Tuesday 30 September 2014

NGH staff spotted serious child abuse or neglect 230 times in a year

NGH staff spotted serious child abuse or neglect 230 times in a year Staff at Northampton General Hospital referred more than 230 children to social services over serious abuse or neglect in a 12-month period. Northampton Chronicle and Echo

NHS chief Simon Stevens launches £650,000 prize fund for innovation

NHS chief Simon Stevens launches £650,000 prize fund for innovation Simon Stevens, NHS Chief Executive, launched a £650,000 prize pot to reward innovation in the NHS.

The NHS Innovation Challenge Prize encourages, celebrates and rewards innovation driven by the frontline doctors, nurses and NHS staff who deliver care every day. The 2014/15 NHS Innovation Challenge Prizes, worth £650,000, will be announced at the Queen’s Nursing Institute conference in London.

Ahead of the announcement, Mr Stevens said: “We have a strong track record in developing and using new medical technologies to revolutionise the way we care for and treat patients – diagnostic ultrasound, the MRI scan, the ophthalmoscope used to examine our eyes – to name but a few. All developed or invented by British innovators and used across the world to deliver healthcare to millions of people every day.”

“We need to find new ways of working if our health service is going to be fit to face the challenges ahead and we know that those ideas come from the brilliant people working in frontline caring and research roles.”

Now in its fourth year, this year’s programme will offer prizes across seven categories including for recognising innovations that support patient safety, enhance care for those with diabetes and prevent people from dying prematurely through the innovative use of technology to speed up diagnosis or improve care.

Previous winners include Dr Neil Guha and Professor Guruprasad Aithal from Nottingham University Hospitals NHS Trust who were awarded £100,000 after developing a new way of detecting early stage liver disease in the community.

The pathway uses a test first developed to detect the ripeness of cheese, to identify early stage liver disease, and has proven its potential to save lives and increase detection rates for cirrhosis. If rolled out nationally, this project could save the NHS as much £74.6 million in the first year.

The NHS Innovation Challenge Prize is open to all NHS organisations in England and deadline for entry is 7 November. For more information, visit the The NHS Innovation Challenge Prize website. NHS England

PM vows seven day GP access by 2020

PM vows seven day GP access by 2020 David Cameron pledges more money to ensure seven day GP access across is rolled out across England by 2020. BBC News

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Midwives vote for strike action

Health Education England launches nurse ‘Come Back’ campaign

Health Education England launches nurse ‘Come Back’ campaign Health Education England (HEE) is putting £4.7 million into training resources over the next three years as part of a major national campaign that will allow former nurses to return to the workforce.

The focus of this campaign is that it has never been easier to return to nursing. It follows a fresh approach offering a supportive, flexible and varied learning experience across England.

Across the country, the Come Back campaign will engage with nurses through social media and digital communications, to deliver news of the refreshed return to practice programmes now available.

Although HEE’s role is to secure the future supply of the workforce, the on-going impact of Francis warrants concerted and special action. So we have been working with stakeholders including the Royal College of Nursing and NHS Employers to deliver this Come Back campaign.

Penny Simmons from Kettering is an experienced nurse who had to leave nursing due to family commitments, at the time her role was not flexible enough for her to support those commitments and continue working as a nurse.

Co-ordinated care survey findings

Co-ordinated care survey findings This report details the results of a survey of RCS members and patients looking into the coordination of care including discharge processes and re-admission for surgical patients in England and Wales. Overall, the results showed that discharge from hospital is an area of particular concern with only one quarter of those surveyed agreeing that there is a thorough coordinated discharge process in place to enable effective transfer of care from the hospital environment. It makes a number of recommendations for where the integration of care for patients can be improved including calling for greater discharge planning to take place from the outset, more information to be available to patients and carers, and greater communication between professionals and services. Royal College of Surgeons

Will a 'wonder drug' be available in 10 years?

Will a 'wonder drug' be available in 10 years? "Wonder drug to fight cancer and Alzheimer's disease within 10 years," is the headline in The Daily Telegraph.

This headline is a textbook example of hope (and hype) triumphing over reality, as the new "wonder drug" is neither available today nor inevitable in the future.

The headline was based on a study that provides new information about the role of the protein N-myristoylation (NMT) in human cells and a mechanism that inhibits it.

The study's authors suggest NMT could be involved in the development and progression of a range of diseases, including cancer, diabetes and Alzheimer's disease.

Inhibiting the actions of NMT could help combat these diseases. But this remains to be seen: if true, this greater understanding may open up new avenues for medical research, which could ultimately lead to new treatments in the future.

While the results are both intriguing and promising, it is very difficult to predict the precise route or timing of future medical developments (drugs, treatments or therapies) based on early laboratory investigations.

Even if treatments based on NMT inhibition were developed and found to be effective, there is no guarantee they would also be safe or free from serious side effects.

All in all, the 10-year timeframe suggested by The Daily Telegraph should be taken with a pinch of salt.

As a nurse I dont feel equipped to treat patients with mental health problems

As a nurse I dont feel equipped to treat patients with mental health problems Nurses qualify with little training in mental health. Is it surprising that sometimes care falls short as a result?

I once heard a nurse tell a patient, who was half dressed and standing in a corridor screaming, to stop acting like a child. I wondered how somebody committed to caring could show such a lack of empathy to somebody so unwell. After years of working in and around the NHS and having qualified as a nurse, I am no longer surprised that the care of people with mental health problems in hospital sometimes falls short. I know that I too have fallen short.

I look after the same people in hospital now whom I met working untrained for mental health support groups. People struggling to cope with poverty, people without support networks, people with chronic illness, people who have lived through awful things. According to Mind, one in four people experience mental health problems each year. This statistic covers a complex range of problems which are as varied and profound as physical illness. Continue reading... The Guardian

Up to 200 'dangerous' GP surgeries face closure under inspection regime

Up to 200 'dangerous' GP surgeries face closure under inspection regime Dozens of GP practices that are failing to provide safe care could be closed down under a new inspection regime, chief inspector of family doctors says. The Daily Telegraph

Women denied drugs which slash breast cancer risk

Women denied drugs which slash breast cancer risk 4,000 cases of breast cancer could be prevented each year, if not for NHS red tape, scientists warn. The Daily Telegraph

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700,000 face ‘hidden risk’ of breast cancer, warns charity

700,000 face ‘hidden risk’ of breast cancer, warns charity More than 700,000 women in the UK are living with a “hidden risk” of developing breast cancer, a charity has warned. The Independent

Monday 29 September 2014

NHS leadership: to err is human, to stay still is unforgivable

NHS leadership: to err is human, to stay still is unforgivable‘Leadership is the moral energy to move people’. We are perhaps used to the refrain that ‘leadership is all about people’, but the word ‘move’ caused my ears to prick up when I heard this phrase at the recent Future of NHS Leadership Summit.

