Forward View Research Articles

Retrieving snow and ice characteristics by remotely sensed emissivity using the multi-view brightness temperature within 8 μm to 14 μm

This study provides a method determining the characteristics of snow and ice with remote sensing by converting top of atmosphere brightness temperature to surface emissivity which depends on wavelength and observation angle with respect to snow and ice properties.Envisat's Advanced Along-Track Spectral Radiometer (AATSR) features dual-view thermal infrared measured brightness temperature. Using bands 11μm and 12μm in nadir and forward (55°) view and a total column water vapour (TCWV) product from Medium Resolution Imaging Spectrometer (MERIS), we obtain four measurements per pixel. We retrieve three surface emissivities ε(λ,θ) per pixel calculated from simulated surface temperatures related to 11μm/nadir view values.We define emissivity “classes” for different snow grain sizes from angular and spectral field measurements of snow grain size and emissivity above snow and ice from Hori et al. (2006, 2007): fine, medium, coarse, suncrust, and ice. Remaining pixels are either indistinct between classes, unclassified, or invalid. Temperatures above the freezing point label pixels as wet. Analysing 26 AATSR scenes in 2007 and 2008, we retrieve a high portion of classification in Greenland, Antarctica, and the sea ice of the Hudson Bay. Steep and heterogeneous topography may cause invalid and unclassified pixels in Eurasia. Close to coasts we generally find a higher snow temperature and a large number of wet pixels.

Reimagining Undergraduate Health and Social Care Education: A Workforce Fit for Purpose in a Changing Landscape of Care. A Position Paper

NHS England’s Five Year Forward View outlines new care models and the need for a workforce that has the skills, values, and competencies to deliver this vision. This is a position paper detailing the context, method, and intentions of a Health Education England funded project led by Manchester Metropolitan University in the North West of England, which the authors see as making a key contribution to addressing issues of illness, crisis, and loss in the changing landscape of health and social care provision in England. Using an action research methodology and drawing together key stakeholders from the sector, the project aims to explore the potential for creating a professional health and social care graduate workforce which meets the needs of an integrated service delivery landscape by identifying key issues to be addressed when redeveloping the undergraduate curriculum.

GPN action plan

Nurse PrescribingVol. 15, No. 9 EditorialGPN action planSophie GardnerSophie GardnerSearch for more papers by this authorSophie GardnerPublished Online:8 Sep 2017https://doi.org/10.12968/npre.2017.15.9.421AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Hawking S. Jeremy Hunt can attack me all he wants – but he is wrong to say the NHS is working. 2017. https://www.theguardian.com/commentisfree/2017/aug/25/jeremy-hunt-attack-nhs-stephen-hawking-crisis (accessed 29 August 2017) Google ScholarNHS England. General Practice Forward View. 2016. https://www.england.nhs.uk/wp-content/uploads/2016/04/gpfv.pdf (accessed 29 August 2017) Google ScholarNHS England. General Practice—Developing confidence, capability and capacity. A ten point action plan for General Practice Nursing. 2017 https://www.england.nhs.uk/wp-content/uploads/2017/07/general-practice-nursing-ten-point-plan.pdf (accessed 29 August 2017) Google Scholar FiguresReferencesRelatedDetails 2 September 2017Volume 15Issue 9ISSN (print): 1479-9189ISSN (online): 2052-2924 Metrics History Published online 8 September 2017 Published in print 2 September 2017 Information© MA Healthcare LimitedPDF download

Research: Stepping into the void: The role of psychology in addressing the rise of long term conditions

The NHS Five Year Forward View champions the use of person-centred models of care as a means to prevent long term conditions. However the training needs of staff appears to have been overlooked. Psychologists can help to bridge this gap.

Ills, pills, and skills: developing the clinical skills of pharmacists in general practice.

The recent national pilot — ‘Clinical Pharmacists in General Practice’1 — heralded in the General Practice Forward View, has enabled 500 pharmacists to potentially have patient-facing, practice-employed roles within general practice, with a further 1500 pharmacist roles planned by 2020. This staff-bolstering scheme, along with new opportunities for other allied healthcare professionals in primary care, comes in response to current concerns about general practice workforce capacity, where modelling around staff recruitment, retention, and retirement have raised concerns about shortfalls in GP numbers.2 Despite the optimistic assertions presented in the ‘next steps’ review of the Five Year Forward View regarding GP workforce,3 NHS data have recently identified an overall reduction of 96 (0.3%) in the numbers of full-time equivalent GPs in the 12 months to September 2016.4 Such GP workforce issues have led general practices to consider strategies for coping with increasing workload,5 including employing clinical pharmacists in patient-facing roles. Pharmacists have traditionally had dispensing roles, though their degree-level training suggests that their potential has not been fully realised. Research evidence indicates that they can contribute favourably to clinical outcomes in primary care.6 Furthermore, increasing multimorbidity and polypharmacy across the population is contributing to the complexity of clinical care.7 Given this context, it seems reasonable to suggest that having additional medication-focused expertise within general practice teams may be of potential benefit. The Royal College of General Practitioners (RCGP), in the context of describing the MRCGP Clinical Skills Assessment (CSA), …

