NHS England | September 2018 | GP online services good practice support and resources guide
The GP online services team is committed to sharing best practice to support you to implement and effectively promote online services. It has produced a guide to provides a wide range of best practice examples from practices across England; all of which vary in location, size, system supplier and demographics (Source: NHS England).
NHS England| August 2018 | Patient Participation Groups: What you need to know about GP Online Services
This resource is for patient participation group members (PPGs) to provide a clearer picture of GP Online Services and how it works for patients, along with NHS England believe it will help transform primary care (GP Practices) and patient care.
The document outlines benefits to patients and GP practices and their staff. It also explains how patient participation group members can support the programme and their practice by spreading the word and raising awareness about online services.
NIHR| August 2018 | Healthcare in 2088 – how will research and innovation transform the NHS in the next 70 years?
In a new post on the NIHR blog Professor Mike Trenell, Director at NIHR Innovation Observatory, envisages how the NHS might look in 70 years’ time. Acknowledging the difficulty in making predictions about the future of the NHS even in a decade’s time, he writes that it is much more problematic to prepare further ahead. Instead, Professor Trenell and his colleagues at the NIHR Innovation Observatory keep an eye on what the future holds. Helping the NHS and healthcare leaders to understand future medicines, devices and diagnostics helps to shape policy, regulation and approvals and stimulate research activity.
They identify three areas that will influence the future of healthcare
Digital Healthcare: In the future, whether you access a GP through a video call, artificial intelligence is used to interpret your MRI scan, or your phone lets you know what dose of a drug to take – digital healthcare holds the potential to fundamentally change how we access and provide care.
Changing Genes: The ability to alter genetic coding was established in 2012, a technology called Clustered Regularly Interspaced Short Palindromic Repeats – CRISPR. But scientists and care teams have translated this into ways to tailor immune therapies to attack cancers or cut out mutations that cause disease.Research taking place in this area right now provides a glimpse of how gene editing might affect future care. For example, researchers funded by the NIHR’s Efficacy and Mechanism Evaluation (EME) Programme are conducting a clinical trial looking at using gene therapy to replace the faulty gene that causes the incurable eye disease choroideremia with a healthy one.
The ability to modify genes will have deep implications for the management and prevention of some diseases, but it will also have deep societal and ethical implications.
Looking after ourselves This area is not an innovation by definition, but it will have important implications for us all. Today the NHS has developed into a world leading health care provision service, but is being challenged by the pressures being put upon it. Obesity rates continue to rise and physical activity levels falling. Although the NHS is keeping us alive longer, it comes at a very real financial and individual cost (are the extra years actually of a quality we would like?).We are moving from an era of biomedical enlightenment into a realisation of its limitations. The future will involve a greater balance of disease prevention and public health as well as disease management – we need to revisit the original remit of the NHS and create a “wellbeing culture”. (Source: NIHR)
The full unabridged blog post is available from NIHR
NHS Employers| July 2018| Future of work: the impact of technology and avoiding solutioning
A new podcast from NHS Employers includes discussion around Wilson Wong, head of insights and futures at CIPD, recent presentation to conference delegates at the NHS Confederation’s 2018 annual conference.
Wilson argues that paying attention to the drivers that are shaping our futures will enable us to put some shape to these futures and consequently act on any blind spots in strategic thinking. He also touches on how the NHS could apply futures methodology to its work, referencing Professor Topol’s review on the NHS Workforce (Source: NHS Confederation).
“We can say with confidence that teens who were exposed to higher levels of digital media were significantly more likely to develop ADHD symptoms in the future” says Professor Adam Leventhal of the Keck School of Medicine of USC discussing the findings of a study that has now been in the JAMA (Journal of the American Medical Association). The research assessed young people’s digital media usage any association between occurrence of ADHD symptoms during adolescence and tracked almost 2600 teenagers over a 24-month period.
The research team’s findings indicate that teens who are heavy users of digital devices are twice as likely as infrequent users to show symptoms of attention-deficit/hyperactivity disorder (ADHD), the study finds. Unlike earlier studies on this topic which were conducted before social media, mobile apps and tablets existed, this study included digital media which Leventhal explains “has increased digital media exposure far beyond what’s been studied before.”