With many acknowledging the case for change in our health system, a call for leadership to ‘move people’, or prompt them into action, seemed apt. This is especially relevant when interpreted in the context of The King’s Fund’s work on collective leadership, which highlights the importance of everyone taking collective responsibility for the success of their organisation.

Gender gap in psychosis treatment

Gender gap in psychosis treatment Men who display symptoms of psychosis are recorded as being untreated for fifty per cent longer than women, based on those where information recorded. This is according to figures published by the Health and Social Care Information Centre

Exploring the cost of care at the end of life

Exploring the cost of care at the end of life This analysis estimates the hospital and non-hospital costs for people in the last 90 days of life. It also explores whether reduced hospital activity and costs at the end of life were likely to be offset by increased care costs in other health and social care settings using the Marie Curie home-based palliative care nursing service. The results suggest that cost savings might be available if community-based support were made more widely available to help people to die in their own homes, where that was their preference. Nuffield Trust

    Antibiotic treatments 'fail' 15% of the time

    Antibiotic treatments 'fail' 15% of the time “Antibiotic treatments from GPs 'fail 15% of the time’,'' BBC News reports. In one of the largest studies of its kind, researchers estimated that just under one in seven antibiotic prescriptions in 2011 "failed".

    This study examined the failure rates of antibiotics prescribed by GPs in the UK for common infections over a 21-year period – from 1991 to 2012. Most of the failures (94%) were cases where a different antibiotic needed to be prescribed within 30 days, suggesting that the first antibiotic had not worked.

    In general, the overall failure rate remained fairly static over the course of three decades; 13.9% in 1991 only increased to 15.4% by 2012.

    When considering specific types of infection in combination with specific classes of antibiotics, there were notable changes in failure rates. For example, when the antibiotic trimethoprim was prescribed for an upper respiratory tract infection, failure rates increased from 25% in 1991 to 56% in 2012. Reassuringly, failure rates with commonly prescribed antibiotics (such as amoxicillin) currently remain fairly low.

    Single national licensing exam for all doctors to come on stream

    Single national licensing exam for all doctors to come on stream GMC says ‘passport to practice’ will be fairer and more reassuring for the public. OnMedica

    Too many care homes are 'truly awful,' watchdog chief warns

    Too many care homes are 'truly awful,' watchdog chief warns Heartbreaking failings to care for the elderly must be consigned to history, says the chief inspector of adult social care, as a new system of regulation is introduced. The Daily Telegraph

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    Alcohol-related mental health problems are a huge issue for older people

    Alcohol-related mental health problems are a huge issue for older people Tony Rao, a community psychiatrist, spends his days managing vulnerable older people who may be at risk of self-harm.

    The first thing that I do when I wake up is take a look at my BlackBerry. We have patients under the home-treatment team, which means that there can be a crisis at any time of the day or night that requires urgent attention. Once Ive finished that, I plan my travel for the morning, looking at bus routes to home visits. These visits can take far longer than other medical assessments. Assessments of older people with mental health problems generally take between 60 and 90 minutes, as aspects of both mental and physical health need to be covered.

    Once back at my community mental health team, I check my caseload using an electronic patient record system, to check on the progress of patients currently on in-patient wards and to update myself on events for community patients within the past 12 hours. Continue reading... The Guardian

    The only NHS hospital run by private firm provides ‘poor’ care, inspectors say

    The only NHS hospital run by private firm provides ‘poor’ care, inspectors say The only NHS hospital run by a private company has come under fierce criticism from inspectors for a catalogue of alleged failings, including incidents of patients being treated in an “undignified and emotionally abusive manner”. Hinchingbrooke Hospital, in Cambridgeshire, was taken over by Circle Health in a £1bn deal in 2011, in an arrangement hailed by a Conservative health minister at the time as a “good deal for patients and staff”. The Independent

    See also:

    Hospitals asking GPs to send fewer patients on to overstretched A&E departments

    Hospitals asking GPs to send fewer patients on to overstretched A&E departments GPs throughout England are receiving emails from their local hospitals warning that A&E departments are under severe pressure and urging family doctors not to send so many patients on. The Independent

    Friday 26 September 2014

    Wither quality?

    Wither quality? To close the gap between the quality of care the NHS should provide, compared to what it does provide, requires improvement at a hitherto unseen scale. Improvers of the NHS, your time is now, says Richard Taunt. The Health Foundation

    CQC sets out new plans for inspecting substance misuse services

    CQC sets out new plans for inspecting substance misuse services At the heart of the new approach is a commitment to tailor inspections to the issues that matter to people using substance misuse services. More ..... Care Quality Commission

    Staff friends and family test results published

    Staff friends and family test results published NHS England has today published the first quarter national results for the Staff Friends and Family Test. Read our highlights. NHS Employers

    Ebola-hit nations may 'face collapse'

    Chlorine contamination at NHS flagship sparks investigation

    Chlorine contamination at NHS flagship sparks investigation Police were called in to Queen Elizabeth Hospital in Birmingham after the discovery of high levels of chlorine in water and concerns of a possible link to the deaths of two patients. Channel 4 News

    Skirt size increase ups breast cancer risk

    Skirt size increase ups breast cancer risk “Skirt size increase linked to breast cancer risk,” BBC News reports. The story comes from a UK study of nearly 93,000 postmenopausal women that looked at whether changes in skirt size since their twenties was associated with increased risk of breast cancer.

    It found that going up a skirt size every 10 years was associated with a 33% increased risk of developing breast cancer after the menopause. As an example, this could be going from a size 8 at 25 years old to a size 16 at 65 years old.

    It's important to stress that the initial risk of developing breast cancer, the baseline risk, is small, with only 1.2% of women involved in the study going on to develop breast cancer.

    This large study used skirt size as a proxy measure for “central obesity” – the accumulation of excess fat around the waist and stomach. While overweight and obesity is known to be a risk factor for several cancers, this study suggests that a thickening waist may be an independent measure of increased breast cancer risk.

