Mental health nurses in short supply as NHS struggles to fill vacancies

Community-based teams care for 97% of mental health patients. And nurses play a pivotal role, building up trust between patients and their families.

However, since 2010 the total number of NHS mental health nurses in England has dropped by 15% – in parts of London, about 20% of job vacancies are unfilled. Helen Gilburt, a fellow in health policy at thinktank the King’s Fund, says: “Community mental health teams are supporting people to stay well, so if you haven’t got sufficient workforce to deliver that care, people are more likely to relapse.”

The nursing shortage is caused partly by an ageing workforce that is not being replaced quickly enough. In 2013, more than 32% of mental health nurses were aged over 50, and the abolition of bursaries for student nurses may also have had an adverse effect on the number of new recruits.

As a result, individual nurses are taking on a higher caseload. Research last year found that some community mental healthcare coordinators – not all of whom are nurses – have caseloads as high as 50 patients.

Ben Hannigan, reader in mental health, learning disabilities and psychosocial care at Cardiff University, who co-authored the study, says: “You will firefight with that number of people – it’s very difficult to do all the things you would aspire to.” Therapeutic care, aimed at helping people to recover, will be harder to provide, he says.

The shortage is affecting the whole service; a 2015 report by the Care Quality Commission revealed that only 14% of mental health patients said they received appropriate care in a crisis. And a review of psychiatric care by the Commission on Acute Adult Psychiatric Care found that 16% of patients per ward could have been treated in an alternate setting, including crisis houses and rehab services, if they had been available.

Trusts are struggling to deal with the shortages. Many, says Neil Brimblecombe, director of nursing at South London and Maudsley NHS foundation trust, are employing agency nurses, meaning that patients “have less opportunity to develop long-term relationships with individual nursing staff”.

Instead of “chasing an increasingly diminishing pool of nurses”, Brimblecombe believes trusts should take a different approach to workforce design. His own trust has joined two neighbouring trusts to develop a new assistant practitioner role to take on some of the work traditionally carried out by registered nurses.

In the long term, Brimblecombe believes the community mental health workforce should include more peer workers with “lived experiences of mental health problems” and more occupational therapists: “There will be an increasing range of new roles. The days when we have doctors, nurses and social workers, and that’s it, have gone.”

Mental health nurses in short supply as NHS struggles to fill vacancies

GP consultations too short for complex cases, says doctors" leader

The length of GP consultations is too short for many people with complex health needs because doctors are “ridiculously overworked”, according to the Royal College of GPs.

The average consultation length of 10 minutes in the UK – thought to be the shortest in the developed world – was “crazy” said the RCGP president, Dr Helen Stokes-Lampard.

While simple health problems could be dealt with in 10 minutes, for people with complex health needs it was inadequate but GPs had to practise “demand management”, she told BBC Radio 4’s Today Programme.

“It is a crazy situation. GPs are ridiculously overworked and there are too few of us – the situation is on the brink.”

Research by the Health Foundation – based on polling of GPs from 11 countries, including Germany, France, Australia and the US – has suggested the amount of time spent by UK GPs with patients is the lowest in the developed world.

The data showed 92% of consultations in the UK are completed in under 15 minutes, compared with 27% in other countries.

Dr Chaand Nagpaul, of the BMA, said: “We spend less than other European countries. We have fewer doctors than other European nations. We have one-third of the hospital beds per head compared to Germany, for example, GPs spend less time per patient than any other European nations. We need to be addressing these issues as a priority.”

Plans to “modernise” the NHS by reducing hospital care and putting more services in the community to save £22bn and make the system more efficient risked undermining care, she said.

The number of GP consultations has already increased by nearly a quarter in the past five years, and while funding for MPs will increase by 14% by 2020, the current infrastructure could not cope, said Stokes-Lampard. “If you haven’t got the infrastructure there you are setting yourself up to fail. It’s a case of putting the cart before the horse.”

Meanwhile, an Ipsos Mori poll for the BBC of 1,033 UK adults found a majority of the public would be open to a tougher approach on people who abuse the GP system.

Seven in 10 said charging people for missed appointments would be acceptable, while 51% said they were against paying to have a guaranteed appointment within 24 hours, although 20% said they would be willing to pay more than £10.

Stokes-Lampard said the issue of charging – which both the Royal College of GPs and the British Medical Association are against – was a “red herring”, as most people who used the GP did not pay for prescriptions and would not have to pay.

