scholarly journals Benefits and Costs of Digital Consulting in Clinics Serving Young People With Long-Term Conditions: Mixed-Methods Approach (Preprint)

2018 ◽  
Author(s):  
Sung Wook Kim ◽  
Jason Madan ◽  
Melina Dritsaki ◽  
Carol Bryce ◽  
Vera Forjaz ◽  
...  
Keyword(s):  
United Kingdom ◽  
Cost Effectiveness ◽  
Young People ◽  
Health Professionals ◽  
Direct Costs ◽  
Long Term Conditions ◽  
Team Members ◽  
The United Kingdom ◽  
Part Model

BACKGROUND Since the introduction of digital health technologies in National Health Service (NHS), health professionals are starting to use email, text, and other digital methods to consult with their patients in a timely manner. There is lack of evidence regarding the economic impact of digital consulting in the United Kingdom (UK) NHS. OBJECTIVE This study aimed to estimate the direct costs associated with digital consulting as an adjunct to routine care at 18 clinics serving young people aged 16-24 years with long-term conditions. METHODS This study uses both quantitative and qualitative approaches. Semistructured interviews were conducted with 173 clinical team members on the impacts of digital consulting. A structured questionnaire was developed and used for 115 health professionals across 12 health conditions at 18 sites in the United Kingdom to collect data on time and other resources used for digital consulting. A follow-up semistructured interview was conducted with a single senior clinician at each site to clarify the mechanisms through which digital consulting use might lead to outcomes relevant to economic evaluation. We used the two-part model to see the association between the time spent on digital consulting and the job role of staff, type of clinic, and the average length of the working hours using digital consulting. RESULTS When estimated using the two-part model, consultants spent less time on digital consulting compared with nurses (95.48 minutes; P<.001), physiotherapists (55.3 minutes; P<.001), and psychologists (31.67 minutes; P<.001). Part-time staff spent less time using digital consulting than full-time staff despite insignificant result (P=.15). Time spent on digital consulting differed across sites, and no clear pattern in using digital consulting was found. Health professionals qualitatively identified the following 4 potential economic impacts for the NHS: decreasing adverse events, improving patient well-being, decreasing wait lists, and staff workload. We did not find evidence to suggest that the clinical condition was associated with digital consulting use. CONCLUSIONS Nurses and physiotherapists were the greatest users of digital consulting. Teams appear to use an efficient triage system with the most expensive members digitally consulting less than lower-paid team members. Staff report showed concerns regarding time spent digitally consulting, which implies that direct costs increase. There remain considerable gaps in evidence related to cost-effectiveness of digital consulting, but this study has highlighted important cost-related outcomes for assessment in future cost-effectiveness trials of digital consulting.

scholarly journals How does the use of digital consulting change the meaning of being a patient and/or a health professional? Lessons from the Long-term Conditions Young People Networked Communication study

2020 ◽  
Vol 6 ◽  
pp. 205520762094235
Author(s):  
Jackie Sturt ◽  
Caroline Huxley ◽  
Btihaj Ajana ◽  
Caitjan Gainty ◽  
Chris Gibbons ◽  
...  
Keyword(s):  
Young People ◽  
Medical Ethics ◽  
Health Professional ◽  
Health Professionals ◽  
Access To Healthcare ◽  
Small Sample ◽  
Interview Data ◽  
Long Term Conditions ◽  
The Impact

Background While studies have examined the impact of digital communication technology on healthcare, there is little exploration of how new models of digital care change the roles and identities of the health professional and patient. The purpose of the current study is to generate multidisciplinary reflections and questions around the use of digital consulting and the way it changes the meaning of being a patient and/or a health professional. Method We used a large pre-existing qualitative dataset from the Long-term Conditions Young People Networked Communication (LYNC) study which involved interviews with healthcare professionals and a group of 16–24 years patients with long-term physical and mental health conditions. We conducted a three-stage mixed methods analysis. First, using a small sample of interview data from the LYNC study, we identified three key themes to explore in the data and relevant academic literature. Second, in small groups we conducted secondary analysis of samples of patient and health professional LYNC interview data. Third, we ran a series of rapid evidence reviews. Findings We identified three key themes: workload/flow, impact of increased access to healthcare and vulnerabilities. Both health professionals and patients were 'on duty' in their role more often. Increased access to healthcare introduced more responsibilities to both patients and health professionals. Traditional concepts in medical ethics, confidentiality, empathy, empowerment/power, efficiency and mutual responsibilities are reframed in the context of digital consulting. Conclusions Our collaboration identified conflicts and constraints in the construction of digital patients and digital clinicians. There is evidence that digital technologies change the nature of a medical consultation and with it the identities and the roles of clinicians and patients which, in turn, calls for a redefinition of traditional concepts of medical ethics. Overall, digital consulting has the potential to significantly reduce costs while maintaining or improving patient care and clinical outcomes. Timely study of digital engagement in the National Health Service is a matter of critical importance.

