CPORT: Effective partnership working to optimize chemotherapy capacity in the UK

e20687 Background: Capacity planning in a complex environment such as a chemotherapy unit is a difficult task; combined with ever increasing patient numbers and limited budgets, time and ability to plan is scarce. This project demonstrates how partnership working between the pharmaceutical industry and NHS service providers can optimise chemotherapy capacity in UK centres. Methods: CPORT stands for “Chemotherapy-Planning Oncology Resource Tool”. The tool is a simulator allowing chemotherapy planners to model how different drugregimens, patient flows, resource levels and ways of working influence the performance of a chemotherapy unit in terms of how many patients are treated, how long they wait, and how much care they receive. A small dedicated team at Roche has been working closely with a team of NHS Facilitators, with the full approval and backing of the National Cancer Action Team. The integrated team have been helping with the roll out of the tool, focusing on supporting cancer units implement CPORT from concept through change and sharing best practice. Results: To date more than 2800 simulations have been run through the tool. Service redesign options have been assessed in minutes and hours, as opposed to weeks and months. The simulator has enabled combinations of several service improvement initiatives to be modelled simultaneously, giving managers the ability to model cancer service delivery in a simulated online environment which is both cost free and risk free. Early results include the better coordination of pharmacy and nursing workload to optimise the available capacity; utlising CPORT to plan the merger of two units and model subsequent resource requirements; modelling the relocation of a unit and predicted caseload of patients. Conclusions: This model represents a successful new form of partnership working between the NHS and the industry to increase capacity within chemotherapy services. It promotes equity of service, better access and an improved experience for all patients receiving chemotherapy, embedding and sustaining the concept of capacity planning within the clinical service. No significant financial relationships to disclose.

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Best practice for chronic oedema in community settings: what can we learn?

British Journal of Community Nursing ◽

10.12968/bjcn.2020.25.12.610 ◽

2020 ◽

Vol 25 (12) ◽

pp. 610-614

Author(s):

Garry Cooper-Stanton

Keyword(s):

Service Provision ◽

Best Practice ◽

Evidence Base ◽

Community Services ◽

Guidance Document ◽

Community Settings ◽

Tissue Viability ◽

Delivery Of Care ◽

Specialist Nurses ◽

The Uk

There are various opportunities and challenges in the delivery of care to those diagnosed with chronic oedema/lymphoedema. Service provision is not consistent within the UK, and non-specialist nurses and other health professionals may be called on to fill the gaps in this area. The latest best practice guidance on chronic oedema is directed at community services that care for people within their own homes in primary care. This guide was developed in order to increase awareness, knowledge and access to an evidence base. Those involved in its creation cross specialist fields (lymphoedema and tissue viability), resulting in the document covering a number of areas, including an explanation of chronic oedema, its assessment and management and the association between chronic oedema and wet legs. The document complements existing frameworks on the condition and its management and also increases the available tools within chronic oedema management in the community. The present article provides an overview of the guidance document and discusses its salient features.

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Recovery Star: validating user recovery

The Psychiatrist ◽

10.1192/pb.bp.111.034264 ◽

2012 ◽

Vol 36 (2) ◽

pp. 45-50 ◽

Cited By ~ 34

Author(s):

Geoff Dickens ◽

Judy Weleminsky ◽

Yetunde Onifade ◽

Philip Sugarman

Keyword(s):

Mental Health ◽

Mental Health Services ◽

Health Services ◽

Internal Consistency ◽

Mental Health Problems ◽

Service Providers ◽

Mental Health Recovery ◽

Addictive Behaviour ◽

Health Service Providers ◽

The Uk

Aims and methodMental Health Recovery Star is a multifaceted 10-item outcomes measure and key-working tool that has been widely adopted by service providers in the UK. We aimed to explore its factorial validity, internal consistency and responsiveness. Recovery Star readings were conducted twice with 203 working-age adults with moderate to severe mental health problems attending a range of mental health services, and a third time with 113 of these individuals.ResultsMental Health Recovery Star had high internal consistency and appeared to measure an underlying recovery-oriented construct. Results supported a valid two-factor structure which explained 48% of variance in Recovery Star ratings data. Two Recovery Star items (‘relationships’ and ‘addictive behaviour’) did not load onto either factor. There was good statistically significant item responsiveness, and no obvious item redundancy. Data for a small number of variables were not normally distributed and the implications of this are discussed.Clinical implicationsRecovery Star has been received enthusiastically by both mental health service providers and service users. This study provides further evidence for its adoption in recovery-focused mental health services and indicates that items relating to addictive behaviour, responsibilities and work could be further developed in future.

