19 minute read
People in deprived areas more likely to visit A&E
People in most deprived areas almost twice as likely to visit A&E
THERE were almost twice as many attendances to A&E departments in England for the 10% of the population living in the most deprived areas (3.1 million), compared with the least deprived 10% (1.6 million) in 2019-20, according to latest official figures.
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The report by NHS Digital1 shows that attendances for the 20% of the population living in the most deprived areas accounted for 27% of all A&E attendances (5.9 million attendances).
The data also reveals that Monday is the busiest day of the week, accounting for 16% of all attendances during 2019-20 (3.63 million attendances). The most frequent time of arrival on a Monday is between 10am and midday, accounting for 15.2% of attendances on this day (552,000 attendances). The number of CHOOSE Osteopathy is a new digital media campaign that has been targeting young people and career changers to consider a career in osteopathy. The campaign has been devised by the Osteopathic Communications Network to coincide with the period prospective students consider their UCAS applications for next year’s university places.
The campaign showcases real osteopaths and their personal stories, expressions of their passion for osteopathy and the rewards of being an osteopath. There is a dedicated webpage, social media assets and videos. THE Royal College of Nursing has produced a new tool to help nursing staff feel confident to talk openly about errors and risks to patient care.
Concerns might include an inability to meet the care of patients in your caseload, an inadequate response to a reported incident, or suspicions of fraud or bullying.
The guidance includes a flowchart to help staff decide what action to take if concerns need to be escalated.
Eileen McKenna, Associate Director of Nursing, Policy and Professional Practice, said: “Any delay in reporting concerns could have a negative impact. It’s important to remember that it’s in everyone’s best interest – patients, staff and managers – to identify when something isn’t right, learn from this and make improvements.” reattendances to A&E within seven days was 1.95 million and accounted for 8.7% of all reported attendances.
Image: mrsiraphol/freepik
Attracting a new generation of osteopaths
1) Hospital Accident and Emergency Activity 2019/20
Katie Griffiths, iO Head of Marketing and Communications, said: “We are targeting 16-23 year-olds and those seeking a change of career into health using digital and social platforms to drive awareness.
“We have a number of young and passionate osteopaths providing videos and testimonials to really engage young people into choosing osteopathy as a career – so all round this has been a great example of how people have collaborated across our profession.”
Enabling nursing staff to talk openly about concerns
www.iosteopathy.org
Image: freepik £2m funding for pain research ORGANISATIONS are invited to apply for funding to set up a pain research data hub.
The hub will be part of the UK Research and Innovation (UKRI) and Versus Arthritis Strategic Priority Fund Advanced Pain Discovery Platform. It will bring together and curate data sets to provide high-value data resources.
UK research organisations eligible for UKRI funding include higher education institutions, approved independent research organisations, approved NHS bodies, and research council institutes. www.ukri.org.
Rheumatology workshop at RCN THE Royal College of Nursing (RCN) is running a rheumatology workshop on 19 March 2021.
The educational opportunity follows the publication earlier this year of the RCN’s Competency Framework for Rheumatology Nurses, supporting role development for practitioners in clinical practice.
The role of the rheumatology nurse specialist is highly complex and may include roles in paediatric nursing, research, advanced level skills in clinical assessment and prescribing and providing intra-articular injections. www.rcn.org.uk
University Hospitals Bristol and Weston NHS Foundation Trust was a winner in this year’s British Society for Rheumatology Best Practice Awards, achieving recognition for an innovative project to help empower osteoporosis patients and drive down the number of hip and spine fractures.
DEBILITATING spinal and hip fractures are becoming a growing problem as the population ages. They’re devastating and painful for patients and are proving increasingly costly to the NHS and social care. The rheumatology unit at University Hospitals Bristol and Weston NHS Foundation Trust was seeing an increasing number of osteoporosis patients asking questions about thin bones, including how to avoid them, what food they should eat and what exercises they should do.
The team, led by consultant rheumatologist Dr Shane Clarke, developed a survey in 2015 for patients coming to the osteoporosis clinic and those having a bone density scan.
Dr Clarke explains: “We didn’t know what the best way to help our patients would be. Our survey helped us to understand that patients wanted to be able to improve their knowledge and learn practical tips to help manage their condition. Half of respondents were keen for regular hourlong sessions and the others wanted half-day sessions, so they didn’t have to come back and forth to the hospital.”
The team, including osteoporosis clinical nurse specialist Terrie Stocker and consultant Dr Matt Roy, developed a six-week course with each 60-minute session divided into two.
Dr Clarke says: “The first half would deal with one aspect of thin bones, such as nutrition, diagnosis of osteoporosis, how to interpret DXA results and fracture risk, what medications are available, their advantages and potential adverse
Images: kjpargeter/freepik events. The second half was devoted to tailored group exercise.”
