The cost of primary care consultations associated with long COVID in non-hospitalised adults

Tufts, J. et al. | The cost of primary care consultations associated with long COVID in non-hospitalised adults: a retrospective cohort study using UK primary care data | BMC Primary. Care 24, 245 (2023) | https://doi.org/10.1186/s12875-023-02196-1

The economic impact of managing long COVID in primary care is unknown. We estimated the costs of primary care consultations associated with long COVID and explored the relationship between risk factors and costs.

Based on an analysis of 472,173 patients with COVID-19 and 472,173 unexposed individuals, the annual incremental cost of primary care consultations associated with long COVID was £2.44 per patient and £23,382,452 at the national level. Among patients with COVID-19, a long COVID diagnosis and reporting of longer-term symptoms were associated with a 43% and 44% increase in primary care consultation costs respectively, compared to patients without long COVID symptoms. Older age, female sex, obesity, being from a white ethnic group, comorbidities and prior consultation frequency were all associated with increased primary care consultation costs.

The costs of primary care consultations associated with long COVID in non-hospitalised adults are substantial. Costs are significantly higher among those diagnosed with long COVID, those with long COVID symptoms, older adults, females, and those with obesity and comorbidities.

Full paper: The cost of primary care consultations associated with long COVID in non-hospitalised adults: a retrospective cohort study using UK primary care data

Continuity of care: Delayed diagnosis in GP practices

via Health Services Safety Investigations Body

Patients who visit their GP practice with an ongoing health problem may see several different GPs about the same symptoms. To make sure they receive safe and efficient care, there needs to be a system in place to ensure continuity of care. In the context of this report, continuity of care is where a patient has an ongoing relationship with a specific doctor, or when information is managed in a way that allows any doctor to care for a patient.

While some GP practices in England operate a formalised system of continuity of care, many do not. This investigation explored the safety risk associated with the lack of a system of continuity of care within GP practices.

This investigation’s findings, safety recommendations and safety observations aim to prevent the delayed diagnosis of serious health conditions caused by a lack of continuity of care and to improve care for patients across the NHS.

Full report: Continuity of care: delayed diagnosis in GP practices

Transforming health and wellbeing services through population health management

via NHS Confederation

A rising number of NHS organisations are combining traditional approaches – responding to illness where it occurs – with population health approaches that seek to better understand, target and prevent illness. Evidence suggests that when these changes are possible, they bring benefits for systems and citizens.

Understanding how these have developed could help address some of the key challenges of increasing health inequalities and efficient use of resources and, at scale, help health and social care systems to create a better balance between treating existing conditions to preventing illness.

This report explores four case studies where population health and population health management approaches have been developed in recent years and show demonstrable benefits.

Full report: Transforming health and wellbeing services through population health management

Partnering with purpose: how integrated care systems and industry can work better together

via NHS Confederation

This paper captures the learning from a masterclass series, delivered jointly by the NHS Confederation and Association of the British Pharmaceutical Industry, on how integrated care systems and industry can work better together. It was developed, researched and written by both organisations.

Full paper: Partnering with purpose: how integrated care systems and industry can work better together

The future of health care is digital

This month The Health Foundation focusses on the transformational potential of digital technology to support radical innovation and improvement in health and social care – with expert views from the sector and updates about a wide range of our own work in this field:

What will it take for digital technology to finally fulfil its potential?
Director of Innovation and Improvement, Malte Gerhold, thinks technology is an enabler of the fundamental transformation needed in how care is delivered. But only if we genuinely focus on supporting the changes needed to implement it.

A game changer for health care as we know it
Professor Robert Wachter is a respected international voice on health care technology. Following his recent visit to the UK, he explains why now is the time for the NHS to truly harness the potential of AI and digital technology.

AI, virtual wards and digital scribes: embracing digital technology in health
Tara Donnelly, previously Chief Digital Officer for NHS X/NHS England, says when it comes to digital technology, the NHS needs to be bold, paint a positive picture of the future, and listen to what patients want.

Does better tech always mean better health care?
Justine Karpusheff shines a light on new research into the anticipated, but unintended consequences of remote consultations for antibiotic prescribing.

Putting people at the heart of data-driven health systems to address inequalities
Mai Stafford and Josh Keith reflect on partnership work with the Ada Lovelace Institute to explore inequalities in the UK’s digital health services and data-driven health systems, and what we can do to address them.

