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Found 57 results
  1. Content Article
    In the challenging journey of addiction recovery, trust is a cornerstone of success. For individuals seeking help and the healthcare providers who guide them, it forms the bedrock upon which every aspect of treatment rests. Therefore, building trust in addiction treatment is a vital component that can determine the course of recovery. 
  2. News Article
    There will be no national mandate for GPs to use advice and guidance in a certain number of cases, NHS England has told Pulse. National medical directors for primary and secondary care said that formalised pathways should be developed ‘locally’, and decisions should be based on an area’s population. In September, it was reported that NHS England’s upcoming outpatients strategy would further increase the use of advice and guidance (A&G) before GP referrals are accepted, with the RCGP then "voicing concerns" about this proposal. However, when asked about the reports that this would be mandated, Dr Stella Vig, national medical director for secondary care and clinical director for elective care, said she ‘doesn’t know’ where that came from, and ‘doesn’t recognise’ those comments. NHS England also released guidance clarifying the medico-legal risks and clinical responsibility for clinicians using A&G or referral assessment services (RAS), which is now available on the NHS Futures website. The guidance said that these forms of specialist advice are "expanding rapidly" as a result of improvements to digital services. On legal issues, it said liability ‘will be determined on a case by case basis’ but that GPs could be liable if "all relevant clinical information is not provided" when sending an A&G request. But specialists at hospitals would be accountable if they send back advice to the GP which is ‘not clinically appropriate’ or if they ‘refuse to accept a patient’. On turnaround times, NHS England has said that ‘local variables will ultimately dictate the agreed response times’ for hospital teams dealing with A&G – but the guidance recommends that the response time "should not exceed 10 working days for routine requests". Read full story Source: Pulse, 30 November 2023
  3. News Article
    National leaders are looking to greatly reduce the number of direct hospital referrals made by GPs, by insisting that they first discuss cases with hospital consultants. The approach – known as “advice and guidance” or “A&G” – involves GPs sending a patient’s details to a consultant who specialises in their condition before making a referral. The consultant then advises on the best course of action. “A&G’ has been voluntarily adopted by many health systems, but HSJ has now learnt that a move to significantly increase its use of it is being discussed as part of a new national strategy for outpatient services, due to be published by December. Theresa Barnes, outpatients lead at the Royal College of Physicians, is part of a group of clinicians helping to develop the strategy in partnership with NHS England, and said there is a case for A&G to be used “in preference” to direct referrals in a vast number of cases where it is clinically appropriate. She told HSJ: “I think there should be a push to use advice and guidance in preference to direct referrals, so we can maximise that pre-referral interaction and deliver as much care as close to patients’ homes as they can get it and without the delay of potentially waiting for a secondary care appointment.” Read full story (paywalled) Source: HSJ, 20 September 2023
  4. News Article
    YouTube has launched a verification system for healthcare workers in the UK as it battles disinformation online. In 2022, health videos were viewed more than three billion times in the UK alone on the video-sharing platform. Doctors, nurses and psychologists have been applying for the scheme since June and must meet rigorous criteria set by the tech giant to be eligible. Successful applicants will have a badge under their name identifying them as a genuine, licensed healthcare worker. But YouTubers have warned the system is only meant for education purposes, not to replace medical advice from your GP. Vishaal Virani, who leads health content for YouTube, said it was important simply due to the sheer number of people accessing healthcare information on the video-sharing platform. "Whether we like it or not, whether we want it or not, whether the health industry is pushing for it or not, people are accessing health information online," he told the BBC. "We need to do as good a job as possible to bring rigour to the content that they are subsequently consuming when they do start their care journey online." Read full story Source: BBC News, 8 September 2023
  5. Content Article
    The Maternity Survey 2022, run by Ipsos on behalf of the Care Quality Commission, looked at the experiences of women and other pregnant people who had a live birth in early 2022. In this article Anita Jefferson from Ipsos looks at the results of this and considers what they tell us about experiences of maternity services.
