Peer Review of Paediatric Endocrine Services in the UK: A Template for Quality and Service Improvement

2021 ◽  
pp. 1-6
Author(s):  
John Schulga ◽  
Heather Mitchell ◽  
S. Faisal Ahmed ◽  
Assunta Albanese ◽  
Justin Warner ◽  
...  
Keyword(s):  
Peer Review ◽  
National Level ◽  
Quality Of Healthcare ◽  
Healthcare Services ◽  
British Society ◽  
Service Improvement ◽  
Paediatric Endocrinology ◽  
Test Feasibility ◽  
Specialist Nurses ◽  
The Uk

<b><i>Background:</i></b> Independent peer review of healthcare services can complement existing internal-, institutional-, and national-level regulatory mechanisms aimed at improving quality of healthcare. However, this has not been reported for paediatric endocrinology services in the UK. We aimed to test feasibility and acceptability through a first cycle of a national peer review of paediatric endocrine services. <b><i>Methods:</i></b> Tertiary centres in paediatric endocrinology across the UK were assessed against 54 quality standards, developed by the British Society for Paediatric Endocrinology and Diabetes (BSPED) in five domains of healthcare by a team comprising paediatric endocrinologists and specialist nurses. The evaluation was supported by a self-assessment. A post-peer-review questionnaire was used as feedback. <b><i>Results:</i></b> All 22 centres in the UK underwent independent peer review between 2011 and 2017. Each served a median population of 2.6 million (range 1–8 million) and offered 1,872 (range 779–6,738) outpatient consultations annually. A total of 43 (range 30–49) standards were met in combined evaluation of all centres. Variance of adherence for essential standards ranged from 52 to 97% at individual centres with 90% adherence demonstrated by 32% of centres. Post-review feedback showed 20/22 (95%) validating the utility of the peer review. <b><i>Conclusions:</i></b> The BSPED peer review of all UK centres providing paediatric endocrine services is shown to be feasible and provides a quality benchmark for replication by national services.

The short Synacthen test: a questionnaire survey of current usage

2012 ◽  
Vol 97 (10) ◽  
pp. 870-873 ◽  
Author(s):  
Charlotte Jane Elder ◽  
Pooja Sachdev ◽  
Neil Peter Wright
Keyword(s):  
Low Dose ◽  
Inhaled Corticosteroids ◽  
British Society ◽  
High Dose ◽  
Paediatric Endocrinology ◽  
Children With Asthma ◽  
Synacthen Test ◽  
The Uk ◽  
Meta Analyses ◽  
Short Synacthen Test

BackgroundSupported by meta-analyses, the low-dose Synacthen test (LDST) has gained in popularity, with many believing it to be more sensitive than the supraphysiological standard (250 µg) short ST (SSST), particularly when assessing children prescribed high-dose inhaled corticosteroids (HDICS). However, consensus is lacking about its specific clinical application, what is considered ‘low dose’ and how that dose is made up.MethodsTo ascertain current use of the short Synacthen test (SST), a questionnaire was emailed to members of the British Society of Paediatric Endocrinology and Diabetes in the UK and Ireland (N=257), requesting a response from each department (N=92). A reminder was sent a month later to members of departments which had not responded.ResultsThe authors received 39 replies, giving a response rate of 42%. All departments use the SST: 82% use an LDST, 87% use the SSST and 69% use both. The 1 µg dose was used by 44% of hospitals, with the other 56% using seven different doses based on age, weight and body surface area. There were 14 different methods of preparing the low dose test. Additionally, variations in the timings of cortisol sampling and the diagnostic cut-offs for adrenal insufficiency were found. Increased requests for SSTs in children with asthma prescribed HDICS were noted by 44% of respondents, with 67% reporting the detection of adrenal suppression in this group.ConclusionStandardisation of the SST is required to address the considerable variation in the methodology and application of this test in the UK and Ireland.

scholarly journals A survey of the management of 16–18-year-olds presenting with diabetic ketoacidosis in the UK: a need for standardisation

2019 ◽  
Vol 19 (1) ◽  
pp. 29-33
Author(s):  
Ketan Dhatariya ◽  
Peter Winocour ◽  
Andrew Raffles
Keyword(s):  
Diabetic Ketoacidosis ◽  
Poor Response ◽  
Standard Of Care ◽  
British Society ◽  
Clinical Settings ◽  
Specialist Nurse ◽  
Mailing Lists ◽  
Paediatric Endocrinology ◽  
Medical Teams ◽  
The Uk

Background: The standard of care of 16–18-year-olds presenting with diabetic ketoacidosis (DKA) is uncertain. It is unknown who looks after them or what guidelines are used to manage their DKA.Methods: We carried out a survey using a standardised questionnaire sent to diabetes and emergency care teams across the UK using mailing lists from the Association of British Clinical Diabetologists, The Diabetes Specialist Nurse Group (UK) and the British Society of Paediatric Endocrinology and Diabetes.Results: There was a relatively poor response rate; only 32 completed questionnaires were received between May and November 2018. The data suggest that the care was highly variable across the UK. There were no consistencies on how ‘16–18 years old’ was defined; who looked after them either during the acute phase once they had been triaged through the emergency department or during the later stages of their admission; or what guideline was used to treat their DKA. Several other aspects of care were also varied.Conclusions: The care of 16–18-year-olds presenting with DKA needs to be standardised across the UK. Furthermore, because a large number are looked after by adult non- specialist general medical teams, there is a clear need to ensure a consistent straightforward joint guideline that can be readily applied in all acute clinical settings regardless of whether care takes place in a paediatric or an adult clinical setting.

