Hinchingbrooke Health Care NHS Trust


Hinchingbrooke Health Care NHS Trust

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Valsamis E.M.,Hinchingbrooke Health Care NHS Trust | Glover T.E.,Addenbrookes Hospital
BMJ Case Reports | Year: 2017

We describe a case report of a man aged 56 years with a 4-month history of right-sided sciatica-type pain with subclinical disc prolapse evident on MRI. Worsening pain together with the appearance of a tender mass in his right buttock prompted further imaging, which demonstrated an infiltrative mass engulfing the lumbosacral plexus. This was later shown to be a granulocytic sarcoma on biopsy. Intervertebral disc herniation can be an incidental finding and is not always the cause of sciatica.

Subbe C.P.,Bangor University | Jeune I.L.,University of Nottingham | Ward D.,Hinchingbrooke Health Care NHS Trust | Pradhan S.,University of Wales | Masterton-Smith C.,St Thomas Hospital
QJM : monthly journal of the Association of Physicians | Year: 2017

Background: The Society for Acute Medicine's Benchmarking Audit (SAMBA) annually examines Clinical Quality Indicators (CQIs) of the care of patients admitted to UK hospitals as medical emergencies.Aim: The aim of this study is to review the impact of consultant specialty on discharge decisions in the SAMBA data-set.Design and methods: Prospective audit of patients admitted to acute medical units (AMUs) on 25 June 2015 to participating hospitals throughout the UK with subgroup analysis.Results: Eighty-three units submitted patient data from 3138 patients.Nearly 1845 (58%, IQR for units 50-69%) of patients were referrals from Emergency Medicine, 1072 (32%, IQR for units 24-44%) were referrals from Primary Care. The mean age was 65 (SD 20). One hundred and forty-one (4.5%) patients were admitted from care homes and 951 (30%) of patients were at least 'mildly frail' and 407 (13%) had signs of physiological instability. The median and the mean time to being seen by a doctor were 1 h 20 min and 2 h 3 min, respectively. The median and the mean time to being seen by senior specialist were 3 h 55 min and 5 h 56 min, respectively. By 72 h, 29 (1%) patients had died in the AMU, 73 were admitted to critical care units, 1297 (41%) had been discharged to their own home and 60 to nursing or residential homes. For every 100 patients seen specialists in acute medicine discharged 12 more patients than specialists from other disciplines of medicine ( P  < 0.001). The difference remained significant after adjustment for case mix.Conclusion: Specialist in acute care might facilitate discharge in a higher proportion of patients.

PubMed | Hinchingbrooke Health Care NHS Trust
Type: Journal Article | Journal: Nursing standard (Royal College of Nursing (Great Britain) : 1987) | Year: 2016

PREPARATION FOR LEARNING IN A GROUP Group work is an opportunity for sharing ideas, literature, research and initiatives in practice. The learning encounter is enhanced by contributions from a balanced mix to reflect a range of experiences, attitudes and knowledge.

PubMed | Hinchingbrooke Health Care NHS Trust, Bsc hons Psychology. Chairman North Wales Cancer Forum, Consultant Acute, University of Wales and University of Manchester
Type: Journal Article | Journal: Acute medicine | Year: 2016

The Society for Acute Medicine Benchmarking Audit (SAMBA) is an annual national audit in the UK.In SAMBA 2015 patient feedback questionnaires were introduced to help measure the quality of patient experience on Acute Medical Units (AMUs) over a 24-hour period on 25th June 2015.55 AMUs submitted data on 945 patients, of these 824 (87.2%) would be extremely likely or likely to recommend the AMU. Patients below the age of 50 were less likely to recommend the admitting unit (p<0.013). Positive comments were three times more common than critical comments (976 vs 323). Categories of staff attitude, quality of communication, timeliness of care and catering were dominant themes.This survey has identified key themes for patients being managed on an AMU that can be used to guide future innovations.

PubMed | Hinchingbrooke Health Care NHS Trust, Countess of Chester Hospital NHS Trust, Leeds Teaching Hospitals NHS Trust, University of Washington and 12 more.
Type: Journal Article | Journal: Eye (London, England) | Year: 2016

PurposeInternational variations in visual acuity (VA) outcomes of eyes treated for neovascular age-related macular degeneration (nAMD) are well-documented, but intra-country inter-centre regional variations are not known. These data are important for national quality outcome indicators. We aimed to determine intra-country and inter-centre regional variations in outcomes for treatment of nAMD.Patients and methodsProspective multicentre national database study of 13 UK centres that treated patients according to a set protocol (three loading doses, followed by Pro-Re-Nata retreatment). A total of 5811 treatment naive eyes of 5205 patients received a total of 36206 ranibizumab injections over 12 months.ResultsMean starting VA between centres varied from 48.9 to 59.9 ETDRS letters. Mean inter-centre VA change from baseline to 12 months varied from +6.9 letters to -0.6 letters (mean of +2.5 letters). The proportion of eyes achieving VA of 70 letters or more varied between 21.9 and 48.7% at 12 months. Median number of injections (visits) at each centre varied from 5 to 8 (9 to 12), with an overall median of 6 (11). Age, starting VA, number of injections, and visits, but not gender were significantly associated with variation in these VA outcomes (P<0.01). Significant variation between centres persisted even after adjusting for these factors.ConclusionThere are modest differences in VA outcomes between centres in the UK. These differences are influenced, but not completely explained, by factors such as patient age, starting VA, number of injections, and visits. These data provide an indication of the VA outcomes that are achievable in real-world settings.

