scholarly journals Is the Vaccination program the only factor that should determine how fast the COVID-19 restrictions in England should be eased in 2021?

2021 ◽  
Author(s):  
David Miles ◽  
Adrian Heald ◽  
Mike Stedman
Keyword(s):  
Healthcare Services ◽  
Vaccination Program ◽  
Healthcare Provision ◽  
Future Health ◽  
Factors Affecting ◽  
Trade Offs ◽  
Standards Of Living ◽  
Life Years ◽  
The Uk ◽  
The Impact

Vaccination against the COVID-19 virus began in December 2020 in the UK and is now running at 5% population/week. High Levels of social restrictions were implemented for the third time in January 2021 to control the second wave and resulting increases in hospitalisations and deaths. Easing those restrictions must balance multiple challenging priorities, weighing the risk of more deaths and hospitalisations against damage done to mental health, incomes and standards of living, education outcomes and provision of non-Covid-19 healthcare. Weekly and monthly officially published values in 2020/21 were used to estimate the impact of seasonality and social restrictions on the spread of COVID-19 by age group, on the economy and healthcare services. These plus vaccination program assembled into a model that retrospectively reflected the actual numbers of reported deaths closely both in 2020 and early 2021. It was applied prospectively to the next 6 months to evaluate impact of different speeds of easing social restrictions. The results show vaccinations are significantly reducing the number of hospitalisation and deaths. The central estimate is that relative to a rapid easing the avoided loss of 57,000 life years from a strategy of relatively slow easing over the next 4 months come at a cost in terms of GDP reduction of around £0.4 million/life-year loss avoided. This is over 10 times higher than the usual limit the NHS uses for spending against Quality Adjusted Life Years (QALYs) saved. Alternative assumptions for key factors affecting give significantly different trade-offs between costs and benefits of different speeds of easing. Disruption of non-Covid-19 Healthcare provision also increases in times of higher levels of social restrictions. In most cases, the results favour a somewhat faster easing of restrictions in England than current policy implies. Return of non-Covid-19 healthcare activity to ‘normal’ levels might also improve future health outcomes/mortality.

scholarly journals How fast should social restrictions be eased  in England as COVID-19 vaccinations are rolled out?

2021 ◽  
Author(s):  
David Miles ◽  
Adrian Heald ◽  
Mike Stedman
Keyword(s):  
Healthcare Services ◽  
Key Factors ◽  
Healthcare Provision ◽  
Factors Affecting ◽  
Education Outcomes ◽  
Trade Offs ◽  
Standards Of Living ◽  
Life Years ◽  
The Uk ◽  
The Impact

Vaccination against the COVID-19 virus began in December 2020 in the UK and is now running at 5% population/week. High Levels of social restrictions were implemented for the third time in January 2021 to control the second wave and resulting increases in hospitalisations and deaths. Easing those restrictions must balance multiple challenging priorities, weighing the risk of more deaths and hospitalisations against damage done to mental health, incomes and standards of living, education outcomes and provision of non-Covid-19 healthcare. Weekly and monthly officially published values in 2020/21 were used to estimate the impact of seasonality and social restrictions on the spread of COVID-19 by age group, on the economy and healthcare services. These factors were combined with the estimated impact of vaccinations and immunity from past infections into a model that retrospectively reflected the actual numbers of reported deaths closely both in 2020 and early 2021. It was applied prospectively to the next 6 months to evaluate the impact of different speeds of easing social restrictions. The results show vaccinations are significantly reducing the number of hospitalisations and deaths. The central estimate is that relative to a rapid easing, the avoided loss of 57,000 life years from a strategy of relatively slow easing over the next 4 months comes at a cost in terms of GDP reduction of around £0.4 million/life-year loss avoided. This is over 10 times higher than the usual limit the NHS uses for spending against Quality Adjusted Life Years (QALYs) saved. Alternative assumptions for key factors affecting give significantly different trade-offs between costs and benefits of different speeds of easing. Disruption of non-Covid-19 Healthcare provision also increases in times of higher levels of social restrictions. In most cases, the results favour a somewhat faster easing of restrictions in England than current policy implies.

scholarly journals Impact of COVID-19 pandemic social restriction measures on people with rheumatic and musculoskeletal diseases in the UK: a mixed-methods study

