Friday 31 May 2013

Homes to be built on former Rushden hospital site

Homes to be built on former Rushden hospital site:
More than 100 homes will be built on the site of the former Rushden Hospital later this year, prompting a mixed reaction from residents. Evening Telegraph

Corby care home resident pushed by his head

Corby care home resident pushed by his head:
A former care worker at a Corby residential home pushed a resident with mental health problems into his room by his head as he lay on the floor, a court heard. Evening Telegraph

Stress-busting NHS staff scheme expands

Stress-busting NHS staff scheme expands:
 The scheme is meant to help foster a culture of compassionate patient care among NHS staff
Health & Social Care news from Public Service

An NHS for the digital generation

An NHS for the digital generation:
In the West, we have become used to improved living standards for the past fifty or more years. But there are concerns that the cost of healthcare is becoming unaffordable. EHI News

Social media in education and research

Social media in education and research:
The information in this document may be particularly helpful for both NHS and university staff involved in formulating local learning development agreements. NHS Networks

Physical activity: brief advice for adults in primary care

Physical activity: brief advice for adults in primary care:
This guidance aims to support routine provision of brief advice on physical activity in primary care practice. The recommendations include: identifying adults who are inactive; delivering and following up on brief advice; and incorporating advice in commissioning. It is aimed at commissioners of health services and anyone working in primary care whose remit includes offering lifestyle advice. Kings Fund Blogs

High-dose painkiller heart risk: small but significant

High-dose painkiller heart risk: small but significant:

"Study links painkillers to increased risk of heart attack," The Independent reports. This major study found that high doses of the non-steroidal anti-inflammatory drugs (NSAIDs) type of painkiller increased the risk of serious conditions such as heart attacks.
NSAIDs, such as ibuprofen, diclofenac, naproxen and coxibs, are widely used to relieve pain and inflammation.
Many people with painful long-term conditions, such as rheumatoid arthritis, are prescribed high doses of NSAIDs on a long-term basis. It is thought that these people have an increased risk of serious heart conditions compared with those who just take an occasional low-dose ibuprofen pill for a headache.


This new review of hundreds of studies found that coxibs and diclofenac increased the risk of major vascular events – mainly heart attacks – by a third, while ibuprofen was also associated with a greater risk of heart attack. High-dose naproxen did not affect the risk of heart attack.
The actual risk to individuals is small. For example, this study found that for every 1,000 patients taking a high dose of coxib or diclofenac for a year, three more had a major vascular event, one of which was fatal, compared with placebo.
Every treatment comes with both benefits and risks. Your doctor can provide you with information to allow you to make an informed choice and can help you to weigh the benefits of these painkillers against this small risk of a serious side effect.

Where did the story come from?

The study was carried out by researchers from the University of Oxford and was funded by the UK Medical Research Council and the British Heart Foundation. It was published in the peer-reviewed medical journal The Lancet.
It was widely reported in the UK media, and the quality of the reporting was generally of a high standard. Unlike in previous ‘drug-scare’ stories most media sources put the individual risk in its proper context, explaining that it is very small. They also reported the comments made by the researchers that people taking the occasional low dose of an NSAID are unlikely to be at risk.

What kind of research was this?

This research involved meta-analyses of randomised controlled trials (RCTs), including nearly 354,000 participants. The study looked at the risks of NSAIDs compared with placebo treatment and the comparable risks of different NSAIDs. Popular NSAIDs include the older types – ibuprofen, diclofenac, naproxen – and newer cox-II inhibitors (coxibs). Coxibs include celecoxib, etoricoxib and rofecoxib (rofecoxib was withdrawn from the market in 2004 because of concerns over an increased risk of heart attack and stroke).
The researchers were particularly interested in the risk of major cardiovascular events and gastrointestinal complications. They point out that previous research has found that both older and newer types of NSAIDs have a risk of vascular events, while the newer coxib-type NSAIDs are thought to have fewer gastrointestinal effects than older NSAIDs.
This review aimed to provide more accurate estimates of the size, timing and severity of the risk, among different types of patients.

What did the research involve?

The researchers carried out searches of randomised controlled trials that either compared the risks of NSAIDs with placebo treatment or compared the risk of one NSAID with another. The main risks they looked at were of major vascular and coronary events (heart attack, coronary death, stroke, death from any of these and heart failure) and of gastrointestinal complications (perforation of the stomach lining, obstruction or bleeding).
They searched various electronic databases, clinical trial registers, reference lists of relevant papers and also made contact with pharmaceutical companies. Trials (up to 2011) were eligible if they were properly randomised, lasted at least four weeks and compared an NSAID with either a placebo (or open control) or another NSAID.
All trials were reviewed for their eligibility by two researchers, who recorded the key characteristics of the trials that might affect the risk of bias (such as method of randomisation). Where possible, the researchers used data on individual participants or aggregate data (a standard format of results provided by the original researchers). They used standard meta-analytical techniques to give estimates of the risks.

What were the basic results?

