Health Information News December 2016

This newsletter is intended for staff who provide health information to the public to keep informed of latest news and resources available in the Health Information field. If you would like to submit a news item – email (Twitter: @K4H_PPI)

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News

Producing quality patient information – Having the right information and support at the right time can help patients to manage and make decisions about their health. Here, we look at The King’s Fund’s archive to explore how guidance on what constitutes good-quality patient information has changed over the years. An article by Lynsey Hawker

How is the impact of accessible health information evaluated? - A review has been published in the Health Expectations Journal looking at the impact of ‘accessible’ health information for people with intellectual disabilities. The author highlights that there is no single definition of accessible information, and that a range of views include a ‘skew’ towards easy read, alongside the importance of the mode of delivery of information, and the involvement of people with intellectual disability in creating accessible information resources. The review looked at 42 papers published before December 2015. The papers were grouped into 5 categories, and the evaluation data within them was analysed. The authors conclude that there was no clear consensus among the papers reviewed as to what constituted the most important impacts of adapted health information, how to measure these or what would constitute an acceptable degree of quality in evaluation. However, they identify that the reviewed literature does suggest that adapted health information has a better chance of making an impact when it is tailored to an individual’s individual requirements for information and communicative support. You can read the full review here. Deborah Chinn BA (Hons), Dip Clin Psych, PhD, Claire Homeyard RM, BSc (Hons), MSc

Easy read and accessible information for people with intellectual disabilities: Is it worth it? A meta-narrative literature review DOI: 10.1111/hex.12520

Report shares lessons for online health information and apps - The Nuffield Trust have published a report looking at digital initiatives in primary care. ‘The digital patient: transforming primary care?’ reviews the evidence that exists on digital technology and its impact on patients in primary care and the NHS. The report aims to show how professionals and policy-makers can make the most of the opportunities afforded by patient technology and avoid the risks. It explores the impact of seven types of digital services offered by the NHS, including Online sources of health information and advice, targeted interventions and peer support. The report finds that patient-facing technology is already showing promise that it can improve care for patients and reduce strain on the stretched health service – particularly for people with long-term conditions such as diabetes or COPD. In relation to online health information it reviews evidence of impact, and cites studies with findings including:

Patients who access health information online report having more productive conversations with their GP, having a better understanding of their GP’s prognosis and saving time by accessing information rather than making a GP appointment.
For a range of conditions, patients belonging to online communities become more knowledgeable; feel more socially supported and empowered; have improved behavioural and clinical outcomes, compared with non-users.
For rare diseases where established groups do not exist, social media is playing an increasingly large role.
Social media sites are also becoming increasingly prominent sources of health information among adolescents.
It includes a number of lessons related to online health information:
Professionals should actively recommend online patient networks and trusted sources of information.
User-centred design should be the norm.
Target patients effectively.

In relation to apps the report highlights that many have not been officially evaluated, meaning that their effectiveness is unknown. It shares an outline of the planned NHS technology and innovation tariff, which will include a process for ‘approving apps’. The report warns that policy-makers and politicians should avoid assuming that self-care-enabling technology will produce significant savings, at least in the short term. You can read the full report on the Nuffield Trust website.

What works in behaviour change programmes for older people? - Public Health England have published a review of interventions across a range of health behaviours for older adults, to help identify what types of interventions support the uptake and maintenance of healthy behaviours and promote cognitive health among older adults living in the community. The resource is intended for local authority and clinical commissioning groups, and the producers/providers of lifestyle behaviour change programmes and resources, to support the development of evidence-informed prevention packages for older adults. The full report can be read on the Public Health England website.