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e048772
Author(s):  
Toby O Smith ◽  
Pippa Belderson ◽  
Jack R Dainty ◽  
Linda Birt ◽  
Karen Durrant ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Qualitative Study ◽  
Online Survey ◽  
Musculoskeletal Diseases ◽  
Community Dwelling ◽  
Secondary Outcome ◽  
Healthcare Provision ◽  
Social Restriction ◽  
The Uk ◽  
The Impact

ObjectivesTo determine the impact of COVID-19 pandemic social restriction measures on people with rheumatic and musculoskeletal diseases (RMDs) and to explore how people adapted to these measures over time.DesignMixed-methods investigation comprising a national online longitudinal survey and embedded qualitative study.SettingUK online survey and interviews with community-dwelling individuals in the East of England.ParticipantsPeople in the UK with RMDs were invited to participate in an online survey. A subsection of respondents were invited to participate in the embedded qualitative study.Primary and secondary outcome measuresThe online survey, completed fortnightly over 10 weeks from April 2020 to August 2020, investigated changes in symptoms, social isolation and loneliness, resilience and optimism. Qualitative interviews were undertaken assessing participant’s perspectives on changes in symptoms, exercising, managing instrumental tasks such a shopping, medication and treatment regimens and how they experienced changes in their social networks.Results703 people with RMDs completed the online survey. These people frequently reported a deterioration in symptoms as a result of COVID-19 pandemic social restrictions (52% reported increase vs 6% reported a decrease). This was significantly worse for those aged 18–60 years compared with older participants (p=0.017). The qualitative findings from 26 individuals with RMDs suggest that the greatest change in daily life was experienced by those in employment. Although some retired people reported reduced opportunity for exercise outside their homes, they did not face the many competing demands experienced by employed people and people with children at home.ConclusionsPeople with RMDs reported a deterioration in symptoms when COVID-19 pandemic social restriction measures were enforced. This was worse for working-aged people. Consideration of this at-risk group, specifically for the promotion of physical activity, changing home-working practices and awareness of healthcare provision is important, as social restrictions continue in the UK.

scholarly journals Informal Caregiving and Disaster Risk Reduction: A Scoping Review

2021 ◽  
Vol 12 (2) ◽  
pp. 169-187
Author(s):  
Christina J. Pickering ◽  
Maya Dancey ◽  
Karen Paik ◽  
Tracey O’Sullivan
Keyword(s):  
Risk Reduction ◽  
Scoping Review ◽  
Disaster Risk Reduction ◽  
Informal Caregivers ◽  
Healthcare Services ◽  
Informal Caregiving ◽  
Disaster Risk ◽  
Healthcare Provision ◽  
Strategic Action ◽  
Factors Affecting

AbstractInformal caregivers are a population currently in the shadows of disaster risk reduction (DRR), and yet essential to the provision of healthcare services. This scoping review explored the literature to understand issues related to informal caregiving and promising practices to support resilience for disasters. Following guidelines for scoping review as outlined by Tricco et al. (2016), relevant publications were identified from five major databases—Medline, Embase, PubMed, Web of Science, and Scopus. Relevant studies referenced informal caregiving and disasters for a variety of population groups including children, people with disabilities or chronic illnesses, and older adults. Studies were excluded if they discussed formal caregiving services (for example, nursing), lacked relevance to disasters, or had insufficient discussion of informal caregiving. Overall, 21 articles met the inclusion criteria and were fully analyzed. Five themes were identified: (1) the need for education and training in DRR; (2) stressors around medication and supply issues; (3) factors affecting the decision-making process in a disaster; (4) barriers leading to disaster-related problems; and (5) factors promoting resilience. Recommended areas of strategic action and knowledge gaps are discussed. Many informal caregivers do not feel adequately prepared for disasters. Given the important role of informal caregivers in healthcare provision, preparedness strategies are essential to support community resilience for those requiring personal care support. By understanding and mobilizing assets to support the resilience of informal caregivers, we also support the resilience of the greater healthcare system and the community, in disaster contexts.

scholarly journals Genetics in the 21st Century: Implications for patients, consumers and citizens

