Making hospitals safe for people with diabetes

Diabetes UK | October 2018 | Making hospitals safe for people with diabetes

The report from Diabetes UK has been created by an alliance of groups and individuals striving to improve hospital care for people with diabetes. Thorough engagement with diabetes inpatient teams, ward staff, people with diabetes and hospital management means we now understand the depth of the challenges facing the NHS in improving diabetes inpatient care. For their report, Diabetes UK visited
hospitals across the country to find out what works.

Making hospitals safe Diabetes UK

Image source: Diabetes.org.uk

The report outlines six points that the UK needs to make hospitals safer for people with diabetes.

  • multidisciplinary diabetes inpatient teams in all hospitals
  • strong clinical leadership from diabetes inpatient teams
  • knowledgeable healthcare professionals who understand diabetes
  • better support in hospitals for people to take ownership of their diabetes
  • better access to systems and technology
  • more support to help hospitals learn from mistakes.

The report outlines these points in more detail and highlights what needs to be in place in all acute hospitals across England to make sure every stay for someone with diabetes is safe.

The report’s recommendations are based on models from across the UK which have been shown to improve patient care (Source: Diabetes UK).

Simplifying research arrangements to improve patient care

NIHR | October 2018 | Simplifying research arrangements to improve patient care

From this month new arrangements are coming into place to better manage excess treatments costs in non-commercial research, as well as plans to reduce delays and improve commercial clinical research set up and reporting. This will simplify and improve research arrangements, which will ultimately improve future health and care for patients.

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This work follows a joint statement published by NHS England and the NIHR, committing to 12 actions to support and apply research in the NHS. In connection with this a public consultation was carried out by NHS England alongside partners including the NIHR, which centred around two of the twelve actions focusing on excess treatment costs and commercial clinical research (Source: NIHR).

Related: NHS England’s Research Needs Assessment 2018

 

Full details from NIHR Supporting and applying research in the NHS

Transforming care- Is it working?

BBC Radio 4| October 2018 | Transforming care is it working?

According to figures obtained and reported by BBC Radio 4, patients with learning disabilities are 50 per cent more likely to be physically restrained, despite ministers condemning their use.  File on 4 finds that a key milestone to reduce inpatient beds by by March 2019 and to transform the lives of people who have been previously been ‘stuck’ in institutional settings is in danger of being missed (BBC Radio 4). 

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Radio 4 Transforming Care- Is it working? The full episode is vailable on the BBCiPlayer Radio 

BBC News Shameful’ use of restraints on disabled patients

The Independent Restraint on adults with learning disabilities soars by nearly 50% in a year, figures show

See also: The Guardian Physical restraint used on 50% more NHS patients with learning disabilities

Resources to support safer modification of food and drink

NHS Improvement | June 2018Resources to support safer modification of food and drink

NHS Improvement has  issued a resource alert to eliminate use of the imprecise term ‘soft diet’ and assist providers with safe transition to the International Dysphagia Diet Standardisation Initiative (IDDSI) framework, which introduces standard terminology to describe texture modification for food and drink.


Resources to support safer modification of food and drink are here

In the media:

BBC News Patients ‘choked on hospital soft food’

The Telegraph  Safety alert after hospital patients choke on hash browns and peas

Mail Online Hundreds of NHS patients have choked, with two DYING, after being fed solid food when it should have been minced or puréed because they had difficulty swallowing, reveals damning report

Allied Health Professions supporting patient flow

This quick guide demonstrates how NHS emergency care, in particular patient flow through the health and care system, benefits from allied health professionals | NHS Improvement

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Bringing the AHP workforce into patient flow planning can improve quality, effectiveness and productivity.

Each section gives a brief overview of the contribution that AHPs have made to deliver safe, effective patient care and flow, followed by case studies which demonstrate how AHPs:

  • work in the community keeping people safe and well at home
  • ‘front door’ assess, diagnose and treat patients in emergency departments, ambulatory care and assessment units
  • support avoidance of hospital admission
  • enable early rehabilitation and reducing overnight admissions
  • drive ‘Home First’ (discharge to assess) to avoid in-hospital deconditioning of frail, older people.

Full detail: Quick guide: allied health professions supporting patient flow

More than 50 % of patients visiting GPs have multimoribidities, finds Cambridge University study

A new study that is published in the British Journal of General Practice demonstrates that over 14 million people in England have multimorbidities. The researchers provide an up-to-date and comprehensive description of multimorbidity — where patients have two or more currently active, long term conditions.  They found over 50 per cent of GP consultations are now with patients with multimorbidity.
This study looked at the experiences of 404,000 patients within the Clinical Practice Research Datalink (CPRD).  CPRD database is a nationally owned resource of millions of anonymised patient GP records, over the last 30 years it has underpinned 2,000 research articles (via Cambridge University)
heart-1698840_1280The full article can be accessed from the British Journal of General Practice 

Abstract

Background
Multimorbidity places a substantial burden on patients and the healthcare system, but few contemporary epidemiological data are available.

Aim To describe the epidemiology of multimorbidity in adults in England, and quantify associations between multimorbidity and health service utilisation.

Design and setting Retrospective cohort study, undertaken in England.
Method The study used a random sample of 403 985 adult patients (aged over 18 years), who were registered with a general practice on 1 January 2012 and included in the Clinical Practice Research Datalink. Multimorbidity was defined as having two or more of 36 long-term conditions recorded in patients’ medical records, and associations between multimorbidity and health service utilisation (GP consultations, prescriptions, and hospitalisations) over 4 years were quantified.

Results
In total, 27.2% of the patients involved in the study had multimorbidity. The most prevalent conditions were hypertension (18.2%), depression or anxiety (10.3%), and chronic pain (10.1%). The prevalence of multimorbidity was higher in females than males (30.0% versus 24.4% respectively) and among those with lower socioeconomic status (30.0% in the quintile with the greatest levels of deprivation versus 25.8% in that with the lowest). Physical–mental comorbidity constituted a much greater proportion of overall morbidity in both younger patients (18–44 years) and those patients with a lower socioeconomic status. Multimorbidity was strongly associated with health service utilisation. Patients with multimorbidity accounted for 52.9% of GP consultations, 78.7% of prescriptions, and 56.1% of hospital admissions.

Conclusion
Multimorbidity is common, socially patterned, and associated with increased health service utilisation. These findings support the need to improve the quality and efficiency of health services providing care to patients with multimorbidity at both practice and national level.

Full reference: Cassell, A. et al  | 2018 |The epidemiology of multimorbidity in primary care: a retrospective cohort study | British Journal of General Practice |ePub |  D

Workload in general practice

Ensuring patient safety through control of workload and demand management in general practice | The British Medical Association (BMA)

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General practice in England has seen consultation rates soar by nearly 14 per cent between 2007 and 2014, while the 12 months between 2016-17 saw the total number of full-time equivalent GPs fall by 3.4 per cent.

The BMA suggest that this increase in workload is because of growing patient need (complex multi-morbidity) as well as a result of the widespread recruitment and retention crisis and a lack of long-term investment in general practice. It is argued that the issue of GP workload must be addressed urgently.

This document seeks to address the current challenges in primary care.  It sets out a strategy aimed at improving safety and quality of patient care by recommending the development of agreed workload limits at a local level supported by national guidance.

Full document: Workload Control in General Practice. Ensuring Patient Safety Through Demand Management