The future of public services: digital patients

This report highlights the important role app and wearable technology will play in healthcare. It finds that the emergence of wearable and app technology in healthcare presents policymakers with an unprecedented opportunity to engage patients in their own healthcare. It concludes that, if care teams had access to user-generated data, it could enrich their understanding of the patient and how best to manage their condition.

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Read the full report: The future of public services: digital patients.

Watch the interview with researcher William Mosseri-Marlio below:

Hospital to Home Evaluation report

Munro, F. et al. IRISS. Published online: May 2016

Image source: IRISS

This evaluation concerns the final aim of the project: To develop a series of co-designed service recommendations, designed to enable older people to experience a well-supported, co-ordinated and positive pathway from hospital to home.

Using a co-evaluation approach with health and social care practitioners we evaluated how the project Working Group recommendations were used in the case study areas and the impact this had, both for those delivering the new pathways, and those receiving care.

The project recommendations were adapted and used in different ways across South Angus and Dundee with specific system changes being applied and tested. These were mainly adaptions that addressed co-ordinating care and improving communication and trust across different practitioner groups.

These included:

• conducting multi-disciplinary team meetings in community and hospital;
• moving some social work function and assessment into the community;
• assigning coordinators to manage the hospital/home transitions of an older person.

Read the full report here

Gardens and health: it’s time for health policy to bring gardens in from the cold

Buck, D. The King’s Fund Blog. Published online: 17 May 2016

By David Buck

Green space – and its link to improving the public’s health – was one of the areas included in our 2013 report on the evidence around how local authorities could make the most of their existing functions – from housing to supporting employment – to improve their citizens’ health.

Image source: Liam Quinn – Wikimedia // CC BY-SA 2.0

I admit, I started out as a bit of a sceptic when it came to the link between green space and health, thinking that the observed relationship between access to more green space and health was primarily driven – especially in urban areas – by the fact that more-wealthy people live nearer green space than less-wealthy people, and the wealthier you are, the healthier you tend to be. The evidence included in our 2013 report started to challenge my scepticism.

Image source:King’s Fund

I therefore welcomed the opportunity to explore the many and diverse relationships between gardens, gardening and health more thoroughly as part of work commissioned by the National Gardens Scheme, the findings of which are published today in an editorially independent report.

Read the full blog post here

Read the full report here

Place-based services of care

Public Health England

The government requires all local areas to integrate health and care services by 2020. This guidance aims to support healthcare professionals in their role to commission and deliver integrated services to local populations.

Developing care for a changing population: Supporting patients with costly, complex needs

Nuffield Trust

image source: http://www.nuffieldtrust.org.uk/

 

Responding to the needs of the growing numbers of people with complex, chronic illnesses is making new and testing demands of health systems worldwide. This discussion paper looks at emerging evidence from Europe and offers ten reflections for policymakers.

Developing care for a changing population: Patient engagement and health information technology

Nuffield Trust

This discussion paper highlights three applications of health information technology for people with complex health conditions, and lays out principles to bear in mind when designing, promoting and implementing health information technologies.

image source: http://www.nuffieldtrust.org.uk/

Developing care for a changing population: Learning from GP-led organisations

Nuffield Trust

image source: http://www.nuffieldtrust.org.uk/

 

This discussion paper explores the issues associated with running large scale, GP-led organisations that provide services beyond the scope of general practice, and offers examples of some of the challenges faced in adapting services for people with complex needs.

How much information about antibiotics do people recall after consulting in primary care?

Family Practice  cmw022 first published online April 12, 2016 doi:10.1093/fampra/cmw022

Background. Sharing information with patients within a consultation about their infection and value of antibiotics can help reduce antibiotic prescriptions for respiratory tract infections. However, we do not know how often information is given about antibiotics or infections, and if this is related to knowledge and attitudes.

Objectives. To determine the public’s reported use of antibiotics, receipt of information from health professionals about antibiotics and resistance, trust in health professionals and knowledge levels about antibiotics and resistance.

