Co-designing interventions for communicating positive newborn bloodspot screening results: use of online Experience-based Co-design (Preprint)

2021 ◽  
Author(s):  
Jane Chudleigh ◽  
Lynette Shakespeare ◽  
Pru Holder ◽  
Holly Chinnery ◽  
Gemma Hack ◽  
...  
Keyword(s):  
Health Care ◽  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Health Care Professionals ◽  
Specific Information ◽  
Structured Interviews ◽  
Working Groups ◽  
Newborn Bloodspot Screening ◽  
Heath Care

BACKGROUND Each year in England, almost 10,000 parents are informed of their child’s positive newborn bloodspot screening result around 2-8 weeks after birth, depending on the condition. Communication of positive newborn bloodspot screening results is a subtle and skilful task, which demands thought, preparation and evidence to minimise potentially harmful negative sequelae. Evidence exists of variability in the content and the way the result is currently communicated which has the potential to lead to increased parental anxiety and distress. OBJECTIVE The main objective was to co-design interventions to improve delivery of positive newborn bloodspot screening results to families. METHODS The principles of Experience-based Co-design were used with seventeen health care professionals employed in three National Health Service Trusts in England and 21 parents; 13 mothers and 8 fathers of 14 children recruited from the same three National Health Service Trusts. Staff experiences were gathered via semi-structured interviews. Filmed, narrative interviews with parents were developed into a composite film. These data were used to identify priorities for improving communication of positive newborn bloodspot screening results to parents during firstly, separate parent and heath care professionals feedback events followed by joint parent and heath care professionals feedback events. Following this, parents and heath care professionals worked together via online co-design working groups to develop co-designed solutions and additions to existing processes. RESULTS Themes identified from the parent’s interviews included: impact of initial communication; parental reactions; attending the first clinic appointment; impact of staff communication strategies and skills; impact of diagnosis on family and friends; improvements to the communication of positive NBS results; and parents views of NBS. Themes identified from the staff interviews included: communication between health care professionals; process of communicating with the family; parent and family- centred care; availability of resources and challenges to effective communication. Three online co-design working groups were developed, each attended by 12-18 participants who had taken part in the parental or health care professionals’ interviews. The priorities included: changes to the NBS card; standardised laboratory proformas; standardised communication checklists; and an email / letter for providing reliable up to date condition specific information for parents following communication of the positive NBS result. CONCLUSIONS Variation in communication practices for positive NBS results continues to exist. This was influenced by many factors and has the potential to lead to negative sequelae from a parental perspective. Parents and health care professionals were able to successfully work together to identify priorities and develop potential solutions to improve communication of positive NBS results to parents. The adaptation of EBCD to include virtual methods could reduce costs associated with this methodology while also enabling the approach to be more responsive to health care professionals’ and patients’/parents’ busy schedules. CLINICALTRIAL ISRCTN 15330120 INTERNATIONAL REGISTERED REPORT RR2-10.1186/s40814-019-0487-5

Renewing the National Health Service: Labour's Agenda for a Healthier Britain

1996 ◽  
Vol 26 (2) ◽  
pp. 269-308 ◽  
Author(s):  
Rae Barrantes
Keyword(s):  
Health Care ◽  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Health Care Professionals ◽  
Current Status ◽  
Patient Centered ◽  
Labour Government ◽  
Point Of Use ◽  
Tier System

In this report the Labour Party gives its view of the current status of the British National Health Service (NHS), and outlines its plans for the NHS under a Labour government. The values underlying the NHS—comprehensive health care, free at the point of use, based on need rather than ability to pay—have been betrayed. The truly national health service, created by a Labour government in 1948, has been replaced by a market-based service led by accountants. Patients are suffering, health care professionals are dissatisfied, some of the nation's finest hospitals are closing, community care is in chaos, and NHS dentistry has all but been privatized. Under the Tories, the NHS faces a future of privatization, competition, and markets, money wasted on bureaucracy, and the unfairness of a two-tier system. Under Labour, the NHS faces modernization, planned progress, money spent on frontline services, and excellence for all. Labour will follow a model of health care that is patient centered and community led, a properly coordinated and efficient public service.

Is the English National Health Service meeting the needs of mentally distressed Chinese women?

