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NIHR Signal Text message reminders increase attendance at NHS health checks
Sending text messages reminding people to book their NHS health check following their invitation letter increases attendance. There is little evidence to support pre-notification text messages telling people an invitation would soon be sent. NHS health checks are offered to adults aged 40 to 74 years. Identification and management of cardiovascular risk factors has been shown to save lives. Yet only half of adults attend a check when it is offered. This trial conducted across general practices ...
NIHR Signal Diet and physical activity interventions targeting children and youth have different, yet small, effects on preventing obesity
Obesity prevention interventions which include both diet and physical activity may reduce the risk of obesity in pre-school children. Once at school, physical activity appears to be more effective for weight loss than diet alone. Resulting weight loss form any intervention, if any, has been very small with unclear benefits to the individual or population. This NIHR-supported Cochrane systematic review pooled the results of 153 global randomised-control trials (sevenfrom the UK) aiming to preven...
NIHR Signal Closer links between police and health services can improve experiences for people in mental health crisis
Tighter working partnerships between health professionals and police services are likely to improve the care of people who come into contact with police during mental health crises. People experiencing severe mental health episodes can present with extreme and unpredictable behaviour posing a danger to themselves and members of the public. Police are often the first to respond in these challenging situations. New models are emerging of mental health staff working with police. This NIHR-funded ...
NIHR Signal Packages of care interventions ‘not effective’ to reduce repeat admissions for COPD
Care bundles for COPD are difficult to implement, and their introduction in NHS hospitals does not reduce repeat admissions, deaths or use of resources when used on or after admission. Care bundles are packages of interventions which, in other situations, can improve care. COPD care bundles include: checking inhaler technique and medication use providing a written plan for COPD management and supply of emergency medicines assessing willingness to stop smoking assessing suitability for pul...
NIHR Signal Physician associates appear to make a positive contribution to inpatient care
Physician associates improve continuity of care and patient experience within the hospital setting. This first evaluation of the new role in the NHS suggests they could provide safe and equivalent care on defined tasks, freeing up time for doctors, and help with patient flow. However, some say that the actual and perceived potential is being held back by a lack of professional statutory regulation and the ability to prescribe. The number of physician associates trained in some of the tasks done...
NIHR Signal Insights into the transfer between children’s and adults’ services for young people with selected long-term conditions
How young people with type 1 diabetes, autistic spectrum disorder and cerebral palsy experience the transition to adult services depends on their condition and locality. Adult and children’s services need to work together to ensure they are offering young people the sources of support and resilience they need. This NIHR-funded study found that children with type 1 diabetes were more likely to receive help shown to aid transition. For example, around two-thirds said they had met a member o...
NIHR Signal National quality improvement programmes need time and resources to have an impact
A large trial assessing the effectiveness of a UK-wide quality improvement programme did not show any difference in patient outcomes. However, the likely reasons for this were carefully investigated and provide some useful insights on implementation. Several (37) quality improvement components were included in the ambitious package designed to reduce variation in care and improve outcomes for adults undergoing emergency abdominal surgery. There was no difference in survival at 30 days, length o...
NIHR Signal More than 50% of hip replacements appear to last 25 years
Data from national registries and large case series showthat in those countries, around 85% of total hip replacements last for 15 years, with 58% lasting for 25 years. This means that those hip replacements have lasted last longer than was first thought. It is good news for an ageing population, as it should mean that the chances of needing a second hip operation are reducing. However, it is not clear how directly relevant the results of this study are to the UK. The NIHR-funded study didn&rsqu...
NIHR Signal More than 80% of total knee replacements can last for 25 years
Large data sets from national registries and case series show that about 82% of total knee replacements and 70% of partial (unicompartmental) knee replacements last for 25 years. This NIHR-funded review of that data is the first to demonstrate longer-term effectiveness of these procedures. This means that the operation, which aims to relieve pain for osteoarthritis, may not need to be delayed to reduce the chance of a patient needing further surgery at a later date. It is an encouraging finding...
NIHR Signal Centralising stroke services can save lives
Changing access to more specialised stroke centre care in one city (London) was estimated to save an additional 96 lives per year (1%) compared to the reductions occurring in the rest of England. These improvements were sustained over time. Other cities did well on quality of care indicators, including time to admission in a stroke unit and length of stay. Patients and carers reported good experiences despite slightly increased travel times to the central stroke units. A stroke can have devasta...
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