The healthmatters blog; commentary, observation and review
- 45% of UK businesses do nothing to help alleviate workers’ stress
- Despite 25% of workers being less productive when stressed
- Hospitality, leisure and transport bosses least likely to offer ways for staff to manage stress levels
UK BUSINESSES are in danger of having their workforces experience burnout, as despite a huge number feeling stressed at work, few bosses are doing anything to help.
For those British adults in employment, work is by far the most common cause of stress (59%). Yet almost one in two (45%) of British businesses do not offer anything to help alleviate this, according to a study of 3,000 UK workers carried out by Perkbox, the UK’s fastest growing employee benefits platform, as part of the 2018 UK Workplace Stress Report.
Indeed, at least 1 in 10 (10%) of us will call in sick due to stress, while 7% will look for a new job.
Businesses within the hospitality industry are the least likely to provide any kind of guidance or aid to help employees deal with stress, with as many as 64% of workers in this industry claiming that this is the case.
This was closely followed by the leisure sector – where 63% of businesses are guilty of doing nothing to help.
More than 1 in 2 (55%) bosses within transport – where employees experiencing high levels of stress and burn out can be particularly risky – leave employees to manage work stress with no guidance or assistance.
The plumbing and construction (54%), healthcare and education industries (both 45% respectively) completed the list of the top five sectors which are least likely to see employees offered help or assistance with managing levels of work-related stress.
Chieu Cao, CMO & Co-Founder at Perkbox, said: “It’s worrying to see how few businesses seem to be considering stress levels within their workforce their problem. And it is particularly ironic to see that almost 1 in 2 workers within the healthcare industry say their bosses do not do offer anything to help them alleviate stress levels.
Chieu continues: “This can have hugely damaging effects on morale, productivity and sickness absence – all of which ultimately contribute to a company’s overall success – and it is important for bosses to recognise the contribution that work makes to employee stress levels.
“Introducing measures that help to reduce stress or encourage positive coping methods need not be particularly involved or expensive – even free things as simple as introducing flexible working, considering requests to work from home from time to time, or enforcing 1-2-1s with managers, to allow employees to discuss concerns and motivations, can go a long way to help. But ultimately, measures which tackle staff stress head-on work best – including gym membership or exercise classes, discounted or complimentary counselling and mental health services and even spa vouchers.”
To find out more, click here to view or download the 2018 UK Workplace Stress Report.
Which industries are the least likely to offer measures to help staff deal with their stress levels?
- Hospitality – 64%
- Leisure industry – 63%
- Transport – 55%
- Trades (e.g. plumbing, construction) – 54%
- Health and education (joint) – 45%
On 27th February 2018, WeMa Life officially launched its online marketplace and app, which aims to connect care in the community.
For the vast majority of people, there is nothing more important than their health or their loved ones’ wellbeing. However, while so many aspects of our day-to-day lives have benefitted from the proliferation of new, easy-to-use and affordable technologies, the world of healthcare has almost been left behind.
Fortunately, the growth of the global HealthTech market in recent years has started to change all that. New digital solutions are emerging that make it easier for people to manage or improve their health. And WeMa Life has been created to help drive this movement forward further still.
WeMa Life’s multi-service platform offers benefits to both consumers and businesses. For people seeking health, care and wellbeing services – either for themselves or someone close to them – WeMa Life makes it easy to source, book and pay reputable providers.
Services available through the online marketplace and app include: social care; domiciliary care; nursing; domestic help; personal care and hygiene; massages; yoga and Pilates instructors; nutritionists; physiotherapists; personal trainers; and more. Users can book one-off and on-going sessions, as well as services from multiple providers in one transaction.
From young people wanting regular fitness sessions to people in their 50s responsible for looking after elderly parents, WeMa Life has a broad appeal. It also has significant benefits for individuals needing to arrange care before or after clinical treatment, removing stress and complexity from an already difficult situation.
