Wednesday, 25 April 2012

Engaging leadership: Hope for the future lies with a new breed of doctors | John Clark

Engaging leadership: Hope for the future lies with a new breed of doctors | John Clark: As doctors are expected to play increasing roles in the commissioning, delivery and improvement of services, it is vital they are prepared for their increased responsibilities at a much earlier stage in their training and learning. Kings Fund

NHS 'wastes billions on diabetes'

NHS 'wastes billions on diabetes': The bulk of the £9.8bn the NHS spends on diabetes each year is wasted - and the disease could cost it a sixth of its entire budget by 2035, says a report. BBC News

Exclusive: GPs demand telecare savings evidence

Exclusive: GPs demand telecare savings evidence: Investing millions in telehealth could add to GP workload without benefiting patients, the GPC has warned, after the DH refused to explain its claim that the technology would save the NHS £1.2bn. GP Online

Grant links IT to CCG success

Grant links IT to CCG success: The chair of the NHS Commissioning Board has said that the best clinical commissioning groups will be those with the best information systems. E-Health Insider

Industrial action roundup

Industrial action roundup: Dean Royles, director of the NHS Employers organisation, has written to HR directors in the NHS with a general roundup of the current situation in terms of proposed industrial action relating to NHS pension reform. NHS Employers

Inpatient survey 2011

Inpatient survey 2011:
This survey looked at the experiences of over 70,000 people who were admitted to NHS hospitals around England. The results of the survey will be used by NHS trusts to improve their performance and to understand their patients’ experiences, and the results will be used to support the CQC's regulatory, compliance and monitoring activities.

Intentional rounding: what is the evidence?

Intentional rounding: what is the evidence?:
In January 2011 the Prime Minister called for changes in the way nurses deliver care. Following a number of critical reports, concern had been expressed about the need to ensure essential aspects of nursing care are consistently delivered. One of the recommendations is for NHS hospitals to implement hourly nursing rounds, to check on patients and ensure their fundamental care needs are met – an approach related to ‘intentional rounding’ in the US. Within the UK some organisations refer to this type of nursing activity as “care rounds” or “comfort rounds”. This briefing examines different approaches to intentional rounding and reviews available evidence.

NHS is failing gay and bisexual men, major survey reveals

NHS is failing gay and bisexual men, major survey reveals:
Campaigners fear lack of trust may discourage men from accessing crucial health advice and testing
Gay and bisexual men are neglected and sometimes discriminated against by a health service that tends to focus solely on their sexual health, despite the fact they are more likely to self-harm, attempt suicide and experience depression, according to a major study.
Almost 6,900 gay and bisexual men across the UK who had used NHS healthcare services in the last year were surveyed by gay rights charity Stonewall. The survey reveals that a third have had a negative experience related to their sexuality. Confidence in confidentiality systems and lack of opportunities for discussion were so poor that the same proportion had not even come out to their GP or other staff. The men said they were more likely to be open about their sexual orientation with their manager and work colleagues than with healthcare professionals.
Stonewall's chief executive, Ben Summerskill, says the findings of the report – the largest such study in the world – are "deeply troubling" because the lack of trust may discourage Britain's 1.8 million gay and bisexual men from accessing crucial advice and testing services.
Nearly a third of respondents had never had an HIV test, despite early diagnosis now being a public health priority, and 54% had never discussed HIV with a healthcare professional, the survey reveals.
In the last year, 3% of gay men and 5% of bisexual men had tried to kill themselves compared with 0.4% of all men. Over the same period, 7% of gay and bisexual men had deliberately harmed themselves, compared with just 3% of all men.
Mental health issues were even more acute among younger gay and bisexual men: of those aged 16 to 24, 6% had tried to take their own life in the last year and 15% had harmed themselves. Domestic abuse was another serious problem: half of those surveyed had experienced at least one incident from a family member or partner since the age of 16, compared with 17% of all men.
The report lays bare discrimination in the health service. "I overheard the reception staff say to a nurse: 'The poof is here for his appointment,'" David, 23, told Stonewall. Jack, 37, described how his doctor wrote "homosexual" in capital letters on a letter he had to take to hospital after breaking his wrist. Every time a different doctor pulled up his details on the computer, the same tag would appear.
Nathan, 20, said his GP refused to speak with him, ushering him out of the office and telling him to contact the local sexual health clinic instead.
Several respondents talked of health professionals assuming that because they were gay, they must be HIV positive, while others described professionals referring to them having wives or girlfriends, even after they had made it clear they were gay. Some had distressing experiences of their same-sex partner rights being ignored. "My partner is terminally ill with cancer," said Eddie, 52. "Even though he asked for his treatment to be talked over with me and to call me before his family, they have often not done so."
Of the third of respondents who had not been tested for HIV, 70% said it was because they did not think they had put themselves at risk, while a third said it was because they had never had any symptoms of HIV infection.
"These figures raise grave concerns about the effectiveness with which hundreds of millions of pounds of public money have been spent on HIV awareness and prevention in recent years," the report says.
Summerskill adds: "Patients accessing healthcare should be confident that they'll be treated compassionately, confidentially and with complete openness. But this research reveals that for many gay and bisexual men in Britain this is simply not the case."
The report also finds that respondents were more likely to smoke, drink and take illegal drugs. "It ill-serves our gay and bisexual communities when these uncomfortable truths are ignored," says Summerskill.
The report makes a number of recommendations that could help health services improve, from the Royal Colleges updating professional development programmes for their members to include topics such as same-sex partner rights, to frontline staff being trained about the importance of not assuming someone's sexual orientation. Workers should also encourage disclosure by asking open questions and having clear confidentiality policies. Just one in 11 of respondents said they had been given the opportunity to come out.
Policies explicitly protecting gay and bisexual people from discrimination should be displayed at surgeries and hospitals, and improving access to sexual health services for gay and bisexual men should be made a public health priority, the report concludes.
A Department of Health spokeswoman says lesbian, gay and bisexual people are prioritised in its mental health strategy because it recognises "they are at a higher risk of mental health problems, violence and self-harm". She adds that the latest GP Patient Survey shows that 84% of gay, lesbian and bisexual respondents described their overall experience of their GP surgery as "good". The Guardian