GP consultations too short for complex cases, says doctors" leader

NHS set to fall £150m short of target on payments from foreign patients

The NHS is set to miss its target of recovering £500m a year for treating patients from overseas, the Whitehall spending watchdog has said.

The National Audit Office (NAO) said hospital trusts in England were getting back more money from overseas visitors who were not entitled to free treatment, but were still facing a shortfall of more than £150m by 2017-18.

The target for reducing the cost of treating overseas patients was announced by the Department of Health in 2014 in a drive to cut trusts’ deficits and counter claims the NHS was being overly generous.

The amount collected has risen from £73m in 2012-13 to £289m in 2015-16. However, the NAO said the increase was mainly due to a new surcharge on temporary migrants from outside the European Economic Area (EEA), which brought in £168m last year.

The department’s forecasts suggest trusts will recover £346m in 2017-18, significantly less than the £500m target. The NAO said the shortfall was in part due to the failure to take account of the cost of administering the programme, while patients were still not paying the full amounts they owed.

“The charging regulations are complex. Trust staff may have to rely on judgment in determining whether a patient is chargeable, sometimes with limited information,” the NAO’s report said.

There was a “particular challenge” in collecting payments from patients – mainly from outside the EEA – who were personally liable for the cost of their treatment, it said. On average, only about half the amount due was being collected.

The head of the NAO, Amyas Morse, said: “Hospital trusts remain some way from complying in full with the requirement to charge and recover the cost of treating overseas visitors.

“In the past two years, the amounts charged and amounts actually recovered have increased. Much of this increase is the result of changes to the charging rules. If current trends continue and the charging rules remain the same, the department will not achieve its ambition of recovering up to £500m of overseas visitor income a year by 2017-18 and faces a potential shortfall in the region of £150m.”

NHS set to fall £150m short of target on payments from foreign patients

Make Individuals Early Mornings Extraordinary With A Short Treadmill Workout

How you start your morning, tends to set the tone for the rest of your day. Vitality flows from commence to end and stays the very same except if some thing key comes to adjust it. Get charge of your morning and most importantly your day by incorporating in a rapid treadmill workout ahead of you head out.

So many mornings have a tendency to commence off with us dragging ourselves out of the bed to encounter the day. The following time you roll above, toss on some workout gear and hop up on your treadmill to assist change your mood, boost your target and get a good begin to your day.

Positive aspects of Morning Exercises

If walking is fantastic way to hold the doctor away, picture what a swift treadmill run will do. Walks are nice and peaceful early in the day. They get your blood flowing a little bit, but a treadmill exercise can wake you up in a entire new way and has great lasting benefits.

• 
  Boosts Your Metabolic process – Waking up naturally and jumping on a treadmill to perform on cardio, puts your entire body in higher gear early morning. Once you are completed, your physique will hold operating all through the day to burn fat. Your metabolic process is at rest when you rest and if you wait till the end of the day to exercise, you’ve missed out on some further unwanted fat burning options.


• 
  All Day Vitality – Once your blood starts flowing, oxygen flow increases and you become much more alert. Despite the fact that your heart rate goes down once you’re accomplished, your body is nonetheless functioning and energized. The elevated blood flow to your brain and healthful meal choices during the day will hold you feeling motivated to tackle something in the course of the day.


• 
  Freedom – As much as you adore fitness, at times the imagined of operating out soon after a lengthy day would seem a bit dreadful. If you modify your sleeping to nonetheless get eight sound hours, wake up earlier than you used to and push out a killer treadmill work out, the rest of your day is free of charge. This will give you time to do a lot more issues you love or just chill out at home.

Sample Workout

I’ve supplied a sample exercise to get you started on your new fitness journey. Usually be certain to warm up soon after you wake up to get your muscles and joints loosened. The time column lets you know how extended you need to be operating for. The pace column offers three numbers for newcomers, intermediate and advanced runners, respectively. The percentage in the incline column represents in which your incline must be. You close out with one particular fast sprint to really set the tone for your day.

Warm Up
Time	Velocity	Incline
two minutes	five/six/seven
one minute	6/seven/8
one minute	six/7/eight	2%
thirty seconds	7/8/9	2%
1 minute	6/seven/8	2%
30 seconds	seven/eight/9	two%
one minute	6/seven/eight	2%
30 2nd sprint	eight/9/10	two%
Cool Down
1 minute	four/5/six	%

Right after you finish your treadmill exercise, consider a great shower and grab a wholesome breakfast to refuel your physique for the upcoming day. You should be feeling upbeat, energized and ready to get on the world.