Meanwhile, the tools available through the online portal and mobile app enable businesses to improve the management and delivery of their services. As well as opening them up to communities of potential customers across the nation, WeMa Life lets health and care providers roster staff, arrange appointments, communicate with customers, accept payments and enhance efficiency.
WeMa Life is a family business; it was founded by myself, the COO, along with my parents Rajal Patni (CFO) and Rohit Patni (CEO). We were inspired to develop a tech-based solution after experiencing first-hand how difficult it is to find and book reputable healthcare providers for an elderly relative.
What’s more, research commissioned by WeMa Life to coincide with its launch, which was carried out independently among more than 2,000 UK adults, showed just how common these experiences are and therefore how great the need is for new digital tools to take the pain out of booking health, care and wellbeing services.
Our study found that 15% of UK adults currently act as informal carers, each spending on average 13 hours a week taking on duties such as cooking, cleaning and caring for someone close to them. More than half (53%) say the role has had a significant emotional impact on them, with 30% falling out with friends or family because of tensions around their responsibilities. Furthermore, 46% find it difficult to source suitable providers and two thirds (66%) want to see an online solution to make it easier to source and book healthcare services.
Empowering individuals to better manage their own is at the heart of WeMa Life’s proposition. But, as stated, the multi-faceted HealthTech solution also stands to improve how healthcare professionals – from individual, self-employed carers through to businesses providing wellbeing services – can connect with new and existing customers.
WeMa Life is constantly seeking new service providers to join its platform – to find out more or to register interest in doing so, click here.
Vivek Patni, COO and co-founder, WeMa Life
The non-biologic influenza vaccine, which can be delivered orally, could herald a revolution in vaccine delivery.
Stable at room temperature, the new type of vaccine, which could be given in pill form, does not require refrigeration – a process that can account for most of the cost of delivery of many current vaccines.
Vaccines that do not require refrigeration can be transported more easily and are more suitable for developing countries where it can be difficult to keep things cool.
Professor Andrew Sewell, from Cardiff University’s School of Medicine, who led the study, said: “There are many benefits to oral vaccines. Not only would they be great news for people who have a fear of needles but they can also be much easier to store and transport, making them far more suitable for use in remote locations where current vaccine delivery systems can be problematic.”
As the first synthetic and stable vaccine, the new form of preparation was made in a very novel way, by using ‘mirror images’ of the protein molecules that make up life.
Standard vaccines usually work by introducing a safe form of a germ, or a harmless part of that germ (often proteins) into our bodies. These foreign proteins stimulate our immune cells which then remember it and launch a stronger attack if they encounter it again. Normal germs or proteins would usually be digested if eaten. The new work shows that stable ‘mirror image’ forms of parts of such proteins can also induce a protective immune response. These ‘mirror image’ molecules cannot be digested, opening up the possibility for stable non-biologic vaccines to be supplied in pill form.
Professor Sewell explained: “The carbon molecules that form all proteins on Earth are left-handed molecules, but they also have a non-biologic, right-handed form. Even though these two forms of a molecule look identical at first glance they are actually mirror images of each other, just like our right and left hands, and cannot be superimposed on each other. The left-handed forms of proteins are easily digested and do not last long in nature. The unnatural, right-handed forms of these molecules are vastly more stable.
“Our demonstration that unnatural molecules, like these mirror image molecules, can be successfully used for vaccination opens up possibilities to explore the use of other unnatural, stable molecular ‘drugs’ as vaccines in the future.”
This new work provides proof-of-concept in a laboratory setting. A lot more research will be required to develop such approaches for the entire population and other diseases. It is likely to take several years before a non-biologic vaccine could be tested in humans.
Divya Shah, from Wellcome’s Infection and Immunobiology team, said: “This is a very exciting first proof of concept study that could provide a potential route to make vaccines that are thermostable and be administered orally. This could reduce the cost and increase accessibility across the globe, however much more research is needed to translate the findings into real-world vaccines.”
