State of the World’s Nursing Report-2020

In a week and a day on the 12th of May 2020 it will be the bicentennial of Florence Nightingale’s birth. This year as always the International Council of Nurses (ICN) leads global celebrations on International Nurses Day, the anniversary of the birth of nursings most famous pioneer. This year the celebrations should have been “extra special” because 2020 has been designated the Year of the Nurse and Midwife by WHO but it really is the year of the nurse for much more sombre reasons. In the UK has now become more dangerous than being in the army.  https://www.nursingtimes.net/news/workforce/in-memory-a-list-of-nursing-staff-who-have-sadly-died-from-covid-19-20-04-2020/ 

If you are a nurse though what has probably passed you by completely is a landmark publication by the WHO’s State of the World’s Nursing Report 2020, which should have been one of the highlights of the year. So it has now been published and its interesting although somewhat depressing to look at. This is some of what it says.

  • The global shortage of nurses, which was estimated to be 6.6 million in 2016, had decreased slightly to 5.9 million nurses in 2018. An estimated 5.3 million (89%)
    of that shortage is concentrated in low- and lower middle-income countries, where the growth in the number of nurses is barely keeping pace with population growth, improving only marginally the nurse-to-population density levels.
  • Countries with lower numbers of younger nurses (ie under 35), like the UK and many other westernised economies  will have to increase graduate numbers and strengthen retention packages to maintain current access levels to health services.
  • To address the shortage by 2030 in all countries, the total number of nurse
    graduates would need to increase by 8% per year on average, alongside an improved capacity to employ and retain these graduates.
  • 78 countries reported having advanced practice roles for nurses. There is strong evidence that advanced practice nurses can increase access to primary health care
    in rural communities and address disparities in access to care for vulnerable populations in urban settings.
  • One nurse out of every eight practises in a country other than the one where they were born or trained.
  • Nursing remains a highly gendered profession with associated biases in the workplace. Approximately 90% of the nursing workforce is female, but few leadership positions in health are held by nurses or women. There is some evidence of a gender-based pay gap, as well as other forms of gender-based discrimination in the work environment.

The report suggests 10 key actions to address these international nursing problems.

  1. Increase funding to educate and employ at least 5.9 million additional nurses worldwide
  2. Strengthen capacity for healthcare workforce data collection, analysis and use.
  3. Nurse mobility and migration must be effectively monitored and responsibly
    and ethically managed.
  4. Nurse education and training programmes must produce nurses
    who drive progress in primary health care and universal health coverage.
  5. Nursing leadership and governance is critical to strengthening the workforce.
  6. Planners and regulators should optimize the contributions made by nurses to make use of their full scope of practice.
  7. Countries must provide an enabling environment for nursing
    practice to improve attraction, deployment, retention and motivation of the nursing
    workforce.
  8. Countries should deliberately plan for gender-sensitive nursing workforce
    policies.
  9. Professional nursing regulation must be modernized.
  10. A huge amount of collaboration, more than we have ever witnessed before is required to achieve key actions 1-9.

The report concludes that if the investment in nursing is made then the returns for societies and economies can be measured in terms of improved health outcomes for billions of people, creation of millions of qualified employment opportunities, particularly for women and young people, and enhanced global health security.

The full report can be accessed at: https://www.who.int/publications-detail/nursing-report-2020

A summary in English of the report, which this Blog has been based on is available at: https://apps.who.int/iris/bitstream/handle/10665/331673/9789240003293-eng.pdf

The case for investing in nursing education, jobs and leadership is very clear when you read this. Relevant Governments, professional organisation and all  stakeholders must commit to taking action.  SOON… the clock is already ticking.

Improving Well-being: Step 1-Physical Activity

Public Health England have recently published new evidence and online guidance to help healthcare professionals embed physical activity into daily life.

Called Physical Activity: Applying All Our Health  the resource aims to help health professionals prevent ill health and promote well-being as part of their everyday practice.

The information provided aims to help front-line health and care staff use their trusted relationships with patients, families and communities to promote the benefits of physical activity. It also recommends important actions that managers and staff holding strategic roles can take.

It includes examples to help healthcare professionals understand specific activities or interventions which can:

  • prevent physical inactivity
  • protect through physical activity
  • promote healthier more active lifestyles

Also in the post is a link to an eLearning version of the information provided by eLearning for Healthcare (Worth signing up to because of the number of resources you can access).

The NHS Scotland equivalent page can be found at http://www.healthscotland.scot/health-topics/physical-activity/physical-activity-overview

but its perhaps not as interesting.

It’s Allied Health Professions Day! Let’s Celebrate Their Work #AHPsDay #AHPsDayScot #ProudToBeAHP

There are fourteen different healthcare roles recognised as Allied Health Professionals (AHPs); each one of them carrying out an important role in the lives of the people that they are caring for. If you want to find out more about the 14 professions see the following page at Health Careers

So this week rather than focusing on a paper or a topic that’s in the news let’s  just highlight what the 14 professions do and how they make a difference.

