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Cold weather alerts

From the winter vomiting virus to spring hay fever, summer heat strokes to autumn seasonal affective disorders (SAD); every season has its peak illnesses. Of course, any of these can occur at any time, but health professionals are aware that as the seasons turn so too do differing conditions come to the fore.

With that in mind, as health professionals just how do you prepare to meet the differing challenges which the changing of the seasons throws up? It’s not always easy. Whilst some conditions, such as SAD which is triggered by shortening day length, are fairly easy to predict; others may depend on more variable factors.

For example, whilst summer rains might initially help allergy sufferers by washing pollen out of the air, a couple of days later with plant growth having been triggered by the rain you may well find an increase in pollen or mould levels, leading to an increase in allergy presentations. Or to look at another scenario, winter slips and falls are far more likely to occur in icy conditions than on comparatively milder days.

What this adds up to is a need for weather to be taken into account in resource planning. Local forecasts may be of help here, especially when viewed alongside national resources such as the Met Office’s cold weather alert service.

Operating from 1 November to 31 March each year in conjunction with the UK Health Security Agency (UKHSA), the cold weather alert service aims to reduce the impact of severe cold weather on people’s health. It does so by not only predicting weather severity but also providing advice to individuals, communities and agency on how they should prepare and manage differing scenarios.

Building on an alert level 0 which looks towards all year round planning, four other levels look towards steps required to manage anything from mild winter conditions (Level 1) to a major weather incident (Level 4.) So, for instance, Level 2 looks for social and healthcare services to work to ensure that they are prepared to take swift action to reduce the risk of harm from a period of cold weather whilst Level 3 requires those agencies to take specific actions in order to protect high-risk groups.

At the time of writing we are facing alert level 1 in the three northernmost regions of England with alert level 2 across the rest of the country. The level 2 alert specifically warns of a “70% probability of severe cold weather between 1800 on Thursday 13 Jan and 0900 on Monday 17 Jan in parts of England. This weather could increase the health risks to vulnerable patients and disrupt the delivery of services.”

Information such as this helps health providers to create flexible solutions which can be triggered depending on need. Even something as simple as being able to transfer phone calls to a virtual assistant service when demand is high could help with resource management. When the pressure is on to treat as many individuals as possible, the ability to outsource some routine administration matters such as phone answering or even the booking of appointments could just tip the balance towards effective care when it is most needed.

Promoting card payments

The days of credit and debit cards being viewed as something out of the ordinary are long gone; as it appears is our initial reluctance to use contactless card payments. So much so that the UK banking trade body UK Finance has announced that in July 2019 alone there were six hundred and forty seven million contactless card payments; accounting for 50% of all non-cash transactions.

Not that that means the banking industry is getting complacent about promoting the use of card payments. In the week of writing this article the Royal Mint has announced the launch of a solid gold payment card. At the same time NatWest has started trialling contactless credit cards which use biometric fingerprint recognition technology. If successful, the trial could open up the way to increased contactless limits alongside a more secure card payment process.

For businesses as a whole, the general acceptance of cards as a payment medium represents a significant opportunity. For those which rely on client appointments, the potential benefit is twofold. Firstly, using cards as a method of payment at the time of the appointment both speeds up cashflow and saves time on administration. There are no invoices to raise and post out, no chasing unpaid bills and no waiting for payment receipts.

It has to be acknowledged that, thanks to the rise in card use, payment at the time of appointment has become the generally accepted payment method. But what about those businesses in the health sector and elsewhere which rely on clients attending booked appointments in order to generate income? For these businesses, a missed appointment can result in a loss of income, not to mention the lost opportunity to potentially treat another individual.

In those instances, taking card details at the time of booking could be one way of helping to ensure that appointments are either attended or cancelled in good time. By requiring either up-front payment or pre-authorising the card up to an agreed limit; health practices and others can ensure that even if the client doesn’t show, the agreed payment can still be taken. Payment is secure and if the client does attend the appointment but at the time prefers to pay by another method then the pre-authorisation can simply be released.

