How to build effective teams in general practice

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For doctors with mental illness, ‘help me’ can be the hardest words

There is a greater openness about mental health generally, but for medical professionals the taboo remains Click here for newspaper link

An uncommon approach: four organisations selected to replicate health and social care interventions

Four organisations have each been awarded £145,000 by the Health Foundation to replicate successful health and care interventions using social franchising and licensing techniques. Social franchising and licensing are methods to replicate and scale interventions that have not yet been used widely in health care in the UK.

The projects are:

Scaling and replicating IRIS through social franchising

Lead organisation: IRISi

IRIS is a successful general practice-based training, support and referral programme that improves the identification and support offered to people with experience of domestic violence and abuse (DVA). One in four women and one in six men will experience DVA during their lifetime, with DVA against women being more frequent and more severe, with long-lasting effects that also have an impact on children. IRIS will be replicated through social franchising so that the programme can be implemented more widely, and more people can be supported. IRISi, a social enterprise set up to house the programme, will support other sites to engage commissioners, and recruit and train staff.

Replicating Pathway’s homeless health hospital team model to towns and cities experiencing significant homelessness

Lead organisation: Pathway

Homeless patients attend emergency departments four times more often than the general population, are admitted eight times more often and stay three times as long. Ten hospitals have implemented Pathway’s integrated care model ensuring that homeless patients admitted to hospital have access to the health care they need and support to recover. Pathway will use social franchising or licensing to replicate the model in places with significant homeless populations that would benefit from adopting it.

Scale up, replication and licensing of the PINCER intervention

Lead organisation: The University of Nottingham

In a recent study, prescribing errors were identified in 5% of prescription items, with one in 550 items containing a severe (potentially life threatening) error. This equates to around 1.8 million serious prescribing errors in English general practices each year. PINCER is a successful pharmacist-led information technology intervention for reducing common medication errors in general practice prescribing, and has been incorporated into national guidelines to support medicines optimisation. PINCER will be replicated in GP surgeries across the country; helping them to protect patients at risk of errors, and reduce medication-related hospital admissions and deaths.

Developing a licensed, social franchising model for regional hubs to roll out effective local multi-professional maternity training

Lead organisation: PROMPT Maternity Foundation

The PRactical Obstetric Multi-Professional Training (PROMPT) programme has been associated with a significant reduction in the number of babies with a low oxygen level at birth and also babies born with a permanent nerve injury following difficulties with their shoulders. Through social franchising and using a regional hub system, it is hoped that this improved implementation model will ensure that PROMPT training may be associated with the same improvements in outcomes across the country.

The new projects are currently subject to contracts being finalised.

Transforming care: views sought on NHS quality checkers’ toolkits

NHS England is testing toolkits for quality checkers to use in the assessment of services for people with autism and/or learning disabilities including GPs, community services, dental, acute care, accident and emergency and mental health.

These draft toolkits have been co-produced with people with a learning disability, autism or both and include health issues that are important to them. Most of the toolkits have been tested in some NHS services, but NHS England wants to gain the views of people who work in the services, commissioners and others who are interested in this work. The closing date of 1 December 2017.

Speak up: annual report 2016/17

The Healthwatch network heard from 341,000 people, carers and staff during the last year about what they think of health and social care service.

This annual report to Parliament highlights a summary of the common theme in people's good and bad experiences and what could be improved.

Monitoring noncommunicable disease commitments in Europe: progress monitor indicators

This report from Macmillan argues that the health and care system is failing to support recovering cancer patients with the physical and emotional trauma following treatment. It argues that the lack of appropriate aftercare is also placing pressure on the NHS with as cancer patients have 60 per cent more A&E attendances and 50 per cent more contact with GPs, 15 months after diagnosis.

Enabling providers to develop new care models

Commissioners will play an important role in empowering providers to work together to establish the collaborations that may evolve to become the accountable care systems of the future.  Find out more in these four articles, published by PCC:

• Getting GPs on board remains a big issue for accountable care organisations
• NHS England’s proposed contractual approaches for accountable care models
• Commissioners must drive but leave providers to steer new care models
• Accountable care organisations need support to get GPs’ pay right

e Natural health service: wildlife volunteers get mental health boost

Research supports the idea that nature could be widely prescribed by doctors as a therapy, easing the burden on the NHS. Click here for newspaper article

Look out for people at risk of having ADHD diagnosis missed, says NICE

NICE is urging doctors to think about a potential ADHD diagnosis in people who are at higher risk of having the condition, but who are usually overlooked. Click here for NICE news link

Not enough specialist support for people with dementia

Most of the healthcare received by people in the later stages of dementia is provided by GPs or emergency services, with little support from specialist healthcare professionals.

