scholarly journals P580 Benchmarking IBD Pharmacy Services to optimise, strengthen and align IBD Expert Pharmacy Practice

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S535-S535
Author(s):  
A St Clair Jones ◽  
U Meade
Keyword(s):  
Pharmacy Practice ◽  
Patient Survey ◽  
Team Work ◽  
Leadership Role ◽  
Pharmacy Services ◽  
Self Assessment ◽  
Pharmacy Profession ◽  
Pharmaceutical Society ◽  
The Uk ◽  
First Time

Abstract Background UK IBD Standards 2019 (ibduk.org) for the first time embed and describe Specialist Pharmacy Services (SPS) as an integral part of the IBD multidisciplinary team (MDT) and enable recognition and commissioning of Expert Pharmacists in IBD (EPharmIBD). The Benchmarking Tool, comprised of the IBD Patient Survey and Service Self-Assessment 2019/2020 provides a benchmark of expert pharmacy practice. Methods The Benchmarking Tool developed by IBD UK to drive quality defines A-D descriptors for all IBD standards (A=’excellent, proactive’ to D=’minimal, inadequate’ care). Descriptors for 4 (7%) standards describing SPS were developed through an e-Delphi process by IBD UK with EPharmIBD representation. Royal Pharmaceutical Society standards and SPS feedback were used to define descriptors for leadership, medicines expert role and MDT working. All UK IBD services were asked to complete the self-assessment between Oct 2019 and Jan 2020. Results 10,222 IBD patients complete the IBD Patient Survey 166 (72%) paediatric and adult IBD services took part across the UK. MDT Standard 46% (n=81/166) of all IBD Services have pharmacist input to the IBD MDT, but only 13% of all adult services (n = 18/134) met or exceeded the standard for 0.6 WTE EPharmIBD /250,000 population. Leadership role 76% (n=98/129) of services with IBD leadership team work with a pharmacist of which 48% (n=47/98) work with an EPharmIBD on the annual formulary review. Of these teams 66% (n=31/47) work with an EPharmIBD on annual protocol/policy review, with actions and outcomes, actively develop pharmacy services within IBD. Medicines expert role Ward pharmacists in 95% (n=157/166) of IBD Services have access to an advanced generalist pharmacist for advice. Of these services 54% (n=84/157) are supported by an EPharmIBD but in only 41% (n=34/84) of these patients and ward pharmacists have access to an EPharmIBD on admission and during their stay for medication review, optimisation and personalised consultation. Conclusion Benchmarking shows a low level of pharmacy IBD expertise in the UK with a minority of services, ward pharmacists and patients having access to an EPharmIBD. Few IBD leadership teams work with an EPharmIBD and a small number of services have adequate EPharmIBDs commissioned. In contrast where services report meeting the IBD Standards criteria for the number of EPharmIBDs, patients responding to the Patient Survey were more likely to be given appropriate information about potential treatments to help them make informed decisions. This highlights the high need for advanced competencies and prioritisation of service commissioning in IBD.The pharmacy profession needs to respond urgently to this challenge to ensure high quality pharmaceutical care for IBD patients.

scholarly journals P129 IBD care in the UK: A comprehensive, novel service assessment with feedback from 10,222 patients and 166 NHS organisations to inform a vision for quality improvement

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S220-S221
Author(s):  
R Wakeman ◽  
R Ainley ◽  
I D Arnott ◽  
K J Barrett ◽  
G Bell ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Information Provision ◽  
Patient Survey ◽  
Service Performance ◽  
Care Plan ◽  
Self Assessment ◽  
Recommendations For Action ◽  
Comprehensive Picture ◽  
The Uk

