The healthmatters blog; commentary, observation and review
A new report from independent research organisation MindMetre has summarised the evidence for return-on-investment from pathology services in the NHS and questioned any urgent pressure to consolidate pathology laboratories – within and between NHS trusts.
The MindMetre report, which reviewed the range of existing evidence and also canvassed views among a sample of 30 laboratory managers and principal biochemists in England and Wales, was conducted in response Lord Carter’s latest report, Operational productivity and performance in English NHS acute hospitals: Unwarranted variations (February 2016).
The Carter report notes that, “If benchmarks for pathology are unlikely to be achieved [by the deadline of April 2017], trusts should have agreed plans for consolidation and outsourcing to, other providers by January 2017.” The MindMetre review and research cautions against such a tight deadline being imposed, arguing that merger planning is not a substitute for within-laboratory efficiency and improvement drives.
The MindMetre review suggests that a mandatory pathway is set for laboratory productivity improvement (particularly turnaround time reduction), recognising that all aspects of the NHS have to deliver efficiency savings in the current policy environment. However, the review also suggests that the high value offered by pathology services be re-appraised at the strategic level to determine their position in the NHS service funding priorities.
Evidence covered in the review suggests that the immediate and knock-on effects of pathology service capacity and efficiency/productivity are more considerable than service funding would suggest, and could make an even more disproportionately positive contribution to patient outcomes, rapid diagnosis and the avoidance of unnecessary interventions and chronic condition development further down the line.
Paul Lindsell, Mind Metre Managing Director, comments: “A knee-jerk push to consolidate pathology labs is not an easy universal panacea. There is evidently significant headroom for efficiency and productivity gains in pathology workflows and emerging technology. Our report recognises frustrations that greater productivity gains have not yet been achieved. However, we also suggest that the through-the-line benefits that pathology services offer mean it would be a mistake to potentially squeeze such resources in the NHS. In fact, there may be a rationale to put greater resources into pathology services, so long as they are strictly pegged to productivity improvements.”
Awareness of domestic violence in the UK is at an all-time high following the story of Helen Titchener in the BBC Radio 4 soap ‘The Archers’. The Royal Society for Public Health (RSPH) and Institute of Health Visiting (iHV) are highlighting the need for domestic violence and abuse (DVA) to be treated as a public health priority. Their call comes as a survey of 397 health visitors by the iHV reveals that about two in five (42%) think services to support families affected by DVA in their area have got worse in the past two years, with less than a third (32%) saying they were no worse.
There are more than 11,000 health visitors in England. Health Visitors are specialist community public health nurses who work closely with families with children under five, particularly from vulnerable or deprived groups, to promote healthy lifestyles and prevent illness. The iHV survey of health visitors in England also found that almost half (47%) of health visitors surveyed believed a challenged relationship between parents is impacting on their children in more than one in five (20%) of the families they work with. Almost two thirds (62%) of those surveyed said the families they work with affected by DVA are not empowered to do anything about their situation.
Shirley Cramer CBE, Chief Executive of RSPH, said:“Domestic violence and abuse often underpins a wide range of other health and wellbeing issues, especially mental health problems, not just for partners but also for children in affected families. Tackling DVA and its effects should therefore be a major public health priority at both a local and national level. Domestic abuse extends beyond physical violence to controlling and manipulative behaviour, and is far more common than is generally acknowledged – with the recent Archers storyline having raised awareness of the plight of real life Helens, this is a good time to be considering how both the core and wider public health workforce can do their bit to tackle the issue.”
Dr Cheryll Adams CBE, Executive Director of the Institute of Health Visiting, said: “It is of no surprise to us that health visitors see so much domestic abuse in families. Tolerance of this will reduce if it becomes a much more conspicuous public issue, as has happened with the Archers storyline. Domestic violence and abuse impacts not only on the recipient but on her/his ability to parent, so hence on children, which will ultimately have a societal impact, so addressing the scale of this must be seen as a public health priority.”
