Burden of child and adolescent obesity on health services in England. 

Viner RM, Kinra S, Nicholls D, et al. Burden of child and adolescent obesity on health services in England. Archives of Disease in Childhood Published Online First: 01 August 2017. doi: 10.1136/archdischild-2017-313009

Abstract

Objective To assess the numbers of obese children and young people (CYP) eligible for assessment and management at each stage of the childhood obesity pathway in England.

Design Pathway modelling study, operationalising the UK National Institute for Health and Care Excellence guidance on childhood obesity management against national survey data.

Setting Data on CYP aged 2–18 years from the Health Survey for England 2006 to 2013.

Main outcome measures Clinical obesity (body mass index (BMI) >98th centile), extreme obesity (BMI ≥99.86th centile); family history of cardiovascular disease or type 2 diabetes; obesity comorbidities defined as primary care detectable (hypertension, orthopaedic or mobility problems, bullying or psychological distress) or secondary care detectable (dyslipidaemia, hyperinsulinaemia, high glycated haemoglobin, abnormal liver function).

Results 11.2% (1.22 million) of CYP in England were eligible for primary care assessment and for community lifestyle modification. 2.6% (n=283 500) CYP were estimated to be likely to attend primary care. 5.1% (n=556 000) were eligible for secondary care referral. Among those aged 13–18 years, 8.2% (n=309 000) were eligible for antiobesity drug therapy and 2.4% (90 500) of English CYP were eligible for bariatric surgery. CYP from the most deprived quintile were 1.5-fold to 3-fold more likely to be eligible for obesity management.

Conclusions There is a mismatch between population burden and available data on service use for obesity in CYP in England, particularly among deprived young people. There is a need for consistent evidence-based commissioning of services across the childhood obesity pathway based on population burden

The Recruitment, Retention And Return Of Nurses To General Practice Nursing In England

This report, authored by Ipsos MORI, outlines the findings of qualitative research into the drivers and barriers to entry into general practice nursing (GPN) | NHS England

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It finds that the general perception is that general practice is more suitable for older or more experienced nurses. As student placements in general practice are rare, there is a lack of opportunity for students to develop an understanding of the GPN role. The research also highlights the need for greater support for GPNs and the lack of standardisation in pay for GPN roles.

Where next for commissioning?

David Evans chief executive of Northumbria Healthcare NHS Foundation Trust shares his view on where next for commissioning as part of Provider Voices | NHS Providers.

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My honest opinion is that the purchaser-provider split has outlived its usefulness. The NHS environment has changed hugely from the time when commissioning seemed like a good idea. Back then, there was plenty of money in the system, and options for getting better deals for your money by managing the market.

Now money is tight, the question must be whether money spent on commissioning wouldn’t be better used delivering services. Look at the situation nationally: some providers are in dire financial straits and their commissioners sit on surpluses. In other places, the reverse applies.

We have seen private providers hit this wall too, as well as some high-profile commissioning decisions (as in Cambridgeshire) that fall foul of the reality of providing services.

Read the full post here

Dementia in older age: barriers to primary prevention and factors

Evidence review showing that changing some behaviours in midlife can reduce the chances of getting dementia in older age | PHE

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These documents help commissioners and researchers make decisions about prioritisation of primary prevention measures relevant to dementia.

This review, by the Personal Social Services Research Unit (PSSRU) at the London School of Economics and Political Science (2016), shows that there is evidence that the risk of dementia is increased by:

  • physical inactivity
  • current smoking
  • diabetes
  • hypertension in mid-life
  • obesity in mid-life and depression

It also shows that mental activity can reduce the risk of dementia.

To promote primary prevention of dementia, it is important to understand both the barriers to primary prevention and factors which facilitate primary prevention.

Read the full overview here

Cancer app developed by GPs being trialled by CCGs

A GP-developed app aiming to help GPs navigate the tests and urgent referrals necessary for patients presenting with cancer symptoms is being trialled by two CCGs | Pulse

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C the Signs was co-founded by newly qualified GP Dr Bhavagaya Bakshi and fellow doctor Miles Payling and quickly checks symptoms of more than 200 cancers against multiple diagnostic referral pathways.

Last week the app won the People’s award at the Tech4Good awards and is now set to be trialled with GPs in the East of England to test its real world cost and clinical effectiveness.

Read the full news story here

General Practice Nursing – Developing confidence, capability and capacity

This Ten Point Action Plan for General Practice Nursing, describes the nursing element of the General Practice Forward View (GPFV) | NHS England

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The GPN ten point action plan sets out the measures required to bring about the changes that are needed, which will be taken forward by NHS England, Health Education England, NHS Improvement, Public Health England, The Royal College of Nursing, The Royal College of General Practitioners, The Queens Nursing Institute and The British Medical Association. These organisations will support commissioners and providers to implement the actions at local level. Delivery of this Ten Point Action Plan at a local level will be supported by one of four Regional GPN Delivery Boards.

General practice at scale and new care models provide fresh opportunities for supporting general practice nurses to develop skills and advance their careers. This will assist recruitment and retention which will in turn ease GPs’ workload as well as improving the experience of care for individuals, the outcomes of care and treatment, the use of NHS resources and staff experience.

New draft recommendations for the care of acute medical emergencies

This draft guideline includes recommendations for the organisation and delivery of emergency and acute medical care | NHS Networks

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It includes recommendations for practice and for research. Recommendations are included on:

  • first points of contact with emergency and acute care services
  • alternatives to hospital care
  • opening hours and locations of acute care services
  • services within hospitals
  • ward rounds, transfers and discharges
  • monitoring and managing hospital bed capacity.

Who is it for?

  • Commissioners and providers of health and social care.
  • Health and social care practitioners.
  • People with or at risk of a medical emergency or acute illness, and their families and carers.

Read the full draft here