The researchers included 639 trials in their analysis. Almost all trials involved a coxib or a high-dose NSAID (diclofenac 150mg daily, ibuprofen 2,400mg daily, naproxen 1,000mg daily).
  • Coxibs and diclofenac increased the risk of a major vascular event by about a third (coxibs rate ratio (RR) 1.37, 95% confidence interval (CI) 1.14–1.66; diclofenac RR 1.41, CI 1.12–1.78). Most of this increased risk was due to an increase in major coronary events such as heart attack.
  • Ibuprofen also significantly increased major coronary events (RR 2.22, CI 1.10–4.48), but not major vascular events, such as stroke.
  • Of 1,000 patients allocated to a coxib or diclofenac for a year, three more had major vascular events (one of which was fatal) compared with placebo.
  • Naproxen did not significantly increase major vascular events (RR 0.93, CI 0.69–1.27).
  • The risk of death from a vascular event was increased significantly by coxibs (RR 1.58, 99% CI 1.00–2.49) and diclofenac (RR 1.65, CI 0.95–2.85), but the increase seen with ibuprofen (RR 1.90, CI 0.56–6.41) and naproxen (RR 1.08, 0.48–2.47, p=0.80) was not significant.
  • Heart failure risk was roughly doubled by all NSAIDs.
All NSAIDs increased upper gastrointestinal complications:
  • naproxen RR 4.22, CI 2.71–6.56
  • ibuprofen RR 3.97, CI 2.22–7.10
  • diclofenac RR 1.89, CI 1.16–3.09
  • coxibs RR 1.81, CI 1.17–2.81
A further hypothetical analysis by the researchers indicated that the increased risk of heart attacks is highest in those with a previous history of heart disease or risk factors such as high cholesterol.

How did the researchers interpret the results?

The researchers say that the vascular risks of high-dose diclofenac, and possibly ibuprofen, are comparable to coxibs, whereas high-dose naproxen is associated with less vascular risk than other NSAIDs.
Although NSAIDs increase vascular and gastrointestinal risks, they say that the size of these risks can be predicted, which could help guide doctors making decisions on medications for their patients.

Conclusion

This large review adds to, and expands on, the current evidence on the risks of vascular disease and gastrointestinal complications for different NSAIDs. It largely concentrates on trials of high doses of NSAIDs that can only be prescribed by a doctor. It is unclear from this study whether there is any risk from taking lower doses available over the counter. While most experts advise that low-dose NSAIDs, taken occasionally, are safe for most people, an accompanying editorial points out that there are still “large gaps” in evidence on the risks with lower doses of NSAIDs.
While the risk to individuals is small, it is important to remember that high doses of NSAIDs are used by millions of people worldwide to manage chronic pain, for example from arthritis.  Even a one in 1,000 risk of NSAID-associated death would amount to 1,000 deaths in a population of 1 million. Such risks are worth bearing in mind when deciding on treatment with your doctor.
This means that any evidence that improves the safety of prescribing of this kind of medication is vital. The evidence presented in this study is likely to be of particular interest to organisations that advise doctors on which drugs to prescribe, such as NICE (the National Institute for Health and Care Excellence).
As an accompanying editorial argues, “identification of safe and effective strategies for chronic pain is sorely needed. In the meantime, long-term use of high dose NSAIDs should be reserved for those who receive considerable symptomatic benefit from the treatment and understand the risks”.
Anyone concerned about using NSAIDs on a long-term basis should seek the advice of their GP or the doctor in charge of their care.

NHS Choices 


Links To The Headlines

Study links painkillers to increased risk of heart attack. The Independent, May 30 2013
Painkiller taken for arthritis is heart risk. The Daily Telegraph, May 30 2013
Painkillers taken by millions could increase heart risk: Prolonged use 'leads to significant danger'. Daily Mail, May 30 2013
Common painkillers 'pose heart risk'. BBC News, May 30 2013
Painkillers may increase risk of heart attacks, strokes and death. Metro, May 30 2013
Painkillers 'could increase risk' of heart problems. ITV News, May 30 2013


Links To Science

Coxib and traditional NSAID Trialists' (CNT) Collaboration. Vascular and upper gastrointestinal effects of non-steroidal anti-inflammatory drugs: meta-analyses of individual participant data from randomised trials. The Lancet. Published online May 30 2013

World Health Organisation warns against 'threat to the entire world' from new Sars-like virus

World Health Organisation warns against 'threat to the entire world' from new Sars-like virus:
A new Sars-like virus discovered in humans could pose “a threat to the entire world”, the World Health Organisation warned this week. Independent

Hospital admissions linked to alcohol rise to more than a million in year

Hospital admissions linked to alcohol rise to more than a million in year:
Doctors repeat call for alcohol pricing rule to deter heavy drinkers as Alcohol Concern warns of lack of help for addiction
An estimated 1.22m hospital admissions in England were linked to drinking too much alcohol in 2011-12, according to NHS figures – a 51% rise over the past nine years.
Drug prescriptions to treat alcohol dependency outside hospital are also continuing to go up. Nearly 180,000 prescriptions were dispensed by doctors, nurses and pharmacists in 2012, 6% up in a year and nearly 75% more than in 2003.
Hospital admissions for which drink was the main cause rose to 200,900 in 2011-12, 1% more than the previous year, and more than 40% up on 2002-03.
Men accounted for three in five of the patients whose alcohol consumption was the main reason for admission. Admission rates were highest in north-west England and lowest in the east.
The bleak figures prompted doctors to call again for minimum alcohol pricing, which is the subject of a legal battle between the drinks industry and the Scottish government and is still formally under consideration in England although there is little ministerial appetite for it.
Nick Sheron, adviser on alcohol at the Royal College of Physicians, said the rise in prescriptions of drugs indicated "the huge strain alcohol abuse puts on our society" but focused on the admissions.
He added: "Today's statistics show that in 2012, hospitals in England admitted 200,900 cases where the main reason for admission was an alcohol-related condition.
"The rise in alcohol addiction is being driven by cheap alcohol. A minimum unit price for alcohol would effectively tackle this problem. In Canada, a 10% increase in minimum unit price caused a 32% reduction in deaths.
"Our own research in Southampton shows that a minimum unit price of 50p would, on average, cost patients with alcohol dependency and cirrhosis an additional £36 a week.
"The impact on moderate drinkers was less than 30p a week, because these patients simply do not drink the ultra-cheap, ultra-strong booze. Minimum unit pricing is targeted at very heavy drinkers whose families are devastated by the impact that drinking has on their lives."
Emily Robinson, director of campaigns at the charity Alcohol Concern, said that the government "must get a grip and implement measures that will prevent this urgent situation from getting worse … The real issue is the vast numbers of people who are not getting help for their alcohol addiction. We estimate that only one in 16 people with alcohol problems is receiving specialist help as there is just not enough treatment available."
A Department of Health spokesman said the figures proved alcohol was causing harm to the health of hundreds of thousands of people.
"That is why we are already improving prevention by funding alcohol risk assessments at GPs and encouraging increased access to alcohol liaison nurses in hospitals.
"The alcohol industry has also pledged to take one billion units out of the market by 2015 and we have consulted on a range of options to tackle irresponsible practices and strengthen local licensing powers."
A British Beer and Pub Association spokesman said: "Alcohol misuse remains a problem for a minority and is something we must all work to tackle. Nevertheless, key trends are moving in the right direction."
Guardian

