scholarly journals The relationship between alcohol-related hospital admission and specialist alcohol treatment provision across local authorities in England since passage of the Health and Social Care Act 2012

2020 ◽  
pp. 1-3 ◽  
Author(s):  
Emmert Roberts ◽  
Matthew Hotopf ◽  
Colin Drummond

Summary To our knowledge no previous studies have been conducted at the local authority level assessing relationships between alcohol-related hospital admission, specialist alcohol treatment provision and socioeconomic deprivation since the UK government passed the Health and Social Care Act in 2012. Our results, using publicly available national data-sets, suggest that the local authority areas in England most in need of adequately funded specialist alcohol treatment, because of high prevalence of alcohol dependence and deprivation, are not receiving targeted increased funding, and that the national rise in alcohol-related hospital admissions may be fuelled by local authority funding cuts to specialist alcohol treatment.

2020 ◽  
Vol 56 (1) ◽  
pp. 28-33
Author(s):  
Thomas Phillips ◽  
Chao Huang ◽  
Emmert Roberts ◽  
Colin Drummond

ABSTRACT Aims We assessed the relationship between specialist and non-specialist admissions for alcohol withdrawal since the introduction of the UK government Health and Social Care Act in 2012. Methods Using publicly available national data sets from 2009 to 2019, we compared the number of alcohol withdrawal admissions and estimated costs in specialist and non-specialist treatment settings. Results A significant negative correlation providing strong evidence of an association was observed between the fall in specialist and rise in non-specialist admissions. Significant cost reductions within specialist services were displaced to non-specialist settings. Conclusions The shift in demand from specialist to non-specialist alcohol admissions due to policy changes in England should be reversed by specialist workforce investment to improve outcomes. In the meantime, non-specialist services and staff must be resourced and equipped to meet the complex needs of these service users.


BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e047353
Author(s):  
Henry Aughterson ◽  
Alison R McKinlay ◽  
Daisy Fancourt ◽  
Alexandra Burton

ObjectivesTo explore the psychosocial well-being of health and social care professionals working during the COVID-19 pandemic.DesignThis was a qualitative study deploying in-depth, individual interviews, which were audio-recorded and transcribed verbatim. Thematic analysis was used for coding.ParticipantsThis study involved 25 participants from a range of frontline professions in health and social care.SettingInterviews were conducted over the phone or video call, depending on participant preference.ResultsFrom the analysis, we identified 5 overarching themes: communication challenges, work-related stressors, support structures, personal growth and individual resilience. The participants expressed difficulties such as communication challenges and changing work conditions, but also positive factors such as increased team unity at work, and a greater reflection on what matters in life.ConclusionsThis study provides evidence on the support needs of health and social care professionals amid continued and future disruptions caused by the pandemic. It also elucidates some of the successful strategies (such as mindfulness, hobbies, restricting news intake, virtual socialising activities) deployed by health and social care professionals that can support their resilience and well-being and be used to guide future interventions.


2016 ◽  
Vol 22 (4) ◽  
pp. 263-268 ◽  
Author(s):  
Jennifer Perry ◽  
Fiona L. Mason

SummaryThe health and social care landscape in the UK is changing, and there is now, more than ever, a real need for doctors to embrace leadership and management. Evidence shows that medical leadership is associated with better outcomes for patients. Psychiatrists are particularly well suited to such roles, given the interpersonal skills and self-awareness that they develop in their training. In this article, we examine the role of the psychiatrist in leading at a patient, team and organisational level and the impact this has. We also discuss different leadership and management styles.


Author(s):  
Esme Choonara

The emergence of the Black Lives Matter movement in 2020 in the context of a COVID-19 pandemic that was already disproportionally impacting on the lives of people from black, Asian and other minority ethnicities in the UK and the US has provoked scrutiny of how racism impacts on all areas of our lives. This article will examine some competing theories of racism, and ask what theoretical tools we need to successfully confront racism in health and social care. In particular, it will scrutinise the different levels at which racism operates – individual, institutional and structural – and ask how these are related. Furthermore, it will argue against theories that see racism as a product of whiteness per se or ‘white supremacy’, insisting instead that racism should be understood as firmly bound to the functioning and perpetuation of capitalism.


BJGP Open ◽  
2020 ◽  
Vol 4 (1) ◽  
pp. bjgpopen20X101013
Author(s):  
Jonathan Donald Kennedy ◽  
Serena Moran ◽  
Sue Garrett ◽  
James Stanley ◽  
Jenny Visser ◽  
...  

BackgroundRefugees and asylum seekers have specific health and social care needs on arrival in a resettlement country. A third group — migrants with a refugee-like background (refugee-like migrants) — are less well defined or understood.AimUsing routinely collected data, this study compared demographics, interpreter need, and healthcare utilisation for cohorts of refugee-like migrants and refugees.Design & settingA retrospective cohort study was undertaken in Wellington, New Zealand.MethodData were obtained for refugee-like migrants and refugees accepted under the national quota system (quota refugees), who enrolled in a New Zealand primary care practice between 2011 and 2015. Data from the primary care practice and nationally held hospital and outpatient service databases, were analysed. Age and sex standardisation adjusted for possible differences in cohort demographic profiles.ResultsThe cohorts were similar in age, sex, deprivation, and interpreter need. Refugee-like migrants were found to have similar, but not identical, health and social care utilisation to quota refugees. Primary care nurse utilisation was higher for refugee-like migrants. Clinical entries in the primary care patient record were similar in rate for the cohorts. Emergency department utilisation and hospital admissions were similar. Hospital outpatient utilisation was lower for refugee-like migrants.ConclusionThis research suggests that health, social care, and other resettlement services should be aligned for refugee-like migrants and quota refugees. This would mean that countries accepting quota refugees should plan for health and social care needs of subsequent refugee-like migrant family migration. Further research should investigate matched larger-scale national health and immigration datasets, and qualitatively explore factors influencing health-seeking behaviour of refugee-like migrants.


