The Cost of Diabetes Treatment Set to Rise

In 2013-14, there were an estimated 3.2 million people aged 16 years or older with diabetes in England. The condition is estimated to cost the NHS £5.6 billion a year.  International evidence suggests that the UK performs well compared to other countries in terms of outcomes for diabetes patients.    However, there are significant variations in the routine care and support that diabetes patients receive, and in outcomes for diabetes patients.

The Public Accounts Committee has been reporting on the availability and quality of diabetes services in England.  The committee found weaknesses in the approach of the Department for Health and NHS England to treating this disease and believes that as a result "the costs of diabetes to the NHS will continue to rise".

It found that whilst progress has been made since the Committee last examined diabetes services, there remains "unacceptable variations in the take up of education programmes, delivery of recommended care processes, achievement of treatment standards and in outcomes for diabetes patients".

These include geographic variations across clinical commissioning groups, as well as variations between different groups of diabetes patients.

Very few new diabetes patients are taking up education that could help them manage their condition, and the number of diabetes patients experiencing complications (which account for over two-thirds of the cost of diabetes to the NHS) continues to rise. 

While the number of diabetes patients experiencing complications continues to increase, diabetes specialist staffing levels in hospitals are not keeping pace with the increasing percentage of beds occupied by diabetes patients.

The Committee calls on the Department and NHS England to take rapid action to improve the spread of best practice in preventing and treating the condition.

Key recommendations:

·         By April 2016, diabetes data should be used to identify clinical commissioning groups performing poorly compared to the national average, and "establish interventions to help them improve".

·         By April this year, NHS England and Public Health England should set out a timetable "to ramp up participation in the national diabetes prevention programme" to 100,000 people a year.

·         By July, the Committee urges the Department and NHS England to put in place a separate timetable "to reduce geographical variations and variations between different patient groups".

·         Making it mandatory for GP practices to submit data for the National Diabetes Audit, and for NHS England to develop a "better and more flexible range of education support" for diabetes patients.

Meg Hillier MP, Chair of the PAC, said today:

"The NHS and Department for Health have been too slow in tackling diabetes, both in prevention and treatment.

The number of people with diabetes is increasing, as is the number of patients who develop complications. It is a very serious condition that can have a huge impact on people’s lives. Yet support available to patients and those at risk varies hugely across the country.

There’s clear evidence of what works and as a priority action must be taken to ensure best practice in treatment and education is adopted across the board.

Taxpayers must have confidence that support is available when and where they need it, rather than by virtue of where they live."

Liverpool GP Practice Lifted Out of Special Measures

England’s Chief Inspector of General Practice has taken Kensington Park GP Surgery in Liverpool out of special measures following improvements in the quality of its services.

The practice, operated by SSP Heath Ltd, was rated Inadequate for being safe and well-led, and as requires improvement for being effective and responsive.  It was put into special measures in October 2014.  Since then it has worked hard to improve patient safety and developed better processes for reporting serious events, with staff receiving training in this area. Analysis of events and complaints is now undertaken regularly to identify themes, and lessons learned are shared to encourage learning.

At the CQC latest inspection, in October 2015, inspectors found the practice had improved in all the areas previously identified for concern. Inspectors rated the practice good for services provided to all population groups and in all key areas of inspection.

Professor Steve Field, Chief Inspector of General Practice, said:

"It is clear that Kensington Park Surgery has made improvements since our original inspection when we had serious concerns relating to the safe delivery of services and the leadership of the practice.

"With the support of NHS England and Liverpool Clinical Commissioning Group, the practice has been able to make improvements, and is now providing a safe and clinically effective service.

“I am pleased to announce that Kensington Park Surgery will come out of special measures and I congratulate them on the progress they have made so far.

Sue McMillan, Deputy Chief Inspector of General Practice for the North of England, said:

“When we inspected the practice in October 2015 we found improvements had been made in several areas. There was a renewed leadership focus and the vision of care at the practice was more widely understood. Lessons had been learned and regular quality audits were taking place.