Abstract Background The IBD Benchmarking Tool, comprising an online Service Self-Assessment and Patient Survey, has provided a unique and comprehensive picture of Inflammatory Bowel Disease (IBD) care across the UK. The aim was to evaluate current local service performance to facilitate future quality improvement. Methods The IBD Patient Survey (PS) ran from July to November 2019 and the Service Self-Assessment (SSA) from October 2019 to January 2020. Detailed views were collected of the quality of IBD care from patient and clinician perspectives, measured against the UK IBD Standards 2019.1 The IBD UK National Report will be published in April 2021. Results 10,222 patients completed the PS. 89% (9,100/10,222) had found it hard to cope with having Crohn’s or Colitis over the previous year. 72% (6,954/9,640) rated the quality of their care as excellent, very good or good and 28% (2,686/9,640) rated the quality of their care as fair or poor. The top three factors that predicted how highly people with IBD rated their quality of care were: feeling supported by a team of specialists; having regular reviews; and discussing wider life goals and priorities, as part of planning their care. 26% (535/2,089) had waited more than a year for their diagnosis. 41% (849/2,087) had visited Accident & Emergency at least once before being diagnosed. 32% (656/2,057) were not offered any information about their condition when diagnosed. 91% (8,284/9,099) did not have a personalised care plan. Over the previous 12 months, 70% (6,732/9,574) had one or more flares and 72% (1,622/2,250) of inpatient admissions were unplanned. A key finding from the SSA (166 centres: 134 adult, 32 paediatric) was that no adult IBD services reported meeting the IBD Standards’ recommendation for whole time equivalent (WTE) staffing across the IBD team. Where services reported meeting the WTE for IBD nurse specialists, patients were more likely to rate the quality of their care highly and to have regular clinical review of their Crohn’s or Colitis. Conclusion The results highlight four key areas for change: improvements in diagnosis and information provision; personalised care and support for self-management; faster access to specialist advice and treatment; and effective multidisciplinary team (MDT) working. The Report sets out recommendations for action in each of these areas. To our knowledge, this is the first time that healthcare professionals and patients have assessed care against a common set of standards. The IBD Benchmarking Tool provides location-matched service performance and patient experience as an exemplar for others to follow. Reference

scholarly journals Public governance, agility and pandemics: a case study of the UK response to COVID-19

2021 ◽  
pp. 002085232098340
Author(s):  
Paul Joyce
Keyword(s):  
Leadership Role ◽  
Public Confidence ◽  
Strategic Decisions ◽  
Public Governance ◽  
Local Initiative ◽  
Government Response ◽  
Local Resources ◽  
The Government ◽  
The One ◽  
The Uk

The UK government’s leaders initially believed that it was among the best-prepared governments for a pandemic. By June 2020, the outcome of the collision between the government’s initial confidence, on the one hand, and the aggressiveness and virulence of COVID-19, on the other, was evident. The UK had one of the worst COVID-19 mortality rates in the world. This article explores the UK government’s response to COVID-19 from a public administration and governance perspective. Using factual information and statistical data, it considers the government’s preparedness and strategic decisions, the delivery of the government response, and public confidence in the government. Points for practitioners Possible lessons for testing through application include: Use the precautionary principle to set planning assumptions in government strategies to create the possibility of government agility during a pandemic. Use central government’s leadership role to facilitate and enable local initiative and operational responses, as well as to take advantage of local resources and assets. Choose smart government responses that address tensions between the goal of saving lives and other government goals, and beware choices that are unsatisfactory compromises.

To bee or not to beet with neonicotinoids

2021 ◽  
Vol 23 (2) ◽  
pp. 103-109
Author(s):  
Lynda M. Warren
Keyword(s):  
Sugar Beet ◽  
Weather Conditions ◽  
The European Union ◽  
Environmental Standards ◽  
Economic Interests ◽  
Precautionary Approach ◽  
The United Kingdom ◽  
Commercial Sugar ◽  
The Uk ◽  
First Time

In January 2021 the UK government granted an application for authorisation to use thiamethoxam, a neonicotinoid pesticide, to protect commercial sugar beet crops from attack by viruses transmitted by aphids. This was the first time such an authorisation had been granted in the United Kingdom (UK) and there were concerns that it signalled a weakening of environmental standards now that the UK was no longer part of the European Union. In fact, similar authorisations had been granted by several European Member States in the last 2 years, despite the ban on the use of neonicotinoids introduced in 2018. Nevertheless, the reasons for granting the authorisation do suggest that the balance between adopting a precautionary approach to environmental protection and taking emergency action to protect economic interests may have shifted. It was acknowledged that the proposed mitigation to safeguard bees and other wildlife was not entirely satisfactory. In the end, due to unforeseen weather conditions it meant that the pesticide is not necessary, which in itself demonstrates that short-term emergency measures are unsuitable for dealing with the problem. If the sugar beet industry is to continue to prosper in the UK, it will need to be managed in a way that provides resistance to virus infection without the use of controversial chemicals.

