Unexpected Results From the Dementia and Physical Activity (DAPA) Trial? (Pharmacoeconomics Open)

Summary

Previous research has suggested that physical exercise has the potential to slow the progression of dementia in people with pre-existing mild cognitive impairment through to moderate dementia. Evidence for the cost-effectiveness of structured physical activity programmes has been lacking, so far, however.

The current study, conducted from the UK NHS and personal social services perspective with backing from the National Institute of Health Research’s Health Technology Assessment (NIHR HTA) programme, compared the cost-effectiveness of a “tailored, structured, moderate- to high-intensity exercise programme versus usual care in people with mild to moderate dementia”.

The particular structured exercise programme evaluated here did not slow rates of cognitive decline in people with mild cognitive impairment or moderate dementia. Accordingly the economic evaluation found that the programme was not cost-effective.

Full Text Link

Reference

Khan, I. Petrou, S. Khan, K. [et al]; DAPA Trial Group, with contributions from Hill, L. Johnson, L. Lord, L. Johnson, L. Qassam, T. Sadier, S. Shipman, A. South, L. Statham, J. Tomkins, J. [and] Weaver, D. of Black Country Partnership NHS Foundation Trust (2019). Does structured exercise improve cognitive impairment in people with mild to moderate dementia? A cost-effectiveness analysis from a confirmatory randomised controlled trial: the Dementia and Physical Activity (DAPA) Trial. Pharmacoeconomics Open. June 2019; 3(2): pp.215-227.

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Dementia Care in Acute Hospitals: Comparisons Between Specialist Inpatient Dementia Units Versus Standard Ward Care (Aging Clinical and Experimental Research)

Summary

A recent systematic review investigated the literature on the comparative effectiveness of Specialist Inpatient Dementia Units (SIDUs) in acute hospital settings versus that of standard ward care (SWC). Studies that scored poorly relating to possible bias were excluded from the meta-analysis.

It was concluded that while SIDUs may be associated with improved care outcomes, the evidence of their effectiveness has not yet been established conclusively. More research is recommended. The authors conclude, circumspectly:

“Although there is little consistent evidence that SIDU are superior to SWC, this more person-focused form of clinical care for people with dementia appears to be associated with greater patient and carer satisfaction, possible reduced readmission rates, more accurate history taking and documentation of resuscitation decisions and increased rates of discharge to the patients’ own home. Although mortality data was comparable, SIDU may represent a higher quality model of care for patients living with dementia”. p.602.

Full Text Link

Reference

McCausland, BMS. Patel, HP. [and] Amin, J. [et al] (2019). A systematic review of specialist inpatient dementia care services versus standard inpatient dementia care in acute hospitals. Aging Clinical and Experimental Research. May 2019; Vol.31(5): 595-610.

Posted in Acute Hospitals, For Carers (mostly), For Doctors (mostly), For Nurses and Therapists (mostly), For Researchers (mostly), Integrated Care, Management of Condition, Models of Dementia Care, Non-Pharmacological Treatments, Person-Centred Care, Personalisation, Quick Insights, Statistics, Systematic Reviews, UK, Universal Interest | Tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , | Leave a comment

Interim NHS People Plan (NHS Improvement / BBC News)

Summary

The Interim NHS People Plan, formerly the Workforce Implementation Plan promised in the NHS Long Term Plan, covers staffing levels, recruitment and education issues. It also states a commitment to making the NHS the best place to work; to be achieved by improving leadership, and tackling “cultural problems” – through more inclusive and person-centred leadership. NHS managers will get more support and development opportunities.

Regarding nursing, there is funding for 5,700 extra hospital and community placements for student nurses, and an increased number of nursing associate roles, rising to 7,500. International nurse and doctor recruitment will increase.

More multi-disciplinary working will support the NHS Long Term Plan goal of integrating primary and secondary care. Staff will have access to training in digital skills via the NHS Digital Academy to better realise the potential of new technology. More flexible working and career development will be allowed.

The main section hadings comprise:

  • Making the NHS the best place to work.
  • Improving the leadership culture.
  • Tackling the nursing challenge.
  • Delivering 21st Century care.
  • A new operating model for workforce.
  • Developing the full People Plan.
  • Other resources.

It is called an Interim NHS People Plan because the development of a workforce strategy to tackle nurse, GP and hospital doctor shortages etc. is still underway. The actual NHS People Plan is to be published after the Autumn spending review.

Full Text Link

Reference

Interim NHS People Plan. London: NHS Improvement, June 2019.

There are also mini-plans for the allied health professions and psychological professions, dentistry, the science workforce, the medical workforce, and the pharmacy workforce.

Comment and analysis from BBC News:

Full Text Link

Reference

Pym, H. (2019). Can the NHS get all the doctors and nurses it needs?  London: BBC Health News, June 3rd 2019.

International Nurses and Doctors Recruitment

Pause for thought / reality check:

Full Text Link

Reference

NHS staff shortage: How many doctors and nurses come from abroad? London: BBC Health News / BBC Reality Check Team, May 13th 2019.

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

CQC Interim Report on Restrictive Interventions in Mental Health, Learning Disabilities or Autism Care Institutions (BBC News / CQC / DHSC / NHS England / Children’s Commissioner / HQIP)

Summary

The Care Quality Commission (CQC) has released an interim report on the persistence of restraint, seclusion and segregation in the care of people with a mental health problems, learning disabilities and / or autism.

Full Text Link

Reference

Triggle, N. (2019). ‘Broken’ care system for most vulnerable. London: BBC Health News, May 21st 2019.

This relates to:

Full Text Link

Reference

Interim report: Review of restraint, prolonged seclusion and segregation for people with a mental health problem, a learning disability and or autism. [Online]: Care Quality Commission (CQC), May 2019.

