The Coffee Break 78

News updates this fortnight primary care, improvement, leadership and innovation.


Primary Care

Firstly this fortnight we look at a report by the Scottish Parliament Information Centre investigating how primary care operates in Scotland and posing the question what does primary care look like for the next generation? The Scottish government has produced a number of policies to move care out of hospital and into the community. In 2011, against changing demography, the economic environment and the Scottish public health record, the Scottish Government set out its strategic vision for achieving sustainable quality in the delivery of healthcare services. The 2020 Vision’s ambitions includes “by 2020 everyone is able to live longer healthier lives at home, or in a homely setting”.

Moving on, in a blog post the Kings Fund discusses the creation of Primary Care networks and mental health services. The long-term plan commits to improving ‘core’ community mental health services, this will certainly overlap with primary care and in doing so will bring investment into services. “It presents PCNs with the opportunity to work with mental health trusts to develop an integrated offer across primary and secondary care, including groups of people who have traditionally been excluded from both”.



An article in the Harvard Business Review discusses research that shows it takes about 17 years for hospital and clinics to adopt a new practice or treatment after the first systematic evidence shows it helps patients. Problems with new practices conflicting with existing ones means that trying to adopt and integrate new practices can be extremely difficult. ‘Tweaking’ the new practice or deviating from the evidence base in order to fit into to an organisations’ existing environment can weaken the effectiveness of the practice and lessen the benefit. Therefore, health care leaders have to balance the needs of adhering to standards and customizing the practice for the local context. The article explains four approaches in adapting evidence based practices while staying close to the foundational evidence.



A commentary published by Dovepress looks at healthcare leadership in the United States. The author encourages healthcare leaders to be bold and forge ahead to work towards population-based healthcare and invest within communities. The article acknowledges that much is being done but argues that more needs to be done in order to improve the health of the community. “Research shows that investing in social care services and community-based investments results in lower health care expenditures and better health outcomes”.



A recently published report by Reform looks at data driven technology and their applications in mental health. With nearly 10,000 mental health apps available to download the NHS is keen to catch up and in 2017 announced a £67.7 million funding package to develop digital mental health services. However, the value of data-driven technologies in mental healthcare extends far beyond apps. “By opening up new types of data collection and analysis, data-driven technologies present opportunities to advance understanding of the causes of mental illness, improve detection and diagnosis, and help redesign services around the needs of patients.”

And finally this week, with all this rain we many have forgotten about the soaring temperatures of a week or two ago but an NHS England and NHS Improvement news item praises NHS ‘Heat Heroes’ for braving record temperatures to help patients keep cool. Heat busting strategies included free ice creams and lollies for hospital staff; ‘hydration stations’ in London’s hospitals; ‘water buses’ and even heat alerts provided by a health care assistant from his personal weather station.