NHS Digital Lauds Granting Local Pharmacists Access to GP Patient Records

Granting local pharmacists access to summary information from GP patient cuts administration time in dealing with pharmacists by as much as 80% in some cases, according to NHS Digital.

One pharmacist cut down on calls to their local GP practice from 200 to just 30 a month after being given access to the practice’s summary care records (SCRs), according to Harpreet Shergill.

Shergill is NHS Digital’s lead for rolling the scheme out across community pharmacy.

With some practices having up to five pharmacies working with them, this has the potential to drastically cut down on GP workloads once the technology beds down, he said.

Shergill, who works as a pharmacist as well, stated that the new policy represents the “biggest single change in pharmacy in the last 10 years”.

And early data indicates that some pharmacies access the system as many as 70 times a week.

Shergill spoke at a King’s Fund event on emerging models in primary care, and suggested that “having access to this information empowers me as a pharmacist to provide care back to patients”.

Recent reports have suggested that many pharmacies face closure following new government regulations.

But the government has indicated its belief that there are two many pharmacies operating in Britain.

Clearly this is a critical time for this valuable part of the healthcare system.

Meanwhile, the new initiative will ensure that pharmacies are not reliant on practices being open to deal with certain enquiries.

This will enable allowing issues to be addressed in the evening and on Sundays.

A smart card system has been put in place for system access.

Around 41% of pharmacies are enabled to use SCRs so far.

And all pharmacies should be live on the system by the end of March 2017.

And Shergill was enthusiastic about the potential of the system.

“Having access to this technology and this subset of the GP patient record allows me to contribute directly to patient care and support primary care in the provision of that care. Historically, by not having access to the SCR, that would have necessitated a phone call to the practice, a conversation with the receptionist – or even with the GP. Access to the information can quickly cut through all that and give clarity to patient.”

The pharmacist outlined the impact that this SCR system has already achieved.

“We used to ring our local GP practice probably 200 times a month with all these queries around patients, prescriptions and medication. After the SCR was introduced and we got used to the technology, that call volume fell to 30 calls per month. That’s an 80% reduction in calls going in to that GP practice. So, if I’m a GP practice – and I had five pharmacies surrounding me locally – then how many calls are coming into my practice? How much time is being taken up by reception having to filter those calls, then deciding what needs to happen.”

And Shergill believes that there are other advantages of SCR as well.

“The second benefit is because we’re solving this in-pharmacy, there’s a reduction in unplanned patient visits and footfall into GP practices.”

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Doctors to be Sent on Communication Courses

The medical director of the NHS has announced that thousands of the doctors and nurses working within the healthcare system will be sent on courses in compassion and communication.

Prof Sir Bruce Keogh suggested that many doctors and nurses are failing to adequately listen to patients, and that the communication skills of healthcare professionals could be significantly improved.

The new initiative will be part of an overall national drive intended to help patients improve their health.

Keogh believes that the future of the NHS depends on coaching staff to have what he described as a “more equal conversation” with patients.

Such skills are needed to help patients tackle unhealthy lifestyles which have left the health service under unprecedented strain, according to Keogh.

Yet many nurses and doctors will undoubtedly believe that this is little short of patronising, and communication problems in the NHS are mainly caused by the undue pressure placed on rank-and-file healthcare professionals.

The national plan follows pilot schemes which have seen more than 2,000 doctors and nurses sent on two-day training courses, which have been funded by the NHS.

Dr Penny Newman, a former GP running the scheme, indicated her belief that staff require guidance on handling difficult conversations, with many people working within the NHS system guilty of lecturing patients rather than listening.

“People need to feel listened to – we know that just handing out advice doesn’t work,” she said. “It’s no good saying to a patient, ‘you need lose two stone, cut out the cakes. You need to ask ‘What is stopping you from losing the weight?’ so that the patient can develop a plan that works. The way we talk to patients is fundamentally important. If we don’t get it right we can make mistakes and we can miss an opportunity to change patients’ behaviour”.

Newman went on to suggest that proper communication could actually save both time and resources.

“The clinician has to be able to really listen, to understand and to be compassionate, in order for a patient to be able to speak comfortably,” she said. “It’s not about telling patients what to do.” If you don’t have a proper conversation with patients in the first place people just come back. It’s unsatisfying for the doctor as well as the patient and it doesn’t save resources”.

