Work And Wellbeing In The NHS: Why Staff Health Matters To Patient Care – Royal College of Physicians – 13 March 2015Read Full Post | Make a Comment ( Comments Off on Work And Wellbeing In The NHS: Why Staff Health Matters To Patient Care – Royal College of Physicians – 13 March 2015 )
“The National Care of the Dying Audit for Hospitals, England, has found significant variations in care across hospitals in England. The audit shows that major improvements need to be made to ensure better care for dying people, and better support for their families, carers, friends and those important to them.”Read Full Post | Make a Comment ( Comments Off on National care of the dying audit for hospitals, England – Royal College of Physicians – May 2014 )
Why asthma still kills, the National Review of Asthma Deaths (NRAD) – Royal College of Physicians – 6 May 2014
“There are messages for doctors, nurses, patients, parents and carers in the findings and recommendations of the report. Deficiencies were found in routine asthma care and the review outlines recommendations to be taken forward by not only those who treat patients with this chronic condition but also pharmacists, NHS service managers, policy makers, commissioners and patient and professional bodies.
Why asthma still kills calls for an end to the complacency around asthma care in order to save lives and highlights four key messages:
Every hospital and GP practice should have designated, named clinician for asthma services.
Better monitoring of asthma control; where loss of control is identified, immediate action is required including escalation of responsibility, treatment change and arrangements for follow-up.
Better education is needed for doctors, nurses, patients and carers to make them aware of the risks. They need to be able to recognise the warning signs of poor asthma control and know what to do during an attack.
All patients should be provided with a personal asthma action plan (PAAP), which can help them to identify if their asthma is worsening and tell them how and when to seek help.”
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Acute care toolkit 7: Acute oncology on the acute medical unit – Royal College of Physicians – October 2013
“Advances in cancer management continue to improve patient outcomes, but this has been accompanied by a steady increase in emergency admissions with disease- or treatment-related complications. The acute medical unit (AMU) currently shoulders much of this burden. Providing efficient and excellent care to this complex patient group in a busy AMU presents a key challenge. A good working partnership between the AMU and acute oncology service (AOS) can result in a significant improvement in patient care together with opportunities for admission avoidance and early discharge.”Read Full Post | Make a Comment ( Comments Off on Acute care toolkit 7: Acute oncology on the acute medical unit – Royal College of Physicians – October 2013 )
Future Hospital Commission: Care comes to the patient in the future hospital – Royal College of Physicians – 12 September 2013
“A new report from the Future Hospital Commission recommends that in future, care should come to the acutely ill patient, rather than the patient being moved around the hospital.
This is one of 50 recommendations aimed at improving care for acute medical patients in Future Hospital: Caring for medical patients, which puts the patient experience and the concept of ‘clinician citizenship’ back into the very heart of healthcare. This is matched with a radical restructuring of the wards where acutely ill patients are treated, and a new organisational and management structure whose responsibilities for acutely ill medical patients will stretch out from the hospital into the wider community, developing the idea of a local healthcare system.”
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Smoking and mental health – Royal College of Physicians and Royal College of Psychiatrists – 29 March 2013
“A major new report from the Royal College of Physicians (RCP) and Royal College of Psychiatrists (RCPsych) says that smoking in people with mental disorders is neglected by the NHS. Smoking and mental health says that much of the substantially lower life expectancy of people with mental disorders relates to smoking, which is often overlooked during the management and treatment of their mental health condition.
One in three of the UK’s 10 million current smokers has a mental disorder. Although 20% of the general population smokes, the figure among people with mental health disorders is 40%, and is even higher in those with more severe mental disorders. Those with mental disorders also smoke more cigarettes, are more addicted to nicotine, and find it harder to quit, than those without.”
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Alcohol and cancer: a report from the Alcohol Health Alliance UK – Royal College of Physicians – March 2013
“Alcohol and cancer draws on the latest research to explain the relationship between alcohol and cancer and why this is a problem that the UK needs to tackle now.
Alcohol is one of the most important preventable causes of cancer in the UK. The more a person drinks overall the higher their risk of developing cancer, yet even drinking within current guidelines can increase the risk for certain cancers. There is no level of drinking that can be considered ‘safe’ from the risk of cancer.
Despite these risks, the UK population continues to drink substantially more than we did 50 years ago. The solution is clear – reducing how much people drink overall will reduce their risk of cancer.
