Tuesday 10 July 2012

The Allied Health Professional’s Continuing Personal and Professional Development (CPPD) Toolkit




As a set of professions we have many common functions that need to be supported through development. This document illustrates how CPPD processes may be maximised to enhance
clinical delivery.

This piece of work comes out of a project undertaken by NHS London that investigated how AHPs interact with the CPPD mechanisms available. Often it was reported that AHPs did not
make the most of flexibilities or felt held back from participating.  A toolkit has been designed to ensure that clinicians and managers are enabled to make best use
of the opportunities presented to them. There is great benefit to be gained in working directly with education providers and in collaborating with colleagues to increase the quality and range
of educational experiences that AHPs can use.

Monday 9 July 2012

BAPO Conference 2013


A Cohort-Controlled Trial of Customized Foot Orthotics in Trochanteric Bursitis

JPO Journal of Prosthetics & Orthotics:
July 2012 - Volume 24 - Issue 3 - p 107–110
doi: 10.1097/JPO.0b013e3182627659
Original Research Article

A Cohort-Controlled Trial of Customized Foot Orthotics in Trochanteric Bursitis

Ferrari, Robert MD, MSc (Med) FRCPC, FACP

ABSTRACT: Customized foot orthotics are widely prescribed for patients with lower limb pain from a variety of disorders, but there are few trials demonstrating effectiveness and none for trochanteric bursitis. Sixty-eight consecutive patients presenting with symptoms and findings compatible with a case definition for acute or subacute trochanteric bursitis (pain <3 months, point tenderness along the femoral greater trochanter, and pain on resisted hip abduction) were included in the study. A total of 34 subjects were prescribed a local corticosteroid injection under fluoroscopic guidance (control group), and 34 subjects were prescribed a local corticosteroid injection with the addition of customized foot orthotics (orthotics group). All subjects completed the Oswestry Disability Index at baseline, and the number of subjects using prescribed analgesics for their hip pain was recorded at baseline and at follow-ups of 8 weeks and 4 months. Subjects were asked at each follow-up if they felt they had recovered from their "hip and thigh region pain," with recovery arbitrarily being defined as having pain or symptoms in this region for 1 day per week or less. All subjects who failed to report recovery at 8 weeks underwent a repeat corticosteroid injection. A total of 32 subjects in each group completed the study at 8 weeks, and 30 subjects in each group completed the 4-month follow-up. The 2 groups were well matched in terms of age, sex distribution, duration of pain, unilateral or bilateral nature of bursal involvement, and baseline Oswestry Disability Index score. At 8 weeks, 50% reported recovery in the control group and 75% reported recovery in the orthotics group. The number of subjects who reported recovery at 4 months, however, was markedly different between groups, with only 40% reporting recovery in the control group and 90% reporting recovery in the orthotics group. The control group thus reported a high rate of recurrence of trochanteric bursitis. In a cohort-controlled trial of primary care patients with acute or subacute trochanteric bursitis, the addition of custom-made foot orthotics to local corticosteroid injection appears to improve the short- and long-term outcome, with fewer recurrences.

Developing our NHS care objectives: A consultation on the draft mandate to the NHS Commissioning Board

New objectives for the improvement of health and healthcare have been set out for public consultation.

'Our NHS care objectives: a draft mandate to the NHS Commissioning Board', sets out Health Secretary Andrew Lansley's expectations for the health service and marks the move to a more patient-centred, independent, transparent and outcomes focused NHS.

Read the news story

Consultation documents

Our NHS care objectives: A draft mandate to the NHS Commissioning Board

Developing our NHS care objectives: A consultation on the draft mandate to the NHS Commissioning Board

Our NHS care objectives: A draft mandate to the NHS Commissioning Board – Annexes

Impact Assessments and Equality Analysis

NHS Evidence QIPP collection – call from NICE for new case studies

The Quality, Innovation, Productivity and Prevention (QIPP) Evidence Collection
 
The NHS is facing a significant challenge to improve the quality of care in difficult economic times, and demonstrate that money is being spent wisely, with the best possible outcomes.
 
As you will be aware, the QIPP collection on NHS Evidence (www.evidence.nhs.uk/QIPP) provides quality-assured, real life examples of how things can be done differently in health and social care, whilst still providing optimal standards of care to patients. This includes evidence-based examples that have been shown to improve quality and save money (the QIPP Evidence Collection), plus areas of potential disinvestment from NICE guidance and Cochrane reviews.  Examples from other QIPP national work streams are also highlighted.
 