Tackling staff shortages means lifting the pay cap

NHS England launched the General Practice Forward View (GPFV) in April 2016 to address increasing demand, an ageing population, people living longer with multiple complex health conditions and greater acuity in primary and community care settings.

Compact polarization-based dual-view panoramic lens.

Panoramic annular lens (PAL) is a type of special optical system that can transform the cylindrical side view onto a planar annular image. We propose a compact polarization-based dual-view panoramic lens to solve the two major limitations of the conventional PAL structure: large front annular lens and lack of forward view. Dual-view imaging capability, which is highly needed for some applications, is achieved by using a polarization technique. The diameter ratio of the proposed front PAL lens and the sensor is reduced to less than 1.5, while it is larger than 2.5 for traditional PAL systems, expanding its applications in space-confined environments.

Using action research for workforce development and planning in integrated care

Introduction: Context – The NHS England (NHSE) Five Year Forward View (2015) aims to improve health, the quality of care and the predicted financial gap of 30 billion pounds by 2021. Strategic initiatives include prevention and self-care; enhancing primary care; efficiency measures; technology and innovation; workforce development; ‘local’, ‘joined up' services delivered ‘out of hospital’. In 2015, 29 ‘vanguard’ sites were chosen as part of the NHS New Care Models Programme to develop and test different, innovative, local models of integrated care. These models include ‘multispecialty community provider’, ‘enhanced health in care homes’, ‘acute care collaborations’,’ urgent and emergency care collaborations’ and ‘primary and acute care’ systems. The Sunderland ‘multispecialty community provider’ site is in the northeast of England (high deprivation). Risk stratification shows that 3% of the population account for 50% of the health/social care spend (frail elderly with 2 or more co-morbidities with high risk of hospital admission). Three models have been developed – Enhanced primary care; Community integrated teams (one in each of the 5 areas of the city); a Recovery at home service to facilitate early discharge and prevent re-admission. The problem – Workforce planning ‘across the system’ had not been addressed. Key issues - Historic recruitment challenges, workforce engagement, change management and governance. Practice change implemented: Action research to support the development of the workforce to deliver integrated care. Aim and theory of change: Research questions: What are the skills, knowledge and behaviours which staff need to work in integrated care to deliver high quality effective care for patients? How can current workforce development and planning approaches be improved and delivered? Action research includes phases of action and evaluation, with findings fed back into the service developmental process. It is useful when there is little evidence of best practice, where new roles/services are being developed, or there is potential for tension across services. It can also support behavioural change. The research includes documentary analysis, semi-structured interviews and focus groups. Targeted population/stakeholders: System leaders, frontline health/social care staff, patients/carers Timeline: January 2016 - April 2017 (3 phases) Highlights: Documentary analysis and scoping interviews with ‘system leaders’ in phase 1 elicited themes/challenges which have been translated into actions and are being implemented and evaluated (report Autumn 2016). Sustainability: The process/outputs will be evaluated as part of the final report Transferability: Findings are fed back to participants for validation and the New Care Models workstream to share learning and develop the evidence base. Conclusions: Phase 1 themes/challenges: • Day-to-day management • Team-working • The change process • Technology skills • Mental health skills • Patient/carer engagement and co-production • Clinical pathway development • Care co-ordination • Holistic care skills - prevention and self-care Discussion: Phase 1 results have provided a focus for the development of a workforce strategy for integrated care. Action research appears to support the engagement and development of the workforce – this will be tested further in phase 2/3. Lessons learned: To date: Building trust to share information/learning between partner organisations from the onset