Physiotherapist Katrina Hutchins developed exercises to improve patients’ core strength and a 12-station activity circuit including tai-chi, Pilates, strengthening and balance exercises, relaxation, and a practical session on getting up off the floor after a fall. Dr Clarke said: “The whole idea was to see whether we could encourage people to carry on with the exercises at home once they’d completed the course.”
The half-day courses allowed them to include a session with a dietitian and support from an occupational therapist. The team partnered with the Royal Osteoporosis Society (ROS) who supported them with administration, signposting patients and providing trained volunteers who came into clinics to talk to patients.
Once four of the courses had been run over the first year, the team brought 37 “alumni” patients back together to reflect on what had gone well, what needed to change and to find out how many were still exercising.
Dr Clarke said: “They retained most of their osteoporosis knowledge, but their confidence in continuing to exercise had waned. After the review we altered the balance of the courses to focus on a medium-term aim to continue exercising at home. By the time of the second alumnus meeting, which was very well attended, the majority had continued to exercise regularly.”
More than 200 patients have now been through the courses and hip fracture rates locally have reduced. As well as the Best Practice Awards, the team has been particularly recognised for Outstanding Patient Involvement.
Dr Clarke says: “The main thing is that people who go through the course feel less frightened by fractures. What we’re trying to do is get people to go out and have a good quality of life, rather than sit at home worried about breaking bones. This award win is great for the team, but it’s a clear reflection on all the hard work put in by our Royal Osteoporosis Society volunteers too.”
The team recognises that men were underrepresented on the courses. It’s now working on a new venture to get more regular exercise into
the community, particularly to include older men. The team is linking with Gloucester County Cricket and cricket writer Scyld Berry to introduce cricket games between residential homes in Bristol using specially manufactured softballs that can’t cause fractures, once the pandemic is over.
Dr Clarke said: “It’s about engaging people to continue exercising into their 70s, 80s and 90s – the health and social benefits are beyond doubt.”
Reproducible service model
Chair of the judging panel and British Society for Rheumatology president, Dr Elizabeth Price, believes the project stood out from the crowd. She said: “It’s such a simple idea and it really captured my imagination. It delivers education and practical help with appropriate exercise in a group setting for those with osteoporosis. The team has worked collaboratively with the Royal Osteoporosis Society and developed a very cost-effective, reproducible service model.”
Four volunteers from the charity Versus Arthritis, who all have lived experience of arthritis and accessing health services, helped judge the entries. They gave the team full marks for exceptional patient involvement, highlighting that patients were central to the design of the project and
Images: kjpargeter/freepik commended how patient feedback helped shape improvements.
Dr Clarke’s advice to other clinics is that you need to survey your patients: “It would be nice to say if you introduced this everywhere it would work, but each area is different. Do the survey and get buy-in from patients. After each course, we always collected information from patients aiming to make the content more relevant and helpful for subsequent groups. Getting it right for your local community is what it’s all about.” www.rheumatology.org.uk www.uhbristol.nhs.uk www.theros.org.uk www.versusarthritis.org
The challenge
Osteoporosis affects more than 3 million people in the UK, and more than 500,000 people a year receive hospital treatment for fragility fractures resulting from osteoporosis1 . Patients who are at high risk of fracture require targeted education to explain their condition and what steps they can take to self-manage it through medication and exercise. Education programme Participants gain knowledge to help them understand their osteoporosis and the practical steps they can take to reduce their risk of a fragility fracture and minimise the effect a fracture might have on their daily life if they do break a bone. Exercise programme Promoting the ROS ‘Strong, Steady and Straight’ guidelines, for exercise in patients with osteoporosis, participants gain practical experience and confidence in doing exercises that improve bone strength as well as balance and stability that can reduce the risk of falls. 1) NHS. Overview: Osteoporosis. 2019 (www.nhs.uk/ conditions/osteoporosis)
To help you keep your sports and physical activity going through the winter, Sport England has produced an Activity Toolkit that’s packed with resources and information.
SPORT ENGLAND’S Activity Toolkit brings together the latest advice and guidance on what is and isn’t allowed and a range of assets to help organisations and individuals. You can use the materials as they are or adapt them with local imagery and calls to action.
The toolkit also connects you to the best and most recent insight about the way people are feeling about sport and physical activity in the current climate, as well as how you can join up with Sport England’s three existing campaigns, This Girl Can, We Are Undefeatable and Join the Movement.
