nhs hot topics Flashcards
Why is Public Health important?
-battling against diabetes, cancer, heart disease and dementia to maintain the health and well-being of the population
- preventative nature, prevention is far more effective and far less expensive than cure
-detect health issues as early as possible and responds appropriately to avoid the development of disease
- diverse and takes into account the health of the whole population, rather than focusing on health at an individual level
-ensures everyone is aware of health hazards through educational programmes, campaigns and through influencing government policies e.g. covid 19 campaigns, adverts etc.
-ensuring no one is disadvantaged regardless of their socio-economic background.
State the NHS values and what they mean
-working together for patients
patients come first in everything we do
respect and dignity
-we value every person – whether patient, their families or carers, or staff – as an individual, respect their aspirations and commitments in life, and seek to understand their priorities, needs, abilities and limits
commitment to quality of care
-we earn the trust placed in us by insisting on quality and striving to get the basics of quality of care – safety, effectiveness and patient experience right every time
compassion
-ensure that compassion is central to the care we provide and respond with humanity and kindness to each person’s pain, distress, anxiety or need
improving lives
-strive to improve health and wellbeing and people’s experiences of the NHS
everyone counts
-maximise our resources for the benefit of the whole community, and make sure nobody is excluded, discriminated against or left behind.
How could you improve the NHS?
1st problem= staffing issues
-increase med school places (problem is that it costs abt 500k to train 1 doctor so look at reducing years of med school)
-increase retention of staff (improving working conditions and pay)
-bringing in staff from abroad
2nd problem=agreeing national standards
-To equalise access to healthcare will need a triage system run by trained staff (not GP receptionists) and prioritisation of calls – the ambulance service does this already. This may involve redistributing people and resources away from secondary care and towards primary care.
3rd problem= lack of preventitive med
- screening centres, possibly funded in part by soliciting public contributions, would make an enormous difference: one place providing blood pressure testing, cholesterol testing and prostate screening for men; and one for cervical screening, breast cancer and osteoporosis screening for women.
4th problem- effective obesity strategy (starting with education in schools)
-key to reducing cardiovascular or cancer mortality. We should set up a programme of diet education in schools with a new (compulsory) GCSE on personal health. Within a few years the public health benefits would be enormous.
5th problem= gap in MH services
-better access to therapy for mentally distressed people, removing the stigma of mental illness and most importantly tackling critical early life events such as school exclusions, a significant cause of mental health problems.
What is the biggest problem of the NHS?
STAFFING CRISIS:
-short 154000 staff
-could increase to 571000 by 2036 if nothing changes
-pay cuts, worsening conditions
-more people leaving and less entering
NHS VS OTHER EU NATIONS:
-need addional 46,300 full time Dr’s just to bring us up to the avg.
-8% of medical posts unfilled in NHS
DUE TO:
1) difficulty forecasting how many Dr’s/nurses needed
2) tendency towards undertraining - more than 50,000 to train a nurse and 500,000 to train a consultant
3) insufficent use of forgein recruitment(migration policies)
GOVT PLAN:
-increase med school places
-increase nurses trained
-shortening length of med school
How would you deal with problems such as overpopulation?
problems caused:
1) environmental- pollution, resources, space, food and water, deforestation
2) increased poverty- fewer jobs but still high demand for housing but small supply, unemployment rate increases, drug use
3)international conflict- some countries better at adapting than others, when food and water become precious commodities, conflict is inevitable
SOLUTIONS:
1) sex education- reducing risk of unwated pregancies
2) increasing acess to contraception- extremely difficult to get in some areas of the world and can be expensive, may be expensive to implement this but its nothing in comparison to overpopulation issues
3) general education- opens door to oppurtunities and higher paying jobs and more people will be focused on career than starting big families
4) teaching about overpopulation
5) changing government policies
What problems would you see daily as a GP working in Brighton?
-One in 20 Brighton and Hove residents said they were in poor health when asked in the 2021 census
-8% of Brighton and Hove residents were classed as disabled in 2021
-Brighton & Hove Health and Wellbeing Board is required to produce a Joint Strategic Needs Assessment (JSNA) ; description of the current and future health, social care and wellbeing of the population
-one of the most deprived areas in the South East
- commonest causes of death in the city are
cancers, circulatory diseases, respiratory
diseases and digestive diseases, a higher suicide rate, highest HIV prevelance outside London, nearly 1/10 adults depressed, more than 1 in 100 have COPD (chronic obstructive pulmonary disease),
4.1% diabetic, flu jab uptake and breast screening rate lower than nationally, >3000 have a visual impairment, >20,000 have a hearing problem, childhood obesity, highest smoking rate amongst young people in England, highest proportion of young people trying canabis
What medical issues are prominent in the Brighton and hove area and how would you resolve them?
obesity, COPD, diabetes, suicide, depression, mental illness, HIV, respiratory and circulatory diseases, smoking
- public health campaigns which promote healthy lifestyles e.g. better diets, more excericse
- incentives to exercise e.g. free coffee, movie tickets etc.
- education in schools about the importance of healthy eating and exercise and the dangers of smoking, alcohol and drugs
- breakfast clubs in school
- school rules where only one ‘treat’ food in the lunch box (introducing alternatives)
- school dinners with lower saturated fat and sugar
- education about sexual health and contraception
-support for those who can’t buy contraception
What are the NHS values and why are they important?