The Research was funded by Wellcome and BBSRC and is published in the Journal of Clinical Investigation.
The results of NHS England’s latest Staff Survey 2017 are “challenging”, show that staff cannot absorb further work pressures, and show that investment is needed in health and social care services, according to NHS Employers chief executive Danny Mortimer.
“Employers in the NHS have been anticipating worsening results from this most recent survey and sadly their concerns have been reflected in the outcome.
“The country needs to take these challenging results seriously. We cannot expect staff to absorb additional work pressures year on year without it having an adverse effect on their experience of work. A long-term solution to sustainable investment in the NHS – and other vital public services – is clearly required.
“It’s disappointing but understandable that staff are less satisfied with the standard of care they are able to provide and that they are feeling more stressed.
“I am however encouraged that staff continue to be willing to recommend the NHS as a place to be cared for.
“The fact that more staff feel their managers and organisations support their health and wellbeing is positive and is a result of longstanding efforts by employers to address workplace health issues. The increasing focus on supporting staff through mental health issues is clearly having a positive impact and we are keen to share the lessons learnt from the NHS with other employers.”
* The NHS Staff Survey 2017 was published by NHS England on 6th March, 2018.
* Of the survey’s 32 key findings, 21 have worsened and 11 have improved in 2017 compared with 2016.
* Questions about staff satisfaction are valued on a scale of 1 to 5, with 1 being “strongly disagree” and 5 “strongly agree”.
* Participating staff are asked 30 mandatory core questions, with the option to answer more questions on patient experience, health and safety, leadership and development, and values. Staff in ambulance trusts have a separate optional questionnaire on patient experience.
* The Staff Survey has been conducted every year since 2003.
* Staff taking part in the survey are informed that their responses for the survey are treated with confidence, and that no one in their organisations will be able to identify individual responses.
Revolving doors keep going round
Former NHS Improvement chair Ed Smith will join a new board of senior government and NHS figures advising the private digital GP company ‘Push Doctor’, according to the Health Service Journal (March 2nd 2018). The board (see box below for its membership) will advise on regulation, governance and a strategy to “expand its digital health services”.
‘Push Doctor’ is one of a number of companies, such as ‘Babylon’ and ‘Now Healthcare’, which offer GP video consultation services. However, unlike Babylon, ‘Push Doctor’ does not have much of a base in the NHS, and aims its’ services at self-funding users or subscribers. A ‘Push Doctor’ consultation costs £20 for 10 minutes and it charges an £8 administration fee for private prescriptions, which must be paid for by the customer.
Board members are:
Ed Smith, former chair, NHS Improvement
Nicola Blackwood, former health minister
Christine Outram, chair, The Christie FT
Dr Kathryn Patrick, primary care director, Yeovil District Hospital
Dr Marc Farr, information director, East Kent Hospitals University FT
Michael Lennox, member of NHS England local professional network for pharmacy
Matthew Campbell-Hill, non-executive director, Department of Digital, Culture, Media and Sport
Cut out the middle man
In November 2016, pwc asked YouGov Research to conduct a survey of the general public across Europe, the Middle East and Africa to understand three things:
- if there was the appetite to engage with artificial intelligence (AI) and robots for healthcare;
- the circumstances under which there would be greater or lesser willingness to do so; and,
- the perceived advantages and disadvantages of using AI and robots in healthcare.
Respondents in England identified four benefits of AI and robots in medicine:
- A quicker diagnosis was identified as the biggest benefit, with one in three (33%) UK consumers believing robots would reach a decision on their condition much faster
- As well as faster diagnosis, one in four (25%) British consumers believe they would get a more accurate diagnosis from AI
- A quarter of UK consumers (25%) said robot technology would mean they wouldn’t have to rely on booking an appointment with a GP,
- while 24% said the biggest benefit would be no longer having to take time off work to visit a doctor
NHS 111 enquiries will be handled by robots within two years, some believe.