New Cochrane review finds that NRT, bupropion and varenicline are effective treatments for smoking cessation

New Cochrane review finds that NRT, bupropion and varenicline are effective treatments for smoking cessation: Smoking is the main preventable cause of premature illness and death worldwide. Approximately 20% of deaths in men and 5% in woman over 30 can be attributed to smoking. The World Health Organization (WHO) estimates that 6 million people die from smoking related disease each year, with tobacco being the number one risk factor for [read the full story...] Mental Elf

No proof coffee causes obesity and diabetes - NHS Choices

No proof coffee causes obesity and diabetes - NHS Choices:

NHS Choices
Go to NHS Choices homepage Your health, your choices. Information navigation. Search entire site. Enter a search term: Main navigation. Health A-Z. Hundreds of conditions explained; Arthritis information; Asthma information; Back pain information ...

and more »

Thursday 30 May 2013

Air ambulance paramedics given go-ahead to use advanced medication

Air ambulance paramedics given go-ahead to use advanced medication:
Paramedics for Warwickshire & Northamptonshire Air Ambulance will now be able to administer even more advanced care when they are called to accidents and emergencies across the county. Evening Telegraph

Delivering high quality, effective, compassionate care: developing the right people with the right skills and the right values

Delivering high quality, effective, compassionate care: developing the right people with the right skills and the right values:
 This mandate to HEE includes a comprehensive and wide-ranging series of measures and is intended as a blueprint for NHS staff training. It emphasises the importance of training for support staff providing community care, and preventing patients with long term conditions for example needing to go into hospital. Kings Fund Blogs

Insights into Developing Caring Cultures: a review of the experience of The Foundation of Nursing Studies

Insights into Developing Caring Cultures: a review of the experience of The Foundation of Nursing Studies: This report outlines insights from the Caring Cultures programme of work, which aimed to help nurse-led teams to create healthcare workplaces that are conducive to the delivery of high quality care, and provide a supportive place for staff to work. Kings Fund Blogs

NHS England announces new technical guidance to improve patient care

NHS England announces new technical guidance to improve patient care:
NHS England has today published guidance for GP practices explaining how better use of anonymised patient information from general practice will help commissioners improve the quality, efficiency, and equity of health care services.
The GP Technical Specification and its associated guidance was developed in partnership with the British Medical Association and Royal College of General Practitioners. The document explains the process of how data from general practice will be collected, anonymised and used to improve patient care.
The initiative is designed to link information from general practice, with information from hospitals and community health care services.  This will help the NHS evaluate and improve the quality and safety of the NHS, and enables patients to make more informed choices about the treatments and services they use.
The data will be held in a secure, controlled environment and will be made available to NHS organisations in anonymised form.
The data will be used to support local health and care commissioners by giving them access to timely and accurate information that they can use to plan health services that best fit the needs of their local community.
Implementation will start with a small number of practices to test the process, and GP practices will be written to well in advance of any extract so that they can raise awareness with patients about the new service.

Notes
For further information, please contact NHS England at nhscb.media@nhs.net or call 07768 901293
GP practices will be contacted directly with further details and materials in June.
NHS

Overcrowded A&E units forced to turn away ambulance calls on 350 occasions

Overcrowded A&E units forced to turn away ambulance calls on 350 occasions:
NHS hospitals were forced to shut their doors to ambulances on more than 350 occasions last year because they were too full to cope with more emergency patients.
Independent

'Virtual wards' urged as answer to strain on NHS

'Virtual wards' urged as answer to strain on NHS:
Report urges patients to opt for 'virtual ward', saying they can be back at home within hours after treatment
The NHS is being urged to relieve the pressure on hard-pressed hospitals by treating thousands of patients in "virtual wards" – at home, with regular visits from health staff replacing long stays on wards.
The service could create 5,800 "virtual beds" in people's homes to help hospitals cope with bed shortages and overcrowded A&E units deal with patients arriving as emergencies, a new report says.
A few hospitals have begun treating certain types of patients this way in an effort to provide a patient-friendly response to growing demand at a time when NHS budgets are tight. In some places up to 35 patients a week, whom doctors agree do not need to be kept in hospital, are being cared for this way.
Patients who agree to have their treatment in a virtual ward can avoid anything more than a few hours of treatment at hospital before being discharged to such care.
Advocates of virtual wards claim that patient satisfaction with such arrangements is very high and recovery is hastened by being at home. Hospitals save money as virtual wards are cheaper to provide than the typical £250-a-night cost to the NHS of an overnight stay.
The new report is by NHS specialist consultant Alex Kafetz of ZPB Associates in conjunction with the NHS Confederation and some trusts which already operate virtual wards on behalf of private healthcare firm Healthcare at Home. It urges NHS chiefs to dramatically expand the currently patchy provision of such care.
University Hospital Southampton NHS Foundation Trust began looking after small numbers of patients who had undergone surgery such as a hip or knee replacements in virtual wards in 2010. Around 120 mainly elderly patients every month now stay at home, where they receive up to three visits a day from a nurse to change a dressing, give them an injection or check their blood pressure and up to several visits a week from a physiotherapist who helps them regain their mobility through intensive mobilisation.
Jane Hayward, the trust's chief operating officer, said: "Only 2% of patients on the scheme end up back in hospital again compared to the average, which is 7%.
"We started this because we are a big, busy trust and didn't have anywhere else physically to expand into and so needed to think how to do differently."
So far the trust has looked after 2,366 patients this way and saved 14,228 bed days through what it calls "enhanced supported discharge" or "healthcare at home". In a survey 98% of such patients said being at home had benefitted their wellbeing, while 90% were very satisfied with the home care they received.
The Royal Free London NHS Foundation Trust offers a similar service but plans to add video consultations – where the patient can speak directly to their consultant while at home – to the package of care they offer. "Patients absolutely love this service. It's optional. They can choose to stay in or go home, but pretty much all of them go home", said Katie Donlevy, the trusts's director of integrated care. "Medically the care is better than being in hospital because the patient cane recover more quickly at home, especially complex elderly patients, who may otherwise be stuck in a bed in hospital."
A spokeswoman for NHS England said virtual wards were an excellent idea which typified the sort of innovation the NHS needed to embrace in order to meet the growing challenges it is facing.
Denis Campbell Guardian