-commitment to quality of care: every patient should receive effective and safe care that is tailored to their needs and personal values, autonomy + benificence, communication, empathy
-improving lives: healthcare staff should aim to improve the wellbeing and health of their patients (benificence + non-malificence)
-respect and dignity: understand the priorities and wishes of your patients, alongside their family, autonomy
-compassion:attend to their patients’ condition in a way that addresses their physical and emotional distress (empathy and benificence)
-everyone counts: NHS’s resources should be distributed equally across society to prevent any group from being discriminated against and to maximise the good that these resources can provide (justice)
1)states that discrimination against any patient is unacceptable and shouldn’t effect their care.
2)guides how money is used across the NHS and which services and treatments are or are not offered.
-working together for patients: good patient outcomes should be at the forefront of everything the medical team does, benificence , teamwork
ensured that the healthcare people received was based on their clinical needs and not their financial position
why is it important to reduce excessively long A&E waiting times
1) patients have to wait a long time to see doctors while in pain and can deteriorate (shown by data)
2) patients put off which -ve impact future health
3) ambulance cant offload patient so long queues outside and less ambulances on the road
4)staff may cut corners with patient treatment in order to get as many patients seen
-not met the standard any yr since 2013-2014
WHY?
-fewer hospital beds
-higher admmitance to hospital
-understaffed
-more trips to a&e
WHAT CAN BE DONE:
-reduce ppl going to a&e (111 reduces up to 12M)
-incentivise GPs to see non-urgernt patients more often
-more a&e and bigger departments
what should be the NHS main priorities over the next 5 years
1) adult social care
-if care not available, patients stay in hospital longer using up bed which are needed
-poorer care and outcomes for patients in overflowing hospitals
2) staffing levels
-gov want to increase med school places
-increase retention of health professionals (increase working conditions)
3) long waiting lists
-increases patient mortality and morbidity
-worsened by pandemic
what are the barriers to accessing primary care (community bases care-first point of contact)
1) health literacy
-some dont have health education to understand key symptoms of diseases or navigate the healthcare system
2) availability
-fewer primary care providers means fewer appointents, longer waiting times, limited clinic hours
3) language + cultural barriers
-difficulty expressing concerns and understanding medical advice
4) geographical barriers
-remote or rural areas
5) age
-elderly patients constant appts can be hard due to their weakening physical state
5) stigma and fear
-fear of judgement for MH issues
6) technology
-lack of skills or access makes it hard to acess online appt scheduling systems
7) work+family obligations
-hard to take time off
social media has allowed healthcare staff to speak about medicine and the NHS. What are the advantages and disadvantages of this
ADVANTAGES:
-social media very prevelant in young generation
-adress misinfo e.g. vaccines, diets, treatments
-educate public on tretments, prevention, conditions
-insight into NHS staff lives can encourage prsopective students
-improve comms and networking between healthcare proffessionals
DISADVANTAGES:
-confidential info shared, jeaporidzes rep of healthcare system
-doctors may push personal agendas and advocate for certain treatments
-blur lines between personal and professional relationships between doctors and patients
-doctors posting unprofessional behaviour can damage patient trust
-lack of regulation on false identies e.g. pretending to be a dr and spreading misinfo
what has been the most important technological advance in the NHS in the last 5 yrs and why
GENOME SEQUENCING
-investigate genetic basis to diseases
-increasing targeting and increasing healthcare lifespan
-ensuring we have the most effective treatments
-covid pandemic
-NHS announced extra 50M investment in developing AI to improve the diagnosis of deadly diseases
-genetic basis to cancer treatments, cancer can be caused by so many dif things and some are genetic bases
-identifying genetic component to a disease means we can have personalised medicine which is key to tageting individual cancers depending on their pathophysiology
-personanalised med allows treating patients as a whole rather than just the disease
-my wex in a histology lab allowed me to look into this
what’s the importance of NHS smoking cessation services
-smoking is huge risk factor which plays into development + deterioration of many diseases which place a huge strain on the nhs e.g. cancer, respiratory diseases
-important to educate through public health campaigns on the risks
-offer 1 to 1, group therapy (measure CO levels week on week to see progress) and helplines
-quit smoking advisors (trained professionals)
-nicotine replacement therapy to reduce symptoms and cravings
-prescription meds to help quit e.g. bupropion
BENIFITS OF QUITTING:
-reduces risk of cardiovascular and respiratory dieases + cancer
- positively impact QAL, mood, self-esteem, cognitive function
-reduced heslthcare costs
-reduce secondhand smoke exposure
-shown smoking rates drop over last 10-15 yrs
in what ways has the NHS contributed to improving sexual health
-education ins chools on STI’s and contraception and where to get access
-NHS provides free access to wide range of contraception including condoms, birth control pills, IUD’s
-free testing + treatment for STI’s e.g. chlamidyia, hiv, gonnarhea
-access to rapid testing
-sexual health clinics (testing, treatment, advice)
-campaigns to improve public awarnessof issues and safe sex practices
-GP and pharmacies
-screening (discreet nature of postal tests due to stigma)