F1000Research ◽  
2017 ◽  
Vol 6 ◽  
pp. 2020 ◽  
Author(s):  
Jonathan Roberts ◽  
Anna Middleton
Keyword(s):  
Human Genome Project ◽  
Personalised Medicine ◽  
Building Blocks ◽  
Healthcare Services ◽  
Genome Project ◽  
Human Response ◽  
Future Health ◽  
Policy Makers ◽  
Human Genes ◽  
The Impact

The first human genome project, completed in 2003, uncovered the genetic building blocks of humankind. Painstakingly cataloguing the basic constituents of our DNA (‘genome sequencing’) took ten years, over three billion dollars and was a multinational collaboration. Since then, our ability to sequence genomes has been finessed so much that by 2017 it is possible to explore the 20,000 or so human genes for under £1000, in a matter of days. Such testing offers clues to our past, present and future health, as well as information about how we respond to medications so that truly ‘personalised medicine’ is now a reality.   The impact of such a ‘genomic era’ is likely to have some level of impact on all of us, even if we are not directly using healthcare services ourselves. We explore how advancements in genetics are likely to be experienced by people, as patients, consumers and citizens; and urge policy makers to take stock of the pervasive nature of the technology as well as the human response to it.

scholarly journals A Cost-Effectiveness Analysis of Newborn Screening for Severe Combined Immunodeficiency in the UK

2019 ◽  
Vol 5 (3) ◽  
pp. 28 ◽  
Author(s):  
Alice Bessey ◽  
James Chilcott ◽  
Joanna Leaviss ◽  
Carmen de la Cruz ◽  
Ruth Wong
Keyword(s):  
Cost Effectiveness ◽  
Severe Combined Immunodeficiency ◽  
Cost Effective ◽  
Sensitivity Analyses ◽  
Combined Immunodeficiency ◽  
Tree Model ◽  
Life Years ◽  
The Uk ◽  
The Cost ◽  
The Impact

Severe combined immunodeficiency (SCID) can be detected through newborn bloodspot screening. In the UK, the National Screening Committee (NSC) requires screening programmes to be cost-effective at standard UK thresholds. To assess the cost-effectiveness of SCID screening for the NSC, a decision-tree model with lifetable estimates of outcomes was built. Model structure and parameterisation were informed by systematic review and expert clinical judgment. A public service perspective was used and lifetime costs and quality-adjusted life years (QALYs) were discounted at 3.5%. Probabilistic, one-way sensitivity analyses and an exploratory disbenefit analysis for the identification of non-SCID patients were conducted. Screening for SCID was estimated to result in an incremental cost-effectiveness ratio (ICER) of £18,222 with a reduction in SCID mortality from 8.1 (5–12) to 1.7 (0.6–4.0) cases per year of screening. Results were sensitive to a number of parameters, including the cost of the screening test, the incidence of SCID and the disbenefit to the healthy at birth and false-positive cases. Screening for SCID is likely to be cost-effective at £20,000 per QALY, key uncertainties relate to the impact on false positives and the impact on the identification of children with non-SCID T Cell lymphopenia.

scholarly journals The impact of the COVID-19 lockdown on orthopaedic emergency presentations in a remote and rural population

2020 ◽  
Vol 1 (10) ◽  
pp. 621-627
Author(s):  
Ahmed S. Elhalawany ◽  
James Beastall ◽  
Gerard Cousins
Keyword(s):  
Healthcare Providers ◽  
Local Area ◽  
Time Frame ◽  
Healthcare Provision ◽  
Proportional Increase ◽  
Minor Injuries ◽  
The Uk ◽  
A Minor ◽  
The Impact ◽  
Second Wave

