Self-Care Guide (Regional Voices)

Summary

A Regional Voices briefing supports patients in actively managing their own health. It also promotes wider recognition of the potential role(s) for voluntary and community services in enabling self-care.

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Reference

Self-care: everybody’s talking about it. The Voluntary and Community Sector as enablers of self-care. [Online]: Regional Voices, March 2017.

Posted in Charitable Bodies, Commissioning, Community Care, For Carers (mostly), For Nurses and Therapists (mostly), For Researchers (mostly), For Social Workers (mostly), Integrated Care, Local Interest, Management of Condition, Mental Health, National, NHS, Non-Pharmacological Treatments, Patient Information, Person-Centred Care, Personalisation, Quick Insights, UK, Universal Interest | Tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , | Leave a comment

More on NHS Funding and Expenditure: Questions of Balance Regarding Income Versus Outgoings (BBC News / King’s Fund / Health Foundation)

Summary

NHS England hopes to save between £100 – £400 million of spending annually, by no longer funding / prescribing products and services identified by NHS Clinical Commissioners as having little or no clinical value.

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Reference

Triggle, N. (2017). NHS targets suncream prescriptions for cuts. London: BBC Health News, March 28th 2017.

This relates to:

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NHS England to issue new guidance on low value prescription items. London: NHS England, March 28th 2017.

Approaches to Funding

Different NHS funding models have been much in debate recently:

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Pym, H. (2017). Should the NHS have its own tax? London: BBC Health News, March 16th 2017.

This relates to:

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Health and social care: delivering a secure funding future. An interim report. London: Patients Association, March 2017.

Amid questions about sustainability of NHS funding, the King’s Fund offers brief international comparisons and a summary of the alternative funding models. Most countries fund health care using a combination of methods.

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Reference

McKenna, H. Dunn, P. [and] Northern, E. [et al] (2017). How health care is funded. [Online]: King’s Fund, March 23rd 2017.

Rising Imbalances?

With the NHS England Five Year Forward View now half-way through towards completion, a Health Foundation report analyses reasons for growing concern about the prospects of closing funding gaps:

  1. The financial position of NHS providers has continued to worsen.
  2. Additional funding for health care announced in the 2015 Autumn Statement has been front-loaded in 2015/16 and 2016/17, but rising costs continue to out-pace the growth in the funding for NHS providers.
  3. Demand for care has risen faster than NHS provider income. Emergency admissions have “crowded-out” elective admissions.
  4. Projected NHS efficiency gains have become increasingly slow, difficult to achieve and have fallen below target.
  5. Consultant numbers have increased, yet consultant productivity has fallen (a case of diminishing marginal utility or inappropriate deployment?).
  6. The NHS does not operate in isolation, so whole-system re-design and improved integration remain important for tackling intractable financial problems and under-performance at their root cause(s) across the health and care system.

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Reference

Lafond, S. Charlesworth, A. [and] Roberts, A. (2017). A year of plenty? An analysis of NHS finances and consultant productivity. London: Health Foundation, March 2017.

A Growing Role for the Independent Sector?

A Health Foundation analysis for the Financial Times discovered that, in England, about £1 in £8 (12.5%) of local commissioning budgets gets spent on care provided by non-NHS organisations. Overall, the Department of Health is thought to spend less than 10% of its budget on independent providers.

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NHS bosses ‘spent half of extra Autumn Statement cash on outside services’. London: BBC Health News, March 27th 2017.

Miscellaneous Other Economies

Possibly of interest:

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NHS to introduce £20m cap on new drugs. London: BBC Health News, March 15th 2017.

Believe It or Not?

An “upbeat” assessment of supposed-problems and dismissal of common NHS-related “myths”, which aims to minimise readers’ concerns about the NHS and / or displace responsibility elsewhere:

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Reference

Anandaciva, S. (2017). NHS myth-busters. [Online]: King’s Fund, March 23rd 2017.