Burrowing into a niche market
Commercial Healthcare company Fortius Clinic has linked up with Bupa to open a joint centre in London for carrying out hip and knee replacements using the latest robotic technology. MAKO robotic technology enables highly accurate placement of personalised knee or hip implants, smaller incisions, and faster recovery times. The latest evidence-based critical care pathways used at the new clinic aim to accelerate and improve all aspects of a patient’s recovery process following their surgery.
Mr Andy Williams, Consultant Orthopaedic Surgeon and one of Fortius Clinic’s Founding Surgeons, says: “The future of joint replacement surgery must focus on ensuring consistent outcomes – in recovery, performance and longevity. There is a wide variability of surgery outcomes and complication rates in current orthopaedic practice. This is why we need to shift our focus to further training on using new technologies within the field to improve patient outcomes.
For more information visit: https://www.fortiusclinic.com/fortius-joint-replacement-centre
Joining forces, shaping up
The Association of Independent Healthcare Organisations (AIHO) and the NHS Partners Network (NHSPN) have announced that NHSPN will lead on representation of the private healthcare sector. The move reflects the fact that private players in in the health care market want industry representation to cover all private sector service delivery, including both NHS-funded and privately-funded services.
Traditionally AIHO was the trade association representing hospital members delivering privately-funded healthcare services and NHSPN was the trade body for independent providers of NHS-funded services, covering a range of sectors from acute to primary and community care as well as diagnostics and clinical home healthcare. As the healthcare economy has developed over recent years there has been a significant increase in the number of private healthcare organisations simultaneously delivering services for NHS patients and for private patients.
In the view of the industry this makes the time right for creating a single entity for the private healthcare sector covering all parts of the market. The newly expanded NHS Partners Network, which will remain part of the NHS Confederation group, will begin representing the interests of the entirety of the independent healthcare sector from 1st June 2018.
Today the Office for National Statistics (ONS) have released their estimates of personal wellbeing in the UK, with analysis by country, age and sex. David Tabor, from the ONS shares the key messages and calls for readers to take part in a survey on wellbeing inequalities.
Since 2011, we have asked personal well-being questions to adults in the UK. They provide insight into people’s feelings about their lives and surroundings which economic statistics (such as GDP) alone cannot provide. This information aims to support better decision making among policy-makers, individuals, communities, businesses and civil society.
- Continued, but small, improvements: In the year ending September 2017, there continued to be slight improvements in the UK for average ratings of life satisfaction, feeling that the things done in life are worthwhile and happiness; there was no overall change in reported anxiety levels.
- England driving wellbeing increase: The improvement was driven by England, which was the only UK country with any changes in average reported personal wellbeing over this period.
- Low wellbeing remains proportionally same: The proportion of people reporting low ratings for measures of life satisfaction, worthwhile and happiness remained unchanged since September 2016; there was also no change in those reporting high anxiety.
- Women higher wellbeing, also anxiety: In the year ending September 2017, women reported higher life satisfaction, worthwhile and happiness ratings compared with men but also reported higher levels of anxiety.
- Specific age groups seeing continual improvements: There have been improvements for all measures of personal wellbeing for those aged 30 to 34, 40 to 59 and 65 to 69 years, since we began measuring personal wellbeing in 2011.
WHY DO WE REPORT THIS DATA?
It is important to consider a variety of aspects of life, such as people’s thoughts and feelings about their current situation, to explore if and how they could have an impact on people’s well-being.
The wellbeing dashboard is our current tool to display measures for the different areas of life that matter most to the UK public.
PERSONAL WELLBEING IN THE UK: OCTOBER 2016 TO SEPTEMBER 2017
Today’s figures provide the latest headline estimates of personal wellbeing in the UK. Average ratings of life satisfaction, feeling that the things we do in life are worthwhile and happiness have slightly increased in the UK.
