scholarly journals The future of rehabilitation in the United Kingdom National Health Service: Using the COVID-19 crisis to promote change, increasing efficiency and effectiveness

2020 ◽  
pp. 026921552097114
Author(s):  
Derick T Wade
Keyword(s):  
Healthcare Providers ◽  
Organisational Change ◽  
Well Being ◽  
Healthcare Services ◽  
Rehabilitation Services ◽  
Complex Needs ◽  
Cord Injury ◽  
Palliative Care Services ◽  
The Uk ◽  
Rehabilitation Needs

The problem: Rehabilitation services in the UK are inadequate, with insufficient capacity or flexibility to meet the needs of patients after Covid-19. History: Rehabilitation developed in a piecemeal way, focused on specific problems: spinal cord injury, burns, polio, stroke, back pain, equipment and adaptations etc. Rehabilitation is also provided using other names (e.g. intermediate care). Patients with complex needs do not fit easily within this system. System failure: After Covid-19, patients have problems that cross existing condition-specific and/or treatment-specific services. Covid-19 has exposed the lack of any coherent organisational principle underlying development or commissioning of rehabilitation services. Consequently, in order to have their needs met, patients either have to engage with two or more separate services or they receive good management for some problems and sub-optimal management for other problems. The goals: The multitude of small specific services need to coalesce into an integrated service able to meet all the needs of any patient referred. Second, rehabilitation needs to be fully integrated into all healthcare services. A solution: The purpose of healthcare is to ‘ improve our health and well-being . . . to stay as well as we can to the end of our lives’. (NHS constitution) All healthcare services need to consider patients holistically, giving equal attention to disease, disability, and distress. Rehabilitation, acute care, mental health and palliative care services need to work in parallel to achieve this purpose. Healthcare providers, supported by commissioners and rehabilitation experts, could achieve structural and organisational change, meeting the needs of patients.

scholarly journals Socio-Sexual Experiences and Access to Healthcare Among Informal PrEP Users in the Netherlands

2020 ◽  
Author(s):  
Mart van Dijk ◽  
John B. F. de Wit ◽  
Rebecca Kamps ◽  
Thomas E. Guadamuz ◽  
Joel E. Martinez ◽  
...  
Keyword(s):  
Sexual Behavior ◽  
Qualitative Study ◽  
The Netherlands ◽  
Healthcare Providers ◽  
Well Being ◽  
Healthcare Services ◽  
Interpretive Description ◽  
Sex Partners ◽  
Sex With Men ◽  
Incorrect Information

AbstractThe aim of this qualitative study was to explore the experiences of informal PrEP users regarding access to PrEP and PrEP-related healthcare, community responses, sexual behavior and well-being. We interviewed 30 men who have sex with men (MSM) in semi-structured online interviews between March and August 2018. Interviews were analyzed using interpretive description. Informal PrEP users were well informed about the use of PrEP, but sometimes did not make use of renal testing. Participants reported a lack of PrEP knowledge among healthcare providers, which limited their access to PrEP and put them at risk, as they received incorrect information. Although some participants reported negative reactions from potential sex partners, most received positive reactions and were sometimes seen as more desirable sex partners. PrEP healthcare services should not only be accessible to formal PrEP users, but also to PrEP users who procure PrEP informally.

scholarly journals Implementation of Primary Healthcare Services in Community Health Stations in Highly Urbanized City

2021 ◽  
Vol 4 (3) ◽  
pp. 123-132
Author(s):  
Hanna B. Gella ◽  
Merlita V. Caelian
Keyword(s):  
Community Health ◽  
Primary Healthcare ◽  
Healthcare Providers ◽  
Well Being ◽  
Healthcare Services ◽  
Health Improvement ◽  
Patient Centeredness ◽  
Sustainable Development Goal ◽  
The Sustainable Development ◽  
Child Healthcare

