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Found 41 results
  1. News Article
    Researchers have warned there is a lack of evidence around prescribing antidepressants for chronic pain. Guidance from the National Institute for Health and Care Excellence (Nice) in 2021 recommends that an antidepressant (amitriptyline, citalopram, duloxetine, fluoxetine, paroxetine or sertraline) can be considered for people aged 18 and over with pain lasting longer than three months which cannot be accounted for by another diagnosis. The guidance said the drugs may help with quality of life, pain, sleep and psychological distress, even if the patient is not suffering depression. A separate guideline on neuropathic (nerve) pain recommends offering a choice of treatments, including amitriptyline and duloxetine, alongside a discussion on possible benefits and side-effects. However, researchers writing in the BMJ have warned that recommending antidepressants for pain is not always backed by evidence. Professor Martin Underwood from the University of Warwick, said: “There is a role for antidepressants in helping people living with chronic pain, however, this is more limited than previously thought. “Antidepressants may have unpleasant side effects that patients may wish to avoid. “We need to work harder to help people manage their pain and live better, without relying on the prescription pad.” Read full story Source: The Independent, 1 February 2023
  2. News Article
    One in eight adults in the UK have paid for private medical care in the last year because of long delays in getting NHS treatment, renewing fears that the NHS is becoming “a two-tier system”. “Around one in eight (13%) adults reported they had paid for private medical care, with 5% using private insurance and 7% paying for the treatment themselves,” according to a new report by the Office for National Statistics (ONS). Patients also say that waiting for tests or treatment is badly affecting them, including making their illness worse. The ONS survey of 2,510 adults across the UK found that one in five were waiting for an appointment, test or treatment at an NHS hospital. Of those in that situation: Three-quarters said their delay had had either a strongly (34%) or slightly (42%) negative impact on their life 36% said waiting had made their condition worse 59% said it had damaged their wellbeing A third said long waits had affected either their mobility (33%) or ability to exercise (34%) Read full story Source: The Guardian, 16 December 2022
  3. Content Article
    IAPT services are characterised by three things: Evidenced-based psychological therapies: with the therapy delivered by fully trained and accredited practitioners, matched to the mental health problem and its intensity and duration designed to optimise outcomes. From April 2018 all clinical commissioning groups are required to offer IAPT services integrated with physical healthcare pathways. The IAPT Pathway for People with Long-term Physical Health Conditions and Medically Unexplained Symptoms guidance is intended to help with implementation and sets out the ideal pathway for IAPT services. Routine outcome monitoring: so that the person having therapy and the clinician offering it have up-to-date information on an individual’s progress. This supports the development of a positive and shared approach to the goals of therapy and as this data is anonymised and published this promotes transparency in service performance encouraging improvement. Regular and outcomes focused supervision so practitioners are supported to continuously improve and deliver high quality care. If you live in England and are aged 18 or over, you can access NHS psychological therapies (IAPT) services. A GP can refer you, or you can refer yourself directly without a referral.
  4. Content Article
    Key points The health and social care system is gridlocked. People are struggling to access care. Inequalities pervade and persist. The quality of maternity care is not good enough. The care for people with a learning disability and autistic people is still not good enough. Mental health services are struggling to meet the needs of children and young people. Ongoing problems with the Deprivation of Liberty Safeguards process. Depleted workforce. Challenges and opportunities in local systems.
