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Found 949 results
  1. Content Article
    This article in the International Journal of Environmental Research and Public Health proposes a new approach to hospital bed planning and international benchmarking. The number of hospital beds per 1000 people is commonly used to compare international bed numbers. The author, Rodney Jones, suggests that this method is flawed because it doesn't consider population age structure or the effect of nearness-to-death on hospital use. To remedy this problem, Jones suggests a new approach to bed modelling that plots beds per 1000 deaths against deaths per 1000 population. Lines of equivalence can be drawn on the plot to delineate countries with a higher or lower bed supply. This method is extended to attempt to define the optimum region for bed supply in an effective health care system. England is used as an example of a health system descending into operational chaos due to too few beds and manpower. The former Soviet bloc countries represent a health system overly dependent on hospital beds. Several countries also show evidence of overuse of hospital beds. The new method is used to define a potential range for bed supply and manpower where the most effective health systems currently reside. The role of poor policy in NHS England is used to show how the NHS has been led into a bed crisis. The method is also extended beyond international benchmarking to illustrate how it can be applied at a local or regional level in the process of long-term bed planning.
  2. Content Article
    Increasing diversity amongst surgeons results in a wide range of sizes and strengths. There are many types of biases affecting women surgeons. This study evaluates what challenges women surgeons may have with surgical equipment. Key findings include: 89% of women surgeons report difficulty with surgical instruments due to size. 71% of women surgeons report difficulty with surgical instruments due to grip strength. The study highlights a potential source of gender bias which could be addressed to improve equity for women surgeons.
  3. Content Article
    A monthly journal for all operating theatre staff covering surgical and anaesthesia news.
  4. Content Article
    D-Coded is an online resource that presents easy-to-understand summaries of diabetes research studies. It aims to make the latest knowledge and developments accessible to people who don't have a medical or scientific background. In this blog, Jazz Sethi, Founder and Director of the Diabesties Foundation and part of the global team that developed D-Coded, discusses the need for the resource and outlines how it will help people living with diabetes to better understand and manage their condition.
  5. Content Article
    Paediatric health research is fraught with both ethical and practical challenges that can prevent the successful completion of research studies. Listening to, and acting on, the voices of children and young people in the design and delivery of paediatric health research (otherwise known as Patient and Public Involvement) is one way to overcome these challenges. This paper describes the authors' experiences of working directly with children and young people in various health research initiatives. They outline the journey of involving children and young people as partners and give examples to demonstrate the unique knowledge and insights gained in the production of high-quality research.
  6. News Article
    Many people are deeply confused about the growing number of “physician associates” in the NHS and wrongly assume they are doctors, research suggests. Around 4,000 physician associates work in the NHS in England. Ministers and health chiefs plan to increase the figure to 10,000 to help plug widespread gaps in the NHS workforce. However, there is widespread confusion among the public about their role and relationship with fully trained medics, according to a survey commissioned by the British Medical Association (BMA). A quarter of the representative sample of 2,009 people erroneously believed that a physician associate was a doctor, while a fifth made the same mistake about “physician assistants”. Many respondents thought that a physician associate was more senior than a junior doctor, even though only the latter have a medical degree. The expansion of physician associates has prompted a backlash by grassroots medics. They fear patients will be misled into thinking they have seen a doctor despite physician associates not having the same skills and training. The government has moved to try to quell criticism of physician associates by legislating to ensure they are regulated by the General Medical Council (GMC). Read full story Source: The Guardian, 13 December 2023
  7. News Article
    The risk of dying from cancer in England “varies massively” depending on where a person lives, according to a study that experts say exposes “astounding” health inequalities. Researchers who analysed data spanning two decades found staggering geographical differences. In the poorest areas, the risk of dying from cancer was more than 70% higher than the wealthiest areas. Overall, the likelihood of dying from cancer has fallen significantly over the last 20 years thanks to greater awareness of signs and symptoms, and better access to treatment and care. The proportion dying from cancer before the age of 80 between 2002 and 2019 fell from one in six women to one in eight, and from one in five men to one in six. However, some regions enjoyed a much larger decline in risk than others, and the new analysis has revealed that alarming gaps in outcomes remain. “Although our study brings the good news that the overall risk of dying from cancer has decreased across all English districts in the last 20 years, it also highlights the astounding inequality in cancer deaths in different districts around England,” said Prof Majid Ezzati, from Imperial College London, who is a senior author of the study. Read full story Source: The Guardian, 11 December 2023
  8. Content Article
    Cancers are the leading cause of death in England. This study from Rashid et al. published in Lancet Oncology aimed to estimate trends in mortality from leading cancers from 2002 to 2019 for the 314 districts in England. The study found that declines in overall cancer mortality have been unequal both geographically and among different groups of cancers. The greatest geographical inequality was observed for cancers with modifiable risk factors and potential for screening for precancerous lesions. Addressing risk factors such as smoking and alcohol use, expanding access to and utilisation of screening for prevention and early detection, and improving the quality of care should be used to reduce deaths in areas where they remain highest. High-resolution spatiotemporal data can help identify where intervention is required and track progress.
