scholarly journals The emergence and utilisation of frailty in the United Kingdom: a contemporary biopolitical practice

2018 ◽  
Vol 40 (4) ◽  
pp. 695-712 ◽  
Author(s):  
Louise Tomkow
Keyword(s):  
Health Care ◽  
United Kingdom ◽  
Older People ◽  
Health Care Professionals ◽  
Geriatric Medicine ◽  
Adverse Outcomes ◽  
Ageing Population ◽  
Political Climate ◽  
The United Kingdom ◽  
The Impact

AbstractFrailty has recently emerged as a dominant concept against a backdrop of media and governmental narratives that frame the growing ageing population as an economic threat to the current configuration of health care in the United Kingdom (UK). Despite frailty's popularity amongst geriatricians and policy makers, the concept faces resistance from other health-care professionals and older people themselves. This paper draws on the Foucauldian idea of biopower; by suggesting that the contemporary emergence and utilisation of frailty represents a biopolitical practice a number or critical observations are made. First, despite biomedical experts acknowledging ambiguities in the definition of frailty, the concept is presented as a truth discourse. This is driven by the ability of frailty measurements to predict risk of costly adverse outcomes; the capability of frailty scores to enumerate complex needs; and the scientific legitimacy frailty affords to geriatric medicine. Consequently, frailty has become pervasive, knowable and measurable. Second, the routine delineation between frail and robust objectifies older people, and can be said to benefit those making the diagnosis over those being labelled frail, with the latter becoming disempowered. Last, studies show that frailty is associated with increasing wealth inequalities in the UK; however, experts’ suggested management of frailty shifts the focus of responsibility away from ideologically driven structural inequalities towards the frail older person, attempting to encourage individuals to modify lifestyle choices. This neglects the association between lifestyle opportunities and socio-economic deprivation, and the impact of long-term poverty on health. These observations, set against the contemporary political climate of economic austerity, cuts to public services and rationalisation of health resources, bring the urgency of a critical consideration of frailty to the fore.

scholarly journals Surgery in the older person: Training needs for the provision of multidisciplinary care

2016 ◽  
Vol 98 (6) ◽  
pp. 367-370 ◽  
Author(s):  
L Pearce ◽  
J Bunni ◽  
K McCarthy ◽  
J Hewitt
Keyword(s):  
Older People ◽  
Perioperative Care ◽  
Health Care Professionals ◽  
Geriatric Medicine ◽  
Multidisciplinary Care ◽  
Surgical Patients ◽  
Surgical Patient ◽  
Ageing Population ◽  
Older Person ◽  
Surgical Trainees

Introduction Many older surgical patients are exposed to high risks of morbidity and mortality when undergoing both elective and emergency surgery. Methods We provide an overview of perioperative care teams and the educational opportunities available to surgeons who undertake surgery in the older person. Findings The number of older people undergoing surgery is increasing at a rate faster than the proportion of older people in the overall population. Management of the older surgical patient throughout the surgical pathway forms part of the Specialty Training Curriculum for Geriatric Medicine. While ‘surgery in childhood’ continues to form part of the general surgical higher training syllabus, surgery in the later years of life does not. There are limited postgraduate courses and training opportunities currently available to surgeons in this field. There is clear societal need to address perioperative care for older surgical patients, which has proved successful in some centers. Moreover, surgical trainees support the inclusion of geriatric medicine issues into their training. Conclusions The ageing population requires a multidisciplinary perioperative approach, with dedicated and appropriately trained clinicians and allied health care professionals to improve outcomes.

Undergraduate education in geriatric medicine

2001 ◽  
Vol 11 (4) ◽  
pp. 295-298 ◽  
Author(s):  
Mujtaba Hasan
Keyword(s):  
Developing Countries ◽  
United Kingdom ◽  
Older People ◽  
Health Professionals ◽  
Undergraduate Education ◽  
Geriatric Medicine ◽  
Age Group ◽  
The United Kingdom ◽  
The World ◽  
Care For Older People

In the developed, as well as developing countries, there is an immediate challenge to ensure an adequate supply of health professionals trained in providing care for older people to meet the needs of increasing numbers. Currently 20% of the population of the United Kingdom (UK) is over 60 – 12 million people. By 2031 this proportion will be nearly a third – 18.6 million people. The largest increases are anticipated among the over-85 age group, from 0.8 million in 1987 to 1.4 million in 2025. In Europe the number of people aged over 80 years will double within the next 25 to 30 years. It is estimated that there will be more than 1.2 billion elderly people in the world by the year 2025 – three-quarters of them living in the developing countries.