Of course, pre-authorisation isn’t the only way that clients can be helped to remember appointments. SMS text or e-mail reminders have also proved to be a useful trigger in reminding clients of booked appointments. This not only increases attendance, it also encourages those individuals who genuinely cannot make the appointment to cancel, thereby freeing up the time slot for the benefit of another client.

The rise in contactless payments partly reflects the growing demand for secure payment methods which are time-efficient. Contactless or not, by accepting debit or credit cards as a method of payment, businesses in the health sector are better able to manage cash flow whilst minimising administration time. And with pre-authorisation allied to appointment reminders, businesses can also optimise treatment times, whilst minimising no-shows.

Prevention is better than falling

When thinking about the contribution made to society by health professionals it can be all too easy to view their work as reactive; diagnosing and helping people to recover from illness or injury. But to do so would be to ignore the increasing movement towards proactive health care; enabling individuals to live healthy lives either through prevention or early intervention.

One such success story comes thanks to the Chartered Society of Physiotherapy (CSP). Their research in conjunction with Agile, a professional network for physiotherapists working with older people, has identified that a multifactorial approach can lead to a 24% reduction in falls amongst older people. When coupled with an evidence based exercise programme that increases to 34%. That is a significant reduction, particularly when taking into account the cost of falls in terms of mobility and longevity, not to mention resource allocation.

As the CSP paper highlights, falls which result in injury are the leading cause of mortality in older people. So much so that following a fall there is a 10% probability of older people dying within a year and half will experience serious mobility impairments. With an estimated 500,000 fragility fractures each year and an overall cost of falls to the NHS of £2.3b per year, any measures which can result in a reduction in fall outcomes can only benefit individuals and the wider society.

By undertaking a multifactorial risk assessment, physiotherapists are not only able to detect early difficulties with mobility, strength and balance; they can also identify other environmental factors which could contribute to the chance of falls. These include the physical environment as well as behavioural and cognitive factors. With early identification comes the chance of early intervention; providing a range of strength and balance exercises to reduce the risk of falls. Providing holistic support such as recommending home modifications or referrals to other agencies can also help individuals to be mobile and play an active role within the community for longer. And of course, the more active someone is the better their chance of managing other health conditions such as obesity.

Interestingly, although half of those who have experienced a fall are afraid of falling again, up to half of those who have not fallen also have the same fear. This can lead to a modification of behaviour which in itself can lead to negative outcomes. For example, if an individual is afraid of falling whilst out walking then they may isolate themselves in their home. Helping people to understand and manage risk, including showing them how to get up safely after a fall, can help to overcome these fears.

In outlining the case for early intervention the CSP makes the case for effective service provision and the beneficial use of physiotherapy services. More importantly it also demonstrates the value of supporting preventative health services and the long term benefit which such support can deliver. Each successful intervention can lead to a significant improvement in the long term quality of life for the individual as well as a reduction in long term costs for the health service as a whole.

Calling for help

When you need help it is good to know that there is someone there for you. More importantly, you need the reassurance that the help you require will be provided as swiftly as possible. That is one reason why a number of emergency services have adopted the what3words system; an app which can pinpoint a caller’s location anywhere in the world to within a 3x3m square; identifying it with a unique combination of three words.

Signing up to the system in 2019 the South West Ambulance service commented that “Having this type of technology integrated within our Command and Control system has changed the way we are able to deal with incidents where the location isn’t known” adding “If you download the app, it will mean we can find you more easily in an emergency when every second counts. It really could be the difference between life and death.”

Of course not all emergencies are life threatening. Nevertheless, whatever the level of help required it is still good to know that support is there when you need it most. This is particularly true for those in the healthcare sector who themselves need to ensure continuity of care and support for their patients.