scholarly journals Radiation oncology teaching provision and practice prior to and during the first wave of the COVID-19 pandemic in medical schools in the United Kingdom and the Republic of Ireland: a cross-sectional survey

2021 ◽  
Author(s):  
Gerard M Walls ◽  
Orla A Houlihan ◽  
Ciaran Mooney ◽  
Rebecca Prince ◽  
Katie Spencer ◽  
...  
Keyword(s):  
United Kingdom ◽  
Radiation Oncology ◽  
Medical Schools ◽  
Team Members ◽  
Republic Of Ireland ◽  
The United Kingdom ◽  
Short And Long Term ◽  
The Uk ◽  
The Impact

Objectives: Radiotherapy is a key cancer treatment modality but is poorly understood by doctors. We sought to evaluate radiation oncology (RO) teaching in medical schools within the United Kingdom (UK) and Republic of Ireland (RoI), as well as any impacts on RO teaching delivery from the coronavirus disease 2019 (COVID-19) pandemic. Methods: A bespoke online survey instrument was developed, piloted and distributed to oncology teaching leads at all UK and RoI medical schools. Questions were designed to capture information on the structure, format, content and faculty for RO teaching, as well as both the actual and the predicted short- and long-term impacts of COVID-19. Results: Responses were received from 29/41 (71%) UK and 5/6 (83%) RoI medical schools. Pre-clinical and clinical oncology teaching was delivered over a median of 2 weeks (IQR 1–6), although only 9 (27%) of 34 responding medical schools had a standalone RO module. RO teaching was most commonly delivered in clinics or wards (n = 26 and 25 respectively). Few medical schools provided teaching on the biological basis for radiotherapy (n = 11) or the RO career pathway (n = 8), and few provide teaching delivered by non-medical RO multidisciplinary team members. There was evidence of short- and long-term disruption to RO teaching from COVID-19. Conclusions: RO teaching in the UK and RoI is limited with minimal coverage of relevant theoretical principles and little exposure to radiotherapy departments and their non-medical team members. The COVID-19 pandemic risks exacerbating trainee doctors’ already constrained exposure to radiotherapy. Advances in knowledge: This study provides the first analysis of radiotherapy-related teaching in the UK and RoI, and the first to explore the impact of the COVID-19 pandemic on radiationoncology teaching.

scholarly journals The importance of the therapeutic relationship when providing information to parents of children with long-term disabilities: The views and experiences of UK paediatric therapists

2018 ◽  
Vol 22 (3) ◽  
pp. 371-381 ◽  
Author(s):  
Jim Reeder ◽  
Jane Morris
Keyword(s):  
United Kingdom ◽  
Therapeutic Relationship ◽  
Health Professionals ◽  
Positive Relationship ◽  
Information Provision ◽  
Parental Engagement ◽  
Professional Responsibility ◽  
Main Theme ◽  
The United Kingdom

The purpose of this study was to understand the views and experiences of paediatric therapists working in the United Kingdom regarding the importance of the therapeutic relationship when providing information for parents of children with long-term disabilities. The aim was to develop new perspectives, to encourage dialogue and reflection for change and to identify practical suggestions for health professionals when developing therapeutic relationships. This study employed an interpretive phenomenological methodology. Semi-structured, in-depth interviews were carried out with seven health professionals from a single National Health Service trust in the United Kingdom (children’s physiotherapists, occupational therapists and speech therapists). Resultant data were analysed using a systematic process of thematic content analysis. One main theme ‘The Importance of the Therapeutic Relationship: Balancing a Positive Relationship with Professional Responsibility’ is presented and discussed. Paediatric therapists recognize that fostering a positive therapeutic relationship is vital to facilitate parental engagement with the information they provide. Despite this it was felt that efforts to maintain a positive relationship needed to be carefully balanced with discharging professional responsibility to the child. A preliminary model ‘The Therapeutic Relationship Continuum’ is presented, aiming to help health professionals self-assess and reflect on the dynamic interface between the therapeutic relationship and information provision.