Competition and Containment in Health Care

2000 ◽  
Vol 30 (2) ◽  
pp. 257-284 ◽  
Author(s):  
Ben Griffith
Keyword(s):  
Health Care ◽  
United Kingdom ◽  
Cost Effectiveness ◽  
Transaction Costs ◽  
Health Care Services ◽  
Internal Markets ◽  
Care Services ◽  
The United Kingdom ◽  
Additional Funding ◽  
The Impact

In the United Kingdom and elsewhere, the preconditions for well-functioning internal markets (in relation to market structure, transaction costs, and information) may not exist in health care. Similar doubts exist about the impact of internal markets on cost-effectiveness. While the quantity of health care has increased, the effects on quality are ambiguous and costs have not been successfully restrained. With respect to equity of health care, fears have been raised that sections of the population may be discriminated against. In the United Kingdom, resources have been shifted away from deprived areas and toward the more affluent. Health care services are once again being reformed, by New Labour in the United Kingdom and similar administrations elsewhere. The rhetoric of competition has given way to talk of partnership. The imposition of new forms of rationing has been reshaped, not abandoned. Additional funding is required, along with an effective commitment to the pursuit of equity and quality in health care.

A Systematic Review of the Impact of Healthcare Reforms on Access to Emergency Department and Elective Surgery Services

2017 ◽  
Vol 48 (1) ◽  
pp. 81-105 ◽  
Author(s):  
Sandeep Reddy ◽  
Peter Jones ◽  
Harsha Shanthanna ◽  
Raechel Damarell ◽  
John Wakerman
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Emergency Department ◽  
United Kingdom ◽  
Elective Surgery ◽  
Grey Literature ◽  
Unintended Consequences ◽  
Health Care Reforms ◽  
The United Kingdom ◽  
The Impact

This systematic review sought to identify whether health care reforms led to improvement in the emergency department (ED) length of stay (LOS) and elective surgery (ES) access in Australia, Canada, New Zealand, and the United Kingdom. The review was registered in the PROSPERO database (CRD42015016343), and nine databases were searched for peer-reviewed, English-language reports published between 1994 and 2014. We also searched relevant “grey” literature and websites. Included studies were checked for cited and citing papers. Primary studies corresponding to national and provincial ED and ES reforms in the four countries were considered. Only studies from Australia and the United Kingdom were eventually included, as no studies from the other two countries met the inclusion criteria. The reviewers involved in the study extracted the data independently using standardized forms. Studies were assessed for quality, and a narrative synthesis approach was taken to analyze the extracted data. The introduction of health care reforms in the form of time-based ED and ES targets led to improvement in ED LOS and ES access. However, the introduction of targets resulted in unintended consequences, such as increased pressure on clinicians and, in certain instances, manipulation of performance data.

scholarly journals Accreditation and professional integration experiences of internationally qualified dentists working in the United Kingdom

2022 ◽  
Vol 20 (1) ◽  
Author(s):  
Latha S. Davda ◽  
David R. Radford ◽  
Sasha Scambler ◽  
Jennifer E. Gallagher
Keyword(s):  
Health Care ◽  
United Kingdom ◽  
Dental Care ◽  
Health Care Professionals ◽  
European Economic Area ◽  
The European Union ◽  
Framework Analysis ◽  
Professional Integration ◽  
The United Kingdom ◽  
The Uk

Abstract Introduction Regulatory processes for Oral health care professionals are considered essential for patient safety and to ensure health workforce quality. The global variation in their registration and regulation is under-reported in the literature. Regulatory systems could become a barrier to their national and international movement, leading to loss of skilled human resources. The General Dental Council is the regulatory authority in the UK, one of the nine regulators of health care overseen by the Professional Standards Authority. Aim The aim of this paper is to present the professional integration experiences of internationally qualified dentists (IQDs) working in the UK, against the background of regulation and accreditation nationally. Methods Registration data were obtained from the General Dental Council to inform the sampling and recruitment of research participants. Semi-structured interviews of 38 internationally qualified dentists working in the United Kingdom were conducted between August 2014 and October 2017. The topic guide which explored professional integration experiences of the dentists was informed by the literature, with new themes added inductively. A phenomenological approach involving an epistemological stance of interpretivism, was used with framework analysis to detect themes. Results Internationally qualified dentist’s professional integration was influenced by factors that could be broadly classified as structural (source country training; registration and employment; variation in practising dentistry) and relational (experiences of discrimination; value of networks and support; and personal attributes). The routes to register for work as a dentist were perceived to favour UK dental graduates and those qualifying from the European Economic Area. Dentists from the rest of the world reported experiencing major hurdles including succeeding in the licensing examinations, English tests, proving immigration status and succeeding in obtaining a National Health Service performer number, all prior to being able to practice within state funded dental care. Conclusion The pathways for dentists to register and work in state funded dental care in UK differ by geographic type of registrant, creating significant inconsistencies in their professional integration. Professional integration is perceived by an individual IQD as a continuum dictated by host countries health care systems, workforce recruitment policies, access to training, together with their professional and personal skills. The reliance of the UK on internationally qualified dentists has increased in the past two decades, however, it is not known how these trends will be affected by UK’s exit from the European Union and the COVID-19 pandemic.

