Early palliative care improves coping & quality of life for patients with incurable cancers

ScienceDaily | Published online: 7 September 2016.

A randomized clinical trial found that introducing palliative care shortly after a diagnosis of certain metastatic cancers greatly increases a patient’s coping abilities, as well as overall quality of life. Researchers also found that early integration of palliative care results in an increase in discussions about patient end-of-life care preferences.

The findings are part of a growing body of evidence demonstrating the benefits of palliative care on patient quality of life. This study will be presented at the upcoming 2016 Palliative Care in Oncology Symposium in San Francisco.

To explore the effects of early palliative care, researchers randomly assigned 350 patients, who had been recently diagnosed with incurable lung or non-colorectal gastrointestinal cancer, to receive early palliative care integrated with oncology care or oncology care alone.

Read the abstract commentary here

Using information technology to improve the NHS

Report by National Advisory Group on Health Information Technology in England

This report begins by covering the relevant background, in five areas:

1) General policy/practical issues that relate to health IT

2) A brief history of NPfIT

3) A brief history of health IT in England’s GP sector

4) A brief history of the US experience with digitising its healthcare system, with some possible lessons for the NHS

5) The recent consensus on digitising secondary care in England, reflected in the work of the National Information Board, the Five Year Forward View report, and the allocation of £4.2 billion to support digitisation.

After exploring this background, the report goes on to outline methods, and describe 10 overall findings and principles drawn from  interviews, site visits, and deliberations.

Finally,  10 implementation recommendations are listed along with their rationales.

Image source: http://www.gov.uk/

Executive summary available here

Full report:

Making IT Work:
Harnessing the Power of Health
Information Technology to
Improve Care in England
Report of the National
Advisory Group on Health
Information Technology
in England

Person and community-centred approaches to health and wellbeing

The Health Foundation in partnership with the innovation charity Nesta has published two reports in their Realising the Value series which aims to strengthen the case for people taking an active role in their health and care.

Image source: http://www.nesta.org.uk/

• Spreading change: a guide to enabling the spread of person- and community-centred approaches for health and wellbeing: This report outlines how behavioural science can help spread the take-up of person- and community-centred approaches to health and wellbeing.  It is aimed at people who champion these approaches in health and social care, in other statutory bodies and in community-based organisations.

• Supporting self-management: A guide to enabling behaviour change for health and wellbeing using person- and community-centred approaches:  This guide offers two things: a framework for understanding and changing behaviour, and real-world examples of how these changes happen in practice.

General practice in England

The Nuffield Trust has published Large-scale general practice in England: what can we learn from the literature?

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

Collaborative ‘at-scale’ models are increasingly being heralded as the answer to the formidable challenges facing general practice. NHS England has signalled that large-scale general practice organisations should form a core component of their vision for new care models set out in the Five Year Forward View. But can these organisations really deliver what is expected of them? This report presents findings of an extensive literature review examining the evidence.

We can solve poverty in the UK

JRF’s comprehensive strategy, ‘We can solve poverty in the UK’, sets out recommendations on how all of us can act to solve poverty.

Image source: http://www.jrf.org.uk/

This report from the Joseph Rowntree Foundation looks to answer the question, What would it take to solve UK poverty? Over the past four years, JRF has worked with experts in research and practice, and commissioned and analysed evidence reviews to find out what works. The findings and recommendations are presented following  work with the public as well as employers and businesses, practitioners, civil servants and politicians from all parties, across all four nations of the UK.

The five-point plan to solve poverty in the UK will:

• Boost incomes and reduce costs;
• Deliver an effective benefit system;
• Improve education standards and raise skills;
• Strengthen families and communities; and
• Promote long-term economic growth benefiting everyone.

Read the full report here

Starting the conversation – working together to solve poverty:

Understanding quality in district nursing services

Understanding quality in district nursing services. Learning from patients, carers and staff. | Kings Fund

District nursing services play an important role in helping people to maintain their independence by supporting them to manage long-term conditions and treating acute illnesses – and demand for such services is increasing. These services will be key to the success of policies that aim to provide more care closer to home.

