Caring for People with Liver Disease including Liver Transplantation: a Competence Framework for Nursing

Caring for People with Liver Disease including Liver Transplantation: a Competence Framework for Nursing

Royal College of Nursing 18 September 2019

• This updated framework describes the professional standards expected of practitioners when caring for people with liver disease including liver transplantation. It is designed to support practitioners in a clear, consistent and evidence-based format to reflect their specialist knowledge and skills. This edition includes competencies for liver transplantation.

Developing the nursing associate role in a critical care unit

Developing the nursing associate role in a critical care unit
Nursing Times [online]; 115: 10, 21-24. 16 September 2019

• This article looks at the experience of a small critical care unit in North Devon in taking on an nursing associate trainee.

Abstract

Chemotherapy at home in Cheshire and Merseyside

Chemotherapy at home in Cheshire and Merseyside
Innovation Agency, the Academic Health Science Network for the North West Coast, 6 July 2019

• Evaluation of a trial of chemotherapy treatment (subcutaneous administration of trastuzumab) at home and subsequently in the workplace delivered by The Clatterbridge Cancer Centre NHS Foundation Trust.
• Economic analysis by the Royal College of Physicians over the course of 2017 estimated savings to the trust of £182 per treatment episode at home compared to in the hospital, resulting in total estimated savings of nearly £400,000. The research did not take into account NHS patient transport costs or missed appointments, meaning that total savings to the NHS are almost certainly higher.

Clinical radiology UK workforce census report 2018

Clinical radiology UK workforce census report 2018
Royal College of Radiologists April 2019

• This report provides an overview of the radiology workforce in September 2018 (size, trends, specialisms, working activities and less than full time working), workforce forecasts and documents changes in demand for radiology services.

ACE Programme MDC pilot evaluations

Distinguishing features of the MDC model within the five ACE projects

Cancer Research UK February 2019

• This article considers the shared approaches undertaken across five ACE Programme projects during the period of evaluation, draws out the distinguishing features of the Multidisciplinary Diagnostic Centres (MDC) model, and identifies where distinctions have added value to the overall design of the pathway.

Emerging Multidisciplinary Diagnostic Centre (MDC) models and design principles
Policy Research Unit for Cancer Screening, Awareness and Early Diagnosis February 2019

• This report is based on insights from 128 one-to-one interviews with MDC clinicians, managers, commissioners and other key informants from the five MDC projects, and represents a significant resource on the development and implementation of MDC-based pathways. 
• It provides insight into the factors that affected implementation success, such as: organisational culture; leadership; change skills and capacity; and, ability to support different ways of clinical working.

Both reports are available on the Cancer Research UK Multidisciplinary Diagnostic Centres (MDCs) webpage.

The Topol Review - genomics, digital medicine, AI and robotics

The Topol Review

• An independent report on behalf of the Secretary of State for Health and Social Care, 11 February 2019

This report aims to examine

• how technological and other developments (including in genomics, artificial intelligence, digital medicine and robotics) are likely to change the roles and functions of clinical staff in all professions over the next two decades to ensure safer, more productive, more effective and more personal care for patients;

• what the implications of these changes are for the skills required by the professionals filling these roles, identifying professions or sub-specialisms where these may be particularly significant;

• the consequences for the selection, curricula, education, training, development and lifelong learning of current and future National Health Service staff.

Digital healthcare technologies, defined here as genomics, digital medicine, artificial intelligence (AI) and robotics.

The Review proposes three principles to support the deployment of digital healthcare technologies throughout the NHS:

1. Patients need to be included as partners and informed about health technologies, with a particular focus on vulnerable/marginalised groups to ensure equitable access.

2. The healthcare workforce needs expertise and guidance to evaluate new technologies, using processes grounded in real-world evidence.

3. The gift of time: wherever possible the adoption of new technologies should enable staff to gain more time to care, promoting deeper interaction with patients.

Digital technologies will have an impact on patients, carers and the wider community, health workforce, and health service leadership.

Recommendations

Advanced critical care practitioners

Advanced critical care practitioners at Newcastle upon Tyne Hospitals NHS FT
NHS Employers 8 October 2018

• This case study looks at how Newcastle upon Tyne Hospitals NHS Foundation Trust introduced advanced critical care practitioners (ACCPs) into multidisciplinary teams across its critical care units. 

Key issues of neonatal service configuration in England: the NeoNet multimethods study

A framework to address key issues of neonatal service configuration in England: the NeoNet multimethods study
Health Serv Deliv Res 2018;6(35), October 2018

• Geographic analysis and computer models were used to investigate a range of alternative scenarios for neonatal care, looking at the impact of greater and lower levels of centralisation. The models suggest that having fewer units, especially for intensive care, could potentially improve infant survival rates. Costs and resource implications (e.g. the number of nurses required), as well as the impact on parental travel time, were also investigated using these models.

CQC Radiology review

Radiology review: A national review of radiology reporting within the NHS in England 

CQC 19 July 2018

• A CQC review of NHS radiology services in England 2016-17 found
• The timescales for reporting on radiology examinations, and arrangements for monitoring and managing backlogs, vary widely between trusts.
• There are few national standards that trusts can benchmark themselves against. 
• Even trusts that were monitoring their performance did not always report on time.
• Issues with staffing, including an average vacancy rate of 14% across trusts that responded. This supports existing evidence about the national difficulties in recruiting and retaining radiologists.