Exploring public attitudes towards the use of digital health technologies and data
Latest polling shows that overall, the public thinks technology improves the quality of health care and is supportive of its many possible uses – with some exceptions.

Improving health and care at scale: learning from the experience of systems

via NHS Confederation

NHS England has outlined plans to develop an improvement approach – NHS IMPACT – to support continuous improvement. There are also ambitions for integrated care systems to become ‘self-improving systems’.

This report, written and researched by Sir Chris Ham and jointly commissioned by the NHS Confederation, the Health Foundation and the Q community, reviews the experience of a number of ICSs identified as being at the forefront of this work, focusing on the approaches they have taken and the results achieved.

Full report: Improving health and care at scale: learning from the experience of systems

Key points: Improving health and care at scale: learning from the experience of systems

Seasonal trends in antidepressant prescribing, depression, anxiety and self-harm in adolescents and young adults

Jack, R.H. et al. | Seasonal trends in antidepressant prescribing, depression, anxiety and self-harm in adolescents and young adults: an open cohort study using English primary care data | BMJ Mental Health 2023; 26: e300855 | http://dx.doi.org/10.1136/bmjment-2023-300855

The objective of this cohort study was to determine whether there are seasonal patterns in primary care antidepressant prescribing and mental health issues in adolescents and young adults.

The findings show an increase in SSRI prescribing, depression and anxiety incidence in male and female adolescents in the autumn months (September–November) that was not seen in older age groups. These higher rates of antidepressant prescribing and consultations for depression and anxiety at the start of the school year among adolescents suggest that support around mental health issues from general practitioners and others should be focused during autumn. Future research should examine whether these patterns are also seen in younger children and those who do not present to GPs.

Full paper: Seasonal trends in antidepressant prescribing, depression, anxiety and self-harm in adolescents and young adults: an open cohort study using English primary care data

People-centred primary health care: a scoping review

Khatri, R.B. et al. | People-centred primary health care: a scoping review | BMC Primary Care 24, 236 (2023). https://doi.org/10.1186/s12875-023-02194-3

This scoping review aimed to synthesise available evidence on people-centred primary health care (PHC) and primary care. A total of fifty-two studies were included in the review, primarily focusing on patient-centred primary care. Themes under each component of the framework included:

• Engaging and empowering people and communities (engagement of community, empowerment and empathy)
• Strengthening governance and accountability (organisational leadership, and mutual accountability)
• Reorienting the model of care (residential care, care for multimorbidity, participatory care)
• Coordinating services within and across sectors (partnership with stakeholders and sectors, and coordination of care)
• Creating an enabling environment and funding support (flexible management for change; and enabling environment)

Potential strategies for people-centred PHC could be engaging end users in delivering integrated care, ensuring accountability, and implementing a residential model of care in coordination with communities. Flexible management options could create an enabling environment for strengthening health systems to deliver people-centred PHC services.

Full paper: People-centred primary health care: a scoping review

Improvement as mainstream business

via The Health Foundation

Improvement approaches, which provide a systematic means of bringing about measurable improvements in the quality and outcomes of care for patients as well as care productivity, have been in common use in some health care settings for more than 20 years, often producing impressive results where they are deployed well. Yet approaches to improvement are far from being embedded into the core strategy and operations of every health care organisation or system-wide partnership of organisations.

This briefing examines why this is still the case, argues that embedding improvement approaches across all health care settings is now vital, and describes what needs to happen to shift improvement from the margins to the mainstream of health care.

Full detail: Improvement as mainstream business. The strategic case

What do technology and AI mean for the future of work in health care?

via The Health Foundation

Recent developments in artificial intelligence (AI) have sparked fears about the potential threat to jobs in many industries, including health care. Drawing on labour market modelling, this long read analyses what makes health care different from other industries predicted to be more heavily impacted by new technologies.

The article explains that role evolution should not be viewed as a passive process, but should be actively planned and shaped. It calls for a shared vision for how professions and occupations – as well as new roles – should develop with greater use of technology. This vision must be supported by national workforce planning, education and training strategies, and more opportunities for NHS staff to signal the technologies they need.

Full detail: What do technology and AI mean for the future of work in health care?