The NHS is failing in its commitment to create a digital first service and improve care through technology, according to new research, which found nearly 60 per cent of patients are not satisfied with current processes.
In 2014, the health sector published a five-year vision to improve patient care through technology, but nearly half way through the process patients remain unsatisfied.
A lack of accessible information rated among the highest complaints in the report by Apadmi Enterprise, a leading mobile application and technology developer, with almost 80% of patients calling for hospitals to bring in apps to improve access to basic information.
At present, the healthcare sector is failing to live up to its promises to create a digital first service as over half (55%) of patients claimed they have never used mobile technology to engage with the NHS ahead of, or during a hospital visit.
The majority of patients (76%) said they would like to use a form of technology to manage hospital appointments, such as booking, cancelling or confirming an appointment. And over half (55%) would want technology to store their prescriptions.
Patients claim the lack of hospital information currently available, particularly around parking, is one of their biggest bug bears (59%), which explains why two thirds (66%) want the NHS to develop a digital offering that can assist with this kind of information.
Technology that empowers patients with regards to their own healthcare is also another key consideration. 45% would like a digital way to access their healthcare records so they can make better decisions about their health and 43% said they would want to use the technology to help them manage their own illness – such as tracking their medications, or keeping a food diary.
The research forms part of a report called ‘How can mobile application technology change the way patients engage with healthcare organisations?’. The aim is to give healthcare professionals valuable insight into what patients want and expect from mobile technology in the healthcare sector.
Matt Hunt, CEO of Apadmi Enterprise, said: “Mobile technology has huge potential to transform the way healthcare is provided and accessed in the UK. New technology and services will allow healthcare professionals to better serve their patients, as well as enable people to be more proactive in managing their own health and well-being.
“When it comes to hospitals, there is a clear need to improve patient engagement and communication, and our research highlights that focus needs to be around providing regular updates so patients feel informed during the entire visit, as well as offering greater access to patient information so they feel empowered to manage their own health too.
“But while it’s clear that digital first service and mobile technology adoption in hospitals is still in its infancy, our research demonstrates that there is a strong demand from patients for this kind of tech to be implemented. Organisations will undoubtedly need help managing utilisation, streamlining processes and handling the vast amounts of data that will be stored or generated. But it seems there is no better time for healthcare organisations to seize the opportunities of mobile app technology to take advantage of greater efficiencies and better patient outcomes.”
For more information, please visit http://www.apadmi.com/
CANCER RESEARCH UK is launching its first online course to help people have more confident conversations about cancer.
The free course, Talking About Cancer, aims to help prevent cases and improve early diagnosis. It is designed for health workers and professionals including doctors, nurses and volunteers who talk to others about cancer, particularly about prevention.
The course is also suitable for anyone interested in helping others improve their health.
The course teaches conversation techniques to advise people how to make healthy lifestyle changes and to see a doctor when they notice an unusual change in their body. It also covers myths and facts about the disease.
It is taught by Cancer Research UK trainers, alongside actors playing roles to show effective and ineffective conversations. It includes videos and quizzes, and participants can take part in online discussions. The course doesn’t require any previous training in the subject.
The course begins on 10th October 2016 and is open for registration now*.
The course takes three hours to complete. Arranged in short modules, it is designed to be easy to navigate, and participants can do it at their own pace, over three weeks, stopping and starting as they wish.
Jo Cooke, director of patient and public engagement at Cancer Research UK, said: “Talking about the disease can be tough. People might be worried that they’ll say the wrong thing, that they don’t know enough about the subject – or they may be unsure about how the conversation will go. We’re launching this course to help people overcome any obstacles to talking about cancer.
“More than 2,000 people took the course in a trial run earlier this year, and they showed gains in cancer knowledge, communication skills and confidence. Some participants have already put the skills into practice, helping others find reliable information or making healthy changes to their lifestyle.”