    The good news is that the “skirt size effect" appears to be reversible, as losing weight and trimming your waist size may help reduce your breast cancer risk.

    Exclusive: Practices could merge into hospital-led organisations under Labour plans

    Exclusive: Practices could merge into hospital-led organisations under Labour plans GP practices could be swallowed up by hospital-led integrated care organisations under Labour's plans to transform the NHS, according to shadow health secretary Andy Burnham. GP Online

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    Its time to stop bullying in the NHS for the sake of patients

    Its time to stop bullying in the NHS for the sake of patients Bullying whistleblowers has damaged staff health and cost employers sick pay and turnover

    Bullying in the NHS is a serious problem. Robert Franciss 2010 report into the Mid Staffordshire hospital scandal said an explanation for staffs reluctance to come forward with concerns was that they were scared, witnesses described an endemic culture of bullying, and the report provides graphic examples of the victimisation of those who did raise concerns.

    The omission of bullying from the 290 recommendations in his 2013 report was a serious mistake that Robert Francis could remedy in his current independent review into whistleblowing in the NHS. Since 2010, NHS bullying has further increased. According to the NHS national staff survey, the proportion of staff reporting being bullied, harassed and abused by colleagues and managers rose from 14% in 2010 to 22% in 2013. Staff surveyed said under half of these cases were reported while the proportion of cases being reported fell from 54% in 2004 to 44% last year. Continue reading... The Guardian

    Patients waiting times on NHS a national disgrace GP leader

    Patients waiting times on NHS a national disgrace GP leader Royal College of GPs chair speaks out as NHS figures show one in six patients has to wait at least a week before they see a GP

    Intolerably long waiting times to see a GP have become a national disgrace that could endanger peoples health, the leader of Britains family doctors has warned.

    Increasingly unacceptable waits for an appointment risk illnesses not being spotted quickly enough and chances to prevent them being missed, said Dr Maureen Baker. Continue reading... The Guardian

    Cancer sufferers want more help from GPs

    Cancer sufferers want more help from GPs One in ten cancer sufferers sees GPs five times before being referred to hospital, amid growing patient dissatisfaction. The Daily Telegraph

    See also:

    MMR uptake at highest level ever but remain below WHO targets

    MMR uptake at highest level ever but remain below WHO targets  The MMR vaccine is being given to more children than ever before but uptake rates still remain below World Health Organisation targets. The Daily Telegraph

    Thursday 25 September 2014

    Mums call for more investment as Northamptonshire breastfeeding tails off

    Mums call for more investment as Northamptonshire breastfeeding tails off

    The number of babies still being breast fed at eight weeks in Northamptonshire has fallen annually for the past three years, latest figures reveal. 
    Northampton Chronicle & Echo

    NHS workers across England to strike for four hours over pay

    NHS workers across England to strike for four hours over pay

    The Government is facing a week of industrial action by public sector workers in worsening disputes over pay after news that health staff are to go on strike. Independent

    Paper records could cause thousands of NHS deaths

    Paper records could cause thousands of NHS deaths

    Mistakes using paper charts to monitor patients could result in thousands of hospital deaths, study suggests. Telegraph

    Patient safety incident reporting continues to improve

    Patient safety incident reporting continues to improve


    NHS England today welcomed the publication of six-monthly data on patient safety incidents reported to the National Reporting and Learning System (NRLS) between 1 October 2013 and 30 April 2014. The data shows the NHS is continuing to get better at recognising and reporting patient safety incidents.

    Acute hospitals, mental health services, community trusts, ambulance services and primary care organisations report incidents to the NRLS where any patient could have been harmed or has suffered any level of harm. The data published today sees an increase of 12.8% in the number of incidents reported compared to the same six month period in the previous year. This increase shows the NHS is continuing to be more open and transparent around the reporting of patient safety incidents.

    The reporting of incidents to a national central system helps protect patients from avoidable harm by increasing opportunities to learn from mistakes and where things go wrong. The NHS uses these reports to identify and take action to prevent emerging patterns of incidents on a national level via patient safety alerts. These alerts are a crucial part of the NHS’ work to rapidly alert the healthcare system to risks and to provide guidance on preventing potential incidents that may lead to avoidable harm or death.

    Incident reporting is also important at a local level as it supports clinicians to learn about why patient safety incidents happen within their own service and organisation, and what they can do to keep their patients safe from avoidable harm.

    Data published today on the NRLS website shows that:
    In the six months from October 2013 to March 2014, 778,460 incidents in England were reported to the system – 12.8% more than in the same period in the previous year.
    Of those reported, 69.1% were reported as causing no harm. 24.8% were reported as causing low harm, meaning the patient required only increased observation or minor treatment as a result of the incident.
    5.5% were recorded as causing moderate harm, meaning that the patient suffered significant but not permanent harm, requiring increased treatment.
    The proportion of incidents resulting in severe harm or death remains less than 1% of all incidents reported, with the percentage resulting in death at 0.24%, down from 0.26% reported for the same period in the previous year.
    The top four most commonly reported types of incident have remained the same: patient accidents (20.9%), implementation of care and ongoing monitoring/review incidents (11.4%), treatment/procedure incidents (11.3%), and medication incidents (10.7%).

    Clinicians in NHS England review all incidents resulting in severe harm and death, and have observed that the accuracy in coding of these incidents is improving, further demonstrating increased engagement with the importance of reporting and learning from patient safety incidents. NHS Commissioning

    HEE Research and Innovation Strategy now live

    HEE Research and Innovation Strategy now live


    HEE’s Research and Innovation Strategy has been published this week. This follows extensive consultation with stakeholders and sets out a series of plans to develop a flexible workforce that is actively engaged with research and innovation.

    Our objectives include:
    Establishing a system wide coherence to education and training which will facilitate and sustain the organisational and cultural changes required to embed research and innovation.
    Ensuring that the evidence on best practice for training in research and innovation informs and influences the delivery of effective education and training within the healthcare system.
    Development of a multi-professional Clinical Academic Careers Framework for patient benefit.
    Establishing a HEE Research and Innovation Evidence Hub to ensure investment in future education and training is evidence informed.

    Professor Nicki Latham, Chief Operating Officer, Health Education England said:

    ‘This strategy is important for HEE and the NHS workforce because the demands placed on our healthcare services will continue to change over time and we need to develop a workforce that can respond and adapt to these changes.