It offers outdoor activity advice, with tips and guidance on getting active away from home safely and in line with the regulations. There are resources for helping you be active– with a selection of online exercise platforms providing free access or extended trials. You can Join the Movement and share how you’re getting active during this time. Image: freepik Roll out the... get active at home GET ACTIVE AT HOME
Nike Training Club
Nearly 200 free workouts across strength, endurance, yoga and mobility. Sessions range from 15-45 minutes and are designed to help you see and feel results. www.nike.com/gb/ntc-app
The Body Coach
The home of Joe Wicks’ workouts with hundreds available for all fitness levels. These fun workouts can be done at home with no equipment. www.youtube.com/channel/ UCAxW1XT0iEJo0TYlRfn6rYQ
Yoga with Adriene
High quality practices on yoga and mindfulness to inspire people of all ages, shapes and sizes across the globe. www.youtube.com/user/yogawithadriene
Rachel Lawrence Pilates
Pilates instructor Rachel Lawrence shares her expertise in a warm, friendly style with a wide range of classes to inspire, inform and challenge. www.youtube.com/channel/
UCIfUrFyAWGeB6kMaEVRqR5Q
THE Sport England-funded campaign We Are Undefeatable is encouraging people with long-term health conditions to keep active in the face of coronavirus restrictions.
The campaign, which is led by 15 major health charities and inspires people to be physically active in any way that works for them by sharing real life stories and experiences, is promoting Team Undefeatable which is made up of virtual teams people can get involved with at home.
Former England international footballers Emile Heskey and Kelly Smith have backed the initiative, which comes at a time when new figures have revealed the impact lockdown had on activity levels during the early part of the pandemic.
The most recent Active Lives Adult Survey revealed that inactivity rose by 11% for people with long-term health conditions between March and May, with a quarter of people living with such a condition saying they will not return to communal sport and leisure centres until there’s a vaccine, or coronavirus is no longer a threat in the UK.
This is despite widespread understanding that regular physical activity can reduce the risk of developing some long-term health conditions by up to 40%. Regular bouts of exercise also help improve immune function and reduce systemic inflammation, leading researchers to suggest that physical activity could reduce the severity of coronavirus symptoms and shorten recovery times.
Online communities can help people to keep moving when many of the activities they normally enjoy are no longer available in an accessible form.
Walking football and dance programmes are available on the We Are Undefeatable website and there are handy tips for setting up a virtual team, as well as advice for coaches on how to tailor sessions for people living with health conditions.
Inclusive dance teacher Katie Mason has been involved with a dance squad that
GREAT ACTIVITIES FOR OLDER ADULTS
10 Today
A set of fun, 10-minute audio and video workouts, intended to easily fit into your day, that help get you stretching and moving at home. https://10today.co.uk/tune-in/
Move it or Lose it
A series of fitness videos for older people by exercise instructor Julie Robinson. www.youtube.com/user/MoveitorloseitUK
NHS sitting exercises
These sitting exercises are great for all ages, but particularly if you’re over 65. Click on the button below to also find strength, balance and flexibility exercises. www.nhs.uk/live-well/exercise/sittingexercises
Image: freepik EXERCISE WITH THE KIDS
Get Kids Moving
A selection of workouts that put the fun back into fitness and help engage kids. Children can train alongside their favourite superheroes from the comfort of their home. www.youtube.com/channel/ UCokO71NW3TgndaSNyHIqwtQ
Disney workouts
A chance for parents and kids to get moving to the songs they love. Learn their moves or put your own spin on their routines. www.thisgirlcan.co.uk/activities/disneyworkouts/
Image: master1305/freepik WALK, RUN OR RIDE
Walking
Walking is one of the easiest ways to get active, if you can access your garden or public space and are able to follow the government guidelines on social distancing. www.thisgirlcan.co.uk/activities/walking/
Couch to 5k
A nine-week programme of podcasts that does exactly what it says on the tin – taking you from the couch to running 5kms.
Consisting of three runs a week, the programme gradually builds up intensity and gives you a choice of coaches – from the NHS’s Laura, to multiple Olympic champion Michael Johnson. www.nhs.uk/live-well/exercise/couch-to5k-week-by-week/
Let’s Ride Local
British Cycling have created a tool to encourage safe and responsible cycling –the website includes tips and advice on riding locally, as well as instructions on teaching children how to ride. www.letsridelocal.co.uk/ www.sportengland.org/jointhemovement
Follow exercise and dance moves at home... or step up the pace outdoors
includes eight women living with various long-term health conditions such as MS, cancer, cerebral palsy and osteoporosis.
“Our classes were a time when the individuals could just think about dancing and enjoy the feeling rather than worry about what they may be going through. I’d urge anyone to set up their own groups, find an online or in-person group (if allowed to do so), or just follow some moves and dance alone.”
The squad, who had been rehearsing on Zoom together for 10 weeks, decided to surprise their friends and family with a virtual dance performance. https://weareundefeatable.co.uk
Will life ever be quite the same again once the pandemic ends? Not for many of us, it seems...