Study links painkillers to increased risk of heart attack

Study links painkillers to increased risk of heart attack:
Some of the most commonly used painkillers can increase long-term users' heart-attack risk by more than a third, an in-depth study into their side-effects has shown. Independent

Adopting a pharmacy-first approach can improve health and wellbeing

Adopting a pharmacy-first approach can improve health and wellbeing:
Pharmacists could alleviate pressure on GPs, who currently undertake 57 million consultations for minor ailments yearly
As the responsibility for public health is put into the hands of local councils, the pressure is on for clinical commissioning groups to improve the quality of service provided to the public. A new report, The Wells Family Challenge: A Pharmacist First Approach, suggests that pharmacists could transform the improvement of health and wellbeing in local communities.
The report, which 2020health worked on closely with the Sainsbury's Pharmacy team, assesses the impact of in-store pharmacy advice on the health and lifestyles of 10 families. Although undertaken on a small scale, the results suggest minimum intervention from a pharmacist over a small amount of time could have a significant impact on public health if replicated on a larger scale. The pharmacists involved in the challenge improved health literacy levels, and in doing so provided much more than a service to treat coughs and colds. They actually helped prevent illness – a function that GP surgeries are not always able to fulfil due to competing demands. This demonstrated that they could play a role in alleviating pressure on GPs who currently undertake 57 million consultations each year for minor ailments that could have been dealt with by a pharmacist.
Even more importantly, they could help detect the early signs of cardiovascular disease. In the initial pharmacist visit of the study, 81% of family members who were diagnosed with high cholesterol (68% of the total sample) were completely unaware beforehand, as were almost as many of those suffering from high blood pressure. The health advice given by the pharmacists over the 12 months led to measureable improvements including 65% of adult participants losing weight (an average 4kg), 58% reducing their risk of stroke or heart attack and over a 50% reduction in unhealthy levels of cholesterol. The families found simple advice and strategies offered by the pharmacists such as putting a fruit bowl by the front door to encourage healthy snacking and reducing dinner plate sizes useful in contributing to these kinds of reductions.
Cardiovascular disease costs the NHS £19bn per year. If pharmacists can detect the signs early enough, through providing monitoring services for cholesterol, blood pressure and weight management, and offer the guidance to change habits and prevent the serious effects of prolonged poor lifestyle choices, they could alleviate pressure on NHS services and help reduce costs in the long run.
So within the new NHS landscape, and as local health delivery systems take shape, we need to increase the understanding of the pharmacist's role and the value they bring to preventing ill health and assisting the public in self-managed treatments.
A three-pronged approach needs to be adopted. First, to help clinical commissioning groups succeed in maintaining the health of the population, the measurable impact our 80,000 pharmacists could have on public health should be recognised; pharmacists have a wealth of knowledge and expertise which should be drawn upon in terms of shaping and designing health and wellbeing strategies and addressing the wider determinants of health. Second, Public Health England needs to develop a clear strategy for how local authorities can partner with pharmacies more effectively in order to deliver the range of mandated public health services which they are now responsible for. And third, the NHS Commissioning Board needs to give a clear steer as to the contribution that pharmacists should make in the delivery of services which prevent those illnesses so sadly common in the UK today.
Gail Beer is director of operations at the thinktank 2020health. She worked in the NHS for over 30 years as an executive director at Barts and the London NHS Trust
Guardian

Wednesday 29 May 2013

The new NHS in 2013 infographic poster

The new NHS in 2013 infographic poster: It aims to explain how the new NHS is structured. NHS Employers says the diagram has been simplified for the benefit of patients and staff. NHS Employers

Bird flu drug resistance concern

Bird flu drug resistance concern: Drug resistance has been detected in patients infected with the new bird flu that has emerged in China, say doctors. BBC News

Coronavirus death reported in France

Coronavirus death reported in France: A patient infected with the novel coronavirus has died in France, according to the health ministry, after travelling in Dubai. BBC News

Surgery at end of week 'more risky'

GPs 'risk losing patient trust' over CCG cuts, LMCs warn

GPs 'risk losing patient trust' over CCG cuts, LMCs warn: Commissioning GPs must put patients ahead of CCG finances or risk destroying patient trust in the profession, LMCs have warned. GP Online

Monthly meetings for NHS staff

The potential risks of closing small A&Es

The potential risks of closing small A&Es: Why closing small A&Es may not be the answer. HSJ

Anti-stigma project helps GPs handle people with mental health problems

Anti-stigma project helps GPs handle people with mental health problems: Time to Change hopes its model for raising awareness among primary care staff can be rolled out across the country.
It seems like common sense that the first place someone with a health problem is likely to turn for help is their GP, who is expected to deal with them in an appropriate manner. For people with mental health problems, however, this isn't necessarily the case. According to the anti-stigma campaign Time to Change (TTC), many people experiencing mental distress arrive at the GP surgery to find that primary care professionals are ill-equipped to deal with their needs. Sometimes the sheer volume of work GPs must contend with means there aren't the resources available. But often a lack of awareness and training about mental health issues means patients do not receive the care and attention they need.