Sometimes it is the simplest problems which can cause the most disruption. For example, when a telephone system goes down or a member of the support team calls in sick, the resulting disruption can impact across the health practice. Clinicians may have to take time away from patient-facing duties, or patients may not be able to arrange or cancel appointments; turning an already heavy workload into a stressful situation.

That’s where Clinic Appointments can help to take the strain. Available as and when required we can step in when your daily routine steps out. Equally importantly, as we specialise in the healthcare sector, we understand the importance of treating each call with professionalism and discretion. So whether you have an emergency and need to direct all of your calls to us or simply require us to soak up an overload you can trust our trained operators to answer your calls.

For health practitioners that means that clinicians can concentrate on patient treatments without having to stop and answer a phone call, thereby helping to ensure continuity of care. And for support staff, the availability of Clinic Appointments as a back stop means that they can undertake their duties without the added stress of worrying about unanswered phone calls.

Of course, Clinic isn’t only there for the stressful times. Health practices also have the option of signing up to an ongoing service with our trained operatives answering calls on a daily basis. With added options including a diary management service including appointment reminders via SMS text, digital patient records and secure payment processing we can help to ensure patient contact is maintained, leaving the health practice to concentrate on what matters most; maximising patient treatment times.

Tackling a culture of bullying

It’s time to take bullying out of healthcare. That’s the aim of an anti-bullying and undermining resource which has been launched by a coalition of health organisations including the Royal Medical Colleges.


Why is this campaign required? Surely with health being a caring profession bullying at most occurs in isolated incidences and only affects a few individuals? Sadly not! Studies have shown that over a quarter of NHS staff have experienced some form of bullying or undermining within the last year. And when someone is being bullied there are ongoing consequences not just for the individual, not just across the immediate team, but also in terms of levels of care and patient outcomes.


Shockingly, an analysis has suggested that bullying and harassment costs the NHS in England at least £2.28 billion per year. Moreover, in the perioperative area alone, 67% of adverse events, 71% of medical errors, and 27% of deaths have been attributed to bullying and disruptive behaviours by members of the health team.


Those statistics alone take bullying away from being a one-on-one behaviour. Quite simply, the responsibility for stamping out negative behaviour rests with every healthcare professional. With this in mind the Royal College of Surgeons of Edinburgh have developed a set of standards which they expect all of their members to uphold. These include a requirement to challenge and report bullying and undermining behaviour, to investigate all allegations as appropriate, and to demonstrate exemplary professional behaviour in ensuring that they themselves do not bully or undermine colleagues, either deliberately or inadvertently.


Being honest, when patients’ lives and livelihoods are at risk and when the demand for services outstrips available resources, the provision of healthcare can be a stressful and demanding occupation. But when patient outcomes are negatively affected by negative behaviour, the answer has to be for health professionals to provide mutual support by working together to promote a culture of positivity.


The NHS isn’t alone in experiencing bullying behaviour. Other health professionals including dentists and physiotherapists may well have also experienced negative levels of behaviour and indeed so too will businesses in other walks of life. And whilst awareness and be prepared to challenge unacceptable behaviour is one line of approach, health leaders can also take action in other ways in order to reduce levels of stress. Working smarter not harder may be a cliché, but every time that technology is successfully deployed in order to reduce or smooth out routine tasks, potential sources of stress are removed.


That’s where true teamwork comes into play, not only looking out for each other on a day-to-day basis but also finding ways to help each other over the long-term. It might be something as simple as digitising patient notes in order to make access and transfer easier. It may be a concerted effort to reduce patient no-shows by telephoning or sending SMS text reminders. It may even be a move towards online booking of appointments in order to reduce administration time. Whatever the approach, when we stop undermining and start building positivity that we ourselves, our patients and the health service as a whole can only benefit.

