Category: Uncategorised

What week is it? Sometimes it can be hard to keep track of time, with work days merging into an endless stream punctuated by weekends or days off.  But take a look around and you might well find milestones, special events which can help to break up the pattern and inject fresh awareness and outlook.

Take the current week of the 13^th to 19^th June 2022 for example. There are no Bank Holidays, nor even school holidays, to break up the time. And yet, this week is special with not one, nor two, but three national campaigns to focus in on.

Let’s start with Men’s Health Week. Run by the Men’s Health Forum, this campaign calls on men to give themselves an MOT, to ‘take notice of what’s going on in your body and mind’ and to take action. Prostate cancer diagnosis fell by 29% between 2019 and 2020 due to covid lockdowns so that is one area of concern. But the MOT also looks at a range of areas from pulse and blood pressure rates to weight and mental awareness, encouraging men to check for common areas of potential concern and to take action.

With blood pressure and weight in mind, it is also the British Nutrition Foundation’s Healthy Eating Week. The aim of the week is to encourage everyone to have “a healthier and more sustainable diet.” Each day has a theme from Monday’s focus on fibre to Friday’s reduce food waste with 5 a day, protein, and hydration filling the other days.

What we eat can affect our health, so it is perhaps pertinent that the 13^th to 19^th June is also Diabetes Week. Promoted by Diabetes UK, the week is designed not only to celebrate those who are living with diabetes but also to promote awareness of the condition. Alongside events for everyone to get involved in there is also a ninety minute diabetes CPD course for non-specialist health care professionals, helping to provide the knowledge and skills required to better support diabetes patients.

For those in the health care profession, week’s such as these can be invaluable; not simply as ways of generating targeted publicity but also as a means to help patients to be aware of risks and opportunities and to take action to improve their own health. A general leaflet or quick chat is one thing; a national campaign is quite another. And whilst some patients may be galvanised by national publicity to check their own health and make appointments to discuss any concerns, health professionals can also proactively use these campaigns in order to reach out to those under their care.

Being aware of forthcoming campaigns can also enable health professionals to plan workloads and to ensure that they have the resources available should a particular action week result in an increase in patient calls. Even something as simple as having a call answering service on standby to take overflow calls or provide simple information could help health professionals to optimise the results from action weeks. Raising awareness is after all only the start of the journey to improving health and lifestyles.

How secure is your business? Do you check visitors in and out of the office, perhaps restrict access to certain confidential files, or work on a need to know basis? Or perhaps you operate a more free and open style, trusting your people to know what should and shouldn’t be shared and to act in the best interests of the organisation.

Whatever your approach, there may be one area which is leaving your company information open to the world; your passwords. According to a 2019 Data Breach investigations report by Verizon, 80% of data breaches are caused by weak and compromised passwords and little has changed since. It seems as though, despite the danger, the temptation to use easy to remember passwords overcomes any concern about data breaches.

A more recent survey by NordPass revealed that the top passwords used by CEOs, executives, business owners and managers have little changed over time. There are a few variants on a theme but overwhelmingly ‘123456’, ‘password,’ and ‘qwerty’ seem to be the password of choice. Those of a more adventurous nature may look towards animals and mythical creatures with ‘dragon’ and ‘monkey’ coming top of that list; whilst others may simply opt for the inclusion of family or pet names.

If that is the tone being set at the top of organisations, it is hardly surprising that others lower down the ranks fail to take password security as seriously as they might. That’s one reason why World Password Day, which takes place towards the beginning of May each year, gives prominence to the promotion of strong passwords which are less likely to be hacked.

So what is a strong password? You might think that randomness equals strength. And it does, to an extent. However, make the password too random and it becomes so hard to remember that it will be written down; not something you want for password security. As an alternative, in 2016 the UK’s National Cyber Centre recommended using a combination of three random words such as ‘coffeetrainfish.’ These are hard for hackers to guess and yet are far easier for individuals to remember.

When you are looking at password management, don’t forget your phone system. If individual phones, or the system itself, are still using the default passwords they came with on installation then they are open to hacking. And once your phone system is vulnerable then not only can phishing attackers gain access to an apparently secure line, fraudsters may also be able to use your system to run up expensive calls to premium numbers. Add in the potential for hackers to access caller details and it is easy to see how data breaches can cost businesses their livelihoods and reputation.

Apart from ensuring that default ‘1111’ or similar pass codes are not being used, another option is to ensure that unused extensions are not left available. Callagenix’s Extension Control App and ACD Login Service enable supervisors to switch extensions on and off as required; perhaps something to consider if offices are to be left empty over the extended Jubilee Bank Holiday weekend.