Primary healthcare is integral to the Sustainable Development Goal (SDG) of ensuring healthy lives and promoting well-being.  A descriptive study assessed the implementation of primary healthcare services in community health stations through a researcher-made questionnaire among healthcare providers and beneficiaries of 30 community health stations.  The results revealed that, as a whole, the implementation of primary healthcare services in community health stations is great, with maternal and child healthcare implemented to a very great extent while the treatment of non-communicable diseases to a great extent only.  The major challenges encountered are the lack of medical drugs, supplies and equipment, and medical professionals.  Primary healthcare has made contributions to the community's health improvement; however, challenges imply that the quality and efficiency of the services need improvement. The study contributed to new knowledge on implementing healthcare at the lowest level of government, emphasizing patient-centeredness.

scholarly journals Instruments of health and harm: how the procurement of healthcare goods contributes to global health inequality

2020 ◽  
pp. medethics-2020-106286
Author(s):  
Mei L Trueba ◽  
Mahmood F Bhutta ◽  
Arianne Shahvisi
Keyword(s):  
Occupational Health ◽  
Health Risks ◽  
Healthcare Providers ◽  
Well Being ◽  
Ethical Analysis ◽  
Surgical Instruments ◽  
The United Kingdom ◽  
The Uk ◽  
Health Rights ◽  
Health And Well Being

Many healthcare goods, such as surgical instruments, textiles and gloves, are manufactured in unregulated factories and sweatshops where, amongst other labour rights violations, workers are subject to considerable occupational health risks. In this paper we undertake an ethical analysis of the supply of sweatshop-produced surgical goods to healthcare providers, with a specific focus on the National Health Service of the United Kingdom. We contend that while labour abuses and occupational health deficiencies are morally unacceptable in the production of any commodity, an additional wrong is incurred when the health of certain populations is secured in ways that endanger the health and well-being of people working and living elsewhere. While some measures have been taken to better regulate the supply chain to healthcare providers in the UK, further action is needed to ensure that surgical goods are sourced from suppliers who protect the labour and occupational health rights of their workers.

scholarly journals What do parents of children with dysphagia think about their MDT? A qualitative study

BMJ Open ◽  
2014 ◽  
Vol 4 (10) ◽  
pp. e005934 ◽  
Author(s):  
Emma Cowpe (Jebson) ◽  
Ben Hanson ◽  
Christina H Smith
Keyword(s):  
Negative Impact ◽  
Healthcare Providers ◽  
Well Being ◽  
Symptomatic Treatment ◽  
Phenomenological Approach ◽  
Community Settings ◽  
Facilitators And Barriers ◽  
The Uk ◽  
Barriers To Collaboration

ObjectivesTo seek the experiences and perspectives of parents caring for children with dysphagia, with emphasis on their experiences of working within their child's multidisciplinary team (MDT).SettingThis research was completed in community settings, within families’ homes across the UK.Participants14 families self-selected to participate in the study. Criteria specified that participants must care for a child under the age of 18 and to decrease ambiguity the term ‘diagnosis of dysphagia’ was defined as the need for modified (thickened) fluids. Exclusion criteria: caring for an adult over the age of 18; diet and fluid modifications for reasons other than dysphagia (eg, for symptomatic treatment of gastro-oesophageal reflux disease. Participants were interviewed within their homes using a semistructured questionnaire and data was analysed using a descriptive phenomenological approach through use of thematic coding and constant comparison. Themes and relationships were inductively generated from the data.ResultsParticipants universally expressed a desire to be involved with their child's MDT; this study identified the following facilitators and barriers to collaboration: accessing services, professional knowledge and professional skillset. Participants described three means of responding to these barriers: reacting emotionally, seeking solutions and making decisions.ConclusionsThis study recorded in-depth reports of participants’ experiences of working with healthcare providers. Despite government-driven efforts towards person-centred healthcare and social care, participants shared accounts of times when this has not occurred, describing a negative impact on the well-being and quality of life of their child and family.

scholarly journals Mental health rehabilitation services in the UK in 2007

2009 ◽  
Vol 33 (6) ◽  
pp. 215-218 ◽  
Author(s):  
Debbie Mountain ◽  
Helen Killaspy ◽  
Frank Holloway
Keyword(s):  
Service Provision ◽  
Rapid Change ◽  
Community Services ◽  
Rehabilitation Services ◽  
Clinical Implications ◽  
Complex Needs ◽  
The Past ◽  
Health Rehabilitation ◽  
Mental Health Rehabilitation ◽  
The Uk