There are now over 120 best practice quality and productivity examples on NHS Evidence, and more are being added on a regular basis. If you have good examples that have been shown to or have the potential to work – and which can help the NHS nationally meet its challenge - we want to hear from you. Your organisation could become a beacon of best practice for others to follow. If you have already submitted a case study, please consider whether you have any new examples to provide.
 
The QIPP collection already has the potential to make a huge difference. Taking all the published local examples, the national equivalent monetary value (using a conservative estimate of a 50% roll out) of improved quality, improved efficiency or reduced costs stands at almost £2 billion.
 
For your QIPP initiative to be considered for inclusion on NHS Evidence, you will need to complete an online form which you can find at http://www.evidence.nhs.uk/QIPP together with a User Guide outlining what types of supporting information the assessment team is looking for.
 
It would be very helpful if you could send your completed submission to NHSevidenceqipp@nice.org.uk. Once your submission has been processed, a member of the assessment team will contact you. Alternatively, if you would like to discuss your initiative and the level of detail required first, you can also request a call back by sending an email to NHSevidenceqipp@nice.org.uk.

Single Operating Model for Commissioning Primary Care

The NHS Commissioning Board Authority has published the single operating model for the commissioning of primary care services within the NHS.

The new system will come into effect from 1 April 2013. At this date, the NHS Commissioning Board will take on many of the current functions of PCTs with regard to the commissioning of primary care health services, as well as some nationally-based functions currently undertaken by the Department of Health.

Securing excellence in commissioning primary care describes the system by which the NHS Commissioning Board will use the £12.6bn the NHS spends on commissioning primary care to secure the best possible outcomes for patients.  In time, through this new system, the NHSCB will also develop the future strategy for primary care.

The benefits the Board Authority hopes to achieve from this change are:

  • Greater consistency and fairness in access and provision for patients, with an end to unjustifiable variations in services and a reduction in health inequalities
  • Better health outcomes for patients as primary care clinicians are empowered to focus on delivering high quality, clinically-effective, evidence-based services
  • Greater efficiencies in the delivery of primary care health services through the introduction of standardised frameworks and operating procedures.

It is a system change which will have an impact on patients, providers and their teams, and commissioners, and the Board Authority has systematically taken 18 months to research, develop and consult upon the proposals to ensure they are practical and workable. It has worked closely with current commissioners, patient representatives, PCT medical directors, dental, pharmaceutical and optometric advisors, and key national, regional and local stakeholder and professional bodies to seek to understand and preserve the best of the current system, learn from good practice, and ensure that the system changes will be managed effectively.

The document is based on three guiding principles:

  • People should have access to continuously improving, high quality primary care provision regardless of where they live
  • The commissioning system should be clinically led and professionally managed to balance the needs of local communities within a single operating system
  • There should be consistency in the contractual relationship between providers and the NHS Commissioning Board as the commissioner.

Over the next few months, local area teams, which will be responsible for the delivery of the new system, will be appointed as will central and regional primary care commissioning teams.  CCGs, commissioning support services and local authorities will start to assume their future roles and responsibilities. This document will provide a guide these teams and bodies as they establish and/or further develop their organisations.


http://www.commissioningboard.nhs.uk/2012/06/22/ssom-comm-pc/

The Year 2011/12 – NHS Chief Executive’s annual report published

The year 2011/12 launched today at the annual NHS Confederation Conference and Exhibition. This is the annual report for 2011/12, in which Sir David Nicholson reviews the NHS achievements of the previous 12 months and considers the challenges to come.

This edition includes the quarter, which provides the definitive account of how the NHS is performing at national level against the requirements and indicators set out in the NHS Operating Framework 2011/12.

In his introduction to the year (PDF, 3.9MB), Sir David acknowledges the hard work and diligence of NHS colleagues, with the service now fully committed to delivering the Quality, Innovation, Productivity and Prevention (QIPP) efficiency savings.

Against a backdrop of massive organisational change, Sir David praises, 'the heroic efforts made by the 1.2 million staff who work for our patients in the NHS.' Together, they have delivered key successes, including the lowest infection rates since the introduction of mandatory surveillance, lower waiting times for A&E, cancer care and dentistry, and the delivery of £5.8 billion efficiency savings.

