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Found 570 results
  1. Content Article
    Key points Rural and remote areas experienced problems that differentiate them from their more urban counterparts even before the Covid-19 pandemic. However, the pandemic has both exacerbated some of these challenges, as well as thrown up new ones. Covid-19 has had a more detrimental effect on hospital waiting times in rural and remote trusts than for trusts in more urban areas. In April 2020, the proportion of patients seen for their first consultant appointment for cancer fell by two-thirds (66%) in rural trusts compared with April 2019, whereas a decrease of 59% was seen in trusts located in more urban areas. Activity has fallen particularly dramatically in rural areas. Emergency admissions in April to June 2020 fell by 57% in rural trusts compared with the year before, while they fell by 45% elsewhere. The level of referral for talking therapies – via the Improving Access to Psychological Therapies (IAPT) programme – in rural areas was below half the level in April 2020 than it was a year before. The pandemic has exacerbated workforce issues in remote trusts. Remote trusts spend more on temporary staff (8% of their staffing budget) compared with other areas (6%). While the number of hospital and community health staff increased by 7% nationally in the year to June 2020, the workforce of remote trusts grew by only 5% over the same period. The underlying financial position of rural and remote services was worse than the position of more urban trusts before the pandemic started, and the pandemic may well have exacerbated this. Remote trusts’ debt was equivalent to more than half (56%) of their annual operating income in 2018/19. Remote trusts also typically do not seem to get their fair share of additional funding that goes into the NHS.
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    Key findings In England, Scotland and Wales, life expectancy and healthy life expectancy at birth are lowest for people living in more deprived areas. On average, people in the most deprived 10% of local areas are expected to live a shorter life than those in the least deprived areas. They are also more likely to spend more of their life in poor health. Of these three countries, Scotland has the largest difference between people in the most deprived 10% of local areas and those in the least deprived. This is true both for healthy life expectancy (25 years for men and 21.5 years for women) and life expectancy (13.3 years for men and 10 years for women). It is followed by England and then Wales.
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    The Conservatives have been accused of “failing women” as analysis reveals gynaecology waiting times have trebled in the past decade, with more than 540,000 waiting for NHS care. NHS England data shows that in October 2012, the average waiting time to see a gynaecologist was 4.8 weeks. By October 2022, the most recent month for which figures are available, that figure had increased by 225% to 15.6 weeks. Many of the conditions experienced by women waiting to see a gynaecologist are progressive. Left untreated, they can need more complex or invasive surgery. Thousands are living in extreme pain as a result of the long waits, doctors, health experts and charities told the Guardian. The figures reveal that 38,231 women have been waiting more than a year. Ten years ago there were 15 women in England waiting longer than 12 months – and no one waiting two years. Today, 69 women have been waiting more than 24 months. Dr Ranee Thakar, the president of the Royal College of Obstetricians and Gynaecologists, said: “This new analysis adds to our own research that gynaecology waiting lists were outstripping other specialities long before the pandemic, and they continue to grow rapidly. “Shockingly, the fact we can now track this pattern back 10 years, shows how long overdue action is to address the unequal growth in waiting lists.” Thakar added: “Women’s health has been consistently deprioritised. Gynaecology waiting times are currently the longest we’ve seen since waiting list targets were introduced, leaving thousands of women with symptoms including extreme pain, heavy menstrual bleeding and incontinence.” Read full story Source: The Guardian, 19 December 2022
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    The Covid-19 pandemic has laid bare deep-seated health inequalities and the issue is now at the forefront of the minds of people across the health and care system, as they seek to develop strategies aimed at reducing health inequalities at a regional, integrated care system (ICS) and place level. This conference will bring together individuals and teams developing health inequalities strategies. We will discuss the need for universal action at a population health level and targeted action to address issues affecting people facing the worst health outcomes, showing how these two approaches interlink. The conference will also explore opportunities across health and care to tackle health inequalities and learn from local and international leaders about how they are overcoming the challenges of turning evidence into action to make a difference to health inequalities. Register
