Biomedical subjects
Publications and source records attributed to Ann Dix.
Poor performance on cancer waiting-time targets has been partly blamed on the government only recently pushing it to the top of the agenda. The first priority is to improve data collection. A number of trusts have made good progress, through streamlining services and encourging whole-trust ownership of the problem.
Addenbrooke's trust in Cambridge had an acute staff shortage in radiotherapy four years ago. The trust enthusiastically signed up to a DoH New Ways of Working programme for developing radiographers. New roles helped to bring the radiography department to the near-full level of staffing it has today.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Heart failure accounts for about 5 per cent of all admissions to general medical and acute wards and 10 per cent of bed occupancy. Improvements in care need to encompass the whole patient pathway. Specialist, nurse-led services offer major benefits.
Neurological conditions account for a fifth of all acute hospital admissions. The long-term neurological conditions NSF takes a structured approach to improving the patient journey. The healthcare commission will have a crucial role in ensuring implementation.
The new pharmacy contract awards pharmacists for range and quality of services, not volume of medicines dispensed. Pharmacists' cross-area access to patients makes them well placed to take a lead role in the management of long-term conditions. Funding may be a barrier to development under the new contract, as money for developing local enhanced services must come from existing primary care trust budgets.
Primary care trusts are increasingly using 'local enhanced service' programmes to target excluded groups, according to new research. One in seven PCTs were using an LES for asylum seekers and other examples include homelessness, learning disabilities and work with young people. Other PCTs are using LESs to shift work from secondary to primary care via referral management incentive schemes, while one in five had set up an LES-based phlebotomy service.
Sixteen GP practices in Epsom Downs have formed an NHS limited company, bringing them together as one provider-contracting organisation. Practices and the PCT hope to use these new flexibilities together with practice-based commissioning to redesign local services. By pooling resources, the practices can treat more patients within primary care, keeping expenses low.
South Staffordshire Healthcare trust is the standard-bearer for mental health supplementary nurse prescribers, employing 50 of just 250-300 in England. The trust runs a course with Staffordshire University, including training nurses in improving patients' concordance with medication. The scheme has improved patient satisfaction, and increased collaboration between consultants and GPs.
One solution to restrictions on junior doctors' hours being tried in London is hiring out the services of surgical research fellows to smaller hospitals. Revenue can be used to partly fund salaries for research posts, offering the doctors clinical development. A potential pitfall is the creation of 'bogus' research positions to fill gaps in cover.
Unique Care was pioneered by Castlefields health centre and is now being popularised by the National Primary Care Development Team. It is claimed to be a better, practice-based alternative to Evercare. The programme was briefly extended to mental health.
Doctors are learning how to be clinical leaders on a course which teaches them about the wider NHS functions and how they fit in with them. One element of the course--the Skills Factory workshop--aims to empower doctors to make change to improve patient care. Participants have praised the programme for improving their 'ability and influence'.
Because of a national shortage of radiologists, sonographers in one trust are performing 95 per cent of ultrasound scans. Using a team approach and flexible working, waiting lists have gone down from 20-24 weeks to four to six weeks for most procedures. The model could be applied to other radiology departments.
A course developed by an Isle of Wight diabetes consultant teaches patients to instruct other patients on self-management of the condition. Supporters say the training is more relevant to diabetes than the expert patient programme. Health professionals' wariness of the scheme has taken its toll on take-up of the service.
Hepatitis C is a potentially fatal virus, but as many as 90 per cent of people with it are unaware they are infected. A government campaign this autumn is likely to increase demand for testing. Much work on hepatitis C is done by drug teams in isolation, but work in the South West is leading to a more co-ordinated approach.
There is evidence that hospital play hastens children's recovery, increases compliance and reduces the need for general anaesthesia. The children's national service framework recommends that all children in hospital have daily access to a play specialist. A survey showed an 11 per cent rise in the number of play specialists in the past two years, but more are needed.
Eating disorders have the highest mortality rate of any psychiatric condition, yet a 2001 study showed that half of health authorities had no specialist eating disorder service. This postcode lottery of provision means many people end up without effective treatment or have to travel long distances. New NICE guidelines set the standard for effective treatment for eating disorders, but will significant funding and training implications.