Sir David acknowledges the efforts of GPs to begin driving clinically-led commissioning and the wider NHS engagement with the new public health agenda and the creation of the Health and Wellbeing Boards.

Although the Health and Social Care Bill has now passed through Parliament, Sir David reminds NHS colleagues of the hard work to come 'to implement the transition from the old system to the new'. While acknowledging this 'daunting challenge,' he believes the annual report demonstrates strong foundations are in place to deliver further change for staff and patients.

Watch the video of Sir David Nicholson, Chief Executive of the NHS, discussing the challenges facing the NHS and the huge progress being made across health services.


http://www.dh.gov.uk/health/2012/06/the-year-2011_12/

Friday 6 July 2012

Report outlines effect of the NHS Constitution

A report on the effect of the NHS Constitution on patients, staff, carers and members of the public has been published today by Health Secretary Andrew Lansley. The report will inform efforts to fully embed the Constitution throughout the NHS.

The report seeks to clarify the effect of the NHS Constitution on those who use NHS services and who work in the NHS. It considers whether, and to what extent, the Constitution has made a difference to patients, staff, carers and the public, and examines the degree to which it is succeeding in its aims.

The independent NHS Future Forum, chaired by Professor Steve Field, advised the Health Secretary on the effect of the Constitution and outlined the need to raise awareness, and promote real understanding about, and use of, the Constitution.

Public awareness of the Constitution remains generally low and there is little evidence that patients use it as a means of exercising their rights. Staff awareness of the NHS Constitution is significantly higher than among the public but still few feel well informed about it.

In its advice to the Health Secretary, the Future Forum said:

'We take heart from the fact that staff who are most informed about the NHS Constitution are also the most likely to value and champion it; and from the extent to which people in the East of England have become aware of the Constitution, showing the effectiveness of efforts made there. It is also clear that, when shared with different groups, the Constitution has the power to enthuse and galvanise people.'

The Future Forum will now consider how the Constitution can be strengthened and reinforced for the future, in terms of both content and awareness.

The NHS Future Forum will present its advice to the Government in the autumn. Following this, there will be a public consultation on any changes to strengthen the Constitution so that patients, staff and the public have the chance to have their say.

Read the report on the effect of the NHS Constitution
Read the letter to the Health Secretary Andrew Lansley from Professor Steve Field of the NHS Future Forum
Read the awareness survey NHS Constitution Wave 3 Report

Reconfigurable mould machine for orthotics

University researchers have been developing software for a machine that can produce medical braces for a variety of patients, helping to save health services money, time and space and cutting serious environmental pollution.

Currently medical braces - or orthotics - are tailored to an individual patient for use in occupational therapy, rehabilitation and the treatment of fractures or deformities. A new mould for each orthotic is produced for every patient in a messy, time and labour intensive process, with a large amount of storage space required for any unused moulds. 

But a team of researchers, led by Vice-Provost for Research Professor Nabil Gindy and Dr Yan Wang, plan to replace dedicated moulds with a reconfigurable array of pins capable of producing a large variety of moulds. By utilising reconfigurable screw-pins to control the shape of a former, the same pin array can be reconfigured and reused many times.

A scanner would capture the geometry of a patient's body with the captured image then being transferred directly to a hybrid machine capable of using this image to produce a vacuum formed cast directly. 

It is estimated that the new technology would overcome the traditional lead time and cost issues associated with manufacturing components in low volumes. 

The cost of a one off machine is approximately £38,500. As an example, if the machine was used at Nottingham's Queen's Medical Centre, the investment would be returned after eight months and the hospital would save £123,000 over three years. 

Source: http://www.nottingham.ac.uk/research/international-campuses/reconfigurable-mould-machine-for-orthotics.aspx


Thursday 5 July 2012

Health Professions Council Name Change

On Wednesday 1 August 2012, the Health Professions Council will change their name to the Health and Care Professions Council. At the same time, they will also become the statutory regulator of social workers in England, taking over regulatory responsibilities from the General Social Care Council. These changes have been made by government through the Health and Social Care Act 2012.

Although not everyone who is registered with the HPC works in 'health' or 'care', the new name is intended to better reflect the increasingly diverse professions they regulate, many of whom work in a range of settings including education, community or social care. They will be adopting a new strapline 'Regulating health, psychological and social work professionals'.