Yoga and Healthcare in the United Kingdom

2017 ◽  
Vol 27 (1) ◽  
pp. 121-126 ◽  
Author(s):  
Heather Mason ◽  
Nicole Schnackenberg ◽  
Robin Monro
Keyword(s):  
United Kingdom ◽  
Treatment Options ◽  
Cost Savings ◽  
Cost Effective ◽  
Long Term Conditions ◽  
Yoga Therapy ◽  
The Public ◽  
The United Kingdom ◽  
Regional Hospitals

Abstract The emergence of yoga therapy in the United Kingdom began about 45 years ago with the emergence of yoga therapy organizations that offered both treatment and training. The integration of yoga into the National Health Service (NHS) is gradually happening Because: (a) yoga research supports its efficacy as a cost-effective, preventive and complementary treatment for a host of non-communicable diseases; and (b) the escalating economic burden of long-term conditions is overwhelming the NHS. The NHS is actively developing ‘sustainability and transformation plans’ that include yoga. Chief among these is ‘social prescribing,’ which empowers patients with complex health needs through activities groups. These activities reduce sedentary habits and social isolation, while helping patients to be more self-reliant. The NHS has allocated £450 million in funding to implement a variety of programs for its own staff, in which staff yoga classes were expressly mentioned. The yoga community is mobilizing forces and applying for funding to pilot relevant NHS staff yoga courses that can support the service in achieving its vision. Research shows that integrating yoga therapy for the treatment of low back pain (LBP) into the NHS would result in significant cost savings as compared with usual care. The National Institute for Health and Care Excellence (NICE) Guidelines on LBP and sciatica include yoga as one of the recommended treatments for these conditions. Three groups of yoga teachers, using different yoga practices, have gained traction with the NHS for the application of yoga therapy to LBP. Many regional hospitals in England have yoga classes. The NHS Choices website, which conveys information to the public regarding treatment options, has a page dedicated to the health benefits of yoga. Several institutions offer comprehensive training programs in yoga therapy and yoga therapy is recognized as an official profession. The Yoga in Healthcare Alliance has been established to help integrate yoga therapy into the NHS. This consists of parliamentarians, leaders in the NHS, yoga researchers, health professionals, and representatives from leading yoga organizations.

China will largely abide by Hong Kong handover terms

2017 ◽  
Keyword(s):  
Hong Kong ◽  
United Kingdom ◽  
Young People ◽  
Political Repression ◽  
Content Type ◽  
The United Kingdom ◽  
Uk Government ◽  
The Uk ◽  
The City

Significance This case adds to a growing list of incidents, including the abduction of five Hong Kong booksellers by mainland agents in 2015, that feed fears in Hong Kong that Beijing is undermining the autonomy the city was promised when the UK government handed it over to China in 1997. Impacts The United Kingdom is unlikely to escalate disputes over Beijing's adherence to the handover treaty since doing so might backfire. Evidence of China interfering with business in Hong Kong would be far more economically damaging than targeted political repression. Even limited encroachments by Beijing will increase pessimism about the city's long-term future and make young people keener to emigrate.

scholarly journals Participation in voluntary and community organisations in the United Kingdom and the influences on the self-management of long-term conditions

2014 ◽  
Vol 23 (3) ◽  
pp. 252-261 ◽  
Author(s):  
Mark Jeffries ◽  
Amy Mathieson ◽  
Anne Kennedy ◽  
Susan Kirk ◽  
Rebecca Morris ◽  
...  
Keyword(s):  
United Kingdom ◽  
The Self ◽  
Self Management ◽  
Long Term Conditions ◽  
The United Kingdom ◽  
Community Organisations
Sign in / Sign up

Export Citation Format

Share Document