Today’s update also provides a breakdown of personal wellbeing by age and sex. For example, in the year ending September 2017 figures have shown, as noted above, that women report higher life satisfaction, worthwhile and happiness ratings compared to men but interestingly they also report higher levels of anxiety.
In addition to providing data on mean averages, it is also worth considering the distribution of the figures. As part of our personal well-being outputs, we provide analysis on ‘thresholds of personal wellbeing’, which look at those providing high and lower ratings of personal wellbeing. Our latest report has shown that, comparing the years ending September 2012 and 2017, fewer people have reported low levels of life satisfaction, worthwhile and happiness over time. We have also seen a decrease in the number of people reporting high levels of anxiety.
Last week, the BBC’s Tomorrow’s World launched Secrets of Happiness, a national survey to gather data on wellbeing. Here, the former President of the British Psychological Society and the Centre’s community lead Peter Kinderman, who is involved in the ‘citizen science’ research project, sets out how the results might help us better understand the relationship between mental health and wellbeing.
The relationship between mental health and wellbeing is a complex, and fascinating, issue in our work at the Centre. Surprisingly, in 2018, we still don’t really understand the fundamental interconnections. Few would argue against the need to offer much better mental health services, but the idea that ‘human misery’ is, in part, ‘caused by mental illness’ is a little more controversial. One group of psychologists commented that “… people suffer when bad things happen to them. [It is] obvious that ‘mental illness’ will predict ‘misery’ … These two terms relate to the same experiences”.
DIFFERENT PATHWAYS FOR WELLBEING AND MENTAL HEALTH
In 2013, we found that there were different pathways for poor wellbeing, anxiety, and depression. Low levels of subjective wellbeing were associated with social isolation and low levels of adaptive coping. Alternately, mental health problems were associated with negative life events and rumination. This is consistent with the idea that mental health and wellbeing lie on ‘two continua’: that it’s possible to have high levels of wellbeing (with appropriate support) even if we experience specific mental health problems.
That specific mental health problems and subjective wellbeing might have different causal mechanisms, and different mediating psychological processes is interesting and important. It makes the topic more complex, and that’s before we consider the different trajectories and causal factors that might apply to community, rather than individual, wellbeing.
FLUID RELATIONSHIP BETWEEN WELLBEING AND MENTAL HEALTH
It seems too simplistic to suggest that our wellbeing and our mental health are merely two opposing poles of a single continuum. It’s clearly possible to have low levels of wellbeing without experiencing mental health problems. But it is also easy to see how our wellbeing can be threatened by mental health issues, especially if we don’t have appropriate help. This implies that the relationship may be asymmetrical (a technical statistical challenge for researchers). This may mean that the relationships are different for different kinds of challenges, whether that is different threats to our wellbeing (loneliness or poverty, perhaps) or different mental health problems (depression, hearing voices, self-harm, for example).
NEW CITIZEN SCIENCE PROJECT ON WELLBEING
In collaboration with the University of Liverpool, Dr Sara Tai at the University of Manchester and BBC’s Tomorrow’s World, we have launched a ‘citizen science’ research project to investigate these questions.
As many thousands of people – including you – can complete our survey, we should be able to tease out at least some of these relationships. It will give us a better understanding of social factors such as income; employment and loneliness; our family history of mental health problems; the events that happen to us, both in our childhood and in recent months; and the ways in which we make sense of, understand, and respond to those events.
Importantly, we hope to be able to collect data at two time points. This allows us to predict both wellbeing and mental health – anxiety and depression – over a six-week period, much more powerful in scientific terms.
Sampling and representation in the survey
This kind of research is complex. And a little controversial. For example, our research uses crowd-sourced data from an entirely unrepresentative group of people with uncertain motivation accessing the website, without any kind of purposive or stratified sampling. This is very different from the careful, epidemiologically rigorous, approach used by organisations such as the Office for National Statistics, although we are using the standard methodology recommended for the measurement of wellbeing.
