One in Five UK Hospital Patients are Harmful Drinkers

A team mainly from Kings College in London conducted as part of the first author’s MRC Addiction Research Clinical (MARC) Fellowship, has found that 1 in 5 in-patients in the UK hospital system uses alcohol harmfully, and that 1 in 10 is alcohol dependent.

They conducted a systematic review and meta-analysis that looked at studies of any design that reported the prevalence of one of 26 wholly attributable alcohol conditions defined by the WHO’s International Classification of Diseases, Version 10 (ICD‐10).

They looked at 124 studies which were all conducted in one or more of the constituent nations of the United Kingdom and in an in‐patient setting (general wards, intensive care units, accident and emergency departments or mental health in‐patient units). The 124 studies meant that they were reporting on a total of 1 657 614 patients.

Having arrived at what is a shocking statistic they have rightly suggested that hospital staff need to be skilled in the diagnosis and management of alcohol‐related conditions given the number of people that they will see as inpatients. They have also pointed out that formal screening for alcohol‐related conditions in hospital remain low and that needs to change

Given the fact that other less prevalent diseases such as diabetes, are routinely screened for and often have dedicated in‐hospital specialist care teams their study provides weight  for increased routine universal screening and support to improving everyone’s training concerning alcohol‐related conditions given this high frequency of encounters.

This study is very pertinent given the UK government’s development of a new alcohol strategy and the NHS 10‐Year Plan which included funding allocations to combat alcohol‐related conditions.

Last year figures suggested that at least 41 English hospitals do not currently have an alcohol care team (ACT’s) in place. This is despite the 10 year plan including a commitment to place ACT’s in hospitals with the highest rate of alcohol dependence-related admissions (according to this study that will be all of them!) although the plan for increasing ACT’s, does not seem to have to any material funding.

To view the whole report see

Roberts E, Morse R, Epstein S, Hotopf M, Leon D, Drummond C. The prevalence of wholly attributable alcohol conditions in the United Kingdom hospital system: a systematic review, meta-analysis and meta-regression. Addiction. 2019 Jul 3 [Epub ahead of print]. doi: 10.1111/add.14642. PMID: 31269539

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Alzheimer Scotland Dementia Nurse Consultants Supporting #DAW2019 and Doing Their #oneweething

I am going to cheat this week and not write my own Blog piece. Instead I am going to provide a platform for two other people I know and another Blogging site called — Let’s Talk about Dementia.

The Let’s Talk about Dementia Blog was set up following on from Scotland’s Dementia Awareness Week 2014 which focused on the theme “lets talk about dementia”.  Five years later the Blog is still talking about Dementia because talking helps us make sure that nobody faces dementia alone. The Blog shares the work and practice of the allied health professionals in relation to dementia care and offers advice for people living with dementia, their carers, partners and families.

This week is dementia awareness week in Scotland and on the 7th of June Helen Skinner and Lyn Irvine, two of Scotland’s Dementia Nurse Consultants wrote this piece for  Lets talk about Dementia, which I am happy to share! Look for the 5 key things guide for people coming into hospital which they mention.

The Alzheimer Scotland Dementia Nurse Consultant (ASDNC) Group are excited to have launched two new documents at the Alzheimer Scotland Dementia Awareness Week conference on the 3rd June and then sharing this work in our first ever blog post. The first document is the ‘Leadership and Innovation in Hospital Care: Alzheimer Scotland Dementia Nurse Consultant […]

via Alzheimer Scotland Dementia Nurse Consultants Supporting #DementiaAwareness week — Let’s Talk about Dementia

More Insight into Gender Equality and Health

Today The Lancet has published a series of papers on on Gender Equality, Norms, and Health. This is a collection of five papers, led by Gary Darmstadt of the Stanford King Center on Global Development and his colleagues, that provides a new analysis and insight into the impact of gender inequalities and norms on health, and the opportunities that exist within health systems, programmes, policies, and research to transform gender norms and inequalities. The series of papers highlight that potential advances in health and development are thwarted by systemic neglect of gender by health institutions across the globe.

They also show that the same systems that perpetuate these injustices against women and girls also harm men and boys and gender and sexual minorities. As a result they affect a broad array of health outcomes for all people. Through this series of papers the authors hope to inform the global health community of effective actions to recognise and transform gender inequalities, and their intersections with other social inequalities—including those related to age, race/ethnicity, religion, and socioeconomic status.

Their ultimate goal is to catalyse actions to enable all people to live to their full human potential, by upholding human rights and improving health and well-being for all.

You can access the papers and commentary around them at

https://www.thelancet.com/series/gender-equality-norms-health

You are likely to hear a lot more about this work via mainstream media in the next few days so if it sparks your interest and you want to avoid the hype, remember to go back to the source.

So why does this matter to older people?

Ageism and sexism in health services affects the quality of care, patient-provider interaction, patient self-perceptions, and the planning of health education programmes for older women. The stereotyping of older women in health care encounters, although often subtle, can have far-reaching effects on the health status of older women (Sharpe, 1995)

That’s without discussing ageism towards women in the workplace, media and elsewhere….

