The healthmatters blog; commentary, observation and review
New research among more than 2,000 UK adults commissioned by HealthTech start-up WeMa Life has revealed the struggles informal carers face. The independent, nationally representative survey found:
- 15% of UK adults currently consider themselves to be informal carers – equating to 7.85 million people
- On average, an informal carer spends 13 hours a week taking on duties such as cooking, cleaning and caring for someone close to them
- 53% of informal carers say the role has had a significant impact on their emotional state
- 30% of carers have fallen out with friends and family because of tensions around their responsibilities
- Two fifths (39%) say the financial burden of being an informal carer has prevented them from leading the lifestyle they want
- 35% would pay for professionals to take on the carer duties but cannot afford to do so
- 77% of informal carers across the UK – 14.08 million people – think they ought to get more support from the Government
Acting as an informal carer is causing significant stress and financial strain to almost 8 million people across the UK, new research commissioned by HealthTech start-up WeMa Life has revealed.
An informal carer is any individual giving regular, on-going assistance to another person – typically a family member, friend or neighbour – free of charge. According to WeMa Life, 15% of UK adults currently consider themselves an informal carer, equating to 7.85 million people across the country, while a further 10.5 million (10% of UK adults) have previous acted as an informal carer for someone.
On average, these informal carers – both presently and from years gone by – spend 13 hours a week performing these duties. Moreover, the study uncovered that being an informal carer has had a huge impact on their day-to-day lives.
More than half (53%) of informal carers say the role has put them under notable emotional stress, with 30% stating that they have fallen out with friends or family members because of tensions around the responsibilities they have taken on.
Almost two fifths (39%) of informal carers have been prevented from leading the lifestyle they want or previously had because of the financial strain of the role. Meanwhile, 35% say they would pay for professionals to take on the carer duties but cannot afford to do so.
As a result of the significant disruption it causes to their lives, the overwhelming majority (77%) of informal carers believe the Government must do more to offer financial, emotional or educational support to informal carers across the UK.
Rohit Patni, CEO and co-founder of WeMa Life, commented on the findings: “Today’s research sheds light on a hugely important issue. Whether for a close friend, elderly relative or long-time neighbour, many people at some stage in their life take on the responsibility of being an informal carer for someone close to them. However, in doing so they are clearly putting a massive financial and emotional strain on their day-to-day lives.
“More support is clearly needed for the country’s informal carers. Technology stands to make things far easier, with digital solutions making it simpler for people to manage and monitor their health. But the survey has also uncovered a clear desire among informal carers for the Government to offer greater support to those sacrificing time and money to care for their loved ones.”
9:30 am Arrival & Registration
Plenary Session 1
10:10 The people’s stake: Can citizen’s wealth funds solve the inequality crisis?
Stewart Lansley, University of Bristol & City, University of London
10:35 Socioeconomic inequalities in stillbirth rates in Europe: Measuring the gap using routine data from the Euro-Peristat Project
Prof Alison Macfarlane
11:00 Data in Society: Challenging Statistics in an age of globalisation. A progress report on the Radstats collection
Jeff Evans, Humphrey Southall and Sally Ruane, Radical Statistics
11:20 Coffee/Tea break
11:40 Workshops I (choice of)
Citizen’s wealth funds: pros, cons and alternatives
Socioeconomic inequalities and reproductive health
12:40 pm Lunch
Plenary Session 2
1:40 Inequality and Intimate Partner Violence against Women
Dr Jude Towers, University of Lancaster
2:05 Greentown by numbers: exploring the feasibility of a new low- or zero-carbon town in the UK
Dr Mike Page, University of Hertfordshire
2:30 Coffee/Tea break
2:50 Workshops II (choice of)
Housing and inequality: Has Grenfell lifted the lid?
Measuring violence: opportunites and treats
Full details and booking
Today is the launch of The Origins of Happiness by Andrew Clark, Sarah Flèche, Richard Layard, Nick Powdthavee and George Ward. Prof. Layard outlines the key findings and recommendations from the research.
