Multi-Morbidity Re-Visited (BBC News / Academy of Medical Sciences)

Summary

The Academy of Medical Sciences has produced a report on the unprecedented burden of “multi-morbidity”, i.e. the clustering of two or more physical and mental health conditions in the same patient. This is a summary of emerging evidence on the prevalence, determinants, prevention and treatment of multimorbidity. It may be time for health services and professionals to adopt approaches better suited to treating the “whole person” instead of the patient’s individual illnesses in isolation.

“Over the last year, the number of over-50s in England with two or more conditions has increased from 32% to 43%”.

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Reference

Triggle, N. (2018). Being a patient ‘a full-time job’. London: BBC Health News, April 19th 2018.

This relates to:

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Reference

Multimorbidity: a priority for global health research. London: The Academy of Medical Sciences, April 2018.

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Posted in Acute Hospitals, BBC News, Commissioning, Community Care, Depression, Diagnosis, For Doctors (mostly), For Nurses and Therapists (mostly), For Researchers (mostly), For Social Workers (mostly), In the News, Integrated Care, International, Management of Condition, Mental Health, National, Non-Pharmacological Treatments, Person-Centred Care, Personalisation, Pharmacological Treatments, Quick Insights, Statistics, Systematic Reviews, UK, Universal Interest | Tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , | Leave a comment

Advance Care Planning for People With Dementia (NHS England)

Summary

NHS England’s Dementia Team and End of Life Care Team have released a guide about advance care planning for people with dementia in all care settings.

An aim featured in the Dementia Challenge 2020 was the requirement for all people with a diagnosis of dementia to have the opportunity for advance care planning.

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Reference

My future wishes: Advance Care Planning (ACP) for people with dementia in all care settings. Redditch: NHS England, April 2018. Publications Gateway Reference No. 07872.

Posted in Acute Hospitals, Alzheimer's Society, Charitable Bodies, Commissioning, Community Care, End of Life Care, For Carers (mostly), For Doctors (mostly), For Nurses and Therapists (mostly), For Researchers (mostly), For Social Workers (mostly), Integrated Care, Management of Condition, Models of Dementia Care, National, NHS, NHS England, Person-Centred Care, Personalisation, Quick Insights, UK, Universal Interest | Tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , | Leave a comment

Integrated Care Systems: Plus ca Change? (BBC News / NHS England)

Summary

Integrated Care Systems (ICSs) are actually running in ten areas of England to date, out of 44 Sustainability and Transformation Partnerships (STPs).

Full Text Link

Reference

Pym, H. (2018). NHS reform: How many patients will benefit? London: BBC Health News, April 18th 2018.

This relates to:

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Reference

Integrated care systems (ICSs). [Online]: NHS England, April 2018.

Some local dissent in Leicestershire:

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Reference

Leicestershire County Council wants branding off NHS reform plans. [London / Leicester]: BBC Health News / BBC Leicester News, April 11th 2018.

The Integrated Commissioning for Better Outcomes Framework 2018

Updated information has been provided from the Local Government Association and NHS Clinical Commissioners on “commissioning for better outcomes”, to reflect the latest structural changes in the commissioning environment.

Full Text Link

Reference

Integrated Commissioning for Better Outcomes: a commissioning framework 2018. London: NHS Clinical Commissioners (NHSCC) and Local Government Association, April 11th 2018.

Posted in BBC News, Commissioning, Community Care, For Carers (mostly), For Doctors (mostly), For Nurses and Therapists (mostly), For Researchers (mostly), For Social Workers (mostly), In the News, Integrated Care, National, NHS, NHS England, Person-Centred Care, Quick Insights, Standards, UK, Universal Interest | Tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , | Leave a comment

Pharmacological Treatment of Agitation in Persons With Dementia (British Journal of Clinical Pharmacology)

Summary

A systematic review and meta‐analysis of pharmaceutical treatments for alleviating agitation in dementia has been performed. Regarding the efficacy and treatment acceptability of these medications, it is reported that:

“Risperidone, SSRIs as a class and Dextromethorphan / Quinidine demonstrated evidence of efficacy for agitation in dementia, although findings for Dextromethorphan / Quinidine were based on a single RCT. Our findings do not support prescribing Haloperidol due to lack of efficacy, or Oxcarbazepine due to lack of acceptability. The decision to prescribe should be based on comprehensive consideration of the benefits and risks… ”.

Full Text Link

Reference

Kongpakwattana, K. Swangjit, R. [and] Tawankanjanachot, I. [et al] (2018). Pharmacological treatments for alleviating agitation in dementia: a systematic review and network meta-analysis. British Journal of Clinical Pharmacology. April 10th 2018. [Epub ahead of print].

Posted in Antipsychotics, For Doctors (mostly), For Nurses and Therapists (mostly), For Researchers (mostly), International, Mental Health, Pharmacological Treatments, Quick Insights, Systematic Reviews | Tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , | Leave a comment

Persistent Failings Versus Quality Improvement in Mental Health Care (PHSO / CQC)

Summary

The Parliamentary and Health Service Ombudsman (PHSO) has published a report addressing failings in specialist mental health services in England, and their devastating impact on patients and their families. The complaints in this report predate the Five Year Forward View for Mental Health, but reflect ongoing concerns noted in the Care Quality Commission (CQC)’s 2017 report section on the state of mental health care. Five main themes emerged regarding persistent failings:

  1. Diagnosis and failure to treat.
  2. Risk assessment and safety.
  3. Dignity and human rights.
  4. Communication.
  5. Inappropriate discharge and provision of aftercare.