  9. Content Article
    The Covid-19 pandemic increased the sense of urgency to advance understanding and prevention of infectious respiratory disease transmission. There are extensive studies that demonstrate scientific understanding about the behaviour of larger (droplets) and smaller (aerosols) particles in disease transmission as well as the presence of particles in the respiratory track. Methods for respiratory protection against particles, such as N95 respirators, are available and known to be effective with tested standards for harm reduction. However, even though multiple studies also confirm their protective effect when N95 respirators are adopted in healthcare and public settings for infection prevention, overall, studies of protocols of their adoption over the last several decades have not provided a clear understanding. This preprint article demonstrates limitations in the methodology used to analyse the results of these studies. The authors show that existing results, when outcome measures are properly analysed, consistently point to the benefit of precautionary measures such as N95 respirators over medical masks, and masking over its absence.
  10. Content Article
    In this study, Westbrooke et al. identified individual and organisational factors associated with the prevalence, type and impact of unprofessional behaviours among hospital employees. The study found that unprofessional behaviour is common among hospital workers. Tolerance for low level poor behaviour may be an enabler for more serious misbehaviour that endangers staff wellbeing and patient safety. Training staff about speaking up is required, together with organisational processes for effectively eliminating unprofessional behaviour.
  11. Content Article
    Early recognition and treatment of sepsis are linked to improved patient outcomes. Machine learning-based early warning systems may reduce the time to recognition, but few systems have undergone clinical evaluation. In this prospective, multi-site cohort study, Adams et al. examined the association between patient outcomes and provider interaction with a deployed sepsis alert system called the Targeted Real-time Early Warning System (TREWS). The findings indicate that early warning systems have the potential to identify sepsis patients early and improve patient outcomes and that sepsis patients who would benefit the most from early treatment can be identified and prioritised at the time of the alert.
  12. Content Article
    Patient safety incidents, including medical errors and adverse events, frequently occur in intensive care units, leading to a significant psychological burden on healthcare professionals. This burden results in second victim syndrome, which impacts the psychological and psychosomatic wellbeing of these staff members. This systematic review and meta-analysis aimed to examine the occurrence of second victim syndrome among intensive care unit healthcare workers, including the types, prevalence, risk factors and recovery time associated with the condition.
  13. Content Article
    The 2022 LeDeR report seeks to investigate and learn from the avoidable deaths of people with a learning disability in England. The report, which is produced for NHS England, was led by researchers from the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s College London, the University of Central Lancashire, and Kingston University London. Researchers found: gentle but continuous improvement in the median age of death for people with a learning disability in 2022. In 2018, the median age of death for adults with a learning disability was 61.8 years but has since risen to 62.9 in 2022. If children are included, the age at death increased from 60.1 years in 2018 to 62.7 in 2022. a drop in the number of avoidable deaths since 2021 – 42% of deaths were deemed “avoidable” for people with a learning disability in 2022 compared to 50% in 2021. a sharp drop in the number of deaths due to Covid-19 – from 24% of all causes of death in 2020 to 19% in 2021 and 6% in 2022 for adults with a learning disability. "While there are positives, it’s also clear that more work still needs to be done. People from ethnic minority groups died younger, and there is a need to improve access to care pathways to improve prevention and better manage some conditions in people with a learning disability, such as cancer, lung, heart and circulatory conditions. We also identified a concerning effect on excess deaths of people with a learning disability during heatwaves. This means care homes and hospitals looking after people with a learning disability need to be better prepared for weather events in the light of climate change. Improvements during 2022 should certainly be celebrated, but we shouldn’t overlook how much we still don’t know." Professor Andre Strydom, Chief Investigator and Professor in Intellectual Disabilities at King’s IoPPN. Read the full report via the link below.