Quality Expeditions for GP Federations

Introduction : The five-year forward view for the English NHS sets out an ambition to integrate care by decisively breaking down the barriers in how care is provided between family doctors and hospitals, between physical and mental health, between health and social care. The future will see far more care delivered locally but with some services in specialist centres, organised to support” (The NHS five-year forward view). One of the proposed model to do this would bring together GPs with nurses and other community health services, hospital specialists and perhaps mental health and social care to create integrated out-of-hospital care as the Multispecialty Community Provider. Across England many GP practices, presently small independent businesses have started to fall into groups or GP federations with an ambition to develop new care models. At present many of these organisations are emergent, have poorly defined infrastructure including the infrastructure to deliver quality at the scale of their ambition. We see this as an opportunity to embed quality as a core founding principle of these organisations. integrated care, person centred care and population level responsibility are hallmarks of these new models, we wish to help GP Federations develop Quality Strategies based on these aspects. Recognising that there is an is often a disconnection between evidence conducted on single disease populations with participation from a narrow band of the population to patients with multiple diseases and complicated integrating needs both health and social and mindful that research is often conducted within the dominant paradigm that health is an absence of disease; rather than an ability to cope with life challenges, contribute and feel content whilst also living with multiple conditions. We have developed an approach to allow emerging organisations to explore quality and to develop their own quality strategies and frameworks. Target Audience : Those in or supporting the emergence of integrated care models or with an interest in Quality in an integrated care context. Workshop Objectives : To explore with the delegates a participative approach to the development of Quality Strategies and how quality approaches should be developed in integrated care organisations. Much of our methodology of the delivery of the event has been adapted from the Hackathons methodology as it is applied to healthcare. During events teams are led through a series of sprints, each addressing a particular aspect of quality. We make available resources, and subject experts either in person or via IT links he wouldn’t be available to be engaged as the teams see that as part of their quality expedition. The structure provided by the sprints or help guide the teams to consider quality within the context of integrated new models of care, covering Planning – quality control and quality improvement & innovation (after Juran’s trilogy). During a workshop there would be opportunity to experience a sprint as well as discuss the learning points from our experience of applying the methodologies.

A novel use of QR code stickers after orthopaedic cast application.

INTRODUCTION We present a novel solution to ensure that information and contact details are always available to patients while in cast. An information sticker containing both telephone numbers and a Quick Response (QR) code is applied to the cast. When scanned with a smartphone, the QR code loads the plaster team's webpage. This contains information and videos about cast care, complications and enhancing recovery. METHODS A sticker was designed and applied to all synthetic casts fitted in our fracture clinic. On cast removal, patients completed a questionnaire about the sticker. A total of 101 patients were surveyed between November 2015 and February 2016. The questionnaire comprised ten binary choice questions. RESULTS The vast majority (97%) of patients had the sticker still on their cast when they returned to clinic for cast removal. Eighty-four per cent of all patients felt reassured by the presence of the QR code sticker. Nine per cent used the contact details on the cast to seek advice. Over half (56%) had a smartphone and a third (33%) of these scanned the QR code. Of those who scanned the code, 95% found the information useful. CONCLUSIONS This study indicates that use of a QR code reassures patients and is an effective tool in the proactive management of potential cast problems. The QR code sticker is now applied to all casts across our trust. In line with NHS England's Five Year Forward View calling for enhanced use of smartphone technology, our trust is continuing to expand its portfolio of patient information accessible via QR codes. Other branches of medicine may benefit from incorporating QR codes as portals to access such information.

STPs need money to succeed.

British Journal of NursingVol. 26, No. 12 RegularsSTPs need money to succeedIan PeateIan PeateSearch for more papers by this authorIan PeatePublished Online:22 Jun 2017https://doi.org/10.12968/bjon.2017.26.12.653AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Alderwick H, Dunn P, McKenna P, Walsh N, Ham C (2016) Sustainability and Transformation Plans in the NHS: How Are They Being Developed in Practice? The King's Fund, London. http://tinyurl.com/jcp9p5s (accessed 7 June 2017) Google ScholarBritish Medical Association (2017) £9.5bn capital funding needed to deliver STPs. News, 13 February. http://tinyurl.com/ybwlb4b5 (accessed 7 June 2017) Google ScholarNHS England (2014) Five Year Forward View. October. https://tinyurl.com/oxq92je (accessed 7 June 2017) Google ScholarNHS England (2016a) Sustainability and Transformation Plan Footprint. http://tinyurl.com/y8ktwogu (accessed 7 June 2017) Google ScholarNHS England (2016b) Health and care bodies reveal the map that will transform healthcare in England. News, 15 March. http://tinyurl.com/yb9asr9y7 (accessed 7 June 2017) Google Scholar FiguresReferencesRelatedDetails 22 June 2017Volume 26Issue 12ISSN (print): 0966-0461ISSN (online): 2052-2819 Metrics History Published online 22 June 2017 Published in print 22 June 2017 Information© MA Healthcare LimitedPDF download

