Talking therapies and body dysmorphia

Cognitive behaviour therapy is being used with growing numbers of people for treatment of anxiety and depression, but also for social phobias and obsessive-compulsive disorders. This is not news and not surprising, but the appearance in the data of body dysmorphia is both. Could it be that CBT services are taking some of the strain from the closure of gender identity clinics? 

Source: NHS Talking Therapies, for anxiety and depression, NHS Digital Annual reports, 2022-23  16 Jan 2024  

Holism?

No doubt the Nation is grateful for the medical bulletins about Charles III and his pesky prostate. Not a word from the Homeopaths, ‘though.

Sickness absence measurement – a pseudoscience?

In 2022 the NHS recorded 27 million days sickness absence. The NHS attempts to mitigate sickness absence by using a management formula – the Bradford factor – that individualises interventions to reduce sickness absence. Unfortunately attendance management policies often lead to unpredictable results, like disciplinary warnings leading to a reduction in one- or two-day absences but an increase in longer-term spells. Likewise the use of the Bradford score, or similar scoring systems, may shift attention employees with long-term health conditions, who may be prone to short-term but unpredictable sickness absence, but whose overall attendance is above average and acceptable. Sickness absence is very serious but the mechanisms designed to reduce it are not individualised enough. 

Source: The NHS’s approach to sickness absence is ineffective and discriminatory

Roger Kline & Cameron Black HSJ 24 January 2024

Collaboration, collaboration, collaboration

An Education Quality Intervention Review report into trauma and orthopaedic training at William Harvey Hospital in Ashford, Kent came up with an interesting finding. Theatre staff  “deliberately slowed down” elective activity to limit the number of operations that could be done each day. The Review was launched after concerns were raised by Trust staff in the General Medical Council’s annual national training survey. 

There was animosity between the trauma theatre team (mostly nurses) and the surgeons. Trauma theatre staff often resisted the number of cases scheduled, claiming it was “unrealistic”. Cases were sometimes cancelled because the trauma theatre team feared the operating list would overrun. However, operations would often finish at 16:00, having started relatively late in the morning.

HSJ readers recognised the problem and had much to say.  “Shocking clinical behaviour and clearly an organisation that needs a clear out of clinical and operational leadership”.

I doubt this is an isolated occurrence. There is a reason why the same team is so productive [doing operations for the] Waiting List Initiative or Private List vs NHS List surgery.

The problem is not just found in trauma surgery. East Kent Hospitals University Foundation Trust (EKHUFT) runs the William Harvey Hospital, amongst others. Overall theatre utilisation across EKHUFT is “down at 77%...what have the theatre matron, director of nursing for theatres & anaesthetics, theatre manager and a very expensive managing director been doing about this because the data shows not a lot”.

“The NHS only reaches about 70% productivity of a well-run hospital internationally.
The reasons are Capital: Outdated real estate embeds poor practices, badly designed IT.
Revenue: poor flow/ processes, inadequate training capacity, no incentives to align personal, patient and organisational goals”. 

Sources:1) Alison Moore Theatre staff 'deliberately slow down' operations, review finds. HSJ 19 January 2024  2) Education Quality Interventions Review Report  East Kent Hospitals University NHS Foundation Trust Trauma and Orthopaedic Surgery Risk-based Review   Date of Final Report: 16 October 2023

Wokingham here we come!

The UK is getting poorer and sicker, and this trend is not equal across the country. Poorer and sicker areas are getting poorer and sicker the most quickly. So says the Institute of Public Policy Research (IPPR ) in its latest report on inequities, Healthy Places, prosperous lives.

The report finds that there is a stark divide in health and wealth throughout the UK, leaving many health black spots as health inequalities cluster in the same places. The UK now has among the largest health inequalities of any advanced economy, with one in every four people in England and Wales who are economically inactive living in the unhealthiest 50 local authorities.  

The concerning ‘double injustice’ of areas suffering high levels of sickness and low levels of economic activity are exacerbated by also being more likely to experience worse levels of productivity, material deprivation, child poverty, unemployment and household income.

To share the findings of the research and IPPR’s proposed solutions the Institute is  hosting a webinar on Monday 19 February, from 9.00 - 10.15am.  Speakers include:

• Andy Burnham, Mayor of Greater Manchester and IPPR Commissioner

• Rt Hon Sir Norman Lamb, former Minister of State for Care and Support

• Councillor Angela Macpherson, Deputy Leader and Cabinet Member for Health and Wellbeing, Buckinghamshire Council (invited)

• Efua Poku-Amanfo, Research Fellow and Lead Author of the Report, IPPR

• Chair: Chris Thomas, Head of the Commission on Health and Prosperity, IPPR

IPPR’s policy is focused on a simple premise: that if everywhere was as healthy as Wokingham, the UK would be the healthiest and most equal country in the world. IPPR’s focus is on giving places, local leaders and communities the tools to deliver on this premise.

For more information on the event please contact h.dickinson@ippr.org 

Source: https://www.ippr.org/articles/healthy-places-prosperous-lives 

Read more News from Nowhere and articles on the NHS in ERA 3 at http://www.healthmatters.org.uk/