 g/day) was associated with an increased risk of colorectal cancer. Alcohol was also associated with an increased risk of colorectal cancer, whereas fibre from bread and breakfast cereals was associated with a reduced risk.

 

The article is available to read in full in the International Journal of Epidemiology 

In the news:

The Independent Even government guideline amounts of red meat and bacon increase risk of bowel cancer, study finds 

The Guardian Even moderate intake of red meat raises cancer risk, study finds

BBC News A rasher of bacon a day ‘ups cancer risk’ 

JAMA: Trial finds workplace wellness program has no significant effects on clinical measures of health, health care spending and utilization, or employment outcomes

Song, Z., &  Baicker, K. | 2019| Effect of a Workplace Wellness Program on Employee Health and Economic OutcomesA Randomized Clinical Trial | JAMA |321| 15 | P.1491-1501. doi:10.1001/jama.2019.3307

A US study used a randomised controlled trial (RCT) to evaluate a multicomponent workplace wellness program resembling programs offered by US employers

Using data from 160 workplaces the research team 20 randomly selected treatment worksites which received a wellness program which 8 modules focused on nutrition, physical activity, stress reduction, and related topics implemented by registered dietitians; the 140 randomly selected as control worksites received no wellness program.

 

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Key Points

Question  What is the effect of a multicomponent workplace wellness program on health and economic outcomes?

Findings  In this cluster randomized trial involving 32 974 employees at a large US warehouse retail company, worksites with the wellness program had an 8.3-percentage point higher rate of employees who reported engaging in regular exercise and a 13.6-percentage point higher rate of employees who reported actively managing their weight, but there were no significant differences in other self-reported health and behaviors; clinical markers of health; health care spending or utilization; or absenteeism, tenure, or job performance after 18 months.

Meaning  Employees exposed to a workplace wellness program reported significantly greater rates of some positive health behaviors compared with those who were not exposed, but there were no significant effects on clinical measures of health, health care spending and utilization, or employment outcomes after 18 months

Question  What is the effect of a multicomponent workplace wellness program on health and economic outcomes?

Findings  In this cluster randomized trial involving 32 974 employees at a large US warehouse retail company, worksites with the wellness program had an 8.3-percentage point higher rate of employees who reported engaging in regular exercise and a 13.6-percentage point higher rate of employees who reported actively managing their weight, but there were no significant differences in other self-reported health and behaviors; clinical markers of health; health care spending or utilization; or absenteeism, tenure, or job performance after 18 months.

Meaning  Employees exposed to a workplace wellness program reported significantly greater rates of some positive health behaviors compared with those who were not exposed, but there were no significant effects on clinical measures of health, health care spending and utilization, or employment outcomes after 18 months

Abstract

Importance  Employers have increasingly invested in workplace wellness programs to improve employee health and decrease health care costs. However, there is little experimental evidence on the effects of these programs.

Objective  To evaluate a multicomponent workplace wellness program resembling programs offered by US employers.

Design, Setting, and Participants  This clustered randomized trial was implemented at 160 worksites from January 2015 through June 2016. Administrative claims and employment data were gathered continuously through June 30, 2016; data from surveys and biometrics were collected from July 1, 2016, through August 31, 2016.

Interventions  There were 20 randomly selected treatment worksites (4037 employees) and 140 randomly selected control worksites (28 937 employees, including 20 primary control worksites [4106 employees]). Control worksites received no wellness programming. The program comprised 8 modules focused on nutrition, physical activity, stress reduction, and related topics implemented by registered dietitians at the treatment worksites.

Main Outcomes and Measures  Four outcome domains were assessed. Self-reported health and behaviors via surveys (29 outcomes) and clinical measures of health via screenings (10 outcomes) were compared among 20 intervention and 20 primary control sites; health care spending and utilization (38 outcomes) and employment outcomes (3 outcomes) from administrative data were compared among 20 intervention and 140 control sites.

Results  Among 32 974 employees, the mean participation rate in surveys and screenings at intervention sites was 36.2% to 44.6% (n = 4037 employees) and at primary control sites was 34.4% to 43.0% (n = 4106 employees) (mean of 1.3 program modules completed). After 18 months, the rates for 2 self-reported outcomes were higher in the intervention group than in the control group: for engaging in regular exercise and for actively managing weight (69.2% vs 54.7%; adjusted difference, 13.6 percentage points; adjusted P = .02). The program had no significant effects on other prespecified outcomes: 27 self-reported health outcomes and behaviors (including self-reported health, sleep quality, and food choices), 10 clinical markers of health (including cholesterol, blood pressure, and body mass index), 38 medical and pharmaceutical spending and utilization measures, and 3 employment outcomes (absenteeism, job tenure, and job performance).

Conclusions and Relevance  Among employees of a large US warehouse retail company, a workplace wellness program resulted in significantly greater rates of some positive self-reported health behaviors among those exposed compared with employees who were not exposed, but there were no significant differences in clinical measures of health, health care spending and utilization, and employment outcomes after 18 months. Although limited by incomplete data on some outcomes, these findings may temper expectations about the financial return on investment that wellness programs can deliver in the short term.

The article is available in full from JAMA 

In the news:

The Independent Workplace wellness schemes don’t improve productivity or cut absences, trial finds

Community Services: Our time

The latest report of this Provider voices series explores the future of the community services sector in the context of the NHS long term plan. Through ten interviews with representatives from social care, primary care, integrated care systems and community services providers, the authors draw out the common themes, opportunities and challenges | NHS Providers

The NHS long term plan, published in January of this year, puts the community services sector at the forefront of the health service’s drive to deliver truly integrated care. For the first time, community services, along with primary care, will receive a greater than average funding increase. This comes with the expectation they will lead a reimagining of community-based urgent care, working alongside GPs, with whom they will be forging new working relationships via primary care networks (PCNs).

All of the leaders interviewed for this publication expressed a sense of optimism about the community sector in light of the NHS long term plan’s recommendations.

Further detail at NHS Providers

Introducing asthma guidance in Shropshire schools

NHS England | April 2019 | Introducing asthma guidance in Shropshire schools

School nurses in Shropshire have developed and implemented asthma management guidance to provide support and treatment for school children with asthma. 

At the outset the school nursing team undertook an audit of primary and secondary children across Shropshire. Responses demonstrated that:

  • 10% of pupils with asthma had an asthma care plan in place
  • 44% of schools had written guidelines on managing an acute asthma episode
  • 57% of schools had received education and training to support them to manage children with asthma conditions
  • 50% of asthma inhalers kept by schools weren’t appropriate for pupils to use efficiently during an attack

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As a result of this a steering group was established and the group produced guidance on managing asthma in school:

  • Schools should have an identified asthma lead who will act as a key contact and take responsibility in ensuring oversight and coordination of the guidance principles into practice, as well as staff education, training and support;
  • School staff should ensure that children with asthma have their relieving medication with them in school and take steps where this isn’t the case to maximise safety;
  • Children with asthma should have easy access to their relieving medication at all times while in school;
  • Children with asthma should have an individual healthcare plan highlighting their specific triggers and symptoms;
  • School staff should document when children take their medication, self-administered or otherwise; and,
  • School staff should be equipped and trained to manage an acute asthma attack within the school setting. (Source: NHS England)