To reflect the name change they have revised the main corporate logo as well as the registration logo, a bilingual English / Welsh logo and variants for use across our social media channels including Facebook, LinkedIn and Twitter

HPC's existing professions will not be paying for these changes as they are being brought about through the Health and Social Care Act 2012. A grant from the Department of Health will cover the cost of amending materials due to the change of name and the work to allow social workers in England to join the Register.

There is no deadline for the discontinuation of the old registration logo or a requirement for registrants to change their marketing materials immediately. Where possible, we hope that registrants will move to the new logo as soon as possible, but understand that some may need time to use up stationery or materials. We are not asking registrants to incur undue costs as a result of this change, but to gradually phase in the changes where they can.

For more information see their website: www.hpc-uk.org/aboutus/namechange

Wednesday 4 July 2012

Consultation on new care objectives for improving health and healthcare

New objectives for the improvement of health and healthcare have been set out for public consultation.

'Our NHS care objectives: a draft mandate to the NHS Commissioning Board', sets out Health Secretary Andrew Lansley's expectations for the health service and marks the move to a more patient-centred, independent, transparent and outcomes focused NHS.

The mandate aims to:

  • set care objectives that really matter to people
  • ensure that patients continue to receive high quality care every time – care that is effective, safe and results in patients having as positive an experience as possible
  • make sure that there is clear accountability and a transparent way to tell whether the Board is getting results
  • set out a clear expectation for continual improvement across the health service.

Find out more about the draft mandate and the consultation

The care objectives are set out in five domains that broadly cover the range of work the NHS does:

  • preventing premature deaths – helping people live longer
  • supporting people with a long term condition to look after themselves
  • supporting people through their recovery from episodes of ill health or injury
  • making sure that people have a positive experience of care in the NHS
  • treating people in a clean, safe, environment and protecting them from unnecessary harm.

These are standards that the Health Secretary expects to continue and improve.

Health Secretary Andrew Lansley said:

'In the past there has been too much focus on systems and processes rather than people. For the first time the mandate will focus on holding the health service to account for results that make a difference to people.

'Objectives for improving care will be shaped by what the public needs and will be one of the most important ways the Government can hold the new system to account.'

Health Secretary’s annual report on the NHS and public health published

The Secretary of State's annual report has been published today, a year earlier than is required by law, in order to enable Parliament and the public to see the direction the NHS is heading. From 1 April 2013, the Secretary of State for Health will be under a new duty to produce the annual report relating to the performance of the health service in England, which will be laid before Parliament. The Health Secretary's annual report will be the principal method by which Parliament will hold the Health Secretary to account for the performance of the health service in England.

The National Health Service and Public Health Service in England: Secretary of State's Annual Report 2011/2012 covers a wide range of achievements from across the health service,  including:

  • 96 per cent of patients spending less than 4 hours waiting in A&E
  • 212 clinical commissioning groups on their way to being authorised by January next year
  • 12,500 patients helped to access the cancer drugs previously denied them.
  • £400 million invested to complete the roll out of the improving access to physcological therapies (IAPT)
  • MRSA infections down 24.7 per cent and C difficile infections down 17 per cent, the lowest levels since mandatory surveillance began.

Friday 29 June 2012

Inter-assessor reliability of practice based biomechanical assessment of the foot and ankle


Hannah L Jarvis1
Christopher J Nester
Richard K Jones
Anita Williams
Peter D Bowden

Abstract
Background
There is no consensus on which protocols should be used to assess foot and lower limb
biomechanics in clinical practice. The reliability of many assessments has been questioned by
previous research. The aim of this investigation was to (i) identify (through consensus) what
biomechanical examinations are used in clinical practice and (ii) evaluate the inter-assessor
reliability of some of these examinations.
Methods
Part1: Using a modified Delphi technique 12 podiatrists derived consensus on the
biomechanical examinations used in clinical practice. Part 2: Eleven podiatrists assessed 6
participants using a subset of the assessment protocol derived in Part 1. Examinations were
compared between assessors.
Results
Clinicians choose to estimate rather than quantitatively measure foot position and motion.
Poor inter-assessor reliability was recorded for all examinations. Intra-class correlation
coefficient values (ICC) for relaxed calcaneal stance position were less than 0.23 and were
less than 0.14 for neutral calcaneal stance position. For the examination of ankle joint
dorsiflexion, ICC values suggest moderate reliability (less than 0.61). The results of a random
effects ANOVA highlight that participant (up to 5.7°), assessor (up to 5.8°) and random (up
to 5.7°) error all contribute to the total error (up to 9.5° for relaxed calcaneal stance position,
up to 10.7° for the examination of ankle joint dorsiflexion). Kappa Fleiss values for
categorisation of first ray position and mobility were less than 0.05 and for limb length
assessment less than 0.02, indicating slight agreement.
Conclusion
Static biomechanical assessment of the foot, leg and lower limb is an important protocol in
clinical practice, but the key examinations used to make inferences about dynamic foot
function and to determine orthotic prescription are unreliable.