Will the nurse training overhaul rebalance the curriculum v caring conundrum?

Will the nurse training overhaul rebalance the curriculum v caring conundrum?:
After a barrage of reports involving the neglect of hospital patients, the training and education of nurses is going under the microscope
Nursing may not quite be in crisis, but it is certainly going through a rough patch. So the launch today of a commission of inquiry into nurse education and training is enormously significant both for its timing and for who is behind it.
The commission is to be led by educationist Lord [Phil] Willis, a Liberal Democrat, and it has been initiated by the Royal College of Nursing. Hitherto an unswerving advocate of the model of training that the profession has been moving to over the past 20 years, culminating in it becoming degree-entry only from next year, the RCN is seizing the initiative before it is grabbed by others.
As its chief executive and general secretary Peter Carter acknowledges, "nursing has recently come under increased scrutiny from various sources, some of which have questioned the compassion and dedication of the profession". In setting up the commission, the college has decided to act "rather than refuse to accept that there may be issues in some areas".
This is an important and sensible admission. The charge sheet is now too long to deny that some nurses lack a certain something in the way they approach the job. Stories of ward staff chatting at nursing stations while their patients struggle to reach food and drink are legion, while the horrors of the mid-Staffordshire scandal – involving hundreds of unnecessary deaths of neglected patients – will be revisited later in the year by publication of the report of the public inquiry.
And the evidence keeps coming. In a new report on Leeds general infirmary, inspectors of the Care Quality Commission describe how they felt obliged to step in to seek help for patients during a recent two-day visit. "Had we not intervened, we believe some needs would not have been met," they say, formally registering "major concerns" about care standards and staffing levels.
Plainly there were questions of adequacy of staff numbers at Leeds. But the outlook for NHS funding means that hospitals and community health services will be waiting a long time for reinforcements. Besides which, many critics of modern nursing think the profession's leaders are too ready to hide behind defences of team size and skill mix.
The draft report of the Commission on Improving Dignity in Care, published in February, argued forcefully that there is a compassion deficit in the attitude of many nurses and other health workers towards older patients. It called for recruitment to be based as much on assessment of a candidate's caring qualities as on their academic record. Others, however, think that basic caring skills are no longer being taught properly during nurse training, and this is where the spotlight will be on the RCN's new commission.
The argument goes that in replacing hospital-based training with a university-based system, with nursing students doing placements in care settings, the reforms of the early 1990s sowed the seeds of today's failings. Abolition of state enrolled or assistant nurses, and their replacement by cheaper healthcare assistants, served to compound the problem.
Will Willis, whose mother was a district nurse, venture into this territory? He says he has no preconceptions and is being given a free hand to explore the commission's remit of identifying the "defining features" of nurse education to produce a workforce fit for the future. That will, he makes clear, include looking at the curriculum and at whether there is "the right balance" between classroom and workplace.
It seems unlikely, though, that the commission will question the principle of degree-based training. Across the rest of Europe and beyond, Willis points out, there is "a strong move towards a graduate nursing profession". The Guardian

NHS reforms will put children's lives at risk: NHS managers

NHS reforms will put children's lives at risk: NHS managers: Children's lives will be put at risk by the Coalition's health reforms because confusion among new organisations could lead to another Baby P, NHS managers have warned. The Daily Telegraph

Cancer tests 'not widely available'

Cancer tests 'not widely available':
Cancer patients may be missing out on the most effective treatments because of poor access to new biomarker tests, according to a survey of senior hospital doctors. The Independent

Drugs firm sues doctors for being cost conscious

Drugs firm sues doctors for being cost conscious:
Independent experts have condemned the Swiss pharmaceuticals company Novartis for trying to force the NHS to buy an expensive drug to treat patients suffering from a degenerative eye disease, rather than using a cheaper, unlicensed alternative. The Independent

Information Data Requests – Guidance for NHS Foundation Trusts and Sponsors

Information Data Requests – Guidance for NHS Foundation Trusts and Sponsors: This document explains the changed requirements relating to information data requests to NHS Foundation Trusts. Monitor