Category Archives: Mortality

Going the Distance: Exercise professionals in the wider public health workforce

By Royal Society for Public Health (2018)

This report, written with ukactive, explores how fitness professionals can play an enhanced role in supporting the public’s health. It calls for GP drop-in and smoking cessation services inside gyms and leisure centres to help ease pressure on local health facilities and improve access to health improvement services.

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Tackling obesity: what the UK can learn from other countries

By 2020 Health (2018)

2020health’s third report on obesity since 2014 highlights the fact that strong and mandated central policy, supporting bold, holistic local action, is still needed to impact what is arguably the greatest health challenge of the 21st century. The report examines topical obesity intervention strategies from around the world to frame the question: can the UK learn from policy abroad?

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Transforming health care in nursing homes

By The Nuffield Trust (2018)

This study finds that a new GP service offering seven-day-a-week support to four nursing homes has resulted in a 36 per cent reduction in emergency admissions to hospital, with the largest reductions happening during the last three months of a person’s life.

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Effectiveness of interventions to reduce homelessness: a systematic review and meta-analysis

By Campbell Collaboration (2018)

This review assesses the effectiveness of interventions combining housing and case management as a means to reduce homelessness and increase residential stability for individuals who are homeless, or at risk of becoming homeless.

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Tackling multiple unhealthy risk factors: emerging lessons from practice

By The King’s Fund (2018)

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  • Previous research by The King’s Fund has shown that unhealthy behaviours cluster in the population. Around seven in ten adults do not follow guidelines on tobacco use, alcohol consumption, healthy diet or physical activity, yet most behaviour change services address these behaviours separately, not reflecting the reality of people’s lives.
  • This report shares learning and insight from services that are using innovative ways to address the problem of multiple unhealthy risk factors in their populations. It draws on interviews and information from eight case studies in local authorities and the NHS and updates the evidence base on tackling multiple unhealthy risk factors.
  • Most services included in the report are local authority led and are integrated health and wellbeing services. These provide behavioural advice and support to people across a range of different behaviours, including smoking, weight management and physical activity.
  • The NHS is also addressing multiple unhealthy behaviours. We set out learning from two hospitals supporting individuals with multiple risk factors.
  • The evidence for these behaviour change services to draw on, in the context of multiple unhealthy risk factors, remains limited. These services are in a position to develop the evidence base on how best to address multiple unhealthy behaviours.
  • The report makes recommendations on how services can develop and share evidence, and for how the Department of Health and Social Care and Public Health England can support further innovation in such services.

Right care: wrong answers

Dropkin, G. Journal of Public Health, https://doi.org/10.1093/pubmed/fdx136

Published: 03 November 2017

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Background

NHS RightCare is an NHS England programme describing itself as ‘a proven approach that delivers better patient outcomes’. It identifies opportunities for savings and quality improvements, comparing each Clinical Commissioning Group (CCG) with the ‘Best 5’ of a fixed set of ‘Similar 10’ CCGs chosen using equally weighted demographic and deprivation indicators. This article tests whether these indicators are sufficient and equal weighting is appropriate, and evaluates significance.

Methods

Robust public data on lung, colorectal, and breast cancer mortality is modelled using the indicators and incidence. Peers chosen using the preferred models are compared with the Similar 10. Confidence intervals are obtained for comparator group averages. RightCare significance is simulated.

Results

Preferred models have unequally weighted covariates. Incidence is the strongest predictor of lung cancer mortality. The ‘Similar 10’ are inappropriate comparators. RightCare significance ignores variability of comparator outcomes, causing 12% Type I errors. Whilst RightCare shows 1842 annual avoidable lung cancer deaths in 80 CCGs, only 168 deaths in 8 CCGs appear exceptional using appropriate peers and CIs.

Conclusion

CCGs cannot expect to match the average performance of the RightCare ‘Best 5’. Until the methodology is examined with data of known quality, claims that RightCare is a ‘proven approach’ are unsubstantiated.

 

Current, future and avoidable costs of stroke in the UK – Societal costs of stroke in the next 20 years and potential returns from increased spending on research

By The Stroke Association (2017)

This report estimates that the current cost of stroke to the UK is £26 billion every year, a threefold increase from the previous estimated cost of £9 billion. The figures also predict that a growing and ageing population, increasing numbers of stroke survivors, and rising care costs are crucial factors behind the increasing financial burden of stroke over the next 20 years.

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