As part of the day a Google site has been created and on the site is a whole lot of material of use to help people understand AHP roles and the contributions they make. The site can be found HERE 

It includes video, NHS Recruitment information, some materials from the AHP’s  professional bodies and some teaching materials.

The Nursing Midwifery and Allied Professions group at NHS Education for Scotland have also released a series of videos from their AHP staff on the programmes that they are currently involved in which you can view at https://twitter.com/NESnmahp

This week the Alzheimers Scotland Blog “Lets Talk About Dementia” are also running a serieds of Blogs on AHP contributions to Dementia care which you can access at https://letstalkaboutdementia.wordpress.com/

So lots to celebrate and be proud of if you are an AHP. AND if you are an AHP reading this Blog have a great day and keep up the good work!

Hospital Admissions of Older People Continue to Rise

This week the SCoOP report was published. Otherwise known as the Acute Hospital Outcomes Report 2017/18; it provides an overview of the outcomes of acute geriatric medicine services in Scotland and is published by Scottish Care of Older People National Audit Project which amongst other things is trying to evaluate the variation in service provision for older people who require health and social care in various settings, to serve as a driver for standardisation and improvement of care across Scotland.

They have reported that admissions to geriatric medical wards in Scotland’s 19 largest hospitals with major emergency departments have risen by 10% for three consecutive years, reaching 43,311 in 2017/18.

The report has also concluded the length of stay dropped across all sites by an average of one day over the same period.

More concerningly they have noted the number of admissions varied widely across sites in Scotland, with some areas showing large increases in activity while others are in decline. There was also a large variation in the typical length of time patients spent in different hospitals. In some cases, there were up to 12-fold differences in the length of stay, while hospitals with higher activity levels usually had lower lengths of stay.

There was also a strong relationship between the time waiting to get to a specialist bed and the overall length of time patients spent in hospital; suggesting that delays in accessing specialist services contribute markedly to longer stays in hospital.

Differences in readmission rates and mortality were less marked between hospitals, broadly remaining stable over the last three years.

The report does not attempt to explain the variations but aims to stimulate discussion, learning and action that could be used to help benchmark some key patient outcomes and encourage interorganisational learning.

Professor Graham Ellis, Co-Chair of SCoOP Steering Group and the National Clinical Lead for Older People, Healthcare Improvement Scotland said:

“The wider goal is to reduce unwarranted and unjustifiable variation in outcomes, which may represent a threat to patient safety and/or a failure to learn from best practice.”

 

Registered Nurses Within Social Care

I’ll make my apologies now I am “borrowing” a lot of this from the latest edition of Nursing Older People but its a subject close to my heart, the lack of recognition given to nurses working in the social care sector (and that includes care homes). Its estimated that around 42,000 UK nurses work in social care for voluntary, private and state sectors employers. Unfortunately the turnover rate in this sector is excessive (around 30%) and about 5,000 post lie vacant, which is not a happy position  to be in.

Last week Skills for Health (England), published a new document called “Registered Nurses: Recognising the Responsibilities and Contribution of  Registered Nurses Within Social Care”. The document sets out to provide a description of the complex role nurses undertake and demonstrates the way that they not only use all of their nursing knowledge, but also contribute to important national health and social care agendas.

It was developed in consultation with registered nurses and the people they support, plus other professionals who work in and with the adult social care sector, and colleagues who work with the nursing regulatory framework. 

You can download the document and accompanying infographic HERE

The Myth busting video is here and well worth a watch

 

Have You Looked at the NHS Apps Library?

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Did you know that the NHS (in England) has been developing an NHS Apps Library.

Created in 2017; NHS Digital has worked with more than 350 developers to provide a library of digital health tools which are accessible to everyone. The Apps can be trusted because they are assessed rigorously before making the platform. This assessment also means that they are easy to use.

Since 2017, the library has been growing and covers many health and care needs including

  • support to prevent and manage diabetes including diet, exercise and lifestyle change
  • mental health apps offering advice and support on managing thoughts, feelings and behaviour and coping with panic attacks
  • apps to support personal well-being and a healthy lifestyle
  • tools to help manage the symptoms of chronic conditions such as asthma and high blood pressure
  • support to cope with the impact of breast cancer

Last year the Apps Library had already proved to be a great success. There was over a quarter of a million visits from launch to summer 2018 and more than half of those were from mobile phones, which shows how patient access to health care is transforming.

Digital Health continue to work with developers to offer apps which are relevant, helpful and empower patients to manage their own condition, which has been proven to lead to better outcomes.

To visit the library CLICK HERE

Having the NHS Apps Library also helps the public navigate the confusing array of health apps, advising them which apps have met NHS standards. Now they have added an NHS App which provides a simple and secure way for people to access a range of NHS services on their smartphone or tablet.