  5. Content Article
    Key findings Workforce and sector size An estimated 17,900 organisations were involved in providing or organising adult social care in England as at 2021/22. Those services were delivered in an estimated 39,000 establishments. There were also 65,000 individuals employing their own staff. The total number of adult social care posts in 2021/22 was 1.79m. 1.62m of these posts were filled by a person (filled posts) and 165,000 were posts that employers were actively seeking to recruit somebody to (vacancies). The adult social care sector was estimated to contribute £51.5 billion gross value added (GVA) per annum to the economy in England (up 2% from 2020/21). Recent trends – workforce supply and demand The total number of posts in adult social care in England as at 2021/22 was 1.79 million (up 0.3% from 2020/21). Of these posts, 1.62m were currently filled by a person (filled posts) and 165,000 were posts that employers were actively seeking to recruit somebody to (vacancies). Skills for Care workforce estimates show a decrease in the number of filled posts in 2021/22. Overall, the decrease was around 3% (50,000 posts). The vacancy rate has risen over the same period to the highest rate since records began in 2012/13. The number of vacancies increased by 52% in 2021/22 by 55,000 to 165,000 vacant posts. The vacancy rate in 2021/22 was 10.7%. This shows that the decrease in filled posts is due to recruitment and retention difficulties in the sector rather than a decrease in demand. Employers have not been able to recruit and keep all the staff they need. As a result, an increasing number of posts remain vacant. The starter rate has fallen from 37.3% in 2018/19 to 30.8% in 2021/22. The turnover rate these periods remained at a similar level (29% in 2021/22). Therefore, around the same proportion of people are leaving their roles, but there are fewer people replacing them. The UK vacancy rate has increased rapidly in the past year. This increase has created competition for staff and contributed to the increase in the adult social care vacancy rate over the same period. During 2022, following the relaxation of rules regarding testing and isolation, sickness rates have begun to decrease towards pre-pandemic levels (6.2 days as at August 2022 compared to 4.6 days in 2019/20). Workforce characteristics The adult social care workforce continued to be made up of around 82% female workers, the average age was 45 (with 28% aged 55 and over), 23% of the workforce had black, Asian and minority ethnicity and 16% had a non-British nationality. Data collected in the ASC-WDS since care workers were added to the shortage occupation list showed more people were arriving in the UK to take up adult social care jobs. In 2022, between February and August, 11% of workers new to their role within the year had also arrived in the UK within the year. This was greater than the equivalent period in 2021 (4%) and 2020 (2%). Almost a quarter of the adult social care workforce (24%, or 358,000 filled posts) were employed on zero-hours contracts. In April 2021, the NLW rose from £8.72 to £8.91 (2.2% in nominal terms). This increase contributed to a 5.4% increase in the median nominal care worker hourly rate from March 2021 to March 2022. This was the second highest increase over the recorded period. The median hourly rate for care workers decreased, in real terms, by 1.5% between March 2021 and March 2022. This compares to an average increase of 1.8% per year since September 2012. This decrease was driven by the high cost of living in 2021/22 with inflation rising to 7.0%. Analysis of workforce data from the ASC-WDS shows that there were differences in diversity between job roles. Notably, there were proportionally more males and more white people in senior roles than front line roles. The root cause of this difference can’t be ascertained from ASC-WDS data alone. Our forecasts show that if the number of adult social care posts grows proportionally to the projected number of people aged 65 and over in the population between 2021 and 2035, an increase of 27% (480,000 extra posts) would be required by 2035. Employers with favourable workforce metrics (such as high levels of learning and development), on average, had better outcomes (lower staff turnover and/or high CQC ratings).
  6. News Article
    Patients are being excluded from life-saving eating disorder treatment as services are severely underfunded, experts have warned. Adult eating disorder services are so severely underfunded and understaffed that they are having to employ rationing measures and turn away patients, leading psychiatrist Dr Agnes Ayton told The Independent. In their research, Dr Ayton and 22 other psychiatrists found that in 2019-20, just 31% of eating disorder services accepted all patients, regardless of the level of illness. The researchers warned that the situation had become more serious following the pandemic, which had driven a “worsening of the demand and capacity” crisis across the services. Experts have called for emergency funding to meet the needs of adult patients with eating disorders, and say that these services should be receiving at least £7m per million population each year to meet standards. Dr Ayton warned that patients who are “literally on death’s door” are not getting care when they need it. Read full story Source: The Independent, 25 September 2022
  7. News Article
    For the first time, a US government-backed expert panel has recommended that adults under 65 should be screened for anxiety disorders. The influential US Preventive Services Task force also said that all adults should be checked for depression, consistent with past guidance. The change follows widespread warnings from experts on the mental health toll of the Covid-19 pandemic. The task force stopped short of a screening recommendation for suicide. The panel acknowledged that suicide is a leading cause of death among American adults but said there was "not enough evidence on whether screening people without signs or symptoms will ultimately help prevent suicide". The draft guidance is aimed at young and middle-aged adults, including those who are pregnant and post-partum. It envisions the mental health screening as part of routine visits with primary care physicians, said Dr Lori Pbert, a task-force member and professor in the Department of Population and Quantitative Health Sciences at UMass Chan Medical School. "When you go to your primary care provider, you get screened for many, many preventive conditions - blood pressure, heart rate, all kinds of things," she said. "Mental health conditions are just important as other physical conditions, and we really need to be treating mental health conditions with the same urgency that we do other conditions." Read full story Source: BBC News, 20 September 2022
