Peer support may reduce readmissions following mental health crises
People discharged from mental health crisis teams are less likely to re-enter acute services within a year if they receive self-management support. The support in this study was provided by a peer worker, someone with experience of mental illness. The peer worker used a workbook to provide information and talk through recovery goals. The study compared this with those who had received the workbook by post.
Participating adults had a range of mental illnesses and had been managed by six crisis r...
Abdominal aortic aneurysm screening for women is unlikely to be a fair use of NHS resources
Nearly 4,000 women would need screening to prevent one death, and a third of aneurysms detected wouldn’t have influenced the individual woman's health or lifespan.
Aneurysm rupture is a life-threatening emergency with low survival. Men are known to be at higher risk of an aneurysm and are offered screening at age 65 to allow early diagnosis of aneurysms large enough to warrant surgical repair. However, a third of deaths from rupture are in women.
This NIHR-funded study is the first t...
Tools for GPs can help reduce unnecessary antibiotic prescribing
Interventions to reduce inappropriate antibiotic prescribing for upper respiratory tract infections are most effective when they provide a negotiation tool to support patient interaction. These interventions are more likely to be rejected if they are perceived as interfering with individual clinical judgment or damaging patient relationships.
Upper respiratory tract infections often resolve themselves within a few days, without the need for antibiotics, yet antibiotics are often prescribed. Thi...
Closing five emergency departments not linked with increased hospital admissions, though ambulance call-outs increased
Closure of five small emergency departments in England was not associated with change in the number of hospital admissions, urgent care attendances or deaths among the local populations. However, ambulance call-outs increased by 14% relative to comparison areas, with a four-minute increase in the time to reach a hospital with an emergency department.
Emergency departments continue to be under high pressure, while staff shortages increase patient safety concerns. One option is to close smaller s...
Non-urgent attendances to emergency departments are more common among younger adults
Adults aged 16 to 44 years are more likely to attend emergency departments for non-urgent presentations than older adults. They were more than three times more likely to present for non-urgent reasons than those over 65 years.Non-urgent attendances are also more common during out-of-hours periods, especially at night.
Emergency departments are consistently under high pressure with long waiting times. Understanding the characteristics of non-urgent attendances that could be managed in the commun...
Patient-centred care for multimorbidity improves patient experience, but quality of life is unchanged
A patient-centred intervention in general practice for people with multiple chronic conditions, based on recommended best practice, had no effect on patient quality of life or burden of illness and treatment. Patients were, however, more likely to report being satisfied with their care.
An increasing number of people in the UK are living with multimorbidity, defined as two or more long-term health conditions. NICE recommends a comprehensive approach to care, tailored to the patient’s need...
Routine measurement of grip strength can help assess frailty in hospital
Training clinical staff to routinely measure grip strength can help identify frail older hospital inpatients. This could help tailor their care.
This NIHR-funded study was conducted across five acute medical wards in one hospital in England over a nine-month period. Nursing staff were trained to measure grip strength of people aged over 80 years. They were instructed to assess if those with low grip required nutritional supplements and to refer them to physiotherapy for consideration of strengt...
The proportion of patients not transported to emergency departments after an ambulance is called varies across the country
Nationally, around half of people making urgent calls for ambulance services are not then taken to hospital. This is called the non-conveyancing rate. But this rate varies two-fold from region to region. There are differences too in what happens to patients not going to hospital. Some places discharge more patients at the scene, offer telephone advice or send to other non-emergency health services like walk-in centres.
This NIHR mixed methods study used observation and analysis of routine ambul...
Women rate quality and safety of birth experience as important
Most healthy women would like a natural birth if possible, but acknowledge the unpredictability and risks of childbirth. They also appreciate the supportive care environment where healthcare providers are competent, kind and respectful to them, their partners and their baby.
In a large review of studies with over 1,800 women’s views on what matters in childbirth, having a healthy baby was important. Avoiding unnecessary medical intervention and retaining a sense of control over their birt...
General hospital care for children with learning disabilities has scope for improvement
Less than half of NHS staff surveyed said they were routinely informed that a child has learning disabilities through a dedicated flagging system on admission.
Many general hospital staff lack confidence and organisational support in providing care for children and young people with learning disabilities. In an NIHR national hospital staff-awareness survey, staff were uncertain or unaware of local policy and practice. Only half of the children’s hospitals had a learning disability nurse, ...