Support for carers

Thomas S, Dalton J, Harden M, Eastwood A, Parker G. Updated meta-review of evidence on support for carers. Health Serv Deliv Res 2017;5(12)

The University of York Centre for Reviews and Dissemination has published Updated meta-review of evidence on support for carers.

This review updates what is known about effective activities to support carers of ill, disabled or older adults.  The report concludes that there is no ‘one size fits all’ intervention to support carers but potential exists for effective support in specific groups of carers.

 

Long term conditions and prescription charges

The Prescription Charges Coalition has launched a new survey looking at the ways in which prescription charges affect the lives of people in England with long-term conditions.

At the moment, people with long term conditions in England who work have to pay for their medicines, because the list of illnesses that qualify for free prescriptions is limited and out of date.  The prescription charges coalition is campaigning for all people with long-term conditions to receive free prescriptions.

Find out more about the campaign, at the Prescription Charges Coalition website.

Local support for people with a learning disability

This report from the National Audit Office examines how the NHS in England and local authorities seek to improve the lives of the 129,000 people aged 18 to 64 who use local authority learning disability support services.

Key Facts

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

The report also assesses the setting up of the Transforming Care programme which aims to move some of the 2,500 people with a learning disability and/or autism out of mental health hospitals; and progress of the programme

The key questions of the report are:

• How much does the government spend on supporting people with a learning disability?

• Is support improving outcomes?

• Has the Department made progress with its programme to provide community services and reduce mental health hospital beds for people with a learning disability?

The full report can be viewed here

General practice nursing

Health Education England has published The General Practice Nursing Workforce Development Plan.

Image source: http://www.hee.nhs.uk

This report aims to offers guidance and steps that can be taken to improve general practice nursing recruitment and retention, and encourage nurses to return to the profession by setting out how best to respond to the current and anticipated workforce challenges at both strategic and local levels.

Key report recommendations include:

• improving training capacity for the general practice nurse workforce by providing access to accredited training to equip them for each level of their role;
• raising the profile of general practice nursing, to increase the uptake of the role as a first-destination career;
• developing GPN educator roles to cover all CCG areas, including the promotion of mentor training for all GPNs  to retain the knowledge and expertise of existing GPNs; and
• the development of a sustainable and easily accessible ‘how-to’ toolkit and web based resource to support the implementation of general practice nursing workforce initiatives.
• a nationwide standardised general practice nursing ‘return to practice’ education programme which includes a general practice placement, mentorship and appropriate support to meet the NMC requirements for ‘return to practice’.

Full report is available here

Retrospective observational study of emergency admission, readmission and the ‘weekend effect’

Shiue I, McMeekin P, Price C. Retrospective observational study of emergency admission, readmission and the ‘weekend effect’. BMJ Open 2017;7:e012493. doi: 10.1136/bmjopen-2016-012493 

Excess mortality following weekend hospital admission has been observed but not explained. As readmissions have greater age, comorbidity and social deprivation, outcomes following emergency index admission and readmission were examined for temporal and demographic associations to confirm whether weekend readmissions contribute towards excess mortality.

Design A retrospective observational study. Individual patient Hospital Episode Statistics were linked and 2 categories created: index admissions (not within 60 days of discharge from an emergency hospitalisation) and readmissions (within 60 days of discharge from an emergency hospitalisation). Logistic regression examined associations between admission category, weekend and weekday mortality, age, gender, season, comorbidity and social deprivation.

Setting A single acute National Health Service (NHS) trust serving a population of 550 000 via 3 emergency departments.

Participants Emergency admissions between 1 January 2010 and 31 March 2015.

Outcome measure All-cause 30-day mortality.

Results Over 5 years there were 128 966 index admissions (74.7% weekday/25.3% weekend) and 20 030 readmissions (74.9% weekday/25.1% weekend). Adjusted 30-day death rates for weekday/weekend admissions were 6.93%/7.04% for index cases and 12.26%/13.27% for readmissions. Weekend readmissions had a higher mortality risk relative to weekday readmissions (OR 1.10 (95% CI 1.01 to 1.20)) without differences in comorbidity or deprivation. Weekend index admissions did not have a significantly increased mortality risk (OR 1.04 (95% CI 0.98 to 1.11)) but deaths which did occur were associated with lower deprivation (OR 1.24 (95% CI 1.11 to 1.38)) and an absence of comorbidities (OR 1.17 (1.02 to 1.34)).

Conclusions Associations with emergency hospitalisation were not identical for index admissions and readmissions. Further research is needed to confirm what factors are responsible for the ‘weekend effect’.

 

Care for older people

‘Worked up? Speak up’ – Care for older people campaign launches | Care Quality Commission

 

The aim of this campaign is to get more people aged 60 and over, and their friends and families, to share their experiences of health and social care. Research has shown that older people are less likely to complain about services and less aware of the different ways they can share their views.

Knowledge transfer partnership programme announced

Knowledge Transfer Partnership announced at CSO Conference ‘Bringing Science and Innovation to the Heart of the NHS’

NHS England is set to launch its first Knowledge Transfer Partnership Programme, a 12 month development programme, aimed at clinical leaders in healthcare science.  Successful applicants who secure a place will work with other leading healthcare scientists and build long-term collaborations across clinical, research and industry sectors, whilst identifying new approaches to measuring improved outcomes, ultimately for NHS patients.

Learning and Mindfulness: Improving Perioperative Patient Safety

Graling, P.R. (2017) AORN Journal. 105(3) pp. 317–321

Image source: stavos – Flickr // CC BY-NC-ND 2.0

In 1980, McLain identified the top five risk management issues in the OR as wrong patient; wrong procedure performed; improper consent; unreconciled sponge, needle, or instrument count; and burns from equipment.

Approximately 20 years later, the Institute of Medicine report To Err Is Human: Building a Safer Health System described the complexity of health care systems in the United States and the epidemic occurrence of medical errors. Despite widespread awareness of medical errors, there has been little progress in this area to improve patient safety, and sentinel or never events continue to occur in the United States.

Read the abstract here

Telecare is more than just technology – it has the power to create care networks for older people

Telecare is a range of remote care technologies and associated services that have been developed to accommodate an ageing population while helping people to stay in their homes | The Conversation

Image source: Moyan Brenn – Flickr // CC BY 2.0

Over the next 25 years, the percentage of people aged over 85 is set to more than double, with one in four in this age group already counting as “frail”. In the over 65s, this is estimated at one in ten. At the same time, the number of people, such as family, who might be caregivers is reducing due to different patterns of marriage and parenting, people living apart at greater distances and more women in paid employment.

Traditionally, elderly people who need care in their own homes rely on paid or unpaid carers. Telecare can be thought of as a form of care at a distance, which can allow older and frailer people to live independently. While some might see a risk of decreasing social contact, it can provide safety and security to those people who because of mobility problems and other health issues are housebound. Telecare should be considered as an aid, not a solution to growing demands for care.

Telecare can provide some care on a personal level through attachments that can develop between users and telephone operators, who regularly check in with the telephone operators for weekly test calls.

Read the full blog post here

Productivity, Technology and the NHS

Productivity, Technology and the NHS | Newchurch

This paper looks at the approach of the NHS to productivity improvement half-way through the implementation of the Five Year Forward View. It particularly examines the role of digital technology in delivering productivity improvements.