News

Gastrointestinal NursingVol. 15, No. 4 NewsNewsSue LearnerSue LearnerSearch for more papers by this authorSue LearnerPublished Online:18 May 2017https://doi.org/10.12968/gasn.2017.15.4.6AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Olivia Newton-John Cancer Wellness & Research Centre (2017) Tumour breakthrough boosts gastrointestinal cancer hopes. https://tinyurl.com/mb9e9jb (accessed 24 April 2017) Google ScholarPoh AR, Love CG, Masson F et al. (2017) Inhibition of hematopoietic cell kinase activity suppresses myeloid cell-mediated colon cancer progression. Cancer Cell 31(4): 563–75. https://doi.org/https://doi.org/10.1016/j.ccell.2017.03.006 Crossref, Google ScholarCancer Research UK (2017) Cancer incidence for common cancers. https://tinyurl.com/op8d9oa. (accessed 24 April 2017) Google ScholarCao Y, Wu K, Mehta R et al. (2017) Long-term use of antibiotics and risk of colorectal adenoma. Gut (online). https://doi.org/https://doi.org/10.1136/gutjnl-2016-313413 Crossref, Google ScholarBBC News (2017) Childhood obesity: cut unhealthy food multi-buy offers – MPs. http://tinyurl.com/kn8x4wo (accessed 24 April 2017) Google ScholarGelaye B, Sacco S, Brown WJ et al. (2017) Body composition status and the risk of migraine: a meta-analysis. Neurology (online). https://doi.org/https://doi.org/10.1212/wnl.0000000000003919 Crossref, Google ScholarScience Daily (2017) Majority of incontinence treatments deliver poor results. http://tinyurl.com (accessed 24 April 2017) Google ScholarCancer Research UK (2017) NHS England sets target of 5,000 more people each year surviving cancer. https://tinyurl.com/lpjnyv7 (accessed 24 April 2017) Google ScholarNHS England (2014) Five Year Forward View. https://tinyurl.com/oxq92je (accessed 24 April 2017) Google ScholarNHS England (2017) Next steps on the NHS Five Year Forward View. https://tinyurl.com/m8shskk (accessed 24 April 2017) Google Scholar FiguresReferencesRelatedDetails 2 May 2017Volume 15Issue 4ISSN (print): 1479-5248ISSN (online): 2052-2835 Metrics History Published online 18 May 2017 Published in print 2 May 2017 Information© MA Healthcare LimitedPDF download

General practice: the heart of the NHS

General practice is often hailed as the jewel in the crown of the NHS.1 However, a decade of underfunding, increasing patient complexity, issues with recruitment, and rising bureaucracy have led to a loss of its lustre. Amid a drive to move care into the community we continue to have the most stressed GPs in the Western world.2 This is doubtless impacting on junior doctors and medical students contemplating a career in general practice, as highlighted by Professor Wass’s recent report By Choice — Not by Chance .3 It is general practice that makes the NHS one of the world’s most cost-effective health services, yet spend on general practice continues to be outstripped by that on hospital outpatient clinics alone. Never before has the need for an optimised version of general practice felt more critical to the long-term sustainability of the NHS. As Roland and Everington write, ‘If general practice fails, the whole NHS fails.’ 4 The General Practice Forward View (GPFV) was launched in April 2016 by NHS England and Health Education England, with the support of the RCGP. It is a complex plan for a complex set of issues that have besieged primary care for too long.5 NHS England is backing this plan with a 14% real-terms increase in funding to support general practice services over 5 years. This is almost double the investment going into other parts of the NHS, and a notable change from a system that has historically prioritised the acute sector. At a time of austerity, this remarkable shift seeks to both stabilise …

Digitising the NHS (again)

British Journal of NursingVol. 26, No. 5 RegularsDigitising the NHS (again)Ian PeateIan PeateSearch for more papers by this authorIan PeatePublished Online:22 Mar 2017https://doi.org/10.12968/bjon.2017.26.5.257AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Honeyman M, Dunn P, McKenna H for the King's Fund (2016) A Digital NHS? An Introduction to the Digital Agenda and Plans for Implementation. http://tinyurl.com/z2cdjvo (accessed 16 February 2017) Google ScholarNational Information Board (2016) National Information Board Annual Report. http://tinyurl.com/zmp96dq (accessed 16 February 2017) Google ScholarNHS England (2014) Five Year Forward View. http://tinyurl.com/oxq92je (accessed 16 February 2017) Google Scholar FiguresReferencesRelatedDetails 9 March 2017Volume 26Issue 5ISSN (print): 0966-0461ISSN (online): 2052-2819 Metrics History Published online 22 March 2017 Published in print 9 March 2017 Information© MA Healthcare LimitedPDF download

Developing the practice manager workforce

Following the announcement of the general practice development programme as part of the General Practice Forward View, Dave Hancock looks at the training available now and promised for the future

Medical leadership – in the scrum or shouting from the sidelines?

