Wednesday 31 August 2016

Patient safety: closing the implementation gap

Patient safety: closing the implementation gap I’ve been to many conferences on quality and safety in the NHS, and never cease to be frustrated by suggestions of creating yet another policy or checklist, or by people bemoaning the difficulty of implementing improvement measures with the common complaint ‘Why is it so hard for people just to do the right thing?’ The King's Fund

Guidance: FGM: video resources for healthcare professionals

Guidance: FGM: video resources for healthcare professionals Videos to help healthcare professionals understand, safeguard and care for women and girls affected by female genital mutilation (FGM). Department of Health

Community pharmacy forward view

Community pharmacy forward view Written jointly with Pharmacy Voice, this document sets out the ambitions for community pharmacies to enhance and expand personalised care, support and wellbeing services offered by the sector. The paper also argues for fuller integration with other local health and care services and highlights the role of the community pharmacy in being the facilitator of personalised care for patients with long-term conditions and in being a neighbourhood health and wellbeing hub. Pharmaceutical Services Negotiating Committee

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New joints: private providers and rising demand in the English National Health Service

New joints: private providers and rising demand in the English National Health Service This paper explores how NHS reforms to allow for entry of private providers has affected demand for elective surgical procedures. The study found that for elective hip replacements, at least seven per cent of publicly-funded procedures were conducted by private hospitals. Using clinical audit data, the report finds that these additional procedures are not substitutions from privately-funded procedures but that they represent new surgeries. Institute for Fiscal Studies

Growing antibiotic resistance forces updates to recommended treatment for sexually transmitted infections

Growing antibiotic resistance forces updates to recommended treatment for sexually transmitted infections New guidelines for the treatment of 3 common sexually transmitted infections (STIs) have been issued by WHO in response to the growing threat of antibiotic resistance.

Chlamydia, gonorrhoea and syphilis are all caused by bacteria and are generally curable with antibiotics. However, these STIs often go undiagnosed and are becoming more difficult to treat, with some antibiotics now failing as a result of misuse and overuse. It is estimated that, each year, 131 million people are infected with chlamydia, 78 million with gonorrhoea, and 5.6 million with syphilis.

Resistance of these STIs to the effect of antibiotics has increased rapidly in recent years and has reduced treatment options. World Health Organization

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Ex-Army chief Dannatt 'sorry' over malaria drug Lariam

Ex-Army chief Dannatt 'sorry' over malaria drug Lariam A former head of the Army has apologised to troops given an anti-malaria drug he refused to take himself because of "catastrophic" mental health effects. BBC News

Autism in girls and women 'undiagnosed'

Autism in girls and women 'undiagnosed' Autism campaigners fear that women and girls with the condition are not getting the help they need because they often go undiagnosed. BBC News

Record high numbers of diabetes amputations

Record high numbers of diabetes amputations There are around 20 diabetes-related amputations every day in England – a record high – according to a new analysis released today by Diabetes UK.

The figures were calculated using Diabetes Footcare Activity Profiles data from, Public Health England’s National Cardiovascular Intelligence Network, and show the number of diabetes-related amputations was now 7,370 a year, compared to the previous figure of 7,042 when comparing 2014-15 with 2012-13. OnMedica

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Under-fire Southern Health chief quits over 'media attention'

Under-fire Southern Health chief quits over 'media attention' NHS trust’s leadership was criticised after death of Connor Sparrowhawk, and Katrina Percy says her role has become untenable.

The boss of an NHS trust that was widely criticised for failing to investigate unexpected deaths of patients with mental health problems or learning disabilities has resigned, citing “media attention”.

Katrina Percy, the chief executive of Southern Health NHS foundation trust, who has been under pressure to stand down for months, announced her resignation on Tuesday. Continue reading... The Guardian

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Mind your language; they're not 'bed blockers' but older people

Mind your language; they're not 'bed blockers' but older people Units, targets, blockers. Language matters and can undermine the compassionate care the NHS was created for and has delivered for 70 years.

The NHS is faced with a rising tide of demand for care combined with a tight rein on both NHS and social care finances. The impact of these pressures is seen across the health and care system. It manifests itself obviously in delayed transfers out of hospitals.

Year on year these delays are rising, with more people staying in hospital when they don’t need to be there. It has an impact on the care of some of the frailest and most vulnerable people and is the subject of continued attention from the media, healthcare regulators and politicians. Continue reading... The Guardian

Junior doctors plotting five-day strikes EVERY month until the end of the year 

Junior doctors plotting five-day strikes EVERY month until the end of the year Junior doctors are plotting week-long strikes every month for the rest of the year.

They would walk out from 8am to 5pm for five straight days, according to leaked papers.

The first strike could start on September 12 – causing unprecedented havoc and the loss of thousands of scheduled operations.

Since January junior doctors have been locked in a bitter row with ministers over a new contract that will see them paid less for weekend work. The Daily Mail

The children as young as THREE with body issues: Nearly a third of nursery staff have heard youngsters describe themselves as fat or ugly

The children as young as THREE with body issues: Nearly a third of nursery staff have heard youngsters describe themselves as fat or ugly Research conducted by the Professional Association for Childcare and Early Years suggested young children were being influenced by television, animation films and images in story books. The Daily Mail

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Tuesday 30 August 2016

Northampton Hospital: Bung left in gynaecological patient

Northampton Hospital: Bung left in gynaecological patient Surgical staff left medical equipment in a patient undergoing a hysterectomy at a hospital in Northamptonshire.

The bung was left in place after the procedure at Northampton General Hospital.

A report which went before the hospital's public trust board said the patient was discharged home and the bung fell out four days later.

The hospital has apologised for the incident and said it had learned from the error.

It was one of two "never events" to happen at the hospital in Cliftonville in 2016. BBC Northampton

Some junior doctors in Northampton unpaid after payroll error

Some junior doctors in Northampton unpaid after payroll error Northampton General Hospital is working to resolve a pay error that has seen members of its newest cohort of junior doctors unpaid this month. Northampton Chronicle and Echo

The childhood obesity plan – brave and bold action?