While the researchers acknowledge the study does not show causation there was a significant association between higher frequency of modern digital media use and subsequent symptoms of ADHD over a two-year follow-up. 9.5 percent of the 114 children who used half the digital media platforms frequently and 10.5 percent of the 51 kids who used all 14 platforms frequently showed new ADHD symptoms. By contrast, 4.6 percent of the 495 students who were not frequent users of any digital activity showed ADHD symptoms, approximate to background rates of the disorder in the general population (via Science Daily).
Importance Modern digital platforms are easily accessible and intensely stimulating; it is unknown whether frequent use of digital media may be associated with symptoms of attention-deficit/hyperactivity disorder (ADHD).
Objective To determine whether the frequency of using digital media among 15- and 16-year-olds without significant ADHD symptoms is associated with subsequent occurrence of ADHD symptoms during a 24-month follow-up.
Design, Setting, and Participants Longitudinal cohort of students in 10 Los Angeles County, California, high schools recruited through convenience sampling. Baseline and 6-, 12-, 18-, and 24-month follow-up surveys were administered from September 2014 (10th grade) to December 2016 (12th grade). Of 4100 eligible students, 3051 10th-graders (74%) were surveyed at the baseline assessment.
Exposures Self-reported use of 14 different modern digital media activities at a high-frequency rate over the preceding week was defined as many times a day (yes/no) and was summed in a cumulative index (range, 0-14).
Main Outcomes and Measures Self-rated frequency of 18 ADHD symptoms (never/rare, sometimes, often, very often) in the 6 months preceding the survey. The total numbers of 9 inattentive symptoms (range, 0-9) and 9 hyperactive-impulsive symptoms (range, 0-9) that students rated as experiencing often or very often were calculated. Students who had reported experiencing often or very often 6 or more symptoms in either category were classified as being ADHD symptom-positive.
Results Among the 2587 adolescents (63% eligible students; 54.4% girls; mean [SD] age 15.5 years [0.5 years]) who did not have significant symptoms of ADHD at baseline, the median follow-up was 22.6 months (interquartile range [IQR], 21.8-23.0, months). The mean (SD) number of baseline digital media activities used at a high-frequency rate was 3.62 (3.30); 1398 students (54.1%) indicated high frequency of checking social media, which was the most common media activity. High-frequency engagement in each additional digital media activity at baseline was associated with a significantly higher odds of having symptoms of ADHD across follow-ups. This association persisted after covariate adjustment. The 495 students who reported no high-frequency media use at baseline had a 4.6% mean rate of having ADHD symptoms across follow-ups vs 9.5% among the 114 who reported 7 high-frequency activities and vs 10.5% among the 51 students who reported 14 high-frequency activities.
Conclusions and Relevance Among adolescents followed up over 2 years, there was a statistically significant but modest association between higher frequency of digital media use and subsequent symptoms of ADHD. Further research is needed to determine whether this association is causal.
Ra CK, Cho J, Stone MD, et al |Association of Digital Media Use With Subsequent Symptoms of Attention-Deficit/Hyperactivity Disorder Among Adolescents| JAMA| 2018| 320| (3)|P.255–263| doi:10.1001/jama.2018.8931
The article can be requested by Rotherham NHS staff here
Health Education England | June 2018 | The Topol ReviewPreparing the healthcare workforce to deliver the digital future
Health Education England (HEE) has published its interim report on preparing the healthcare workforce for future developments. The review is considering four key questions:
How are technological (genomics, digital medicine, artificial intelligence (AI) and robotics) and other developments likely to change the roles and functions
of clinical staff and their support in all professions over the next two decades?
What are the implications of these changes for the skills required?
For which professions or sub-specialisms are these likely to be particularly significant?
What does this mean for the selection, curricula, education, training, development and lifelong learning of current and future NHS staff?
Based on its work so far, HEE’s Review is proposing three key principles, which should govern the NHS’s future workforce strategy, these are: • Patients: If willing and able to do so, will be empowered by new tools to become more actively involved and engaged in their care. The patient generated data will be interpreted by algorithms enabling personalised self-management and self-care.
• Evidence: The introduction of any technology must be grounded in robust research evidence and a fit for purpose and ethical governance framework that patients, public and staff can all trust.
• Gift of time: Whenever possible, the adoption of technology should be used to give more time for care, creating an environment in which the patient-clinician relationship is enhanced.
The Interim Report June 2018- A Call for Evidence is at HEE