New mothers hassled in hospitals by babycare firms, warns Mumsnet

New mothers hassled in hospitals by babycare firms, warns Mumsnet: The online forum Mumsnet has criticsed the “intrusive” sales tactics of a childcare company endorsed by the NHS. Bounty gives out 2.6 million free “baby bags” a year, containing samples of babycare products, money-off coupons and catalogues. They are available in most hospitals. The Independent

See also:

Illustrating Potential Efficiency Gains from Using Cost-Effectiveness Evidence to Reallocate Medicare Expenses

Illustrating Potential Efficiency Gains from Using Cost-Effectiveness Evidence to Reallocate Medicare Expenses: Commonwealth Fund–supported researchers illustrate the potential gains in health and efficiency if decision-makers at the Centers for Medicare and Medicaid Services were to take into account cost-effectiveness when making Medicare coverage decisions. The Commonwealth Fund

Understanding competition and choice in the NHS

Understanding competition and choice in the NHS: "This report examines the changes in the roles of the NHS and the private sector in the funding and provision of two elective in-patient procedures: hip and knee replacements." Nuffield Trust, Institute for Fiscal Studies

Tuesday 28 May 2013

'Lack of support' after intensive care

'Lack of support' after intensive care: A study of former intensive care patients suggests many still suffer pain up to a year after leaving hospital. BBC News

Big rise in medical trial volunteers

Big rise in medical trial volunteers: The number of people volunteering for clinical trials - including one into typhoid - has trebled over the last five years. BBC News

Nursing goes 'back to the future'

Nursing goes 'back to the future': How a Dutch district nursing firm is reshaping care. BBC News

How NICE plans to reshape general practice

How NICE plans to reshape general practice: Professor David Haslam, the new chairman of NICE, believes technology is the key to integration. Stephen Robinson reports. GP Online

Many of the system-wide issues we face won’t be solved by management processes, says Jan Sobieraj

Many of the system-wide issues we face won’t be solved by management processes, says Jan Sobieraj: If the future sustainability of the NHS means its leaders will need to make tough decisions, how can leaders make sure they are making the right ones? In my chief executive roles in the NHS, I’ve made some difficult decisions – some clinical, some financial, many staff related. All had patient and service impact. You … Continue reading » NHS Voices

GPs reject call to take over out-of-hours care

GPs reject call to take over out-of-hours care: Doctors at BMA conference vote almost unanimously against proposal to place them back on call at evenings and weekends
GPs yesterday overwhelmingly reiterated their opposition to taking back responsibility for providing out-of-hours care, with some predicting that many older family doctors would quit if that was imposed on them.

Protect NHS whistleblowers urges consultant who lost job and home after raising concerns

Protect NHS whistleblowers urges consultant who lost job and home after raising concerns: An eminent hospital consultant has called for more protection for NHS whistleblowers after telling how he lost his job and home, and considered taking his life after being unfairly sacked when he raised his concerns about patient safety. The Daily Telegraph

Cap on number of GP visits being considered by Tories

Cap on number of GP visits being considered by Tories:
A cap on the number of times patients can visit their GP in a year is being considered by the Conservative Party, it emerged yesterday. The Independent

See also:

Wellbeing boards are 'missing a chance' to tackle diabetes

Wellbeing boards are 'missing a chance' to tackle diabetes: NHS organisations are "missing an opportunity" to tackle the tide of diabetes, a charity has warned. The Independent

See also:

Jeremy Hunt to outline plans for more GPs

Jeremy Hunt to outline plans for more GPs:
Thousands more medical students will be trained as family doctors under plans to be announced today by Jeremy Hunt, the Health Secretary. The Independent

See also:

Friday 24 May 2013

Inquiry call over NHS 111 'debacle'

Inquiry call over NHS 111 'debacle': An independent inquiry is needed into the NHS non-emergency 111 phone line "debacle" in England, GPs say. BBC News

See also:

Is the NHS going to blow a gasket?

Is the NHS going to blow a gasket?: But is the NHS going to blow a gasket? BBC News

WHO urges sharing over coronavirus

WHO urges sharing over coronavirus: The WHO urges countries with possible cases of novel coronavirus to share information amid concern over patent rights held by commercial labs. BBC News

Section 251ed

Section 251ed: NHS England's director of data and information management, Ming Tang, likens the commissioning board's efforts to sort through the information governance facing the new NHS to "working through treacle." E-Health Insider

Money allocated to general practice will fall by 2016

Transforming care: a national response to Winterbourne View hospital

Transforming care: a national response to Winterbourne View hospital: This final report into the events at Winterbourne View hospital sets out a programme of action to transform services so that vulnerable people no longer live inappropriately in hospitals and are cared for in line with best practice. The actions highlighted include: strengthening accountability of boards of directors and senior managers for safety and quality of care; transferring patients to community-based support where appropriate; and the establishment of a new NHS and local government-led joint improvement team.