I have to confess to being a pragmatist – one of the joys of working with the Centre is that it is about bringing the best available evidence to bear for policy makers. It’s focussed on quality, but also on practicality. When we get the opportunity to reach out to large numbers of people, we should grasp it. Even when the sampling is non-random, it allows us to explore statistical relationships between many different inter-related factors with much greater precision that would be possible with more carefully-controlled, but smaller, samples.
Here, we are not attempting to map or survey wellbeing or mental health across the UK population, nor to draw conclusions about epidemiology or prevalence (issues for which, admittedly, our methodology would be weak). And we should always be aware of the limitations and weaknesses of our research methodologies.
What we should be able to say, with more detail, how social and environmental issues affect our mental health and wellbeing, how the ways in which we think about, understand and react to these events influence their impact, and a little more about the complex relationship between wellbeing and mental health.
Without doubt, our research will lead to even more questions and discussion (possibly even disagreement)… but that’s a good thing!
During this winter period, it has become clear that the National Health Service (NHS) in the UK is under even more than the usual additional strain. With routine operations already being cancelled to manage emergency treatment, hospitals cannot afford any delayed discharge of patients because of the knock-on impact on available beds. However, evidence suggests that delayed discharge is once again on the rise.
The rise of delayed discharge
The media is already making headlines from numerous figures, including:
- Delayed discharge currently costs the NHS £900 million a year, including over £100 million in Scotland;
- Up to 8,000 deaths a year may be caused by increases in delayed discharge; and
- Delayed discharge has risen 52 per cent in the last three years.
Delayed discharge, also known as “bed-blocking”, occurs when patients are well enough to be discharged from hospital, but remain there because they do not have the correct care, support or equipment at home or in the community to continue their recovery. These patients can often spend weeks in hospital when they could be cared for at home or in the community, where their recovery might well be quicker. This practice is putting unnecessary pressure on A&E departments and wards, increasing waiting times and staffing costs, and often leading to cancelled operations.
This is not a simple problem. It occurs at the boundary between health and social care (and perhaps more importantly, their budgets), and involves issues relating to family responsibilities. Various solutions have been trialled to address the issue, with mixed results but often increasing costs. These have included increasing the supply of nursing staff, building more care homes, keeping a ready supply of equipment in hospitals and changing the system of managing people coming to A&E, as well as merging health and social care organisations and budgets.
Developing patient flow modelling
No single organisation will ever hold all the answers to delayed discharge or bed-blocking. Cooperation is always going to be the best way to attempt to manage the problem, and, indeed, to improve patient outcomes across the system.
However, individual organisations can improve matters, for example, by use of patient flow modelling. This is a discrete simulation model which will allow hospitals to improve patient management, bed control, the logistics supporting the movement of patients and overall bed use.
The model includes:
- Patient points of entry;
- Recovery units;
- Hold time thresholds;
- Routing process; and
- Staffing levels/beds.
It can be used to model complex interactions between patients and units, key decision points, and ‘what if’ scenarios. It also provides comprehensive KPIs that can help managers in hospitals and social care understand the causes and effects of delayed discharge. This is important because these vary considerably around the country, and the solutions are therefore different. Understanding the ‘pinch points’ and problem areas means that tailored solutions can be put in place to manage delayed discharge at particular hospitals, or in specific areas or regions, and help improve patient outcomes as well as reduce cost.
Developing a data-informed NHS
Hospitals have not traditionally made decisions based on extensive data analysis. However, this type of modelling offers them a chance to increase efficiency and address their problem areas.
Understanding the problem is still only the first step towards addressing it, but it is an important one. Solving issues of delayed discharge will require hospitals to work closely with social care and community providers, to develop a fully integrated care model. Nobody is suggesting that this will be easy, but ensuring that the model is based on evidence – and not just ‘gut feeling’ – will make it more likely to succeed. This, in turn, will result in better patient outcomes, increased efficiencies and cost savings for the NHS and its partners. That’s something we all want to see
Mark Frankish, SAS Data Scientist, SAS UK