The childhood obesity plan – brave and bold action? After months of waiting and numerous delays, the government’s childhood obesity plan was finally published in mid-August (which also happened to be during the Olympics, when most of us were sitting and watching comfortably from our sofas – and when parliament was not sitting, in this case definitely a bad thing).

Expectations were high. Writing in the Daily Telegraph just a month ago, Simon Stevens labelled obesity ‘the new smoking’ and called for an ‘activist’ strategy with comprehensive action on food reformulation (changing the nutritional content of processed foods) and on promotions and advertising of unhealthy food and drink. Jeremy Hunt has described the rise in childhood obesity as a ‘national emergency’ and promised a ’game-changing’ response from the government. Now that the dust has settled, was it worth the wait? The King's Fund

Chart: how stressful GPs in the UK find their job

Chart: how stressful GPs in the UK find their job 59% of GPs in the UK describe their job as extremely or very stressful, higher than anywhere else in the Commonwealth Fund Survey. The Health Foundation

Bias in leadership: What's your story?

Bias in leadership: What's your story? In his insightful blog Dan Robertson from the Employers Network for Equality & Inclusion, talks about bias in leadership and the key qualities of an exceptional leader. NHS Employers

Third 'given wrong initial heart attack diagnosis'

Third 'given wrong initial heart attack diagnosis' Almost a third of patients in England and Wales are being given the wrong initial diagnosis after a heart attack - with women having a far higher chance of being affected, a study suggests. BBC News

Quick turnaround GP appointments are 'running general practice into the ground'

Quick turnaround GP appointments are 'running general practice into the ground' GP appointments should be lengthened to 15 minutes and limited to 25 a day per doctor, industry leaders have said.

The British Medical Association (BMA) suggested the changes in a bid to stop general practice being “run into the ground”. The Independent

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Why are we making nurses pay for their training when the NHS needs to recruit 25,000 each year just to keep going?

Why are we making nurses pay for their training when the NHS needs to recruit 25,000 each year just to keep going? Andrew Street, a professor of health economics at York University, is speaking out after the Government confirmed it is scrapping nursing bursaries, with nurses now having to apply for a student loan. The Daily Mail

The NHS will simply collapse unless politicians have the courage to reform it

The NHS will simply collapse unless politicians have the courage to reform it Despite the Conservative Party having promised to increase NHS spending by £8 billion a year during this parliament – the minimum demanded by its managers – we learn of a crisis within the institution that promises a financial shortfall of £20 billion by 2020-21. Without (so far) any consultation, the NHS proposes a massive reorganisation that could include hospital closures and cuts, and these could start within months, just as the NHS suffers its winter overload. The Daily Telegraph

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Doctors' watchdog places one in four hospitals on danger watch list

Doctors' watchdog places one in four hospitals on danger watch list Almost 80 hospitals have been placed under surveillance by health watchdogs over concerns about patient safety and their ability to train doctors.

The General Medical Council said it had taken the “special measures” as part of efforts to prevent a repeat of the Mid Staffs scandal.

The regulator stepped in after finding alarming levels of bullying, handover systems so poor that desperately ill patients got “lost” and left at risk of serious harm during weekends, unmanageable workloads and bed shortages in intensive care. The Daily Telegraph

Friday 26 August 2016

Kettering disability support provider rated as ‘good’ by inspectors

Kettering disability support provider rated as ‘good’ by inspectors A Kettering disability support provider is celebrating after being rated as ‘good’ by the Care Quality Commission. Northamptonshire Telegraph

Securing meaningful choice for patients: CCG planning and improvement guide

Securing meaningful choice for patients: CCG planning and improvement guide This guide is designed to help CCGs deliver their statutory duties by highlighting the actions they need to take to make choice work for the populations that they serve. CCGs are encouraged to focus specifically on choice of provider and team for first outpatient appointments and choice of a suitable alternative provider if patients are not able to access certain services within the waiting time standards. The guide sets out a number of enablers for patient choice and the actions that can be taken to deliver each of these. NHS England

The state of NHS finances at Q1 2016/17

The state of NHS finances at Q1 2016/17 NHS Providers conducted a survey in the first half of August 2016 with NHS foundation trusts and trusts. We asked finance directors how their finances are faring after the first quarter of 2016/17, how much confidence they have in their plans going into the rest of the year, and their view on the effectiveness of measures outlined in NHS Improvement's financial 'reset'.

NHS cuts 'planned across England'

NHS cuts 'planned across England' Plans are being drawn up that could see cuts to NHS services across England.

The BBC has seen draft sustainability and transformation plans (STPs) which propose ward closures, cuts in bed numbers and changes to A&E and GP care in 44 areas.

There have been have been no consultations on the plans so far.

NHS England, which needs to find £22bn in efficiency savings by 2020-21, said reorganising local services is essential to improve patient care. BBC News

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How You Can Raise Mental Health Awareness And Why You Should

How You Can Raise Mental Health Awareness And Why You Should Mental health illnesses affect 1 in 4 people. Is it really right that 90% of those face stigma and discrimination because of it? Mental health illnesses are a lot more common than most people think and in this post I am going to go over why people don’t talk about mental health, why you should raise awareness for mental health and ways you can. Huffington Post UK

NHS at breaking point despite deficit reduction, say trusts

NHS at breaking point despite deficit reduction, say trusts Deficit in first quarter more than halved from last year, but funding increases are set to slow down in next two years

A combination of growing demand, staff shortages and future slowdowns in funding increases mean the NHS is at breaking point despite a reduction in deficit compared with the same period last year, trusts have said.

The deficit in the first quarter of the financial year (April to June) was £461m, less than half the amount in the same period last year (£930m), but without emergency injections of cash it probably would have been little changed. Continue reading.. The Guardian

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Meet the victims of post-natal depression

Meet the victims of post-natal depression The cause of Jessica Addicott's detachment from her elder child? Ongoing postnatal depression (PND) — a disease that is still affecting far too many British women after giving birth. The Daily Mail

Lifelike baby dolls designed to deter teenage pregnancies actually have opposite effect, scientists find

Lifelike baby dolls designed to deter teenage pregnancies actually have opposite effect, scientists find Lifelike baby dolls that cry and are designed to stop teenage pregnancies actually increase the number of underage mothers, suggests new research.