Over the course of our lives, what factors stand out as having the biggest impact on our wellbeing? All else being equal, what single element, or group of elements, make a difference to how anxious or dissatisfied we are with our lives?
I and my colleagues looked at the evidence from survey data on over 100,000 individuals in Australia, Germany, the UK and the US to discover what the origins of happiness might be.
WHAT DID WE FIND?
- Schools and teachers matter: Schools and individual teachers have a huge effect on the happiness of their children. Indeed, the school that children attend affects their happiness nearly as much as it affects their academic performance.
What’s more, if we wish to predict which children will lead satisfying adult lives, the best indicator is their emotional health at age 16. This is more important than their academic qualifications right up to the age of 25 – and more important than their behaviour in childhood.
- Children’s emotional health is vital: The best predictor of an adult’s life satisfaction is their emotional health as a child.
- Relationships count: Most human misery is due not to economic factors but to failed relationships and physical and mental illness. Even in poor countries, mental illness accounts for more misery than physical illness does.
- Tackle mental illness: Eliminating depression and anxiety would reduce misery by 20% while eliminating poverty would reduce it by 5%. Mental illness deserves a much greater share of resources in every country.
- Rethink inequality: The fundamental inequality between people is the inequality of wellbeing, not the inequality of income. Those who most need help are the miserable, whatever the reasons for their misery.
- Life satisfaction predicts elections: In European elections since 1970, the life satisfaction of the people is the best predictor of whether the government gets re-elected – much more important than economic growth, unemployment or inflation.
WHAT DOES THIS MEAN FOR POLICY IN THE UK?
Public policy needs a new focus: not ‘wealth creation’ but ‘wellbeing creation’. Public expenditure, taxation and regulation should increasingly be based on evidence about how they affect the subjective wellbeing of the people.
Andrew Clark of the Paris School of Economics is a professorial research fellow of the Centre for Economic Performance. Sarah Flèche is a research officer in CEP’s wellbeing programme. Richard Layard is founder director of CEP and its wellbeing programme. Nick Powdthavee and George Ward are research associates in CEP’s wellbeing programme.
- Research from the 2017 Britain’s Healthiest Workplace survey (BHW) has revealed that employees lose, on average, the equivalent of 30.4* days of productive time each year as they take time off sick and underperform in the office as a result of ill-health (otherwise known as presenteeism)
- This is equivalent to each worker losing six working weeks of productive time annually
- Productivity loss due to physical and mental health issues is costing the UK economy an estimated £77.5** billion a year
- Worryingly, employee work impairment and the associated productivity loss appears to be on a worsening trend, up from 27.5 days and £73 billion respectively in 2016
Shaun Subel, Director of Corporate Wellbeing Strategy at VitalityHealth, said: “The Britain’s Healthiest Workplace results illustrate the significance of the productivity challenge facing the UK, but importantly also point to an exciting alternative in how employers can approach this problem.
“For too long, the link between employee lifestyle choices, their physical and mental health, and their work performance has been ignored. Our data demonstrates a clear relationship – employees who make healthier lifestyle choices benefit from an additional 25 days of productive time each year compared to the least healthy employees, and also exhibit higher levels of work engagement and lower levels of stress. As a result, effective workplace health and wellbeing solutions can deliver tangible improvements in employee engagement and productivity, and make a significant impact on an organisation’s bottom line.”
*Figure calculated using an average work impairment of 11.7% and an average working year of 260 days. Work impairment is calculated using the Work Productivity and Activity Impairment (WPAI) Scale across the 31,950 employee participants in Britain’s Healthiest Workplace 2017.
**Figure calculated using ONS statistics for the period July-September 2017, and making adjustment for part-time workers. £26,468 average wage; 32.324 million people in work (of which 8.439 part-time); 10.8% cost of lost productivity as a proportion of total wage bill (calculated from Britain’s Healthiest Workplace 2017).
***The Britain’s Healthiest Workplace research process took place between February and August 2017. It looked at a number of lifestyle, mental wellbeing, clinical risk and productivity factors amongst 31,950 employees, together with a broad view of leadership and cultural dimensions and organisational policies, practices and facilities that could directly impact on employee health, across 167 companies. Results based on UK workforce as reported by each company surveyed.