TQM Self‐assessment in the UK

1994 ◽  
Vol 6 (4) ◽  
pp. 56-61 ◽  
Author(s):  
Mark Finn ◽  
Leslie J. Porter
Keyword(s):  
Self Assessment ◽  
The Uk

The duties of impartiality, disclosure, and confidentiality: lessons from a London-seated arbitration

2021 ◽  
Author(s):  
Samuel Yee Ching Leung ◽  
Alex Chun Hei Chan
Keyword(s):  
United Kingdom ◽  
Important Case ◽  
Careful Examination ◽  
International Arbitration ◽  
The United Kingdom ◽  
Key Concepts ◽  
The Uk ◽  
First Time

Abstract Halliburton Company v Chubb Bermuda Insurance Ltd (formerly known as Ace Bermuda Insurance Ltd [2020] UKSC 48 is an important case not only to the UK but also to the international arbitration community for several reasons: first, it examines indispensable duties in international arbitration and for the first time recognises and explicates upon the duty of disclosure at the highest court of the United Kingdom; secondly, it addresses and clarifies key concepts in international arbitration; thirdly, it confirms the objective nature of the test of justifiable doubts which has wider implications for other arbitral forums; fourthly, it illustrates how the duties of impartiality, disclosure, and confidentiality interact with and affect each other and how the key concepts should be applied to this interaction; and finally, it lays down useful guidance for arbitrators. For these reasons, this case deserves close and careful examination. This article aims to explain the significance of the aforesaid and suggests that, in addition to what has been addressed, further judicial explanations are warranted in what other aspects.

Defence Medical Services’ REBOA training course

2021 ◽  
pp. bmjmilitary-2021-001926
Author(s):  
Max E R Marsden ◽  
C Park ◽  
J Barratt ◽  
N Tai ◽  
P Rees
Keyword(s):  
Training Programme ◽  
Balloon Occlusion ◽  
Medical Services ◽  
Skill Retention ◽  
Training Course ◽  
Challenges And Opportunities ◽  
Haemorrhage Control ◽  
Surgical Teams ◽  
The Uk ◽  
First Time

Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) enables temporary haemorrhage control and physiological stabilisation. This article describes the bespoke Defence Medical Services (DMS) training package for effectively using REBOA. The article covers how the course was designed, how the key learning objectives are taught, participant feedback and the authors’ perceptions of future training challenges and opportunities. Since the inaugural training course in April 2019, the authors have delivered six courses, training over 100 clinicians. For the first time in the UK DMS, we designed and delivered a robust specialist endovascular training programme, with demonstrable, significant increases in confidence and competence. As a result of this course, the first DMS REBOA-equipped forward surgical teams deployed in June 2019. Looking to the future, there is a requirement to develop an assessment of skill retention and the potential need for revalidation.

Do we need medical leadership or medical engagement?

2015 ◽  
Vol 28 (3) ◽  
pp. 173-184 ◽  
Author(s):  
Peter Spurgeon ◽  
Paul Long ◽  
John Clark ◽  
Frank Daly
Keyword(s):  
Care Quality ◽  
Current Evidence ◽  
Organisational Performance ◽  
Content Type ◽  
Care Quality Commission ◽  
The Uk ◽  
Medical Leadership ◽  
First Time ◽  
Practical Implications ◽  
A Current

