Recorded Deaths With a Dementia Diagnosis More Than Doubled Since 2001? (PHE)

Summary

Public Health England (PHE) has released detailed statistics about the deaths of people recorded with dementia between 2012 and 2014. The proportion of people dying with a recorded dementia diagnosis increased from 6.6% of all deaths in 2001 to 15.8% of deaths in 2014. This apparent increase has been attributed largely to increasing dementia awareness, resulting in more common diagnosis and recording of the condition. The data comes from the Dementia Intelligence Network (DIN) and the National End of Life Care Intelligence Network (NEoLCIN), and addresses various issues including:

  1. Changes in the proportion of dementia-related deaths.
  2. Characteristics of people who die with dementia.
  3. Where people with dementia die (place of death).
  4. Causes of death in people with dementia.

Some indications of health inequalities:

  • People in deprived areas tend to die with dementia at a younger age than people from affluent areas.
  • People with dementia are more likely to die in hospitals and care homes, compared to the general population who are more likely to die in preferred places of death; namely at home, or in end of life care settings / hospices.

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Reference

Increase in the number of people dying with dementia. [Online]: Public Health England, September 29th 2016.

This relates to:

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Reference

National Dementia Intelligence Network and National End of Life Care Intelligence Network briefing. London: Public Health England / Dementia Intelligence Network (DIN) / National End of Life Care Intelligence Network (NEoLCIN), September 2016.

and a more detailed analysis:

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Reference

Data Analysis Report: Dying with Dementia. London: Public Health England / Dementia Intelligence Network (DIN) / National End of Life Care Intelligence Network (NEoLCIN), September 2016.

Further resources are available, including a Dying With Dementia Infographic a Dying With Dementia Presentation and detailed Excel file tables of local statistics: Dying With Dementia: Dataset By Local Authority and Clinical Commissioning Group.

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), In the News, Local Interest, Models of Dementia Care, National, NEoLCIN, Person-Centred Care, Public Health England, Quick Insights, Standards, Statistics, UK, Universal Interest | Tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , | Leave a comment

More on Housing and Health (King’s Fund / New NHS Alliance / National Housing Federation)

Summary

The King’s Fund’s “Economics of Housing and Health” report, commissioned by the National Housing Federation and produced in cooperation with the New NHS Alliance, investigates the economic arguments for more integrated commissioning between the housing and health sectors, and makes the case for further collaborative working across these two sectors.

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Reference

Buck, D. Ross, S. [and] Simpson, M. (2016). The economics of housing and health: the role of housing associations. London: King’s Fund [and] New NHS Alliance, September 2016.

A Suite of Three Reports

The above document is one of three related reports, produced by the New NHS Alliance and the King’s Fund, on strengthening the potential connections between commissioning in housing and health.

One of these further report explains how the health sector uses evidence in decision-making:

Full Text Link

Reference

Buck, D. Ross, S. [and] Simpson, M. (2016). Health professionals’ attitudes to evidence and the influence it has on decision making. London: King’s Fund, National Housing Federation [and] New NHS Alliance, September 2016.

The other report explains how housing organisations can make their strongest business case when addressing potential health partners:

Full Text Link

Reference

Buck, D. Ross, S. [and] Simpson, M. (2016). Developing a business case for health: what does good look like? London: King’s Fund, National Housing Federation [and] New NHS Alliance, September 2016.

Posted in Charitable Bodies, Commissioning, Community Care, For Carers (mostly), For Nurses and Therapists (mostly), For Researchers (mostly), For Social Workers (mostly), Housing, Integrated Care, King's Fund, Management of Condition, National, NHS, NHS Alliance, Non-Pharmacological Treatments, Person-Centred Care, Quick Insights, Standards, UK, Universal Interest | Tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , | Leave a comment

More on the Avoidable Costs of Lifestyle Risk Factors (BBC News / PHE)

Summary

Public Health England (PHE) has estimated that health problems associated with unhealthy lifestyle practices – such as poor diet, obesity, physical inactivity, drinking and smoking – cost the NHS in England approximately £11 billion per year.