This report by the Alcohol Health Alliance UK draws on the latest research to explain the relationship between alcohol and cancer and why this is a problem that the UK needs to tackle now. It calls for the implementation of key strategies to lower the amount the UK population drinks as a whole and to support those who drink excessively to cut down.”Read Full Post | Make a Comment ( Comments Off on Alcohol and cancer: a report from the Alcohol Health Alliance UK – Royal College of Physicians – March 2013 )
“Bringing together findings from the Medical registrar report and 2011 Census, Hospital workforce: fit for the future? looks at the key challenges that are facing the medical workforce.
It finds that:
•There is significant geographical variation in the number of consultants per head of the population across the country; there are also variations among specialties.
•There are not enough doctors with the skills to care for frail older patients.
•The workload of the medical registrar is increasingly unmanageable.
The report concludes that there needs to be a rethink of the skills in which doctors are trained, in order to better meet patients’ needs; while the role of the medical registrar and the esteem in which it is held must be reassessed and better valued.”Read Full Post | Make a Comment ( Comments Off on Hospital workforce: fit for the future? – Royal College of Physicians – 4 March 2013 )
Action on obesity: comprehensive care for all – Royal College of Physicians report of a working party – January 2013Read Full Post | Make a Comment ( Comments Off on Action on obesity: comprehensive care for all – Royal College of Physicians report of a working party – January 2013 )
“Obesity is an increasing and costly public health problem which is not being addressed by current services or policy. This new report confronts the issues, and sets out how the NHS should adapt to meet the demands of an increasingly obese nation.”Read Full Post | Make a Comment ( Comments Off on Action on obesity: Comprehensive care for all – Royal College of Physicians – 1 January 2013 )
Acute care toolkit 5: teaching on the acute medical unit – Royal College of Physicians – 27 November 2012
This toolkit helps clinicians and trainees ensure there is a focus on quality education as well as delivering essential care. It focuses on maximising opportunities for teaching and learning, and includes technical tips and examples for weaving teaching and learning into the daily work of an acute unit.
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Cancer patients in crisis: responding to urgent needs – Royal College of Physicians (RCP), Royal College of Radiologists (RCR) – 21 November 2012
“Emergency admissions for patients with cancer remain problematic despite the development of acute oncology. There is more that could be done to improve their care and subsequent experiences and outcomes.
Patients and their carers often have a lack of information about what to expect and who to contact when their condition suddenly worsens and requires urgent medical attention – this is often referred to as a crisis. Cancer management is complex and involves a number of teams and there has been little emphasis on planning for potential problems. More proactive care would ensure that patients, their carers and health professionals are better equipped to respond when a person becomes acutely unwell.
When admitted to hospital there is a need to improve decision-making, coordination of care and communication between professionals and – crucially – with patients themselves. In unplanned and urgent situations, patients themselves may receive confusing or conflicting information or feel less able to assert their concerns and wishes. Too often patients receive fragmented care. Patients are often seen by multiple healthcare professionals and sometimes multiple medical specialties during an admission.
This results in some patients being treated suboptimally, especially where the cancer diagnosis clouds other considerations in their management. Others, especially nearing the end of life, may undergo repeated investigations and interventions that are not to their benefit. Some admissions, especially among patients already approaching the end of life, may be avoidable.
This new report Cancer patients in crisis: responding to urgent needs from the Royal College of Physicians (RCP) and Royal College of Radiologists (RCR), including a foreword from Professor Sir Mike Richards, national clinical director for cancer, provides decision making tools to health professionals working in hospitals and the community, to help improve the care of cancer patients in crisis. It also proposes standards of good practice in each care setting which should reduce risk and improve outcomes.
Patient and carer representative members of the working party have led on the development of an innovative planning wallet for patients. This is intended to encourage timely discussions about unexpected problems at any point in a patient’s journey. It will prompt patients to seek and keep to hand important information and help to facilitate forward planning regarding their care.”
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Acute care toolkit 4: delivering a 12-hour, 7-day consultant presence on the acute medical unit – Royal College of Physicians – 11 October 2012
“Acute medical illness is a 7-day problem – patients are just as likely to develop an acute illness requiring an emergency admission on a Saturday or Sunday as on a weekday. Evidence that patients admitted at weekends have poorer outcomes than those admitted on weekdays, and that patient mortality is higher at weekends, led to the RCP and the Society of Acute Medicine (SAM) recommending that a consultant physician ‒ dedicated to the care of acutely ill patients ‒ should be available on site to review patients for at least 12 hours a day, every day.
