Military healthcare challenges: deployed Role 1 healthcare delivery on Operation TRENTON. A personal view

2021 ◽  
pp. bmjmilitary-2020-001647
Author(s):  
Gregory Dean Smith ◽  
A Wainscot
Keyword(s):  
Healthcare Delivery ◽  
Careful Consideration ◽  
Musculoskeletal Injuries ◽  
Construction Work ◽  
Personal View ◽  
Primary Care Nurses ◽  
Military Healthcare ◽  
Common Illnesses ◽  
The Uk ◽  
Care Ward

Op TRENTON is the UK response to support the United Nations Mission in South Sudan. This article documents a 5-month Engineering deployment after the UK Hospital had ended their mission and some of the medical challenges encountered. During this time, there were 2104 individual patient interactions recorded, with the main common illnesses being musculoskeletal injuries, gastrointestinal infection and dermatology. Given the nature of the tour, there were no battlefield-related injuries and trauma was limited to a handful of minor cases related to physical training or construction work. Recommendations for future deployments would include careful consideration of the required clinical skillsets, particularly identifying individuals who can undertake multiple secondary functions such as Primary Care Nurses, capable of patient care, ward management and Healthcare Governance.

scholarly journals ‘Not just a piece of skin in front of you’—a qualitative exploration of the experiences of adolescents with eczema and psoriasis with healthcare professionals

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e041108
Author(s):  
Isabella Joy de Vere Hunt ◽  
Abigail McNiven ◽  
Amanda Roberts ◽  
Himesh Parmar ◽  
Tess McPherson
Keyword(s):  
Young People ◽  
Skin Disease ◽  
Healthcare Professionals ◽  
Healthcare Delivery ◽  
Healthcare Providers ◽  
Secondary Analysis ◽  
Emotional Impact ◽  
Skin Conditions ◽  
The Uk ◽  
Qualitative Exploration

BackgroundThere is little qualitative research in the UK focussing on adolescents’ experience of their healthcare providers, and inflammatory skin conditions are a common heath problem in adolescence.AimTo explore the experiences of adolescents with eczema and psoriasis with healthcare professionals, and to distil the participants’ key messages for their healthcare providers.DesignThis is a secondary thematic analysis of interviews with adolescents with eczema or psoriasis.ParticipantsThere were a total of 41 text transcripts of interviews with young people with eczema or psoriasis who had given permission for secondary analysis; 23 of the participants had eczema, and 18 psoriasis. Participants were living in the UK at time of interview, and aged 15–24 years old.ResultsWe have distilled the following key messages from young people with eczema and psoriasis for healthcare providers: (1) address the emotional impact; (2) give more information, with the subtheme and (3) appreciate patient research. We identified the following eczema-specific themes: (ECZ-4) ‘It’s not taken seriously’; (ECZ-5) offer choice in treatment and (ECZ-6) lack of structure/conflicting advice. Two psoriasis-specific themes were identified: (PSO-4) feeling dehumanised/treat me as a person; and (PSO-5) think about how treatments will affect daily life.ConclusionThis qualitative data analysis highlights the need for greater recognition of the emotional impact of skin disease in adolescence, and for more comprehensive provision of information about the conditions. We call for greater sensitivity and flexibility in our approach to adolescents with skin disease, with important implications for healthcare delivery to this group.

A UK Operational Practitioner View – some Challenges of Health Informatics are Trans-national

2002 ◽  
Vol 41 (01) ◽  
pp. 55-59
Author(s):  
J. Roberts
Keyword(s):  
Health Informatics ◽  
Common Ground ◽  
Healthcare Delivery ◽  
Different Dimensions ◽  
The Uk

Summary Objective: To explore the relevance of catalysts and inhibitors to the achievement of an inclusive identity for health informatics; particularly from an operational perspective in the UK. Methods: Consideration of the different dimensions of health informatics, as practised in a working healthcare delivery environment; specifically commenting on the synergy and disjunctions with academic and scientific practitioners in the same domain. Results and Conclusions: There appear to be common ground and internationally applicable issues across the domain. Recognising the differences and similarities will contribute towards harmonisation of the field and its ultimate elevation to a mature discipline and profession.