Posted in BBC News, Charitable Bodies, Commissioning, Department of Health, Health Foundation, In the News, Integrated Care, King's Fund, National, NHS, NHS England, Quick Insights, Standards, Statistics, UK, Universal Interest | Tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , | Leave a comment

Vitamin E and / or Selenium for Dementia Prevention? (JAMA Neurology)

Summary

The Prevention of Alzheimer’s Disease by Vitamin E and Selenium (PREADViSE) trial investigated the potential use of antioxidant supplementation (whether Vitamin E and / or selenium) for the prevention of dementia in asymptomatic older men. This study has now concluded that neither Vitamin E or selenium, nor the combination of these supplements, prevents dementia. ​

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Reference

Kryscio, RJ. Abner, EL. [and] Caban-Holt, A. [et al] (201). Association of antioxidant supplement use and dementia in the Prevention of Alzheimer’s Disease by Vitamin E and Selenium Trial (PREADViSE). JAMA Neurology. March 20th 2017. [Epub ahead of print].

Posted in For Doctors (mostly), For Nurses and Therapists (mostly), For Researchers (mostly), International, Non-Pharmacological Treatments, Nutrition, Pharmacological Treatments | Tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , | Leave a comment

Dementia-Friendly Community Pharmacies (Greater Manchester Pharmacy LPN / RPS)

Summary

The Greater Manchester Pharmacy Local Professional Network have produced a brief guide on the seven elements of good practice:

  1. The pharmacy environment.
  2. The pharmacy team.
  3. Public health messages, including lifestyle.
  4. Over the counter medicines.
  5. Prescription ordering and collection / delivery of medicines.
  6. Medicines adherence.
  7. Signposting.

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Reference

Seven steps to becoming a dementia friendly pharmacy practice. Manchester: Greater Manchester Pharmacy Local Professional Network, October 2016.

Possibly also of wider interest:

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Frontline pharmacists: making a difference for people with long term conditions. London: Royal Pharmaceutical Society (RPS), November 2016.

Posted in Commissioning, Community Care, For Nurses and Therapists (mostly), Integrated Care, Management of Condition, Mental Health, Models of Dementia Care, Person-Centred Care, Pharmacological Treatments, Quick Insights, Standards, UK, Universal Interest | Tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , | Leave a comment

The NHS Mandate: a Mandate from the Government to NHS England, April 2017 to March 2018 (Department of Health)

Summary

The Department of Health’s updated “NHS Mandate 2017 to 2018” defines long-term NHS objectives and goals up to 2020. The Mandate is based around seven “big picture” objectives:

  1. Improving local and national health outcomes, and reduce health inequalities, through better commissioning.
  2. Helping to create the safest, highest quality health and care service in the world.
  3. Balancing the NHS budget and improving efficiency and productivity.
  4. Leading a “step change” in the NHS in preventing ill-health and supporting people to live healthier lives.
  5. Maintaining and improving performance against core standards.
  6. Improving out-of-hospital care.
  7. Supporting research, innovation and growth.

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Reference

The Government’s mandate to NHS England for 2017-18. A mandate from the Government to NHS England: April 2017 to March 2018. Presented to Parliament pursuant to Section 13A(1) of the National Health Service Act 2006. London: Department of Health, March 2017.

Financial Sustainability Directions to NHS England (2017-18)

The accompanying financial directions cover expenditure controls with which NHS England must comply in order to meet budgetary controls applied by HM Treasury on the Department of Health.

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Reference

2017-18 Financial Directions to NHS England. London: Department of Health, March 2017.

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

Review of Interventions for BPSD: a SENATOR-ONTOP Systematic Review (BMJ Open)

Summary

A recent broad-ranging systematic review of non-pharmacological interventions for behavioural and psychological symptoms in dementia (BPSD) covers (i) sensory stimulation, including acupressure, aromatherapy, massage / touch therapy, light therapy and sensory gardens, (ii) cognitive / emotion-oriented interventions including cognitive stimulation, music and dance therapy, dance therapy, snoezelen, transcutaneous electrical nerve stimulation, reminiscence therapy, validation therapy and simulated presence therapy, (iii) behaviour management techniques and (iv) other therapies including exercise therapy, animal-assisted therapy, special care units and dining room environment-based interventions.