PubMed | Hinchingbrooke Health Care NHS Trust, Foundation University, Belfast Health and Social Care Trust, University of Washington and 14 more.
Type: Journal Article | Journal: The British journal of ophthalmology | Year: 2015

To study the effectiveness and clinical relevance of eyes treated with good (better than 6/12 or >70 Early Treatment Diabetic Retinopathy Study letters) visual acuity (VA) when initiating treatment with ranibizumab for neovascular age-related macular degeneration (nAMD) in the UK National Health Service. Currently eyes with VA better than (>) 6/12 are not routinely funded for therapy.Multicentre national nAMD database study on patients treated 3-5years prior to the analysis. Anonymised structured data were collected from 14 centres. The primary outcome was the mean VA at year 1, 2 and 3. Secondary measures included the number of clinic visits and injections.The study included 12951 treatment-naive eyes of 11135 patients receiving 92976 ranibizumab treatment episodes. A total of 754 patients had baseline VA better than 6/12 and at least 1-year of follow up. Mean VA of first treated eyes with baseline VA>6/12 at year 1, 2, 3 were 6/10, 6/12, 6/15, respectively and those with baseline VA 6/12 to >6/24 were 6/15, 6/17, 6/20, respectively (p values <0.001 for comparing differences between 6/12 and 6/12-6/24 groups). For the second eyes with baseline VA>6/12, mean VA at year 1, 2, 3 were 6/9, 6/9, 6/10 and those with baseline VA 6/12 to >6/24 were 6/15, 6/15, 6/27, respectively (p values <0.001-0.005). There was no significant difference in the average number of clinic visits or injections between those with VA better and worse than 6/12.All eyes with baseline VA>6/12 maintained better mean VA than the eyes with baseline VA 6/12 to >6/24 at all time points for at least 2years. The significantly better visual outcome in patients who were treated with good baseline VA has implications on future policy regarding the treatment criteria for nAMD patients funding.

PubMed | Hinchingbrooke Health Care NHS Trust and RCN Institute
Type: Journal Article | Journal: Nursing standard (Royal College of Nursing (Great Britain) : 1987) | Year: 2016

There are many differing interpretations of what a seminar actually comprises. The interpretation suggested by de Tornyay and Thompson ( 1987 ) is that of a discussion during which learners take responsibility for the structure and content of an educational encounter. Cooper ( 1979 ) proposed that seminars are particularly useful in the dissemination and critical evaluation of nursing research, and this can take the form of a student- led presentation followed by a whole class participatory discussion.

Quince T.,University of Cambridge | Abbas M.,Queen Edith Medical Practice | Murugesu S.,Imperial College London | Crawley F.,West Suffolk Hospital NHS Trust | And 3 more authors.
BMJ Open | Year: 2014

Objective: To explore undergraduate medical students' attitudes towards and opinions about leadership and management education. Design: Between 2009 and 2012 we conducted a qualitative study comprising five focus group discussions, each devoted to one of the five domains in the Medical Leadership Competency Framework, (Personal Qualities, Working with Others, Managing Services, Improving Services and Setting Direction). Each discussion examined what should be learnt, when should learning occur, what methods should be used, how should learning be assessed, what are the barriers to such education. Participants: 28 students from all three clinical years (4-6) of whom 10 were women. Results: 2 inter-related themes emerged: understanding the broad perspective of patients and other stakeholders involved in healthcare provision and the need to make leadership and management education relevant in the clinical context. Topics suggested by students included structure of the National Health Service (NHS), team working skills, decision-making and negotiating skills. Patient safety was seen as particularly important. Students preferred experiential learning, with placements seen as providing teaching opportunities. Structured observation, reflection, critical appraisal and analysis of mistakes at all levels were mentioned as existing opportunities for integrating leadership and management education. Students' views about assessment and timing of such education were mixed. Student feedback figured prominently as a method of delivery and a means of assessment, while attitudes of medical professionals, students and of society in general were seen as barriers. Conclusions: Medical students may be more open to leadership and management education than thought hitherto. These findings offer insights into how students view possible developments in leadership and management education and stress the importance of developing broad perspectives and clinical relevance in this context.

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