The news that the NHS is rolling out a smart watch to help with the monitoring and treatment of Parkinson’s patients is just one of a long line of health innovations which are making the most of smart technology. Worn around the clock for six days, the watch contains sensors which enable clinicians to assess the progress of the disease in patients. This in turn will help to identify whether current medication may need updating or whether additional therapies such as physiotherapy may be of benefit.

Developed by the University of Plymouth in conjunction with the local hospital trust, the monitor can also digitally remind patients to take their medications. Lead clinician, Dr Camille Carroll, an associate professor in Neurology at the University of Plymouth and an Honorary Consultant Neurologist at University Hospitals Plymouth NHS Trust commented that the device: “helps to provide reassurance for patients and also means that NHS staff can provide a comprehensive six-monthly review, while also allowing hard-working staff to free up clinical capacity for those who need face-to-face appointments.”

 This project demonstrates the way in which the development of technological solutions has the power to transform health services. Some of these solutions are simple but can have a marked impact on patient care and outcomes. Developments such as the sending of patient reminders via SMS may seem obvious now but they help to optimise patient attendance. Similarly, digitising patient records may not seem as remarkable as it once did but the ability to retrieve and share information electronically can not only save time but could also improve outcomes; particularly in patients with multi-care needs.

Another area which is proving beneficial to patient outcomes is the harnessing of video-conferencing and instant communications in order to share knowledge. The BMJ recently reported on the way in which video-conferencing is not only helping surgeons in the UK, Europe and elsewhere to train and support colleagues in Ukraine in the treatment of battlefield injuries, it is also being used in other fields, such as in Kenya to improve caesarean section outcomes.

 There are also a number of new projects in the pipeline, all of which have the power to transform monitoring and treatment of health issues. Announced in March 2022, the latest tranche of digital health partnership award winners include the use of a secure video platform to support young people with epilepsy, and the use of digital health solutions to transform outpatient care for those with chronic kidney disease. Other award winners deploy remote monitoring programmes in areas as varied as paediatric cardiac care, asthma care, and wound management. All these aim to reduce the need for multiple appointments whilst improving the level of care. Along the way this helps to free up clinical time, thereby increasing the number of people who can be treated at any time.

The number and variety of smart solutions will only grow as technology improves and as health services learn to harness the power of existing technology. Some solutions may be complex, some simple, but the outcome is improved patient care within in a health service which makes the most of available resources.

There’s nothing new about stress. So much so that the stress response, or fight or flight response as it is perhaps more widely known, was first developed by our distant ancestors in response to threats which they encountered within their environment.

Some of those long ago threats may no longer be there but the response remains, being triggered by real and perceived threats to our health and wellbeing. And when the stress response kicks in it doesn’t really matter if it has been triggered by a speeding car hurtling towards you, being placed in a situation which triggers a phobia, or a repeating pattern which causes psychological distress. Whatever the cause, the stress response is real; flooding our system with substances such as adrenaline and cortisol and causing changes in areas such as heart rate, breathing and blood flow.

Whilst the stress response changes might be necessary in a sudden life or death situation, triggering those responses on a regular and ongoing basis can lead to permanent damage not only to the cardiovascular system, but also to areas such as eyesight, the immune system and digestion. That’s why stress management is so important; not simply to overcome the immediacy of response but also to prevent long term impacts on health.

It’s hardly surprising therefore that the whole of April has been devoted to stress awareness. First instigated in 1992, Stress Awareness Month seeks to raise awareness both of the impact of stress and potential ways of mitigating stress. For 2022 Stress Awareness Month has chosen the theme of community. It’s a particularly apt theme, following on as it does from two years in which lockdowns lead to isolation at work, at home, and in the community.

Studies have shown that isolation can lead to depression and stress. Conversely, socialising with others, having someone to talk to or enjoy activities with can help to reduce stress levels. That community feeling can come from anywhere. It might arise in the home or in the neighbourhood, in a social club or at work. To this end the charity Mates in Mind has launched a series of resources in tandem with Stress Awareness Month. These include a ‘Let’s talk stress’ factsheet to help facilitate open conversations about workplace stress and a ‘Managing and reducing Workplace stress’ handbook.

The handbook lists a number of causes of stress in the workplace including a lack of support from supervisors and colleagues. It also makes the valid point that stress can build up over time, especially when a succession of potentially small things are left unresolved. The handbook then goes on to highlight potential signs of stress before outlining steps which employers and colleagues can play in managing workplace stress and supporting individuals.

