What’s Been Happening at NICE?

man-getting-better

This is probably the longest gap in posts since I started this weekly Blog so for regular followers my apologies for missing last week completely. I was unwell last week and didn’t feel well enough to post, which was followed by a very busy week when I just ended up each night too tired to write.

Hopefully, normal service is now resumed and I might even try and do an extra post this week.  So the question now that I am back, has to be why am I drawing your attention to the National Institute of Healthcare Excellence (NICE).

Well as many of my students know I have not been a big fan of what they put on their website until quite recently. I never thought that it was enough to just release Guidance and not really do much to show or explain how it should be used. However, that’s all changing. I am a big fan of their Pathways, very handy if you are trying to work out what ideal care in the UK should look like for particular illnesses and conditions. I am also probably an even bigger fan of their Clinical Knowlege Summaries which are really useful when you are considering what to do in practice. They are almost like checklists for what you should be doing in particular circumstances and incorporate all the appropriate NICE guidance.

Now they are doing it again. They have started producing a series of Quick Guides, developed jointly with the Social Care Institute for Excellence (SCIE) which are based on NICE guidelines and health and social care quality standards (Unfortunately the English ones and not the Scottish ones). There aren’t many yet but it’s really worth keeping an eye on these as the collection grows particularly if you are involved in integrated care, social care or providing care home care.

The most recent one is for intermediate care services, which help people to recover from illness or an accident, to regain independence and to remain in their own homes. This new guide gives people who use the services and their families and carers an overview of:

  • The types of service available
  • The four stages of intermediate care
  • The professionals involved in providing care

A new place to look for well-written evidence-based and useful materials.

 

 

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Scotland’s Obesity Issue and What About Mental Health?

This week saw the publication of the Scottish Health Survey for 2016. Possibly the most significant piece of news from this for older people was the following information reported on BBC Scotland’s Health Page Scotland’s health: What we learned

From the report, they have stated that amongst adults men were significantly more likely than women to be overweight including obese (68% compared with 61%). Worryingly it was adults aged 65-74 who were most likely to be obese (36% of all adults this age). The average BMI (Body Mass Index) for both Scottish men and women was 27.7, up from 27.0 in 2003.A BMI of 25 or less is said to be normal and 25 to 30 is overweight.

A BMI of 25 or less is said to be normal and 25 to 30 is overweight.

Obesity was lowest in the 16 to 24 age group (14%) but it doubled to 28% in the 25-35 range. The largest jump between age groups. It would appear that while the message to reduce obesity in Scottish children is getting through to the public the same cannot be said of the message about the need for our older people to avoid obesity and stay active to reduce the likelihood of cardiovascular disease and diabetes. The Scottish Government are planning an ambitious new strategy to improve Scotland’s diet and help address obesity. Let’s hope they include older people in their plans.

For information about staying healthy in old age, this page on the Age Scotland site is useful

Perhaps a missing element from this survey is more detail on the mental health of older people. More will be reported about this but it’s perhaps worth remebering that up to 40% of people over the age of 65 experience mental health problems and about one-fifth of all suicides happen in older people. Last month Alistair Burns, the National Clinical Director for Older People’s Mental Health and Dementia took to social media to announce the launch of “A Practice Primer on Mental Health in Older People” a document which highlights for  primary care health workers in particular GP’s, symptoms often attributed to ‘old age’ but where a mental health diagnosis and follow-up may be more appropriate.

You can read what he said here and find the link to the document he is discussing (if you didn’t click the link above already) In the document he talks about this film that looks at Improving Access to Psychological Therapies. I am with him on this!

 

Dementia Awareness Month Begins

It’s the 1st of September, so as always this is the commencement of World Alzheimer’s Awareness Month.

 

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World Alzheimer’s Month has been observed in September every year since its launch in September 2012. The decision to introduce a full month, to contain the existing World Alzheimer’s Day, which is on the 21st. of September every year was made to enable national and local Alzheimer associations worldwide to extend the reach of their awareness programmes over a longer period. The 21st of September was chosen because it marked the opening of Alzheimer’s Disease International’s (ADI’s) annual conference in Edinburgh on 21 September 1994 which was the organisations 10th anniversary.

 

For more information about this years theme and campaign click here.

It also means that the next World Alzheimers Report will be released. This year the aim is to highlight the importance of early detection and diagnosis of dementia. So look out for it’s publication around the time of World Alzheimer’s Day.

Help Needed! Do you Live in Lanarkshire?

 

 

NHSlanarkshire
NHS Lanarkshire

 

I am helping to stage an event on behalf of the British Society of Gerontology and NHS Lanarkshire next week where it hoped we can bring staff, students and older people together to discuss and identify some local priorities for research in the coming years. If we create a list of priorities then people within the Health Board and at the university can encourage our Master’s students, in particular, to take on projects that look at these priority areas. So a win-win situation for everyone! However, we don’t have enough older people attending and we would really like their help since their priorities are everyone’s priority!

So if you are living in the area covered by the Health Board and are over 60 please come and join us. You will be made most welcome. You only need to come along in the afternoon from about 12:00, if you want to join us for lunch until 3 pm. If you stay afterwards you can find out what a Tovertafel is? For full details of the event click this link. If you can make it let Caroline know at caroline.gibson@uws.ac.uk or call her at 016984441.

