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15 million NHS patients in England with long-term conditions such as diabetes, arthritis and asthma account for 70% of the annual expenditure of the NHS in England. One projection estimating that the bill for treatment of long-term conditions will require the NHS to find £4 billion more each year by 2016. Increasingly, patients do not have a single long-term condition but live with two or more conditions, complicating treatment and adding to its cost. The Committee strongly supports the development of individual care planning for people with long-term conditions, based on the principles successfully demonstrated in the NHS House of Care programme. Care planning approaches will involve GPs, community health services and specialists sitting down with the patient to draw up a personalised plan for the care required, which includes the support needed to help the patient manage his or her own condition. The challenge, though, of introducing personalised care planning for 15 million people is substantial. The Committee looked at the prevailing view that services to treat long-term conditions should be moved out of hospitals and into primary and community care. To provide effective care for these conditions, services have to be maintained across all settings, from support in the home through to acute specialist care, and many conditions will continue to require specialist services delivered in hospital. Effective management of long-term conditions also requires collaboration with other government providers, such as housing and transport services.
Most of those who complain about NHS services do not seek financial redress. They do so because they wish to have their concerns and experiences understood and for any failings to be acknowledged and put right so that others do not suffer the same avoidable harm. Where such errors occur, patients and their families deserve to be met with a system which is open to complaints, supports them through the process and which delivers a timely apology, explanation and a determination to learn from mistakes. The current system for complaints handling however, remains variable. Too many complaints are mishandled with people encountering poor communication or at worst, a defensive and complicated system which results in a complete breakdown in trust and a failure to improve patient safety. The Committee welcomes the progress made since their last report, but in this, the Committee's final report on complaints and concerns in this Parliament, an overview is set out of the developments and recommendations to date as well as those expected in 2015. The Committee also makes a number of recommendations where further action is required.
Diet, obesity, and physical activity all have important impacts on health. For too long however, physical activity has been seen merely in the light of its benefits in tackling obesity. A core message from this inquiry is the compelling evidence that physical activity in its own right has huge health benefits totally independent of a person's weight. The importance of this - regardless of weight, age, gender or other factors - needs to be clearly communicated. Interventions focused on encouraging individuals to change their behaviour with regard to diet and physical activity need to be underpinned by broader, population-level measures. Whilst both are important, population-level interventions have the advantage of impacting on far greater numbers than could ever benefit from individual interventions. The Committee recommends that the next Government prioritises prevention, health promotion and early intervention to tackle the health inequalities and avoidable harm resulting from poor diet and physical inactivity. The Committee regards it as inexplicable and unacceptable that the NHS is now spending more on bariatric surgery for obesity than on a national roll-out of intensive lifestyle intervention programmes that were first shown to cut obesity and prevent diabetes over a decade ago. All tiers of weight management services should be universally available and individual clinicians should use every opportunity to help their patients to recognise and address the problems caused by obesity and poor diet, and to promote the benefits of physical activity.
Bridging the gap between undergraduate and postgraduate knowledge and experience, this new full colour resource uses an interdisciplinary approach to help manage chronic conditions – osteoarthritis, Achilles tendinopathy, gout, rheumatic diseases, forefoot/rearfoot entities, stress fractures/reactions, cerebral palsy – in the lower limb and foot. Each chapter includes sections on predisposing factors, diagnosis, impairments, function, quality of life and management strategies while highlighting any complex features of a condition which may present. The latest advances are discussed with suggestions for new paths of research – 'future directions'. The text is further supported by additional commentaries from internationally renowned researchers who highlight the key elements of the work and provide a supplementary perspective of the particular clinical condition. A general view of the patient's needs is offered throughout, connecting clinical realities to real-world patient experiences. Management of Chronic Conditions in the Foot and Lower Leg is a comprehensive, practical tool that can be used to inform daily decision making in practice as well as to support those who build policy and management strategies in the clinical areas covered. - Clear content and structure supported by full colour illustrations - Includes less discussed conditions such as gout and cerebral palsy - Focus on pain, impairment, function, quality of life and management strategies - Critical reflections by experts highlight current clinical practice and thinking in research - Provides a sound interpretation of research findings - Features patient-reported outcome measures and health related behaviour strategies
Exercise referral describes the process of consultation, planning and instructing physical activity programmes and applying appropriate behaviour change strategies for clients presenting a range of low- to medium-risk medical conditions. Exercise Management for Referred Medical Conditions is the first book to integrate exercise prescription with the development of healthy behaviours and the promotion of physical activity and well-being and provides students with an evidence-based, applied guide to becoming effective exercise referral practitioners. The book draws upon the latest research and recommends best practices for creating referral pathways, providing exercise programmes and engaging clients in health lifestyles. Covering the pathology, medical management, role of exercise and recommendations for programming in each case, it discusses a range of conditions, including: Obesity and type I and II diabetes Hypertension and dyslipidaemia Asthma Low back pain, osteoarthritis and joint replacement, rheumatoid arthritis, and osteoporosis Depression, anxiety and stress disorders Consistently organised and laden with pedagogical features, including learning objectives, key terms, case studies, future developments and chapter summaries, no other book offers such a clear, holistic model for exercise referral. This is a vital resource for any student undertaking vocational courses in exercise referral and an important reference for exercise scientists, physical therapists, fitness professionals or local policy-makers interested in the use of physical activity in healthcare.