2018 ◽  
Vol 2 (2) ◽  
Author(s):  
Daniel Beech

The Professional Standards Authority (PSA) reviews the fitness-to-practise decisions of all nine health and social care regulators in the UK. In 2016–17, the authority reviewed 4,285 determinations. If the PSA deems a particular decision to be ‘insufficient for the protection of the public’ (previously the test was ‘unduly lenient’), that decision can be referred to the High Court, where it can be reviewed and, if appropriate, overturned. To help illustrate this aspect of the work of the PSA, this report presents the case of a midwife whose fitness to practise had been considered by the Nursing and Midwifery Council (NMC), the statutory regulator of nurses and midwives. The PSA considered that the outcome had been unduly lenient (i.e. it was considered under the earlier test), and the High Court agreed. The matter was remitted back to a differently constituted committee of the NMC, where it was decided that the appropriate outcome was that her name should be removed from the register, thereby effectively ending the career of the midwife.


BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e053099
Author(s):  
Elizabeth Rapa ◽  
Jeffrey R Hanna ◽  
Catriona R Mayland ◽  
Stephen Mason ◽  
Bettina Moltrecht ◽  
...  

ObjectiveThe objectives of this study were to investigate how families prepared children for the death of a significant adult, and how health and social care professionals provided psychosocial support to families about a relative’s death during the COVID-19 pandemic.Design/settingA mixed methods design; an observational survey with health and social care professionals and relatives bereaved during the COVID-19 pandemic in the UK, and in-depth interviews with bereaved relatives and professionals were conducted. Data were analysed thematically.ParticipantsA total of 623 participants completed the survey and interviews were conducted with 19 bereaved relatives and 16 professionals.ResultsMany children were not prepared for a death of an important adult during the pandemic. Obstacles to preparing children included families’ lack of understanding about their relative’s declining health; parental belief that not telling children was protecting them from becoming upset; and parents’ uncertainty about how best to prepare their children for the death. Only 10.2% (n=11) of relatives reported professionals asked them about their deceased relative’s relationships with children. This contrasts with 68.5% (n=72) of professionals who reported that the healthcare team asked about patient’s relationships with children. Professionals did not provide families with psychosocial support to facilitate preparation, and resources were less available or inappropriate for families during the pandemic. Three themes were identified: (1) obstacles to telling children a significant adult is going to die, (2) professionals’ role in helping families to prepare children for the death of a significant adult during the pandemic, and (3) how families prepare children for the death of a significant adult.ConclusionsProfessionals need to: provide clear and honest communication about a poor prognosis; start a conversation with families about the dying patient’s significant relationships with children; and reassure families that telling children someone close to them is dying is beneficial for their longer term psychological adjustment.


2017 ◽  
pp. 145-158
Author(s):  
Sue Westwood ◽  
Andrew King ◽  
Kathryn Almack ◽  
Yiu-Tung Suen ◽  
Louis Bailey

2020 ◽  
Vol 33 (4) ◽  
pp. 351-363
Author(s):  
John Duncan Edmonstone

Purpose This paper aims to make the case that there is a need to move beyond a focus on an approach to leadership development which is confined to health care only. It argues that, given the economic, financial, social and organisational context within which health and social care organisations in the UK operate, there is a need to develop leadership within health and social care systems, rather than within the existing “siloed” sectors. Design/methodology/approach The paper considers the context within which health and social care organisations in the UK operate; examines the nature of those organisations; makes the case for focusing on the health and social car system through systems leadership; and identifies the need for leadership, rather than leader development. Findings There is a danger of health and social care organisations “walking backwards into the future” with eyes fixed on the past. The future lies with treating health and social care as a system, rather than focusing on organisations. The current model is individual leader focused, but the emerging model is one of collective multi-agency teams. Originality/value The paper seeks to go beyond a health-care-only focus, by asserting that there is a need to regard health and social care as a single system, delivered by a multiplicity of different organisations. This has implications for the kind of leadership involved and for how this might be developed.


BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e037483
Author(s):  
Holly Standing ◽  
Rebecca Patterson ◽  
Mark Lee ◽  
Sonia Michelle Dalkin ◽  
Monique Lhussier ◽  
...  

ObjectivesTo explore current challenges in interdisciplinary management of end-of-life care in the community and the potential of an Electronic Palliative Care Co-ordination System (EPaCCS) to facilitate the delivery of care that meets patient preferences.DesignQualitative study using interviews and focus groups.SettingHealth and Social Care Services in the North of England.Participants71 participants, 62 health and social care professionals, 9 patients and family members.ResultsFour key themes were identified: information sharing challenges; information sharing systems; perceived benefits of an EPaCCS and barriers to use and requirements for an EPaCCS. Challenges in sharing information were a source of frustration for health and social care professionals as well as patients, and were suggested to result in inappropriate hospital admissions. Current systems were perceived by participants to not work well—paper advance care planning (ACP) documentation was often unavailable or inaccessible, meaning it could not be used to inform decision-making at the point of care. Participants acknowledged the benefits of an EPaCCS to facilitate information sharing; however, they also raised concerns about confidentiality, and availability of the increased time and resources required to access and maintain such a system.ConclusionsEPaCCS offer a potential solution to information sharing challenges in end-of-life care. However, our findings suggest that there are issues in the initiation and documentation of end-of-life discussions that must be addressed through investment in training in order to ensure that there is sufficient information regarding ACP to populate the system. There is a need for further qualitative research evaluating use of an EPaCCS, which explores benefits and challenges, uptake and reasons for disparities in use to better understand the potential utility and implications of such systems.


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