Those steps can be as simple as redesigning workflow to reduce points of stress or raising awareness of support mechanisms which are available when workloads become too heavy to manage. Whatever the pathway, the key to successful stress management comes from awareness coupled with open dialogue. Stress is a very real part of all our lives. Learning how to acknowledge, manage and mitigate it could help those lives to be longer, more healthy and more fulfilling.

Nearly 1.9million diagnostic tests were carried out by the NHS in January 2022. Add in the 1.8million calls fielded by NHS 111 in the same month and it is not difficult to see why some areas of our health services are stretched. Particularly so, as the same report from NHS England revealed that, despite 1.2million people starting consultant-led treatment in January, the waiting list for routine hospital procedures reached 6.1million.

There is little doubt that health services staff are working to manage the backlog which grew throughout the pandemic. There is also little doubt that people and services are stretched; particularly so as covid may have reduced in severity but it has not gone away. A separate report by NHS England revealed that in acute hospital trusts alone an average of 55,832 members of staff were off sick each day in the week prior to the 10^th March. That’s hardly surprising. Whilst covid is still around in any form, increased levels of absenteeism are to be expected.

All of this means that the ‘delivery plan for tackling the Covid-19 backlog of elective care’ which was announced in February may, in its initial stages at least, come under pressure. And that could have a knock on effect right across healthcare services in the UK.  Acknowledging this the sponsors of the plan, Sir David Sloman and Sir James Mackey, comment that :

“Recovering elective services is going to require a huge, collective effort from systems and providers. This is not just in hospitals but across the entire health and social care system. We will only be successful in delivering these commitments if we are to draw on the collective ingenuity, determination, and resilience of teams across the country.”

That resilience in part is going to depend on inbuilt system flexibility. When working under pressure, it only takes a small change in resources to derail carefully planned schedules. By identifying key pinch points, health providers may be able to devise backup solutions which can kick in as required.

For example, some users call on our call handling service to manage all incoming calls but we can also act as an overflow call handling solution as required. So if a health practice’s reception team are short staffed, we can step in and help to keep call management and diary services on track. Not only will this help to ensure a smooth throughput of patients, it can also act to reduce internal pressures and therefore better enable clinicians to concentrate on patient treatments.

Another way of helping to ensure that appointment times are optimised is by sending out reminders either by SMS text messaging or e-mail. Not only can reminders help to ensure attendance, they can also prompt individuals to get in touch and cancel or rearrange appointments if they are unable to attend. This in turn enables the health practice to call on other prospective patients to fill gaps in schedules; thereby helping to speed up treatment times and clear any covid backlog.  

Sometimes when things get too much, a quiet chat can make all the difference. And generally the first people we would turn to are friends, family, or colleagues. But there are times when those informal talks aren’t enough. Times when we need something more to help us to recover our equilibrium. That’s where talking therapy can come into play.

Perhaps traditionally seen as an option for those suffering from stress, anxiety, or depression; taking therapy can take a number of forms. These include Cognitive Behaviour Therapy (CBT), counselling, behavioural activation, and guided self help. This variety of options available enables people to receive the optimum therapy that will best suit themselves and their condition.

Whilst some therapies may work best in a face to face situation, in a number of instances talking therapy can be carried out over the phone, perhaps with the call being supplemented by work books and information sent to the home. That ability to carry out telephone talking therapies has proved to be extremely beneficial during lockdown. So much so that according to statistics released by the NHS a record 634,649 individuals completed a talking therapy course in the 2020/21 period. That is a rise of five percent on the previous year. And that’s only the start. The NHS long term plan aims to help 1.9 million adults with talking therapies by the year 2023/24, with a focus on long term conditions. This is in addition to the provision of private treatment options.

Not only did the number of people undergoing talking therapy rise year on year, the average number of sessions in a course of treatment also rose to 7.5 from 6.9 the previous year. Whether that rise in treatment length is due to patients requiring greater amounts of help, or simply the provision of phone sessions freeing up extra time is unknown. Certainly the fact that in the period in question 90% of people started treatment within six weeks of identifying a need, again a rise on the previous year, with 51.4% of those completing a course being seen to have recovered from anxiety or depression is to be commended. On the other hand, it has been estimated that the number of adults in England with depression has doubled since the start of Covid; revealing an even greater need for talking therapy provision.

It’s another example of the strain which health services across the board are facing. And it can at times seem as though no matter how many technical solutions are put in place to save time, that time is taken up in meeting additional patient needs. That doesn’t mean we shouldn’t look towards time saving solutions such as switching calls to a virtual assistant service, putting appointments online, or digitising patient notes. On the contrary, the more time can be saved in streamlining routine administration tasks, the better. But in the spirit of ‘physician heal thyself’ there are times when it pays to step back, to take time out to renew and refresh, or maybe just to talk.