The baby simulators form part of sex education classes across the world and are touted as a key weapon to discourage girls from having sex.

But a new study of the programme in Australia, published in The Lancet, found girls who took part were twice as likely to get pregnant and a third more likely to have an abortion than those who did not. The Daily Telegraph

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Thursday 25 August 2016

We must make the most of Alzheimer’s disease research – Professor Alistair Burns and Professor Martin Rossor

We must make the most of Alzheimer’s disease research – Professor Alistair Burns and Professor Martin Rossor We recently wrote about the challenge for dementia clinical services if immunotherapy for Alzheimer’s disease proves to be successful.

It is important to plan for the future but there is some thinking and planning to be done before we arrive there.

The focus of research has shifted significantly away from established and moderately severe Alzheimer’s disease to the much earlier stages of the illness and in some cases when symptoms are very mild or even absent. People have called this “Prodromal” Alzheimer’s disease or “Asymptomatic” Alzheimer’s disease. NHS England

Health in a hurry: the impact of rush hour commuting on our health and wellbeing

Health in a hurry: the impact of rush hour commuting on our health and wellbeing This report highlights the impact of passive commuting (via rail, bus or car) on the public's health and wellbeing. The report outlines how longer commute times are associated with increased stress, higher blood pressure and BMI and contributes to reduced time available for health promoting activities such as cooking, exercise and sleeping. The report calls for a greater adoption of flexible and remote working and greater restrictions on unhealthy food and drinks outlets in stations. Royal Society for Public Health

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Guide for clinical audit leads

Guide for clinical audit leads This guide is intended to support clinicians who are responsible for leading clinical audit in clinical services and at senior levels in healthcare organisations. This is an update to the previous guide for clinical audit leads which was published by HQIP in 2011. Healthcare Quality Improvement Partnership

Rotavirus infections 'greatly reduced' since vaccine

Rotavirus infections 'greatly reduced' since vaccine Rotavirus infections have fallen by 84% in England since a vaccine has been offered to young babies, figures from Public Health England suggest. BBC News

Experts say stronger MDMA and ecstasy is causing 'more mental issues'

Experts say stronger MDMA and ecstasy is causing 'more mental issues' There's a warning that increasingly strong ecstasy and MDMA is causing the biggest risk to users' mental health in decades.

Ecstasy is getting stronger and experts are worried the negative effects the drug has on people are getting worse.

Professor Philip Murphy has been researching the drug for nearly 20 years and says he's worried about the supply currently on the market.

"The danger is much greater now than it was in the late 1990s," he says.

"The risk now of young people using stronger ecstasy is higher in terms of being able to regulate emotion and your ability to think clearly." BBC News

CCGs rated best and worst for tackling health inequalities

CCGs rated best and worst for tackling health inequalities New indicators have revealed large variation in CCGs’ performance in tackling health inequalities in their area, which are said to have led to 264,000 excess hospitalisations over the past financial year.

The indicators of how well the NHS is tackling health inequality across the country have now been adopted by the NHS and have just been rolled out as part of the NHS Clinical Commissioning Group Improvement and Assessment Framework, launched earlier this year.

They focus on emergency hospitalisation for patients with long-term conditions such as dementia, diabetes, respiratory and heart diseases, and are designed to help local NHS managers reduce potentially avoidable A&E admissions arising from social inequality. OnMedica

Defence body calls for early help to cut GP legal costs

Defence body calls for early help to cut GP legal costs GPs need urgent help with their legal costs which are spiraling upwards, according to the UK-wide defence organisation the Medical and Dental Defence Union of Scotland (MDDUS).

The plea comes as early results from the MDDUS’s annual report that have been made public, show that there was a 16.4% rise in the past year in the number of claims for clinical negligence made against its GP members and a 22% rise for all doctors. OnMedica

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NHS needs EU employees to avoid collapse, says thinktank

NHS needs EU employees to avoid collapse, says thinktank Institute of Public Policy Research says EU nationals who have lived in Britain for six years should get automatic citizenship

The NHS would collapse without its 57,000 workers who are EU nationals and they must be offered free British citizenship so they don’t leave the country after Brexit, according to a leading thinktank.

The Institute of Public Policy Research (IPPR) says in a report released on Thursday the concessions to EU nationals living in Britain are needed to prevent a post-Brexit brain-drain of talent harming the economy. Continue reading... The Guardian

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Home cooks serving rare burgers are putting millions at risk of food poisoning, FSA warns

Home cooks serving rare burgers are putting millions at risk of food poisoning, FSA warns Home cooks are putting millions of Britons at risk because they believe burgers can be left pink in the middle, the Food Standards Agency (FSA) has warned.

Almost a third of Britons incorrectly believe that eating a rare burger is the same as a rare steak when it comes to food poisoning risk.

Despite almost three quarters of people worrying about food poisoning, 36 per cent admit they would eat a burger that is not fully cooked through and more than one in 10 said they actually preferred them this way, a survey for the FSA found. The Daily Telegraph

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Wednesday 24 August 2016

Call centre to help healthy patients get home from Northamptonshire hospitals quicker

Call centre to help healthy patients get home from Northamptonshire hospitals quicker

Healthcare staff at a new Northampton call centre are to help bed blocking patients get home from hospital more quickly. Northampton Chronicle

Good practice guide to demand management

Good practice guide to demand management

NHS England has published a good practice guide to demand management.
NHS Networks

When prescribed in small doses and for a short time, HRT is an effective form of treatment, says RCGP

When prescribed in small doses and for a short time, HRT is an effective form of treatment, says RCGP

She said: “The menopause can cause great distress for many women – and for some specific symptoms, such as hot flushes, hormone replacement therapy is the only medical treatment for which we have good evidence.
“While many women are understandably concerned about the link that has been made between HRT and increased risk of breast cancer, the research today confirms that there are no adverse effects from the simpler type of HRT given to women who have had a hysterectomy (oestrogen only), and only a slightly increased risk from the combined treatment, used in women who still have their womb. “It is important to remember that the increased breast cancer risk is closely related to prolonged use of HRT in older women and that these risks reduce substantially after treatment is stopped – usually within a year or two. “When HRT is prescribed, best practice is to prescribe the lowest possible dose, for the shortest possible time - and any decision to issue a prescription needs to come out of a discussion between GPs and individual patients about their unique circumstances, the pros and cons of treatments, and how to achieve the best possible health outcome. “Patients shouldn’t panic and stop taking HRT as result of reading about this study, but instead see their GP in a routine review appointment if they have any concerns and want to discuss the matter fully.”
RCGP

Depression: A revolution in treatment?