Pharmacists could deliver more information support to people with long term conditions - The Royal Pharmaceutical Society (RPS) have launched a report stressing the crucial role pharmacists could play in the support of people with long term conditions. The report outlines how pharmacists can support prevention, self care and self management, including through providing health education and advice to people at their points of interaction with a pharmacist. It highlights that around 1.2 million visits to pharmacies for health related reasons take place each day, and that 89% of the population (in England) are within a 20 minute walk of a pharmacist. Access is even greater in the highest areas of deprivation (99.8%). The report argues that pharmacists are ideally placed to provide a reliable and confidential source of health and medicines information. And are also able to ensure that patients are signposted to trusted resources and support groups, both national and local, for further information about their physical and mental health. The RPS believes that public health organisations should fund the use of community pharmacies to target specific health promotion subjects that impact on the management of long term conditions. The report argues that the expertise and clinical knowledge of pharmacists must be fully utilised to support people with long term conditions and help them to achieve the desired outcomes from their medicines, thereby making more efficient use of National Health Service (NHS) resources. To maximise the contribution of pharmacists to the management of long term conditions at each stage of the patient journey, the RPS report recommends the following actions:

Pharmacists providing direct patient care should have the opportunity to train to become a prescriber, fully utilising those skills as part of the multidisciplinary approach to managing and supporting people with long term conditions.
The patient journey will be made easier by enabling pharmacists to directly refer to appropriate health and social care professionals, improving patient access to care and reducing the number of unnecessary appointments.
Patients will benefit from further integration of pharmacists into their multidisciplinary team, ensuring support at every stage of their journey, from prevention through to treatment and management of their long term condition(s).
All pharmacists directly involved in patient care should have full read and write access to the patient health record, with patient consent, in the interest of high quality, safe and effective patient care.

The full report can be read on the RPS website.

Mental health of children and young people - About 695,000 children aged 5 to 16 years in England have a clinically significant mental illness according to a new report by Public Health England. The mental health of children and young people in England also reveals that just 1 in 4 (25%) children across the country who need treatment for mental ill health receive it. The report aims to describe the importance of mental health in children and young people and the case for investing. It also seeks to analyse current levels of mental health and summarise the evidence on what works in order to help transform local services. The report looks at challenges with the commissioning and provision of children and adolescent mental health services. You can access the report on the Public Health England website.

The Mental Health Foundation has published a new guide on managing and reducing stress and a report on mental health as a workplace asset.
The Education Policy Institute has published a report into the transformation of children and young people's mental health services. It raises concerns about the absence of ring-fencing for promised funding.

Leaflets to support evidence-based public health – from Knowledge & Library Services, South West and Thames Valley, Public Health England:

Finding the evidence: Health inequalities, equality and diversity - the Evidence for health inequalities Nov 2016 FINAL.pdf

Finding the evidence: Research support for PHE staff undertaking university courses - the evidence studying leaflet Oct 2016 FINAL.pdf
Finding the evidence: Research support for public health teams based in local authorities - the evidence local authorities leaflet Oct 2016 FINAL.pdf

Making Every Contact count - The Making Every Contact Count website has been newly updated to provide all those with an interest or role in population health and prevention with a library of national and local resources that can be used to support the development, implementation and evaluation of MECC programmes across local communities. The resources available include sample frameworks, case studies, signposting to useful e-learning sessions and healthy lifestyle resources, amongst others.

GP based pharmacists provide important support for patients - A survey carried out by the Patients Association has explored the experiences of patients and carers that have accessed pharmacists based in GP services. They survey was carried out in summer 2016 and was completed by 300 people. Of those who spoke to pharmacists about their medicines, 74% felt completely involved in discussions, and 15% felt somewhat involved. The report identifies that there is a need for staff training to develop these skills in pharmacy to improve patient experience, as well as raising awareness to patients and families about that facet that they can be involved in decision making, when and how. 77% of people felt their pharmacist listened to them, and the same proportion found it easy to understand what their pharmacist was telling them.

69% of people who responded to the survey felt they didn’t have to see the GP after speaking to their clinical pharmacist. The researchers highlight that patients often need clarification of medications, especially if they have been given several different prescriptions. The data gathered from the survey showed that a vast majority who had contact with a clinical pharmacist found reviewing their medication to be particularly useful to them. They also found that a better understanding is needed by patients and carers of the role and function of clinical pharmacists as well as their qualifications and competencies. Patients and their families/carers need to be reassured that the clinical pharmacist is adequately qualified to be able to provide the advice needed and be provided with more information about the role of the pharmacist within the GP practice team. Their recommendations include:

A profile raising campaign should be targeted at the public to enable a better understanding of the role and function of pharmacists in GP practice teams as well as their expertise, knowledge and qualifications.
Pharmacists should receive training in how to involve patients and carers in shared decision making and aspects of safety as part of the whole concept of working together as equals.