This toolkit provides practical guidance to senior hospital managers and clinical staff on how to organise acute medical services to ensure that the 12-hour consultant presence delivers consistent high-quality care to acutely ill patients.
The guidance provides answers to key questions including:
How many consultants are required to provide a daily 12-hour presence on the acute medical unit (AMU)?
How many patients should a consultant be expected to review during their shift on the AMU and how long should this shift be?
How should consultant working and support services be organised in order to provide high-quality patient care every day of the week?”
Hospitals on the edge? The time for action A report by the Royal College of Physicians – September 2012
“All hospital inpatients deserve to receive safe, high-quality, sustainable care centred around their needs and delivered in an appropriate setting by respectful, compassionate, expert health professionals. Yet it is increasingly clear that our hospitals are struggling to cope with the challenge of an ageing population and increasing hospital admissions.
Overview of challenges facing acute hospitals
The pressures on the acute service are relentless and intense:
Increasing clinical demand.
Increasing clinical demand.
Out-of-hours care breakdown
Looming workforce crisis in the medical workforce.
Staff health improvement project – Royal College of Physicians (RCP) – 20 August 2012
“The Royal College of Physicians (RCP) has published the interim report and a summary of its Staff Health Improvement Project.
In 2010 the RCP’s Health and Work Development Unit (HWDU) – a partnership between the RCP and the Faculty of Occupational Medicine (FOM) – measured how far NHS trusts across England had progressed with implementing the NICE public health guidance for the workplace. The audit covered areas such as obesity, mental wellbeing and management of long-term sickness absence.
Implementation of the NICE recommendations benefits organisations by improving staff health and wellbeing, leading to better productivity, improved patient outcomes and increased financial savings.
Phase one of the Staff Health Improvement Project involved interviewing 22 trusts about their approach to successfully implementing the guidance. The interim report and summary describes the findings from those interviews, including a description of enablers and barriers to implementation and a summary of the key initiatives that have been put in place.
The summary interim report is aimed at HR Directors and board members with responsibility for staff health and wellbeing. The full interim report is aimed at health and wellbeing implementers.”
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National early warning score. Standardising the assessment of acute illness severity in the NHS – Royal College of Physicians – July 2012
Early detection, timeliness and competency of clinical response are a triad of determinants of clinical outcome in people with acute illness. Numerous recent national reports on acute clinical care have advocated the use of so-called ‘early warning scores’ (EWS), ie ‘track-and-trigger systems’ to efficiently identify and respond to patients who present with or develop acute illness. A number of EWS systems are currently in use across the NHS, however, the approach is not standardised. This variation in methodology and approach can result in a lack of familiarity with local systems when staff move between clinical areas/hospitals – the various EWS systems are not necessarily equivalent or interchangeable. Put simply, when assessing acutely ill patients using these various scores, we are not speaking the same language and this can lead to a lack of consistency in the approach to detection and response to acute illness. This lack of standardisation also bedevils attempts to embed a culture of training and education in the assessment and response to acute illness for all grades of healthcare professionals across the NHS. Building upon recommendations in the RCP’s Acute Medicine Task Force report Acute medical care: the right person, in the right setting – first time, published in 2007, the RCP commissioned a multidisciplinary group to develop a National Early Warning Score (NEWS).”
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“The FallSafe project involved educating, inspiring and supporting acute, rehabilitation and mental health nurses to deliver multifactorial assessments and interventions through a care bundle approach. The care bundle, the FallSafe project final report, and How to… guides for implementation comprise the Falls Prevention Resource pack, which launches today.
Access the Falls Prevention Resource.
Over 280,000 patient falls are reported from hospitals and mental health units annually, costing approximately £15 million per annum. Most hospital fallers are aged over 75 years and have multiple long term and acute illnesses. Although in purely financial terms the healthcare costs of falls are only a small fraction of a percentage of trust income and expenditure, the costs to a trusts’ reputation, patient and carer confidence, and social care costs can be significant.
The FallSafe project was delivered by the Royal College of Physicians (RCP) as part of the Health Foundation’s Closing the Gap Programme, which aimed to reduce the gap between best practice and routine delivery of care. Although all falls cannot be prevented without unacceptable restrictions to patients’ independence, dignity and privacy, research has shown that falls can be reduced by 20-30% through multifactorial assessments and interventions.
The main mechanism of improvement was supporting a designated nurse – a FallSafe lead – to lead local improvement on their own wards, influencing not only the ward nurses and healthcare support workers but also their physiotherapist, occupational therapist, pharmacist, and medical colleagues.”
