Happy Birthday to #ourNHS70

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The NHS celebrates its 70th Birthday on Thursday 5th of July 2018. I am not going to bang on about how wonderful it is. Lots of people will do that. If you need reminding see: The History of the NHS in Charts and #ourNHS70

Lots of things to watch out for this week as a result.

The NHS: To Provide all People is a good starting point. This is a film poem that charts the emotional and philosophical map of what defines the NHS and the personal experiences at the heart of the service and recognises its achievements and the challenges it faces. Based on real interviews conducted with NHS staff.

The BBC centrepiece of the season was NHS 70 Live, a 90-minute event broadcast live from a hospital on BBC Two. Hosted by Nick Robinson and Anita Rani. The programme asked some of the big questions about the NHS today and its future. Drawing on landmark independent research from four leading think tanks, the programme gave audiences a chance to contribute to the wider conversation around the NHS.

More details of what can be found on the BBC related to the NHS at 70 can be found here

The highlights on ITV include the NHS Heroes Awards and A&E Live. Their programme line-up can be found at ITV marks NHS70

Well that’s enough on Telly and catch-up to keep you busy for quite a while!  Don’t forget there ar also many local events. On Thurday I’ll be in Manchester at the #BGS2018 Conference “Ageing in an Unequal World” conference. Say hello to me if you are there as well.

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News for Nurses’ Day #ThisNurse

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Not Enough Healthcare Staff Here Either!

Well a return to some of the topics that I repeatedly go on about in this blog. So this week saw the release of a groundbreaking paper from Finland (which has very similar staffing levels in their hospitals to UK hospitals), which revealed that having an excessive daily nurse workload increases the risk of patient safety incidents and deaths. The chances of a patient safety incident increased by up to about 30% if nurses’ workload went above what is considered “optimal” levels and the odds of a patient dying increased by about 40%!! As we approach a growing crisis in the UK around nurse numbers, nursing vacancies and difficulties recruiting to the profession this only adds to the call to make nursing a more attractive profession an to introduce safe staffing levels. Not a new message, especially not in my Blog. It is time politicians started listening. This is not going to solve itself while we undervalue all nurses and allied healthcare professionals. If you want to find out more see the Nursing Times and this is the link to the study on BMJ Open .

I am also a big fan of the National Institute of Health Research (NIHR) Signals have created a My Signals page for Nurses. In the My Signals resources service users, in this case nurses, tell you what research is important to them and why they feel others need to know about it. So go take a look by clicking this link. You can find out more about all of  NIHR Signals by clicking here!

Finally tomorrow, Saturday 12th my is International Nurses Day!   There are a list of UK events on the Nurses’ Day page and you can follow #ThisNurse on Twitter.

A Bad Week All Round

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Some weeks are bad weeks but this week could rank as one of the worst for bad news about the NHS and its relationship with older people in a long time.

Firstly we had the revelation that 450,000 women aged between 68-71 had not been invited to routine breast cancer screening due to a computer error, that has been traced back to 2009!. Public Health England has said that it was not aware of a national problem with the screening programme until January 2018, which seems a bit worrying when they were aware at the same time that screening uptake amongst older women was falling. Watch out for the public inquiry and subsequent report particularly since NHS “everywhere else” didn’t have the same problem. Most people are probably unaware that a full review of the NHS breast screening programme was undertaken in 2012. So if you are affected by this systems failure in any way it’s worth looking at THIS REPORT and making your own mind up about the impact that it may have had on you or your loved one. My concern is that if this had been any other group would it have been noticed sooner and acted upon earlier?

As if that wasn’t bad enough a report released today (May 4th. 2018) is probably worse and even more significant. The annual report for 2017 of the Learning Disabilities Mortality Review (LeDeR) was released today and did make the national news. Their findings are very worrying and point to problems with institutional discrimination across services dealing with people with learning disabilities to the extent that life expectancy at birth if you have a learning disability is 19.7 years lower than for people without learning disabilities. Equally disturbing is that more than a third of deaths of people with learning disabilities were potentially amenable to health care interventions. Again much more will be said about this in the coming days and months so it’s worth taking a look at the primary source, which you can see and download from THIS SITE.

