United kingdom

Demand for hospital diabetic retinopathy (DR) appointments is increasing and exceeding capacity, leading to long waiting lists. Delays in appropriate treatment can cause irreversible yet avoidable vision loss. We assessed if capacity of the DR service could be safely expanded by utilising virtual clinics. Virtual clinics increased the service capacity by more than 100% and did not cause delays in delivering urgent treatments. The majority of patients reviewed had low-risk disease and follow-up could be maintained in the virtual clinic...

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There is a pressing need to increase the availability of emotional support to healthcare professionals in training and those in early career, in particular junior doctors. Schwartz Rounds provide a space for staff and students to reflect on the emotional impact of their work. The Rounds are a multidisciplinary forum for all staff and students working in healthcare settings. The key premise is that supporting healthcare staff and students' wellbeing, providing a way for them to gain insight into their feelings and those that they work with, helps them to work compassionately with patients...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

AIM: Routine carcino-embryonic antigen blood testing is required after colorectal cancer resection, requiring face-to-face appointments. This has workforce implications, and impacts patients' lives. We assessed feasibility and acceptability of self-taken blood tests. METHODS: 50 colorectal cancer patients with experience of face-to-face phlebotomy surveillance agreed to self-testing finger-prick kits. Follow-up questionnaires assessed perspectives and preferences...

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The central importance of the biopsychosocial model of chronic disease is increasingly recognised in the management of long-term conditions (LTC), which are often associated with chronic pain, fatigue and disability. Despite the physical and mental health impact, 'struggle' to maintain self-efficacy, gap in effective transition to adult pathways and long term consequences of poor disease control and lifestyle choices in young people with LTCs, innovation in this age range is rarely reported in generic journals...

Blockchain is topical in many areas of science. The impact on clinical care of physicians is not known. We undertook a rapid review of the literature to identify areas of interest for clinicians in active practice focusing on evidence relevant to clinical care. We found limited evidence for use blockchain in clinical practice with most studies focusing on technical aspects of prototypes and implementation with no evidence of standardised metric to measure impact for patients, clinicians, and organisations. Personal Health Records for use across organisational and geographic boundaries emerged as the strongest clinical use-case...

The NHS is continuously evolving and with it, traditional notions of leadership and management must be reimagined and redefined. In order to be effective leaders, however, we must first gain a deeper understanding of the context in which we lead and recognise how to navigate the system's intricacies. This article explores the characteristics of Complex Adaptive Systems and how we can understand the patterns of these systems through our experiences leading in the NHS. It then analyses leadership approaches both past and present and considers how future leaders can be effective in tomorrow's NHS...

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INTRODUCTION: Cancer multi-disciplinary team (MDT) meetings are an important component of consultant workload, however previous literature has suggested trainees are not satisfied with their current curriculum in preparing for MDT working. METHODS: This educational pilot assessed whether multi-speciality simulated scenarios with pre-defined learning objectives, could prepare specialist registrars for interacting within an MDT. Participants completed pre- and post-questionnaires assessing a number of areas including: current experience of training, confidence presenting patients and whether the course would alter future practice...

Bad design in safety-critical environments like healthcare can lead to users being frustrated, excluded or injured. In contrast, good design can make it easier to use a service correctly, with impacts on both the safety and efficiency of healthcare delivery, as well as the experience of patients and staff. The participative dimension of design as an improvement strategy has recently gained traction in the healthcare quality improvement literature. However, the role of design expertise and professional design has been much less explored...

This opinion piece emphasies the critical role of translational research in enhancing the UK's resilience against future pandemics. The COVID-19 pandemic demonstrated the lifesaving potential of scientific innovation, including genomic tracking of SARS-CoV-2, vaccine development, data linkage, modelling, and new treatments. These advances, achieved through collaborations between academic institutions, industry, government, public health bodies, and the NHS, occurred at an unprecedented pace. However, the UK's pandemic preparedness planning, as reflected in the 2016 Exercise Cygnus report, notably lacked provision for scientific innovation...

Early Comprehensive Geriatric Assessment is a key component of the assessment of older adults presenting to hospital with frailty syndromes, often this is facilitated through Acute Frailty Units. In this paper we describe how using QI methodology we improved access to our Frailty Unit using a digital solution. The impact of this improvement was demonstrated via the reduction in length of stay that these patients experienced compared to patients admitted to General Care of the Older Person wards.

Degradation of junior doctors pay has led to strikes in the UK. Improved pay is important, however to feel valued at work, doctors must have good conditions as well. The author describes how their experience working in New Zealand (NZ) highlighted several insights into how better working conditions make doctors feel more valued. Three factors are discussed which improve doctors daily experience. Firstly, the use of 'relief doctors', who cover inevitable absences caused by sickness or holiday, allow maintenance of proper staffing levels...

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In order to train a future workforce able to meet the needs of its patients it is vital to ensure that opportunities to engage in research are inbuilt to training programmes. This strategy meets national recommendations recently published by NIHR, RCP and GMC. A nationally funded expansion of 'standard' Foundation programmes offers a unique opportunity to develop innovative new posts which include exposure to clinical research. In NHSE Midlands a pilot Foundation Year two (F2) post in Diabetes Research was implemented in August 2022, embedded into a standard Foundation programme...

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Venous thromboembolism is the third most common cause of cardiovascular death globally and many diagnoses are preventable. The UK NHS has led international efforts to reduce VTE, particularly hospital-associated VTE, through coordinated national policy action and world-leading research. Despite this, VTE remains an important cause of morbidity and mortality in the UK, as underlined by the recent COVID-19 pandemic. Future reductions in VTE incidence/deaths will require progress on several fronts: a better understanding of case mix; revisiting VTE risk assessment, focussing on thromboprophylaxis failure and improving awareness of VTE amongst clinicians and the public...