    We recognise that partnership working with our stakeholders will be key to the success of our work in this area and would like to thank all of the organisations that provided feedback on the strategy earlier this year.’ 
    Health Education England

    To view the full strategy, please visit here

    Tax breaks for employers who help tackle obesity

    Tax breaks for employers who help tackle obesity

    Simon Stevens, NHS England chief executive, will announce a five-year plan with the aim of tackling the rise in obesity. NHS England

    Children born too close together face autism risk

    Children born too close together face autism risk

    Children born too close to their siblings face a greater chance of being autistic, a study has found. Telegraph

    Introduction of shingles vaccine for people aged 70 and 79 years

    Introduction of shingles vaccine for people aged 70 and 79 years

    Since April 2013, immunisation has been offered to people at 70 with a catch-up jab at 79. NHS Networks
    More

    Cultural change is as important as funding in transforming mental health

    Cultural change is as important as funding in transforming mental health


    There is a growing disquiet around mental health. Across the board people are calling for change, but what exactly is it that needs to be done and how can we bring about the ‘parity of esteem’ that we all seek?

    As the London Health Commission considers how best to provide for the health and wellbeing of Londoners, the London Mental Health Trust Chief Executives Group asked The King’s Fund to engage with stakeholders to help develop a vision for London’s mental health over the next 5–10 years. Our report, Transforming mental health: a plan of action for London, is the culmination of that process.

    Our engagement events attracted a wide range of attendees, including:
    NHS mental health and primary care providers
    social care providers
    specialist housing providers
    local authority and clinical commissioning group (CCG) commissioners
    representatives from NHS England, Public Health England and the Metropolitan Police Service
    independent and voluntary sector providers and innovators
    academics
    clinicians
    service users and carers.

    These events were booked up immediately, showing that there is a real passion to improve the mental health of those living in London. The experiences that were shared at those events also demonstrated an abundance of expertise in the capital. By the end of the workshops participants had developed a strong consensus on what was working, where the problems were and, importantly, what needed to change.

    So, are Londoners unique? It appears not. Many of our findings are reflected in the most recent national vision, Starting today. And a more thorough search of the literature highlights the same issues arising again and again in reports going back over a decade. For the organisations writing these documents alarm bells should be ringing!

    Mental health can rarely be considered in isolation; its impact infiltrates every part of our lives and all sections of society. As mental health cannot be separated from physical health, so improving health outcomes overall requires the involvement of multiple stakeholder groups. However, while attendees at our sessions could agree on a vision for the future, they held disparate and often conflicting views on how to achieve this. This was matched on the ground by widespread reports of disharmony between providers and commissioners; a lack of engagement with services users, carers and clinicians; and numerous strategies with duplication of effort and little in the way of shared agendas. Therein lies the problem.

    These cultural issues create a significant barrier to implementing change. While we are not blind to the financial pressures that face mental health provision (our previous work on mental health transformation highlighted the importance of financial support for transformation), funding alone is unlikely to deliver the systemic changes being demanded without a shared plan of action.

    But there is light at the end of the tunnel. Our work on collective leadership demonstrates that collaboration is at the heart of culture change. Observing commissioners, providers, service users, academics, carers and clinicians working together to create the first parts of the action plan proves that it can be done. Groups such as Lambeth Living Well Collaborative are already putting this into practice at a local level. Our report highlights nine key steps to facilitating collective solutions and ensuring progress at an organisational and systemic level.

    As we move towards a general election, the voice of the mental health community has not gone unheard, but shouting about the siloed status of mental health is not the same as breaking down the walls of that silo. As anyone who lives with mental health problems will tell you, navigating life is a continual process of reaching out and building relationships in order to overcome barriers – isn’t it about time everyone else stepped up to do the same?  Kings Fund Blog
    Download the report, Transforming mental health: a plan of action for London
    Read more on mental health

    Correspondence: Improving palliative care data collection: joint statement from PHE and NHS England

    Correspondence: Improving palliative care data collection: joint statement from PHE and NHS England

    Joint statement from PHE and NHS England on plans for improving palliative care data.

    Working with the National Council for Palliative Care, Help the Hospices and the Cicely Saunders Institute.

    Involving hospital staff is key to implementing new technology

    Involving hospital staff is key to implementing new technology


    Asking clinicians for suggestions and feedback during new IT projects can lead to better patient outcomes
    How to implement a new IT system in healthcare live discussion

    During 2013-14, University hospitals of Leicester NHS trust (UHL) treated 1,194,000 patients (or 3,271 patients a day). With the numbers treated set to rise year-on-year, we need to better equip our staff to cope with the additional pressures that will bring.

    Like many trusts, our staff are feeling the pressure of the NHS constantly being in the media spotlight. The media focus is often on poor outcomes. It is almost forgotten that the vast majority of hard-working staff provide world-class patient care. Guardian

    Continue reading...

    Link consumer tech to health IT - Newton

    Link consumer tech to health IT - Newton

    More interoperability is needed between consumer health technology and NHS systems, Public Health England's chief innovation officer has argued. EHI News

    Bowel screening benefits even late-stage cancers

    Bowel screening benefits even late-stage cancers

    Patients with late-stage bowel cancers can still benefit from screening, according to research that suggests it improves survival odds compared with cancers detected from symptoms alone. GP Online

    Long-term weight-gain increases women's risk of breast cancer by a third, study suggests

    Long-term weight-gain increases women's risk of breast cancer by a third, study suggests

    Going up a skirt size every 10 years between the age of 20 and 64 increases a woman’s risk of breast cancer later in life by 33 per cent, a new study has shown. Independent

    Wednesday 24 September 2014

    Care Act is needed to avoid a social care ‘crash’: Northamptonshire County Council leader

    Care Act is needed to avoid a social care ‘crash’: Northamptonshire County Council leader Failure to change the social care system could lead the whole system to ‘crash’ in the next decade, the leader of Northamptonshire County Council is expected to announce to the authority tomorrow. Northampton Chronicle and Echo

    Carers at breaking point

    Carers at breaking point Based on the experiences of over 5,000 carers, this analysis examines the causes of carer breakdown, the impact of crisis and what support can prevent carers’ mental and physical health breaking down. More .....  Carers UK

    Emergency surgery policy briefing

    Emergency surgery policy briefing This briefing sets out the main challenges facing emergency surgery, and the high-level actions the Government and other policy-makers can take to support patients who require emergency surgical care. It highlights concerns about variations in mortality rates following emergency surgery and argues for clearer protocols and standards on how patients undergoing emergency surgery should be treated and for the NHS to measure outcomes for patients much more rigorously by publishing audits. Royal College of Surgeons 

    Watch less TV to prevent obesity, says NICE

    Watch less TV to prevent obesity, says NICE “Take TV-free days to combat obesity, health experts urge,” The Guardian reports. This is one of a range of new recommendations from National Institute of Health and Care Excellence (NICE)draft guidelines that are designed to help adults and children maintain a healthy weight.

    Although the headlines have largely focused on TV (as well as other types of screen time, such as smartphones), the recommendations cover a range of health-related behaviours, such as walking to work and avoiding fizzy drinks.

    This draft guidance is mainly aimed at people in organisations who set up, pay for, or put into practice programmes that aim to help people maintain a healthy weight and prevent excess weight gain. The guidance is designed to help them know what sorts of behaviours these programmes should target.

    Respect patient autonomy and share decision-making, doctors reminded

    Respect patient autonomy and share decision-making, doctors reminded Reminder comes in wake of recent high profile disputes between doctors and patients about care. OnMedica

    Urgent and emergency care is in crisis action is needed now

    Urgent and emergency care is in crisis action is needed now Political parties take the issues seriously but NHS is running out of time.

    Why dont we charge people who go to A&E?
    How to reduce the pressure on A&E departments

    Urgent and emergency care (UEC) needs some urgent and emergency care. A victim of its own success, it is facing relentless rising demand up by nearly 7% in the last five years despite programmes designed to reverse the trend.

    The range of pressures on UEC has also widened. Patients coming through the doors could need anything from immediate cardiac care to emergency mental health intervention. They might also arrive with less serious needs but still be in need of immediate care, whether for physical or mental health, or in the social care sector. So-called winter pressures are no longer confined to winter this summer has been busier than last winter. Continue reading... The Guardian

    NHS faces week of industrial action by up to 500,000 staff

    NHS faces week of industrial action by up to 500,000 staff Unions set to announce four-hour strike and other actions amid anger over Jeremy Hunts denial of 1% pay rise

    The NHS is to be hit by strike action over pay for the first time in 32 years amid staff anger at being denied a 1% salary rise by the health secretary, Jeremy Hunt.

    Up to nine unions representing around 500,000 NHS personnel, including nurses and midwives, are set to take part in coordinated action next month intended to force Hunt into a U-turn on a policy that has led to a widespread feeling of betrayal. Continue reading... The Guardian

    Nurses' anger over pay boost for NHS senior managers

    Nurses' anger over pay boost for NHS senior managers Nurses accuse ministers of 'seriously warped priorities' after figures show pay boost for managers was six times that of junior staff. The Daily Telegraph

    See also:

    Ageism in the NHS may mean elderly trauma patients suffer worse care: doctors

    Ageism in the NHS may mean elderly trauma patients suffer worse care: doctors The elderly who suffer broken bones in falls and accidents are not getting specialist care because of ageism in the NHS, doctors have warned. The Daily Telegraph

    Ebola outbreak: 164 NHS health workers volunteer to join the fight in Africa

    Ebola outbreak: 164 NHS health workers volunteer to join the fight in Africa At least 164 NHS staff have joined the fight against West Africa’s Ebola outbreak, less than a week after England’s top doctors issued a nationwide call for volunteers. The Independent

    See also:

    NHS will get £2.5bn boost funded by mansion tax and and levy on tobacco firms, pledges Ed Miliband

    NHS will get £2.5bn boost funded by mansion tax and and levy on tobacco firms, pledges Ed Miliband An incoming Labour Government would give the NHS a £2.5bn injection, funded by a mansion tax, a levy on tobacco firms and closing tax loopholes exploited by hedge funds, Ed Miliband announced today. The Independent

    See also:

    Tuesday 23 September 2014

    The road to a national strategy for human factors: Part 3 – what should it be like?

    The road to a national strategy for human factors: Part 3 – what should it be like? Martin Bromiley discusses how we can move the NHS forward using human factors to underpin learning from disasters, driving improvements and developing systems and policy to make it easy to do the right things. The Health Foundation

    World Alzheimer's report 2014

    World Alzheimer's report 2014 This report calls for dementia to be integrated into both global and national public health programmes alongside other major non-communicable diseases. It reveals that control of diabetes and high blood pressure as well as measures to encourage smoking cessation and to reduce cardiovascular risk, have the potential to reduce the risk of dementia even in late-life. The report found that diabetes can increase the risk of dementia by 50%. Obesity and lack of physical activity are important risk factors for diabetes and hypertension, and should, therefore, also be targeted. Alzheimer's Disease International

    Late cancer diagnosis 'costing lives and money'

    Late cancer diagnosis 'costing lives and money' "Almost half of cancer patients diagnosed too late," says The Guardian, citing a new report that explored both the financial and health impact of late cancer diagnosis.

    The late diagnosis of almost all types of cancer usually means the disease has already spread within the body, making it less treatable, reducing a patient's chances of survival, and potentially increasing the cost of effective treatments.

    This means an enduring aim of cancer treatment is to pick up the disease as soon as possible, so treatment is more likely to be effective.

    The report predicted around 52,000 cases of four common cancers (colon, rectal, lung andovarian) may be spotted too late every year, costing the NHS around an extra £150 million to treat.

    Various theories have been put forward to explain why this is the case, including "patients put[ting] their heads in the sand when they feared cancer", and how "doctors are struggling to get patients seen quickly".

    Who produced this report on late cancer diagnoses?

    The report was produced by Incisive Health, a specialist health policy and communications consultancy, in collaboration with experts at Cancer Research UK, a leading cancer charity. It was funded by Cancer Research UK.

    The report – titled "Saving lives, averting costs: an analysis of the financial implications of achieving earlier diagnosis of colorectal, lung and ovarian cancer" – presumed that early diagnosis is crucial, and aimed to uncover the financial implications of achieving earlier diagnosis for colon, rectal, non-small cell lung (the most common type of lung cancer) and ovarian cancers.

    The report estimated the number of people currently diagnosed with cancer using national guidance and data sources. This included data on the stage of the cancer when it was diagnosed (where available), and the authors calculated the cost of treatment. They then modelled what would happen if the cancers had been diagnosed earlier.