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Supporting information for appraisal and revalidation: guidance for physicians – Royal College of Physicians – 28 June 2012
“In readiness for the launch of revalidation at the end of 2012, the RCP has produced guidance for physicians on the supporting information required for appraisal and revalidation.
The guidance has been designed to offer practical examples of the types of supporting information that doctors might present at their annual appraisal and include in their revalidation portfolio, upon which their responsible officer will recommend to the General Medical Council (GMC) that they remain fit to practise. It has been widely consulted upon, with input from all physician specialties, and is applicable across the many areas of physician practice.
The GMC has set out the requirements for revalidation for all doctors in their Good Medical Practice framework for revalidation and their guidance on supporting information. The RCP guidance builds upon the GMC guidance to offer clear and practical examples, relevant to practising physicians.
The GMC recommends that doctors in specialist practice should consult the supporting information guidance provided by their college or faculty. This guidance expands on the headings provided by the GMC, by providing additional detail about the GMC requirements and what each college or faculty expects relating to this, based on their specialty expertise. These expectations are laid out under ‘Requirements’.”
“A new report released today highlights the need for all NHS staff to be given good advice about back pain. Musculoskeletal problems such as back pain account for 40% of sickness absence amongst NHS staff and costs approximately £400 million per year.
The Royal College of Physicians’ (RCP) National clinical audit of back pain management looked at how occupational health professionals cared for NHS staff who are experiencing back pain. It found that the care and management occupational health professionals give to staff suffering with back problems has improved in the three years since the previous audit in 2008.
However, in half of the 5,524 cases included in the audit, sufferers required clearer information about back pain. This included the fact that in most cases back pain is likely to get better spontaneously and that it is important to return to work as soon as possible. This advice applies even if they are experiencing some pain. If they do not, they risk developing chronic pain and disability.”
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Acute care toolkit 3: acute medical care for frail older people – Royal College of Physicians – 24 April 2012
“The third in the series of acute care toolkits from the Royal College of Physicians aims to improve the care of the frail older patient.
Older people make up 60–70% of hospital inpatients, and most are admitted through an Acute Medical Unit (AMU), making this a key area in which care for older people can be influenced. It can be difficult for doctors to assess frail older patients as they can often arrive at hospital with multiple symptoms or conditions which can make it difficult to deduce the true cause of the admission.
The new six-page toolkit, produced in collaboration with the British Geriatrics Society, recommends procedures for both initial assessment on admission and later Comprehensive Geriatric Assessment (CGA).”
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“30 lung cancer teams across England have been working together to improve care for patients. The Improving Lung Cancer Outcomes Project (ILCOP), based at the Royal College of Physicians (RCP), and involving eight partner organisations*, brought the teams together to work collaboratively and share practice to improve the quality of care and patient experience for lung cancer patients.
Data from the National Lung Cancer Audit (NLCA) had previously revealed variations in lung cancer outcomes across England. ILCOP was established to identify reasons for the variation in clinical (NLCA) outcomes as well as patient experience outcomes, which were collected through a specifically designed lung cancer patient questionnaire. The project used proven quality improvement measures to support the teams to make improvements and came up with an educational programme to spread the learning across the 30 teams and the wider lung cancer clinical community.
The project paired hospitals and multi-disciplinary teams, and encouraged them to visit each others’ services and review their processes. This collaborative approach allowed lung cancer teams to share practice, resulting in a variety of practical improvements to processes, the patient pathway, and patient experience, as detailed in the attached booklet.
Practical examples of quality improvement projects undertaken by ILCOP teams include the following:”
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Tools for auditing patient record keeping standards launched by Royal College of Physicians – 11 April 2012
“In a project funded by the Healthcare Quality Partnership (HQIP), the Royal College of Physicians Health Informatics Unit (HIU) has developed three tools for auditing patient records against the HIU standards covering generic record-keeping standards, standards for admission clerking and discharge summaries.
Find out more about the tools: http://www.hqip.org.uk/record-keeping-audit-tools/
Three audit tools are available for download and for auditing against the:
Generic Multi-Disciplinary Clinical Record Keeping Standards
Hospital Admission Clerking Standards
Hospital Discharge Document Standards”
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An evaluation of consultant input into acute medical admissions management in England – Royal College of Physicians – 2 April 2012
“A survey of over 100 hospitals in England by the Royal College of Physicians has shown for the first time that patients have better outcomes and are less likely to be readmitted to hospital if cared for on wards where the physicians practising acute medical care:
are on call for more than one day at a time
have no other routine duties during that time
do two or more ward rounds per day in the acute medical unit (AMU)
are present in the (AMU) for more than 4 hours for 7 days.