http://www.jfootankleres.com/content/pdf/1757-1146-5-14.pdf

NICE Venous Thromboembolic Diseases Clinical Guideline

NICE have published and update on the Venous thromboembolic diseases (144) clinical guideline on
27/06/12 and is now available at the NICE website at:

Tuesday 12 June 2012

Guidance aims to improve procurement across healthcare system

Guidance aimed at improving procurement across the healthcare system has been published by the Department of Health.

'NHS procurement: raising our game' sets out proposed actions for NHS trusts and the Department and focuses on taking immediate action to start tackling six key areas for improvements:

  • levers for change
  • transparency and data management
  • NHS standards of procurement
  • leadership, clinical engagement and reducing variation
  • collaboration and use of procurement partners
  • suppliers, innovation and growth

Read NHS Procurement: raising our game

This guidance is launched in advance of a procurement strategy planned for later in 2012 that will be developed following a wider call for evidence. It aims to start the journey to world class procurement by identifying those issues and actions that require immediate attention in order to lay the foundations for a fuller and further-reaching strategy later in the year.

In support, we are also publishing NHS Standards of Procurement, which will support trusts in understanding what good procurement looks like and in planning their improvements at a local level.

The standards can be used to identify what a trust's areas of strengths and weakness are in their procurement and suggest ways in which they can start to monitor and measure improvements.

Read NHS Standards of Procurement

Sunday 10 June 2012

Racial differences in foot disorders and foot type: The Johnston County Osteoarthritis Project

Golightly, Yvonne M, Hannan, Marian T, Dufour, Alyssa B, Jordan, Joanne M (2012); Racial differences in foot disorders and foot type: The Johnston County Osteoarthritis Project'; Arthritis Care & Research; Arthritis Care Res; John Wiley & Sons, Inc.; 2151-4658; http://dx.doi.org/10.1002/acr.21752

Objective.
To describe racial differences in the frequency of structural foot disorders and pes planus, and cavus foot types in a large cohort of African American and Caucasian men and women 50+ years old. 

Methods.
Of 1,695 Johnston County Osteoarthritis Project participants evaluated for foot disorders/type in 2006-2010, four with lower extremity amputation were excluded, leaving 1,691 available for analyses (mean age 69 years, mean body mass index [BMI] 31.5 kg/m2, 68% women, 31% African American). The most common foot disorders/types were identified using a validated foot examination. Each foot disorder/type was compared by race using logistic regression, controlling for age, BMI, and gender. Effect modification between race (African American versus Caucasian) and age, BMI (categorized as ≥30 [obese] or <30 kg/m2 [non-obese]), gender, and education were examined. 

Results.
Hallux valgus (64%), hammer toes (35%), overlapping toes (34%), and pes planus (23%) were common. Compared to Caucasians, African Americans were almost 3 times more likely to have pes planus and were nearly 5 times less likely to have Tailor's bunions or pes cavus. Among the non-obese, African Americans were more likely than Caucasians to have hallux valgus (adjusted odds ratio [aOR] =2.01, 95% confidence interval [CI] = 1.39-2.92), hammer toes (aOR=2.64, 95% CI=1.88-3.70), and overlapping toes (aOR=1.53, 95% CI=1.09-2.13). 

Conclusions.
Foot disorders are common among adults 50 years of age or older and differ by race. Future research is needed to determine the etiology of foot problems, especially those with racial differences, in order to inform prevention approaches.

Thursday 7 June 2012

New rules applicable to students for NHS Bursary Scheme from September

There are two different sets of rules applicable to students depending on when their course first started. These document published today sets out the new rules which will apply to students who started their course on or after 1 September 2012. The rules for students who started their course before 1 September 2012 are set out in the thirteenth edition of The NHS Bursary Scheme old rules. In each case the rules apply in relation to the academic year starting on or after 1 September 2012 but before 31 August 2013.