scholarly journals Gender differences in leadership, workforce and scholarly presentation within a national society: a gastroenterology perspective

2018 ◽  
Vol 10 (1) ◽  
pp. 2-6
Author(s):  
Alenka J Brooks ◽  
Eleanor Jane Taylor ◽  
E A Arthurs ◽  
Cathryn Edwards ◽  
Richard Gardner ◽  
...  
Keyword(s):  
National Level ◽  
Female Leadership ◽  
British Society ◽  
National Society ◽  
Leadership Roles ◽  
Student Attendance ◽  
Medical Specialties ◽  
Medical Speciality ◽  
The Uk ◽  
Female President

In the UK, gastroenterology has been a male predominant medical speciality. Data regarding gender within workforce, academia and leadership at a national level are lacking. Data regarding scholarly presentation at the following annual conferences were collected and analysed; British Society of Gastroenterology (BSG) 2013, 2014, and Digestive Diseases Federation (DDF) in 2015. Data from the 2013–2015 BSG annual workforce reports were examined. In 2015, female higher specialty trainees (STs) made up 39% (328/848) of the trainee workforce, versus 37% and 35% in 2014 and 2013. From 2013 to 2015, less than a fifth of all consultant gastroenterologists were women. Female consultant (18%), ST (39%), associate (86%) and student attendance (47%) at DDF 2015 did not change significantly from 2013 to 2014. Female speakers (trainees and consultants) were significantly lower at DDF 2015 compared with BSG 2014; 43/331 (13%) versus 56/212 (26.4%) (p=0.0001) and BSG 2013 63/231 (27%) (p=0.0001). The number of female chairs, delivery of the named lectures and prizes awarded to women did not differ across the 3-year period. Female leadership via representation at Council and Executive at BSG was 4/30 (13%) in 2015 and did not differ in 2013/2014, with no elected council members since 2008 and one female president in 1973.The proportion of female gastroenterology trainees and consultants is increasing, but remains lower than across all medical specialties and is reflected in attendance and scholarly contributions. Action within the BSG is underway to address female under-representation in leadership roles.

Increasing the heart failure nursing workforce: recommendations by the British Society for Heart Failure Nurse Forum

2019 ◽  
Vol 14 (11) ◽  
pp. 1-12 ◽  
Author(s):  
Jayne Masters ◽  
Carys Barton ◽  
Lynda Blue ◽  
Jenny Welstand
Keyword(s):  
Heart Failure ◽  
Patient Outcomes ◽  
Significant Proportion ◽  
British Society ◽  
Timely Manner ◽  
Specialist Nurse ◽  
Heart Failure Patients ◽  
Specialist Nurses ◽  
The Uk ◽  
Improve Patient

There are almost 1 million people diagnosed with heart failure in the UK, and this number continues to rise. It is a common cause of hospitalisation and costs associated with those hospitalisations account for a significant proportion of the NHS budget. Studies have demonstrated that community heart failure specialist nurses improve patient outcomes and reduce the costs associated with hospitalisation. Yet, despite increased prevalence, considerable advances in therapies, and new recommendations from the National Institute for Health and Care Excellence, the recommended number of heart failure specialist nurses per 100 000 has stayed the same. This article will describe the development of community heart failure nursing in the UK, and outline the challenges currently facing heart failure specialist nurses. It makes a number of recommendations that would ensure heart failure patients are able to be seen by a heart failure specialist nurse in a timely manner, help reduce inequalities of care, reduce costs associated with heart failure hospitalisations and help ensure sustainability of heart failure services over the longer term.

Best practice for chronic oedema in community settings: what can we learn?

2020 ◽  
Vol 25 (12) ◽  
pp. 610-614
Author(s):  
Garry Cooper-Stanton
Keyword(s):  
Service Provision ◽  
Best Practice ◽  
Evidence Base ◽  
Community Services ◽  
Guidance Document ◽  
Community Settings ◽  
Tissue Viability ◽  
Delivery Of Care ◽  
Specialist Nurses ◽  
The Uk

There are various opportunities and challenges in the delivery of care to those diagnosed with chronic oedema/lymphoedema. Service provision is not consistent within the UK, and non-specialist nurses and other health professionals may be called on to fill the gaps in this area. The latest best practice guidance on chronic oedema is directed at community services that care for people within their own homes in primary care. This guide was developed in order to increase awareness, knowledge and access to an evidence base. Those involved in its creation cross specialist fields (lymphoedema and tissue viability), resulting in the document covering a number of areas, including an explanation of chronic oedema, its assessment and management and the association between chronic oedema and wet legs. The document complements existing frameworks on the condition and its management and also increases the available tools within chronic oedema management in the community. The present article provides an overview of the guidance document and discusses its salient features.