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Quality improvement in general practice: what do GPs and practice managers think? Results from a nationally representative survey of UK GPs and practice managers

BMJ Open Quality ◽

10.1136/bmjoq-2020-001309 ◽

2021 ◽

Vol 10 (2) ◽

pp. e001309

Author(s):

Jennifer Gosling ◽

Nicholas Mays ◽

Bob Erens ◽

David Reid ◽

Josephine Exley

Keyword(s):

General Practice ◽

Quality Improvement ◽

General Practitioners ◽

Service Improvement ◽

Protected Time ◽

Routine Work ◽

Professional Interest ◽

Quality And Outcomes ◽

Nationally Representative ◽

The Uk

BackgroundThis paper presents the results of the first UK-wide survey of National Health Service (NHS) general practitioners (GPs) and practice managers (PMs) designed to explore the service improvement activities being undertaken in practices, and the factors that facilitated or obstructed that work. The research was prompted by growing policy and professional interest in the quality of general practice and its improvement. The analysis compares GP and PM involvement in, and experience of, quality improvement activities.MethodsThis was a mixed-method study comprising 26 semistructured interviews, a focus group and two surveys. The qualitative data supported the design of the surveys, which were sent to all 46 238 GPs on the Royal College of General Practitioners (RCGP) database and the PM at every practice across the UK (n=9153) in July 2017.ResultsResponses from 2377 GPs and 1424 PMs were received and were broadly representative of each group. Ninety-nine per cent reported having planned or undertaken improvement activities in the previous 12 months. The most frequent related to prescribing and access. Key facilitators of improvement included ‘good clinical leadership’. The two main barriers were ‘too many demands from external stakeholders’ and a lack of protected time. Audit and significant event audit were the most common improvement tools used, but respondents were interested in training on other quality improvement tools.ConclusionGPs and PMs are interested in improving service quality. As such, the new quality improvement domain in the Quality and Outcomes Framework used in the payment of practices is likely to be relatively easily accepted by GPs in England. However, if improving quality is to become routine work for practices, it will be important for the NHS in the four UK countries to work with practices to mitigate some of the barriers that they face, in particular the lack of protected time.

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Perceptions of Peer Support for Victim-Survivors of Sexual Violence and Abuse: An Exploratory Study With Key Stakeholders

Journal of Interpersonal Violence ◽

10.1177/08862605211007931 ◽

2021 ◽

pp. 088626052110079

Author(s):

Alison Gregory ◽

Emma Johnson ◽

Gene Feder ◽

John Campbell ◽

Judit Konya ◽

...

Keyword(s):

Sexual Violence ◽

Peer Support ◽

Service Provision ◽

Exploratory Study ◽

Good Practice ◽

Medical Model ◽

Service Improvement ◽

Physical And Mental Health ◽

Safety Considerations ◽

The Uk

Experiences of sexual violence, childhood sexual abuse, and sexual assault are common across all societies. These experiences damage physical and mental health, coping ability, and relationships with others. Given the breadth and magnitude of impacts, it is imperative that there are effective, accessible services to support victim-survivors, ease suffering, and empower people to cope, recover and thrive. Service provision for this population in the United Kingdom is complex and has been hit substantially by austerity. Since positive social support can buffer against negative impacts, peer support may be an effective approach. The aim of this exploratory study was to capture the views and perspectives of professional stakeholders concerning service provision for victim-survivors, particularly perceptions of peer support. In-depth semistructured interviews were conducted in the UK during 2018 with six professional stakeholders, highly experienced in the field of service provision for victim-survivors of sexual violence and abuse. An abductive approach to analysis was used, applying principles from thematic analysis. Our sample comprised four females and two males, and their roles included psychiatrist, general practitioner, service improvement facilitator, and senior positions within victim-survivor organizations. Interviews highlighted models of peer support for this population, good practice and safety considerations, and a lack of uniformity regarding quality and governance standards across the sector. Findings indicated that current funding models impact negatively on victim-survivor services, and that provision is fragmented and insufficient across statutory and not-for-profit sectors. The influence of the medical model upon service provision was evident, which resulted in apprehension around support delivered in less-usual forms—including peer support. Further research is needed to explore the potential of peer support for victim-survivors of sexual violence and abuse.

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Development of clinical guidelines for service provision of functional electrical stimulation to support walking: mixed method exploration of stakeholder views

BMC Neurology ◽

10.1186/s12883-021-02299-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

C Bulley ◽

C Meagher ◽

T Street ◽

A Adonis ◽

C Peace ◽

...

