The document summarizes key changes being made to the UK's National Health Service (NHS) as outlined in the government's Health and Social Care Bill. It discusses the bill's proposals to devolve power to general practitioner-led clinical groups and local authorities while establishing an independent NHS commissioning board. It also notes implications for practice nursing, including threats to nursing leadership and specialist posts in the short term, but potential opportunities if nurses seize new roles and influence policy development.
LTC Year of Care Commissioning Model
Lesley A Callow, Delivery Support Manager - Long Term Conditions Year of Care Commissioning Model
NHSIQ
Fionuala Bonnar, Year of Care Programme Manager
LTC Year of Care benefits:
Improved outcomes and wellbeing:
Patients receive care that is better managed, more seamless across different care services and more needs focused.
Reduction in acute admissions to hospital; and shorter lengths of stay when these are required.
Clinical professionals contribute to a more holistic service for patients by working within an integrated patient-centred care plan
Local health and Social Care economies:
Provide care that delivers value for money and is better managed by integrated teams.
Incentive to improve services for patients
Improved joint working and shared responsibility for outcomes
NHS Improving Quality undertook a scoping exercise of rehabilitation services, which included:
Identification of the different practice models illustrated through case studies looking at integrated models of adult rehabilitation service provision
A high level baseline mapping exercise of the current availability of adult rehabilitation services across England.
NHS Improving Quality also assisted in capturing the views from key stakeholders by supporting and facilitating a series of stakeholder engagement events hosted by NHS England.These events aimed to develop and agree principles and expectations to underpin high quality rehabilitation services.
LTC Year of Care Commissioning Model
Lesley A Callow, Delivery Support Manager - Long Term Conditions Year of Care Commissioning Model
NHSIQ
Fionuala Bonnar, Year of Care Programme Manager
LTC Year of Care benefits:
Improved outcomes and wellbeing:
Patients receive care that is better managed, more seamless across different care services and more needs focused.
Reduction in acute admissions to hospital; and shorter lengths of stay when these are required.
Clinical professionals contribute to a more holistic service for patients by working within an integrated patient-centred care plan
Local health and Social Care economies:
Provide care that delivers value for money and is better managed by integrated teams.
Incentive to improve services for patients
Improved joint working and shared responsibility for outcomes
NHS Improving Quality undertook a scoping exercise of rehabilitation services, which included:
Identification of the different practice models illustrated through case studies looking at integrated models of adult rehabilitation service provision
A high level baseline mapping exercise of the current availability of adult rehabilitation services across England.
NHS Improving Quality also assisted in capturing the views from key stakeholders by supporting and facilitating a series of stakeholder engagement events hosted by NHS England.These events aimed to develop and agree principles and expectations to underpin high quality rehabilitation services.
7 Day Services webinar - Workforce and delivering 7 day servicesNHS England
This webinar explores how use of enhanced roles can help Trusts in the delivery of seven day services, and aims to help trusts understand the practical issues associated with developing enhanced roles and implementing these into their organisations. During this session you will hear about:
* Workforce planning and the delivery of 7 day Services. Health Education England will provide an update regarding the national picture and provide insight into innovative workforce solutions which will support the delivery of 7 Day Services
* Practical examples from colleagues in acute trusts, where new roles have been utilised in delivering the 4 priority clinical standards
Key speakers:
Kevin Moore - Head of Workforce Transformation, Health Education England
Miss Fiona Kew - Consultant Gynaecologist, Modernising the Workforce: Physician's Associates – Sheffield Teaching Hospital
Darren McGuiness - Endoscopy Manager Royal Liverpool & Broadgreen NHS Trust. Seven Day Services in Endoscopy
Nicky Taggart - General Manager, Radiology and Imaging, Royal Liverpool & Broadgreen NHS Trust. Seven day services in Radiology
Evidencing the quality and productivity of Allied Health Professionals' (AHPs...NHS Improvement
We recently hosted four regional events ‘Evidencing the quality and productivity of AHPs care’ with a target audience of Allied Health Professional leads in NHS provider organisations.