Happy 30th. Birthday “Nursing Older People”

Thought I’d join the Editor Lisa Berry (@RCNi_Lisa) in wishing her journal Nursing Older People a Happy 30th Birthday since it falls in June. I’ve been a subscriber since 2013, possibly a little longer. Just occasionally my colleagues, students and former students get something published in it. So thanks for being there and spreading the word about some of the great things they do.

Unfortunately you generally need to subscribe or buy it to get to see the articles but just occasionally they make some items freely available and that’s why I am bringing it to your attention this week.

Ahead of the RCN Congress they released a free to access frailty resource that contains an RCNi Learning module called “Reframing frailty as a long-term condition”

Some video case studies on using the Comprehensive Geriatric Assessment (CGA) tool in both acute and community settings and some further advice on managing frailty are included. I think this resources might be due to close soon, so pay a visit and take a look while you still can. It’s at https://rcni.com/features/frailty-resource-collection-84906#.XOP-wrRGOtM.twitter

@LuminateScotland and@MH_Arts Are on Now! Go to Both and be Inspired!

 

I’ve missed a week again 😦  Had to spend some time dealing with a death in my family so my weekly postings seemed a lot less important than usual. However, back to Blogging and at a very good time if you have an interest in the arts.

May 1st saw the launch in Scotland of the Luminate Festival  a month long festival of events celebrating what growing older means to each of us.

Luminate has a wide diversity of events held in a wide variety of venues from care homes to music halls from Ullapool to Kirkudbright. Highlights include “In the Ink Dark” a dance and poem inspired by conversations with people in Glasgow and Dundee and “Come and Sing” a massed Singing event in Aberdeen where the nationwide “Dementia Inclusive Choirs Network” will be launched. Dementia choirs are quite prominent in the news this week after the BBC Programme “Our Dementia Choir” documentary was shown on BBC One last night (Thursday 2nd of May). Available now on the BBC iPlayer HERE (Hankies required).

Not only does Luminate run over the month the Scottish Mental Health Arts Festival also  starts today.. This includes over 300 events across Scotland including film screenings, theatre productions, exhibitions talks and even walks. The events run from May 3rd through to May 26th.  For more details about the events CLICK HERE 

So my message for this month get out and take part in something from both events taking place near you. Be inspired or have your thoughts provoked by some of the fabulous showcase events and exhibitions hosted during this month.

Looking Forward to 2020 and Looking Back

In 2015, the world united around the World Health Organisation (WHO) Agenda for Sustainable Development, pledging that no one will be left behind and that every human being will have the opportunity to fulfil their potential in dignity and equality. The following year they released their Global strategy and action plan
on ageing and health committing the member states to ensure the goals are applied as a response to population ageing and urging them to make efforts to further support Healthy Ageing.  Now as a response the WHO has set out 10 Priorities that are needed to achieve the objectives of their strategy and action plan and now we are about to embark on a decade of concerted action on the Decade for Healthy Ageing from 2020-2030. 

The 10 priorities make for interesting reading so a link to the WHO publication 10 Priorities: Towards a Decade of Health Ageing is HERE 

The link between the Sustainable goals for healthy ageing and the sustainable development goals is best explained HERE

More about the WHO’s work in Ageing and the Lifecourse can be found by watching the video and on this webpage which includes what they say about Age-Friendly Environments.

In a bit of a contrast to looking forward, there is a new exhibition at the RCN Library and Heritage Centre in London exploring the place of nursing within the care of older people in the UK, which has changed dramatically in the past two centuries. Created with the help of the RCN Older People’s Forum, Aspects of Age charts the shift from the days of Victorian workhouses to at-home care and future technologies. It also looks at how specialist nurses can help destigmatise old age.  Information related to the exhibition is available at the Aspects of Age exhibition page HERE 

You can also visit the exhibition at RCN headquarters in London from 11 April to 20 September, then at RCN Scotland in Edinburgh from October.

@TheKingsFund, @HealthFdn and @NuffieldTrust Warn of Urgent Need to Tackle NHS Workforce Crisis

In the three years or more that this Blog has existed, this topic is one that I have kept returning to. Finally we seem to have reached a point where what is going on is obvious to everyone.

According to The Nuffield Trust, The King’s Fund and the Health Foundation the UK is facing massive staff shortages across the National Health Service that are so severe that services will suffer, with no chance of the shortfall in GP’s ever being fully addressed. The report predicts that without the kind of actions the new report called Closing the Gap proposes, nurse shortages will double to 70,000 and the GP shortage in England would triple to 7,000 in just 5 years (by 2023/24).

For nursing alone the report concludes that even with grants and expansion of postgraduate training, bringing 5,000 more students onto nursing courses each year and actions to stop nurses leaving the NHS, the gap cannot be entirely filled domestically and that in order to keep services functioning, 5,000 nurses a year must therefore also be ethically recruited from abroad. Essentially rubbishing the salary restrictions to recruitment proposed in the Immigration White Paper.

In fact they suggest that the government needs to fund the visa costs incurred by NHS Trust recruitment. Also, as I have said on numerous occassions before in this blog a comprehensive overhaul of social care funding is needed immediately to stop the poor pay and condition that both drives staff away and makes new recruitment near impossible.

Apparently the NHS England’s own Workforce Implementation Plan is expected next month. My guess is that is being ripped up and binned as we speak along with the aspirations of the recent NHS Long Term Plan

To download the report in full GO HERE

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