As a result, the RCP will now recommend this system of cover above all others. This new research fully supports the RCP’s recent call for consultant physicians to be on site for 12 hours per day, seven days a week.
The survey was commissioned by the RCP through its Clinical effectiveness and evaluation unit, in association with the Society for Acute Medicine and the British Geriatrics Society, who helped develop and distribute the survey. It matched various systems of consultant cover against patient outcome data from hospital episode statistics, to see if there was an advantage to patient care from any of the different systems. The results in brief:”
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“Standards for the structure and content of core clinical headings are being developed in a project led by the Health Informatics Unit (HIU). These headings are meant to apply to the patient focused record, and be accessible in any care context and communication.
This project aims identifies those pieces of core clinical information in all electronic health records, and to develop standard headings and precise definitions for them. Throughout the process of drafting of these standard headings, the Health Informatics Unit (HIU) has ensured that there has been large-scale clinical engagement and specialist contribution to the development of the standards. This has included extensive consultation with all the medical royal colleges, specialist societies, patients and carers, and with acute and mental health trusts.
This work is being carried out as part of phase two of the clinical documentation and generic record standards (CGDRS) programme of work, due for completion in 2012, and funded by NHS Connecting for Health. It is a clinically led project and the deliverables will be submitted to the Academy of Medical Royal Colleges for approval prior to submission to NHS Connecting for Health.”Read Full Post | Make a Comment ( Comments Off on Standards for core clinical information – Royal College of Physicians – 26 March 2012 )
“Consultant physicians are at the forefront of delivering care to patients presenting to hospital with medical emergencies. Delivering this care depends on competent and expert clinical staff, organised with optimal working arrangements to match patient demand, supported by the right level of resources and facilities.
This toolkit, the second in a series on acute care, focuses on the delivery of high-quality acute care, looking at current problem areas and factors threatening care delivery, and suggesting a range of recommendations for improving quality.
The toolkit is accompanied by two appendices: the RCP position statement on out-of-hours care, and guidance notes on the provision of 12-hours-per-day, 7-days-per-week consultant care.”Read Full Post | Make a Comment ( Comments Off on Acute care toolkit 2: High quality acute care – Royal College of Physicians – 21 October 2011 )
N=1: Why people matter in medicine – Royal College of Physicians – 27 September 2011
“A new report has outlined the need to bridge the gap between patients and the medical industry for a more beneficial, effective system of prescribing.
N=1: Why people matter in medicine has been published by a subgroup of the Royal College of Physicians (RCP) Medicines Forum and highlights the part that patient understanding and belief plays in determining whether or not a medicine is taken as advised, or even taken at all.
The report, based on consultations held over a period of 11 months with representatives of patient groups, specialists and views of the RCP’s patient and carer network, makes particular reference to the need for healthcare professionals to use ‘patient terms’ and real life language. The authors note that ‘conversations need to be derived from what the public wants and needs to know about medicines and their effects – not from what professionals want to tell them.’
The report highlights that there is often uncertainty about what is available to the public in terms of life-changing therapeutic products and what modern medicine is actually able to offer.
A key recommendation of the report is that GPs should be able to refer patients with medication problems to a pharmacist adviser who can also be used as a source of advice for both patients and GPs on medication related issues.
Other practical recommendations in the report focus on more effective engagement, service improvement and improving research for the benefit of the public.”
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“With the changing landscape of shorter working hours, the main pitfalls appear to be at the front line of acute medical services. There is increasing evidence of sub-standard care delivered to patients admitted to hospital in the evenings and at weekends. The RCP recognises the need to ensure consistent high-quality care, 24 hours a day, seven days a week, 365 days a year across the NHS, which is reflected in the recent RCP statement recommending consultant presence 12 hours a day, seven days a week in acute care settings.
A series of toolkits
Currently there are clear difficulties in providing high-quality service and training within the constraints of the shorter working hours. To tackle this issue, this year RCP will prepare a series of toolkits with the goal of ensuring that patients get access to the highest quality of acute medical care wherever and whenever it is needed. Each toolkit will include concise practical guidance to enhance patient safety, medical effectiveness and high quality service and training within current working patterns. The first toolkit in the series will address handover.”