2002 ◽  
Vol 7 (4) ◽  
pp. 216-221 ◽  
Author(s):  
Gill Green ◽  
Hannah Bradby ◽  
Anita Chan ◽  
Maggy Lee ◽  
Kimmy Eldridge
Keyword(s):  
Mental Health ◽  
Health Care ◽  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Health Care Professionals ◽  
Service Providers ◽  
Chinese Women ◽  
Institutional Racism ◽  
Care Group

Objectives: To identify barriers to communication between health care workers and Chinese women living in England, a group who are known to use the National Health Service (NHS) less than other ethnic groups; to consider whether such barriers lead to inequitable access to NHS mental health treatment; and to determine the extent to which this results from institutional racism. Method: A purposive sample of 42 Chinese women living in South-East England aged 29-60 years derived from a primary care group, two secondary mental health service providers and three Chinese associations. Subjects had all consulted a general practitioner and had either experienced mental distress ( n = 24) and/or had used traditional Chinese medicine ( n = 25). Results: Communication with health care professionals was hindered by a lack of common language and an absence of shared concepts concerning the causes and manifestations of health and illness, particularly mental health. This lack of communication resulted in delayed diagnoses, misunderstood treatment regimens and deterred women from (re-)presenting to the NHS. Among our informants, these types of problem were more acute for those women who were most marginalised from English-language culture. Conclusions: Linguistic and conceptual problems explain Chinese women's relatively poor access to mental health services. The continuing failure to tackle systematically these communication problems through the routine provision of interpretation and advocacy services lays the health care system open to the charge of 'institutional racism'.

Transition from higher education to National Health Service for visually impaired physiotherapists: An interpretative phenomenological exploration

2013 ◽  
Vol 31 (1) ◽  
pp. 32-46 ◽  
Author(s):  
Karen Atkinson ◽  
Jane Owen Hutchinson
Keyword(s):  
Higher Education ◽  
National Health Service ◽  
Health Service ◽  
Lived Experience ◽  
National Health ◽  
Health Care Professionals ◽  
Visually Impaired ◽  
Phenomenological Approach ◽  
Structured Interviews ◽  
Wide Range

This idiographic study aims to hear the voices of a small group of visually impaired physiotherapists to explore their lived experience 1 of transition from higher education (HE) into employment. The findings are based on six semi-structured interviews analysed using an interpretative phenomenological approach. Participants were visually impaired physiotherapists who are either working, or have worked, in the National Health Service (NHS). A number of interrelated themes emerged concerning the work of the disabled self, compensation, stigma and passing, disclosure, barriers, disempowerment, and positive experiences. These appear to be linked to a reluctance by participants to engage with their disability identity. The experiences and perceptions of participants do not provide evidence of a commitment to disability-related support for disabled health-care professionals. The results of this study indicate that a wide range of both personal and institutional barriers still exist in the NHS.

THE UK NHS EXPERIENCE OF BURNOUT: TIME FOR ACTION

2021 ◽  
Vol 9 (3) ◽  
pp. 7-18
Author(s):  
Helen L. Millar
Keyword(s):  
Health Care ◽  
National Health Service ◽  
Health Service ◽  
Patient Care ◽  
National Health ◽  
Health Care Professionals ◽  
Care Delivery ◽  
Work Place ◽  
The Uk ◽  
The Impact

Background: Burnout, as a global phenomenon, has probably always existed and been present in all cultures but more recently has been increasingly identified in the public health sector work place. The UK National Health Service (NHS) is the largest employer in Europe with over 1.3 million workers. It therefore reflects many of the challenges common to global health care systems. The escalation of burnout in the UK NHS (National Health Service) is now recognized given the impact on workforce sustainability and the health care delivery. Objectives: This article aims to highlight the current epidemic of burnout in the UK NHS, its causes, and impact on the workforce and quality of care provided. Strategies developed to improve the health of the NHS workforce will be reviewed and appraised in terms of their impact and limitations to date. Methods: The methodology includes a broad overview of selected articles/publications focusing on the concept of burnout and the impact on the workforce and patient care and is not intended to be a systematic review. Publications include peer reviewed articles, governmental strategic documents, recent surveys, and relevant responses by health care professionals and other relevant independent bodies. Results: The current literature highlights that burnout in the NHS is a major concern. It is clear that recognition of the extent of the problem and its impact are crucial for the sustainability of the NHS. The alarming rate of work force attrition is evident and unless immediate drastic steps are taken to address the root causes, the pressure on remaining staff will escalate to breaking point resulting in an inability to sustain services due to further staff losses. Evidence demonstrates that staff burnout adversely affects patient care and increases errors. Conclusion: It is vital that burnout is addressed as a matter of urgency in order to ensure a healthy and productive workforce and to ensure patients are treated safely and effectively. The NHS’s very survival depends on direct and urgent action to remedy this situation.

scholarly journals Integrating sport and exercise medicine clinics into the National Health Service: a qualitative study

2020 ◽  
Vol 6 (1) ◽  
pp. e000888
Author(s):  
Dane Vishnubala ◽  
Katherine Rose Marino ◽  
Margaret Kathryn Pratten ◽  
Andy Pringle ◽  
Steffan Arthur Griffin ◽  
...  
Keyword(s):  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Thematic Analysis ◽  
Heavy Exercise ◽  
Structured Interviews ◽  
Ultrasound Education ◽  
Exercise Medicine ◽  
Sport And Exercise ◽  
Inductive Thematic Analysis