Responding to cancer survival rates published today Friday 16 September, Lynda Thomas, Chief Executive of Macmillan Cancer Support said:
“It is great news that these figures today show that – thanks to better treatments and earlier detection – more people are surviving cancer in both the long and short term. For example, more than 8 out of 10 (81%) women diagnosed with breast cancer in 2015 are estimated to live for at least a decade . But of course, surviving is not necessarily the same as living well, and too many people with cancer miss out on the support they badly need once treatment has finished.
“The trauma of a cancer diagnosis and treatment affects every individual differently, with some suffering from depression while others will contend with fatigue and chronic swelling resulting from treatment. Whatever the situation, it is rarely easy, and that‘s why it is essential for everyone to be given a package of support that is right for them as an individual.
“While today’s figures are to be celebrated, they should also act as a warning that as the number of long term survivors increases, we will need a health service that is able to cope with this increasingly complex situation.”
A CANCER RESEARCH UK study has found that cervical screening prevents 70 per cent of cervical cancer deaths and if all eligible women regularly attended screening this would rise to 83 per cent.
The new research, published in the British Journal of Cancer*, is the first to establish the impact that screening has on deaths from cervical cancer by using screening information from women who have been diagnosed with the disease.
In England around 800 women die from cervical cancer each year. This new study suggests that without screening an additional 1,827 more women would die from the disease. But if all women aged between 25-64 were screened regularly an extra 347 lives could be saved – extensively reducing the number of deaths from the disease.
The researchers, based at Queen Mary University of London, studied the records of more than 11,000 women in England who had been diagnosed with cervical cancer.
The biggest impact of screening is among women aged between 50-64 where there would be five times more women dying from cervical cancer if there were no screening.
As well as helping to pick up the disease at an early stage, screening can also prevent cervical cancer from developing. The researchers estimated that there would be more than twice the number of cervical cancers diagnosed if there were no screening programme.
Professor Peter Sasieni, lead researcher based at Queen Mary University of London, said: “This study looked at the impact of cervical screening on deaths from the disease and estimated the number of lives the screening programme saves each year. Thousands of women in the UK are alive and healthy today thanks to cervical screening. The cervical screening programme already prevents thousands of cancers each year and as it continues to improve, by testing all samples for the human papilloma virus (HPV), even more women are likely to avoid this disease.”
Cervical cancer screening is offered in the UK to women aged between 25 and 64. The screening programme invites women every three years between the 25 and 49; after that they are invited every five years until they’re 64.
Dr Claire Knight, health information manager at Cancer Research UK, said: “Whether or not to go for screening is an individual choice, but Cancer Research UK recommends women take up the offer to attend cervical screening when invited.
“It’s important to remember that cervical screening is for women without symptoms. Women who have any unusual or persistent bleeding, pain, or change in vaginal discharge – even if they’ve been screened recently and whatever their age – should get it checked out by their GP. Chances are it won’t be cancer but, if it is, getting it diagnosed and treated early can make a real difference.”
Responding to the report ‘ social care for older people: home truths ’ (15 September 2016) by The King’s Fund and the Nuffield Trust, Phil McCarvill, Deputy Director of Policy at the NHS Confederation, said:
“Insufficient social care funding is now the most urgent threat to the NHS and the wider health and care system.
“In August we told a Commons Select Committee that too little money is being provided for social care and this is putting increasing pressure on the NHS.
“In the run up to last year’s Spending Review we urged the Government to stop seeing the NHS, social care and public health as three separate funding streams and instead view them as part of a single system. If we are to truly join up health and care then we need to support people to receive the care when and where they need it. Inadequate funding in one part of the system has a profound impact on the other parts to deliver the right care. Without this, local coordination and planning will become increasingly disjointed and the care individuals receive will suffer.
“Our members in, partnership with social care organisations are working hard to transform services in their local communities but it’s vital that the government supports this work by providing the funding social care so desperately needs.”
A coalition of 29 health and social care organisations has been created to ensure sustainable EU staff workforce supply and thereby ensure standards of care are maintained as Britain withdraws from the EU. The Cavendish Coalition is here to provide those leading Brexit negotiations with the expertise, evidence and knowledge required on issues affecting the health and social care sectors.