Trust, efficacy and ethicacy when testing prisoners for COVID-19

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Steve Lambert ◽  
Dean Wilkinson
Keyword(s):  
Large Scale ◽  
Current System ◽  
Epidemiological Studies ◽  
Careful Consideration ◽  
Power Relationships ◽  
England And Wales ◽  
Content Type ◽  
Large Scale Testing ◽  
The Uk ◽  
The Impact

Purpose The outbreak of the severe acute respiratory syndrome coronavirus 2 virus and subsequent COVID-19 illness has had a major impact on all levels of society internationally. The extent of the impact of COVID-19 on prison staff and prisoners in England and Wales is unknown. Testing for COVID-19 both asymptomatic and symptomatic, as well as for antibodies, to date, has been minimal. The purpose of this paper is to explore the widespread testing of COVID-19 in prisons poses philosophical and ethical questions around trust, efficacy and ethicacy. Design/methodology/approach This paper is both descriptive, providing an overview of the widespread testing of COVID-19 in prisoners in England and Wales, and conceptual in that it discusses and argues the issues associated with large-scale testing. This paper provides a discussion, using comparative studies, of the issues associated with large-scale testing of prisoners across the prison estate in England and Wales (120 prisons). The issues identified in this paper are contextualised through the lens of COVID-19, but they are equally transferrable to epidemiological studies of any pandemic. Given the prevalence of COVID-19 globally and the lack of information about its spread in prisons, at the time of writing this paper, there is a programme of asymptomatic testing of prisoners. However, there remains a paucity of data on the spread of COVID-19 in prisons because of the progress with the ongoing testing programme. Findings The authors argue that the widespread testing of prisoners requires careful consideration of the details regarding who is included in testing, how consent is gained and how tests are administered. This paper outlines and argues the importance of considering the complex nuance of power relationships within the prison system, among prisoner officers, medical staff and prisoners and the detrimental consequences. Practical implications The widespread testing of COVID-19 presents ethical and practical challenges. Careful planning is required when considering the ethics of who should be included in COVID-19 testing, how consent will be gained, who and how tests will be administered and very practical challenges around the recording and assigning of COVID-19 test kits inside the prison. The current system for the general population requires scanning of barcodes and registration using a mobile number; these facilities are not permitted inside a prison. Originality/value This paper looks at the issues associated with mass testing of prisoners for COVID-19. According to the authors’ knowledge, there has not been any research that looks at the issues of testing either in the UK or internationally. The literature available details countries’ responses to the pandemic rather and scientific papers on the development of vaccines. Therefore, this paper is an original review of some of the practicalities that need to be addressed to ensure that testing can be as successful as possible.

scholarly journals Selenium supplementation: does soil supplementation help and why?

2003 ◽  
Vol 62 (2) ◽  
pp. 393-397 ◽  
Author(s):  
John R. Arthur
Keyword(s):  
Effective Means ◽  
Careful Consideration ◽  
Selenium Supplementation ◽  
Physiological Changes ◽  
Disease Treatment ◽  
Hormone Synthesis ◽  
Metabolic Functions ◽  
Wide Range ◽  
The Uk ◽  
Se Status

There are now concerns that dietary Se intake is inadequate for the population in the UK and parts of Europe. Many different methods can be proposed to deal with this problem. Experience from Finland suggests that the addition of Se to fertiliser is a safe and effective means of increasing the intake of the micronutrient in the human population. However, careful consideration needs to be given to the potential consequences of increasing Se intake. It is important to understand the biochemical and physiological changes that may occur with any increase in Se intake within the UK population. Se is an essential component of at least twenty functional proteins within mammals. These proteins are essential for a range of metabolic functions, including antioxidant activity, thyroid hormone synthesis and immune function. Thus, any increase in Se intake has the potential to influence in a wide range of factors that may impinge on the incidence of chronic disease. Treatment of soil with Se-supplemented fertiliser will certainly increase total Se in food products derived from areas where this treatment is in place. Consumption of such foods will increase Se status in many populations where the existing intake does not meet requirements. If the increases in Se intake are not toxic the overall consequences have the potential to be beneficial.