Methods. Face-to-face computer-assisted survey with 1625 adults over 15 years in randomly selected households using multistage sampling. Rim weighting was used to correct for any selection biases.

Results. About 88% trusted their GP to determine the need for antibiotics. Of those who took antibiotics in the past year, 62% were for a throat infection, 60% for sinus infection and 42% for a cough. Although 67% who had been prescribed an antibiotic recalled being given advice about their infection or antibiotics, only 8% recalled information about antibiotic resistance. Those in lower social grades were less likely to recall advice. About 44% correctly indicated that antibiotics effectively treat bacterial rather than viral infections. Only 45% agreed that ‘healthy people can carry antibiotic resistant bacteria’.

Conclusion. GPs and health carers are trusted decision-makers, but could share more information with patients about the need or not for antibiotics, self-care and antibiotic resistance, especially with younger patients and those of lower social grade. Better ways are needed for effective sharing of information about antibiotic resistance.

Strengthening leadership as a catalyst for enhanced patient safety culture: a repeated cross-sectional experimental study

BMJ Open 2016;6:e010180

Objectives Current literature emphasises that clinical leaders are in a position to enable a culture of safety, and that the safety culture is a performance mediator with the potential to influence patient outcomes. This paper aims to investigate staff’s perceptions of patient safety culture in a Danish psychiatric department before and after a leadership intervention.

Methods A repeated cross-sectional experimental study by design was applied. In 2 surveys, healthcare staff were asked about their perceptions of the patient safety culture using the 7 patient safety culture dimensions in the Safety Attitudes Questionnaire. To broaden knowledge and strengthen leadership skills, a multicomponent programme consisting of academic input, exercises, reflections and discussions, networking, and action learning was implemented among the clinical area level leaders.

Results In total, 358 and 325 staff members participated before and after the intervention, respectively. 19 of the staff members were clinical area level leaders. In both surveys, the response rate was >75%. The proportion of frontline staff with positive attitudes improved by ≥5% for 5 of the 7 patient safety culture dimensions over time. 6 patient safety culture dimensions became more positive (increase in mean) (p<0.05). Frontline staff became more positive on all dimensions except stress recognition (p<0.05). For the leaders, the opposite was the case (p<0.05). Staff leaving the department after the first measurement had rated job satisfaction lower than the staff staying on (p<0.05).

Conclusions The improvements documented in the patient safety culture are remarkable, and imply that strengthening the leadership can act as a significant catalyst for patient safety culture improvement. Further studies using a longitudinal study design are recommended to investigate the mechanism behind leadership’s influence on patient safety culture, sustainability of improvements over time, and the association of change in the patient safety culture measures with change in psychiatric patient safety outcomes.

Exploring the views of GPs, people with dementia and their carers on assistive technology: a qualitative study

BMJ Open 2016;6:e011132

Objectives To explore the views and experiences of people with dementia, their family carers and general practitioners (GPs) on their knowledge and experience of accessing information about, and use of, assistive technology (AT) in dementia care.

Design Qualitative methods with semistructured interviews and thematic analysis.

Participants 56 participants comprising 17 GPs, 13 people with dementia and 26 family carers.

Setting Community care settings in the North East of England.

Results 4 main themes emerged: awareness and experience of AT; accessing information on AT; roles and responsibilities in the current care system and the future commissioning of AT services. All participants had practical experience of witnessing AT being used in practice. For people with dementia and their families, knowledge was usually gained from personal experience rather than from health and social care professionals. For GPs, knowledge was largely gained through experiential, patient-led learning. All groups acknowledged the important role of the voluntary sector but agreed a need for clear information pathways for AT; such pathways were perceived to be essential to both service providers and service commissioners.

Conclusions People with dementia and their family carers appear to be mainly responsible for driving a gradual increase in both awareness and the use of AT in dementia care. GPs should be equipped with the relevant knowledge to ensure families living with dementia receive appropriate information and support to enable them to live independently for as long as possible. There is an urgent need to simplify current complex community care pathways; as demonstrated in other chronic health conditions, a single point of access and a named lead professional may improve future care.

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