The aforementioned Keogh claimed that the training would help secure the future of the NHS.

“For the NHS to be sustainable, people need to become more active in managing their own health, wellbeing and care. They need to be supported to make good choices and more equal conversations, based on a strong partnership between clinician and patient, are vital for achieving this.”

Coaching could also play a role in ensuring that patients take adequate personal responsibility for their general health.

“By providing clinicians with new skills that help patients identify what’s most important to them, and tapping into their own internal motivation, evidence shows health coaching can also address health inequalities, improve health behaviours and reduce avoidable admissions,” Keogh commented.

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MIT Researchers Make Major Chemotherapy Breakthrough

In a major cancer breakthrough, scientists have discovered a molecular mechanism that allows tumours to develop resistance to chemotherapy.

This research has been reported in the journal Cancer Cell, with scientists from the Massachusetts Institute of Technology (MIT) in Cambridge having documented the process.

The new discovery will act as a backup when a specific gene called p53 is missing. This gene usually helps healthy cells prevent mutations.

Backing up the system usually is a pathway called MK2, which allows cells with damaged DNA to repair themselves.

The study ultimately found that a measure of the MK2 pathway performed excellently in terms of predicting which patients responded to chemotherapy.

In the absence of p53, cell division continues during chemotherapy, ensuring that cancer cells continue to proliferate after the process has be completed.

Michael Yaffe, a professor of biology and biological engineering, elaborated on the process:

“I would argue that this particular RNA-binding protein is really what makes tumor cells resistant to being killed by chemotherapy when p53 is not around.”

Prof. Yaffe and colleagues discovered that when p53 is missing – as it is in about half of all tumours – the MK2 pathway takes over.

They thus suggest that targeting the backup system could make p53-deficient tumour considerably more susceptible to chemotherapy.

Yaffe states that researchers discovered that the MK2 pathway does not take over all of p53’s function, only part of it:

“It only rescues the bad parts of p53’s function, but it doesn’t rescue the part of p53’s function that you would want, which is killing the tumour cells.”

The researchers found that measuring levels of the mRNA for Gadd45 and p27 could also help predict which patients are likely to respond to chemotherapy.

In a trial of patients with stage 2 lung cancers, it was demonstrated that those with high levels of mRNA for Gadd45 and p27 did not respond as well to chemotherapy as patients who had low levels of both.

Prof. Yaffee indicates that this measure could be utilised as a surrogate for the presence or absence of the pathway and concludes:

“In this trial, it was very good at predicting which patients responded to chemotherapy and which patients didn’t.”

The study shows that cancer cells have molecular mechanisms that help them maintain their integrity and survive.

It is hoped that this research will lead to a greater understanding of cancer in the continuing battle against the debilitating condition.

There are over 160,000 deaths from cancer every year in the UK alone.

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British Geriatrics Society Suggests Inpatient Falls Response Still Sub-Optimal

A unique and innovative report on the extent of inpatient falls has just been revealed at an event in Brighton.

The British Geriatrics Society’s Autumn Conference in the southern seaside town revealed that this low-key issue is actually a significant problem in the health service.

This latest report, entitled The National Audit of Inpatient Falls, at least reveals that many trusts across the NHS have suitable policies in place to offer fall prevention.

However, the report also suggests that there is often little relation between the supposed policies and the actual care that patients receive once admitted to hospital and other healthcare institutions.

And 20 percent of patients in the study were unable to access their call bell, and almost one-third of patients could not safely access their walking aid.

Both of these issues would have a significant impact on the ability of patients to mobilise safely.

The report also discusses some of the positive work that is currently being undertaken by trusts within the NHS to prevent falls in hospitals.

Such measures included assessing medication, providing safe footwear, or checking for any visual impairment which might increase the risk of falling.

However, the British Geriatric Society was also keen to emphasise that not all trusts are assessing falls risk optimally, and thus may be missing opportunities for prevention.

Although falls in hospitals may be considered a relatively trivial issue by many, the reality is that they are in fact the most commonly reported patient safety incident within the NHS.

Previously published research has demonstrated that 700 falls occur daily across hospitals in England; the equivalent of around 250,000 annually.