A Covid-19 Social Study conducted by UCL Epidemiology & Health Care found that, while just over half (51%) of people felt they were more likely on balance to return to how things were before lockdown, a fifth (22%) felt they were more likely to change things and this rose to around a quarter in those aged 3059 (25%) and for those with a diagnosed mental illness (26%).
The factor that people were most likely to change was increasing their support for local businesses (40%), with around a third of people also saying they would save more money (33%), exercise more (35%) or make more use of online shopping (33%). A quarter of adults expressed a plan to work from home more; this increased to nearer a third (29% of 18-29 year-olds and 32% of 30-59 year-olds) when excluding those over the age of 60.
The ongoing study is funded by the Nuffield Foundation with additional support from Wellcome and UK Research and Innovation (UKRI). It is the UK’s largest study into how adults are feeling about the lockdown, government advice and overall wellbeing and mental health with more than 70,000 participants
More people aim to holiday in the UK
who have been followed across a period of 23 weeks.
A quarter (26%) of people across all age groups also reported wanting to spend more time with family outside of their homes, or holiday more in the UK. Just under a fifth (18%) of people aged 18-29 also expressed a desire to find a new romantic relationship once the pandemic is over.
Lead author Dr Daisy Fancourt said: “Our study shows that during lockdown many people’s priorities have changed, with a substantial number of people expressing a
MEDICAL research charities are expected to lose almost 38% of their fundraising income this year, and more than 25% next year, according to the Institute for Public Policy Research (IPPR).
Restrictions on fundraising events, charity shop closures and wider economic uncertainty are all contributing to these losses, according to the think tank.
The IPPR estimates that this lost charity income and the adverse economic conditions will cause a cumulative £7.8 billion shortfall in health research and development (R&D) investment between now and 2027 – equal to 10% of UK health R&D.
These figures constitute a “reasonable worst-case scenario” according to the researchers. However, even in the “bestcase scenario” the study predicts £4.5 billion less R&D investment – £2 billion of which is attributable to lost charity income. Ultimately, this will lead to fewer treatments for patients, warns IPPR.
Commenting on the forecast, British Heart Foundation’s chief executive Dr Charmaine Griffiths said: “Charities have driven significant breakthroughs which have turned the tide on some of our biggest killers, including heart disease and cancer. But without Government commitment to a Life Sciences-Charity Partnership Fund, charities will be forced to make devastating cuts to their research which will be hugely damaging for patients and UK science.” www.ippr.org www.bhf.org.uk
Image: rawpixel.com/freepik
desire to change parts of their life and routine once the pandemic is over.
“This is likely down to the upheaval of lockdown breaking many habits and leading to people reassessing what they feel is important or worthwhile, be that spending time with
The loss of funding will impact on new medical discoveries and treatments
their family, supporting their community, or saving money, to name some of the more popular responses.”
Groups least likely to report that they would make changes to their lives were those who lived alone, those on lower household incomes, and those without children. Those aged 60+ were most likely to say they would return to living exactly as they had before, with 16% saying they would, versus just 7% of the population under 60.
Cheryl Lloyd, Education Programme Head at the Nuffield Foundation, said: “While many respondents say they would make lifestyle changes after the pandemic, this is less likely to be the case among people from lower income households. This prompts important questions about whether lifestyle changes feel less feasible for people with lower household incomes who are, for example, more likely to be in precarious employment and have less disposable income. To be effective, policies should be targeted and designed in consultation with at-risk groups, to ensure they do not exacerbate existing health and social inequalities.” www.ucl.ac.uk/epidemiology-
health-care
Online platform to support physical and emotional recovery from Covid-19
A NEW NHS digital platform has been launched to help health professionals support people who are recovering from Covid-19 at home.
“Your Covid Recovery” has two key components: a public site with general information on all aspects of recovering from Covid-19 including physical, emotional and psychological wellbeing; and an interactive rehabilitation platform specifically for patients with post-Covid syndrome, which requires referral and face-to-face assessment from a healthcare professional.
Patients who are referred to the resource will receive advice, support and face-to-face assessments from a healthcare professional, to help them recover in the short and immediate term after having Covid-19. It is intended as an adjunct rather than a replacement for usual primary care support and rehabilitation services, and – as Covid rehab – is funded as additional unmet need and funds are not taken from already underinvested areas of rehab.
The Chartered Society of Physiotherapy (CSP) has been involved in developing and reviewing the online platform. Chief executive Karen Middleton said: “It could help thousands of people to chart and self-manage their conditions at home. However, we must keep in mind that while virtual rehab will work very well for a lot of people, it won’t for everyone and it’s essential that no-one falls through the gaps.
“We must also not forget the huge, unmet rehabilitation needs of non-Covid patients coping with a variety of longterm conditions and we must tackle the health inequalities that Covid-19 has laid bare.”
CSP members are being encouraged to inform their patients about the platform and raise awareness of the new resource, so that people across the UK have access to this rehabilitation support.