A new approach to improving local health and wellbeing, adopted by Fleetwood in Lancashire, is discussed.

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Reference

Hughes, D. (2016). Illnesses associated with lifestyle cost the NHS £11bn. London: BBC Health News, September 26th 2016.

This relates, in part, to a set of statistical “local health” maps and reporting tools:

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Reference

Local health. [Online]: Public Health England, September 2016.

Related interest:

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Reference

Spencer, M. (2016). The doctor who wants to make his town better. London: BBC Health News, September 26th 2016.

Posted in BBC News, Commissioning, Community Care, For Carers (mostly), For Nurses and Therapists (mostly), For Researchers (mostly), In the News, Integrated Care, Local Interest, National, NHS, Non-Pharmacological Treatments, Person-Centred Care, Public Health England, Quick Insights, Statistics, UK, Universal Interest | Tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , | Leave a comment

Immovable Antipsychotic Prescribing Practices in Care Homes? (BMJ Open)

Summary

Incredible as it may seem, and contrary to years of high-level campaigning plus the circulation of awareness raising reports and guidelines, antipsychotic prescribing in long-term residential care in England did not, in fact, decline measurably during the four years following the launch the National Dementia Strategy (2009). Experts are thought to be baffled.

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Reference

Szczepura, A. Wild, D. Khan, AJ. [et al] (2016). Antipsychotic prescribing in care homes before and after launch of a national dementia strategy: an observational study in English institutions over a 4-year period. BMJ Open. BMJ Open. September 20th 2016; 6(9): e009882.

Posted in Antipsychotics, Commissioning, Community Care, For Carers (mostly), For Doctors (mostly), For Nurses and Therapists (mostly), For Researchers (mostly), For Social Workers (mostly), In the News, International, Management of Condition, Mental Health, Models of Dementia Care, Pharmacological Treatments, Quick Insights, Standards, Statistics, UK, Universal Interest | Tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , | 1 Comment

Update on Overuse: Further Information on the Potential Costs and Risks of Over-Diagnosis and Over-Treatment (JAMA Internal Medicine)

Summary

An updated systematic review indicates a growing awareness and debate concerning overuse of medical care. The literature on a broadly Too Much Medicine and / or a Less is More theme has grown rapidly, whereby reviewers found 821 relevant articles in 2015 compared with 440 the year earlier.

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Reference

Morgan, DJ. Dhruva, SS. [and] Wright, SM. [et al] (2016). Less is more. 2016 update on medical overuse: a systematic review. JAMA Internal Medicine. September 19th 2016; [Epub ahead of print].

Earlier:

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Reference

Morgan, DJ. Dhruva, SS. [and] Wright, SM. [et al] (2015). Update on medical practices that should be questioned in 2015. JAMA Internal Medicine. December 2015; 175(12): 1960-4.

The 2014/5 review mentioned above:

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

Reference

Morgan, DJ. Dhruva,SS. [and] Wright, SM. [et al] (2015). Update on medical overuse. JAMA Internal Medicine. January 2015; 175(1): 120-4.

Posted in Commissioning, For Doctors (mostly), For Nurses and Therapists (mostly), For Researchers (mostly), In the News, Integrated Care, International, Person-Centred Care, Quick Insights, Standards, Statistics, Universal Interest | Tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , | Leave a comment

Screening For Frailty: as Easy as eFI? (NHS England / Age and Ageing)

Summary

The “electronic Frailty Index (eFI)” is discussed, by NHS England’s National Clinical Director for Older People and Person Centred Integrated Care, as a validated tool which might assist in the proactive identification, diagnosis and management of frailty.

Potentially, the eFI can analyse data already collected and coded routinely within general practices to differentiate between older patients with mild, moderate and severe levels of frailty. The aim is then to target resources more precisely to better avoid the risk of costly adverse outcomes such as avoidable mortality, preventable hospitalisations or premature / unnecessary nursing home admissions.

“ …screening for frailty now creates the opportunity to identify people in our local populations living with severe frailty, thereby opening the way for targeted assessment of need and better coordination and planning for delivery of interventions. This provides us with greater opportunity to reduce the likelihood and impact of significant future life events”.