  6. Content Article
    Whole-body bathing or showering with a skin antiseptic to prevent surgical site infections (SSI) is a usual practice before surgery in settings where it is affordable. The aim is to make the skin as clean as possible by removing transient flora and some resident flora. Several organisations have issued recommendations regarding preoperative bathing. The care bundles proposed by the United Kingdom (UK) High impact intervention initiative and Health Protection Scotland recommend bathing with soap prior to surgery. The Royal College of Surgeons of Ireland recommends bathing on the day of surgery or before the procedure with soap . The USA Institute of Healthcare Improvement bundle for hip and knee arthroplasty recommends preoperative bathing with CHG soap. Finally, the UK-based National Institute for Health and Care Excellence (NICE) guidelines recommend bathing to reduce the microbial load, but not necessarily SSI. In addition, NICE states that the use of antiseptics is inconclusive in preventing SSI and that soap should be used. The purpose of this systematic review is to assess the effectiveness of preoperative bathing or showering with antiseptic compared to plain soap and to determine if these agents should be recommended for surgical patients to prevent SSI.
  7. Content Article
    'The Family Oops and Burns First Aid' is a free children's book written by Kristina Stiles, beautifully illustrated by Jill Latter, created to support children and their families learning about burns prevention and first aid principles together. The book describes an accident prone family who are not burns aware, who have to go to school to learn about burn safety and first aid principles within the home. The book is aimed at KS1 children and their families, and is available as hard copy book by request from Children's Burns Trust and also as an audio/video book via YouTube.
  8. News Article
    Avoiding GP referrals by providing ‘advice and guidance’ will contribute significantly towards NHS performance on the government’s elective care targets, according to draft NHS plans seen by HSJ. Under the elective recovery plan, hospital specialists are being asked to offer more advice when GPs are deciding whether to refer a patient for an outpatient appointment, which would avoid some patients being added to waiting lists. This is aimed at reducing instances where GPs may want to be risk averse and refer a patient when they might be unsure whether a secondary referral is needed. New documents seen by HSJ, shared in draft by NHSE last week, reveal this avoided activity will be counted in assessing if the service or individual trusts have hit key government targets to increase activity. NHS England has agreed with government to carry out 10% more ‘clock-stop’ activity in 2022-23 than was taking place pre-covid, but this is “after accounting for the impact of an improved care offer through system transformation, and advice and guidance”. Read full story (paywalled) Source: HSJ, 28 February 2022
  9. News Article
    Callers to NHS 111 services are twice as likely to be judged as needing an ambulance in some regions as others – and up to eight times more likely to abandon their calls. An HSJ investigation has revealed striking differences in performance between 111 providers. The new integrated urgent care data set, published by NHS England, shows the differences in performance across the country. HSJ analysed data from April to December last year – the first year this data set has been produced. For example, 15.7% of answered calls to North East Ambulance Service Foundation Trust resulted in an “ambulance disposition” while just 7.7% of calls to London Ambulance Service Trust did so. A total of 14.2% of callers to the privately owned Practice Plus Group were judged to require an ambulance. 41.9% of calls were abandoned before being answered by NEAS and 30.6% of those made to the West Midlands Ambulance Service University FT ended the same way. In contrast just 5.2%of callers from Lincolnshire to services provided by Derbyshire Health United abandoned their calls. The “standard” for abandoned calls is just 3%, but the average performance across England was 24.1%. In a statement, the Practice Plus Group said its staff were trained to a high standard on NHS Pathways and it was confident its staff were making appropriate and safe decisions. Over 70 per cent of decisions to instigate a category 3 or 4 ambulance callout were validated in January. As a result ambulances were dispatched in just 20 per cent of those cases, with other patients being directed to alternative pathways. “We are always looking to enhance the service which is why we are running developmental training for our call handlers in more effective probing to reduce the category 2 ambulance disposition numbers and have introduced GoodSam video technology as part of an NHSE pilot which will support clinicians with eyes on with a patient,” the company added. Read full story (paywalled) Source: HSJ, 18 February 2022
  10. News Article