Millions of Brits are ‘too busy’ to be healthy, a study has found.
A poll of 2,000 adults found more than half want to eat healthily and get plenty of exercise – but are hindered by their hectic lifestyles.
Two thirds admit they often eat ‘badly’ because they don’t have the time to prepare nutritious food.
And 75 per cent revealed they skip meals entirely for the same reason.
It also emerged, three quarters have avoided going to the gym because they have been too rushed off their feet.
In fact, more than one fifth have cancelled memberships altogether because they have been too busy to attend sessions.
Commissioned by healthy recipe box company, Mindful Chef, the research found two thirds are worried about the impact their hectic lifestyle could be having on their health.
Giles Humphries, co-founder of Mindful Chef,www.mindfulchef.com, said: “Whilst the importance of a healthy diet is becoming increasingly recognised, it’s clear a huge proportion of us need more help to achieve a healthy lifestyle.”
The research also found one third don’t have the time to plan ahead to ensure they eat healthy dinners throughout the week.
Amid this, six in 10 said they find it difficult to find recipes which inspire them to eat more nutritious meals.
When those polled do find the time to buy food from supermarkets, 68 per cent said they choose unhealthy meals because they believe it is quicker to prepare.
And half have skipped breakfast, lunch or dinner when they haven’t had enough time to do a food shop.
Incredibly, those surveyed said they typically skip mealtimes a whopping 136 times a year in total as a result of their chock-a-block lifestyles.
Giles Humphries added: “Our research found of those who have tried a recipe box, eight in 10 said it made eating healthily easier.
“We think this shows a healthy lifestyle is possible – even for the large chunk of us who lead incredibly busy lives.”
Breast cancer mortality rates have fallen by 10% in five years, according to the latest analysis released by Cancer Research UK ahead of World Cancer Day (Sunday).*
In 2015, 35 women out of every 100,000 in the UK died from breast cancer. Five years before this was 39 women per 100,000.
A better understanding of the genetics of the disease, together with new drugs and surgical techniques, have all contributed to a falling death rate. Research has led to broader uses for drugs such as tamoxifen, as well as the development of newer drugs such as aromatase inhibitors revolutionising the treatment of breast cancer.
Research has helped inform women and their doctors about the risk factors linked to breast cancer and how to reduce the chances of developing the disease to start with. Knowledge of the signs and symptoms has also helped to get breast cancer diagnosed at an early stage when treatment is usually successful.
Mortality rates across all cancer types decreased by 5% between 2010 and 2015. The four most common cancer types, breast, prostate, lung and bowel, which account for more than half of all cancer cases, have all seen considerable decreases.**
Despite the ‘big four’ cancer types seeing death rates fall by over 5%, the overall rate is tempered by the hard-to-treat cancer types. Survival remains stubbornly low in cancers of the pancreas, brain and oesophagus showing how much research is still needed to lower mortality rates across the board. Only 1% of pancreatic cancer patients survive their disease for ten years or more.***
Sir Harpal Kumar, Cancer Research UK’s chief executive, said: “It’s fantastic to see research saving lives right now, with the rate of women dying from breast cancer dropping year on year. But while the rate of people dying from cancer overall is decreasing, the overall number of people developing and dying from cancer in the UK and worldwide is expected to rise. This is because the population is growing and more of us are living longer.
“This World Cancer Day it’s important to celebrate how much things have improved, but also to renew our commitment to saving the lives of more cancer patients. More still needs to be done to bring down the number of women affected by breast cancer and to tackle the cancers that are harder to diagnose and treat. By donating and investing in more crucial research we can keep fighting this devastating disease.”
Tracey Brader, mum of three from London, was diagnosed with breast cancer in January 2015 after finding a lump while taking a shower. After going through a mastectomy and chemotherapy treatment, Tracey, aged 56, is now taking tamoxifen and getting her life back to normal.
She said: “The diagnosis was a total shock. The kids were 21, 19 and 14 at the time and I had to wait to tell them as my eldest was doing finals. When we finally had the conversation, they each responded in a different way. It was a challenge to manage their different emotions as well as my own.