“The practice had worked on strengthening the reporting of serious events and the investigations that followed, and action had been taken to address concerns over the lack of clinical audits to improve the service.”

Employability And Graduation

Soon you may be casting your net into the sea of employment and hoping for a catch. There are many challenges facing graduates today. A lack of jobs, being seen as 'inexperienced', underqualified (or overqualified!) and voluntary internships that seem to last forever.

Employability is important and therefore something worth taking the time to prepare for. How can you make yourself stand out from the crowd?

Engaging With Your Education

Taking time to seek out new challenges provides you with the opportunity to learn new skills. This puts you in a strong position in the employment market. Find out how your university or college supports employability. Challenge yourself to try something new, and start planning your career path early. Ensure you have clear goals and plan how you can begin to achieve them, whether through networking, placements or research. 

Seek Advice

Once you have chosen a career, seek advice on how best to proceed. Find out if there are any skills necessary for the job that you can develop early. Where can you gain experience of the role to show how enthusiastic and committed you are? Consider the skills you already have, some of which may be transferrable from a hobby or personal challenge you have achieved.

Soft Skills

Having the technical knowledge and expertise to fill a role is all well and good, but employers are also looking for those 'soft skills' that add a human element. 'Soft skills' refers to qualities such as organisational ability, time management, team work, using initiative and problem-solving. It is possible to 'learn' some of these skills.  

The CV

Take time with your CV. Write it early on and then proofread it. Consider the skills you have learned over the course of time. What are your strengths? Include those 'soft skills' that employers are looking for. Have you held any positions of responsibility? Ensure it is relevant to the role you are seeking.

Get Active

Consider learning a new language, volunteering for an organisation, or starting a blog related to your chosen career path. Join networks such as LinkedIn and follow groups relevant to your future role. Get yourself noticed by joining in and contributing to conversations on current issues. 

The world is your oyster, so go fishing!

 

Setting Up A Small Business Ethically

Small business ventures face a number of ethical challenges in today's world. Some from leadership and management approaches, others from decisions involving profit margins versus 'the right thing to do'.

The 'organisational culture' of a business encompasses the shared values, goals, rules and routines that make up that organisation. Once this is established, it is the hardest thing to change. As you set up your business, consider what you would like your organisational culture to resemble. Encouraging your employees to take an ethical approach to their work and leading by example, will help to embed this train of thought throughout your business. As Anita Roddick, 1942 (founder of The Body Shop) states: "Being good is good business.". 

What Customers Want

There is a high consumer demand for ethical businesses in today's society. Clients want to feel that they are valued and provided with a high quality service. Disillusion occurs when customers hear grand claims that turn out to be poor sales gimmicks, or when they feel a company is putting personal profit before their clientele and the good of the community. Some businesses seem to believe that an alienated customer will forgive and forget, but very often this is not the case.

Knowledgeable staff who provide easily accessible information are also a big plus. There is nothing more frustrating than asking for help from someone who doesn't know how. Customers want value for money, respect and good service.

Employees

Those that work for you are key to the success of your business. They provide the front line for customer satisfaction, or lack thereof. The way you treat them will have a huge impact on their motivation and morale. Consequently this will affect their productivity. Employees appreciate a listening ear, someone who values what they have to say. If you decide to provide a reward system for great ideas, or effort beyond the call of duty, make sure you follow through.

Ensure you communicate your needs clearly and concisely to your employees. It is frustrating to work hard at something, only to be told 'That's not what I wanted.'. Good communication is vital to efficiency and clarity of vision. Poor communication leads to confusion, wasted time and a lack of motivation.

Learn the strengths of your employees and use them. Find out what interests them, get to know them. Most people respond poorly to a culture of micromanagement, which does not foster an ethos of trust and mutual respect. It can lead to a lack of creativity and progress. Far better to encourage a 'growth mindset' where employees take control of their own productivity, with the freedom to use their initiative and thrive. This also presents a far better use of the manager's time, rather than checking up on every last detail of every last employee. 