    Roy Cairns, 58, was diagnosed with liver cancer in 2019. Twelve months later a tumour was found on his lung. Mr Cairns said taking part in the cancer prehab programme piloted by the Northern Ireland's South Eastern Health Trust after his second diagnosis was a "win-win", not only for himself but also his surgeons. "I think when you get that diagnosis you are left floundering and with prehab the support you get gives you focus and a little bit of control back in your life," he said. Prehabilitation (prehab) means getting ready for cancer treatment in whatever time you have before it starts. Mr Cairns is one of 175 patients referred to the programme which involves the Belfast City Council and Macmillan Cancer Support. Dr Cherith Semple said the point of the programme is to " improve people's physical well-being as much as possible before treatment and to offer emotional support at a time that can be traumatic". Dr Semple, who is a leader in clinical cancer nursing, said this new approach to getting patients fit prior to their surgery was proving a success, both in the short and long-term. She said: "We know that it can reduce a patient's hospital stay post-surgery and it can reduce your return to hospital with complications directly afterwards." Read full story Source: BBC News, 20 July 2022
  11. News Article
    England's first women's health ambassador is calling for "one-stop shops" where women can sort out their health needs. Dame Lesley Regan, also a practising doctor, wants to make it easier for women and girls to access care such as contraception and smear tests in the community. Her new role aims to close the "gender health gap". She will also support the upcoming government-led women's-health strategy. "At the moment, we waste a lot of resource in telling girls and women that they cannot have things," she told BBC News. "So you might go off to your doctor or gynaecologist or heart specialist and get told, well, you cannot have a smear here, even if it is due, or you need to go somewhere else for this, that and the other. "We should make it very, very easy for people to access this out in the community - why do you need to go to a secondary or tertiary facility for things that are very easy to provide?" Instead, she wants health hubs where women could "go for half a day and get all these things sorted out" and then get on with their lives. "A one-stop shop is what I want for myself and what I want for my daughters and I'm sure it is what every other girl and woman wants and what every man and boy wants for the women in their lives, to be looked after that way," Dame Lesley said. Read full story Source: BBC News, 17 June 2022
  12. News Article
    Pharmacies do not have the capacity to absorb pressure from GPs unless it comes with additional funding, pharmacy leaders have warned. A new NHS England ad campaign, announced earlier this week, aims to redirect patients from GP practices to local pharmacies for minor conditions such as coughs, aches, cystitis and colds. But community pharmacy negotiating body PSNC has spoken out against the campaign calling it ‘deeply concerning’, ‘irresponsible, ‘extremely unhelpful’ and ‘irritating’. Malcom Harrison, chief executive of the Company Chemists’ Association (CCA) said: ‘Community pharmacies are often the best place for patient to go for help with minor health concerns. ‘However the current situation that many pharmacies find themselves, with a 30% cut in real term funding, the NHS recruiting their pharmacists and technicians to work in general practice and with the continuing increase in the number of medicines prescribed, will mean that there is now a very real risk that when patients visit a pharmacy, they will be faced by exhausted teams and longer than expected waiting times. ‘The NHS policy of moving asking patients to visit their local pharmacy does not address the problem of delays to access in primary care, it simply moves it from one pressurized location to another. The NHS must address the chronic underfunding of primary care, and of pharmacy in particular, if patients are to be able to access the care they need and should rightly expect.’ Read full story Source: Pulse, 28 February 2023
  13. News Article
    Two-thirds of GPs feel ‘advice and guidance’ is preventing patients who really need a referral to secondary care from getting one, according to the findings of a snapshot survey of Pulse readers. Advice and guidance (A&G) services, which involve GPs accessing specialist advice before making a referral, have become a major part of NHS England’s plans for clearing the pandemic backlog. But of the 366 GP survey respondents in England who said they had used advice and guidance, 68% said they felt the pathway is blocking necessary referrals. The survey also found that of those 366 GPs who had used A&G services: Around half (49%) said A&G was reducing referrals; More than three-quarters (78%) said it was increasing their workload; Just over half (60%) said it was requiring them to work beyond their competence; Two-thirds (68%) said A&G was resulting in patients complaining because their wish to see a consultant had been diverted. One GP who wished to remain anonymous commented: "An increasing number of referrals are being rejected for secondary care service pressure reasons rather than clinical need. [This] often duplicates GP admin work as we need to re-refer, rewriting the referral and/or enclosing further information or tests results in order to get a referral accepted." Read full story Source: Pulse, 25 January 2023 Further reading on the hub: Rejected outpatient referrals are putting patients at risk and increasing workload pressure on GPs Patient referrals and waiting lists: A ticking time bomb A child left waiting for ‘urgent’ surgery, a blog by Clare Rayner