Aims COVID-19 remains the major focus of healthcare provision. Managing orthopaedic emergencies effectively, while at the same time protecting patients and staff, remains a challenge. We explore how the UK lockdown affected the rate, distribution, and type of orthopaedic emergency department (ED) presentations, using the same period in 2019 as reference. This article discusses considerations for the ED and trauma wards to help to maintain the safety of patients and healthcare providers with an emphasis on more remote geography. Methods The study was conducted from 23 March 2020 to 5 May 2020 during the full lockdown period (2020 group) and compared to the same time frame in 2019 (2019 group). Included are all patients who attended the ED at Raigmore Hospital during this period from both the local area and tertiary referral from throughout the UK Highlands. Data was collected and analyzed through the ED Information System (EDIS) as well as ward and theatre records. Results A total of 1,978 patients presented to the ED during the lockdown period, compared to 4,777 patients in the same timeframe in 2019; a reduction of 58.6%. Orthopaedic presentations in 2020 and 2019 were 736 (37.2%) and 1,729 (36.2%) respectively, representing a 57.4% reduction. During the lockdown, 43.6% of operations were major procedures (n = 48) and 56.4% were minor procedures (n = 62), representing a significant proportional shift. Conclusion During the COVID- 19 lockdown period there was a significant reduction in ED attendances and orthopaedic presentations compared to 2019. We also observed that there was a proportional increase in fractures in elderly patients and in minor injuries requiring surgery. These represented the majority of the orthopaedic workload during the lockdown period of 2020. Given this shift towards smaller surgical procedures, we suggest that access to a minor operating theatre in or close to ED would be desirable in the event of a second wave or future crisis.

scholarly journals Genetics in the 21st Century: Implications for patients, consumers and citizens

F1000Research ◽  
2018 ◽  
Vol 6 ◽  
pp. 2020 ◽  
Author(s):  
Jonathan Roberts ◽  
Anna Middleton
Keyword(s):  
Human Genome Project ◽  
Personalised Medicine ◽  
Building Blocks ◽  
Healthcare Services ◽  
Genome Project ◽  
Human Response ◽  
Future Health ◽  
Policy Makers ◽  
Human Genes ◽  
The Impact

The first human genome project, completed in 2003, uncovered the genetic building blocks of humankind. Painstakingly cataloguing the basic constituents of our DNA (‘genome sequencing’) took ten years, over three billion dollars and was a multinational collaboration. Since then, our ability to sequence genomes has been finessed so much that by 2018 it is possible to explore the 20,000 or so human genes for under £1000, in a matter of days. Such testing offers clues to our past, present and future health, as well as information about how we respond to medications so that truly ‘personalised medicine’ is now moving closer to a reality.The impact of such a ‘genomic era’ is likely to have some level of impact on an increasingly large number of us, even if we are not directly using healthcare services ourselves. We explore how advancements in genetics are likely to be experienced by people, as patients, consumers and citizens; and urge policy makers to take stock of the pervasive nature of the technology as well as the human response to it.

scholarly journals Effective diabetes complication management is a step toward a carbon-efficient planet: an economic modeling study

2020 ◽  
Vol 8 (1) ◽  
pp. e001017
Author(s):  
Ric Fordham ◽  
Ketan Dhatariya ◽  
Rachel Stancliffe ◽  
Adam Lloyd ◽  
Mou Chatterjee ◽  
...  
Keyword(s):  
Glycemic Control ◽  
Single Agent ◽  
Economic Modeling ◽  
Total Carbon ◽  
Carbon Intensity ◽  
Diabetes Model ◽  
Life Years ◽  
Third Line ◽  
The Uk ◽  
The Impact

BackgroundThe management of diabetes-related complications accounts for a large share of total carbon dioxide equivalent (CO2e) emissions. We assessed whether improving diabetes control in people with type 2 diabetes reduces CO2e emissions, compared with those with unchanging glycemic control.MethodsUsing the IQVIA Core Diabetes Model, we estimated the impact of maintaining glycated hemoglobin (HbA1c) at 7% (53 mmol/mol) or reducing it by 1% (11 mmol/mol) on total CO2e/patient and CO2e/life-year (LY). Two different cohorts were investigated: those on first-line medical therapy (cohort 1) and those on third-line therapy (cohort 2). CO2e was estimated using cost inputs converted to carbon inputs using the UK National Health Service’s carbon intensity factor. The model was run over a 50-year time horizon, discounting total costs and quality adjusted life years (QALYs) up to 5% and CO2e at 0%.ResultsMaintaining HbA1c at 7% (53 mmol/mol) reduced total CO2e/patient by 18% (1546 kgCO2e/patient) vs 13% (937 kgCO2e/patient) in cohorts 1 and 2, respectively, and led to a reduction in CO2e/LY gain of 15%–20%. Reducing HbA1c by 1% (11 mmol/mol) caused a 12% (cohort 1) and 9% (cohort 2) reduction in CO2e/patient with a CO2e/LY gain reduction of 11%–14%.ConclusionsWhen comparing people with untreated diabetes, maintaining glycemic control at 7% (53 mmol/mol) on a single agent or improving HbA1c by 1% (11 mmol/mol) by the addition of more glucose-lowering treatment was associated with a reduction in carbon emissions.