  8. News Article
    Adult social care in England is in serious crisis, Tory council leaders have warned the government, as it faces a £3.7bn funding gap and a growing staffing shortage that has brought many local care providers to the brink of collapse. The intervention by the County Councils Network, which represents 36 mainly Tory-run authorities, comes amid widespread local government concern over the increasing fragile state of social care. Care costs have accelerated recently, fuelled by unexpected wage and energy inflation. “We face the perfect storm of staffing shortages, fewer care beds, and higher costs – all of which will impact on individuals waiting for care and discharges from hospital,” said Martin Tett, the Tory leader of Buckinghamshire county council. Cathie Williams, the chief executive of the Association of Directors of Adult Social Services, said: “Too many people are missing out on vital care and support – we estimate that over half a million people are waiting for assessments, care, or reviews. With over 165,000 staff vacancies, this is only set to get worse. ” A government spokesperson said: “The health and social care secretary is focused on delivering for patients and has set out her four priorities of A, B, C, D – reducing ambulance delays, busting the Covid backlogs, improving care, and increasing the number of doctors and dentists. Read full story Source: The Guardian, 21 September 2022
  9. Content Article
    This guideline includes recommendations on: information for patients measuring temperature warming patients before their operation, including transfer to the operating theatre keeping patients warm during their operation, including ambient temperature in the operating theatre and temperature of intravenous fluids keeping patients warm after their operation
  10. Content Article
    MEs are a key element of the death certification reforms, which, once in place, will deliver a more comprehensive system of assurances for all non-coronial deaths, regardless of whether the deceased is buried or cremated. MEs will be employed in the NHS system, ensuring lines of accountability are separate from NHS Acute Trusts but allowing for access to information in the sensitive and urgent timescales to register a death. This case study outlines the approach of South Tees Hospitals NHS Foundation Trust as one of the early adopter sites. To date, the following learning points have been identified and explored: End of Life Care, ceilings of care and avoidable admissions Some investigations have highlighted cases where the End of Life Care pathway could have either been established or fully implemented, where this would have been of benefit to patients and their families. Some patients may not have been cared for in the right location, and some admissions could have been avoided if the End of Life Care pathway had been suitably established and followed. Early detection and response to physiological deterioration, and effective communication Response stretched by implementation of National Early Warning Score (NEWS) but still learning around effective communication of escalation. The use of standardised communication tools is essential. Record keeping and organisation of medical records Some learning was identified in relation to the accuracy and completeness of medical records. It was evident that not all records are reflective of the clinical picture. Discussion with specialty teams is vital to support the investigation An independent review by the ME should be further supported by speciality ‘experts’, and if possible, peer review from other trusts can be sought to allow for full independent review. Seeking speciality opinion from those not directly involved with the case within STHFT has also been shown to be effective. Pathways for links to wider clinical governance processes have been strengthened.
  11. Content Article
    The NHS web page summarises: How capacity is assessed What is 'best interests' Deprivation of liberty Advanced statements and decisions Lasting powers of attorney The court of protection Professionals duties
  12. Content Article
    What can I learn? The role and responsibilities of maternity safety champions. How to build relationships at board-level and with stakeholders. Suggested activities to promote best practice. Signposting to existing safety initiatives and improvements that can offer support. Are you a maternity safety champion? Share your experience and discuss your work with other maternity safety champions on the hub.
  13. News Article
    Everyone with type 1 diabetes in England should be offered some form of continuous glucose monitoring (CGM) technology to support their care, the National Institute for Health and Care Excellence (NICE) has recommended. Updated draft guidelines published on 31 March recommend that all adults with type 1 diabetes should be offered a choice of either real time or intermittent (flash) CGM through a sensor attached to the skin as part of their ongoing NHS care. NICE also recommends that all young people aged 4 years and over with type 1 diabetes should be offered real time CGM and that some people with type 2 diabetes who use insulin intensive therapy (4 or more injections a day) should have access to Flash. Read full story (paywalled) Source: BMJ, 31 March 2022 Read NICE guidelines here.
  14. Content Article
    The document includes guidance on: staff IPC considerations: vaccination, personal protective equipment (PPE), staff movement, testing IPC considerations for people receiving care: vaccination, testing environmental considerations: ventilation, waste management considerations specific to care homes: admissions, testing, visiting, outbreak management.