Music therapy appears to be effective in reducing agitation and anxiety. Behavioural management techniques appear to be effective for reducing BPSD:

“Home-based behavioural management techniques, caregiver-based interventions or staff training in communication skills, person-centred care or dementia care mapping with supervision during implementation were found to be effective for symptomatic and severe agitation”.

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Reference

Abraha, I. Rimland, JM. [and] Trotta, FM. [et al] (2017). Systematic review of systematic reviews of non-pharmacological interventions to treat behavioural disturbances in older patients with dementia. The SENATOR-OnTop series. BMJ Open. March 16th 2017; 7(3): e012759.

About the SENATOR-ONTOP Systematic Reviews

The SENATOR-ONTOP series of systematic reviews and meta-analyses aims to assess the evidence for non-pharmacological interventions designed to prevent or treat various common geriatric conditions.

“The Optimal Evidence-Based Non-drug Therapies in Older People (ONTOP) project [aims to achieve an] extensive, comprehensive systematic overview of reviews concerning non-pharmacological interventions for chronic geriatric conditions as well as the provision of a Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach-based recommendation of the evidence of non-pharmacological interventions”.

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Reference

Abraha, I. Cruz-Jentoft, A. [and] Soiza. [et al] (2017). Evidence of and recommendations for non-pharmacological interventions for common geriatric conditions: the SENATOR-ONTOP systematic review protocol. BMJ Open. January 27th 2015; 5(1): e007488.

Non-Pharmacological Prevention or Treatment of Delirium

Possibly also of interest:

Full Text Link (Note: This article requires a suitable Athens password, a journal subscription or payment for access).

Reference

Abraha, I. Rimland, JM. [and] Trotta, F. [et al] (2016). Non-pharmacological interventions to prevent or treat delirium in older patients: clinical practice recommendations. The SENATOR-ONTOP Series. Journal of Nutrition, Health and Aging. 2016; 20(9): 927-936.

Non-Pharmacological Treatment of Pressure Ulcers

Evidence for the use any no-pharmacological therapies to aid wound healing of pressure ulcers in the elderly remains inconclusive:

Full Text Link (Note: This article requires a suitable Athens password, a journal subscription or payment for access).

Reference

Vélez-Díaz-Pallarés, M. Lozano-Montoya, I. [et al] (2015). Nonpharmacologic interventions to heal pressure ulcers in older patients: an overview of systematic reviews (The SENATOR-ONTOP Series). Journal of the American Medical Directors Association. June 1st 2015; 16(6): 448-69.

Posted in Acute Hospitals, Community Care, Delirium, For Doctors (mostly), For Nurses and Therapists (mostly), For Researchers (mostly), International, Management of Condition, Non-Pharmacological Treatments, Person-Centred Care, Quick Insights, Scotland, Systematic Reviews, UK | Tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , | Leave a comment

Findings of the CQC’s Comprehensive Hospital Inspections Programme (BBC News / CQC)

Summary

The Care Quality Commission (CQC)’s “State of care in NHS acute hospitals: 2014 to 2016” report presents findings from the first round of acute and specialist hospital trust inspections. Analysis shows variations in the quality of care between hospitals, and between different core services at the same hospital(s). The majority of hospitals deliver good quality care, but inspections have uncovered aspects of poor care – even in well-performing hospitals.

“Safety at four in five hospital trusts in England is not good enough”. Professor Sir Mike Richards (CQC).

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Reference

Triggle, N. (2017). NHS standing on burning platform, inspectors warn. London: BBC Health News, March 2nd 2017.

This relates to:

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CQC reveals comprehensive picture of the quality of hospital care in England. [Online]: Care Quality Commission, March 2nd 2017.

The full report:

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Reference

The state of care in NHS acute hospitals: 2014 to 2016: findings from the end of CQC’s programme of NHS acute comprehensive inspections. London: Care Quality Commission, March 2nd 2017.

Posted in Acute Hospitals, BBC News, Commissioning, CQC: Care Quality Commission, For Carers (mostly), For Doctors (mostly), For Nurses and Therapists (mostly), For Researchers (mostly), In the News, Integrated Care, Local Interest, Management of Condition, National, Person-Centred Care, Quick Insights, Standards, Statistics, UK, Universal Interest | Tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , | Leave a comment