This authoritative handbook--now significantly revised with more than 50% new material--introduces practitioners and students to the state of the art in psychological interventions for managing pain. Leading experts review the most effective treatment approaches for enhancing patients' coping and self-efficacy and reducing pain-related disability, including cognitive-behavioral therapy, biofeedback, clinical hypnosis, group therapy, and more. Strategies for integrating psychosocial and medical treatments for specific populations are described, with chapters on back pain, headache, cancer, and other prevalent chronic pain disorders. Attention is given to customizing intervention for individual patients, maximizing treatment adherence, and preventing overuse of opioids and other medications. New to This Edition *Chapter on resilience, focusing on mindfulness- and acceptance-based approaches. *Chapters on managing pain with comorbid psychological disorders (posttraumatic stress disorder and substance use disorder). *Chapter on emerging uses of technology. *Even more practitioner friendly: every chapter concludes with bulleted "Clinical Highlights." *Many new authors; extensively revised with over 15 years of research and clinical advances.
Publisher's Note: Products purchased from 3rd Party sellers are not guaranteed by the Publisher for quality, authenticity, or access to any online entitlements included with the product. Published in collaboration with American Journal of Therapeutics, Therapeutic Advances in Hospital Medicine: Focus on the Older Adult is a concise, practical reference that helps you provide optimal care to geriatric patients in the hospital setting. Ideal for hospitalists, geriatricians, nurse practitioners, and physician assistants, this easy-to-read monograph presents expert advice on effectively managing common conditions seen in this growing patient population.
Thoroughly revised and updated since its initial publication in 2010, the second edition of this gold standard guide for case managers again helps readers enhance their ability to work with complex, multimorbid patients, to apply and document evidence-based assessments, and to advocate for improved quality and safe care for all patients. Much has happened since Integrated Case Management (ICM), now Value-Based Integrated Case Management (VB-ICM), was first introduced in the U.S. in 2010. The Integrated Case Management Manual: Valued-Based Assistance to Complex Medical and Behavioral Health Patients, 2nd Edition emphasizes the field has now moved from “complexity assessments” to “outcome achievement” for individuals/patients with health complexity. It also stresses that the next steps in VB-ICM must be to implement a standardized process, which documents, analyzes, and reports the impact of VB-ICM services in removing patient barriers to health improvement, enhancing quality and care coordination, and lowering the financial impact to patients, providers, and employer groups. Written by two expert case managers who have used VB-ICM in their large fully disseminated VB-ICM program and understand its practical deployment and use, the second edition also includes two authors with backgrounds as physician support personnel to case managers working with complex individuals. This edition builds on the consolidation of biopsychosocial and health system case management activities that were emphasized in the first edition. A must-have resource for anyone in the field, The Integrated Case Management Manual: Value-Based Assistance to Complex Medical and Behavioral Health Patients, 2nd Edition is an essential reference for not only case managers but all clinicians and allied personnel concerned with providing state-of-the-art, value-based integrated case management.
Preceded by Textbook of diabetes / edited by Richard I.G. Holt ... [et al.]. 4th ed. 2010.