Despite the fact that this innovative and important report has not been followed up on since, back in 2007 when it was published, it was estimated at that time that this would cast £15 million to NHS trusts in order to rectify.

It is reasonable to assume that this figure has increased significantly since then.

The National Audit of Inpatient Falls covers nearly 5,000 patients aged 65 years or older across 170 hospitals.

It critically encompasses an assessment of the patient’s environment and the falls risk assessments that they received.

Commenting on the importance of this research, and speaking on behalf of the British Geriatrics Society, Professor Adam Gordon had the following to say.

“High quality data about how individual hospitals perform is an essential part of driving up standards in all aspects of clinical care. The National Audit of Inpatient Falls provides exactly this type of information and represents an important resource for trusts striving to improve their practice. 

Many of the interventions described, such as ensuring availability of call buzzers, seem straightforward but can easily slip by the wayside in busy clinical settings. This audit will allow hospitals which are doing less well to reflect on their current practices and policies, and learn from those parts of the country which are doing better.”

Dr Shelagh O’Riordan NAIF Clinical lead, stated:

“This is the first time there has been a national audit of falls prevention in hospitals across England and Wales. Our results show that although there are pockets of really good care, many hospitals are not doing everything they can to prevent falls.

I hope this inaugural audit is the first step to help reduce the number of falls currently happening in hospitals in England and Wales.”

The National Audit of Inpatient Falls is commissioned by the Healthcare Quality Improvement Partnership (HQIP) as part of the National Clinical Audit and Patient Outcomes Programme (NCAPOP).

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NHS Staff Encouraged to Promote Self Care Week

NHS staff, patients and carers are being encouraged to participate in a week of events intended to raise awareness of the importance of healthy living.

Self Care Week will be held between 16th and 22nd November, and staff across the NHS are urged to help raise awareness of the initiative.

The theme for the week is ‘Self Care for Life’, and a series of events running over the seven-day period will examine and help people understand what they can do to better look after their own health.

Caring for families will also be a critical theme of the week, and there is a general tone of healthy living intended as part of the initiative.

This national campaign is being implemented by the Self Care Forum.

It is intended by the forum for people-facing organisations – such as GP surgeries, CCGs, pharmacies, dentists, local authorities and the voluntary and community sector – to utilise the opportunity provided by the week in order to improve levels of health literacy within the United Kingdom.

Considering the date of the self-care week, with winter approaching, there will also be an emphasis on reminding the public to ensure that the medicine cabinet is well-stocked ahead of this challenging period of the year.

Speaking about this aspect of the event, Dr Pete Smith, a GP and co-chair of the Forum, stated: “By supporting people to help themselves, we can not only improve quality of life for individuals but also use NHS services even more effectively, particularly with winter approaching when we all know our A&E services and GPs face huge demands.”

Self Care Week will also teach members of the public how to solicit appropriate help and assistance on symptoms and illnesses from pharmacists.

More serious conditions will also be a focus of the campaign. Information will be disseminated on how people can prevent deadly, but avoidable, conditions such as type 2 diabetes, heart disease and COPD.

It will also be emphasised that information and advice is readily available from pharmacists in order to deal with a wide variety of lifestyle issues.

Stopping smoking, fighting obesity, and choosing healthy options in order to prevent illness in the first place, while promoting mental well-being, will all be focuses of the week.

Further information will be provided by NHS Choices.

The aforementioned Dr. Smith suggested that Self Care Week could play a significant role in improving the nation’s health.

“Achieving Self Care for Life will be the focus for the conference this year and our objective is to listen to service users about what they need to help them self care, present practical ways in which self care can be embedded into pathways and to identify what support front line staff need at the national and local level to enable this to happen.”

And Dr Martin McShane, NHS England’s National Medical Director for Long Term Conditions, asserted that the message of the campaign is a critical one for the nation.

“Self Care for Life helps raise awareness with people about how they can safely treat minor ailments such as colds or fever, as well as how they can also live healthily and prevent avoidable but more serious problems with long terms conditions such as Type 2 diabetes or heart disease.

“Helping people to help themselves is a two-way partnership between individuals and the NHS to provide information, tools, support and care to allow people to stay well and use health services appropriately.”

The Self Care Forum has been running its annual awareness campaign since 2011, with an ethos of embedding self-care into everybody’s everyday life.

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