“The audit shows that there is unacceptable variation in the quality of NHS services for care and prevention of falls and fractures. In many areas, there is a major gap between what NHS organisations state what they provide, in terms of commissioning, protocols or structure; and what clinical audit reveals in terms of actual care provided. The audit shows that older patients with fractures do not routinely receive key aspects of care for falls prevention or bone health, needlessly exposing them to a greater risk of further falls and fractures.
The audit was commissioned by the Healthcare Quality Improvement Partnership (HQIP) and carried out by the Royal College of Physicians’ Clinical Effectiveness and Evaluation Unit (CEEU). Information on nearly 10,000 patients came from all NHS Acute Trusts, or equivalent, in England, Wales and Northern Ireland, as well as Primary Care Organisations, Mental Health Trusts and a sample of care homes.”Read Full Post | Make a Comment ( None so far )
“Stroke care still improving but concerns remain
The final report of the National Sentinel Stroke Audit shows that care for patients with stroke is still improving 12 years after the start of the audit. 88% of patients spent at least some time on a stroke unit which is excellent progress from 74% in 2008. Patients on stroke units have better outcomes than those admitted to and treated on general wards.
The audit, commissioned by the Healthcare Quality Improvement Partnership (HQIP), was carried out on behalf of the Intercollegiate Stroke Working Party by the Royal College of Physicians’ Clinical Standards Department, and covers 100% of eligible hospitals in England, Wales and Northern Ireland.”Read Full Post | Make a Comment ( None so far )
Future physician: Changing doctors in changing times – Royal College of Physicians – May 2010
Report of a Working Party
The Royal College of Physicians 2005 report Doctors in society: medical professionalism in a changing world set out a definition and wider description of medical professionalism. The report’s pivotal role in raising the profile of medical professionalism provides a background to this new report, which looks at:
the likely context in which healthcare will be provided 15 to 20 years hence
the roles and responsibilities of doctors in this future context
the anticipated challenges
the steps needed to make the most of the opportunities ahead.
This report is a charter for change and should be read by doctors, patients and the public, healthcare organisations, employers of doctors, and those involved in medical education and training.”
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Falls Prevention Services good but problems remain – Royal College of Physicians – 24 February 2010
“In a new survey of over 1,000 patients from the Royal College of Physicians, three-quarters (76% – 767 of 1,028 total respondents) felt that their experience of falls prevention services had been positive.
However, among the 24% of respondents reporting a less than positive experience, the majority of issues were related to communication between patients and healthcare professionals, and many of the physical exercise programmes described in the results were not evidence-based, which limits their effectiveness.
Participants also felt that the exercise programmes they were offered did not continue for long enough, were not sufficiently frequent and that the location was not always convenient enough to be really beneficial.
The postal survey, commissioned by the Healthcare Quality Improvement Partnership (HQIP), carried out by the RCP’s Clinical Effectiveness and Evaluation Unit (CEEU) and supported by Age Concern and Help the Aged, showed that the majority of people were positive about their experiences of local falls prevention services. “Read Full Post | Make a Comment ( None so far )
More acute consultants means shorter hospital stays News : 18 June 2009
“New research published by the Royal College of Physicians shows that more consultants on Acute Medical Units (AMUs) can reduce hospital stays and prevent inappropriate admissions in the first place. AMUs are now found in hospitals all over the country, despite being a relatively new specialty. This is the first evidence to support arguments that they will bring benefits to patient care.”
1. The full team involved in the study consisted of: Dr Nicola Trepte, consultant physician in acute medicine; Dr Gregor McNeill, specialist registrar in acute medicine; Dr Darshan Brahmbhatt, academic foundation house officer 2 in cardiothoracic surgery; and A Toby Provost, medical statistician.
2. The article What is the effect of a consultant presence in an acute medical unit is published in this month’s edition of Clinical Medicine journal [June 2009].Read Full Post | Make a Comment ( None so far )
Preparations for pandemic influenza: Guidance for hospital medical specialties on management during a pandemic influenza outbreak – Royal College of Physicians May 2009
“Preparations for pandemic influenza has been developed by the Royal College of Physicians to help hospitals and staff coordinate care during an influenza outbreak.
The guidelines have been developed and edited during recent months with publication originally set for June this year. Due to current global events the College felt an early release of the information was merited, and hence a pre-press version of the guidance can be found below. However, please note that, as yet, the document is still at proof stage (with author corrections still pending) and the document is not in its final navigable format. All data will be present in the final version, which will be released during May to replace this version.” …. continues on the websiteRead Full Post | Make a Comment ( None so far )