This new report from the National Audit Office considers the current status of out of hours GP services in England, based on data collected during 2013-2014. Although the report is focused on England, there may be lessons for commissioners in other health systems. Methods The report is based on : a web-based survey of CCGs (175 [read the full story…]
This guide is an excellent example of developing resources to help learn from good practice. It has been written for all commissioners and providers, but in particular clinical commissioners, and mental health commissioners and practitioners. Primary care mental health The first section of the guide gives a comprehensive overview of the state of primary care [read the full story…]
This new report, based on a workshop in March 2014, sets out to inform the development of 20 pilots (in England) of the Prime Minister’s Challenge Fund, to improve access to primary care. The report focuses on the debate around unintended consequences of extending (e.g. longer opening hours) or broadening (e.g. phone or online consultations) access – will [read the full story…]
For me, one of the most infuriating aspects of health care is the relegation of mental health problems, and mental health services, as secondary to physical health. There are a myriad of examples of this, from the classic stigma that people with mental health problems receive compared to those with physical health problems (fantastically illustrated [read the full story…]
The health inequalities of people with learning disabilities are well documented in the literature, with increased risks for many physical and sensory health issues as well as mental health issues and responses from health services have often been poor, as documented in the Michael Report. In recent years, the healthcare pathways approach has been introduced [read the full story…]
There are many interfaces in mental health services, such as the one between physical and mental health. Where there are interfaces, there are inevitably gaps for patients to fall through. Consequently opportunities are missed to treat mental health problems in those with physical health problems. There is mounting evidence for the effectiveness of Collaborative Care (CC) [read the full story…]
UK law requires public services to make reasonable adjustments for disabled people following the Disability Discrimination Act (1995) and the Equality Act (2010), which does not cover Northern Ireland. For people with physical disabilities these have predominantly focused on the environment, whilst for people with a learning disabilities it requires more commonly clear explanations and [read the full story…]
Benzodiazepines are used to treat insomnia, anxiety and chronic back pain due to their sedative and muscle relaxing effects. They’ve got a sting in the tail though and can cause memory disruption, loss of coordination and dependence if used long term. It’s therefore recommended that other treatments, such as psychological interventions, are tried first and [read the full story…]
The ideal treatment for common mental health problems in those with chronic physical illness would have to be reliable, easy to deliver, inexpensive and accessible by a group of people whose physical impairment may affect treatment adherence. NICE guidelines (CG90 Depression; the treatment and management of depression in adults) recommend self-help interventions (SHIs) based on [read the full story…]
It is well documented that there are differences in how patients are treated, depending on their ethnicity. Previous inquiries in the UK have suggested that the NHS is institutionally racist (Blofeld et al, 2003). Some groups, for example those from African Caribbean or Aboriginal descent, experience more coercive care and poor outcomes, including higher doses of [read the full story…]