Aims and MethodA survey of UK consultants in rehabilitation psychiatry was carried out to investigate current service provision and changes over the past 3 years.ResultsMost services had undergone multiple changes, with an overall reduction in over half and an overall expansion in a minority. the proportion with low secure provision had doubled. Around a third reported reinvestment of rehabilitation resources into other specialist in-patient and community services.Clinical ImplicationsRehabilitation services are undergoing rapid change with diversion of resources into services that may lack rehabilitation expertise. This risks an increase in independent sector referrals for in-patient rehabilitation for those with complex needs. Expansion of community services should be balanced against the need for local in-patient rehabilitation services.

scholarly journals Balancing COVID-19 preparedness and ‘business as usual’ in hospitals: lessons from executives in China, Norway and the UK

BMJ Leader ◽  
2020 ◽  
pp. leader-2020-000314
Author(s):  
Umar Ikram ◽  
Hui Ren ◽  
Laura Shields-Zeeman ◽  
Jan Frich ◽  
Daniel Northam Jones ◽  
...  
Keyword(s):  
Healthcare Delivery ◽  
Organisational Change ◽  
Well Being ◽  
Frontline Staff ◽  
Leadership Challenges ◽  
Hospital Executives ◽  
Hospital Systems ◽  
The Uk ◽  
Business As Usual ◽  
Dual Responsibilities

BackgroundDuring the first wave of COVID-19 pandemic, hospitals were forced to cancel or postpone non-COVID-19 care. With new outbreaks emerging, hospitals are now figuring out how to balance preparedness for future COVID-19 waves with their elective and regular services. This report discusses how four hospital systems deal with these dual responsibilities in China, Norway and the UK.ReflectionsBased on the experiences and combined reflections of hospital executives, we have formulated five strategic and leadership lessons for hospitals as they manage these dual responsibilities. (1) Redesign organisation to separate COVID-19 and non-COVID-19 services both within and across hospitals. (2) Expand virtual care strategies to improve access. (3) Use data-driven models to allocate resources across COVID-19 and non-COVID-19 units. (4) Invest in programmes to promote frontline staff well-being. (5) Secure financial support to continue to deliver on the dual responsibilities.ConclusionThe COVID-19 pandemic gives rise to leadership challenges that have fuelled organisational change and new approaches to healthcare delivery. Leading hospitals during the pandemic is a balancing act—providing care for both patients with COVID-19 and non-COVID-19, while at the same time preparing for the next waves of the pandemic.

scholarly journals An evaluation of the provision of oncology rehabilitation services via telemedicine using a participatory design approach

2021 ◽  
Author(s):  
Grainne Brady ◽  
Kate Ashforth ◽  
Siobhan Cowan-Dickie ◽  
Sarah Dewhurst ◽  
Natalie Harris ◽  
...  
Keyword(s):  
Participatory Design ◽  
Healthcare Services ◽  
Patient Choice ◽  
Design Approach ◽  
Rehabilitation Services ◽  
Complex Needs ◽  
Cancer Centre ◽  
Staff Members ◽  
Patient Interviews ◽  
Effective Delivery

Abstract Background The COVID-19 pandemic has fundamentally impacted the delivery of healthcare services globally. In line with UK government guidelines on social distancing, the use of telemedicine was implemented to facilitate the ongoing provision of cancer rehabilitation. Purpose We sought to evaluate and co-design telemedicine services to meet the complex needs of our patients and carers at a tertiary cancer centre. Methods Experience-based co-design methodology was adapted to include virtual methods. Staff members (n = 12) and patients (n = 11) who had delivered or received therapies services at our UK cancer centre since March 2020 were recruited to take part in one-to-one virtual interviews. Patient interviews were video recorded, analysed and edited to a 30-min “trigger film”. Patient and staff virtual events were undertaken thereafter. A joint virtual patient and staff event occurred. Staff and patients watched the trigger film and as partners, agreed areas for change and developed groups for service co-design. Results Positive aspects regarding telemedicine provision were highlighted including reduced financial and time burden on patients, and increased flexibility for both staff and patients. The key concerns included digital exclusion, safety, communication and patient choice. Four co-design groups have been established to enact changes in these priority areas. Conclusion Using a participatory design approach, we have worked in partnership with patients and staff to ensure the safe, acceptable and effective delivery of rehabilitation services with integrated telemedicine.

