Dr Kate Lyle is a Research Fellow based in Health Sciences at the University of Southampton
Professor Catherine Pope is Deputy Director NIHR CLAHRC Wessex
Dr Kate Lyle is a Research Fellow in Health Sciences at the University of Southampton and Professor Catherine Pope (right) is Deputy Director of NIHR CLAHRC Wessex
As academics, practitioners, and users of healthcare services we are all used to hearing about examples of successful interventions that have improved health services and care. Indeed one of the core aims of the NIHR CLARHC programme is to improve patient outcomes locally and across the wider NHS. Here in Wessex we have been working hard over the past 5 years to do just that, spreading best practice and evidence based research throughout the NHS.
But what about the things that don’t work? Attempts at service improvement or innovation that went nowhere? Often these are the things we don’t hear about. Yet, arguably there is as much to learn from our failures, as there is from successful innovations.
Dr Melinda Taylor, Senior Research Fellow in Organisational Behaviour, NIHR CLAHRC Wessex Data Science Hub
The first blog in this series described how health professionals in our study found it difficult to define ‘frailty’ but agreed that it was an extremely broad concept with no defined boundaries. This has an impact on training in frailty care. This second blog outlines our participants’ views on frailty care training.
Our study evaluated particular aspects of four initiatives intended to enhance the care provided to people regarded as frail. The diverse nature of the initiatives further demonstrates the complex nature of frailty.
Accident and Emergency wait times seem to be constantly in the news. Less commonly but equally importantly are headlines that waiting lists for elective operations and procedures are on the rise. Although these topics hit our headlines regularly there is actually very little evidence and understanding behind the reasons for these changes in NHS services, and how the NHS can take positive action to cope with these issues.
From what we understand a lot of the currently held beliefs around the causes for pressure on NHS services come from very basic, non peer-reviewed, and potentially flawed analyses. It does not need too much explaining that making decisions based on these might be a bad idea.
Nearly two thirds (65%) of people admitted to hospital in the UK are aged over 65 years old. Many of them are frail and at high risk of poor healthcare outcomes – like staying longer in hospital, reduced physical abilities, becoming dependant, going to a care home, and even death.
National recommendations suggest that these high-risk older individuals should be routinely identified when they are admitted to hospital to allow healthcare teams to provide appropriate individual care that meets patient’s needs (1). It is unclear whether and how those people are identified in hospital. Therefore our study looked at the current practice in one hospital with regard to identification of patients at high-risk of poor healthcare outcomes. To do that, we reviewed a random sample of patient’s clinical notes and interviewed staff members who worked at five acute medicine for older people wards (2).
More and more of us are looking online for information to support our health (see Chris Allen’s work on support in Online Communities). In my research, I have found that the ability to get hold of that information and support, which is personal to you, can make a huge difference to how well you are.
I’m focusing on insulin pumps, which are an alternative means to deliver insulin to people with diabetes – compared to the more traditional multiple daily injections.
Insulin pumps have been developed to help people with Type 1 diabetes manage the condition better; both in terms of their quality of life and by more closely resembling a fully-functioning pancreas.
However, introducing a new health technology to an already difficult to manage condition is not necessarily simple, or easy.
It was palpable with research geekery excitement while travelling to Nottingham for the 2017 Health Services Research UK Conference. I needed this, I thought, an opportunity for positivity, to talk enthusiastically about how we as researchers can help sustain the future of the NHS and wider health services. The conference didn’t disappoint.
We are all too aware of the popular rhetoric that consumes newsfeeds and social media channels, with headlines like ‘The NHS is in Crisis’ and ‘too many people are pitching up to A&E’. All doom and gloom. The conference was a perfect antidote to this. While there are no panaceas to these ongoing issues, my fellow health services researchers offered positivity and direction against the troubling backdrop of public service austerity and Brexit uncertainty.
If you surf to a news website right now or flick on the TV news this evening, you might for a moment think that you watching a bad science fiction movie of a dystopian future starring your local A&E department. Sadly, it is real. The news has gone mad about A&E and the waiting time crisis that it faces. This morning the BBC reported that only 82% of patients are meeting the four-hour waiting time target. It doesn’t make pleasant reading.
In Hampshire, Solent NHS Trust and Commissioners are making use of advanced Health Systems Analytics to visualise their demand, and support their decisions about the how many sexual health clinics should be funded to meet future patient need.
As PPI Champion for the Fundamentals of Care theme within NIHR CLAHRC Wessex, I’ve a great experience and opportunity to be an equal member of a team developing the research priorities for this area of work. Crucially, these weren’t priorities that we developed together in a closed room, but rather they were co-produced at several stages.
Having conversations about the best course of action in the event a person’s condition deteriorates is difficult for everyone involved, whether it is the patient themselves, their family or carer and the clinician.
After an initial study on Advance Care Planning (A. Richardson, S. Lund1), research into the current application of treatment escalation plans across the country, and early engagement with some of the acute trusts in the Wessex region, it was apparent there was a desire to improve this process.
This site promotes independent research by the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care (CLAHRC) Funding Scheme. The views expressed in this blog are those of the author(s) and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health