The Need for Leadership and Vision in Dentistry. A Personal View

2008 ◽  
Vol os15 (3) ◽  
pp. 113-119 ◽  
Author(s):  
Vernon P Holt
Keyword(s):  
Personal Development ◽  
Leadership Skills ◽  
Optimal Level ◽  
Personal View ◽  
Opting Out ◽  
The United Kingdom ◽  
Dental Practitioners ◽  
Dental Profession ◽  
New Vision ◽  
The Uk

This paper considers how dentistry has developed in the United Kingdom (UK) over the last 60 years and concludes that dentists have failed to be proactive and to shape the systems for the delivery of an optimal level of care to the population. It suggests that there is a need for far better leadership and for dentists, as individuals and as a profession, to rediscover the sense of vision that they once had and to shape their destinies, rather than accepting the current situation. The author goes on to explain how this might be done. Since the inception of the National Health Service (NHS), the dental profession in the UK has, to a large extent, been dominated by the politics of the NHS, by changing fee structures and contracts, by reports from the Review Body on Doctors’ and Dentists’ Remuneration (DDRB), and by strategies adopted by successive governments, especially during the last two decades. These strategies have resulted in cohorts of disillusioned dental practitioners reducing their commitment to, or opting out of, NHS contracts and committing themselves, to a greater or lesser extent, to private practice.1 It is now over three years since, for the first time, the proportion of dentistry provided under private contact in the UK, as measured by gross fees, exceeded that provided under NHS contract. The profession has shown a remarkable lack of imagination in organising itself to provide the best kind of care for patients. Instead of being proactive and visionary, it has allowed itself to become a political football. This has led to the progressive deskilling of many practitioners, and a manifest failure to secure the long-term oral health of patients. This paper considers how the situation could be improved and looks at four aspects, which are: 1. 21st century dentistry: state of the art versus reality? The contrast between what is clinically possible and what the profession currently delivers. 2. What are we here for? The need for a new vision for dentistry, the profession and the future, and the need for a new sense of mission. 3. A responsibility for the profession. The responsibility of the profession for providing patients (and funding bodies) with advice. 4. Leading the way: a new-look personal development plan. The personal development needs of dentists, with much more emphasis on interpersonal and leadership skills.

Discrete Event Simulation and Real Time Locating Systems

2012 ◽  
Vol 4 (4) ◽  
pp. 16-28
Author(s):  
T. Eugene Day ◽  
Ajit N. Babu ◽  
Steven M. Kymes ◽  
Nathan Ravi
Keyword(s):  
Health Care ◽  
Real Time ◽  
Discrete Event Simulation ◽  
Medical Center ◽  
Discrete Event ◽  
Healthcare Delivery ◽  
The United States ◽  
Careful Consideration ◽  
Health Administration ◽  
Event Simulation

The Veteran’s Health Administration (VHA) is the largest integrated health care system in the United States, forming the arm of the Department of Veterans Affairs (VA) that delivers medical services. From a troubled past, the VHA today is regarded as a model for healthcare transformation. The VA has evaluated and adopted a variety of cutting-edge approaches to foster greater efficiency and effectiveness in healthcare delivery as part of their systems redesign initiative. This paper discusses the integration of two health care analysis platforms: Discrete Event Simulation (DES), and Real Time Locating systems (RTLS) presenting examples of work done at the St. Louis VA Medical Center. Use of RTLS data for generation and validation of DES models is detailed, with prescriptive discussion of methodologies. The authors recommend the careful consideration of these relatively new approaches which show promise in assisting systems redesign initiatives across the health care spectrum.

Survey of senior frontline clinicians regarding the quality of information technology across the UK

2020 ◽  
Vol 26 (9) ◽  
pp. 220-226
Author(s):  
Sunny Deo
Keyword(s):  
Information Technology ◽  
Service Quality ◽  
Healthcare Delivery ◽  
It Services ◽  
Quality Of Information ◽  
It Service ◽  
Increased Risk ◽  
Questionnaire Method ◽  
The Uk

Background/Aims The quality of information technology (IT) services is key to effective healthcare delivery. However, the high aspirations of health ministers for IT services in hospitals may not be aligned with clinicians' perceptions. This study aimed to assess frontline clinicians' perceptions of the quality of IT services in their institutions. Methods The British Orthopaedics Directors Society online forum was used to invite a group of trauma and orthopaedic clinical leads from a range of hospitals to complete a short questionnaire regarding their perceptions of IT service quality in their practice. Results Negative perceptions of IT service quality were found to be common, with 45% of respondents rating their trusts' overall IT quality as poor or very poor. Of these, 13% deemed their trust's IT service quality to be so poor as to put patients at increased risk. Wide disparities were also reported between respondents' ratings of IT infrastructure quality and institutional responsiveness to concerns. Conclusions This small initial evaluation highlights concerning variations in clinicians' perceptions of IT service quality across different trusts. It also suggests the need for further, more detailed assessment and monitoring of IT quality improvement, for which the same questionnaire method may be useful.