I haven’t even mentioned the dementia care ward at Glan Clwyd Hospital, in Denbighshire which closed in 2013 and it’s culture of “institutional abuse”. Too sad to go there but if you want to know more see this BBC Wales  TIMELINE

Can Scotland Help? @WeNurses #70nursebloggers

It came to my attention this week that Professor Jane Cummings,  The Chief Nursing Officer for England has called on nursing, midwifery and care staff to help mark the 70th anniversary of the NHS by encouraging more nurses and midwives to blog in order to showcase the fantastic contribution that the profession has made to healthcare over the years. Rather than looking backwards, I thought I’d say something about what is going in Scotland that might inspire our nursing and health and social care colleagues in England. So here goes!

Realistic Medicine was initially discussed as a way forward for the NHS in Scotland by the Cheif Medical Officer Dr Cath Calderwood in 2016. It has become an NHS’ vision for introducing the concept of “realistic medicine” concept and is designed to make sure that by 2025 anyone providing healthcare in Scotland will take a realistic medicine approach. NHS Inform states

 Realistic medicine puts the person receiving health and social care at the centre of decisions made about their care. It encourages health and care workers to find out what matters most to you so that the care of your condition fits your needs and situation. Realistic medicine recognises that a one size fits all approach to health and social care is not the most effective path for the patient or the NHS.

Realistic medicine is not just about doctors. It applies to all professionals who use their skills and knowledge to help people maintain their health and prevent and treat illness. This includes nurses of course, but also pharmacists, physios, OT’s, social work and everyone else. The Chief Medical Officer’s third annual report was published last week but if you want to know more about this approach and its impact you can read this and download the 2018 summary from here

One of the features that is really useful for all nurses and healthcare professionals is the idea of encouraging people to ask 5 questions about their treatment. The 5 questions are given in the image below.

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So a challenge to our nursing colleagues elsewhere spread the word and start encouraging your patients to use the 5 questions.

The second initiative is less uniquely Scottish but it has certainly been having an impact and that’s called “What Matters to You”  This Scotland-wide campaign encourages and supports meaningful conversations between people who provide health and social care and the people, families and carers who receive their care. ‘What Matters to You?’ day started in Norway in 2014 and has been growing internationally since. This year ‘What matters to you?’ day falls on the 6th June 2018, so there is still plenty of time to get involved. Of course, asking “What matters to you?” isn’t a question for just one day its a question that we should ask everyone. As Scotland’s Chief Nursing Officer, Fiona McQueen has said,

“The one thing I think that would transform the care that we deliver to people is to listen…… really listen; not just hear what suits us. We need to listen to staff who deliver care and make changes that support them to provide real excellence; but in particular, we need to listen to people who use our services. When we focus on what truly matters to the person and have that ‘what matters to you?’ conversation, that is what will make all the difference”

For a bit of inspiration about personalising healthcare to include what matters, see Why is it important to ask what matters? and  @PersonCntrdSco and if you are on Twitter look for #wmty18

Unfavourable Views of Hospital Care in England are Strongly Linked to Nurse Numbers. Is That a Surprise?

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Now at a time when the Government and all of the national media looks hell-bent on convincing everyone here in the UK that the NHS is broken, rather than being underfunded and under-resourced in terms of staff and beds; there has been very little space given to the published results of the 2010 NHS Survey of Inpatients and a BMJ paper published this month which shows that Patients’ unfavourable views of hospital care in England are strongly linked to insufficient numbers of nurses on duty, rather than uncaring staff, indicates observational research. The paper was published in the online journal BMJ Open so it’s not exactly hidden from journalists politicians etc.