    Links To The Headlines

    Almost half of cancer patients diagnosed too late. The Guardian, September 22 2014

    50,000 lives cut short by cancer diagnosis failings. The Daily Telegraph, September 22 2014

    52,000 cancer cases a year are spotted too late: Delays blamed on 'stiff upper lip' mentality and pressure on GPs not to refer patents for costly tests. Mail Online, September 22 2014

    Almost half of cancers 'caught too late'. ITV News, September 22 2014

    Links To Science

    Cancer Research UK. Half of cancers diagnosed at late stage as report shows early diagnosis saves lives and could save the NHS money. September 22 2014

    Experts predict NHS financial ‘crisis’ within a year

    Experts predict NHS financial ‘crisis’ within a year Fears commissioners cannot help trusts avoid cash crunch. OnMedica

    NHS pay is complicated, unfair and frankly absurd

    NHS pay is complicated, unfair and frankly absurd We must put all the facts on the table and remove perverse incentives if we are serious about making NHS pay fairer

    A year after I started my NHS career, I was surprised to benefit from not one but two pay rises. I was due not only the normal type of pay rise 2% or so to cover the rising cost of living but also an incremental rise. My manager explained that the pay for my job was spread over a number of salary points, and that Id rise through those incrementally each year until I reached the top, as well as getting my cost-of-living pay rise.

    I was amazed at the reams of paperwork that my manager was supposed to assess me against to decide if I was worthy of my increment. And, I was amazed that this bureaucracy was ignored so that we were given the increment automatically. Continue reading... The Guardian

    'Reckless' antibiotic prescribing fuelling superbugs as some GPs prescribing twice as much as others

    'Reckless' antibiotic prescribing fuelling superbugs as some GPs prescribing twice as much as others Former health minister condemns 'reckless antibiotic prescribing' for fuelling superbugs as Telegraph finds some GPs are prescribing twice as much as others. The Daily Telegraph

    NHS staff are being asked to volunteer to fight Ebola outbreak

    NHS staff are being asked to volunteer to fight Ebola outbreak NHS leaders have written to staff to ask them to volunteer to treat Ebola victims in Africa. The Daily Telegraph

    See also:

    Monday 22 September 2014

    Parking at Northampton General Hospital to be reviewed by the borough council

    Parking at Northampton General Hospital to be reviewed by the borough council Inadequate patient parking at Northampton General Hospital (NGH) is to be reviewed by the borough council. Northampton Chronicle and Echo

    The toxic mix of politics, money and the NHS – a possible way forward?

    The toxic mix of politics, money and the NHS – a possible way forward? Various bodies overseeing the NHS in England have reported on how things are progressing in this financial year (2014/15) and it doesn’t make comfortable reading, says Anita Charlesworth. The Health Foundation

    Improvements needed in community mental health care

    Improvements needed in community mental health care A CQC survey of more than 13,500 people who use community mental health services in England asked for views from people who receive community mental health services and included people receiving services under the care programme approach (CPA). Care Quality Commission

    NHS whistleblowing 'problems persist'

    NHS whistleblowing 'problems persist' Whistleblowers still face real problems in speaking out in the health service - despite the push to create a more open culture, campaigners say. BBC News

    GPs income in the UK continues to decline as expenses increase

    GPs income in the UK continues to decline as expenses increase The average income before tax of contractor GPs was £102,000 in 2012/13, a drop of 0.9 per cent on 2011/12 according to the latest report from the Health and Social Care Information Centre (HSCIC).

    See also:

    Delivering alcohol IBA: broadening the base from health to non-health contexts: review of the literature and scoping

    Delivering alcohol IBA: broadening the base from health to non-health contexts: review of the literature and scoping There is good evidence for the effectiveness of alcohol IBA (identification and brief advice) services in primary care and hospital settings. This briefing explores the evidence for broadening out alcohol IBA services to non-healthcare settings such as criminal justice settings or community-based services such as pharmacies. Alcohol Research UK

    Trusts must comply with data standards

    Trusts must comply with data standards NHS England will use "carrots and sticks" to get trusts to comply with data standards and infrastructure requirements, says Tim Kelsey. E-Health Insider

    Mums 'feel shame' about how they feed their babies

    Mums 'feel shame' about how they feed their babies "Mothers are made to feel 'marginalised and ashamed' when they breastfeed in public, according to an international study," the Mail Online reports. But the same study found mothers who bottlefeed also feel subject to criticism.

    The study used discussion groups and interviews to explore the thoughts, feelings and experiences – as well as perceived barriers and facilitators – of feeding infants among a small sample of mothers in north-west England.

    A common theme was the shame felt by both mothers who breastfeed and bottlefeed their babies. For example, some breastfeeding mothers discussed concerns about how they are viewed by others when exposing their bodies in public, while conversely women who bottlefeed their baby often feel frowned upon for not breastfeeding.

    This was a small study involving just 63 women in one region of England, so we cannot assume its findings are representative of other, larger populations. But it does provide a useful insight into how, for some women, breastfeeding has become an emotional minefield. It suggests there is an important psychological, not just physical, aspect to breastfeeding.

    Practice boundary reforms delayed until January, NHS England reveals

    Practice boundary reforms delayed until January, NHS England reveals Plans to allow practices to register patients from outside their local area will be delayed until January, NHS England has revealed. GP Online

    See also:

    Hospitals are facing 'unceasing demand' for A&E and other services

    Hospitals are facing 'unceasing demand' for A&E and other services Growing numbers of hospitals are missing NHS waiting-time targets, figures reveal.

    Hospitals are treating record numbers of patients as they face unprecedented and "unceasing demand" for their services, NHS leaders warned on Friday.

    New official figures from Monitor, the health service regulator, reveal that growing numbers of hospitals are missing NHS waiting-time targets and hitting financial trouble as they struggle to cope with an ever increasing flow of patients. Continue reading... The Guardian

    NHS spends £12 million making new recruits redundant

    NHS spends £12 million making new recruits redundant NHS accused of 'scandalous waste' after new body spends £12 million on redundancy packages for 300 officials. The Daily Telegraph

    Friday 19 September 2014

    Breastfeeding rate fall is unexplained

    Breastfeeding rate fall is unexplained A significant drop in breastfeeding rates in Northamptonshire has been described as “distressing” by the county’s director for public health. Northamptonshire Telegraph

    Guidance: Progress on premature deaths of people with learning disabilities

    Guidance: Progress on premature deaths of people with learning disabilities This report from the Department of Health shows progress against the 18 recommendations in the Confidential Inquiry into premature deaths of people with learning disabilities both locally and nationally.