ObjectivesTo explore the services National Health Service (NHS)-based sport and exercise medicine (SEM) clinics can offer, and the barriers to creating and integrating SEM services into the NHS.MethodsSemi-structured interviews were undertaken to collect data from identified ‘stakeholders’. Stakeholders were identified as individuals who had experience and knowledge of the speciality of SEM and the NHS. An inductive thematic analysis approach was taken to analyse the data.ResultsN=15 stakeholder interviews. The management of musculoskeletal (MSK) injuries (both acute and chronic) and concussion were highlighted as the two key services that SEM clinics can offer that would most benefit the NHS. MSK ultrasound was also mentioned by all stakeholders as a critical service that SEM clinics should provide. While exercise medicine is an integral part of SEM, SEM clinics should perhaps not have a heavy exercise medicine focus. The key barriers to setting up SEM clinics were stated to be convincing NHS management, conflict with other specialities and a lack of awareness of the speciality.ConclusionThe management of acute MSK injuries and concussion should be the cornerstone of SEM services, ideally with the ability to provide MSK ultrasound. Education of others on the speciality of SEM, confirming consistent ‘unique selling points’ of SEM clinics and promoting how SEM can add value to the NHS is vital. If the successful integration of SEM into the NHS is not widely achieved, we risk the NHS not receiving all the benefits that SEM can provide to the healthcare system.

Accountability for Rationing — Theory into Practice

2005 ◽  
Vol 33 (4) ◽  
pp. 660-668 ◽  
Author(s):  
Christopher Newdick
Keyword(s):  
Health Care ◽  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Health Care Systems ◽  
The Public ◽  
Modern Health Care ◽  
Concept Of Health ◽  
Care Systems ◽  
Health Need

Most now recognize the inevitability of rationing in modern health care systems. The elastic nature of the concept of “health need,” our natural human sympathy for those in distress, the increased range of conditions for which treatment is available, the “greying” of the population; all expand demand for care in ways that exceed the supply of resources to provide it. UK governments, however, have found this truth difficult to present and have not encouraged open and candid public debate about choices in health care. Indeed, successive governments have presented the opposite view, that “if you are ill or injured there will be a national health service there to help; and access to it will be based on need and need alone.” And they have been rightly criticized for misleading the public and then blaming clinical and managerial staffin the National Health Service (NHS) when expectations have been disappointed.

scholarly journals The Future of Health Care: Protocol for Measuring the Potential of Task Automation Grounded in the National Health Service Primary Care System (Preprint)

2018 ◽  
Author(s):  
Matthew Willis ◽  
Paul Duckworth ◽  
Angela Coulter ◽  
Eric T Meyer ◽  
Michael Osborne
Keyword(s):  
Machine Learning ◽  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Care Staff ◽  
Primary Health ◽  
The Future

BACKGROUND Recent advances in technology have reopened an old debate on which sectors will be most affected by automation. This debate is ill served by the current lack of detailed data on the exact capabilities of new machines and how they are influencing work. Although recent debates about the future of jobs have focused on whether they are at risk of automation, our research focuses on a more fine-grained and transparent method to model task automation and specifically focus on the domain of primary health care. OBJECTIVE This protocol describes a new wave of intelligent automation, focusing on the specific pressures faced by primary care within the National Health Service (NHS) in England. These pressures include staff shortages, increased service demand, and reduced budgets. A critical part of the problem we propose to address is a formal framework for measuring automation, which is lacking in the literature. The health care domain offers a further challenge in measuring automation because of a general lack of detailed, health care–specific occupation and task observational data to provide good insights on this misunderstood topic. METHODS This project utilizes a multimethod research design comprising two phases: a qualitative observational phase and a quantitative data analysis phase; each phase addresses one of the two project aims. Our first aim is to address the lack of task data by collecting high-quality, detailed task-specific data from UK primary health care practices. This phase employs ethnography, observation, interviews, document collection, and focus groups. The second aim is to propose a formal machine learning approach for probabilistic inference of task- and occupation-level automation to gain valuable insights. Sensitivity analysis is then used to present the occupational attributes that increase/decrease automatability most, which is vital for establishing effective training and staffing policy. RESULTS Our detailed fieldwork includes observing and documenting 16 unique occupations and performing over 130 tasks across six primary care centers. Preliminary results on the current state of automation and the potential for further automation in primary care are discussed. Our initial findings are that tasks are often shared amongst staff and can include convoluted workflows that often vary between practices. The single most used technology in primary health care is the desktop computer. In addition, we have conducted a large-scale survey of over 156 machine learning and robotics experts to assess what tasks are susceptible to automation, given the state-of-the-art technology available today. Further results and detailed analysis will be published toward the end of the project in early 2019. CONCLUSIONS We believe our analysis will identify many tasks currently performed manually within primary care that can be automated using currently available technology. Given the proper implementation of such automating technologies, we expect considerable staff resources to be saved, alleviating some pressures on the NHS primary care staff. INTERNATIONAL REGISTERED REPOR DERR1-10.2196/11232

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