Purpose – The purpose of this paper is to address issues of medical leadership within health systems and to clarify the associated conceptual issues, for example, leadership versus management and medical versus clinical leadership. However, its principle contribution is to raise the issue of the purpose or outcome of medical leadership, and, in this respect, it argues that it is to promote medical engagement. Design/methodology/approach – The approach is to provide evidence, both from the literature and empirically, to suggest that enhanced medical engagement leads to improved organisational performance and, in doing so, to review the associated concepts. Findings – Building on current evidence from the UK and Australia, the authors strengthen previous findings that effective medical leadership underpins the effective organisational performance. Research limitations/implications – There is a current imbalance between the size of the databases on medical engagement between the UK (very large) and Australia (small but developing). Practical implications – The authors aim to equip medical leaders with the appropriate skill set to promote and enhance greater medical engagement. The focus of leaders in organisations should be in creating a culture that fosters and supports medical engagement. Social implications – This paper provides empowerment of medical professionals to have greater influence in the running of the organisation in which they deliver care. Originality/value – The paper contains, for the first time, linked performance data from the Care Quality Commission in the UK and from Australia with the new set of medical engagement findings.

scholarly journals Quantifying the prevalence of assortative mating in a human population

2019 ◽  
Author(s):  
Klaus Jaffe
Keyword(s):  
Assortative Mating ◽  
Genetic Relatedness ◽  
Random Mating ◽  
Human Populations ◽  
Genetic Composition ◽  
Genetic Studies ◽  
Maintenance Of Sex ◽  
Animal Populations ◽  
The Uk ◽  
First Time

AbstractFor the first time, empirical evidence allowed to construct the frequency distribution of a genetic relatedness index between the parents of about half a million individuals living in the UK. The results suggest that over 30% of the population is the product of parents mating assortatively. The rest is probably the offspring of parents matching the genetic composition of their partners randomly. High degrees of genetic relatedness between parents, i.e. extreme inbreeding, was rare. This result shows that assortative mating is likely to be highly prevalent in human populations. Thus, assuming only random mating among humans, as widely done in ecology and population genetic studies, is not an appropriate approximation to reality. The existence of assortative mating has to be accounted for. The results suggest the conclusion that both, assortative and random mating, are evolutionary stable strategies. This improved insight allows to better understand complex evolutionary phenomena, such as the emergence and maintenance of sex, the speed of adaptation, runaway adaptation, maintenance of cooperation, and many others in human and animal populations.

scholarly journals Social justice, diversity and leadership

2018 ◽  
Vol 6 (1) ◽  
pp. 111-125
Author(s):  
Rachel Tribe ◽  
Deanne Bell
Keyword(s):  
Social Justice ◽  
Psychological Distress ◽  
Social Inequalities ◽  
Leadership Role ◽  
Service Users ◽  
Inclusive Practice ◽  
The Uk ◽  
Discriminatory Practice ◽  
Counselling Psychology

This paper will discuss what is meant by social justice in relation to counselling psychology specifically and psychology generally within the UK, as well as briefly considering social justice in the wider context. It will discuss if there is a role for counselling psychologists and psychology in promoting social justice through challenging social inequalities and promoting anti-discriminatory practice. It will review the role of counselling psychology in potentially foregrounding inclusive practice which celebrates diversity and provides leadership on this issue. It will then discuss the possible skills and theories psychologists have at their disposal to undertake work which promotes social justice and equality and takes into consideration human rights. It will provide a range of examples of where psychologists have undertaken social justice work using their training and skills and provided leadership in a range of contexts outside the consulting room. The paper will argue that taking an active leadership role to encourage the promotion of social justice is at the centre of our work as a profession, a division and as individual counselling psychologists. Counselling psychology has traditionally put individual therapeutic work at the centre of training and whilst this work is important, this paper will argue that there are numerous other roles and tasks which psychologists could usefully be involved with. These would help ensure that the requirements of service users/experts by experience (EBE) are met and that the context of their lives are foregrounded at the micro (individual) as well as the macro (contextual) level. This may require counselling psychologists to take a wider holistic or systemic perspective and understanding, advocating or intervening in relation to the structural and contextual issues which may give rise to psychological distress, and thereby promote social justice.

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