scholarly journals Nurse roles in antimicrobial stewardship: lessons from public sectors models of acute care service delivery in the United Kingdom

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Enrique Castro-Sánchez ◽  
Mark Gilchrist ◽  
Raheelah Ahmad ◽  
Molly Courtenay ◽  
Jo Bosanquet ◽  
...  
Keyword(s):  
Public Sector ◽  
Antimicrobial Stewardship ◽  
Health Care Services ◽  
Economies Of Scale ◽  
Care Service ◽  
Careful Consideration ◽  
Context Sensitive ◽  
Inappropriate Use ◽  
Global Threat ◽  
The Uk

Abstract Background Health care services must engage all relevant healthcare workers, including nurses, in optimal antimicrobial use to address the global threat of drug-resistant infections. Reflecting upon the variety of antimicrobial stewardship (AMS) nursing models already implemented in the UK could facilitate policymaking and decisions in other settings about context-sensitive, pragmatic nurse roles. Methods We describe purposefully selected cases drawn from the UK network of public sector nurses in AMS exploring their characteristics, influence, relations with clinical and financial structures, and role content. Results AMS nursing has been deployed in the UK within ‘vertical’, ‘horizontal’ or ‘hybrid’ models. The ‘vertical’ model refers to a novel, often unique consultant-type role ideally suited to transform organisational practice by legitimising nurse participation in antimicrobial decisions. Such organisational improvements may not be straightforward, though, due to scalability issues. The ‘horizontal’ model can foster coordinated efforts to increase optimal AMS behaviours in all nurses around a narrative of patient safety and quality. Such model may be unable to address tensions between the required institutional response to sepsis and the inappropriate use of antibiotics. Finally, the ‘hybrid’ model would increase AMS responsibilities for all nurses whilst allocating some expanded AMS skills to existing teams of specialists such as sepsis or vascular access nurses. This model can generate economies of scale, yet it may be threatened by a lack of clarity about a nurse-relevant vision. Conclusions A variety of models articulating the participation of nurses in antimicrobial stewardship efforts have already been implemented in public sector organisations in the UK. The strengths and weaknesses of each model need considering before implementation in other settings and healthcare systems, including precise metrics of success and careful consideration of context-sensitive, resource dependent and pragmatic solutions.

Introducing physician associates

2017 ◽  
Vol 10 (12) ◽  
pp. 746-753
Author(s):  
Susan Denton ◽  
Krishni Manorajan ◽  
Pahim Miah
Keyword(s):  
Medical Profession ◽  
Healthcare Delivery ◽  
Health Needs ◽  
Delivery Of Healthcare ◽  
The Public ◽  
Health Delivery ◽  
Care Models ◽  
The Uk ◽  
Multi Disciplinary Team

Physician associate (PA) is a new profession that has the potential to change healthcare delivery in the UK. However, it is poorly understood by both the medical profession and the public. Evolving health needs, patient expectations, treatment and delivery of healthcare have led to proposed new care models that require a different skill mix to underpin health delivery. We explore the role of PAs, who as part of a multi-disciplinary team while being supervised by doctors, can help support a sustainable future for primary care.

Working with other Partners — the Retail Sector

2007 ◽  
Vol 35 (5) ◽  
pp. 521-524
Author(s):  
Petrina Fridd
Keyword(s):  
Careful Consideration ◽  
Retail Sector ◽  
Consumer Knowledge ◽  
The European Union ◽  
Animal Testing ◽  
Pressure Groups ◽  
Positive Action ◽  
Great Pressure ◽  
Alternative Testing ◽  
The Uk

Animal testing to demonstrate the safety of cosmetic and toiletries has been used for many years. However, such testing, now viewed by many consumers as an emotive issue, has been banned within the UK, and is severely restricted in the European Union. Consumer knowledge and understanding have been challenged by the use of focus group studies, which showed that consumers were often confused and potentially misled by claims on labels and in leaflets. Despite the fact that some pressure groups had taken positive action, even holding store demonstrations, in attempts to stop such testing or claims, there was still a legal requirement to demonstrate the safety of products, and this involved the use of animal testing. Nevertheless, there was great pressure to move away from animal testing, clarify marketing and pack claims, and provide general transparency to the consumer. Therefore, the decision was taken to actively seek out and work with organisations which were working toward the validation of alternative testing. A number of potential organisations were approached and, after careful consideration of their respective aims and aspirations, it was decided that, for the retailer in question, FRAME was the most appropriate organisation with which to work.

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