Urology: GIRFT Programme National Specialty Report

Urology: GIRFT Programme National Specialty Report
GIRFT 10 July 2018

• The GIRFT programme has examined in detail the way that urology is currently provided in England based on 134 visits to NHS trusts in England that provide urology services. It examined overall departmental workload and organisation, approaches to common conditions and performance against a range of indicators. 
• The report sets out 18 recommendations to improve the way urology services are provided in the NHS in England including changes to service configuration within trusts, changes to staffing arrangements – extending the role of specialist nurses and asking consultants to focus more on emergency care – and a greater emphasis on networking between urology departments.

National Competency Framework for Registered Practitioners: Level 1 Patients and Enhanced Care Areas

National Competency Framework for Registered Practitioners: Level 1 Patients and Enhanced Care areas
Faculty of Intensive Care Medicine, Enhanced Care Working Party, 7 July 2018

• The latest evidence based competencies for registered practitioners working in enhanced care areas and with Level 1 patients on general wards.

Can nurse specialist working practices reduce the burdens of lung cancer?

Can nurse specialist working practices reduce the burdens of lung cancer?
University of Nottingham, 4 July 2018

• A new study has found that patients with lung cancer experience significantly better outcomes in terms of life expectancy, avoiding unnecessary hospital admissions and managing the effects of treatment when cared for by specialist lung cancer nurses.
• The research was based on anonymised patient healthcare records available from PHE and a nationwide survey of lung cancer nurse specialists (LCNS), analysing more than 100,000 people with lung cancer and more than 200 nurses across England.
• The research carried out by the University of Nottingham and London South Bank University, was presented at the National Cancer Registration and Analysis Service (NCRAS) conference on 21 June 2018.

Radiology Information Systems

Special Report: Radiology Information Systems
Digital Health June 2018

• This briefing addresses how radiology information systems could to support management of radiology workload by sharing the reporting workload across NHS trusts, and by using artificial intelligence to automate some of the work currently performed by clinicians.

Clinical oncology UK workforce census 2017

Clinical oncology UK workforce census 2017
Royal College of Radiologists 26 June 2018

• The clinical oncology UK workforce census report provides a profile of the clinical oncology workforce in the UK. 
• Based on data from every UK cancer hospital the key findings show that:
• Demand for cancer services continues to outstrip the workforce supply
• Increased pressure on services mean that time allocated to supporting professional activities is being erroded, potentially impacting on the quality of services
• Training numbers are insufficient to replenish the current shortages in the workforce
• Experienced oncologists are being lost from the workforce through retirements.

Cancer workforce in England 2017

Cancer workforce in England: A census of cancer, palliative and chemotherapy speciality nurses and support workers in England in 2017
Macmillan Cancer Support 30 April 2018

• Includes profile across different Cancer Alliances, vacancies across different geographies and setting of care.

Frequency of consultant review - evidence review for NICE

Frequency of consultant review: What is the most clinically and cost-effective frequency of review by a consultant in AMU, ICU, CCU, stroke units and general medical wards?
NICE 28 March 2018

• An evidence review for "Emergency and acute medical care in over 16s: service delivery and organisation" NICE Guidance NG94 identified only five studies, one of which related to ICU (Kerlin 2013)
• The (low quality) study comprising 1598 participants, evaluated the role of a 24 hour consultant compared to a day time consultant in ICU, in adults and young people at risk of an acute medical emergency, or with a suspected or confirmed acute medical emergency. The evidence suggested that increased consultant reviews found no difference on mortality and length of stay.

Kerlin MP, Small DS, Cooney E, Fuchs BD, Bellini LM, Mikkelsen ME et al. A randomized trial of nighttime physician staffing in an intensive care unit. New England Journal of Medicine. 2013; 368(23):2201-2209

Vanguards are improving patient experience

Improving the experiences of people who use services
NHS Providers 7 March 2018
Sharing learning around patient experience from vanguards including:

• Specialist care closer to home - integrated neurology nurse at the Neuro Network vanguard at Walton Centre, Liverpool.
• Reducing the need to travel - epilepsy specialist nurse providing support and practical care to children treated at Evelina London Children's Hospital closer to home.

HEE Cancer Workforce Plan for England

HEE Cancer Workforce Plan for England
Health Education England 5 December 2017

• The Cancer Workforce Plan for England provides detailed data on key professions so that local Cancer Alliances, HEE and employers can agree the actions needed to help recruit, train and retain the staff necessary to deliver improvements in cancer care.

Full Steam Ahead: Non surgical cancer treatments workforce

Full Steam Ahead: Non surgical cancer treatments workforce
Cancer Research December 2017

• UK-wide data collected on the non-surgical oncology workforce as a whole and gaps in the data. 
• Recommendations:

Radiology Workforce Census 2016

Radiology Workforce Census 2016
Royal College of Radiologists October 2017

• Report, summary slides and infographic. 
• Main findings include:
• Insufficient numbers of radiologists in the UK
• Reported vacancy rates are high and are likely to be an underestimate
• Too few trainees are joining the workforce to replace those retiring 
• Radiology departments are unable to meet reporting demands within normal working hours
• Expenditure on outsourcing/insourcing remains high