Reported in the Guardian (24 September): Junior doctors have suspended plans to go on a series of five-day strikes to protest against changes to their contracts after a “vigorous debate” following a change in leadership.
The British Medical Association’s junior doctors committee (JDC) said it would not go ahead with the industrial action, but was “planning other actions over the coming weeks”. The decision follows a challenge to the leadership of Dr Ellen McCourt, chairwoman of the committee, by doctors from Justice for Health. Dr McCourt fought off the challengers but there were changes to other members of the junior doctors leadership, who held a summit on Saturday to discuss their new strategy.
See also: Junior doctors call off planned five day NHS walkouts (Telegraph); Junior doctors: No more strikes, so what next? (BBC)
The BGS Education and Training Committee are in the process of reviewing the higher specialty grid topics and providing more detailed guidance. The guidance on competencies for community practice is now published here. We hope to be publishing guidance on palliative care and old age psychiatry in due course.
The External Affairs team have today launched the RCP’s new policy report Underfunded, underdoctored and overstretched – the NHS in 2016. The report draws on the experiences, views and concerns of consultant and trainee physicians, which, added to national evidence, highlights the many challenges the NHS faces. •
- The NHS is struggling to cope under with increasing patient need and inadequate funding, resulting in workforce pressures which risk patient outcomes. The RCP are committed to working with parliamentarians, health professionals and the public to find solutions to these challenges; solutions that will build a truly integrated, high quality healthcare system for patients now and in the future. The RCP believe the NHS needs:
- Increases to NHS funding: Realistic targets for efficiency savings, protected funds for transformation and investment in sustainability.
- More doctors: Increases in the number of medical students and doctors in training to be hospital specialists and incentives for doctors to work in challenging areas of medicine.
- A supported and valued workforce: Hydration facilities in hospitals and management and leadership opportunities for trainees.
Reported by the National Health Executive (20 September)|: Support for older patients after they were discharged from hospital led to a reduced rate of readmission and improved patients’ welfare, new research shows.
The ‘Hospital to Home’ service in Leicester and Leicestershire led to 9.2% of patients aged over 75 being readmitted within 30 days, against 15% nationally.
The pilot scheme, from Leicestershire County Council, was staffed by 143 Royal Voluntary Service volunteers, who offered six weeks of practical and emotional support to patients aged over 55 who lack a social network.
David McCullough, chief executive of the Royal Voluntary Service, said: “A stay in hospital can be disorientating and it’s particularly hard to settle back into your home if you have no one there to give you a word of encouragement, make you a cup of tea or check you’ve got your medication.
“These are all simple things but this analysis proves just how vital that support is to the recovery of an older person who has been in hospital. No one should have to go home alone unless they choose to and it’s in no one’s benefit that they do, not the older person nor the NHS as they are more likely to be readmitted if they are not given the support they need after leaving hospital.”
Among patients who took part in the programme, 70% said their social contact had improved, 52% said it had boosted their confidence and 47% said it had increased their happiness levels.
See also: Call for cross-party commission into NHS and social care 'crisis' (Nursing Times)
Reported in Care Management Matters (20 September): A new care home dementia study has identified a failure to reduce antipsychotic prescribing. A study by five universities found that there was no sustained reduction in the prescribing of antipsychotics to dementia patients in UK care homes, following the Government’s 2009 National Dementia Strategy (NDS), which recommended a review of their use in light of potentially serious side effects.
The research – led by Professor Ala Szczepura at Coventry University and published in the medical journal BMJ Open – examined prescribing data between 2009 and 2012 from over 600 care homes across the country. It concluded that there was no significant decline in antipsychotic prescribing rates over the four-year period.
Antipsychotics were originally developed for use in patients with schizophrenia or psychosis, but the study shows that ‘off-label’ prescribing of these drugs to treat the behavioural and psychological symptoms of dementia is a common practice in care homes.
The 2009 Banerjee Report, commissioned by the Department of Health as part of the NDS, examined the use of antipsychotics for people with dementia, concluding that the drugs had a ‘substantial clinical risk’ associated with them and that their overuse ‘must not be allowed to continue’. However, researchers from the universities discovered that – although dosages were usually acceptable – prescribing levels did not reduce over the four years, and length of treatment was ‘excessive’ in over 77% of cases by 2012, up from 69.7% in 2009 (meaning it exceeded not only the recommended six-week course, but also the maximum advised treatment length of 12 weeks).
See also: "Chemical cosh" of powerful drugs still routinely used to knock out dementia patients in care homes (Telegraph)
Reported in the Guardian (21 September): Long delays caused by NHS drive for ‘efficiency savings’ causing misery for mainly elderly patients, charity says. Patients in England are having to wait up to 15 months to have cataracts removed from their eyes amid increasing rationing linked to the NHS’s deepening financial woes, a new report has revealed.
People in the north London borough of Enfield face the longest wait – 467 days – between being referred for cataract surgery and actually having it, according to research by the charity RNIB published on Wednesday. That is more than double the longest delay – 222 days – the RNIB found when it first examined waiting times for the procedure in England in 2013. That occured in Heywood, Middleton and Rochdale in greater Manchester.
Other areas with notably long waits include those covered by the GP-led NHS clinical commissioning group (CCG) in Swindon (180 days), Havering in Essex (176 days) and Southampton (174 days).
See also: Patients wait up to 15 months for cataract ops, in 'devastating' lottery (Telegraph)
Reported in the Guardian (21 September): UK care sector’s reliance on EU workers means they must be given right to remain in any future arrangements, charities say.
Social services for older and disabled people face crisis because post-Brexit migration restrictions could cause a massive shortage of care workers, leading care organisations have said. The 1.4-million-strong UK care sector’s reliance on European migrant workers means it is vital they are given the right to remain in any future migration arrangements, the charities Independent Age and the International Longevity Centre UK (ILC-UK) said.
Currently about 84,000 care workers – equivalent to one in 20 of England’s growing care workforce – are from European Economic Area countries. About 90% do not have British citizenship and their future immigration status remains uncertain.
My father “lost his fight against cancer”. The truth is he didn’t even try to fight it, so one must assume that my father was “a loser”. David Bowie recently died from cancer too and danced his way to death.
Bowie went quietly. There was not a lot of talk about it; and rather than focusing on death, he chose to focus on life. Ever the consummate performer, he steeled “every nerve and sinew” to sing and dance till the end. That was my father’s choice too, as he was efficiently investigated and found to be palliative. He chose a low tech, minimal intervention death at home. He wanted to maximise his time with his loved ones and limit contact with NHS facilities.
My brother was the human hoist; my sister the eternal optimist; and I, the realist. I would ask helpful questions like: “Do you wish you were dead now, dad?”
Nursing Times: A free training package aimed at educating health and social care staff about dementia has been launched by Health Education England.
The training package was launched today by Health Education England through a collaboration with the University of Bedfordshire, Oxford Brookes University, University of Northampton and University of West London. It provides an introduction to dementia and how it affects people and their loved ones. Part of it included a review of existing dementia awareness training, with the findings then used to develop the subsequent training package.
Melsina Makaza, senior lecturer in mental health nursing and dementia lead at Bedfordshire, jointly led a pilot of the package involving 1,500 clinical and non-clinical staff from a variety of health and social settings in 2015.The package can be delivered to any health and social care staff group, including doctors, nurses, GPs, midwives, social workers, porters, administrative staff and cleaners, according to HEE. It also includes videos featuring the lived experiences of people who have dementia, talking about their experience and how the dementia affects them.
The package is free to access and it has been designed with busy health and social care staff in mind.