The NHS Bursary Scheme new rules first edition outlines the student support arrangements for students who start their course on or after 1 September 2012.

The NHS Bursary Scheme old rules thirteenth edition outlines the student support arrangements for students who started their courses before 1 September 2012.

Disclaimer

Students and prospective students should not rely on the current NHS Bursary rules and allowances when planning for subsequent academic years, these may be subject to review in the future and as a result may be liable to change. Further information about the NHS bursary will be posted on the NHS Student Bursaries website as and when it is made available. Students are advised to check the website on a regular basis. The Department of Health and NHS Student Bursaries will accept no responsibility for loss of any type however suffered by students who have relied on current rules and allowances in altering their circumstances (including but not limited to financial circumstances) whether for the current academic year, academic year to begin or indeed for subsequent academic years.

Equality Statement 2012

The NHS Bursary Scheme has been around since the early 1990s and is usually updated annually to take into account changes to policy. The Department of Health has worked with its key partners to undertake a review of the NHS Bursary Scheme. A number of options for the future of NHS student support were developed and assessed against a number of criteria one of which was equality. The Department of Health ran a public consultation on the options to seek the views of others with an interest, including people who were currently considering entering healthcare training. Respondents were asked to consider how far the options met a number of equality aims. The review concluded that, in the future, eligible students will all have access to the same package of financial support from September 2012 irrespective of their course. A report of the consultation, an impact assessment and an equalities impact assessment at the link below was published alongside the outcome of the consultation which is reported in supporting our future NHS workforce: consultation report.

These documents supersede the twelfth edition of the NHS Bursary Scheme. These documents are not distributed in hard copy

Third edition of Long Term Conditions Compendium published

The Department of Health has published the third edition of the Long Term Conditions Compendium of Information. It is aimed at commissioners as well as health and social care professionals, to provide the evidence for improving care and outcomes for people with long term conditions (LTCs).  It updates the second edition of the compendium published in January 2008.

This document contains the latest statistical data on long term conditions, links to the LTC QIPP (quality, innovation, productivity and prevention) workstream and provides data from the ongoing evaluation of the Whole System Demonstrator Programme on telehealth and telecare, which supports the delivery of 3 Million Lives. It also showcases examples of innovative projects across the country where organisations and communities are pushing the boundaries to deliver improvements in LTC care.

The information and evidence captured in this third edition of the compendium continues to reinforce why a focus on LTCs should be a priority.

Long Term Conditions Compendium of Information – third edition

Find out about the long term conditions strategy.

Tuesday 29 May 2012

Procurement call for evidence

A call for evidence on how procurement in the NHS can be transformed is issued. Views and contributions are being sought from the NHS, industry, other government departments, the academic, scientific and third sectors and social care. This could include actions for the Department of Health, wider government, industry, the NHS Commissioning Board, other National bodies, the NHS, or other sectors.

Sir Ian Curruthers letter said:

' Whilst some improvements in NHS procurement are evident, the pace of change is not sufficient to meet the financial challenge facing the NHS.

We need more innovative procurement processes and more widespread procurement of innovation. By harnessing relationships with suppliers, the NHS can adopt existing innovations and stimulate new innovation to deliver quality and value, for both NHS patients and taxpayers.'

Read the call for evidence and ideas document and the letter from Sir Ian Curruthers. To contribute to the call for evidence please see our online form.

Guidance published today provides the first steps that NHS trusts need to takenow. Read further information on Innovation Health and Wealth.



Friday 25 May 2012

The National Audit Office has issued a report examining whether the NHS in England is providing recommended standards of care to people with diabetes

The report finds that, despite some improvements since 2006-07, there is poor performance against expected levels of care, low achievement of treatment standards and high numbers of avoidable deaths, and concludes that diabetes services in England are not delivering value for money.

http://www.nao.org.uk/publications/1213/adult_diabetes_services.aspx

Thursday 24 May 2012

Have your say on long term conditions strategy

The Department of Health is asking people to comment on what should be covered by the cross-government long term conditions strategy.

We are drafting the strategy at the moment and plan to publish it towards the end of this year. The strategy will be a high level vision, describing how we want to see improvements in the lives of people with long term conditions. It will apply to England only.