A study of the role and educational needs of ophthalmic specialist nurses

2021 ◽  
Vol 30 (14) ◽  
pp. 858-864
Author(s):  
Pornjittra Rattanasirivilai ◽  
Amy-lee Shirodkar
Keyword(s):  
Clinical Skills ◽  
Active Role ◽  
Educational Needs ◽  
Assessment Tools ◽  
Standards Of Care ◽  
Learning Needs ◽  
Hands On ◽  
Specialist Nurses ◽  
The Uk ◽  
Training Opportunities

Aims: To explore the current roles, responsibilities and educational needs of ophthalmic specialist nurses (OSNs) in the UK. Method: A survey of 73 OSNs ranging from band 4 to band 8 was undertaken in May 2018. Findings: 73% of OSNs undertake more than one active role, with 59% involved in nurse-led clinics; 63% felt formal learning resources were limited, with 63% reporting training opportunities and 21% reporting time as major barriers to further training. More than 38% emphasised hands-on clinic-based teaching had a greater impact on their educational needs. Some 64% were assessed on their skills annually and 59% felt confident with their skill set. Conclusion: The Ophthalmic Common Clinical Competency Framework provides a curriculum and assessment tools for OSNs to use as a structure to maintain clinical skills and knowledge. Eye departments should use this as guidance to target learning needs and improve standards of care to meet the changing needs of society.

scholarly journals Factors influencing decision making for implementing e-health in light of the COVID-19 outbreak in Gulf Cooperation Council countries

2021 ◽  
Author(s):  
Fahad M Al-Anezi
Keyword(s):  
Decision Making ◽  
United Arab Emirates ◽  
Healthcare Access ◽  
Demographic Factors ◽  
Quality Of Healthcare ◽  
Healthcare Services ◽  
Gulf Cooperation Council ◽  
Factors Influencing ◽  
Electronic Health ◽  
Novel Coronavirus

Abstract Background Electronic health (e-health) approaches such as telemedicine, mobile health, virtual healthcare and electronic health records are considered to be effective in increasing access to healthcare services, reducing operational costs and improving the quality of healthcare services during the coronavirus disease 2019 (COVID-19) outbreak, a pandemic resulting from the spread of a novel coronavirus discovered in December 2019. In this context, the aim of this study was to identify the most important factors influencing decision making on the implementation of e-health in Gulf Cooperation Council (GCC) member states (Bahrain, Kuwait, Oman, Qatar, Saudi Arabia and the United Arab Emirates), which are in the process of digitizing healthcare services. Methods This study reviewed the literature to identify the important factors influencing decision making on e-health. In addition, a questionnaire-based survey was conducted in order to identify the most important criteria to be considered in decision making on e-health. The survey link was forwarded to 978 healthcare practitioners and 42 experts (purposive sampling), from which a final sample of 892 (864 practitioners and 28 experts) was achieved, reflecting a response rate of 87.45%. Results Of the 44 factors identified under seven themes (strategic, quality, management, technology, function characteristics, economic, sociocultural and demographic factors), 22 factors were identified to be the most important criteria. Conclusions Findings from this study suggest that decision making in relation to e-health is a complex process that requires consideration of various factors. It was also found that attention should be paid to sociocultural and demographic factors, which may need to be considered in increasing healthcare access during the COVID-19 outbreak.

scholarly journals Population (Antibody) Testing for COVID-19—Technical Challenges, Application and Relevance, an English Perspective

Vaccines ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 550
Author(s):  
Peter A. C. Maple
Keyword(s):  
National Level ◽  
Herd Immunity ◽  
Population Based ◽  
Biological Properties ◽  
Limited Extent ◽  
Antibody Testing ◽  
Serum Samples ◽  
Oral Fluids ◽  
Antibody Assays ◽  
The Uk

In the UK, population virus or antibody testing using virus swabs, serum samples, blood spots or oral fluids has been performed to a limited extent for several diseases including measles, mumps, rubella and hepatitis and HIV. The collection of population-based infection and immunity data is key to the monitoring of disease prevalence and assessing the effectiveness of interventions such as behavioural modifications and vaccination. In particular, the biological properties of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and its interaction with the human host have presented several challenges towards the development of population-based immunity testing. Measuring SARS-CoV-2 immunity requires the development of antibody assays of acceptable sensitivity and specificity which are capable of accurately detecting seroprevalence and differentiating protection from non-protective responses. Now that anti-COVID-19 vaccines are becoming available there is a pressing need to measure vaccine efficacy and the development of herd immunity. The unprecedented impact of the SARS-CoV-2 pandemic in the UK in terms of morbidity, mortality, and economic and social disruption has mobilized a national scientific effort to learn more about this virus. In this article, the challenges of testing for SARS-CoV-2 infection, particularly in relation to population-based immunity testing, will be considered and examples given of relevant national level studies.

Sign in / Sign up

Export Citation Format

Share Document