“I like to feel like I’m in control and you are waiting for things – results and next steps, there are so many unknowns. I lost my hair, my eyelashes and my eyebrows and I didn’t feel like me anymore. It’s taken some time to build myself back up but I’m getting there.
“I am so grateful for the treatments available to me and without research things could have ended very differently. It’s been difficult but I’m so grateful to still be here with my family and that’s why we are supporting Cancer Research UK this World Cancer Day.”
Cancer Research UK is urging people to show their support this World Cancer Day by wearing a specially designed Unity Band, available from all Cancer Research UK shops and online. Everyone can take a small action to be a part of the generation that transforms the lives of millions who are affected by cancer.
For more information about World Cancer Day visit: http://www.cruk.org/
For more information on cancer statistics visit: https://www.cancerresearchuk.
*Based on the percentage change in annual age-standardised mortality rates in breast cancer (ICD10 C50) from 39 deaths per 100,000 women between 2008-2010 to 35 deaths per 100,000 women between 2013-2015 in the UK.
**Based on the percentage change in annual age-standardised mortality rates in cancer (ICD10 C00-C97) from 291 people dying from cancer per 100,000 in 2008 – 2010 and 277 people dying from cancer per 100,000 in 2013-2015 in the UK.
|Breast (women)||10.4% decrease|
|Prostate (men)||6.1% decrease|
Weight Watchers has released the findings of a new study in partnership with the University of Connecticut which identifies weight loss ripple effect within couples.
The study tracked the weight loss progress of 130 couples over six months. The researchers found that when one member of a couple commits to losing weight, the chances were good the other partner would lose some weight too, even if they were not actively participating in a weight loss intervention.
In the study, approximately one third of the untreated partners lost 3 percent or more of their initial body weight after six months despite not participating in any active intervention. A three percent loss of body weight is considered a measurable health benefit.
The study’s lead investigator, UConn Professor Amy Gorin, calls it a “ripple effect.”
“When one person changes their behaviour, the people around them change,” says Gorin, a behavioural psychologist. “Whether the patient works with their healthcare provider, joins a community-based, lifestyle approach like Weight Watchers, or tries to lose weight on their own, their new healthy behaviours can benefit others in their lives.”
The study, published in the US peer-reviewed medical journal Obesity, also found that the rate at which couples lose weight is interlinked. In other words, if one member lost weight at a steady pace, their partner did too. Likewise, if one person struggled to lose weight, their partner also struggled.
Commenting on the findings, Zoe Griffiths, Head of Programme and Public Health at Weight Watchers said:
“We have helped millions of people lose weight, so it’s great to see the positive impact Weight Watchers can have not only on the individual but on their partner, or on a group too – the more weight you lose, the more they lose too. This study truly does demonstrate the power of support and that’s what Weight Watchers is about. At Weight Watchers we pride ourselves on equipping our members with the skills and tools they need to be the healthiest, happiest version of themselves and with so many people joining and loving the new programme, WW Flex, #theflexeffect really is spreading across the nation!”
Previous findings of a weight loss ripple effect were limited to patients who participated in closely monitored, clinic-based interventions and those who had bariatric surgery. Most of those studies relied on couples self-reporting their weight loss, raising the possibility of error.
The Weight Watchers and UConn study is the first to use a randomised, controlled design to look at couples’ progress in less structured and widely available weight loss programmes. Researchers recorded objective measurements of participants’ weight and examined couples’ weight loss trajectories over time.
Couples, a term used for cohabitating participants regardless of marital status, were assessed at three and six months.
The couples were divided into two groups. In one group, one member of the couple was enrolled Weight Watchers, which provided in-person counselling and online tools such as an app and bar-code scanner, to assist with weight loss. In the second group, one member of the couple received a four-page handout with information on healthy eating, exercise, and weight control strategies (e.g. choosing a low-fat, low-calorie diet, portion control). Contact with those individuals stopped with the handout.
The results showed that the untreated partners of both those who tried losing weight on their own (the pamphlet recipients) and those who were Weight Watchers members also exhibited weight loss at three and six months.