These slides outline sessions from the events and provide an introduction to the Model Hospital, AHP job planning and the early findings of a deployment tracker metric ‘Therapy Hours to Contacts’ that is being implemented.
Read the final report of The Parliamentary Review about the future of health and social care in Wales. Parliamentary Review published a report which is produced in 12 months focused on the sustainability of health and social care in Wales.
https://gov.wales/topics/health/nhswales/review/?lang=en
Evaluation of IC initiatives - challenges, approaches and evaluation of Engla...Sax Institute
This presentation from Nicholas Mays, Professor of Health Policy, Director, Policy Innovation Research Unit, Department of Health Services Research & Policy focuses on the challenges, approaches and evaluation of England's Pioneers.
Understanding the value and contribution of nurses and midwives to public health in the UK - presentation at the Faculty of Public Health annual conference 2016
Direction of Health and Social care in Norfolk CANorfolk
Jon Clemo (Chief Executive, Community Action Norfolk) facilitates a conversation with Melanie Craig (Chief Officer, Norfolk & Waveney Clinical Commissioning Group) and James Bullion (Executive Director, Adult Social Services, Norfolk County Council) on the direction of Health and Social Care in Norfolk based on questions received from the VCSE sector.
7 Day Services webinar - Workforce and delivering 7 day servicesNHS England
This webinar explores how use of enhanced roles can help Trusts in the delivery of seven day services, and aims to help trusts understand the practical issues associated with developing enhanced roles and implementing these into their organisations. During this session you will hear about:
* Workforce planning and the delivery of 7 day Services. Health Education England will provide an update regarding the national picture and provide insight into innovative workforce solutions which will support the delivery of 7 Day Services
* Practical examples from colleagues in acute trusts, where new roles have been utilised in delivering the 4 priority clinical standards
Key speakers:
Kevin Moore - Head of Workforce Transformation, Health Education England
Miss Fiona Kew - Consultant Gynaecologist, Modernising the Workforce: Physician's Associates – Sheffield Teaching Hospital
Darren McGuiness - Endoscopy Manager Royal Liverpool & Broadgreen NHS Trust. Seven Day Services in Endoscopy
Nicky Taggart - General Manager, Radiology and Imaging, Royal Liverpool & Broadgreen NHS Trust. Seven day services in Radiology
Evidencing the quality and productivity of Allied Health Professionals' (AHPs...NHS Improvement
We recently hosted four regional events ‘Evidencing the quality and productivity of AHPs care’ with a target audience of Allied Health Professional leads in NHS provider organisations.
These slides outline sessions from the events and provide an introduction to the Model Hospital, AHP job planning and the early findings of a deployment tracker metric ‘Therapy Hours to Contacts’ that is being implemented.
Read the final report of The Parliamentary Review about the future of health and social care in Wales. Parliamentary Review published a report which is produced in 12 months focused on the sustainability of health and social care in Wales.
https://gov.wales/topics/health/nhswales/review/?lang=en
Evaluation of IC initiatives - challenges, approaches and evaluation of Engla...Sax Institute
This presentation from Nicholas Mays, Professor of Health Policy, Director, Policy Innovation Research Unit, Department of Health Services Research & Policy focuses on the challenges, approaches and evaluation of England's Pioneers.
Understanding the value and contribution of nurses and midwives to public health in the UK - presentation at the Faculty of Public Health annual conference 2016
Direction of Health and Social care in Norfolk CANorfolk
Jon Clemo (Chief Executive, Community Action Norfolk) facilitates a conversation with Melanie Craig (Chief Officer, Norfolk & Waveney Clinical Commissioning Group) and James Bullion (Executive Director, Adult Social Services, Norfolk County Council) on the direction of Health and Social Care in Norfolk based on questions received from the VCSE sector.