Depression: A revolution in treatment?

Can treating the immune system lead to a revolution in treating depression?
BBC News

Syphilis is on the rise when it should be confined to history

Syphilis is on the rise when it should be confined to history As the old saying goes, “Laughter is the best medicine. Unless you have syphilis in which case penicillin is the best choice”. The disease, caused by the bacterium Treponema Pallidum and passed on through unprotected oral, vaginal and anal sex, has affected the famous through the ages (Al Capone and, reportedly, Hitler, to name just two).

But syphilis is in no way confined to big names, nor is it a sexually transmitted infection (STI) of the past. The 2016 Public Health England (PHE) syphilis reporthas shown that infection rates are on the up, with disproportionate rates in London. In 2015, the capital accounted for 56% of all cases in England, with a 22% increase in diagnoses in the year 2014-15. Since 2010 the number of cases of syphilis in Londoners has increased by 163%, with a 22% increase in the year from 2014 to 2015. The borough of Lambeth has the highest rates, closely followed by the City of London and Southwark. The Guardian

The Guardian view on the seven-day NHS: the figures don’t add up | Editorial

The Guardian view on the seven-day NHS: the figures don’t add up | Editorial


Memo to Theresa May: leaked health department documents show Jeremy Hunt’s reform plans are running out of credibility on health, economic and political grounds

At first reading, the words in the health department’s private internal briefing can seem measured and unsensational: “The current financial context means we need to demonstrate that 7DS [seven-day services in the NHS] is achievable and realistic.” Who could disagree with that? Lift the stone and peer beneath, however, and the Whitehall calm soon crumbles as the full implications sink in.

The reality underlying the studied words in the latest departmental document seen by the Guardian and Channel 4 News is that internal anxiety over the health secretary Jeremy Hunt’s flagship 7DS pledge for the NHS is still churning. Is 7DS achievable as the budget stands? Is it realistic? The answers to these apparently innocent questions are extremely uncertain. They signal huge economic and political problems for Theresa May’s government, which cannot afford to be seen as anti-NHS.

Continue reading...

Improving Population Health Management Strategies: Identifying Patients Who Are More Likely to Be Users of Avoidable Costly Care and Those More Likely to Develop a New Chronic Disease

Improving Population Health Management Strategies: Identifying Patients Who Are More Likely to Be Users of Avoidable Costly Care and Those More Likely to Develop a New Chronic Disease

This Commonwealth Fund–supported study explored whether considering a patient’s self-management skills and confidence—as predicted by the commercially available Patient Activation Measure (PAM)—might help health care delivery systems pinpoint additional high-risk patients who could benefit from supportive interventions. Commonwealth Fund

Meningitis could be diagnosed in minutes: Pin-prick blood test could save hundreds of children's lives

Meningitis could be diagnosed in minutes: Pin-prick blood test could save hundreds of children's lives

The test - which ascertains if an illness is being caused by bacteria or a virus - could be available on the NHS within five years, said Imperial College London researchers. Daily Mail

One in five pairs of prescription glasses deemed 'unacceptable' or 'unsafe', as elderly told buying specs online is too risky

One in five pairs of prescription glasses deemed 'unacceptable' or 'unsafe', as elderly told buying specs online is too risky Nearly one in five (18pc) pairs pairs of prescription glasses could be putting people at risk of driving illegally or falling over, eye experts have warned, with spectacles bought online posing a heightened safety risk to consumers.

A damning study on the quality of glasses sold in the UK, funded by the College Optometrists, has warned prescription glasses wearers going online in search of a cheaper deal that they may be more exposed to dangers caused by poor vision. The Daily Telegraph

Tuesday 23 August 2016

New Service To Help Get Patients Home Quickly In Northants

New Service To Help Get Patients Home Quickly In Northants A new service has been developed to help speed up discharge for patients who are medically fit to leave hospital but still need some support in the community.


The Single Point of Access (SPA) Service is a result of partnership working between NHS Corby and Nene Clinical Commissioning Groups, Kettering and Northampton General Hospitals, Northamptonshire Healthcare NHS Trust, Northamptonshire County Council and Olympus Care Services. About My Area

The £22 billion question: how can improvement be spread in the NHS?

The £22 billion question: how can improvement be spread in the NHS? In the mid-1990s, the service improvement methodologies developed by Don Berwick at the Institute for Healthcare Improvement in Boston, US, were first used in the NHS. In 2001 the Department of Health established the Modernisation Agency to develop and spread service improvement skills more widely throughout the NHS. And yet there is still a mountain to climb in terms of both service improvement and productivity, and there is significant variation across the country. Why is it that the best ideas are so hard to spread? The King's Fund

Demand management good practice guide

Demand management good practice guide This guidance is aimed at commissioners and providers in order to support effective management of demand for NHS services. It provides an overview of regional benchmarking of demand in England alongside a summary of actions and initiatives that can be taken to manage demand on a sustainable basis. NHS England

Teenage girls: Mental well-being 'worsening'

Teenage girls: Mental well-being 'worsening' The mental well-being of teenage girls in England has worsened in recent years, says research for the Department for Education. BBC News

GPC scraps ballot on mass resignation after NHS England agrees to talks

GPC scraps ballot on mass resignation after NHS England agrees to talks The GPC has scrapped plans to ballot the GP profession on mass resignations or industrial action after NHS England agreed to accept the BMA's Urgent Prescription as a 'basis for further discussion'. GP Online

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Make emergency care part of 'A&E hubs' to ease pressures, urge experts

Make emergency care part of 'A&E hubs' to ease pressures, urge experts Emergency care departments should become part of ‘A&E hubs’, offering patients access to a broad range of relevant staff, including GPs, concludes a joint report published by the Royal College of Nursing and the Royal College of Emergency Medicine.

The Medicine Needed for the Emergency Care Service draws on the consensus reached among experts from both colleges at a crisis summit held earlier this year. OnMedica

NHS could struggle post-Brexit without EU citizen staff, Department of Health officials admit

NHS could struggle post-Brexit without EU citizen staff, Department of Health officials admit One in 10 NHS professionals are EU citizens, prompting concerns over staffing levels amid post-Brexit uncertainty. The Independent

Secret documents reveal official concerns over 'seven-day NHS' plans

Secret documents reveal official concerns over 'seven-day NHS' plans Internal Department of Health papers drawn up for ministers detail string of dangers in implementing plan

The health service has too few staff and too little money to deliver the government’s promised “truly seven-day NHS” on time and patients may not notice any difference even if it happens, leaked Department of Health documents reveal. Continue reading... The Guardian

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I fail patients in my job as a psychiatric nurse and leave them feeling worse

I fail patients in my job as a psychiatric nurse and leave them feeling worse We try our best for people who need help in their darkest hours but with a lack of beds many are receiving inadequate care

It’s 5am. An hour ago the bed manager called me and asked me to ask a suicidal woman, who had already been in a busy London A&E department for 11 hours, if she would agree to being admitted to a hospital in Manchester.

I didn’t think it appropriate to wake someone at such a time in the morning but allowing her to sleep was not an option because we need the bed space. I approach the patient; she’s already awake. “I haven’t slept all night, it’s so noisy here” she tells me. “I feel awful; can’t I just go home?” I apologise and explain that the only available psychiatric bed is in Manchester. “No, it’s too far from my family”. I tell her I understand. She starts to cry; I want to cry with her. She feels depressed and worthless and I haven’t been able to help. How am I, as a psychiatric nurse, caring for her and helping lift her out of the awful dark place she finds herself in? I think about people who are in physical pain and ask myself whether we would expect them to wait without any treatment for over 11 hours. Continue reading... The Guardian

Virtual fracture clinics enable patients to receive care online

Virtual fracture clinics enable patients to receive care online Patients can get post A&E care and manage their recovery from fractures remotely saving time and money.

A physiotherapist and orthopaedic surgeon are transforming the way patients with fractures are treated and saving the NHS more than half a million pounds in an initiative which could become a national model.

Physio Lucy Cassidy and consultant James Gibbs have established a virtual follow-up clinic for patients with simple fractures or soft tissue injuries. In the past these patients would have come through A&E and have to return for a follow up appointment at a consultant-led fracture clinic. But today these patients receive all their post A&E care online. Continue reading... The Guardian

NHS operations face being axed to avert a winter crisis

NHS operations face being axed to avert a winter crisis In a bid to tackle the worst bed-blocking crisis in NHS history, senior doctors will be drawn away from operating theatres across Britain and into wards and A&E departments this winter to free up beds. The Daily Mail

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Big rise in patients falling victim to NHS surgical mistakes

Big rise in patients falling victim to NHS surgical mistakes Health campaigners have blamed inadequate staffing and pressure in the NHS for a rise in the number of hospital attendances caused by "mistakes" during medical care.

Between 2005 and 2015, the number of attendances by patients caused by an "unintentional cut, puncture, perforation or haemorrhage during surgical and medical care" rose from 2,193 to 6,082.

Peter Walsh, of the charity Action Against Medical Accidents, said that more complex procedures and better reporting of incidents could also partly explain the rise. The Daily Telegraph

Father who backs 'harmful' alternative cancer medication should have baby taken into care, says judge

Father who backs 'harmful' alternative cancer medication should have baby taken into care, says judge A
baby boy whose father advocates the use of "harmful alternative medication" should be taken into council care, a family court judge has decided.

The man had sold Master Mineral Solution (MMS) as a treatment for cancer and autism, social services staff told Judge Helen Black.

Staff said MMS was a sodium chlorite solution equivalent to industrial-strength bleach - and they said the Food Standards Agency had warned that it should not be taken.

They said the man advocated the use of MMS and his website included "paraphernalia for the administration of such products to babies". The Daily Telegraph

Monday 22 August 2016

Obesity strategy by Government is 'letting children down', Northampton-based charity warns

Obesity strategy by Government is 'letting children down', Northampton-based charity warns The new childhood obesity strategy is “letting down a generation of children”, a national diabetes charity based in Northampton has said. Northampton Chronicle and Echo

Local government public health budgets: a time for turning?

Local government public health budgets: a time for turning? In her first month as Prime Minister, Theresa May has signalled that she will focus on inequalities and life chances. Unlike the first woman to occupy Number 10, she may even be one for turning, as evidenced by the Hinkley Point reappraisal. Given this fresh thinking, I wonder whether the Prime Minister will be interested in the current situation with public health budgets.

After a welcome commitment to better funding of public health services in the early years of the coalition (it’s easy to forget that growth in the local government public health grant initially outpaced clinical commissioning group allocations) the ex-Chancellor first slammed the brakes on, then made a £200 million in-year reduction, and finally announced in the Spending Review a further real-terms cut averaging 3.9 per cent each year until 2020/21. The King's Fund

Supporting nurses to prepare for the OSCE

Supporting nurses to prepare for the OSCE Find out how Cambridge University Hospitals is supporting nurses recruited from overseas to prepare to work in the UK in our new blog. NHS Employers

Abortion provider Marie Stopes suspends services

Exclusive: Hospitals ignore guidance and continue to dump work on GPs

Exclusive: Hospitals ignore guidance and continue to dump work on GPs NHS hospitals are ignoring changes to their standard contract that were intended to stop them dumping work on GPs, a poll suggests. GP Online

Significant fall in hospital deaths from pneumonia

Significant fall in hospital deaths from pneumonia But respiratory specialists warn against complacency as UK death rate is third highest in Europe. OnMedica

Worse treatment of poor people by GPs costs the NHS £4.8bn a year, study finds

Worse treatment of poor people by GPs costs the NHS £4.8bn a year, study finds Excess hospital admissions of people from poorer parts of England cost the NHS £4.8bn in a single year, according to new research.

An analysis by York university academics found there were264,000 excess admissions from less well-off areas between April 2014 and April 2015.

The researchers said they had not found out the exact reasons behind the problem, but added that poor people were not being looked after as well as rich people by GPs.

They said this was not necessarily the fault of the doctors, but could be a systemic problem or because poorer people were not going to their local surgery for some reason. The Independent

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Hospital doctors ‘miss signs of illness’ because of chronic staff shortages

Hospital doctors ‘miss signs of illness’ because of chronic staff shortages Survey reveals widespread concern that widening gaps in rotas are risking patient safety and leave ‘pressurised’ medics in tears

“Dangerous” medical understaffing in hospitals is so rife that signs of illness are being missed, blood tests delayed and newly qualified doctors left in charge of up to 100 patients.

Chronic shortages of medics are also leading to those with little experience of some types of illness taking responsibility for wards full of medically needy patients, or with complex issues, whose conditions they know little about and do not feel qualified to give proper care to, including in intensive care and stroke and surgical units. Continue reading... The Guardian

Women and BME community under-represented in top NHS roles – study

Women and BME community under-represented in top NHS roles – study Labour peer criticises ‘disgraceful’ prevalence of white men in senior positions after two-year drive to rectify problem

The NHS has been accused of a “disgraceful” failure to use the talents of women and people from ethnic minorities, after research showed they are badly under-represented in senior positions.

Despite a two-year drive to rectify the problem, far fewer people from either group chair an NHS acute hospital trust or ambulance trust in England than would be proportionate to their numbers in the population, freedom of information responses show. They are also much less likely to be non-executive directors of trusts than white men. Continue reading... The Guardian

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Whistleblowers being 'blacklisted by NHS' as staff records state they were 'dismissed' even after being cleared at tribunal

Whistleblowers being 'blacklisted by NHS' as staff records state they were 'dismissed' even after being cleared at tribunal When Maha Yassaie began to suspect that a colleague was taking money from drug companies to prescribe a certain product and that a GP had obtained controlled drugs to attempt suicide she naturally raised the alarm.

But after reporting these and other concerns about her colleagues the former chief pharmacist at Berkshire West Primary Care Trust was dismissed from her post.

To her dismay Lady Yassaie was told by an internal inquiry that she was “too honest” to work for the NHS. The Daily Telegraph

Health watchdog to review why so few hospitals improved after an inspection

Health watchdog to review why so few hospitals improved after an inspection The NHS quality watchdog is to review the way it carries out inspections after it emerged that almost three-quarters of follow-up visits showed that hospitals had failed to improve.

The Care Quality Commission has said it will try to “better understand” why such a small proportion of hospital trusts are improving their standards after receiving a critical report.

A total of 21 hospital trusts were subject to follow-up visits by the CQC in 2015-16 after an initial inspection identified flaws in care, with 17 failing to show overall improvement. The Daily Telegraph

London council criticised for 'encouraging women to have unprotected sex' in 'disgusting' poster

London council criticised for 'encouraging women to have unprotected sex' in 'disgusting' poster A poster campaign by a council was slammed as "disgusting and offensive" for apparently encouraging women to have unprotected sex on nights out.

Kingston Council's "get it, forget it" campaign aims to promote thecontraceptive coil - a copper device inserted into the womb that works that prevents sperm and eggs from surviving, but does notprotect against sexually transmitted infections (STIs).

The poster, displayed across the south west London borough, read: "You spent the night in Clapham but you left your pill in Kingston, it might be time to consider the coil."

Critics have said the posters do not warn people about the risks of contracting an STI and are giving a dangerous message to women. The Daily Telegraph

Friday 19 August 2016

New film puts spotlight on person centred dementia care

New film puts spotlight on person centred dementia care A new film released by Health Education England highlights the importance of person-centred care in enabling people in care homes to live well with dementia.

The film, Finding Patience – The Later Years, continues to follow Patience and her family, who we were introduced to in the film Finding Patience, as she moves into a care home. It explores the challenges faced by staff and demonstrates what good quality person-centred care looks like.

Healing a divided Britain: the need for a comprehensive race equality strategy

Healing a divided Britain: the need for a comprehensive race equality strategy This report considers race inequality in Great Britain, providing analysis on whether our society lives up to its promise to be fair to all its citizens. It looks across every area of people’s lives including education, employment, housing, pay and living standards, health, criminal justice, and participation. It examines where progress is being made and where there is room for improvement. Equality and Human Rights Commission

Nottinghamshire dentist Desmond D'Mello struck off by General Dental Council

NICE set to remove two drugs from the Cancer Drugs Fund

NICE set to remove two drugs from the Cancer Drugs Fund Everolimus for breast cancer and ibrutinib for mantle cell lymphoma are not cost-effective, NICE says. OnMedica

Cuts to NHS services for sex workers 'disastrous' say experts

Cuts to NHS services for sex workers 'disastrous' say experts British Medical Journal editorial warns of ‘avoidable harms and disastrous long-term costs’ caused by cuts to specialist services

Sex workers are at greater risk of violence and ill health due to substantial cuts to specialist NHS health and support services across the UK, according to experts, service providers and rights groups.

An editorial in the British Medical Journal, published this week, warned of “avoidable harms and disastrous long-term costs” of ongoing funding cuts to services available to sex workers. Continue reading... The Guardian

I learned the hard way that medicine can be humiliating and incestuous

I learned the hard way that medicine can be humiliating and incestuous Dressing downs in front of nurses and not knowing who is married to whom add to a junior doctor’s worries

Early in my career as a junior doctor I had a rotation I was looking forward to, where I was working with different senior doctors in the mornings and afternoons. I was quite excited as this was definitely a part of medicine I was interested in.

On one of my first days I arrived at 6.30am to meet my senior doctor. I waited in the pre-op area, a room with several beds and curtains where patients have their regular checks before an operation. A small congregation of doctors and nurses wandered in talking. I didn’t know what the senior doctor who I would be working with looked like so I asked one of the nurses. “Yes, that’s him there,” she said with a cautious look. I walked proudly up to him and introduced myself. Continue reading... The Guardian

Ebola nurse Pauline Cafferkey faces disciplinary action for 'concealing temperature' from medics

Ebola nurse Pauline Cafferkey faces disciplinary action for 'concealing temperature' from medics Ebola nurse Pauline Cafferkey has been accused of taking paracetamol to lower her temperature so she would pass screening checks at Heathrow Airport.

The Scottish medical worker is expected to face a fitness to practice hearing at the Nursing Midwifery Council (NMC) next month where she is accused of concealing her temperature from Public Health England officials. The Daily Telegraph

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Staff shortages leave 30,000 pregnant women with mental health problems without proper care

Staff shortages leave 30,000 pregnant women with mental health problems without proper care Around 30,000 new mothers with mental health conditions are being left to fend for themselves after giving birth because of a gaping shortage in properly trained staff, NHS figures reveal.

Currently just 15 per cent of areas provide the recommended level of post-birth community care, while 40 per cent offer no service at all.

The data emerged as NHS England announced it was making available the first tranche of a £365 million fund to provide better support for mothers with existing mental illnesses, as well as those with birth-induced conditions such as postpartum psychosis. The Daily Telegraph

Health chiefs' fury as tougher rules on junk food are axed

Thursday 18 August 2016

NHS rationing under the radar

NHS rationing under the radar After years of increasing deficits, that last year culminated in the NHS posting the largest overspend in its history, local health systems have been told to balance their books.

This intensifies the difficult decisions that commissioners and providers have been facing for some time, about how to prioritise limited funding and balance their budgets in the face of rising demand. While the NHS has always had to set priorities, with these unprecedented financial pressures it is inevitable that some organisations will be forced to restrict access to certain services or dilute quality of care as they seek to curtail spending. In some areas this is happening already.

On an individual level, this is like the bank cutting off the overdraft that you rely on when you have just started a family and your rent has gone up. You are forced to cut spending on non-essentials, but deciding what ‘the essentials’ are is tough. The King's Fund

What if antibiotics were to stop working?

What if antibiotics were to stop working? The NHS if is a collection of essays that explores hypothetical scenarios and their impact on the future of health and care. Our aim is to encourage new thinking and debate about possible future scenarios that could fundamentally change health and care. This essay, by Professor Dame Sally Davies and Rebecca Sugden, explores a future in which antimicrobial resistance changes the face of medicine and health care. The King's Fund

Guidance: Healthcare education and training tariff: 2016 to 2017

Guidance: Healthcare education and training tariff: 2016 to 2017This document sets out:
  • the national tariffs for healthcare education and training placements in the academic year 2016 to 2017
  • how the tariffs will be implemented
  • in what circumstances the national tariffs may be varied and how to do this
The tariffs cover non-medical placements and medical undergraduate and postgraduate placements in secondary care.

Any further information that arises during the year will be published on Health Education England’s website. Department of Health

Tailored end-of-life care training

Tailored end-of-life care training This case study outlines how the palliative care and end-of-life care specialists at Leeds Teaching Hospitals offered bespoke departmental teaching and focused interventions to improve care within specific clinical areas. Staff at the trust reported an improvement in their skills and confidence in symptom management; facilitating end-of-life care at home; recognising end of life; and knowledge of community services. The success of this approach has led to the training being rolled out to other clinical areas across the trust. NHS Employers

Childhood obesity: Doctors criticise 'weak' government strategy

Childhood obesity: Doctors criticise 'weak' government strategy The new plan includes a voluntary target for manufacturers to cut sugar in children's food and drink by 20%, and a drive for every primary school child to exercise for an hour a day.

The British Medical Association called the 20% target "pointless" and said ministers had "rowed back" on promises.

A food industry body said manufacturers were making progress in cutting sugar. BBC News

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Depression affects one in three patients after intensive care

Depression affects one in three patients after intensive care Almost one in three people discharged from hospital intensive care units (ICUs) has clinically important and persistent symptoms of depression, according to research published in the journal Critical Care Medicine.

The meta-analysis of reports on more than 4,000 patients show that the prevalence of depressive symptoms in this population is three to four times that of the general population and that in some symptoms can last for a year or more. OnMedica

Cuts to health visitors could have ‘irredeemable’ effects on obesity and mental health

Cuts to health visitors could have ‘irredeemable’ effects on obesity and mental healthLeaders from major healthcare organisations have come together to call on the government to halt deep cuts to health visitor posts in order to keep other problems, such as childhood obesity and mental ill health, from escalating further.

In a joint letter to the Times – signed by the CEOs of 11 health bodies, such as the Royal College of Nursing (RCN), Unite, the Royal College of GPs, the RCPCH, the NSPCC and the National Children’s Bureau – professionals said cuts to the Health Visitor Implementation Programme is deteriorating public health.

The government’s Health Visitor Implementation Plan invested enough funds to train more than 4,000 health visitors, a job that plays a “vital and unique” role to prevent ill health and promote healthy lifestyles to children.

But five years on, posts are being cut harshly throughout England, with the latest workforce figures showing numbers have been falling since the beginning of the year – including a significant drop of 433 posts just between March and April. National Health Executive

Building better mental health in cities from the ground up

Building better mental health in cities from the ground up Creating green spaces and better connections between people are just two of the ways urban planners can improve mental health

The frenetic, isolating nature of city life can be a day-to-day struggle for millions of people. An environmental cocktail of densely packed streets and homes, cramped and lengthy commutes and noise pollution as well as significant pockets of poverty and deprivation can take their toll. As a result, mental ill health and urban life are inextricably linked.

With urban areas expected to house two-thirds of the world’s population by 2050 and some cities, such as in China, undergoing unprecedented expansion, the relationship between urban environments and mental health – and what to do about it – is rapidly coming to the fore. Continue reading... The Guardian

How real-time data is reducing A&E waiting times

How real-time data is reducing A&E waiting times Systems at East Kent hospitals university NHS foundation trust display live waiting times and help the trust know when to redirect patients

In many trusts, the only way to find out something like how long people are waiting in accident and emergency is to phone the department and ask. “There are not many people at any one time who know what’s going on,” says Marc Farr, director of information at East Kent hospitals university NHS foundation trust. “A hospital has lots of people phoning people all day for information,” he says.