The findings could add a new dimension to national guided weight loss programmes that have traditionally targeted individuals seeking a healthier lifestyle.
Report published today (31 January) by Picker and The King’s Fund has uncovered striking associations between NHS staff and patients’ experiences in hospitals and NHS trusts’ reliance on agency healthcare workers.
The analysis is the first of its kind to be published in the UK. It considers the relationships between the self-reported experiences and wellbeing of NHS staff, measures of workforce pressures in the health system, and patients’ experiences of their care.
The report reveals that there are relationships between staff wellbeing, patient experiences of their care, and the proportion of money NHS trusts spend on agency workers. In trusts where agency spend was higher as a proportion of overall pay, both staff wellbeing and patient experience were typically lower. The NHS provider sector spent £2.9billion on agency and contract staff in 2016/17.
The report also indicated that;
Staff wellbeing is related to issues within the NHS workforce.
Factors that show a relationship with staff wellbeing include numbers of doctors and nurses per bed, and bed occupancy rates. Staff that worked at Trusts with more negative workforce factors and higher spending on agency staff self-reported worse experiences. The authors state that this strongly suggests that ‘staff wellbeing is impacted negatively by a workforce that is overstretched and supplemented by temporary staff’ (page 3).
Patient experience is also impacted upon by some of these workforce issues.
As might be expected, workforce factors such as having fewer doctors and nurses per bed also are also related to patient experience. However, the report also showed that spending more on agency staff has a negative association with patients’ experiences of their care. This signals the risks to the quality of care for patients as the NHS buoys up its struggling workforce with temporary staff.
Staff wellbeing is related to a patient’s experience of their care.
This finding will prove important to NHS management and policy makers, as it provides further evidence of a correlation between staff experience and patient experience. This demonstrates that ‘staff and patient perceptions about quality of care are consistent, and their feedback is both a sensitive and an accurate barometer of quality’ (p18).
The report has been published by Picker, a health and social care charity that champions person centred care, and The King’s Fund, an independent charity working to improve health and care in England.
The report is titled ‘The risks to care quality and staff wellbeing of an NHS system under pressure’ and has been written by Steve Sizmur, Chief Statistician at Picker and Veena Raleigh of The King’s Fund.
Veena Raleigh commented:
“Our work shows that pressures on NHS staff – as reflected in factors such as the numbers of nurses and doctors per bed, use of agency staff, bed occupancy, sickness absence – are negatively associated with staff experience. Such pressures can have a knock-on effect on patients, as seen in the correlations between staff and patient experience. The well-being of staff should be a priority for the NHS.”
Steve Sizmur added:
“The report suggests that investing time and resources into problem-solving some of the systemic issues that necessitate the employment of agency staff – such as long-term absences due to sickness – may improve staff wellbeing and thus patient’s experiences of NHS care.”
The report analysed data from publicly available sources relating to the experiences of staff and patients at NHS Trusts, and on workforce and contextual variables. The data focused on 134 general acute trusts in England. Specialist trusts were excluded as the nature of the care they provide cannot be directly compared to the care provided by general and acute trusts.
The findings add to the developing picture of a NHS workforce that is under increasing stress, and demonstrate the risks to service quality as pressures rise. The report urges policy makers to understand that tackling workforce issues is not just a cost-cutting exercise, but it is also essential in order to maintain and improve the experiences and safety of people using healthcare services in England.
Chris Graham, CEO of Picker, concluded:
“This report shows that patient and staff experiences are typically poorer in NHS trusts that spend more on agency staff.
What policy makers and health service managers must take from this report is that to improve patient experience they must address workforce factors that negatively impact upon staff experience. Patients and staff alike report worse experiences at organisations that rely on using temporary staff to fill gaps in their workforce.
The report does not suggest that agency staff provide lesser care than permanent members of staff, and it is important not to blame or demonise this group. Nevertheless, the evidence demonstrates a need to ensure that the NHS and its workforce are suitably supported to provide high quality person centred care without a systemic reliance on temporary members of staff.”