The full survey report can be found on the Patients Association website.

Self care attitudes in the UK - The Proprietary Association of Great Britain (PAGB) have published research exploring how people use GP and A&E services, and finds that if they understood their own NHS ‘footprint’ 80% would be more likely to seek advice from pharmacists. 5,011 UK adults took part in the research in September 2016. Key findings include:

The majority of people (92%) feel it is important to take responsibility for their own health to ease the burden on the NHS.
But there is a disconnect between attitude and behaviour: more than one third of people visit their GP for conditions they could treat at home.
Almost half the population wouldn’t visit their local pharmacist in the first instance for advice about a self-treatable condition.
Some people feel entitled to see their GP, though admit they would reconsider the frequency of their visits if there was a direct financial consequence

The report identifies a number of actions that could overcome current barriers to increasing self care:

Raise awareness of each individual’s NHS footprint: The research suggests that when people understand the impact of using GP and A&E services when the same advice and/or treatment is available from a pharmacy, many would change their behaviour to save the NHS.
Increase awareness of the expertise of pharmacists: The main barrier preventing people from visiting the pharmacy as the first port of call seems to be a lack of awareness of the skills and expertise of the pharmacist. Of the 47 per cent of people who said they wouldn’t seek advice from their pharmacist first on self-treatable conditions, nearly one in five felt pharmacists weren’t as qualified as doctors and nurses.
Ensure consistent messaging and signposting to appropriate services: Awareness of the health and wellbeing services offered in pharmacies, and confidence in using these services, is low. Consistent information from NHS 111, NHS Choices and all healthcare professionals is needed.
Improve health literacy and promote self care: The research indicates that many people do not know how to self care, and are unsure which conditions can be treated without a visit to the doctor.

The full report can be read of the PAGB website.

10 actions for putting people and communities at the heart of health - This week has seen the publication of the final tools and resources from the Realising the Value programme. Realising the Value was an 18-month programme funded by NHS England and led by Nesta and the Health Foundation, which ran from May 2015 to November 2016. It aimed to enable people to take an active role in their own health and care, in support of the NHS Five Year Forward View vision to develop a new relationship with people and communities. The programme took a whole system view to increase understanding of how person- and community centred approaches add value, and of what works to embed and spread them in practice. It explored in-depth five different methods – peer support; self-management education; health coaching; group activities to support health and wellbeing; and asset-based approaches – to assess their effectiveness, impact on patients, and wider benefits. The final project report sets out ten key actions on what should be done and how people need to work differently to put people and communities at the heart of health and wellbeing. The project resources include:

A guide with practical tips on designing, embedding and spreading the five person- and community-centred approaches to maximise their impact;
An economic modelling tool for commissioners, which builds understanding of how person- and community-centred approaches can support health and wellbeing in local populations, estimates potential savings and wider social benefits, and helps to build the business case;
A report on system levers setting out the role of national bodies in supporting the implementation and spread of person- and community-centred approaches;
A new articulation of value that focuses on what matters to people and communities. This includes a series of calls to action including the need to build a consensus on developing a single simplified outcomes framework, focused on what matters to people.

You can access all the tools resources from the project on Nesta’s website.

CILIP’s 10 Key Principles for the Improvement and Development of England’s Public Libraries - This month, CILIP published an article on its blog, outlining 10 key principles for the improvement and development of England’s public libraries. These principles are intended to shape the approach to targeting and reversing the decline in funding and leadership support for public libraries. This public statement of CILIP’s position is designed to clearly communicate what the library profession expects of Government, the Local Government Association and national lead organisations. To read the full article visit: