Cancer care services face unprecedented challenges post-pandemic

An introduction to articles in the issue is presented on topics including the importance of safety in relation to medication errors and the need for more care when discussing other sensitive issues.

Compassionate mental healthcare relies on a valued workforce

A healthy and valued workforce is vital for safe and compassionate mental healthcare. That was my take-home from the recent senior leadership symposium on advancing and sustaining the mental health nursing workforce.

A survey on the use of remote consultation for people with intellectual disability: The experience of community intellectual disability teams

Since COVID-19, remote consultation (by telephone and video) has become widespread. This study investigated the experience of using remote consultation in Specialist Intellectual Disability Community services. A total of 126 health staff working across eight Specialist Intellectual Disability Community teams in the NHS Health Board of Greater Glasgow and Clyde were asked to complete a short Likert-scale survey about remote consultation. There were 61 (48%) respondents from a range of disciplines. Overall, respondents were positive about remote consultation but found it was often inadequate to complete a full patient assessment. Moving forwards, respondents wanted around 60% of all consultations to remain face-to-face. It was significantly more difficult to engage and communicate with patients with more severe levels of disability. Remote consultation has been successful, but there is still a need for face-to-face assessment in intellectual disability services, particularly when working with people with more severe levels of disability.

Long Covid: definition, diagnosis and management

This article, the first in a three-part series on Long Covid, provides a definition of post-Covid-19 syndrome and Long Covid. It highlights the considerations for diagnosis and an overview of the management of commonly reported symptoms through the experience of one of the 90 NHS England commissioned post Covid (Long Covid) assessment clinics, in addition to lived experiences of persons with Long Covid (PwLC). The next two articles in this series will look at the use of digital technology in Long Covid self-management and virtual group assessments.

Child vaccination schedule: new risks and tackling hesitancy: Uptake of childhood vaccines shows a worrying fall due to several factors, but nurses can answer parents' questions and allay vaccination fears

New data show vaccination coverage for young children fell in 2021-22 for virtually all programmes. Uptake was falling before the pandemic, and COVID-19 is likely to have had a further effect on parents having their children vaccinated.

Community diagnostic centres: what, where and why?

The British Journal of Healthcare Management's editor discusses the potential benefits of community diagnostic centres for patients and the wider NHS, along with key considerations to drive this model forward.

Changing English Local Authority Duties by the Adoption of Easements in the COVID-19 Pandemic, Findings from an Interview-Based Study

This article reports findings from a study on the effect of the adjustments or 'easements' that were made to the 2014 Care Act when measures to manage the impact of COVID-19 were introduced in England in 2020. Only eight local authorities (LAs) implemented the changes permitted. The experiences of five are explored in this article. Data were collected in 2021 through interviews with Directors of Adult Social Services and other senior managers in these LAs and analysed using a thematic approach. Participants referred to the challenges under which they were working pre-pandemic, including resource pressures and problems recruiting and retaining staff. Despite the conditions attached to adopting easements these LAs had done so because of the uncertainties they were facing. All ceased to use them within a short time because they could manage without them. They had been shocked by the concerted opposition to easements and the time necessitated in responding to this. They contrasted their experiences with the apparent ease with which NHS colleagues had been able to change their practices. The experiences of these LAs may contribute to planning for the continuity of social care in any future emergency.

Remote or in-person cancer support? Therapist and service user preferences

Background/Aims: Remote service delivery became a key method of providing therapy for psychological oncology services during the COVID-19 pandemic and beyond. This study aimed to understand the experiences and preferences of both patients and therapists who undertook remote psychological therapy in a cancer support service, with a view to informing ongoing service provision. Methods: A total of 99 out of 152 invited patients completed an online mixed-methods (quantitative and qualitative) audit survey. All patient participants had accessed therapy with the psycho-oncology support team at Guy's Cancer Centre in London. Of the 12 therapists and four trainee therapists working in this service, 11 and two from each group (respectively) completed a corresponding survey about their experiences as therapists. For quantitative data, descriptive statistics were collated. Results: Patients rated their experience of remote therapy as positive, reporting that they felt respected, understood and confident during therapy, and acknowledged the associated advantages of increased accessibility and infection control. Despite this, 87% of patients and 100% of therapists expressed a preference to access or deliver therapy in person, with patients identifying human connection and relationship building as key reasons for choosing in-person delivery. Therapists valued the relational aspects of in-person psychological support and reported that remote delivery had negatively affected the quality of therapy delivered. Conclusions: Understanding the needs and preferences of patients and therapists is important in informing ongoing psychological service delivery. The results highlight the importance of retaining provision for in-person service delivery and offering choice to patients in how they access psychological support, in line with personalised care recommendations made by the NHS Long Term Plan.

How can patient partnership help to improve equality as COVID‐19 moves from pandemic to endemic?

One of the stated aims of the National Health Service (NHS) within its constitution is the promotion of equality. However, there is evidence inequality has increased over the last decade and the COVID‐19 pandemic has exacerbated this. The current pressures on healthcare mean that there is a case for a shift in approach as we transition to living with endemic COVID‐19. This article sets out how putting patient partnership front and centre at an individual, systems and national level has the potential to improve equality and assist the NHS in achieving its founding principles.

A Fresh Approach to Social Work Placements

Social Work Teaching Partnerships were initiated by the UK government in 2015. The purpose was to improve the quality of social work education and training. In the East Midlands, four Local Authorities (Derbyshire, Derby City, Nottinghamshire and Nottingham City) joined with other local organisations to form the "D2N2" Social Work Teaching Partnership (the D2N2 acronym representing the two Derbyshire and two Nottinghamshire local authorities). The Partnership was formally recognised as a Teaching Partnership in 2016. As part of our commitment to improving social work education and training, we identified a need to develop our practice education (field education) further, by developing a revised and improved placement quality assurance system that replaced the Quality Assurance in Practice Learning (QAPL) system, which was not felt to be fit for purpose. This work formed part of a wider Placement Learning System (PLS) and Practice Development Programme (PDP), which were developed in conjunction with the Universities and employer organisations. The PLS enhanced the voice of the student whilst at the same time allowing us to gather a significant amount of data about the quality of placements;and the PDP allowed us to develop our practice educator cohort. This article explores these developments.

The NHS in crisis: what does this mean for neurology?

As 2022 draws to a close, the NHS has never been in a more fragile condition. As a result of the COVID-19 pandemic and, more recently, inflation and the cost-of-living crisis, the NHS is under some of the most significant pressures in its history. But how do these pressures impact on neurology services? Sue Thomas explores the main issues causing the NHS crisis and delves into how neurology services need to respond.

The use of leadership metaphors in the NHS

This article examines the use of leadership metaphors in the NHS. It explores the ways in which metaphors are used, then identifies the most commonly-used metaphors relating to healthcare leadership. Metaphors relating to machines appear to be the most dominant, so the article will consider the implications of this. The potential of the 'living system' metaphor as an alternative to this will also be discussed in relation to the development of integrated care systems.

Charity programme supports practices' mental health services

The article reports that the charity Mind Cymru has urged practice nurses in Wales to refer patients with mild to moderate mental health problems for Great Britain National Health Service (NHS) counseling to a free, guided self-help service. It mentions that the Active Monitoring programme can support practices' mental health service delivery.

Cancer treatment backlog: what's gone wrong and what we need to do to fix it: Nurses in rapid diagnostic centres, one-stop clinics and other services are striving to clear treatment backlogs, but urgent and coordinated action is needed

This time last year it looked like cancer services were back on the road to recovery. The number of people starting treatment was on the rise and had even nudged above pre-pandemic levels.