As has often been the case in its nearly 70-year history, the NHS finds itself in difficult times with very real clinical and financial sustainability challenges and a need to transform itself. The vision has been laid out in the Five Year Forward View, but if there was a 'how-to' manual for delivery it could be argued that it isn't always completely clear and some chapters are incomplete. In the context of change in the modern NHS, medical leadership is often spoken about as being key and yet what this means varies between different people and at different times and on a whole spectrum of scale, from small projects to whole health-economy redesign. This article consists of some personal reflections on what it feels like to be in the midst of both.

Commissioning through competition and cooperation in the English NHS under the Health and Social Care Act 2012: evidence from a qualitative study of four clinical commissioning groups

ObjectiveThe Health and Social Care Act 2012 (‘HSCA 2012’) introduced a new, statutory, form of regulation of competition into the National Health Service (NHS), while at the same time recognising...

Ensuring fair care for people with multiple sclerosis.

In November 2016, the MS Trust published the MS Forward View: a consensus for the future of multiple sclerosis (MS) services.

A new approach to mental health in primary care

Nav Chana, Chairman of the National Association for Primary Care, reflects on the NHS Forward View for Mental Health and the importance of primary care in supporting patients with mental health issues

The NHS Healthy New Towns programme.

The NHS Healthy New Towns programme was developed as an initiative to improve health in communities. In this article, Holly Norman and Daniel McDonnell from the programme describe how this initiative is helping to shape health through the built environment.[Image omitted: See PDF.]In 2014, the Five Year Forward View fired a starting gun in the race to transform health and health care in England.[1] The future vision set out in this document signalled change in many ways: delivering a 'radical upgrade in prevention', moving to new health care 'operating systems' drawing on game-changing technologies and expanding the horizons of the national health system to take in new themes and perspectives.[1]One of the current National Health Service (NHS) programmes that embodies these changes most comprehensively is the Healthy New Towns programme, which partners housing developments with the NHS in order to build better environments for health.[2]As the nation grapples with a national housing shortage, the rapid development of new places and communities forces the question of how health and the wider public sector pull together to turn the ambitions of the Forward View into reality.[3] There is a double imperative here. First, we must ensure that we take steps to protect the health of populations by seizing the chance to embed positive planning and design decisions that will shape places for generations. Second, new developments offer the opportunity to fast-track ideas and inspire existing communities to deliver the radical changes the NHS needs.The potential of new developments to fulfil this second ambition was initially conceived in terms of opportunities to accelerate development of integrated care models and 'design modern services from scratch'.[4] This means thinking hard - and fast - about the implications of the emerging 'Vanguard' care models for healthcare estates and technological infrastructure, demonstrating to the rest of nation what the future might look like as these new models roll out across the country.[5]Ambitions for the programme have evolved rapidly, with equal emphasis now placed on 'shaping new towns, neighbourhoods and strong communities that promote health and wellbeing, prevent illness and keep people independent'.[4] Ideas that bridge public health and planning communities find a home here, such as using planning and design that brings together disciplines and partners to create inclusive public spaces that draw communities together and reduce social isolation or laying out infrastructure to make walking and cycling more appealing options than getting in a car. Combining such approaches with state-of-the-art behavioural insights will help deliver new places in which the easiest choice is also the healthiest choice.Linking the urgent need to build more new homes to building better, healthier homes, the Healthy New Towns programme has hit a vein of interest and support across the country as well as throughout Whitehall. The 10 sites with which the NHS will partner through the programme were announced to press fanfare in March 2016, having been chosen from more than 100 applicants after a selection process lasting five months.[6]-[8] Sites were put forward from every region, ranging from developments of a few hundred households to entirely new towns and suburbs where tens of thousands of people will eventually live. Sites' proposals differed to reflect local circumstances, but all applications shared an enthusiasm to take a holistic place-based approach to public health and healthcare services. They also had in common an appetite to exploit the opportunities for innovation afforded by focussing on new developments less constrained than other places by existing infrastructure such as general practioners' (GP) surgeries, schools and other public buildings that lock-in established behaviours and traditional service models. …