  14. Content Article
    Over the past two years, AHRQ has examined equity and its connections to agency activities in alignment with its mission to improve healthcare for all Americans. A new special issue of Health Services Research sponsored by AHRQ summarises the state of evidence and identifies opportunities to drive more equitable care.
  15. Content Article
    New developments in artificial intelligence (AI) are extensively discussed in public media and scholarly publications. While in many academic disciplines debates on the challenges and opportunities of AI and how to best address them have been launched, the human factors and ergonomics (HFE) community has been strangely quiet. In this paper, Gudela Grote discusses three main areas in which HFE could and should significantly contribute to the socially and economically viable development and use of AI: decisions on automation versus augmentation of human work; alignment of control and accountability for AI outcomes; counteracting power imbalances among AI stakeholders. She then outlines actions that the HFE community could undertake to improve their involvement in AI development and use, foremost translating ethical into design principles, strengthening the macro-turn in HFE, broadening the HFE design mindset, and taking advantage of new interdisciplinary research opportunities.
  16. Content Article
    Triage and clinical consultations increasingly occur remotely. In this study, published in BMJ Quality & Safety, Payne et al. aimed to learn why safety incidents occur in remote encounters and how to prevent them. They found that rare safety incidents (involving death or serious harm) in remote encounters can be traced back to various clinical, communicative, technical and logistical causes. Telephone and video encounters in general practice are occurring in a high-risk (extremely busy and sometimes understaffed) context in which remote workflows may not be optimised. Front-line staff use creativity and judgement to help make care safer. As remote modalities become mainstreamed in primary care, staff should be trained in the upstream causes of safety incidents and how they can be mitigated. The subtle and creative ways in which front-line staff already contribute to safety culture should be recognised and supported.
  17. News Article
    At least 20,000 cancer deaths a year could be avoided in the UK with a national commitment to invest in research and innovation, and fix the NHS, says Cancer Research UK. Progress is being made in finding new treatments for the condition that affects 50% of people at some point. But the charity says the UK lags behind comparable countries for survival. It has launched a manifesto of priorities for this government and the next, ahead of a general election. The document sets out what the charity says needs to change - and fast. Whoever is running the country must commit to developing a 10-year cancer plan, spearheaded by a National Cancer Council accountable to the prime minister to bring government, charities, industry and scientific experts together, it says. Key areas to focus on include: More investment in research to close an estimated £1bn funding gap. Greater disease prevention - banishing smoking to the history books, for example. Earlier diagnosis, through screening. Better tests and treatments, as well as cutting NHS waiting lists and investing in more staff. Read full story Source: BBC News, 28 November 2023
  18. Content Article
    Cancer Research UK has set out how the next UK Government could dramatically improve cancer outcomes and prevent 20,000 cancer deaths a year by 2040.  'Longer better lives: A manifesto for cancer research and care' has been developed with the insights of cancer patients and experts from across health, life sciences, government and academic sectors.   The charity said that huge strides have been made in beating cancer – with survival in the UK doubling over the last 50 years.  But it warned that with NHS cancer services in crisis and around half a million new cancer cases each year expected by 2040 – this hard-won progress is at risk of stalling.    With the UK lagging behind comparable countries when it comes to cancer survival, the charity is calling on all political parties to make cancer a top priority in their party manifestos. 
  19. Content Article
    Digital health inequality, observed as differential utilisation of digital tools between population groups, has not previously been quantified in the NHS. But recent developments in universal digital health interventions, including a national smartphone app and online primary care services, allow measurement of digital inequality across a nation. This study in BMJ Health & Care Informatics aimed to measure population factors associated with digital utilisation across 6356 primary care providers serving the population of England. The authors concluded that the study results are concerning for technologically driven widening of healthcare inequalities. They highlight the need for targeted incentives to digital in order to prevent digital disparity from becoming health outcomes disparity.