  14. News Article
    About 15 million more people in England could be prescribed daily cholesterol-lowering statin pills to cut their risk of heart attacks and stroke, new advice for the NHS says. Given the very cheap price of the tablets and the possible health gains, they should be considered more often, the draft guidance says. There can be side effects though and there is debate about how widely this long-term treatment should be given and what associated risks are acceptable. The National Institute for Health and Care Excellence (NICE), which advises the NHS, says people should be thoroughly assessed before statins are prescribed, warning the pills are not a quick fix or substitute for a healthy diet and exercise. The previous advice was for anyone with a one in 10 chance of having a cardiovascular event, such as a heart attack or stroke, within the next 10 years - based on factors such as age, blood pressure and cholesterol levels - to be offered a statin. But NICE now says including adults with a one in 20 chance could save 2% of them from having a heart attack or stroke during that period. Spokesman Paul Chrisp said patients should discuss the benefits and risks with their doctor, adding: "The evidence is clear, in our view, that for people with a risk of 10% or less over 10 years, statins are an appropriate choice." Read full story Source: BBC News, 12 January 2023
  15. News Article
    Women who underwent mesh surgery were not given accurate information before the life-altering procedure, a case review has found. The study also said poor communication between patients and doctors led, in some cases, to mistrust. Medical notes were often misleading or did not detail the surgery that had occurred or its outcomes. The review spent two years looking at the cases of 18 women who received transvaginal mesh implants. It has now called for a comprehensive register to be set up to keep track of women who have had operations to remove mesh in Scotland, abroad and privately. The Transvaginal Mesh Case Record Review by Glasgow Caledonian University makes a series of other recommendations, including: Better aftercare following surgery Clear language so patients understand exactly what surgery is going to achieve. Read full story Source: BBC News, 21 June 2023
  16. News Article
    Patients contacting NHS 111 in England are having to wait so long for medical help that they are abandoning millions of calls, with 3.6m ditched in the past 12 months, official figures reveal. The national helpline service is supposed to make it quicker and easier for patients to get the right advice or treatment they need, either for their physical or mental health. It is billed as being open 24 hours a day, seven days a week. However, analysis by the House of Commons Library, commissioned by the Liberal Democrats, shows callers are waiting so long to speak to someone that nearly one in five give up. In 2022, 3,682,516 calls to NHS 111 were abandoned. MPs said the “dire” figures exposed how the NHS had reached “breaking point” after years of “neglect and underfunding” by the government. The data suggests that, on average, more than 10,000 callers hang up every day without receiving medical advice or treatment. As well as being distressing for those who are unwell, abandoned NHS 111 calls pose a risk to patient safety. The problem also increases pressure on other urgent care services as people seek care elsewhere. Read full story Source: The Guardian, 10 April 2023
  17. News Article
    Exhausted after three sleepless days in labour, Jane O’Hara, then 34, screamed and burst into tears when the midwives and doctors at Harrogate District Hospital told her the natural birth she wanted was not going to happen. She ended up needing life-saving surgery and 11 pints of blood after a severe haemorrhage. Mercifully, Ivy was fine and is now a healthy 12-year-old. In recent weeks, the NHS has been rocked by the conclusions of an inquiry into the worst maternity disaster in its history: 201 babies and nine mothers died and another 94 babies suffered brain damage as a result of avoidable poor care at Shrewsbury and Telford Hospital NHS Trust. This has been linked to a culture of promoting natural — that is, vaginal — birth and avoiding caesarean sections. Blame thus far has been aimed largely at the NHS — but parents have started speaking out online about what they believe has been the role of the National Childbirth Trust (NCT), a leading provider of antenatal classes in Britain, in promoting vaginal births. “I can absolutely point to key decisions that I made that were influenced by the NCT’s mantra. I was led into a position where I believed I had more control over my birth than I actually did,” says O’Hara, who is now a professor of healthcare quality and safety at the University of Leeds. She believes she was a victim of a “normal birth” ideology that was heavily promoted at the NCT classes she attended. Read full story (paywalled) Source: The Times, 10 April 2022
  18. Content Article
    This episode discusses the role NICE plays in patient safety. The guests are: Professor Kevin Harris, senior responsible office for patient safety at NICE, and clinical advisor to the Interventional Procedures Programme and Professor Jane Blazeby, Professor of Surgery at University of Bristol.