The newly formed group will be a shared voice which influences and lobbies on post-EU referendum issues that affect the social care and health workforce. It will in particular ensure that there is a robust evidence base to support workforce policy across social care and health. The Cavendish Coalition has submitted evidence to a cross-party inquiry chaired by MP Gisela Stuart which will examine options for guaranteeing the status of EU nationals who are currently living in the UK.
The coalition is united in its belief that EU citizens working in the UK’s social care and health sectors should remain. The coalition has committed to secure the workforce required to deliver continuing quality in health and social care through:
- Supporting the economic as well as social health of the communities we work within, through the creation of opportunities for training and employment
- Promoting employment policy and practice which ensures that the UK continues to be able to attract vital skills from Europe and around the world to work in health and social care
- Seeking certainty for those already working in the UK by advocating for the right of the current health and social care workforce originating from European Economic Area (EEA) members to remain here.
Danny Mortimer, Chief Executive, NHS Employers, said: “This coalition of health and social care experts will be a shared voice, working together to ensure continuing quality in health and social care post-EU referendum. We will provide a focal point for engagement with relevant government departments and NHS arms-length bodies and regulators on the workforce issues arising from the Brexit vote”.
“We will also work together to ensure we continue to promote opportunities for employment within social care and health, particularly in our local communities and only where necessary, internationally. The hard work begins now. First and foremost we need to influence and support the Government in a way which allows it to grant indefinite leave to remain for the 144,000 EU staff in health and social care. EU citizens are a hugely valued and appreciated part of the workforce caring for service users and patients and should be treated as such.”
Janet Davies, RCN Chief Executive and General Secretary said:
“Our health and social care services have been relying on hardworking and talented EU staff nurses and others for many years and will continue to do so. The first priority must be to guarantee the futures of these committed EU staff in our health and care services. Allowing any ongoing ambiguity over their future is the wrong way of treating people who care for our friends and family every day, and continues to make recruitment and retention even more difficult.
In the longer term a comprehensive workforce strategy is needed to tackle the chronic shortage of health workers by investing in training more nurses and other health professionals domestically. The coalition gives us an opportunity to address these issues collectively for the long term future of our patients and the populations we serve.”
Care Providers Alliance Chair Frank Ursell and Skills for Care CEO Sharon Allen said: “The coalition is a welcome opportunity for the 19,300 employers in adult social care, the 1.43 million care workers and the workforce that supports children’s services who support citizens with a wide range of care and support needs around our country.
The coalition brings together representatives from social care and health seeking to ensure that we continue to offer seamless, quality person centred services following the decision to leave the EU. “With around 80,000 jobs filled by workers with EU nationality who make a valued contribution to adult social care in England, employers and their workers are uncertain of the impact of the decision to leave.
All the adult social care organisations who have signed up to this coalition can use their knowledge to help British Future inform the post-Brexit decision making process to ensure that millions of people in our communities, and their families and carers, can continue to access quality social care and health provision.”