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Reference

Why is diagnosing frailty important? – Professor Martin Vernon. [Online]: NHS England, September 19th 2016.

This relates to:

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Reference

Clegg, A. Bates, C. [and] Young, J. [et al] (2016). Development and validation of an electronic frailty index using routine primary care electronic health record data. Age and Ageing. May 2016; 45(3): 353-60.

On Count-Based Scores for Measuring and Predicting Multimorbidity

Writing from a contrary position, probably, the authors of the following article appear to cast doubt on the value of count-based measures of multi-morbidity when it comes to predicting emergency admissions, functional decline and other adverse outcomes.

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Reference

Wallace, E. McDowell, R. Bennett, K. [et al] (2016). Comparison of count-based multimorbidity measures in predicting emergency admission and functional decline in older community-dwelling adults: a prospective cohort study. BMJ Open. September 20th 2016; 6(9): e013089.

Posted in Commissioning, Community Care, Diagnosis, For Doctors (mostly), For Nurses and Therapists (mostly), For Researchers (mostly), For Social Workers (mostly), Integrated Care, Management of Condition, National, NHS, NHS England, Non-Pharmacological Treatments, Person-Centred Care, Quick Insights, Statistics, Systematic Reviews, UK, Universal Interest | Tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , | Leave a comment

A Tipping Point in the Sustainability of Health and Care? (BBC News / King’s Fund / Nuffield Trust)

Summary

A King’s Fund / Nuffield Trust report identifies a 26% decline in the number of older people receiving social care, due largely to six years of cuts to local authority funding. Social care providers are found to be under pressure to survive, experiencing problems with staff retention and being possibly unable to maintain quality of care. Local authorities face tough decisions about which service reductions should be made.

It appears to be the elderly themselves, and their families and carers, who are increasingly left to carry the burden. Help from the voluntary sector may plug the gap slightly, as should diversion of “better care” funding from the NHS to social care.

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Reference

Triggle, N. (2016). Care cuts ‘leave frail elderly fending for themselves’. [Earlier title = Care for elderly ‘increasingly rationed’ in England]. London: BBC Health News, September 15th 2016.

This relates to:

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Reference

Humphries, R. Thorlby, R. [and] Holder, H. [et al] (2016). Social care for older people: home truths. London: King’s Fund [and] Nuffield Trust, September 2016.

There is a parallel report examining the impact of service reductions on typical individuals, from the King’s Fund and Nuffield Trust (jointly), which was commissioned by the Richmond Group of Charities. The Richmond Group is a collaboration of twelve large health and care charities in the UK.

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Reference

Hall, P. [and] Holder, H. (2016). Real lives: listening to the voices of people who use social care. London: Richmond Group of Charities / Nuffield Trust, September 2016.

A Continuing Theme: Concerning the Interdependence Between Social Care Provision and NHS Performance

Shortcomings in the availability of adequate social care, home care and community nursing etc. have predictable knock-on effects for patient flows through the NHS system more widely, resulting in record delays in discharging older people from hospital.

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Reference

Pym, H. (2016). Is the NHS facing a perpetual winter? London: BBC Health News, September 12th 2016.

More on the protracted crisis in NHS performance:

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Reference

Pym, H. (2016). NHS England hospital patients face record discharge delays. London: BBC Health News, September 8th 2016.

This relates to:

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Reference

Murray, R. Jabbal, J. [and] Thompson, J. [et al] (2016). Quarterly Monitoring Report. QMR No.20. September 2016. London: King’s Fund, September 8th 2016.

Posted in Age UK, BBC News, Charitable Bodies, Commissioning, Community Care, For Carers (mostly), For Nurses and Therapists (mostly), For Researchers (mostly), For Social Workers (mostly), In the News, Integrated Care, King's Fund, Management of Condition, National, NHS, Non-Pharmacological Treatments, Nuffield Trust, Person-Centred Care, Personalisation, Quick Insights, Standards, Statistics, UK, Universal Interest | Tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , | Leave a comment