OP06 Past Speculations Of Future Health Technologies: What Did They Predict?

2017 ◽  
Vol 33 (S1) ◽  
pp. 4-4
Author(s):  
Lucy Doos ◽  
Claire Packer ◽  
Derek Ward ◽  
Sue Simpson ◽  
Andrew Stevens
Keyword(s):  
Healthcare Services ◽  
Strategic Decision ◽  
Healthcare Provision ◽  
Future Health ◽  
Health Technologies ◽  
Health Related ◽  
Future Technologies ◽  
The Cost ◽  
Technology Type

INTRODUCTION:Rapid technological innovation is leading to new health technologies and interventions becoming available to healthcare markets at increasing speed; these often cost more than current alternatives and significantly affect the cost of healthcare services and delivery (1). Identifying future technologies supports service preparedness, long-term planning, and strategic decision making. The aim of this study was to describe and classify health technologies predicted in fifteen forecasting studies according to their type, purpose and clinical use, and relate these to the original purpose and timing of the forecasting studies.METHODS:This was a descriptive study of predicted healthcare technologies identified in fifteen forecasting studies included in a previously published systematic review (2). Outcomes related to (i) each forecast study including country, year, intent and forecasting methods used, and (ii) the predicted technology type, purpose, targeted clinical area and forecast timeframe.RESULTS:We identified 896 predicted health-related topics, of which 685 were health technologies. Of these, 19.1 percent were diagnostic or imaging tests and 14.3 percent devices or biomaterials; 38.1 percent were intended to treat or manage disease and 21.6 percent to diagnose or monitor disease. The most frequent targeted clinical areas were infectious diseases followed by cancer, circulatory and nervous system disorders. The mean timeframe for technology forecast was 11.6 years (Standard Deviation, SD = 6.6). The forecasting timeframe significantly differed by technology type (p = .002), the intent of the forecasting group (p < .0001), and the methods used (p < .0001).CONCLUSIONS:Our description and classification of predicted health-related technologies from prior forecasting studies provides an overview of the technological and clinical frontiers of innovation in health and healthcare provision.

scholarly journals The Future of Allied Health leadership in New Zealand-Aotearoa: A literature review

2021 ◽  
Vol 16 (2) ◽  
pp. 16-27
Author(s):  
Rebecca Kate George ◽  
Karen Webster
Keyword(s):  
New Zealand ◽  
Leadership Development ◽  
Health Workforce ◽  
Allied Health ◽  
Healthcare Services ◽  
Leadership Roles ◽  
Future Health ◽  
Health Leadership ◽  
Government Websites ◽  
The Uk

Background: The allied heath, scientific and technical (allied health) workforce is the second largest workforce in New Zealand, providing diagnostic, therapeutic and preventative services. Increasingly consumers present with complex conditions requiring multiprofessional integrated services and a legacy of profession-focused leadership development is being challenged. [1] Future health and disability systems require leaders prepared to lead complex services, less focussed on their professional background and more on understanding their interprofessional services. [2, 3] The Allied health workforce is well placed to lead these systems, providing interprofessional experience, a biopsychosocial lens and collaborative models of practice. Aim: To provide an understanding of the literature and research available that addresses the leadership of healthcare services by allied health clinicians. Methodology: An initial database review was completed using a systematic approach, across CINAHL complete; EBSCO Business; Medline; and EBSCO Health databases from March 2020 to September 2020. An expanded search used Google Scholar and NZ, UK and Australian based government websites to access institutional documents, such as policies, reviews and reports. Results: The review identified an emerging pool of research on allied health leadership in Australia and the UK but a paucity of literature on allied health leadership in New Zealand. Three themes were identified and explored within the article: health leadership frameworks, current state and barriers and enablers identified. Conclusions: Literature advocates for a broader scope of clinicians into strategic leadership roles. Despite evidence of strategic allied health roles in New Zealand there remains a dearth of literature on allied health leadership. To foster and sustain the development of allied health leaders in New Zealand it is important to understand the enablers that impact this process.

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