The trust has ended the need for such phone calls. It displays live average emergency waiting times, as well as the number of people waiting, at each of its four hospitals, on its website. As well as informing the public, the business intelligence system helps the trust know when to redirect emergency patients to manage demand. Continue reading... The Guardian

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Cancer drug companies cut prices to win NHS approval

Cancer drug companies cut prices to win NHS approval Tougher new policy by regulator means pharma firms are having to offer better value for money to get treatments accepted by NHS

Drug companies are slashing the prices of new cancer medicines to avoid having them banned from NHS use, following the closure of the Cancer Drugs Fund.

The manufacturers of four cancer drugs have dropped their prices following closure of the fund – a pot of money worth £340m a year to pay for drugs that the National Institute for Health and Care Excellence (Nice) did not find cost-effective. Continue reading... The Guardian

Wednesday 17 August 2016

Meningitis W: Students urged to get vaccine

Meningitis W: Students urged to get vaccine Young people starting university or college this autumn are being urged to get a vaccine against meningitis.

Public Health England says the jab will help protect against meningitis W in particular - a sometimes deadly strain that is on the rise.

Officials say new students are at risk as they often mix closely with groups of unfamiliar people - some who may unknowingly carry the bug.

Scotland and Wales have also renewed calls for students to take up the jab.

The injection - known as the Men ACWY vaccine - was first introduced for new university students in the UK last year. BBC News

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New drugs for dementia

New drugs for dementia This briefing outlines the challenges in developing new drugs to treat dementia, and provides an overview of UK and international research activities to accelerate progress in this field. Parliamentary Office of Science and Technology

Ageing gracefully: the PACE approach to caring for frail elders in the community

Ageing gracefully: the PACE approach to caring for frail elders in the community This case study is one in an ongoing series examining programs that aim to improve outcomes and reduce costs of care for patients with complex needs, who account for a large share of U.S. health care spending. The Commonwealth Fund

New data shows EU rules on language testing of health staff putting patients at risk

New data shows EU rules on language testing of health staff putting patients at risk Leading dentists and surgeons are concerned that patient safety is being put at risk because testing of the clinical English language skills of dentists, doctors and nurses from the European Economic Area (EEA) is insufficient due to EU rules. They say the Government should use post-Brexit negotiations to rectify the situation. Royal College of Surgeons

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Better GP receptionist training might boost patient experience/satisfaction

Better GP receptionist training might boost patient experience/satisfaction Better GP receptionist training in good communication skills might help boost measures of patient experience and satisfaction with their surgery’s performance, suggests the first study* of its kind, published in the British Journal of General Practice.

Patients in some practices are having to ‘push’ for effective service, when calling GP surgeries, rather than automatically being provided with options and alternatives, when their needs can’t be met, the findings show. OnMedica

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Only one in five medical claims win compensation

Only one in five medical claims win compensation Only around a fifth of negligence claims are awarded compensation, the Medical Defence Union’s (MDU’s) Annual Report for 2015* shows.

While complaints may be common, around 80% of those defended by the MDU are defended successfully, the document reveals. OnMedica

How can care homes ensure a good death for residents?

How can care homes ensure a good death for residents? Research reveals that care home staff, healthcare professionals, residents and their families may not always agree on end-of-life care

No one goes into a care home with the express intention of dying. At the same time, most residents have a limited life expectancy and the majority will die within two or three years of moving to a home.

There is a long list of challenges facing all those involved in providing the best possible support for the 460,000 people living in UK care homes. They become even greater when it comes to caring for the eight out of 10 residents likely to suffer from dementia. They are also compounded by the fact that as many as 27 different NHS services can visit to provide care and treatment for residents. Continue reading... The Guardian

The NHS cannot afford to ignore bullying any longer

The NHS cannot afford to ignore bullying any longer Bullying undermines safe patient care, demoralises staff and leads to less effective teams

Do you work in the NHS? Please take our survey and tell us whether bullying is a problem and how it affects your work.

“It ground me down. I lost some of my hair. I began shaking at the thought of going to work and eventually retired on ill health grounds. My manager was not disciplined because although it was agreed he had bullied me, he ‘didn’t intend’ to bully me.”

This nurse left her job and will never work for the NHS again. I have met too many fine staff with similar stories while advising staff who raised concerns about patient care or discrimination. Continue reading... The Guardian

Care home fees top £30k for the first time - and are rising at 10 times the rate of pensioner incomes

Care home fees top £30k for the first time - and are rising at 10 times the rate of pensioner incomes Elderly people needing to go into a care home now face average fees of £30,000 a year, as costs are rising ten times faster than pensioner incomes, a study has found.

A study by Prestige nursing, one of the UK's biggest care agencies, has shed light on the UK's "desperate and worsening" care crisis, with the annual cost of a care home room increasing by £1,536, or 5.2pc over the past year.

This is almost ten times more than the average £156 (1pc) income gains earned by pensioners over the same period, suggesting that paying for care without spending savings is becoming affordable even for the wealthiest pensioners. The Daily Telegraph

Tuesday 16 August 2016

Feeling the Wait: Annual Report on Elective Surgery Waiting Times

Feeling the Wait: Annual Report on Elective Surgery Waiting Times A new report has found a big increase in the number of patients waiting over the 18-week NHS target for elective surgery. The Patients Association

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Every NHS trust in England is now research-active

Every NHS trust in England is now research-active All 240 NHS trusts in England are research-active, as reported in the National Institute for Health Research (NIHR) Clinical Research Network (CRN) annual performance report 2015/2016.

Patients cared for in research-active acute NHS trusts have better patient outcomes, as supported by a study published in 2015 1. Research provides evidence about “what works” so that treatments for patients can be improved. Last year alone, 605,596 people took part in clinical research studies.

Jonathan Sheffield, Chief Executive, NIHR Clinical Research Network: “This is a fantastic achievement for the NHS as a whole and shows a real desire by the NHS to improve care for our patients through, and as a result of, research activity.