  19. Content Article
    Musculoskeletal disorders (MSDs) are one of the main causes of ill health in the workplace, leaving many employees with painful long-term injuries. Health and social care are industries with a particularly high incidence of MSDs among staff. This infographic by the Chartered Institute for Ergonomics and Human Factors (CIEHF) lists the warning signs to be aware of and gives lots of easy-to-follow practical advice on how to prevent or reduce the risk of developing symptoms. There’s also a link to find exercises that could help prevent injuries occurring.
  20. Content Article
    Many people see their GP with symptoms that could either get better without treatment, or be a sign of serious illness; their diagnosis is uncertain. Research has explored how GPs and patients can work together to develop follow-up plans (a process known as safety-netting). New recommendations could help GPs manage uncertain diagnoses. To avoid unnecessary referrals, GPs may adopt a ‘watch and wait’ strategy when someone has an uncertain diagnosis. This strategy should come with a clear follow-up plan so that people understand the possible causes of their symptoms, how to look after themselves and what to do if symptoms persist. This is good safety-netting. Without good safety-netting, watch and wait carries risks. For example, late cancer diagnoses have been linked to poor safety-netting. However, professional guidance on safety-netting is lacking. This is a knowledge and practice gap. A study from Friedemann Smith explored the best ways to deliver safety-netting advice. It suggests that people are more likely to follow advice if they are involved in developing the follow-up plan. They need to understand: why they are receiving this advice what actions are required, and by whom. The lack of time within primary care consultations is well known. This may need to be addressed for clinicians to have long enough to develop a safety-netting plan. Professionals may also need training to develop the appropriate communication skills.
  21. Content Article
    This survey from the Care Quality Commission (CQC) looked at the experiences of women and other pregnant people who had a live birth in early 2022.
  22. Content Article
    This report by the Harmed Patients Alliance (HPA) explores the needs of injured patients and their loved ones for independent advocacy, advice and information when they have been involved in patient safety incidents that are believed to have led to harm. It examines the extent to which this is available or resourced, and aims to stimulate and inform a national discussion about this issue in England among key stakeholders. It looks at the historical context and the moral and economic arguments and implications of resourcing these kinds of services.
  23. Content Article
    Patients benefit from guideline-based preventive, chronic disease, and acute care, but many do not receive it. A limitation to providing high-quality care is insufficient time for primary care providers (PCPs). The aim of this study was to quantify the time needed to provide preventive care, chronic disease care, and acute care for a nationally representative adult patient panel by a PCP alone, and by a PCP as part of a team-based care model. The authors concluded that PCPs do not have enough time to provide the guideline-recommended primary care. With team-based care the time requirements would decrease by over half, but still be excessive.
  24. Content Article
    These case studies, based on MDU members' real-life experiences, provide a valuable opportunity for shared learning across a wide range of specialties and situations. MDU is a UK medical defence organisation.
  25. News Article
    The proportion of newborn babies receiving a timely health visitor check-in has fallen sharply, with one in five missing out in the most recent statistics available. Official data reveals that only 82.6% of babies received a new birth visit within their first fortnight in 2021-22, as is recommended, and in the fourth quarter of the year it dropped as low as 79.3%. This is the lowest proportion recorded in recent years in the annual dataset on health visitor service delivery metrics, published by the Office for Health Improvements and Disparities. According to the NHS website, a health visitor new birth visit is supposed to take place between 10 and 14 days after birth and is designed to offer advice on issues including safe sleeping, vaccinations, infant feeding, infant development, and adjusting to life as a parent. Kate Holmes, head of support and information at charity The Lullaby Trust, said: “Safer sleep saves babies’ lives and all families should be given advice on how to reduce the risk of sudden infant death syndrome for their baby. The new birth visit is a key opportunity for health visitors to talk to families about safer sleep and to provide them with information and support that takes their individual and family circumstances into account.” Read full story (paywalled) Source: HSJ, 7 November 2022
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