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ABDOMINAL TRAUMA in pediatrics part one.drhasanrajab
Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
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Workout Routine
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These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
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3. Discuss the significance of dead space
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5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
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Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
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12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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The changing role of practice nurses
1. Jane Salvage
Chair designate, Queen’s Nursing Institute
Editor, NMC Review
Visiting professor, Florence Nightingale
School of Nursing, KCL
work@janesalvage.me.uk
1
Date of preparation: May 2011. [AXHUR102574m] 1
2. Session objectives
1. Summarize key changes in the NHS
2. Highlight the implications for practice nursing
3. Discuss how practice nurses can face the
challenges and make the most of the
opportunities
Date of preparation: May 2011. [AXHUR102574m] 2
3. “There is nothing around us to reverse the
direction of development and change … thus
we are posed with the question of being the
master of these changes or their servant.”
Mo Im Kim 2003
3
4. Government proposals and timescale
• Equity and Excellence: Liberating the NHS published July
2010
• Health and Social Care Bill presented to Commons,
January 2011
• Secretary of State announced two-month ‘pause’, April 4
• Critical report by Commons health committee, April 5
• Government launched 'listening exercise’, April 6
• Government promises to amend Bill
• Bill now at committee stage, House of Lords
Date of preparation: May 2011. [AXHUR102574m] 4
5. The rhetoric
• The White Paper set out the government’s long-term vision for the future of the
NHS
• It says its vision builds on the core values and principles of the NHS – a
comprehensive service, available to all, free at the point of use, based on need
not ability to pay
• The government says it will:
– put patients at the heart of everything the NHS does, and make the NHS
more accountable to them
– focus on continuously improving the outcome of their healthcare
– empower and liberate clinicians to innovate and focus on improving services
– free staff from excessive bureaucracy and top-down control
Date of preparation: May 2011. [AXHUR102574m] 5
6. Key proposals
• Power and responsibility for commissioning services devolved to
GPs, working in clinical commissioning groups (60% of NHS budget)