    It also recognises that more needs to be done including all local areas:
    • participating fully in the Self-Assessment Framework and act on its results
    • securing the provision of named care co-ordinators
    • ensuring reasonable adjustments are made and audited

    NHS staff vote in favour for strike action

    NHS staff vote in favour for strike action NHS workers in England have voted in favour of striking over pay. Two-thirds of Unison members, which include nurses, healthcare assistants and porters, said they were prepared to take action.

    Three other unions - the Royal College of Midwives, GMB and Unite - have also balloted their members. The results are expected in the coming weeks. BBC News

    See also:

    Beginning with the end in mind: How outcomes-based commissioning can help unlock the potential of community services

    Beginning with the end in mind: How outcomes-based commissioning can help unlock the potential of community services Commissioning based on outcomes has the potential to facilitate the transformation of care and is one way of overcoming the barrier of current payment mechanisms that do not support integrated care. NHS Confederation

    Patients in control: why people with long-term conditions must be empowered

    Patients in control: why people with long-term conditions must be empowered This report argues that more should be done to recognise and support the amount of self-management done by people with long-term conditions and their carers, and to enable people to work in partnership with healthcare providers to agree the services that fit their needs. Institute for Public Policy Research

    Health services finances 'worsening'

    Health services finances 'worsening' Supposedly-elite NHS foundation trusts in England are running up an overall deficit for the first time, the regulator is expected to say later. BBC News

    See also:

    Alcohol-related liver disease: new map highlights regional hotspots

    Alcohol-related liver disease: new map highlights regional hotspots The Health and Social Care Information Centre (HSCIC) has today published a regional map of emergency admissions per 100,000 of the adult population alongside new data at national, Area Team and Clinical Commissioning Group (CCG) level.

    The role of hospital managers in quality and patient safety

    The role of hospital managers in quality and patient safety This is the first systematic review of the literature that has considered the evidence on Boards’ and managers’ time spent, engagement and work
    within the context of quality and safety. BMJ Open (no password required)

    NHS must use international IT standards

    NHS must use international IT standards The NHS needs to use international IT standards if it is to make the most of the current drive towards more integrated care, the chair of IHE UK has argued. E-Health Insider

    Do artificial sweeteners raise diabetes risk?

    Do artificial sweeteners raise diabetes risk? "Artificial sweeteners may promote diabetes, claim scientists," reports The Guardian. But before you go clearing your fridge of diet colas, the research in question – extensive as it was – was mainly in mice.

    The researchers' experiments suggest artificial sweeteners, particularly saccharin, change the bacteria that normally live in the gut and help to digest nutrients.

    These changes could reduce the body's ability to deal with sugar, leading to glucose intolerance, which can be an early warning sign of type 2 diabetes.

    Assessments in human volunteers suggested the findings might also apply to people. But human studies so far are limited.

    The researchers only directly tested the effect of saccharin in an uncontrolled study on just seven healthy adults over the course of a week. It is far too early to claim with any confidence that artificial sweeteners could be contributing to the diabetes "epidemic".

    Deprived women 60% less likely to have any antenatal care

    Deprived women 60% less likely to have any antenatal care Maternal public health education should better target poorer women. OnMedica

    Better Care Fund fast-track projects: cautious, innovative and heroically optimistic

    Better Care Fund fast-track projects: cautious, innovative and heroically optimistic Strategies for five areas have been approved, revealing how local areas plan to meet targets for cutting emergency admissions and saving money

    Will new integration fund be a catalyst or catastrophe?

    The deadline for submitting redrafted plans for the £3.8bn Better Care Fund is on Friday. But strategies for five fast-track areas have just been approved, revealing what this controversial scheme, the biggest ever push to integrate health and social care, might achieve.

    The funds programme team supported by NHS England, the Local Government Association and Department of Health is wary of wildly optimistic claims about what can be done in 2015-16; one of the criteria is that delivery mechanisms must be believable. Continue reading... The Guardian

    The 'Angelina Jolie effect': Her mastectomy revelation doubled NHS breast cancer testing referrals

    The 'Angelina Jolie effect': Her mastectomy revelation doubled NHS breast cancer testing referrals Angelina Jolie’s decision to go public about her double mastectomy led to a doubling in NHS referrals for genetic tests of breast cancer risk, a new study has found. The Independent

    See also:

    Thursday 18 September 2014

    The 2015 Challenge Manifesto: a time for action

    The 2015 Challenge Manifesto: a time for action Coalition of 21 health organisations demands political action on health and care. NHS Confederation

    Ebola trial volunteer immunised

    Ebola trial volunteer immunised A trial of an experimental vaccine against the Ebola virus has begun in Oxford. BBC News

    See also:

    Get serious about obesity or bankrupt the NHS – Simon Stevens

    Get serious about obesity or bankrupt the NHS – Simon Stevens The health of millions of children, the sustainability of the NHS, and the economic prosperity of Britain all now depend on a radical upgrade in prevention and public health, the Chief Executive of NHS England tells the annual conference of Public Health England in Coventry. NHS England

    See also:

    Dementia and risk reduction: an analysis of protective and modifiable factors

    Dementia and risk reduction: an analysis of protective and modifiable factors This report critically examines the evidence for the existence of modifiable risk factors for dementia. It focuses on sets of potential modifiable risk factors in four key domains: developmental, psychological and psychosocial, lifestyle and cardiovascular conditions. The report makes recommendations to drive public health campaigns and disease prevention strategies. Alzheimer's Disease International

    Euro diabetes index 2014

    Euro diabetes index 2014 This report reveals where there has been improvement or standstill in the development of diabetes care in 30 countries. It concludes that while European diabetes care has developed, saving 10,000 lives every year, speedy improvement is critical to meet the growth of diabetes. Health Consumer Powerhouse

    HPV urine test could screen for cervical cancer

    HPV urine test could screen for cervical cancer "A simple urine test which can detect the human papilloma virus (HPV) could offer women a much less invasive alternative to [current] cervical cancer screening," The Independent reports.

    Research found urine-based testing for HPV DNA showed signs it might be accurate enough to provide a viable screening method, given further research and development.