Your Footprint

Finally, consider the footprint you want to leave behind. Are you consuming scarce resources or protecting them? Do you encourage others to consider how their behaviour and lifestyle affects others? Setting up a small business brings responsibilities other than the obvious. Take time to think about how your business will affect others, locally, nationally and globally. 

What will your ethical business look like in the future? How will it look to others?

Overcoming Writer's Frustration

As writers we belong to a group of people who experience a unique set of challenges in our role. It can be a lonely job, with a seemingly unending supply of those who want to tear down your confidence, tug at your strings of self-esteem and watch them steadily unravel.

There is a way through! Even when you feel that all of your ideas have dried up, you can still make it work.

Writer's Block

When this happens, and believe me it will, take a moment to reset. Get some rest, read something you know inspires you (a great book, an inspirational quote).  Exercise. A healthy body contributes to a healthy mind that can focus and create. Click here for some additional advice and guidance. 

No Time

If you are serious about writing you need to ensure it is timetabled into your day/week/month. Plan for it and stick to it. Ensure your nearest and dearest support you in this and understand your need for time alone, in peace and quiet. If you have children, enjoy your time with them, then find something constructive for them to do, or somewhere for them to be. Close the door, or find your favourite cafe and take your laptop there. Make time!

Isolation

As a writer you have a lonely job. In order to share ideas, get constructive feedback and flourish, you need to connect with others. Join a local writer's group where you can share your work and receive useful feedback, increase your repertoire of ideas and find support from like-minded individuals.   

Lack Of Output

Take action. Set a minimum target, say 600 words a day, then stick to it. If you want to be productive you need to 'act' on a regular basis. Don't worry if those 600 words aren't perfect yet. You can revisit, refine and add to them later. Just get them down on paper! 

Confidence

Have faith in yourself. Find a support network in family, friends or a writers group. When someone disagrees with what you write, or gives you negative feedback, look back at something great you've done. Read and keep the positive feedback for times like these. If your writing is your bread and butter, make sure you are confident about how much you are worth and don't be afraid to ask for it.

Keep writing!

Image by Laura Cruise Photography, Flickr

 
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CQC Warns NHS Trusts Against Prioritising Price Over Quality

CQC’s Chief Inspector of Hospitals, Professor Sir Mike Richards and the Chief Executive of NHS Improvement, Jim Mackey have written to all 255 NHS hospital trusts in England to ask them to consider quality and finances on equal footing in their planning decisions.

Trusts have been under great pressure to provide more, with little or no additional funding and concern is growing that this is leading to an imbalance in the decision-making process.  Some Trusts are putting the bottom line above improving quality, and others are choosing to sacrifice the bottom line to ensure quality continues to improve, even where significant addition investment only yields a small increase in quality.

The letter reminds Trusts that financial performance and quality must work together, and be considered as combined and equal priorities. It recognises the role that the CQC and NHS Improvement have in enabling Trusts to deliver the right finance / quality balance.

During the summer of 2015 the Secretary of State requested that the CQC and NHS Improvement work together to produce an assessment process to look at this balance during inspections. Draft proposals will go out for public consultation as part of CQC’s future strategy later this year.

Transforming End of Life Care in Acute Hospitals NHS Guide Updated

NHS England first published its’ strategy for end of life care in England in 2008 and since then the rising trend for deaths in hospital has been reversed.

NHS England recognises that it is not always possible to avoid death in a hospital setting, and at times patients actively choose to receive end of life care in a hospital setting.  The revised guide focusses on supporting this group of patients and their carers.

Commissioned by NHS England, the publication offers practical advice and support for frontline clinicians and leaders for the work required to transform end of life care in acute hospitals.

Over 80 acute hospitals across NHS England are already voluntarily working with the Sustainable Improvement Team, NHS England, using the tools, models and approaches set out in this publication to deliver improvements in services locally. 

Trusts interested in joining the programme are asked to contact Debbie Barnhurst at debbie.barnhurst@nhsiq.nhs.uk 

The revised guide to Transforming End of Life Care in Acute Hospitals: The Route to Success ‘How To’ Guide can be downloaded from: https://www.england.nhs.uk/2016/01/11/transforming-end-of-life-care/