Perhaps pointing out that the number of vacancies in the NHS has soared by 15.8% over the last year, prompting warnings that the service is facing “desperate” problems of understaffing is not what politicians want you to hear. Particularly concerning were the figures for England released in July 2017 by NHS Digital that showed that the number of full-time equivalent posts available rose from 26,424 in March 2016 to 30,613 in March 2017 – the highest number on record.

What this has done is fuel a public view that the NHS is worse than it used to be and that staff are less caring etc. The reality is really very different as anyone working for it knows. Can we please celebrate the success of the NHS at 70 (which happens on the 5th. of July 2018) and stop trying to undermine it. Yes the NHS does need to be reformed, but it would help to see it properly staffed first.

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This week I was involved in publishing a Blog for “Ageing Issues” The blogging space for members of the British Society of Gerontology (BSG) where they discuss contemporary issues raised by ageing societies. The blog was about the BSG small event we held here @uwshealth in Hamilton in August. To read more about it see:

https://ageingissues.wordpress.com/2018/01/09/past-present-and-future-supporting-novice-researchers/

Another great find this week. The Joseph Rowntree Foundation this month launched a new Data Information Source that collects together the latest UK poverty data, statistics and analysis from the JRF’s Analysis Unit. This page is a great tool for finding information about poverty rates and related issues in the United Kingdom and you can access it from here:

UK Poverty Data

 

Safe Staffing Again and ICope

Since it’s all over the UK news this morning I think I have to mention Safe Staffing Levels and the current shortage of healthcare staff across virtually all sectors of healthcare in the UK. Today the RCN have released their Safe and Effective Staffing Report, to a flurry of publicity about this issue. (to see their Safe Staffing page, which includes the report click here )

Some 30,000 staff, including midwives and healthcare support workers, took part in this piece of online research and the RCN describes their stories as “desperately sad”. It’s quite an emotive topic surrounded by political spin (See this BBC article for example) but in the end, its primarily older people who are affected by these shortages and that’s not always clear. In a previous report back in May, the RCN stated what it thought should be done to tackle this ongoing crisis. I wish this was a new issue, I wish I could see some positive steps to improve the situation but so far there is not much progress (See my own post from March last year!) You should note also that this is not just a Nursing crisis the same is true for AHP’s and Doctors.

OK onto better news… This week the WHO launched its Integrated Care for Older People Guidelines (ICOPE, maybe the best acronym ever), asking for individual and systems level changes to be undertaken by all member countries to respond to the needs of older people with a focus on reorienting primary care providers and health systems to respond to the great diversity in physical and mental capacities of older populations and provide care that is person-centred and integrated across health care services, settings which is coordinated with social care. The UK has been struggling with this for a number of years now but progress has been made. If these guidelines are adopted by more countries the hopefully responsive integrated care won’t be an innovation it will be the way all health care is delivered.

Watch out USA one of its key platforms is Universal Health Coverage

Found this about Integrated People Centred Care and I love it. This is what everyone needs to know as healthcare reforms.

Becoming a Delirium Champion

Well done RCN Older People’s Forum and My Dementia Improvement Network for getting behind a campaign to raise awareness of identifying delirium not just in hospital but also within the community. Older people with multiple long term conditions are particularly vulnerable to delirium but are also the most likely not to have it spotted until the possibility of a poor outcome is more likely. To find out more about becoming a delirium champion and get a resource pack to help raise awareness of the need to identify delirium early visit this RCN page.  

I just wished they hadn’t used the label “champion”. Particularly as someone involved in training Scotland’s National Dementia Champions; who are already encouraged to raise awareness of this issue.

Still, it’s a very appropriate issue to highlight during Dementia Awareness Month

Amongst all the worldwide weather chaos that we are currently experiencing I think I should also highlight the biggest one and the one that has the most impact on older people and that is the East Asia Floods. Although its probably the least reported it already has the most deaths reportedly caused by it and has affected by far the most people. The burden in such chaos often falls on older people. To learn more and maybe to contribute to the relief fund please visit Age International South Asia Floods