ABSTRACT Purpose – The purpose of this paper is to introduce and present the first findings of a ... more ABSTRACT Purpose – The purpose of this paper is to introduce and present the first findings of a new English performance indicator in the primary healthcare of adults with Down syndrome. This is a performance target, with associated bonus payment, requiring General Practitioners (GPs) to undertake annually a screening blood test for thyroid hormone deficiency. Design/methodology/approach – Analysis and review of data collected from all GP practices and published by the National Health Service (NHS) Information Centre. Findings – In total, 82 per cent of those identified as in the target group were screened and 10 per cent were identified as not wanting to be screened or screening inappropriate. The target group numbered just over 60 per cent of the number estimated from epidemiological and other studies. The numbers of cases involved is small (0, 1 or 2 cases in 75 per cent of GP practices), and whilst variation in coverage at local level appears important, numbers are too small for the variations seen in the first year's data to be statistically significant. The scope of the data precludes useful strategic analysis of the value of the intervention. Research limitations/implications – Data from several years need to be taken together. The NHS Information Centre should slightly increase the scope of the data to allow analysis of whether the programme is having useful public health benefits. Originality/value – The paper examines a new data source and makes points applicable to a wider range of similar datasets in the same programme.
Background: The deployment of (Trainee) Associate Psychological Practitioners (T/APPs) to deliver... more Background: The deployment of (Trainee) Associate Psychological Practitioners (T/APPs) to deliver brief psychological interventions focusing on preventing mental health deterioration and promoting emotional wellbeing in General Practice settings is a novel development in the North West of England. As the need and demand for psychological practitioners increases, new workforce supply routes are required to meet this growth. Aims: To evaluate the clinical impact and efficacy of the mental health prevention and promotion service, provided by the T/APPs and the acceptability of the role from the perspective of the workforce and the role to T/APPs, patients and services. Methods: A mixed-methods design was used. To evaluate clinical outcomes, patients completed measures of wellbeing (WEMWBS), depression (PHQ-9), anxiety (GAD-7) and resilience (BRS) at the first session, final session and at a 4–6 week follow-up. Paired-samples t-tests were conducted comparing scores from session 1 and se...
The handbook, commissioned by the UK National Screening Committee [UK NSC], Describes the context... more The handbook, commissioned by the UK National Screening Committee [UK NSC], Describes the context, and outlines evidence for a co-ordinated vascular disease control programme to identify and reduce risks of cardiovascular disease in the population. Suggests aims, objectives and a delivery strategy framework appropriate for a Cardiovascular Disease (CVD) risk management programme. Reports key messages from the Diabetes, Heart Disease & Stroke (DHDS) pilot project. Provides examples of tools, resources and standard operating procedures that can be used by health professionals, many of whom are already undertaking some CVD risk assessment in a variety of ways
Background Concerns have repeatedly been expressed about the quality of healthcare that people wi... more Background Concerns have repeatedly been expressed about the quality of healthcare that people with learning disabilities receive in the NHS. Clinical audit can be an effective method for improving the quality of healthcare especially when existing standards are poor. This feasibility study for a national audit of learning disabilities examined the acceptability of data collection methods and the role that audit data could play in raising the standard of care provided. The audit team used these results to recommend how a future national audit should be conducted, including recommendations for standards, recruiting services, data collection methods, and helping services use audit data to improve the quality of care they provide. Findings Results of the study confirm that the quality of care for people with learning disabilities falls below recommended standards. Variation in practice across study sites suggests that it is possible to improve the quality of care people receive. Primar...
Public Health England estimates that every day 30,000 to 35,000 adults with a learning disability... more Public Health England estimates that every day 30,000 to 35,000 adults with a learning disability are wrongly taking a prescribed antipsychotic, antidepressant or both. These are psychotropic drugs. Unnecessary use of these drugs, puts people at risk of significant weight gain, organ failure and even premature death. The workshop and presentation helped to define the problem across Lancashire, challenges, solutions, what help and support available for GP's to carry out their role in delivering the STOMP agenda
Introduction: Type 2 diabetes is a common and serious disease for which selective screening in ce... more Introduction: Type 2 diabetes is a common and serious disease for which selective screening in certain population subgroups has been recommended . Targeted screening using routinely collected clinical data to create a risk score has been developed and tested in the UK. This risk score has been further assessed in South Asian populations. Both Body Mass Index (BMI) and waist circumference (WC) are surrogate measures of obesity, a major determinant of Type 2 diabetes.Numerous BMI cut-off points exist depending on ethnicity as the relationship between BMI and body fat content varies according to body build and body proportion. WC is a simple measure of central adipose tissue accumulation. Method: The following risk factors were used to create a risk score: gender, age, treatment for hypertension, smoking, BMI categories of 25, 25–27.49, 27.5–29.99 and 30 and the following proposed WC risk categories: Logistic regression was carried out on the same population sample identified by Spijke...