    The papers report on a review of 14 diverse studies involving 1,443 women. All of the studies looked at the accuracy of using a self-administered urine test designed to detect HPV DNA. HPV is a group of viruses, some of which can cause cervical cancer in women.

    The advantage of such a self-administered urine test is it may improve uptake of cervical screening. As the researchers speculate, some women may be put off by current screening methods (which involve using a tool to painlessly remove a sample of cells from the cervix) as they may find it embarrassing and time consuming.

    This drop-off in women who attend screening, especially younger women, is of concern as around 3,000 cases of cervical cancer are diagnosed each year in the UK.

    The review findings are promising, but need to be followed up by further investigation and the standardisation of the urine testing method so the potential of using these tests as a screening tool can be assessed.

    How social prescribing is cutting the NHS drugs bill

    How social prescribing is cutting the NHS drugs bill Instead of prescribing medication, some GPs are offering patients access to exercise, social support and help with housing or employment

    How the NHS can deal with soaring drugs prices

    Research has highlighted the growing issues around antibiotic resistance and over-prescribing drugs in the NHS. Patients appear to be under growing expectation that when they enter a GP surgery, they should leave with a prescription for tablets or pills; whether drugs hold the answer to their problem or not.

    Its neither the fault of patients nor GPs that this has become the norm. When people cant find an appropriate solution to their ills, they often turn to an inappropriate one, or the answer they think is best. However, where tablets and pills do not hold the key, increasingly, GPs are finding that social prescribing does. Continue reading... The Guardian

    Poor NHS care kills up to 10,000 people a year, CQC chief claims

    Poor NHS care kills up to 10,000 people a year, CQC chief claims David Prior, who heads the regulator, warns variable standards in the health service lead to thousands of avoidable deaths

    The treatment provided by hospitals and GPs is so "dangerously" variable that poor care kills up to 10,000 patients a year, the head of the NHS regulator claims.

    In a withering criticism of standards in the health service, David Prior, the chair of the Care Quality Commission (CQC), warns that "many patients receive poor care". Continue reading... The Guardian

    Numbers of children using e-cigarettes on the rise

    Numbers of children using e-cigarettes on the rise E-cigarette use among children is on the rise in the UK, but the vast majority of those using them are already current or ex-smokers, a new survey has revealed. The Independent

    Wednesday 17 September 2014

    Second Wellingborough day care centre could close

    Second Wellingborough day care centre could close A day care centre for the elderly in Wellingborough faces closure after losing its funding. Northamptonshire Telegraph

    See also:

    Northamptonshire woman died days after routine hernia operation at NGH

    Northamptonshire woman died days after routine hernia operation at NGH A lack of ‘continuity of care’ contributed to the death of a former scrapyard owner who passed away days after a routine operation to remove a hernia at Northampton General Hospital. Northampton Chronicle and Echo

    Priorities for the next government

    Priorities for the next government The general election will come at a pivotal time for health and social care. An unprecedented funding squeeze has left the NHS on the brink of financial crisis, while reductions in local government funding have led to significant cuts in social care services. The next government must ensure that the focus on improving quality of care established in the wake of the Francis report is sustained. It will also need to set in train a transformation of services to meet the needs of patients more effectively. Looking further ahead, the big question is how to provide adequate funding to meet future demand for health and social care. The King's Fund

    Positive and proactive care: reducing the need for restrictive intervention

    Positive and proactive care: reducing the need for restrictive intervention The Department of Health has launched guidance aimed at promoting the development of therapeutic environments and minimising all forms of restrictive practices so they are only used as a last resort. This briefing, produced by the NHS Confederation in collaboration with the Care Quality Commission, provides a summary of the guidance, highlighting what it means for providers in practice.

    Ebola vaccine trial begins

    Ebola vaccine trial begins A trial of an experimental vaccine against the Ebola virus is to begin in Oxford. BBC News

    See also:

    Comparing lean and quality improvement

    Comparing lean and quality improvement This white paper discusses the relationship between quality improvement and lean and how either or both could best be utilised to improve care systems. Institute for Health Improvement

    Please note that this item requires free registration for full-text access.

    Strategic commissioning of long-term care: can we get more for less?

    Strategic commissioning of long-term care: can we get more for less? This white paper seeks to analyse the state of the UK market in care services for older people, to identify the market failures (and achievements) and to ask if there are any ways to correct the failures – especially the key issue which dogs providers of care services working for a publicly funded clientele, which is the mismatch between public sector commissioners’ need to contain costs in an extended period of austerity, and providers’ need to earn an adequate return in order to sustain existing services and develop the new ones. Laing & Buisson

    More than money: closing the NHS quality gap

    More than money: closing the NHS quality gap The financial gap in NHS finances has been projected to reach £30bn by 2021. This report discusses the implications of this financial gap for quality of care in the NHS. It argues that additional resources alone will not be enough to close the ‘quality gap’: the difference between the quality of care the NHS should deliver, and what it is capable of delivering. Increasingly tight budgets make it likely that the quality gap will get wider. The report highlights the changes needed in order to change how the NHS delivers services and is able to improve care to make it more efficient. The Health Foundation

    Sugar intake guideline 'needs lowering'

    Sugar intake guideline 'needs lowering' “Sugar intake must be slashed further,” reports BBC News today.

    The news reports follow an ecological study estimating the burden of disease caused by sugar-related tooth decay in adults and children across a life course, in a number of different countries.

    It calculated that the burden would be significantly reduced by setting a target limit of less than 3% of total energy intake from sugar. This is much lower than the current figure outlined by the World Health Organization (WHO), which says that sugars should be less than 10% of a person’s daily calorie intake.

    This reassessment of the target figure is not official from either the WHO or Public Health England, but has led to widespread media reports stating, “action needed to curb sugar” (Mail Online), while others have outlined possible sugar bans in schools and hospitals (The Daily Express and The Daily Telegraph) or sugar-related taxes. These angles were not put forward in the academic publication, which only suggested new, lower targets for sugar intake should be developed. It did not specify how to achieve them.

    Soaring GP workload has left morale in tatters, BMA poll shows

    Soaring GP workload has left morale in tatters, BMA poll shows Three quarters of GPs say their workload is unmanageable or unsustainable, according to a snapshot BMA poll that shows the profession's morale is lower than that of any other branch of medical practice. GP Online