Moving care to the community: an international perspective

Moving care to the community: an international perspective: Moving care out of hospitals and into the community has been a UK wide priority for over a decade; however despite the government’s commitment to invest in the community, there is a mismatch between reality and rhetoric. This report sets out the current policies and initiative in the above-mentioned countries to move care closer to home; outlines the impact of these reforms on the nursing workforce; and offers recommendations for key stakeholders in the UK.

Clinical engagement in high-value commissioning: elective surgical procedures

Clinical engagement in high-value commissioning: elective surgical procedures: This casebook describes work led by NHS Right Care on the development of guidance for the commissioning of elective surgical procedures. In
addition to this, two web-based tools have been developed to support and inform the commissioning process.

Research could lead to 'universal' flu vaccine

Research could lead to 'universal' flu vaccine: “Scientists create new flu vaccine that works against many different strains of the virus,” The Independent reports.
This headline, and several others like it, is based on early stage research into the development of alternative flu vaccine technologies. While the results of this research are promising, they do not mean that a universal flu jab has been developed.

Crisis-hit elderly care 'needs money now'

Crisis-hit elderly care 'needs money now': The Coalition will perpetrate a "cruel deception" on elderly people if ministers fail to provide more funding for long-term care to back up their promise to limit costs, the architect of the reforms has warned. The Daily Telegraph

GP leaders clash with Health Secretary, Jeremy Hunt, over A&E crisis

GP leaders clash with Health Secretary, Jeremy Hunt, over A&E crisis: GPs’ leaders have clashed with the Health Secretary, Jeremy Hunt, in their increasingly acrimonious row over who is responsible for the crisis in Accident & Emergency departments. The Independent

See also:

Thursday 23 May 2013

Shocking inspection report reveals East Midlands Ambulance Service is on verge of “falling apart”

Shocking inspection report reveals East Midlands Ambulance Service is on verge of “falling apart”:
A damning inspection report of East Midlands Ambulance Service (EMAC) has revealed it is at “breaking point” and in desperate need of more vehicles and staff. Northampton Chronicle and Echo

See also

Green light for £260 million technology fund to make the NHS safer

Green light for £260 million technology fund to make the NHS safer: Doctors and nurses are to get better information about patients so people get safer care thanks to a new £260 million NHS technology fund, announced by NHS England today.

GPs 'will not shore up unsafe NHS'

GPs 'will not shore up unsafe NHS': Family doctors are not prepared to shore up an emergency health care system left unsafe by "political meddling", a GP leader is to warn in a speech. BBC News

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Community nursing service under fire

Community nursing service under fire: Health unions say the state of NHS services for people who can't get to a GP in many parts of England is "lamentable". BBC News

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GP practice silos 'stifle innovation'

GP practice silos 'stifle innovation': Innovation in primary care has been held back because there are too many small GP practices in England working in 'silos', a senior NHS England official has claimed. GP Online

Patients urged to email or phone GP rather than have a face-to-face consultation

Woman, 31, died after being left with unqualified healthcare worker who mixed up blood samples and scribbled medical records on plastic surgical gloves

Woman, 31, died after being left with unqualified healthcare worker who mixed up blood samples and scribbled medical records on plastic surgical gloves: Michelle Jannetta, from Milton Keynes, died at Milton Keynes Hospital after taking an overdose of painkillers. An inquest heard that staff continued to think she was faking her illness even when she was in a coma. The Daily Mail

Surgeons fear online performance data will damage reputations

Surgeons fear online performance data will damage reputations: Individual rates to be published for the first time in a move hailed as a 'watershed moment' for the profession.
The leader of England's surgeons has warned that the imminent publication of data about individual performance could destroy careers and harm patients if it is wrongly interpreted.

Judges rule back-to-work assessments 'unfair' to mentally ill

Judges rule back-to-work assessments 'unfair' to mentally ill: Iain Duncan Smith's drive to cut the number of people living on disability benefits has suffered a blow after judges ruled that back-to-work assessments discriminate against people with mental health conditions. The Daily Telegraph

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Staff voice fears over quality of care in NHS

Staff voice fears over quality of care in NHS:
Three out of four senior health service staff complain that quality of care is not given sufficient priority in the NHS, according to a survey. The Independent

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Wednesday 22 May 2013

Ambulance service is fined £3.5m

Ambulance service is fined £3.5m: East Midlands Ambulance Service is fined for failing to meet response time targets for a third year. BBC Northamptonshire

Closing the gate before the horse bolts: a new approach to patient safety

Closing the gate before the horse bolts: a new approach to patient safety: The time is now right to move to more actively designing and managing patient safety, says Elaine Maxwell. Health Foundation

Flu drug bill 'shocking waste'

Flu drug bill 'shocking waste': The government squandered taxpayers' money on a drug to treat flu, a public spending watchdog says. BBC News

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NHS help in repairing genital mutilation

NHS help in repairing genital mutilation: NHS clinics help women damaged by female genital mutilation. BBC News

Hunt 'must recognise growing GP crisis', warns RCGP

Hunt 'must recognise growing GP crisis', warns RCGP: The RCGP has hit back at criticism of GPs ahead of a speech this week by health secretary Jeremy Hunt, warning against 'demoralising' talk of tougher regulation. GP Online

Paying for social care: beyond Dilnot

Paying for social care: beyond Dilnot: This report argues that the government reforms alone will not solve the challenge of funding adult social care. It argues that whilst the social care funding cap will provide welcome protection for those who will require long stays in residential care, more should be done to meet mounting financial pressures. It calls for a stronger focus on the challenge of eligibility - ensuring that more people are able to access the right level of support. It also raises concerns that unmet need, and its impact on carers, will place further pressure on an NHS already under significant strain, arguing that it is time to look beyond the Dilnot report at how to secure enough resources to meet current and future needs.

Dying well at home: the case for integrated working

Dying well at home: the case for integrated working: This guide aims to enable people who want to die at home to do so and improving the quality of care they receive. It argues that whilst a good death at home may not be a feasible or desirable death for everyone, it could be a reality for many more people if there are services to support it.