Spring Statement – Better outcomes for patients

On 13th March 2019 the Chancellor of the Exchequer, Philip Hammond, set out his Spring Statement. Unsurprisingly, predictions of future growth were heavily caveated in the light of uncertainties surrounding the final shape of a Brexit deal. So, relatively early within the speech, the Chancellor commented that “if the UK’s withdrawal is less than orderly, then the OBR’s (Office for Budgetary Responsibility) outlook for the economy and public finances is likely to become more pessimistic.”


Nevertheless, with borrowing in 2019 likely to be just 1.1% of GDP and debt levels falling, the Chancellor commented that the country currently remains on track to meet fiscal targets earlier than originally forecast. Fiscal highlights include nine years of growth with the OBR forecasting further growth in the next five years and the best employment figures since 1975. These include the comment that 96% of new jobs created in the UK in 2018 were full time and the OBR forecasting a further 600,000 new jobs in the economy by 2023.


With the positive economic forecasts in mind the Chancellor highlighted the Prime Minister’s earlier announcement of £34b additional funding per year for the NHS by the end of the current spending review period. Philip Hammond commented that this additional spending “putting the NHS first in line – as the British public would expect” is intended to deliver:

  • improved cancer and mental health care
  • a transformation of GP services
  • more doctors, more nurses and better outcomes for patients


Looking forward, the Chancellor took the Spring Statement opportunity to announce a further spending review which, subject to Brexit outcomes, is to be launched before Parliament’s summer recess and which will report in time for the autumn budget. This is intended to “set departmental budgets beyond the NHS” in areas such as social care, local government, schools, police, defence and the environment. This further spending review will have a renewed focus on delivering high quality outcomes, thereby maximising value for taxpayers’ money.


Other areas in which health services may indirectly benefit from government initiatives include action in respect of the digital infrastructure. The Chancellor commented that the government has a strategy for delivering a nationwide full fibre network by 2033; something which will in particular benefit outlying health practices which are present are unable to optimise their processes due to the existence of a slow broadband connection. Areas such as online appointment booking or the digital transfer of patient records depend on fast reliable broadband if they are to deliver efficiency savings.


A review of competition in the digital marketplace was published alongside the Spring statement. Actions arising out of this review, including a study by the Competition and Markets Authority into the digital advertising market, are designed to ensure that the UK’s regulatory model for the digital age will “ensure that competition policy works in consumers interests” and that “the public are protected from online harms.” This too may have implications for health services, particularly if further action is required to strengthen protections around patient confidentiality, including the maintenance and transfer of patient records.

A major breakthrough for physiotherapy

The Chartered Society of Physiotherapy (CSP) has hailed the NHS’s new long term plan as “a major breakthrough for physiotherapy.” The ten year plan which was launched on 7 January 2019 aims to improve the quality of patient care and health outcomes by focusing not only on treatment and ongoing management of conditions but also on prevention. There is also a renewed emphasis on developing digital solutions in order to speed up access to health services and treatments.


With this in mind the core of the new plan aims to enable everyone to get the best start in life, to help communities to live well and to help people to age well. This includes a focus on treatment of major conditions such as cancer, heart and respiratory disease as well as a renewed emphasis on mental wellbeing.


Key to implementation is a move towards an integrated service which will provide both in-patient and home care as required. Treatments are to be patient-focused and will look towards providing an integrated solution. For example, breathlessness can be caused by both pulmonary and cardiac problems so collaboration between those two disciplines could lead to a combined treatment programme.


In terms of physiotherapy specifically, deployment of the new plan will lead to an increase in the number of physiotherapists in primary care alongside the use of first contact physiotherapists. In addition the new emphasis on whole person rehabilitation will require increased levels of physiotherapy contact in a number of disciplines.


But it is not just physiotherapists who will be positively impacted by this new plan. The fresh emphasis on whole patient care will impact a range of health professions from podiatrists to dentists and hair care professionals. The challenge will be to ensure that not only is the right support identified for an individual, the resources are in place to provide that support. Whether that leads to increased training requirements is perhaps a discussion for another time. What is certainly true is that existing health professionals are going to have to work smarter in order to optimise patient care.