• Local authorities to lead joining up NHS, social care & health
improvement
• Independent NHS Commissioning Board to lead on quality & access
• All NHS trusts to become foundation trusts with greater freedoms
• Many more employee-led social enterprises
• Monitor to become economic regulator
• Care Quality Commission inspectorate role strengthened
Date of preparation: May 2011. [AXHUR102574m] 6
7. Employment issues
• Implementation of Boorman report on occupational
health
• Service providers to pay education and training costs
• Individual employers to determine local pay
• Pay frozen for 2 years for those earning over £21,000
• Pensions review
• Review of regulation to reduce burden and cost
Date of preparation: May 2011. [AXHUR102574m] 7
8. Health and Social Care Bill 2011
• Establishes an independent NHS board to allocate resources and
provide commissioning guidance
• Increases GPs’ powers to commission services on behalf of their
patients
• Strengthens role of Care Quality Commission
• Develops Monitor, the body that currently regulates NHS
foundation trusts, into an economic regulator to oversee aspects of
access and competition in the NHS
• Abolishes 152 PCTs and 10 SHAs by 2013
Date of preparation: May 2011. [AXHUR102574m] 8
9. The context: ‘Cutting bureaucracy and improving efficiency’
•Government promises small real-terms rise in NHS funding
•Spiralling costs, rising inflation
•The ‘Nicholson challenge’ – up to £20bn efficiency savings in
NHS in 2011–2014
•45% cut in management costs, 2011–2014
•Thousands of job losses, including front line
•Demand for skilled care outstripping supply
•Massive reorganisation & abolition health bodies
•Department of Health NHS functions will focus on public
health, inequalities, adult social care
Date of preparation: May 2011. [AXHUR102574m] 9
10. Timetable – subject to change!
NHS Commissioning Board established in shadow form as a special health
Authority; statutory body in 2012
NHS Outcomes Framework fully implemented by 2012
PCT commissioning and provision separated by April 2011 > ‘any willing provider’
Comprehensive system of GP consortia in place in shadow form during 2011/12,
taking on increased delegated responsibility from PCTs
Following passage of Health & Social Care Bill, consortia to take on responsibility
for commissioning in 2012–13
NHS Commissioning Board to make allocations for 2013–14 directly to GP consortia
in late 2012
GP consortia to take full financial responsibility from April 2013
Local authorities’ new functions – no date given
Date of preparation: May 2011. [AXHUR102574m] 10
11. NHS Future Forum report, June 2011
People accept need for change but ‘want the changes to be the right
ones and to feel ownership of them’
The current model of care cannot be sustained
GPs ‘must be required to obtain all relevant multi-professional advice
to inform commissioning decisions & the redesign of patient
pathways’ – ‘strong role for clinical and professional networks’ –
establish ‘multi-specialty clinical senates to provide strategic
advice’
Competition should be a tool supporting choices, promoting
integration and improving quality’ – not an end in itself
The pace of the reforms must ‘vary’
More time is needed to get workforce education and training right
Date of preparation: May 2011. [AXHUR102574m] 11
12. Government response, June
Promises key changes – some but not all require Bill amendments
NHS Constitution upheld + NHS free at point of use
Greater assurance that commissioning will ‘involve’ nurses, patients etc
Every clinical commissioning group to have governing body with decision-making
powers, with at least 1 RN, 1 medical specialist, 2 lay members
PCTs cease to exist next April, SHAs to be clustered then abolished
All CCGs to be established by then, but can only start commissioning when they
are ‘ready and willing’
Clinical networks to be strengthened, with stronger commissioning role
Formal role of clinical senates in authorising CCGs
‘Any Qualified Provider’ unchanged, just slowed down a bit
Safeguards against privatisation
Most trusts to be foundation trusts by April 2014
More work to be done on education and training esp CPD
Date of preparation: May 2011. [AXHUR102574m] 12
13. The implications for nursing – negatives
• Unprecedented change
• More to do with fewer staff and less resources
• Damage to nursing leadership, at least in short term
• Fight to maintain and enhance nursing voice at all levels
• Threat to specialist posts
• Much will depend on local structures and relationships
Date of preparation: May 2011. [AXHUR102574m] 13
14. The implications for nursing – positives
• Unprecedented change
• Much will depend on local structures and
relationships
• Opportunities to be seized
• Growing recognition of the need for skilled care,
especially for long-term and complex conditions
Date of preparation: May 2011. [AXHUR102574m] 14
15. Preparation for change and delivery of future services
• Understand policy-making
• Effective leadership in senior roles
• Networking
• Mobilise grass roots
• Alliances with communities and patients
• Developing our evidence base
• Creating and sharing good tools and processes
• Better processes to thrash out differences and present united front
• Need to be more proactive and savvy
• Put nursing on the radar – policy with us rather than about us
• Alignment with overall health policy
Date of preparation: May 2011. [AXHUR102574m] 15
16. Face the challenges, seize the opportunities
We must become policy activists and entrepreneurs:1,2
• Position yourself to influence policy
• Bring together problems, policies and politics into a novel
amalgamate: new policy
• Soften up the system by presenting participants in the network
(visible and invisible) with alternative representations of their
realities
• This leads to opening a window of opportunity – potential for a
truly new policy perspective
References
1.Kingdon, J.W. (1995). Agendas, Alternatives and Public Policies; 2nd ed. Harper Collins College Publishers, New York
2.De Leeuw E. Five books that shaped my view of health policy, Reviews of Health Promotion and Education Online,
2003. http://rhpeo.net/reviews/2003/1/index.htm
Date of preparation: May 2011. [AXHUR102574m] 16
17. Which kind are you?
• those who watch things happen
• those who wonder what happened
• those who make things happen
17
Date of preparation: May 2011. [AXHUR102574m] 17