We would like to hear from people with long term conditions, carers, health professionals, commissioners, local authorities and the voluntary sector. People's experiences, both positive and negative, and their ideas about what could be done differently, are vital to make the strategy as relevant as possible.

The content of the strategy will not be confined to health issues. It will also cover other aspects of people's lives that can be affected by long term conditions and bring together departments across central government to sign up to shared aims.

Find out more about the long term conditions strategy.

NHS Corporate plan 2012-13

The Department of Health's Corporate plan sets out our priorities for the year ahead. The Department's enduring purpose is to achieve better health, better care, better value: working to help people live better for longer.

Now that the Health and Social Care Bill has become law, the Department has a firm platform on which to build clarity about the future direction of the health and social care system as a whole.

The plan groups the Department's activity into six priority areas:

  • Better health; Better care; Better value relate directly to DH's enduring purpose and capture the key business priorities for the Department for this year to April 2013
  • Successful change, delivering the transition to the new system – picks up the work the DH does and its accountability for making this happen
  • Working with our partners – builds on what the DH does now and recognises that in the new system the Department will be working differently
  • Transforming the DH itself – is about the DH's journey to develop its capability.

The plan is also built around how the Department will support the Secretary of State to deliver his five strategic objectives:

  • a patient-led NHS
  • delivering better health outcomes
  • a more autonomous and accountable NHS
  • improved public health
  • reforming long-term and social care.

Take a look at the corporate plan 



Information strategy to give people more control over their care

The Department has published its information strategy – The power of information – which sets a ten-year framework for transforming information for the NHS, public health and social care.

The focus of the strategy is on improving access to information, including a commitment that people will be able to access their GP records online by 2015.

Other ambitions are for test results to be available electronically and that people will be able to book or re-arrange their medical appointments online.

This one-page visual guide helps demonstrate the key benefits to people of having better access to their health and care records and to services online.

Within the strategy the Department has identified dozens of case studies from across the country where GPs, hospital trusts or suppliers are ahead of the game in delivering services in this new way. Examples include:

The strategy also commits to creating a new website, or portal, that will act as a single trusted source of information across the NHS, public health and social care.

To find out more go to the information strategy website where you'll find a summary of what the strategy will mean for you, and the full publication as a download.


 

Saturday 5 May 2012

Pressure-reduction and preservation in custom-made footwear of patients with diabetes and a history of plantar ulceration


Diabet Med. 2012 Apr 30. doi: 10.1111/j.1464-5491.2012.03700.x. [Epub ahead of print]

Pressure-reduction and preservation in custom-made footwear of patients with diabetes and a history of plantar ulceration.

Source

Department of Rehabilitation, Academic Medical Centre, University of Amsterdam, Amsterdam Department of Surgery, Ziekenhuisgroep Twente, Almelo, the Netherlands.

Abstract

Aims  To assess the value of using in-shoe plantar pressure analysis to improve and preserve the offloading properties of custom-made footwear in patients with diabetes. Methods  Dynamic in-shoe plantar pressures were measured in new custom-made footwear of 117 patients with diabetes, neuropathy and a healed plantar foot ulcer. In 85 of these patients, high peak pressure locations (peak pressure > 200 kPa) were targeted for pressure reduction (goal: > 25% relief or below an absolute level of 200 kPa) by modifying the footwear. After each of a maximum three rounds of modifications pressures were measured. In a subgroup of 32 patients, pressures were measured and, if needed, footwear was modified at 3-monthly visits for 1 year. Pressures were compared with those measured in 32 control patients who had no footwear modifications based on pressure analysis. Results  At the previous ulcer location and the highest and second highest pressure locations, peak pressures were significantly reduced by 23%, 21% and 15%, respectively, after modification of footwear. These lowered pressures were maintained or further reduced over time and were significantly lower, by 24-28%, compared with pressures in the control group. Conclusion  The offloading capacity of custom-made footwear for high-risk patients can be effectively improved and preserved using in-shoe plantar pressure analysis as guidance tool for footwear modification. This provides a useful approach to obtain better offloading footwear that may reduce the risk for pressure-related diabetic foot ulcers. 

Reebok to craft custom-built shoes for nation’s tallest man - BostonHerald.com

Reebok to craft custom-built shoes for nation’s tallest man - BostonHerald.com

Some expensive Bespoke Footwear!