Image source: http://www.kingsfund.org.uk/

This report from The Kings Fund  investigates what ‘good’ district nursing care looks like from the perspective of people receiving this care, unpaid carers and district nursing staff and puts forward a framework for understanding the components involved. It also looks at the growing demand–capacity gap in district nursing and the worrying impact that this is having on services, the workforce and the quality and safety of patient care. The report makes recommendations to policy-makers, regulators, commissioners and provider organisations as to how to start to address these pressures.

Tackling falling child vaccination rates

NICE is developing priorities to help ensure unvaccinated children across the country get the protection they need.  In some areas of the country, fewer than 1 in 5 children are vaccinated against diseases such as polio and diphtheria. Experts have warned that unless uptake rates improve there is a risk of these diseases making a comeback.

Last year only a quarter of local authorities met World Health Organization targets to vaccinate 95% of children against measles, mumps and rubella.  A draft quality standard from NICE, out for consultation until 29 September, sets out how to drive up the number of under 19s who receive vaccinations.

Comparative study analysing women’s childbirth satisfaction and obstetric outcomes across two different models of maternity care

Ferrer, M.B.C. et al. BMJ Open. Published online: 26 August 2016

Objectives: To describe the differences in obstetrical results and women’s childbirth satisfaction across 2 different models of maternity care (biomedical model and humanised birth).

Setting: 2 university hospitals in south-eastern Spain from April to October 2013.

Design: A correlational descriptive study.

Participants: A convenience sample of 406 women participated in the study, 204 of the biomedical model and 202 of the humanised model.

Results: The differences in obstetrical results were (biomedical model/humanised model): onset of labour (spontaneous 66/137, augmentation 70/1, p=0.0005), pain relief (epidural 172/132, no pain relief 9/40, p=0.0005), mode of delivery (normal vaginal 140/165, instrumental 48/23, p=0.004), length of labour (0–4 hours 69/93, >4 hours 133/108, p=0.011), condition of perineum (intact perineum or tear 94/178, episiotomy 100/24, p=0.0005). The total questionnaire score (100) gave a mean (M) of 78.33 and SD of 8.46 in the biomedical model of care and an M of 82.01 and SD of 7.97 in the humanised model of care (p=0.0005). In the analysis of the results per items, statistical differences were found in 8 of the 9 subscales. The highest scores were reached in the humanised model of maternity care.

Conclusions: The humanised model of maternity care offers better obstetrical outcomes and women’s satisfaction scores during the labour, birth and immediate postnatal period than does the biomedical model.

Read the full article here

Four tools to enhance significant event analysis in primary care

The Health Foundation | Published online 25 August 2016

Significant event analysis (SEA) is a collective learning technique used to investigate patient safety incidents (circumstances where a patient was or could have been harmed) and other quality of care issues.

The project developed a framework and then a series of practical tools, which aim to help people working in primary care to apply the approach.

1. E-learning module

This short ‘read and click’ e-learning module is available as a PDF from the Quality Improvement Hub. It explains and illustrates the principles which underpin the enhanced SEA approach, including sections on: Basic error theory; Human factors principles; Taking a systems-centred approach; and the Enhanced SEA method.

2. Enhanced SEA booklet

The enhanced SEA booklet (PDF), developed by the project team, gives a clear, readable overview of the approach, including the basics of human factors theory and an example story. It aims to help individuals reflect on the potential emotional impacts of a significant event by using these principles to gain a clearer understanding of all of the contributory factors involved.

Image source: The Health Foundation

3. Deskpad

In addition to individual reflection, it’s important that teams reflect together on events and analysis. Each sheet of this enhanced SEA deskpad (PDF) contains instructions and prompts to help guide a team in taking this approach to event analysis, and to take notes on what was agreed.

4. Reporting template

The project team also designed and developed a new report format (PDF) for writing up SEAs, which accommodates this approach. This format is recommended for GP specialty training and medical appraisal, as well as for practice manager and nurse vocational training and appraisal.  It is also being used in community pharmacy and dental practice in Scotland.

Read the full project overview here