The researchers, from the Marie Curie palliative care research department at University College London, found that GPs were the main providers of medical care, with 96% of people with advanced dementia seeing a GP in their last month of life. Paramedics also played a major role in assessment and healthcare towards the end of life, suggesting a reactive rather than planned response to patients’ needs – nearly one in five (19%) were seen by a paramedic in the month prior to their death.

The Future Of The Mental Health Workforce

Centre for Mental Health -
This report calls for reform of mental health services in order to develop a workforce that is able to meet people's needs in the future. The report describes commissioning of mental health services as in crisis with a diminishing workforce, growing expectations and increasing demand putting pressure on staff across the country. Kings Fund blog

Why should STPs worry about primary care?

Sustainability and transformation partnerships (STPs) have a tough job to do – focused on making the books balance, hamstrung by provider deficits, trying to make an unsustainable system sustainable.

Yet the majority of patient contacts and opportunity for upstream intervention is in primary care, most obviously general practice but also community pharmacies, dentists and optometrists. In this article, PCC chief executive Helen Northall makes the case for better understanding of and engagement with primary care by STPs.

The interface between primary and secondary care: Key messages for NHS clinicians and managers

Good organisation of care across the interface between general practice and secondary care providers is crucial in ensuring that patients receive high-quality care and in making the best use of clinical time and NHS resources in both settings. This briefing document describes the key national requirements which clinicians and managers across the NHS need to be aware of. These are set out in the new NHS Standard Contract for 2017-19, under which clinical commissioning groups (CCGs) commission health services from providers, which came into effect on 1 April 2017 and which will remain in place until 31 March 2019.

• The interface between primary and secondary care: Key messages for NHS clinicians and managers
• Joint letter from NHS England and NHS Improvement

NHS moves to end “fractured” care system

The head of NHS England has pledged to end the “fractured” health and social care system that leaves too many patients “passed from pillar to post” by giving local leaders and communities more control over how they improve health and social care.

Addressing the NHS Confederation in Liverpool, Simon Stevens announced nine areas in England – covering some seven million people – which will be the forefront of nationwide action to provide joined up, better coordinated care breaking down the barriers between GPs and hospitals, physical and mental healthcare, social care and the NHS.

Eight ‘accountable care systems’ (ACSs) will bring together local NHS organisations, often in partnership with social care services and the voluntary sector. They build on the learning from and early results of NHS England’s new care model ‘vanguards’, which are slowing emergency hospitalisations growth by up to two thirds compared with other less integrated parts of the country.

The impact of housing problems on mental health

This report reveals that over the last five years one in five adults suffer mental health problems due to housing pressures. The research also surveyed the experiences of 20 GPs who highlighted the number of patients diagnosed with anxiety or depression directly due to housing issues and that GPs required greater help to support patients with housing problems.

• Report

Four ways GP practices can become dementia friendly

Find out how one local Healthwatch has been showing GP practices how small changes can make a big difference to dementia patients’ experiences of visiting the doctor.

Making a trip to the doctor easier for people with autism

In the report, Children and young people with autism, we heard from over 1,000 people about their experiences of using autism services and the improvements they’d like to see.

Although most people are happy with the care they receive from their GP, we heard that for many a visit to the doctor can be stressful for both people with autism and their families.

In West Sussex, Healthwatch spoke to over 100 members of Autism Support Crawley to understand what changes could be made to help improve services for children with autism. Based on their findings Healthwatch West Sussex created six ways staff in GP surgeries can improve patient experience.

Patients receiving pedometers by post increased their physical activity for at least 12 months

Use of pedometers, received by post, resulted in a sustained increase in walking of around 650 steps a day, equivalent to about one km or 30 minutes of moderate to vigorous physical activity per week. The study was set in London general practices and achieved similar results whether or not people had additional support from a practice nurse.

Does the primary care home make a difference?

Thousands of patients benefit from NAPC’s Primary Care Home programme: new report shows drop in emergency hospital admissions and waiting times for GP appointments

The Primary Care Home (PCH) programme is delivering a range of benefits for patients, staff and the wider health system, according to a new report released today (Friday 31 March).

Key findings from an early analysis of three rapid test sites show significant reductions in A&E attendances, emergency hospital admissions and GP referrals to hospital.

Consultation launched on prescribing of gluten-free foods

The consultation follows NHS England’s announcement this week of new guidance on the prescription of low value items such as travel vaccines, painkillers, and gluten-free (GF) foods.
It will consider ending the prescription of all gluten-free foods in primary care, with estimates suggesting this could save £25.7 million a year for the health service. An additional £10 million could be saved through patients no longer needing to attend GP appointments in order to get their gluten-free prescriptions.