The What Happens Next section of the NHS site dedicated to the ten year plan says that “From publication until the summer of 2019 staff, patients and the public will have the opportunity to help their local NHS work out what NHS Long Term Plan means for their area and how to meet our national ambitions in their community.”  This could also be an opportune time for health practices to review their own practices, perhaps looking for time savings in areas such as appointment booking, diary management and the electronic filing of patient records.


Announcing the new plan the Health and Social Care Secretary, Matt Hancock, said the plan “marks an important moment not just for the health service but for the lives of millions of patients and hardworking NHS staff across the country.” But its ambition to deliver integrated care will require it to also draw in professionals from outside the NHS, helping people to manage their conditions in their own homes and communities and to lead independent lives.


Need to exercise more – get on your bike

What’s your exercise regime? Do you even have one or do good intentions falter under the pressure of work? If exercise falls into the occasional rather than regular category then two reports which have come out in the last month may give you pause for thought.


The first from the World Health Organisation (WHO) says that worldwide a lack of exercise is putting one in four people at risk from a range of conditions including heart disease, some cancers and type-2 diabetes. More worryingly, although this global figure is little changed from 2001 the report says that the higher the income country, the more likely we are to be sedentary. For example, in the UK 36% of people (32% men, 40% women) are now classed as being inactive; undertaking less than 150 minutes of moderate activity or 75 minutes of vigorous exercise per week.


What’s the solution? Well it seems as though we may do well to take the lead from the recently concluded Tour of Britain and get on our bikes. A study from America has concluded that people who exercise regularly report 43% fewer days of poor mental health than those who don’t exercise. Perhaps unsurprisingly those taking part in team sports fare best, benefitting from the social aspect of team work as well as the exercise, but cyclists aren’t far behind. So if time pressures and schedules prevent attendance at team practices and matches, then cycling is a good alternative.


Better still, you don’t need to cycle a lot to help your mental health levels. The researchers concluded that 45 minutes of exercise undertaken between three and five times a week is associated with the lowest risk to mental health. Exceed those levels and the researchers say you won’t gain any extra benefit.


With that in mind, in a technology-led always-on world how do we free up enough time to fit in three 45 minute cycles each week? Well, one way is to take a leaf out of the technology book and take some processes online. For example, why spend time in invoicing when payment card information can be taken at the time of booking? Similarly, why spend time in manual filing and retrieving of documents when an online system can make records available at the touch of a button?


Even small tweaks such as these can add up to a measurable time saving. And even if you don’t spend every freed up minute on exercise, the extra free time could be used to enhance your work/life balance. Either way, with work pressures reduced it could go some way towards helping to maintain a healthy lifestyle which in turn brings good mental and physical benefits. And of course, when we feel good then it is far easier to project a positive image which in turn helps those colleagues and clients who we come into contact with on a regular basis.


What’s your exercise regime? Getting on our bikes may not be the right solution for all of us but nevertheless maybe it is time to look again at how we exercise and stand up for the health of the nation.

The NHS – 70 years young

1948: a time of austerity, of taking stock and coming to terms with the aftermath of war. The initial euphoria of victory has worn off and the work of rebuilding shattered lives, homes and infrastructure is underway. But this too was a time of hope and ambition; a determination not simply to rebuild the past but to create the future. One of the great projects to arise from that time was the National Health Service (NHS).


Seventy years on and the NHS continues to deliver its initial promise to provide healthcare which is free at the point of delivery. The road hasn’t always been smooth and in a strange way the NHS’s success has been the root cause of one of its prime challenges. Pioneering research allied to a drive to develop new techniques and skills has helped people to live on average ten years longer nowadays than at its inception; in the process placing additional strains on resources.