Assets:

http://www.livestrong.com/post/287708-does-operating-out-in-the-morning-speed-up-metabolism/

About the Author: Kevin Jones is a freelance writer and fitness instructor/advisor. He had aided hundreds of folks locate techniques to turn into far more fit and healthy by way of an individualized method. In addition, Kevin has written extensively in the fitness and overall health industries, including creating for businesses this kind of as ICON Fitness for the two the NordicTrack and ProForm brands. Connect with Kevin online LinkedIn – Twitter

Make Individuals Early Mornings Extraordinary With A Short Treadmill Workout

Quick ladies a lot more most likely to have short pregnanices and premature births

Shorter women have shorter pregnancies and smaller babies, in accordance to new research.

And the examine suggests they are also at higher danger of offering birth prematurely.

Researchers studied three,485 Nordic females and their infants, and found that maternal height, which is established by genetic variables, influenced the length of pregnancy and frequency of prematurity. But birth length and birth bodyweight are mainly influenced by transmitted genes.

Babies who survive an early birth face severe and lifelong health problems, like breathing troubles, jaundice, vision reduction, cerebral palsy and intellectual delays.

Medical doctor Joe Leigh Simpson, senior vice president for analysis at the March of Dimes Prematurity Investigation Centre in the US, explained: “A key objective of the nationwide network of March of Dimes prematurity research centres is identifying genes that govern foetal growth and length of pregnancy.

• Revolutionary new 10-minute check ‘can premature births’

“That a woman’s height influences gestational length, independent of the genes she passes on that decide foetal size, is a key discovering by our investigation networks, and the 1st of what we assume to be numerous genetic contributions.”

Doctor Jennifer Howse, president of the March of Dimes, stated: “The revolutionary, group-based model of our prematurity study centers is vital to knowing the unknown brings about or preterm birth.

“This new obtaining adds a single tiny piece towards solving the considerably greater puzzle of preterm birth.”

• Mothers and fathers who ignored doctors’ suggestions to abort premature child celebrate his initial birthday

Doctor Louis Muglia, the major investigator and co-director of the Perinatal Institute at Cincinnati Children’s Hospital Health care Centre, additional: “Our finding demonstrates that a mother’s height has a direct impact on how long her pregnancy lasts.

“The explanation for why this happens is unclear but could rely not only on unknown genes but also on woman’s lifetime of nutrition and her surroundings.”

Quick ladies a lot more most likely to have short pregnanices and premature births

Police fitness exams stats present hundreds falling short

The worst failure rates for the fitness exams had been observed in Suffolk, West Midlands, West Mercia/Warwickshire and Gwent. Photograph: Steve Phillips/Alamy

Hundreds of police officers have failed new fitness tests which are due to turn out to be necessary later on this year, official figures present.

Interim results submitted by 39 forces to the School of Policing showed that 851 officers fell brief, with 3% failing general in a lot more than thirty,000 exams.

Right after taking element in the 15-metre “bleep” shuttle run check, some 253 of the 22,078 male officers who took portion (an average of one%) and 598 of 7,969 female officers (an average of eight%) had been unsuccessful.

The new fitness testing, which will grow to be compulsory in September, was brought in right after suggestions produced by chief inspector of constabulary Tom Winsor.

The worst failure charges had been observed in Suffolk (7%), West Midlands (five.8%), West Mercia/Warwickshire (5.6%) and Gwent (5.5%).

Humberside and Northumbria police have been the only two forces out of a total of 43 in England and Wales who boasted a a hundred% pass prices for both male and female officers.

Information is even now not obtainable for the Metropolitan police, the country’s biggest force, Lancashire, Gloucestershire and Cumbria.

The Winsor suggestions stated that all officers should be produced to consider a “bleep” check annually, with participants having to full a 15-metre shuttle run in shorter and shorter intervals, reaching degree 5.4 – 4 shuttles at degree five.

Officers with special units are expected to complete at greater amounts, with dog handlers needed to total level 5.7 and firearms officers able to do degree seven.six.

Winsor also advised that from 2018 the exams should be created harder, utilizing problems primarily based on the kind of factors an officer may well encounter on duty, but this is becoming regarded by the School of Policing in case it negatively impacts on women.

Assistant chief constable Rob Price explained: “The outcomes to date are encouraging and show the huge bulk of officers examined are match.

“Police forces are sending their results to the college on a quarterly basis and an equality influence evaluation is becoming carried out on those final results.

“New advice will be issued to forces later on this 12 months with a powerful emphasis on delivering supportive measures to support officers pass the check.”

Police fitness exams stats present hundreds falling short