Accessing general health services

2018 ◽  
pp. 347-416
Author(s):  
Owen Barr ◽  
Bob Gates
Keyword(s):  
Mental Health ◽  
Palliative Care ◽  
Intellectual Disabilities ◽  
Well Being ◽  
Healthcare Services ◽  
Practice Nurses ◽  
Care Services ◽  
Palliative Care Services ◽  
People With Intellectual Disabilities ◽  
Community Mental Health Nurses

The knowledge of practical-focused and applied information within this chapter builds on the underpinning information in Chapter 5 relating to physical health and well-being. This provides essential information to nurses for people with intellectual disabilities, so that they can support people access general healthcare services. It explores the remit of general primary, secondary, and palliative care services and the roles of people who work within these services. It provides clear information on the role of all members of the primary care team and the key professionals with whom people with intellectual disabilities will often be in contact, including dentists, podiatrists, audiologists, dieticians, physiotherapists, occupational therapists, community mental health nurses, and practice nurses. It also gives clear practical information about how to support people with intellectual disabilities to access services in general hospital, children departments, emergency departments, dental departments, mental health, and maternity and palliative care.

scholarly journals Perceptions and satisfaction of caregivers regarding rehabilitation services from selected rehabilitation centres in the Western Cape

2018 ◽  
Vol 7 ◽  
Author(s):  
Nondwe B. Mlenzana ◽  
Arne H. Eide ◽  
Jose M. Frantz
Keyword(s):  
Neuromuscular Disorders ◽  
Healthcare Services ◽  
Facility Management ◽  
Rehabilitation Services ◽  
Western Cape ◽  
Thematic Content Analysis ◽  
Cerebrovascular Accidents ◽  
Financial Difficulties ◽  
Rehabilitation Needs ◽  
Depth Interviews

Background: Understanding caregivers’ views on rehabilitation services is important as it may assist in informing healthcare services and patient management.Objectives: The aim of this study was to explore caregivers’ perceptions and satisfaction regarding rehabilitation services in the Western Cape, South Africa, and to inform clinical practice and policy in this emerging field.Method: This study used a descriptive, qualitative design using in-depth interviews with conveniently selected participants. Interviews were conducted with 13 caregivers of patients with: amputations (3), cerebrovascular accidents (5) and neuromuscular disorders (5). Thematic content analysis was conducted with the transcripts.Results: Four key themes emerged, which were (1) financial difficulties, (2) caregiver and therapist relationships, (3) facility management and (4) caregiver experience with service delivery.Conclusion: Based on the participants’ feedback, the rehabilitation services seem to be meeting the basic rehabilitation needs of the patients; however, the needs of the caregivers require attention.

scholarly journals Bibliotherapy-based Wellness Program for Healthcare Providers: Using Books and Reading to Create a Healthy Workplace

2017 ◽  
Vol 38 (2) ◽  
pp. 44-50 ◽  
Author(s):  
Natalia Tukhareli
Keyword(s):  
Healthcare Providers ◽  
Well Being ◽  
Health Department ◽  
Reading Program ◽  
Health And Wellness ◽  
Hospital Employees ◽  
Work Related ◽  
Healthy Workplace ◽  
Related Stress ◽  
The Uk

Within the context of benefits of a healthy workplace, bibliotherapy is seen as an effective way of promoting health and wellness to hospital employees. The paper will present a detailed description of an innovative informational and recreational bibliotherapy-based reading program for healthcare providers developed and implemented by a Health Sciences library, in collaboration with the Occupational Health department. The methodology involved an extensive review of the bibliotherapy research and best practices in the UK and North America. The mechanics, benefits, and challenges of the program will be discussed. The program evaluation included an internal survey to the hospital employees. The evaluation results show that the bibliotherapy program has provided a new venue to address work-related stress and promote health, well-being, and resilience within the organization. Moreover, it helped to expand opportunities for collaborative projects and partnerships for the library as well as increase visibility of the library within the organization. 

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