scholarly journals 128 Getting Healthcare Students to be More Empathatic for Geriatric Patients: The Impact of Simulation Suit on Pharmacy Students

2019 ◽  
Vol 48 (Supplement_4) ◽  
pp. iv28-iv33
Author(s):  
Shaun Lee ◽  
Pei-Lee Teh
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Health Care Professionals ◽  
Intervention Group ◽  
Healthcare Services ◽  
Mental Illnesses ◽  
Controlled Study ◽  
Future Research ◽  
Ageing Population ◽  
The Impact

Abstract Introduction The world’s population worldwide is greying, and it is important that health care professionals such as pharmacists are able to gain proficiency in working with older adults who may be suffering from both physical and mental illnesses. One of the challenges for many schools that offer healthcare related courses is the need to support continued empathy towards this ageing population so that they can offer better healthcare services. Recently, ageing suits which are an immersive simulation suit designed to simulate the effects of ageing have been introduced to enable nursing students to experience what older adults face in health care situation. Method In this randomised controlled study, all year 1 students enrolled in the Bachelor of Pharmacy course (n=120) at our institution were assigned to either a polypharmacy only workshop or use an ageing suit together with polypharmacy workshop (intervention). The intervention group was tasked to perform a series of exercises, including walking a flight of stairs, picking up a coin as well as filling up a form. All participants completed the Jefferson Empathy Scale and semi-structured questionnaire. Results At the end of exercise, intervention group participants had a marginal improvement in their self-reported empathy levels, with an improvement of 1.7 +14.5 points compared to 1.2 + 9.4 points in control (p=0.81). Participants in the intervention reported changes in physical performance consistent with the expected changes associated with ageing. They also reported a change in attitude and were able to empathize better with older adults especially on issues related to patient communication. Conclusion As such, future research should also include and involve a wider range of students to ensure that they become health advocates for the health care needs of older adults. This will enable them to deliver better healthcare services to meet the needs of the older adults.

scholarly journals Exploring factors that impact the decision to use assistive telecare: perspectives of family care-givers of older people in the United Kingdom

2017 ◽  
Vol 38 (9) ◽  
pp. 1912-1932 ◽  
Author(s):  
ERICA J. COOK ◽  
GURCH RANDHAWA ◽  
ANDY GUPPY ◽  
CHLOE SHARP ◽  
GARRY BARTON ◽  
...  
Keyword(s):  
United Kingdom ◽  
Older People ◽  
Family Care ◽  
Influential Factors ◽  
Ageing Population ◽  
Structured Interviews ◽  
Framework Analysis ◽  
Care Givers ◽  
The United Kingdom ◽  
Service Framework

ABSTRACTIn the United Kingdom (UK), an ageing population met with the reduction of social care funding has led to reduced support for older people marked with an increased demand on family care-givers. Assistive telecare (AT) devices are viewed as an innovative and effective way to support older people. However, there is limited research which has explored adoption of AT from the perspectives of family care-givers. In-depth, semi-structured interviews were conducted with 14 family care-givers of patients who used the Assistive Telehealth and Telecare service in Cambridgeshire, UK. Family care-givers were either the spouse (N = 8) or child of the patient (N = 6). The patients' age ranged from 75 to 98, and either received a telecare standalone device or connected service. Framework analysis was used to analyse the transcripts. This study revealed that family care-givers play a crucial role in supporting the patient's decision to adopt and engage with AT devices. Knowledge and awareness, perceived responsibility, usefulness and usability, alongside functionality of the equipment, were influential factors in the decision-making process. AT devices were viewed positively, considered easy to use, useful and functional, with reassurance of the patient's safety being a core reason for adoption. Efforts to increase adoption and engagement should adapt recruitment strategies and service pathways to support both the patient and their care-giver.

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