Worth noting also this week was the report by Audit Scotland into the use of Self Directed Support. Since 2014 councils have been responsible for implementing Self-directed Support (SDS), which offers people more choices around their support and how it is managed. This is now largely provided by the new local health and social care integration authorities drawn from bothcouncils and the NHS.

The report published this week states that says while many people have benefited from SDS, integration authorities still have a lot to do to enable more people to take it up. Local Councils spend £3.4 billion a year on social care supporting more than 200,000 vulnerable adults and 18,000 children and their families. Assistance ranges from everyday tasks such as dressing and preparing meals to helping individuals live more fulfilling lives at home, at work and in their communities. The report highlights areas of good practice such as giving front line staff powers to spend small amounts that can make a big difference.

On the ground, however, not everyone is getting to choose and control their social care the way they want to and staff need more support to try new approaches. The majority of staff are positive about the principles of SDS but everyone involved faces challenges in offering flexible services, particularly recruiting and retaining social care workers. To access the full report click the link to

Audit Scotland Report

 

We Like NIHR Signals!

First of all my heart goes out to everyone caught up in last nights tragedy in Barcelona, a city which I visited for the first time very recently. There are no words to express the shock and horror that will be felt by anyone who lost a loved one. My deepest felt sympathy to everyone affected.

The last few weeks I have concentrated too much perhaps on both dementia and Scotland so today I’ll thank Margo Stewart the Nursing Subject Librarian here at UWS for sharing this with me.

The National Institute for Health Research (NIHR) Dissemination Centre has a page called “Discover the Latest Research” where they release a series of reports called NIHR Signals. NIHR Signals are timely summaries of the most important research that aim to cut through the noise and provide decision makers and others with research evidence they can use. You can find out more about them here and by watching the video!

 

 

Recently the Dissemination Centre launched a new series called ‘My Signals’ where patients, service users and health and social care staff can comment and add their perspectives to Signals summaries of research. It’s not obvious how you do this but if you open the Signal you want to read you will find within it a menu that consists of:

Signal   Published Abstract   Definitions   Comments

Click on the comments link and you can both see what been said and add your own comments.

They are particularly interested in the views of patients and have created a guide to encourage them to contribute My Signals – Patients

The next editions of ‘My Signals’ will feature a Director of Public Health (in September) and three GPs (in October). Further editions will feature the views of surgeons, of nurses and of physiotherapists, so a site worth keeping an eye on.

Note also it’s a brilliant resource presenting easy to understand information, like NHS Choice’s Behind the Headlines which I have posted about before.

 

Care Homes and Bad Press

 

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No More Bad News

 

I am always reluctant to post bad news about UK Care Homes because the negative publicity they receive is often underserved and reflects very poorly on most of the staff I meet from this sector of healthcare that do an amazing job, with far less support and money than their NHS counterparts. However, it was difficult to ignore this week the CQC which has suggested that 1 in 3 care homes in England may not be ‘safe’ with inspectors also noting they had a particular problem recruiting and retaining nurses.

So just to be clear here is the link to the CQC’s own press release that the news stories have been based on which contains the link to the full report which is called “The state of adult social care services 2014 to 2017”

A more interesting take on this is provided by one of my favourite Blogs, written by a man caring for his wife who has Dementia called Remember Me: Seeking the Good Life. To see what he has to say on the topic go to “Dementia Care Homes – The Futility of Inspection”

The obvious question now is how does Scotland fair in comparison? You get some idea from the raw data at the Care Commission Website Are we really in the same country?

After the negatives how about a positive in the same field. This is from England’s My Home Life Blog which is full of great stories and ideas for Care Homes and the particular Blog I am selecting Award Winning Service Share Their Learning is in very sharp contrast to all the usual reports of bad care. Enjoy reading this and exploring the site further.

Looking back at #DAW2017 and Looking Forward; Anticipatory Care Planning

ACP toolkit

As my followers will know it was Dementia Awareness Week in Scotland last week so for those of you who got involved here are some things you might like:

  • #DAW2017 went viral with a video of PC Marshall visiting a Musical Minds group in Kilmarnock during DAW. The video on the ALZScot Ayrshire page was shared across Scottish media including The Scotsman, The Scottish Sun, The Sunday Post and many more!
  • Check out the Dementia Awareness Week gallery over on Facebook and tag yourself.
  • To support the week AlzScot also shared a blog a day from Allied Health Professionals who wanted to share who they are and how they CAN help if you are living with dementia. If you can review the blogs by visiting Let’s Talk about Dementia

Last week also saw the publication of ‘My Anticipatory Care Plan’ (ACP). An anticipatory care plan toolkit designed by Healthcare Improvement Scotland.

Antipatory Care Planning ahead can help many people with chronic health problems to plan what they would like their care to look like on a daily basis or help them to plan fro and manage situations which they may find threatening, like sudden hospital admission.  ACP’s are not legally binding in any way (in the UK) and can be updated at any time to reflect changes in the person’s thinking. Remember this is designed to be their plan and it’s entirely up to the person to decide who to share this information with.

For more information about ACP’s and to access the toolkit please click here

You can also download their ACP App for both iPhone and Android when you visit the site. It really is a fabulous resource and although it may originate in Scotland, it could be used anywhere!