As the cold weather starts to bite, so too does the pressure on health services across the country. Slips and falls on wet leaves or icy pavements bring strains and broken bones to the treatment table, whilst seasonal flu and other viruses contend with the ongoing covid crisis. The result is an increase in patient demand, coinciding with an increased likelihood of healthcare staff needing time off through illness.

At times like these, anything which can reduce the pressure on health services is welcome. And sometimes the simplest ideas can be most effective. Take, for example, a recently announced initiative which aims to provide an early stroke warning system. The initiative will see 220,000 home blood pressure monitors being sent out to individuals who have been diagnosed with uncontrolled blood pressure.

With these individuals monitoring their blood pressure at home and reporting readings on a regular basis to their GPs, it is hoped that any significant changes in blood pressure will be detected as soon as they occur. This in turn will enable early interventions, perhaps in the form of further investigation or the prescription of blood pressure reduction medication, thereby reducing the chance of an individual suffering a stroke or heart attack.

Commenting on the initiative the National Medical Director of Primary Care for the NHS, Dr Nikki Kanani, said:  “These simple checks will help us to save lives.” Meanwhile the Health and Social Care Secretary, Sajid Javid, said “This is just one way we’re backing the health service to harness the potential of new technology, to support hardworking staff and save thousands of lives.”

That comment about harnessing technology is an important one. In recent years, we have seen how technology can be used as a force for good across health services. At one end of the scale we have technologies such as the use of robotics to perform surgery, thereby improving outcomes and patient recovery times. We’ve also seen how gene therapy can be used to stop the progress of, or treat, diseases.

At the other end of the scale we’ve seen how even something as simple as the sending out of SMS text messages to remind patients of appointments due can make a difference to the smooth running of a health practice. In fact, the more that technology can be used to take care of routine administration tasks, the greater the potential to treat patients.

Being able to call up patient records at a touch of a computer key might seem simple but it could help health practitioners to provide a swifter response to patient needs.  And when something like winter flu strikes, the ability to devolve phone answering to a third party could enable a practice to continue providing the care its patients needs despite reduced staffing levels. There is little doubt that health services will be under pressure this winter. Making the best use of technology available might just help to reduce that pressure to a more manageable level whilst providing good levels of patient care.

It may have been running for nearly thirty years but World Mental Health Day is as vital now as when it was first brought into being. Celebrated on 10^th October, the day was initially seen as a way of bringing forward debate on mental health issues. The first ‘theme for the day’ introduced in 1994 was “Improving the Quality of Mental Health Services throughout the World.”

This year’s theme of “Mental Health in an Unequal World” reflects the importance of ensuring equal access for all. This focus on equal access is particularly important in the light of the Covid crisis, with the World Health Organisation singling out groups such as health and frontline workers, students, people living alone and those with pre-existing mental health conditions as having been particularly affected.

In tandem with this year’s theme, in the UK research carried out by the Mental Health Foundation reveals that those with long term health conditions, facing discrimination, or parenting on their own are particularly vulnerable. Commenting that “we are all in the same storm, but we are not all in the same boat,” the Mental Health Foundation study reveals a divergence of support depending on social and/or economic factors. That, they say, leads to a need for a multi-faceted response plan which takes into account not only immediate mental health needs but also looks to alleviate the socio-economic causes of mental health problems.

The fact is that although the country is opening up, the effects of covid are ongoing. And whilst anxiety levels may be decreasing, (49% of the population having felt anxious or worried due to Covid in the third week of June, compared with 62% in mid-March), that doesn’t mean that all is now well. People have been affected by the ongoing Covid pandemic, and there is a fair chance that ongoing anxieties may continue for some time to come.

On a more positive note, the World Health Organisation (WHO) comments that at the world Health Assembly in May 2021, “governments from around the world recognized the need to scale up quality mental health services at all levels” with some countries finding “new ways of providing mental health care to their populations.” The WHO is using World Mental Health Day to highlight some of these successes on its website with testimony from around the world under the theme of “Mental health care for all: let’s make it a reality.”

As highlighted above, when we talk about mental health care for all we should remember that certain groups including those in the medical profession are particularly vulnerable. ‘Physician heal thyself’ may be an old cliché but it is one which is particularly apt here. It can be all too easy for those in the health profession to focus on patient care at the expense of their own mental well being.  That’s where finding ways to work smarter, to call on outside help when needed, and to use digital solutions to reduce administration can make such a difference. Making time to step back and to de-stress is an essential part of health practice. After all, in order to best serve your patients, you need to be fully focused and clear about what you can offer.

World Mental Health Day 2021 calls for equal access for all. Don’t let those in the health profession be the ones to miss out.