Keyword(s):

Electrical Stimulation ◽

Functional Electrical Stimulation ◽

Clinical Guidelines ◽

Service Provision ◽

Clinical Guideline ◽

Service Providers ◽

Delphi Consensus ◽

Stakeholder Views ◽

Key Stakeholders ◽

The Uk

Abstract Background Over the past 20 years Functional Electrical Stimulation (FES) has grown in clinical use to support walking in people with lower limb weakness or paralysis due to upper motor neuron lesions. Despite growing consensus regarding its benefits, provision across the UK and internationally is variable. This study aimed to explore stakeholder views relating to the value of a clinical guideline focusing on service provision of FES to support walking, how people might use it and what should be included. Methods A mixed methods exploration sought the views of key stakeholders. A pragmatic online survey (n = 223) focusing on the study aim was developed and distributed to the email distribution list of the UK Association for Chartered Physiotherapists Interested in Neurology (ACPIN). In parallel, a qualitative service evaluation and patient public involvement consultation was conducted. Two group, and seven individual interviews were conducted with: FES-users (n = 6), their family and carers (n = 3), physiotherapists (n = 4), service providers/developers (n = 2), researchers (n = 1) and distributors of FES (n = 1). Descriptive analysis of quantitative data and framework analysis of qualitative data were conducted. Results Support for clinical guideline development was clear in the qualitative interviews and the survey results. Survey respondents most strongly endorsed possible uses of the clinical guideline as ensuring best practice and supporting people seeking access to a FES service. Data analysis and synthesis provided clear areas for inclusion in the clinical guidelines, including current research evidence and consensus relating to who is most likely to benefit and optimal service provision as well as pathways to access this. Specific areas for further investigation were summarised for inclusion in the first stage of a Delphi consensus study. Conclusions Key stakeholders believe in the value of a clinical guideline that focuses on the different stages of service provision for FES to support walking. A Delphi consensus study is being planned based on the findings.

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The dogs bark and the circus moves on

The Bottom Line Managing Library Finances ◽

10.1108/bl-01-2015-0002 ◽

2015 ◽

Vol 28 (1/2) ◽

pp. 7-18

Author(s):

John D Robinson

Keyword(s):

Digital Library ◽

Capital Investment ◽

Service Providers ◽

Cloud Services ◽

Bottom Line ◽

Content Type ◽

Full Responsibility ◽

Managed Services ◽

Library Function ◽

The Uk

Purpose – The paper aims to set out challenges that libraries face while developing their Digital Library capabilities and capacity and propose an approach to estimating the costs for these functions. There is a skills challenge as well as an organisational challenge. The opportunities to build new teams or re-train existing staff are discussed. Design/methodology/approach – The approach builds on a 2008 paper about Digital Library economics and discusses the changes in the environment since then. A model is described in which a library takes on the full responsibility for building and operating a Digital Library function in-house. This is used to benchmark other options such as managed services, outsourced infrastructure and “cloud” services. Findings – The Open Access Publication and Research Data Management mandates present challenges to all libraries based in academic institutions in the UK. New working methods and new costs are unavoidable. There are a number of ways to deal with this depending upon the institutional circumstance. The bottom line can be increases in revenue budgets of around 10 per cent with variable requirements for capital investment. Originality/value – Libraries and librarians have different experiences in closely working with colleagues in information technology (IT). A number of propositions are presented about the value of cooperation and collaboration between library and IT and also with external partners and service providers.

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A practical example of an open disclosure process for people with intellectual disabilities in the Republic of Ireland

Journal of Intellectual Disabilities ◽

10.1177/17446295211018910 ◽

2021 ◽

pp. 174462952110189

Author(s):

Feabhra Mullally ◽

Deirdre Corby

Keyword(s):

Intellectual Disabilities ◽

Service Providers ◽

Republic Of Ireland ◽

Open Disclosure ◽

The Usa ◽

People With Intellectual Disabilities ◽

Adults With Intellectual Disabilities ◽

The Republic ◽

Communication Needs ◽

The Uk

Literature pertaining to open disclosure predominantly refers to acute care settings; this is the case in, for example, the UK, Republic of Ireland, Australia, Korea and the USA. There is, however, a dearth of literature regarding open disclosure related to people with intellectual disabilities. A practice example of open disclosure is presented here, following a serious adverse event in an organisation supporting adults with intellectual disabilities. The aim of the process was to openly disclose in a meaningful way to adults with significant intellectual disabilities and communication difficulties. An apology pathway was developed by a multidisciplinary team based on individual communication needs. A suite of resources was developed including easy read-picture agendas and sign language to support increased understanding of the apology. Service users received the apology first, followed by meetings with their families. This practice example has positive implications for service providers for people with intellectual disabilities.

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Peer Review of Paediatric Endocrine Services in the UK: A Template for Quality and Service Improvement

Hormone Research in Paediatrics ◽

10.1159/000515238 ◽

2021 ◽

pp. 1-6

Author(s):

John Schulga ◽

Heather Mitchell ◽

S. Faisal Ahmed ◽

Assunta Albanese ◽

Justin Warner ◽

...