Nevertheless we shouldn’t underestimate the impact which the NHS has had not simply on lives but also on society. For example, this writer’s mother joined the NHS as a nurse in the year of its birth. Following initial training in England she was offered an opportunity to further her skills, firstly in France and then in America; a far cry from post-blitz London and offering a level of mobility which may not have been so available for young women before the war. Those skills that she learnt at the infancy of the NHS were then used throughout her life to benefit others.


This is only one story, but as we had heard time and time again over recent weeks it is the individual stories which demonstrate the true worth of our health services. Stories of lives saved or transformed thanks to pioneering techniques; stories of humanity and compassion; and tales highlighting the dedication of those who have followed the path of medicine in order to help others.


But whilst it may be true that in part the NHS is the victim of its own success, technological advances are already making a measurable difference. Online appointment booking, automated appointment reminders and digital records are all helping to reduce admin time. Remote health monitoring is removing the need for multiple hospital appointments, whilst the availability of video links brings specialist knowledge to remote areas of the country. And new developments are coming out all the time. Who would have thought only a few years ago that cancer treatments could be personalised based on an individual’s genetic make-up?


When the NHS started seventy years ago innovations such as these would never have been envisaged, let alone possible. In seventy years time they may be seen as somewhat old-fashioned, replaced by ever improving technologies delivering individual healthcare. But progress or not, one thing remains at the heart of our national health service and that is the relationship of care between those in need and the doctors, nurses, physiotherapists, osteopaths and other health professionals who provide lifelong health services.


A revolution in health care

According to the World Economic Forum we are standing on the brink of change, a time in which the Fourth Industrial Revolution is taking hold of the world. Looking back into the past, the first industrial revolution ushered in an era of mechanisation, process driven and with people merely seen as cogs in the industrial wheel. Then came electric power and mass production followed by the third industrial revolution which ushered in the use of information technology as a driver of automated production.


The fourth Industrial Revolution is one step further on, driven by a ‘fusion of technologies that is blurring the lines between the physical, digital, and biological spheres.’ Put simply, technology has gone so far and is so interconnected that people have stopped becoming cogs in the wheel and instead are the prime drivers of service delivery.


In other words, what differentiates businesses nowadays is user excellence. As a result technological developments are increasingly being focused towards delivering great customer outcomes rather than simply as a way of reaching a mass audience or delivering cost savings.


What’s that got to do with delivering healthcare? Well in this regard there is no difference between the way in which we look to deliver customer or patient outcomes. So much so that there is an increasing recognition that targeting healthcare delivery towards an individual patient can significantly improve recovery. For example, we look to gene mapping as a means of best identifying cancer treatments, or we look to devise treatment plans which fit in with a patient’s lifestyle.


One prime example of this has been highlighted on the Chartered Society of Physiotherapy website. The Western Isles Hospital in Stornoway has linked up with a Glasgow orthopaedic surgeon who specialises in hand injuries. Initial assessments take place via a video-conferencing link with x-rays viewed over the National PACS system. Not only does this save patients the cost and time of a trip to Glasgow for initial assessment, it also speeds up decision-making. If there then is an identified need for surgery, preoperative procedures can be carried out in Stornoway; thereby minimising the time which patients have to spend away from their home base.


This is a perfect example of the way in which integrated technology can not only improve the patient experience but also treatment outcomes. It also illustrates the way in which digitising patient records can help to improve consultation options with patient information being rapidly shared over secure systems. Of course, electronically storing patient records also helps the practitioner; enabling them to call up records quickly and easily as well as saving the time taken in manual filing and retrieval.


Setting people outcomes at the heart of process may require a re-evaluation of the way in which we work. It may also cause us to question the reason behind certain processes, and to evaluate whether there may be alternative approaches which would improve delivery. The fourth Industrial Revolution isn’t simply a revolution in the way in which we use technology, it is also a revolution in attitudes and approaches which truly sets people first.

Contact us today to discover how Clinic Appointments can help your clinic. Book your free demo call now to learn more.