This guideline covers care and support for adults with cerebral palsy. It aims to improve health ... more This guideline covers care and support for adults with cerebral palsy. It aims to improve health and wellbeing, promote access to services and support participation and independent living. A list of downloadable documents created during development available at: https://www.nice.org.uk/guidance/ng119/history
ABSTRACT Purpose – The purpose of this paper is to introduce and present the first findings of a ... more ABSTRACT Purpose – The purpose of this paper is to introduce and present the first findings of a new English performance indicator in the primary healthcare of adults with Down syndrome. This is a performance target, with associated bonus payment, requiring General Practitioners (GPs) to undertake annually a screening blood test for thyroid hormone deficiency. Design/methodology/approach – Analysis and review of data collected from all GP practices and published by the National Health Service (NHS) Information Centre. Findings – In total, 82 per cent of those identified as in the target group were screened and 10 per cent were identified as not wanting to be screened or screening inappropriate. The target group numbered just over 60 per cent of the number estimated from epidemiological and other studies. The numbers of cases involved is small (0, 1 or 2 cases in 75 per cent of GP practices), and whilst variation in coverage at local level appears important, numbers are too small for the variations seen in the first year's data to be statistically significant. The scope of the data precludes useful strategic analysis of the value of the intervention. Research limitations/implications – Data from several years need to be taken together. The NHS Information Centre should slightly increase the scope of the data to allow analysis of whether the programme is having useful public health benefits. Originality/value – The paper examines a new data source and makes points applicable to a wider range of similar datasets in the same programme.
Background: The deployment of (Trainee) Associate Psychological Practitioners (T/APPs) to deliver... more Background: The deployment of (Trainee) Associate Psychological Practitioners (T/APPs) to deliver brief psychological interventions focusing on preventing mental health deterioration and promoting emotional wellbeing in General Practice settings is a novel development in the North West of England. As the need and demand for psychological practitioners increases, new workforce supply routes are required to meet this growth. Aims: To evaluate the clinical impact and efficacy of the mental health prevention and promotion service, provided by the T/APPs and the acceptability of the role from the perspective of the workforce and the role to T/APPs, patients and services. Methods: A mixed-methods design was used. To evaluate clinical outcomes, patients completed measures of wellbeing (WEMWBS), depression (PHQ-9), anxiety (GAD-7) and resilience (BRS) at the first session, final session and at a 4–6 week follow-up. Paired-samples t-tests were conducted comparing scores from session 1 and se...
The handbook, commissioned by the UK National Screening Committee [UK NSC], Describes the context... more The handbook, commissioned by the UK National Screening Committee [UK NSC], Describes the context, and outlines evidence for a co-ordinated vascular disease control programme to identify and reduce risks of cardiovascular disease in the population. Suggests aims, objectives and a delivery strategy framework appropriate for a Cardiovascular Disease (CVD) risk management programme. Reports key messages from the Diabetes, Heart Disease & Stroke (DHDS) pilot project. Provides examples of tools, resources and standard operating procedures that can be used by health professionals, many of whom are already undertaking some CVD risk assessment in a variety of ways
Background Concerns have repeatedly been expressed about the quality of healthcare that people wi... more Background Concerns have repeatedly been expressed about the quality of healthcare that people with learning disabilities receive in the NHS. Clinical audit can be an effective method for improving the quality of healthcare especially when existing standards are poor. This feasibility study for a national audit of learning disabilities examined the acceptability of data collection methods and the role that audit data could play in raising the standard of care provided. The audit team used these results to recommend how a future national audit should be conducted, including recommendations for standards, recruiting services, data collection methods, and helping services use audit data to improve the quality of care they provide. Findings Results of the study confirm that the quality of care for people with learning disabilities falls below recommended standards. Variation in practice across study sites suggests that it is possible to improve the quality of care people receive. Primar...
Public Health England estimates that every day 30,000 to 35,000 adults with a learning disability... more Public Health England estimates that every day 30,000 to 35,000 adults with a learning disability are wrongly taking a prescribed antipsychotic, antidepressant or both. These are psychotropic drugs. Unnecessary use of these drugs, puts people at risk of significant weight gain, organ failure and even premature death. The workshop and presentation helped to define the problem across Lancashire, challenges, solutions, what help and support available for GP's to carry out their role in delivering the STOMP agenda
Introduction: Type 2 diabetes is a common and serious disease for which selective screening in ce... more Introduction: Type 2 diabetes is a common and serious disease for which selective screening in certain population subgroups has been recommended . Targeted screening using routinely collected clinical data to create a risk score has been developed and tested in the UK. This risk score has been further assessed in South Asian populations. Both Body Mass Index (BMI) and waist circumference (WC) are surrogate measures of obesity, a major determinant of Type 2 diabetes.Numerous BMI cut-off points exist depending on ethnicity as the relationship between BMI and body fat content varies according to body build and body proportion. WC is a simple measure of central adipose tissue accumulation. Method: The following risk factors were used to create a risk score: gender, age, treatment for hypertension, smoking, BMI categories of 25, 25–27.49, 27.5–29.99 and 30 and the following proposed WC risk categories: Logistic regression was carried out on the same population sample identified by Spijke...
This guideline covers care and support for adults with cerebral palsy. It aims to improve health ... more This guideline covers care and support for adults with cerebral palsy. It aims to improve health and wellbeing, promote access to services and support participation and independent living. A list of downloadable documents created during development available at: https://www.nice.org.uk/guidance/ng119/history
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Papers by Umesh Chauhan