Keyword(s):

Peer Review ◽

National Level ◽

Quality Of Healthcare ◽

Healthcare Services ◽

British Society ◽

Service Improvement ◽

Paediatric Endocrinology ◽

Test Feasibility ◽

Specialist Nurses ◽

The Uk

Background: Independent peer review of healthcare services can complement existing internal-, institutional-, and national-level regulatory mechanisms aimed at improving quality of healthcare. However, this has not been reported for paediatric endocrinology services in the UK. We aimed to test feasibility and acceptability through a first cycle of a national peer review of paediatric endocrine services. Methods: Tertiary centres in paediatric endocrinology across the UK were assessed against 54 quality standards, developed by the British Society for Paediatric Endocrinology and Diabetes (BSPED) in five domains of healthcare by a team comprising paediatric endocrinologists and specialist nurses. The evaluation was supported by a self-assessment. A post-peer-review questionnaire was used as feedback. Results: All 22 centres in the UK underwent independent peer review between 2011 and 2017. Each served a median population of 2.6 million (range 1–8 million) and offered 1,872 (range 779–6,738) outpatient consultations annually. A total of 43 (range 30–49) standards were met in combined evaluation of all centres. Variance of adherence for essential standards ranged from 52 to 97% at individual centres with 90% adherence demonstrated by 32% of centres. Post-review feedback showed 20/22 (95%) validating the utility of the peer review. Conclusions: The BSPED peer review of all UK centres providing paediatric endocrine services is shown to be feasible and provides a quality benchmark for replication by national services.

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Infection control: current status. risks, research, rules and recycling

Orthodontic Update ◽

10.12968/ortu.2021.14.2.59 ◽

2021 ◽

Vol 14 (2) ◽

pp. 59-66

Author(s):

Jennifer Haworth ◽

Jonathan Sandy ◽

Anthony J Ireland

Keyword(s):

Infection Control ◽

Best Practice ◽

Mainland China ◽

Current Status ◽

Infectious Agents ◽

Emerging Infections ◽

Healthcare Waste ◽

Control Procedures ◽

The Uk ◽

The Impact

We are living through a period of immense change following the outbreak of the COVID-19 pandemic in mainland China in December 2019. Even before the pandemic, the cost of managing healthcare-associated infections in the UK was considerable. The risk of acquiring any infection from the dental environment must be reduced to a minimum. As we have observed in recent years, new infectious agents emerge frequently, and the dental profession must be ready to respond appropriately and quickly. Orthodontic practice presents unique challenges in relation to infection control procedures. The impact of healthcare waste on the environment must also be considered. CPD/Clinical Relevance: This paper describes the range of infectious agents posing a risk to dental team members and patients. The aim is to place the recent coronavirus pandemic in the context of other recent emerging infections. Some of the latest research regarding infection control procedures is reviewed. Current best practice is described.

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Countering Violent Extremism in Canada and Abroad

Inquiry@Queen's Undergraduate Research Conference Proceedings ◽

10.24908/iqurcp.11804 ◽

2018 ◽

Author(s):

Nora Abdelrahman Ibrahim

Keyword(s):

Best Practice ◽

Unintended Consequences ◽

Lessons Learned ◽

Policy And Practice ◽

Far Right ◽

Significant Development ◽

The Us ◽

Violent Extremism ◽

Recent Trends ◽

The Uk

Terrorism and violent extremism have undoubtedly become among the top security concerns of the 21st century. Despite a robust agenda of counterterrorism since the September 11, 2001 attacks, the evolution of global terrorism has continued to outpace the policy responses that have tried to address it. Recent trends such as the foreign fighter phenomenon, the rampant spread of extremist ideologies online and within communities, and a dramatic increase in terrorist incidents worldwide, have led to a recognition that “traditional” counterterrorism efforts are insufficient and ineffective in combatting these phenomena. Consequently, the focus of policy and practice has shifted towards countering violent extremism by addressing the drivers of radicalization to curb recruitment to extremist groups. Within this context, the field of countering violent extremism (CVE) has garnered attention from both the academic and policy-making worlds. While the CVE field holds promise as a significant development in counterterrorism, its policy and practice are complicated by several challenges that undermine the success of its initiatives. Building resilience to violent extremism is continuously challenged by an overly securitized narrative and unintended consequences of previous policies and practices, including divisive social undercurrents like Islamophobia, xenophobia, and far-right sentiments. These by-products make it increasingly difficult to mobilize a whole of society response that is so critical to the success and sustainability of CVE initiatives. This research project addresses these policy challenges by drawing on the CVE strategies of Canada, the US, the UK, and Denmark to collect best practice and lessons learned in order to outline a way forward.

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