There is also a Quick / Easy Read Summary.

Awkward Questions?

Too little room for complacency?

Full Text Link

Reference

Triggle, N. (2019). Whorlton Hall: Hospital abuse missed despite at least 100 official visits. London: BBC Health News, May 23rd 2019.

The DHSC Response

There is to be a working group for learning disabilities and autism, plus funding for specialist advocates to review the care of patients in segregation or long-term seclusion.

Full Text Link

Reference

Department of Health announces new measures to improve care for people with autism and learning disabilities. [Online]: Department of Health and Social Care, May 21st 2019.

NHS England Response

NHS England has announced a further £5 million for reviews to improve the care of people with a learning disability; alongside ongoing work to tackle serious conditions. ​

Full Text Link

Reference

NHS invests £5 million to improve care for people with a learning disability. [Online]: NHS England, May 21st 2019.

Children’s Commissioner “Far Less Than They Deserve” Report

Too many children with a learning disability or autism continue to be held in child / adolescent secure mental health hospitals.

Full Text Link

Reference

Far less than they deserve: children with learning disabilities or autism living in mental health hospitals. London: Children’s Commissioner, May 20th 2019.

The statistics, from BBC News:

Full Text Link

Reference

Dahlgreen, W. (2019). The failings in learning disability services in six charts. London: BBC Health News, May 23rd 2019.

Learning Disabilities Mortality Review (LeDeR) Programme

The third annual English Learning Disabilities Mortality Review (LeDeR) programme report includes statistics about deaths of people with learning disabilities, aged 4 years and over, from July 1st 2016 to December 31st 2018.

Full Text Link

Reference

The Learning Disabilities Mortality Review (LeDeR) Programme. Annual Report, December 2018. London: Healthcare Quality Improvement Partnership (HQIP) [and] University of Bristol, May 21st 2019.

There is also a Quick / Easy Read Summary.

Whorlton Hall: More “First Draft of History” Material

BBC Panorama’s undercover investigation:

Full Text Link

Reference

Plomin, J. (2017). Whorlton Hall hospital abuse and how it was uncovered. London: BBC Health News / BBC Panorama, May 22nd 2019.

and:

Full Text Link

Reference

Triggle, N. (2019). Whorlton Hall: Hospital ‘abused’ vulnerable adults. London: BBC Health News, May 22nd 2019.

Predictable official apology, with some statistics:

Full Text Link

Reference

Whorlton Hall: Minister ‘deeply sorry’ for hospital abuse. London: BBC Health News, May 23rd 2019.

“Bed numbers have been reduced – from 3,400 to below 2,300 since 2012 in England – but that falls short of the government’s target to get the figure down to below 1,700 by March this year”.

Police arrests:

Full Text Link

Reference

Whorlton Hall: Ten arrested over abuse allegations. London: BBC Health News, May 24th 2019.

Insider talk of an unpublished CQC report:

Full Text Link

Reference

Whorlton Hall: Former inspector says warnings were ignored. London: BBC Health News, May 26th 2019.

The CQC is to review what might have been done better regarding missed opportunities and an earlier unpublished inspection report:

Full Text Link

Reference

Whorlton Hall abuse: Care watchdog launches investigations. London: BBC Health News, May 31st 2019.

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

Resources Relating to Dementia Action Week 2019 (Alzheimer’s Society / NIHR)

Summary

The theme of the 2019 Dementia Action Week, falling between May 20th – 26th 2019, is “Inclusion”. Suggestions from the Alzheimer’s Society for workplaces:

Full Text Link

Reference

Dementia Action Week 2019: 20–26 May. Make a difference in your community. A guide for workplaces. London: Alzheimer’s Society, 2019.

See also, suggestions for schools:

Full Text Link

Reference

Dementia Action Week 2019: 20–26 May. Make a difference in your community. A guide schools. London: Alzheimer’s Society, 2019.

Further information for the general public on improving social acceptance and inclusion:

Full Text Link

Reference

All it takes is a conversation to see we’re still us. [Online]: Alzheimer’s Society, 2019.

This relates to:

Full Text Link

Reference

Ask Us Anything: how to start a conversation with someone living with dementia. London: Alzheimer’s Society, May 2019. DAW19WB.

“We want to encourage everyone to have a conversation with someone living with dementia, and what better way to mark the week than with a video showing just how much people with dementia have to offer the world”. Ele Yorke, Alzheimer’s Society Campaigns Team.

Dementia Cannula Sleeves

A voluntary group, “Handmade for Dementia”, knit mitts for patients with dementia in local hospitals and hospices.

Full Text Link

Reference

Ryder, S. (2019). Cannula sleeves: ‘Simple solution for dementia patients’. London: BBC Health News, May 22nd 2019.

Join Dementia Research: NIHR’s LEARN Tool

The National Institute for Health Research (NIHR) has made available an online learning tool, giving health and care professionals insight into encouraging more patients to engage with Join Dementia Research. The NIHR LEARN Tool complies broadly with National Institute for Health and Care Excellence (NICE) guideline recommendations that people with dementia should have an opportunity to take part in research, in order to:

  • Feel more in control about their care.
  • Make informed choices about getting involved.
  • Learn about their condition.

Full Text Link

Reference

Join Dementia Research: Help your patients join dementia research (NIHR LEARN Tool). [Online]: Join Dementia Research / National Institute for Health Research (NIHR), 2019.

Posted in Alzheimer's Society, Charitable Bodies, Community Care, For Carers (mostly), Management of Condition, Mental Health, National, Northern Ireland, Person-Centred Care, Quick Insights, Scotland, UK, Universal Interest, Wales | Tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , | Leave a comment