  20. Content Article
    Sepsis, characterised by significant morbidity and mortality, is intricately linked to socioeconomic disparities and pre-admission clinical histories. This study in eClinical Medicine looked at the association between non-COVID-19 related sepsis and health inequality risk factors amidst the pandemic in England, with a secondary focus on their association with 30-day sepsis mortality. It found that socioeconomic deprivation, comorbidity and learning disabilities were associated with an increased odds of developing non-COVID-19 related sepsis and 30-day mortality in England. This study highlights the need to improve the prevention of sepsis, including more precise targeting of antimicrobials to higher-risk patients. It also revealed that people with learning disabilities were almost four times as likely to develop the life-threatening illness. People with chronic liver disease were just over three times as likely, and chronic kidney disease stage 5 over 6 times more likely to develop non-COVID-19 sepsis. Cancer, neurological disease, immunosuppressive conditions, and having multiple prior courses of antibiotics were also associated with developing non-COVID-19 sepsis.
  21. News Article
    Poor people and those with existing health problems are much more likely to die from sepsis, one of the UK’s biggest killers, a study has found. Sepsis, or blood poisoning, is a potentially fatal condition triggered when the body reacts to an infection by attacking its own tissues and vital organs. It leads to an estimated 48,000 deaths a year in Britain. Research from the University of Manchester has disclosed for the first time how some groups are at much higher risk of dying from the condition than the general population. An analysis of 248,767 cases of non-Covid sepsis in England between January 2019 and June 2022 has found that the most deprived people are twice as likely to die from it within 30 days. The findings, published in the journal eClinicalMedicine, also show that: People with learning disabilities are almost four times more likely to get sepsis. People with liver disease have about three times greater risk. Patients with chronic kidney disease that is at stage 5 are more than six times as likely to develop it. “This study shows socioeconomic deprivation, comorbidity and learning disabilities are associated with an increased risk of developing non-Covid related sepsis and 30-day mortality in England.” Read full story Source: The Guardian, 23 November 2023
  22. Content Article
    A NIHR-funded study has reached an agreement amongst researchers and patients on how best to measure improvement in Long Covid. Researchers have identified a Core Outcome Measure Set (COMS). This is designed to help researchers and clinicians measure the severity and impact of Long COVID. COMS specify key things that should be measured in all patients. This improves how data can be compared and summarised. Researchers say this will speed up the development of treatments for Long Covid. 
  23. Content Article
    Presentation slides from Session 1 of the SEHTA 2023 International MedTech Expo & Conference. This session was on patient voice engagement. Presentations can be downloaded below.
  24. Content Article
    Reducing the amount of time to give antibiotics to sepsis patients should contribute to better health outcomes, but the broad impact of reducing time-to-antibiotics may vary significantly, according to an AHRQ-funded study. In the study, published in Annals of the American Thoracic Society, researchers found that in 60% percent of hospitalisations patients received antibiotics within 48 hours of presentation and in 13% of hospitalisations patients experienced an adverse event, based on records of over 1.5 million hospitalised patients. The authors then ran simulations of 12 hospital scenarios based on the volume of sepsis cases (high, medium and low volume), and found that the effect of faster time to antibiotics varies markedly across simulated hospital scenarios, but new antibiotic-associated adverse events were rare.
  25. News Article
    Liquid bleach does not kill off a hospital superbug that can cause fatal infections, researchers have found. Clostridium difficile, also known as C diff, is a type of bacteria found in the human gut. While it can coexist alongside other bacteria without problem, a disruption to gut flora can allow C diff to flourish, leading to bowel problems including diarrhoea and colitis. Severe infections can kill, with 1,910 people known to have died within 30 days of an infection in England during financial year 2021-2022. Those at greater risk of C diff infections include people aged over 65, those who are in hospital, people with a weakened immune system and people taking antibiotics, with some individuals experiencing repeated infections. According to government guidance, updated in 2019, chlorine-containing cleaning agents with at least 1,000 ppm available chlorine should be used as a disinfectant to tackle C diff. But researchers say it is unlikely be sufficient, with their experiments suggesting that even at high concentrations, sodium hypochlorite – a common type of bleach – is no better than water at doing the job. “With antimicrobial resistance increasing, people need to recognise that overuse of biocides can cause tolerance in certain microbes, and we’re seeing that definitely with chlorine and C diff,” said Dr Tina Joshi, co-author of the research, from the University of Plymouth. While chlorine-based chemicals used to be effective at killing such bacteria, that no longer appears to be the case, she said. “The UK doesn’t seem to have any written new gold standard for C diff disinfection. And I think that needs to change immediately,” she said. Read full story Source: The Guardian, 22 November 2023
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