A Pragmatic Literature Review on the Economic Cost Burden of Four Key Preventable Diseases in the UK

Objectives: This pragmatic review provides a summary of the recently published economic cost of four preventable diseases in the UK (type 2 diabetes, obesity, myocardial infarction, and stroke). Method(s): A MEDLINE (OvidSP) search strategy was designed to identify UK studies reporting economic costs. The search was restricted to UK papers from 2016 onwards. 1,590 records were screened based on title/. 86 were reviewed for eligibility and 20 included. Result(s): 17 studies were extracted, including retrospective studies preceding 2016 with some overlap between diseases. Comparability was difficult due to the variety of methods and models being used, for example: One diabetes study estimated costs of >3Bn associated with poor glycaemic control, and another estimated costs of 5.6Bn/year for hospital care. Obesity studies estimated incremental per obese person costs compared with the general population and by magnitude of obesity but did not estimate an overall direct and societal cost. Myocardial infarction studies also estimated incremental per patient costs. One study estimated a potential saving of 68Bn to the health and social care system over 25 years if people at high risk of cardiovascular disease were detected and managed. Atrial fibrillation is estimated to cost the UK health system between 8 and 16Bn. A stroke study estimated the annual UK health and social care cost will be 17Bn in 2025, while a 2017 European study estimated the annual direct and societal cost to the UK at 7.5Bn. Conclusion(s): These representative preventable diseases impose strong collective pressure on the healthcare system and are costly. These examples also show that delayed action increases the economic burden. Longer-term care represents a significant burden on a constrained health and social care system which the Covid-19 pandemic has further highlighted as fragile. Action should be taken now against preventable disease to help protect the NHS from future shocks. Copyright © 2022

Cancer Experience of Care Improvement Collaboratives in the National Health Service in England

NHS England started the work described in this article with the ambition of using insight and feedback from the adult National Cancer Patient Experience Survey to grow coproduced service improvements leading to improved patient centred quality outcomes in experience for cancer patients. Based on the Institute for Healthcare Improvement’s Breakthrough Collaborative Series, the approach of the Cancer Experience of Care Improvement Collaboratives (CIC) in the English healthcare system was developed, initially with 19 NHS provider organisation teams in 2019 as a face-to-face model, then developing into two collaboratives with an additional 15 NHS provider organisation teams in Cohort 2 and 8 teams in Rare & Less Common Cancers in a virtual framework. Each cohort has reported improvements in patient experience, staff experience and team working, but more fundamentally, have been able to describe a cultural shift in the way they work, together with people, leaving a lasting impact and legacy of this work. Key learning has been recognised with the increasing emphasis on involving people with relevant lived experience as partners and colleagues in the collaborative, alongside flexibility, responsiveness and adaptability as key to enabling project teams to continue where COVID-19 pressures allowed to participate. © The Author(s), 2022.

Living and learning through lockdown: a fictionalisation of the challenges and opportunities of homeschooling during a global pandemic

This article reports on research which investigated the lived experiences of primary school headteachers, teachers and parents during the first lockdown in England between March and July 2020. The study aimed to understand how homeschooling was approached and the challenges and opportunities it afforded. Individual semi-structured interviews were undertaken with participants and the findings are presented in the article in three episodes using fictionalised scenarios. The episodes created are the initial approach to homeschooling, coping with uncertainty and realignment. The themes emerging from each episode are pragmatic decision-making, change and the impact upon welfare and well-being, and shifting priorities. The article illustrates the struggles of homeschooling in lockdown and some surprising outcomes, and also points to future possibilities for education. © 2021 ASPE.