Sharing a bed with your baby ups risk of cot death

Sharing a bed with your baby ups risk of cot death: "Bed-sharing 'raises cot death risk fivefold'," BBC News reports. The news has featured in much of the media, with headlines based on a large analysis of previous studies into the risk of cot death, or sudden infant death syndrome (SIDS), associated with bed-sharing.

Are the mental health needs of people with learning disabilities being met?

Are the mental health needs of people with learning disabilities being met?: Christine Burke, Senior Development Manager talks about our new project with Kings College to explore how people with learning disabilities can more easily access talking therapies (IAPT) in a way that meets their needs. Foundation for People with Learning Disabilities 

NHS funding of private sector rose by £3bn in six years, report says

NHS funding of private sector rose by £3bn in six years, report says: Study shows role of non-NHS providers in delivering NHS-funded care in England has increased dramatically.
Spending on private services by the NHS reached a record £8.7bn last year, a jump of more than £3bn since 2006, according to research.

Casualty units must be reformed to meet demand, says Jeremy Hunt

Casualty units must be reformed to meet demand, says Jeremy Hunt: Accident and Emergency units are so overstretched that they cannot cope with bank-holiday pressures, the Health Secretary has warned. The Daily Telegraph

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Patients should email GP rather than visit them, says leading official

Patients should email GP rather than visit them, says leading official: Patients should email their GP instead of going to see them to free up health services, a leading official said yesterday. The Daily Telegraph

Sir David Nicholson quits: NHS chief steps down in wake of Mid Staffs scandal

Sir David Nicholson quits: NHS chief steps down in wake of Mid Staffs scandal:
The head of the NHS Sir David Nicholson is to step down from his role, it was announced today, following a sustained and sometimes virulent campaign to force his resignation over the Mid Staffordshire scandal. The Independent

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Hospitals freeze A&E targets - because they can’t hit them

Hospitals freeze A&E targets - because they can’t hit them:
Hospitals across Britain have been forced to suspend targets to see accident and emergency patients within four hours because they can no longer cope with demand, doctors and managers have warned. The Independent

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Tuesday 21 May 2013

Impact assessment: Antibiotic Resistance - a Threat to Global Health Security and the Case for Action

Impact assessment: Antibiotic Resistance - a Threat to Global Health Security and the Case for Action:
The UK delegation to the World Health Assembly in Geneva, led by Health Secretary Jeremy Hunt and Chief Medical Officer Professor Dame Sally Davies, is calling for international action to tackle the growing problem of fewer medicines to tackle the soaring number of antibiotic-resistant infections.

This publication contains written reports detailing ways in which countries are tackling Antimicrobial resistance (AMR). It will form the basis for discussions at a side-event at WHA to be held on 21 May and which will be hosted by the UK. Department of Health

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What kind of NHS can Britain afford?

What kind of NHS can Britain afford?: As costs soar, how must the health service change? BBC News

Health Secretary Jeremy Hunt to launch attack on failings of inaccessible family GPs

Health Secretary Jeremy Hunt to launch attack on failings of inaccessible family GPs: In a major speech, Health Secretary Jeremy Hunt will condemn the scandal of out-of-hours services where 'you speak to a doctor who doesn't know you from Adam'. The Daily Mail

NHS urged to improve use of drips

NHS urged to improve use of drips: The lives of hospital patients who are put on a drip are being placed at risk by poor attention by staff to intravenous fluid care, experts warn. BBC News

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Chief inspector of GPs post created

Chief inspector of GPs post created: A chief inspector of GPs is to be appointed as part of a push to improve services outside of hospitals, ministers are set to announce. BBC News

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Joint 'NHS and care budget needed'

Joint 'NHS and care budget needed': Ministers have been told they must go further with their overhaul of social care in England by merging its budget with the NHS. BBC News

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Fatal 'superbug' not being monitored

Fatal 'superbug' not being monitored: One of the most concerning classes of hospital 'superbug' is not being tracked by the Department of Health, it is revealed. BBC News

Blaming GPs for A&E pressure 'threatens future of CCGs'

Blaming GPs for A&E pressure 'threatens future of CCGs': CCGs are at risk from GP workload pressure and the 'fire-storm' being whipped up over out-of-hours provision, a commissioning leader has warned. GP Online

More than 6,000 hospital beds lost

More than 6,000 hospital beds lost: More than 6,000 hospital beds have been closed since the Coalition came to power in the last election, at a time when accident and emergency departments are struggling to cope with a rise in the number of patients. The Daily Telegraph

Care cap becoming 'irrelevant' as 'crisis-mode' system excludes all but a few, report finds

Care cap becoming 'irrelevant' as 'crisis-mode' system excludes all but a few, report finds: The number of elderly people receiving help with their care has dropped by a fifth in just four years as councils support only to those at "crisis-point", think-tank says. The Daily Telegraph

Top A&E doctors warn: 'We cannot guarantee safe care for patients anymore'

Top A&E doctors warn: 'We cannot guarantee safe care for patients anymore':
The Accident & Emergency crisis is now so severe that doctors can no longer guarantee safe care for patients, NHS officials have warned in a leaked letter seen by The Independent.