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    Autistic people in England who do not also have a learning disability are approximately 51% more likely to die in a single year compared to the general population, according to a leaked document which estimates the mortality rate for the first time. According to an internal NHS England document, seen by HSJ, the standardised mortality rate between April 2020 and March 2021 was 16.6 deaths per 10,000 for people with autism and no learning disability compared to 11 deaths per 10,000 for the general population. NHSE also determined life expectancy for this group to be 75 years – 5.4 years less than the general population. Dominic Slowie, former national clinical director for learning disability, told HSJ that because of the different ways autism presents itself, it can be difficult to pinpoint causes of premature mortality. “In some cases, people with autism who are severely disabled and can’t communicate their needs in a conventional way are going to have premature mortality for the same reasons that people with a learning disability do, because people do not really understand the level of their need or do not investigate their need in a reasonably adjusted way,” he said. “While, if someone is presenting atypically in their communication, we mustn’t make presumptions – we must make reasonable adjustments to ensure they are investigated and diagnosed in the same way.” Read full story (paywalled) Source: HSJ, 13 December 2022
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    Key points The study found successful strategies are typically associated with a concert of activities that simultaneously ensure sufficient supply of health care, manage demand and optimise the conditions within the health care system itself. In England in the 2000s, a number of activities were associated with reduced waiting times. These activities were concentrated within the categories of increasing supply and optimising conditions within the health care system itself to achieve the goal of an 18‑week referral to treatment target by 2008. These activities were underpinned by a bigger idea about what the health service as a whole should look and feel like, and incorporated how waiting times are brought down as much as what activities might be used. For the experts interviewed, the achievement of the 18 weeks target was made possible as a result of: valuing and investing in people working in the NHS; a clear, central vision and goal for waiting and an ambition that those working within health care felt equipped to take on; cultivating relationships and leadership at all levels of the health care system; accountability, incentives and targeted support to encourage performance against waiting times targets and other measures of quality of care; and seizing the momentum of wider NHS reform. Whereas the improvement in waiting times performance of nearly 20 years ago took place in a very different political and economic context, the research highlighted not only hope but opportunities to reduce waiting times in the present day: by addressing shortages of health care staff and physical resources urgently; by working with integrated care systems in the spirit of prevention, collaboration, inclusion and community‑based models of care; and by aligning a vision for the health services with a plan that brings staff, patients and the public along on the journey to get there.
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    A new report by the World Health Organization shows evidence of a higher risk of premature death and illness among many persons with disabilities compared to others in the society. The Global report on health equity for persons with disabilities published today shows that because of the systemic and persistent health inequities, many persons with disabilities face the risk of dying much earlier—even up to 20 years earlier—than persons without disabilities. They have an increased risk of developing chronic conditions, with up to double the risk of asthma, depression, diabetes, obesity, oral diseases, and stroke. Many of the differences in health outcomes cannot be explained by the underlying health condition or impairment, but by avoidable, unfair and unjust factors. Read more Source: WHO, 2 December 2022
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    The report highlights that countries need to take urgent action to address the inequities in health caused by unjust and unfair factors within health systems. These factors—which account for many of the differences in health outcomes between persons with and without disabilities—can take the form of: negative attitudes of healthcare providers, health information in formats that cannot be understood, or difficulties accessing a health centre due to the physical environment, lack of transport or financial barriers. 9789240063600-eng.pdf
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    Poorer women in Britain have some of the highest death rates from cancer in Europe, an in-depth new World Health Organization study has found. They are much more likely to die from the disease compared with better-off women in the UK and women in poverty in many other European countries. Women in the UK from deprived backgrounds are particularly at risk of dying from cancer of the lungs, liver, bladder and oesophagus (foodpipe), according to the research by the International Agency for Research on Cancer (IARC), the WHO’s specialist cancer body. IARC experts led by Dr Salvatore Vaccarella analysed data from 17 European countries, looking for socioeconomic inequalities in mortality rates for 17 different types of cancer between 1990 and 2015. Out of the 17 countries studied, Britain had the sixth-worst record for the number of poor women dying of cancer. It had the worst record for oesophageal cancer, fourth worst for lung and liver cancer and seventh worst for breast and kidney cancer. However, the UK has a better record on poor men dying of cancer compared with their counterparts in many of the other 16 countries. It ranked fifth overall, second for cancer of the larynx and pharynx, and third for lung, stomach and colon cancer. That stark gender divide is most likely because women in the UK began smoking in large numbers some years after men did so, the researchers believe. They pointed to the fact that while cases of lung cancer have fallen among men overall in Britain, they have remained stable or increased among women, and gone up among women from deprived backgrounds. Read full story Source: The Guardian, 28 November 2022
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