Full Text Link

Reference

Maintaining momentum: driving improvements in mental health care. [Online]: Parliamentary and Health Service Ombudsman, March 21st 2018.

This relates to:

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Reference

Maintaining momentum: driving improvements in mental health care. HC 906, 2017-18. Manchester: Parliamentary and Health Service Ombudsman, March 19th 2018. ISBN 978-1-5286-0246-4.

Driving Improvement in Mental Health Trusts: Seven Case Studies

Acute mental health trusts are known to suffer financial and workforce pressures, so the question to be answered is how are trusts that require improvement supposed to take steps towards becoming good or outstanding in their Care Quality Commission (CQC) ratings? A CQC report explores possible approaches to raising standards of care in mental health trusts, drawn from seven case studies:

  • Oxleas NHS Foundation Trust.
  • Somerset Partnership NHS Foundation Trust.
  • Lincolnshire Partnership NHS Foundation Trust.
  • South West Yorkshire Partnership NHS Foundation Trust.
  • North Staffordshire Combined Healthcare NHS Trust.
  • Calderstones Partnership NHS Foundation Trust.
  • Sheffield Health and Social Care NHS Foundation Trust.

According to this report, the main “enablers” of change and improvement involve:

Responding to CQC inspection reports / ratings: taking a poor rating as a stimulus for improvement and a springboard for reform.

Leadership: broadening the leadership base, investing in leaders, and ability to listen and communicate openly.

Good governance: changes to systems and processes to drive improvement and monitor improvement; with action plans and regular reporting on outcomes.

Open learning culture: creating an environment in which staff feel able to raise concerns.

Staff engagement: promoting participation and empowerment.

Patient involvement: taking into account the views and experiences of patients and the public.

Outward looking and collaborative: joint working with others in the local health and care system and the voluntary sector.

Relationship with CQC: open relationships with the CQC encourage sharing of concerns and discussions about solutions between inspections.

Continuing improvement: an ongoing journey.

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Reference

Driving improvement: case studies from seven mental health trusts. [Press release]. [Online]: Care Quality Commission (CQC), March 15th 2018.

This relates to:

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Reference

Driving improvement: case studies from seven mental health trusts. Newcastle upon Tyne: Care Quality Commission (CQC), March 2018.

Related comment:

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Reference

Strong leadership essential to delivering improvement in mental health hospital care. [Online]: Care Quality Commission (CQC), March 15th 2018.

Approved Mental Health Professionals Services

Possibly of interest, a Care Quality Commission (CQC) briefing reviews how Approved Mental Health Professionals services are delivered, following recommendations on the monitoring of these services made in the Crisis Care Concordat.

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Reference

Briefing: Mental Health Act: Approved Mental Health Professional services. London: Care Quality Commission (CQC), March 27th 2018.

Posted in Commissioning, Community Care, CQC: Care Quality Commission, Department of Health, Diagnosis, For Carers (mostly), For Doctors (mostly), For Nurses and Therapists (mostly), For Researchers (mostly), For Social Workers (mostly), Integrated Care, Management of Condition, Mental Health, National, NHS, NHS England, Person-Centred Care, Personalisation, Quick Insights, SCIE, Standards, UK, Universal Interest | Tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , | Leave a comment

Care and Support of Older People With Learning Disabilities (NICE)

Summary

The National Institute for Health and Care Excellence has released a guideline on the care and support people with learning disabilities as they get older, including their access to suitable services. It covers:

“ …identifying changing needs, planning for the future, and delivering services including health, social care and housing”.

Full Text Link

Reference

Care and support of people growing older with learning disabilities – guidance (NG96). London: National Institute for Health and Care Excellence, April 11th 2018.

The full guideline, with the associated evidence, is available. There is an associated online NICE Pathways version.

Earlier comment from NICE:

“Around 1.2 million people in England have a learning disability. It is estimated that 10-17% of these people display behaviour that challenges”.

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Reference

Care for people with learning disabilities should be close to home wherever possible, says NICE. London: National Institute for Health and Care Excellence, March 28th 2018.

Further comment from NICE:

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Reference

People growing older with learning disabilities should get regular health checks, says NICE. London: National Institute for Health and Care Excellence, April 11th 2018.

Posted in Commissioning, Community Care, Diagnosis, End of Life Care, For Carers (mostly), For Doctors (mostly), For Nurses and Therapists (mostly), For Researchers (mostly), For Social Workers (mostly), Housing, Integrated Care, Management of Condition, Mental Health, National, NICE Guidelines, Non-Pharmacological Treatments, Patient Care Pathway, Person-Centred Care, Personalisation, Quick Insights, Standards, Telecare, UK, Universal Interest | Tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , | Leave a comment