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of primary care
NAPC News 30 May 2012
Doctors Warn Of Major Flaws In 111 Helpline
Doctors are reporting unease with the implementation of the 111 helpline, claiming that trials of the number have led to more ambulance call outs, and potentially, lowered the standard of care for children.
NHS Direct employs more than 3,000 staff, 40% of whom are trained nurses, but the replacement service will be staffed by call handlers, who will have as little as six weeks’ training. This lack of medically trained staff will lead to more referrals and poorer outcomes, especially for vulnerable patients, doctors said.
Girls Aged Five Worry About Weight And Looks
A report by the All Party Parliamentary Group on Body Image has found that girls as young as 5 are worried about the way they look and their weight – a clear sign that ‘body image pressure in our society has gotten out of hand, Jo Swinson, Chairman of the Group said.
By the age of 14, almost half of British girls and one third of boys have been on diets to change their body shape. Ending society’s emphasis on dieting could eliminate 70 per cent of eating disorders, she added.
Medication For Shopaholics
A drug designed to treat Alzheimer’s may help compulsive shoppers curb their habits. Shopaholics given the medication in tests spent less time shopping and cut the money they squandered on impulse buys.
Psychiatrists tested a medication called memantine, normally prescribed to prevent deterioration in patients with moderate to severe Alzheimer’s. Clinical trial results showed that after weeks both men and women taking the drug reduced the amount of time devoted to shopping and the amount of money they spent.
Overall, symptoms were halved, with less impulsive buying and improvements in brain function linked to impulsive urges, thoughts and behaviour.
Night Shifts Linked To Increased Risk Of Cancer
Women who work night shifts are at a higher risk of breast cancer, researchers have warned. Their findings suggest working at night increases the chances of the disease by 40 per cent.
Experts think a hormone in the body that potentially suppresses tumours may be disrupted by constant exposure to light during night time hours.
There has been mounting evidence that night shifts might boost cancer risk because of the disruption to the body clock and hormone production.
Ibuprofen Could Reduce Risk Of Skin Cancer
Research has found that taking aspirin or ibuprofen dramatically slashes the risk of developing skin cancer and appears to give people who regularly take them protection against it.
Lead researcher, Sigrun Alba Johannesdottir, of Aarhus University Hospital in Denmark, said he hoped the study would inspire more research.
He commented: ‘Given the high skin cancer incidence and the widespread use of NSAIDs, a preventive effect of these agents may have important health implications.’
Paying People To Be Healthy Gets Results
A study has indicated that paying people to eat more fruit and vegetables and watch less television can make them change their way of life for good.
American research has found that people paid to make small changes to their lives carried on with their new habits, even after the money stopped.
Bonnie Spring, from Northwestern University at Lake Michigan, said: ‘We thought they would do it while we were paying them but the minute we stopped they would go back to their bad habits. But they continued to maintain a large improvement in their health behaviours.’
Several NHS and private schemes have offered financial incentives for people to lose weight in the UK, but the idea is controversial.
Why Gardening Can Save The NHS Millions
A study has concluded that by simply helping elderly people to tend their gardens could save the taxpayer as much as £11,000 a year per person.
When Sarah Jackson, a horticulturalist, set up a small scheme finding volunteers to help older people who could no longer maintain their gardens alone, she hoped it would also help keep them fit and active.
Three years on, she can point to a string of examples of people who had not only improved their lifestyles but also built new social networks, helping prevent isolation and depression. She was convinced that they made fewer visits to the doctor as a result and were less likely to end up in hospital.
Soaring Toll Of Elderly Starving In Their Homes
The number of people hospitalised because they are malnourished has soared by 50 per cent in five years, with the latest figures revealing that ten patients a week end up in hospital with a primary diagnosis of malnutrition.
And thousands more people are being admitted to hospital for other reasons and turning out to be badly nourished. Councils are increasing their fees for meals on wheels or denying people access to the service altogether. Critics say the figures show care services are failing to ensure pensioners get the help they need.
Lansley Rejects Health And Social Care Mergers
The health secretary has reiterated his opposition to forcing mergers between health and local authority commissioners, ahead of the publication of a white paper on social care reform.
The white paper is now likely to be published next month. It is a further slip from a May publication date in the Department of Health’s recent corporate plan.
Campaigners for reform have criticised the government’s plan to produce only a draft bill in this parliamentary session, rather than to legislate. They are pessimistic about new funding being found for long term care. However, there is still hope the government will move to joint health and social care budgets, which campaigners think would make funds available for long term care.
Andrew Lansley was asked about the issue at a conference held by the think tank, Reform. He said he recognised there had been calls, including from the Commons health select committee, for health and social care to be encouraged to integrate more.
However, Mr Lansley said this was not the solution. He said there was no meeting of minds about how the commissioners could be joined. He highlighted the differences between them, saying funding systems were different, the commissioning systems were different.’
He said: ‘What we have to do is to incentivise alignment of commissioning activity and outcomes.’ This indicates the white paper may point to clinical commissioners and councils being penalised under the outcomes and performance frameworks if they do not integrate.
Health committee chair, Stephen Dorrell, said he agreed there was no single organisational solution to integration, but said new incentives were not sufficient. He called for the government to create ‘a sense of urgency’ about integration and set out how they were going to do it practically.
The Department of Health is planning to publish its draft social care reform bill soon after the white paper is published. It is likely that there will be measures to tighten the regulation of social care providers and will legislate for all of the recommendations in the May 2011 Law Commission report on social care. This proposed setting a minimum level of service councils should provide, giving them a duty to investigate adult protection cases and encouraging consistent social care provision for people who move to different local authority areas.
It is understood that DH officials are discussing plans to continue transferring funds from the NHS to social care in the next spending round, starting in 2015.
Reform Endangers GP Quality Monitoring
A ground breaking project monitoring the quality of GPs faces an uncertain future once its host strategic health authority is abolished.
NHS London has admitted that its scheme, which tracks individual practice performance against 22 different indicators, could be scrapped if a home was not found for it. The system has been in development two years.
Dr Howard Freeman, associate medical director of primary care at NHS London, admitted it was not absolutely clear what would happen to it. He said the aspiration was that this system, which had huge potential to reduce variation in primary care, would be incorporated into the new structure. This meant making information about health as transparent as possible while providing GPs with an invaluable tool to learn from their peers. Dr Freeman said he hoped the London programme would contribute learning to the Department of Health’s national primary medical care contract management framework, which is expected soon.
The London system grades the capital’s 1500 practices into four quality categories:
- Higher achieving London Practice
- Achieving London Practice
- Approaching review
- Review identified
The figures indicate that roughly 10 per cent of London’s practices are in the top category, while a similar proportion are in the lowest.
Dr Freeman said the results were a standard bell curve distribution and they were not weighted for population need.
Twenty of the indicators mainly concern aspect of care quality or access. Two illustrate a practice’s relationship to the wider health economy. These indicators show how often patients with a long term condition are admitted to hospital in an emergency and how often patients from the practice go to accident and emergency.
NHS London plans to introduce six more outcome measures by September.