The recent High Court decision on the case of Dr Bawa-Garba has caused us great concern. We deeply regret the tragic death of Jack Adcock in 2011, and any distress that may be caused by our comments. We have the utmost respect for Jack’s family and our sympathies are with them.
We believe however, that the issues raised are of grave importance to the future of the medical profession in the UK and must be addressed. The actions of our regulator, the GMC, has set back the gains made in patient safety by 10 years.
Jack’s death was the result of multiple failings. There were many issues that compromised his care, care which fell well short of the standards that any patient should expect. Multiple shortcomings were identified by the University Hospitals of Leicester internal report in to the events of that day, which made 23 recommendations and led to 79 actions by the trust. The situation in which Dr Bawa-Garba was put was hugely challenging; returning from maternity leave, without proper induction, while covering for several absent colleagues, without proper senior supervision. The care she provided that day was inadequate, but she was under severe pressure in a hospital with inadequate staffing and faulty equipment. Following the event, she took responsibility for her actions, reflected upon them and engaged with the subsequent investigation and supervision. We believe that her original conviction of gross negligence manslaughter was wrong, a guilty verdict requires a jury to find a defendant’s actions to be ‘truly exceptionally bad’. This statement is difficult to reconcile with her actions as they occurred in context, however contextual and mitigating evidence was not heard in
The Medical Practitioners Tribunal Service took appropriate account of these circumstances when it concluded that Dr Bawa-Garba should be suspended from the medical register, and that a further hearing should determine whether she is able to return in the future once her period of suspension was complete. This carefully reasoned, and clearly articulated decision was deemed unsatisfactory by the General Medical Council (GMC). The GMC chose to pursue an appeal to the High Court, which was successful and Dr Bawa-Garba has now been removed from the register. We contend this decision was the wrong one, that the sanction benefits no one, and ends the career of an otherwise competent doctor who presents no further risk to the public – apparently to satisfy a demand for blame and punishment.
The criminalisation of medical error is a dangerous precedent and we believe will be directly harmful to improving patient safety. An individual who is reckless, or wilfully negligent should be pursued with the full force of law, but errors of judgement, particularly where there are mitigating circumstances should not generally be pursued through the courts. Honest and open discussion of errors is essential to building a culture of safety. A system where people are afraid to admit mistakes due to potential personal consequences is the antithesis of what we need. If personal reflection can be used as evidence of criminal responsibility (as it was in this case: ed), how will we engage the professional in critical reflective practice?
The message that the courts and the GMC have sent to doctors is that if a patient you are responsible for, suffers harm, then you may be held criminally responsible, and the context may not be considered. This is a very frightening message for all of us working at the front line of the NHS, we are struggling to perform to the best of our ability in a system under enormous pressure, with insufficient staffing and resources. We will inevitably make errors, and unfortunately some of those errors will cause harm. As in the airline industry the best way to minimise harm is to not to blame individuals but to learn from errors, identifying the issues that allowed them to occur.
Blaming individuals for systemic failures is counterproductive. We have made great progress in recent years in the NHS on safety culture, but we still have long way to go and these rulings are corrosive to the culture of learning and support that we must encourage. These rulings are also deeply damaging to the doctor’s trust in the institutions which regulate them. The GMC must have the confidence of the profession. We urge the GMC, the Secretary of State for Health and Social Care and Health Education England to urgently review the decisions made around the use of personal reflection and the processes around investigation, and suspension or removal from the register.
The fundamental principles that need challenging are the use of criminal law to prosecute doctors who make genuine mistakes and the GMC ignoring the context in which doctors are working that have created the conditions for those mistakes. The GMC must take issues such as lack of staff, fatigue and under resourced services into account when determining whether to appeal the outcome of MPTS tribunals. We need a change in the law and the GMC. These are difficult times in the NHS and the energy and commitment of doctors is enormous but not inexhaustible. We must have faith that the institutions which govern us are reasonable and just. We urge all bodies that represent the profession to consider how they will respond to this challenge.
Dr David Wrigley, Chair, Doctors in Unite, GP, Carnforth, Lancashire