ABSTRACT
The studyKyrgiou M, Athanasiou A, Cieslak-Jones D. Comparative effectiveness and risk of preterm birth of local treatments for cervical intraepithelial neoplasia and stage IA1 cervical cancer: a systematic review and network meta-analysis. Lancet Oncol 2022;23:1097-108.To read the full NIHR Alert, go to: https://evidence.nihr.ac.uk/alert/prevention-of-cervical-cancer-what-are-the-risks-and-benefits-of-different-treatments/.
ABSTRACT
The studyBrady MC, Ali M, VandenBerg K, et al. Complex speech-language therapy interventions for stroke-related aphasia: the RELEASE study incorporating a systematic review and individual participant data network meta-analysis. Health Social Care Delivery Res 2022;10.To read the full NIHR Alert, go to: https://evidence.nihr.ac.uk/alert/therapy-for-language-problems-after-a-stroke-is-most-effective-when-given-early-and-intensively/.
ABSTRACT
The studyReeve J, Maden M, Hill R, et al. Deprescribing medicines in older people living with multimorbidity and polypharmacy: the TAILOR evidence synthesis. Health Technol Assess 2022;26:1-148.To read the full NIHR Alert, go to: https://evidence.nihr.ac.uk/alert/how-to-safely-deprescribe-medications-for-people-with-multiple-long-term-conditions/.
Subject(s)
Deprescriptions , Humans , Aged , MultimorbidityABSTRACT
The studyHumphries ABC, Linsell L, Knight M. Factors associated with infection after operative vaginal birth-a secondary analysis of a randomized controlled trial of prophylactic antibiotics for the prevention of infection following operative vaginal birth. AJOG 2023;228:328.To read the full NIHR Alert, go to: https://evidence.nihr.ac.uk/alert/assisted-vaginal-births-women-need-prompt-antibiotics/.
Subject(s)
Antibiotic Prophylaxis , Parturition , Puerperal Infection , Humans , Anti-Bacterial Agents/therapeutic use , Episiotomy/adverse effects , Lacerations , Wound Infection/drug therapy , Wound Infection/prevention & control , Female , Pregnancy , Adult , Delivery, Obstetric , Puerperal Infection/prevention & control , Surgical Wound Infection/prevention & controlABSTRACT
The studySanter M, Muller I, Becque T. Eczema Care Online behavioural interventions to support self-care for children and young people: two independent, pragmatic, randomised controlled trials. BMJ 2022;379:e072007.To read the full NIHR Alert, go to: https://evidence.nihr.ac.uk/alert/online-support-improved-eczema-symptoms-in-children-and-young-people/.
Subject(s)
Eczema , Humans , Child , Adolescent , Cost-Benefit Analysis , Eczema/therapy , Self CareABSTRACT
The studyTesfaye S, Sloan G, Petrie J, et al. Comparison of amitriptyline supplemented with pregabalin, pregabalin supplemented with amitriptyline, and duloxetine supplemented with pregabalin for the treatment of diabetic peripheral neuropathic pain (OPTION-DM): a multicentre, double-blind, randomised crossover trial. Lancet 2022;400:680-90.To read the full NIHR Alert, go to: https://evidence.nihr.ac.uk/alert/combination-therapy-for-painful-diabetic-neuropathy-is-safe-and-effective/.
Subject(s)
Diabetes Mellitus , Diabetic Neuropathies , Humans , Diabetic Neuropathies/drug therapy , Pregabalin/therapeutic use , Analgesics/therapeutic use , Amitriptyline/therapeutic use , Duloxetine Hydrochloride/therapeutic use , Treatment Outcome , Double-Blind MethodABSTRACT
When it comes to the future of the health service, pressure on the workforce is as great a threat, if not greater, than pressure on finances. This was my argument in evidence to the House of Lords' recent inquiry into the long-term sustainability of the NHS.
Subject(s)
Health Workforce , Nurses , State Medicine , United Kingdom , WorkforceABSTRACT
NHS leaders seeking to cut costs and improve quality should focus on STPs as opposed to reconfiguring acute care.
Subject(s)
Delivery of Health Care, Integrated/economics , Quality Assurance, Health Care/economics , State Medicine/economics , Cost Control , Health Care Reform , Health Policy , Humans , United KingdomABSTRACT
Many argue that the solution to the NHS's quality and financial problems lies in the continuing reconfiguration and centralisation of hospital services. However, an ageing population requires good local access to care. This paper reviews the evidence that is available to help guide the reconfiguration of hospital services. The quality overall is poor and, in particular, there is little evidence that reconfiguring hospital services results in financial savings. For acute medical care, there is strong evidence both for enhanced direct and early consultant involvement, and for the importance of comprehensive supporting services. Clinical networks and new technologies may offer opportunities to sustain local access but more evidence is needed to guide network development and to ensure safe but sustainable medical staffing models.
ABSTRACT
In 2000 the English National Health Service (NHS) began a series of workforce redesign initiatives that increased the number of doctors and nurses serving patients, expanded existing staff roles and developed new ones, redistributed health care work, and invested in teamwork. The English workforce redesign experience offers important lessons for US policy makers. Redesigning the health care workforce is not a quick fix to control costs or improve the quality of care. A poorly planned redesign can even result in increased costs and decreased quality. Changes in skill mix and role definitions should be preceded by a detailed analysis and redesign of the work performed by health care professionals. New roles and responsibilities must be clearly defined in advance, and teamwork models that include factors common in successful redesigns such as leadership, shared objectives, and training should be promoted. The focus should be on retraining current staff instead of hiring new workers. Finally, any workforce redesign must overcome opposition from professional bodies, individual practitioners, and regulators. England's experience suggests that progress is possible if workforce redesigns are planned carefully and implemented with skill.