The Cavendish Coalition:
Association of Directors of Adult Social Services, Margaret Willcox, Vice President
Academy of Medical Royal Colleges, Professor Dame Sue Bailey DBE FRCPsych, Chair
Association for Real Change, Lisa Lenton, England Director
Association of UK University Hospitals, Peter Homa CBE, Chair
British Medical Association, Dr Mark Porter, Council Chair
Care England, Professor Martin Green OBE, Chief Executive
Chartered Society of Physiotherapy, Karen Middleton CBE, Chief Executive
Mental Health Network, Rebecca Cotton, Director of Mental Health Policy
National Association of Primary Care, Dr Nav Chana, Chairman
National Care Association, Nadra Ahmed OBE, Chairman
New NHS Alliance, Merron Simpson, Chief Executive
NHS Clinical Commissioners, Julie Wood, Chief Executive
NHS Confederation, Stephen Dalton, Chief Executive
NHS Employers, Daniel Mortimer, Chief Executive
NHS European Office, Elisabetta Zanon, Director
NHS Partners, David Hare, Chief Executive
NHS Providers, Chris Hopson, Chief Executive
Northern Ireland Confederation for Health and Social Care, Heather Moorhead, Director
Pharmacy Voice, Elizabeth Wade, Director of Policy
Registered Nursing Home Association, Frank Ursell, Chief Executive
Royal College of Nursing, Janet Davies, Chief Executive & General Secretary
Shelford Group, Sir Michael Deegan, Chair
Skills for Care, Sharon Allen, Chief Executive
The National Care Forum, Vic Rayner, Executive Director,
The Royal College of Midwives, Professor Cathy Warwick CBE, Chief Executive
The Welsh NHS Confederation, Vanessa Young, Director
UNISON, Christina McAnea, Head of health
United Kingdom Homecare Association, Bridget Warr CBE, Chief Executive
Voluntary Organisations Disability Group, Professor Rhidian Hughes, Chief Executive
Through our work with healthcare professionals and people living with HIV, it has always been clear that when patients have positive interactions with healthcare professionals, it has a beneficial impact on their physical, emotional and mental health. That’s what inspired the team at Waverley Care to create and launch a free new training tool, Putting Caring Conversations into Practice as part of supporting person-centred care.
Available to all staff working within general practice, the interactive tutorial aims to break down barriers that can exist between patients and healthcare professionals, encouraging conversations which result in positive outcomes for both parties and so promote person-centred care.
Funded by the Scottish Government, the resource is based on a model created by Professor Belinda Dewar at the University of the West of Scotland, who observed over 240 hours of conversations in care settings. We worked closely with Belinda to develop the resource as well as with an advisory panel of healthcare professionals who helped us pull together content for the resource, attended design meetings and made suggestions on the overall look and feel.
The tool is completely interactive, bringing to life the benefits of effective conversations in everyday practice settings. The tutorial can be completed either individually or as a group, making it perfect for practice training sessions and can form part of staff CPD logs. The resource includes:
- Patient and healthcare professional case studies
- Individual or group learning options
- A reflective learning approach
- Downloadable resources
- CPD certificate
Healthcare professionals have found that having caring conversations can improve job satisfaction and enjoyment, reminding staff why they entered a care profession in the first place.
Waverley Care has been working with individuals with long-term health conditions since 1991 and we know the importance of creating an environment in which patients feel comfortable to have open and honest conversations about their healthcare needs. The resource will give staff the knowledge, skills and inspiration to put caring conversations into practice and features the inspirational real life stories of healthcare workers and people living with HIV talking about their experiences.
Waverly Care urges GP practices across the country to sign up for this training tool and place Caring Conversations at the heart of their professional practice. To access the free Caring Conversations resource please visit: www.caringconversations.scot
Grant Sugden , Chief Executive of Waverley Care
Dealing with the effects of poverty costs the UK £78bn a year, or £1,200 for every person in the country, according to a wide-ranging report on the impact of deprivation on Britain’s economy.
The Joseph Rowntree Foundation (JRF) estimates that poverty accounts for £1 in every £5 spent on public services. The biggest chunk of the £78bn figure – £29bn – comes from treating illnesses associated with poverty. A further £9bn is linked to the cost of benefits and lost tax revenues.
The research, carried out for JRF by Heriot-Watt and Loughborough universities, highlights the economic case for tackling deprivation in the UK and also looks at some longer-term consequences to the Treasury, in terms of reduced revenues and increased benefit payments to people whose earnings potential will be damaged in the future by the experience of poverty today. The report estimates that the total cost to the treasury equates to over 4% of GDP and is slightly more than the amount the UK Government borrowed in 2015-2016.
As the report concludes, although the calculations made in the report are a broad estimate and cannot be taken as a precise calculation they give a powerful indication of how strongly this is impacting on everyone in the UK. The report also concludes that a coherent strategy to combat poverty would therefore not only improve the lives of those whom it helps but also bring about huge public savings.