Older people with high support needs in housing with care

Older people with high support needs in housing with care: Housing with care (HWC) offers a promising model for improving the quality of life of older people with high support needs, but also poses challenges. This Round-up covers key messages and practice examples from JRF studies into three aspects of HWC: promoting supportive and positive relationships; boundaries of roles and responsibilities; and affordability, choices and quality of life. The Joseph Rowntree Trust

Monday 20 May 2013

Health bus to pull up in Northampton - Northampton Herald and Post


Health bus to pull up in Northampton Sponsored by Pfizer in a joint-initiative with Northamptonshire Healthcare NHS Foundation Trust (NHFT) Stop Smoking Service and local Pharmacy services, the bus is a great way to bring health services into a busy environment, allowing people to pop-in ... Northampton Herald and Post

Guidance: Update on novel coronavirus infection

Guidance: Update on novel coronavirus infection: The Chief Medical Officer provides the latest information and guidance in light of the 2 clusters of severe human cases of the novel coronavirus infection, which were reported in May 2013. Department of Health

Experts warn £260m not enough

Experts warn £260m not enough: A new government fund to boost adoption of e-prescribing will not be enough to help "laggard" trusts start the journey towards electronic patient records, health IT experts warn. E-Health Insider

Mileage arrangements for medical and dental staff

Mileage arrangements for medical and dental staff: New mileage arrangements are being introduced on 1 July 2013 and set out in Pay Circular (AforC) 3/2013. NHS Employers

Evaluation of the first year of the Inner North West London Integrated Care Pilot

Evaluation of the first year of the Inner North West London Integrated Care Pilot: This report outlines the findings of our evaluation of the Inner North West London Integrated Care Pilot, which aimed to develop new
forms of care for older people and those with diabetes. It found that the foundations for change had been laid, with the pilot making good progress in designing and implementing a complex intervention. Progress was underpinned by a new set of governance arrangements and financial incentives.

£140 buys private firms data on NHS patients

£140 buys private firms data on NHS patients: Bupa approved to access sensitive medical records as campaigners question patient consent for release.
Private health firms, including Bupa, can pay £140 to identify potentially millions of patients and then access their health records, detailing intimate medical histories, under a new national arrangement in the NHS, the Guardian can reveal.

David Cameron accused of "scaremongering" over health tourism

David Cameron accused of "scaremongering" over health tourism: Cameron's promise to tackle health tourism faces criticism as official figures show cost to NHS is 18 times less than claimed by government. The Daily Telegraph

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Million 'at risk' from Care Bill

Million 'at risk' from Care Bill: More than a million people in need of care could be totally shut out of the system because of the fine print of the Government's reforms. The Daily Telegraph

Doctors in dispute: What exactly is normal human behaviour?

Doctors in dispute: What exactly is normal human behaviour?:
It is over 1,000 pages long, has undergone more than three years of revisions and has set doctors at each other's throats. But the latest version of the psychiatrists' bible is finally out - to a chorus of criticism that it is pathologising everyday life. The Independent

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Casualty in crisis: A&E - a service in meltdown

Casualty in crisis: A&E - a service in meltdown:
Doctors were placed under “unprecedented pressure” to go live with the new NHS 111 helpline before some were ready, contributing to the A&E crisis in Britain's hospitals, documents seen by The Independent on Sunday reveal.

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Privatised service 'puts patients at risk' with lack of out-of-hours GPs

Privatised service 'puts patients at risk' with lack of out-of-hours GPs:
A private company that took over the running of a GP out-of-hours service in north London has been severely criticised by the NHS regulator for failing to provide enough doctors to keep patients safe. The Independent

Friday 17 May 2013

Workshops to help carers of those looking after loved ones with dementia

Workshops to help carers of those looking after loved ones with dementia: Free workshops to help people caring for a loved one with dementia is set to take place during National Dementia Awareness Week. Northamptonshire Telegraph

Mum asked to repay NHS compensation

Mum asked to repay NHS compensation: A mother who has been asked to pay back £375,000 compensation after her son died fears she could become homeless. BBC News

Benefit assessments 'are unfair'

Benefit assessments 'are unfair': A doctor, who worked for the private company which assesses people for disability benefits, says its methods are "unfair". BBC News

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AUDIO: Mental illness 'caused by chemistry'

AUDIO: Mental illness 'caused by chemistry': The Today programme's science correspondent Tom Feilden reports that a team of scientists based at Cardiff University who found that a handful of genes are implicated in a wide range of debilitating neurological conditions have won £5m for further research. BBC News

Workload pressures 'blocking GP research'

Workload pressures 'blocking GP research': A lack of time is preventing many GPs from taking part in NHS research into new treatments, a survey has revealed. GP Online

The Big EPR Survey: responses

The Big EPR Survey: responses: At the end of EHI's The Big EPR Survey, respondents were asked what single action would have the greatest impact in driving the adoption and use of electronic patient records across the NHS. E-Health Insider

New pay circular for Agenda for Change staff

New pay circular for Agenda for Change staff: The NHS Employers organisation has published a new pay circular and updated terms and conditions handbook for staff on Agenda for Change contracts which covers mileage rates and travel expenses.

The drive for quality: how to achieve safe, sustainable care in our emergency departments

The drive for quality: how to achieve safe, sustainable care in our emergency departments: This report calls for fundamental change in the way emergency care systems are designed, funded and run. Ten recommendations are made across four domains, based on the results of a survey of 131 emergency departments in the UK between 2011 and 2012. These domains cover: system redesign; expansion and sustainable working practices; radical funding change; and a better system to measure success.

A single book has come to dominate psychiatry. That is dangerous - The Economist

A single book has come to dominate psychiatry. That is dangerous - The Economist:

Washington Times

A single book has come to dominate psychiatry. That is dangerous
The Economist
Thomas Insel, the head of America's National Institute of Mental Health, has publicly encouraged scientists not to be constrained by its approach, lest it prevent them finding diagnoses and treatments. In terms of diagnosis, a few psychiatrists ...
Shrinks, Critics Face Off Over Psychiatric ManualThirdAge
FIELDS: Paying for the new psychiatryWashington Times
Mental health problems 'should not be treated like an illness', leading ...Daily Mail
Capecodonline -Medical Xpress
all 64 news articles »