Come on NHS Scotland its time to catch up! I could only find these so far.

https://www.nhsinform.scot/care-support-and-rights/tools-and-apps and http://www.knowledge.scot.nhs.uk/home/mobile/mobile-knowledge.aspx

You might also find this interesting http://myhealthapps.net/ which was originally a European Directory of Health Apps.

Becoming an Age Friendly Place to Live

Two stories caught my eye this week and they are both part of the same issue, which is really about making towns and cities in the future fit for older people to live in.

Urbanisation alongside Ageing are the biggest demographic shifts of my life time and governments have been very slow to react to both. However Manchester, yes the UK one :), was the first UK city to join the World Health Organization’s (WHO) newly established Global Network for Age-friendly Cities and Communities in 2010. Last year Greater Manchester set a similar precedent when it became the UK’s first city-region to join the network. Working with the University of Manchester Age Friendly Manchester a partnership involving organisations, groups and individuals across the city have been testing some of the theories about how age-friendliness might be achieved helping to define key priorities for ongoing and future work. The result is a detailed workplan a summary of which you can find HERE 

For more about the collaboration with the University of Manchester CLICK HERE 

The second story is a report by the Centre for Better Ageing decrying the state of the UK housing stock and the need to build homes more suitable to the needs of Britain’s older people. This is a topic that I return to more frequently now in my blog probably because inadequate housing and heating kills. Work done in Manchester, commissioned by Greater Manchester Combined Authority and funded by the Centre for Ageing Better, has revealed that those on low- and middle- incomes can find themselves trapped in homes which are no longer appropriate for them as they age. For more on this topic see Building better homes is good for everyone – not just older people

The key messages from both these stories is that that we must improve accessibility within our cities for everyone. We also need a radical rethink on the design and accessibility of new homes and  the condition and accessibility of existing housing needs a lot more attention (and spending) than its getting currently.

Making environments more age-friendly will benefit us all! 

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.

Why are UK Citizens Overwhelmingly Negative About Getting Old?

‘The Perennials’, a study carried out in partnership between IPSOS MORI and the Centre for Ageing Better, reveals that just three in ten (30%) of UK adults say they are looking forward to later life. Half (50%) say they worry about getting old.

The Report called “The Perennials: The Future of Ageing” looks our ageing societies and the challenges and opportunities this presents. The Ipsos Mori study was global in that it was conducted and illustrates attitudes to ageing across 30 different countries.

Their research shows that, globally, there is a great deal of negativity towards later life, with financial and health concerns prevalent. However, much of this negativity is propagated by a media that does not do enough to portray later life as a time of potential. It is, therefore, perhaps, little surprise that when describing those in old age, people commonly reach for terms like ‘frail’, ‘lonely’.

However, as Ben Page, the Chief Executive of Ipsos MORI states this fails to do justice to the full diversity of experiences in later life.

The over-50s now command nearly half of all spending power in many countries.
People in their later years are increasingly packing their life to the full. For many, their reality doesn’t necessarily align with the labels the media are giving them. They are not slowing down but taking on new challenges, roles and responsibilities. Those with money to spend are smart about spending it.

They’re not digital natives but they are more connected than we give them credit for. They’re not withdrawing from life, but demanding more from it and from their societies.

Yes, old age is a time of great hardship and there are very real issues such as poverty,
isolation and ill-health that needs urgent attention. However, there is also another side of later life – one that we don’t hear about often enough because it doesn’t fit with ageist and lazy media stereotypes.

For a breath of fresh air visit the Report website at https://thinks.ipsos-mori.com/the-perennials-the-future-of-ageing/

To download and read the full report CLICK HERE

More Insights into Global Ageing

On Universal Health Coverage Day, which fell on the 12th. of December 2018, HelpAge International and the AARP Foundation launched Global AgeWatch Insights 2018, a new report that analyses older people’s right to health in the context of current demographic, epidemiological and health systems transitions.

As the global population ages, health systems need to adapt to ensure older women and men can realise their right to health. How much they need to be changed can be illustrated with just a few statistics.

In 2018, the global population aged 60 and over surpassed one billion, and it continues to rise in almost all countries around the world. This move toward an ageing population is accompanied not unsurprisingly by a shift towards a rise in the number of people dying from non-communicable diseases (NCDs).

Of the 41 million annual deaths caused by non-communicable diseases globally, 32 million occur in low and middle-income countries, which is changing the demands being placed on these healthcare systems.

The key findings of this new report worth noting

  • Some healthcare systems are reliant on data which should inform the planning and delivery of health services systematically excludes older people.
  • Older people are prevented from accessing health services by cost, lack of transport, discrimination, and inadequate training of health workers.
  • Although women are living longer, they live more years in poor health, and with disability, depression and dementia.

As with all their Global Age Watch reports this one is accompanied by some great infographics including the one I have chosen to highlight below.

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