Accident and Emergency crisis – is there an answer? Read our guest post from Zameel Panthakkalakath


Zameel Panthakkalakath

Zameel Panthakkalakath

As regular readers know one of the big interested of this blog is the use of social media and communications technology to improve patient care and outcome.  So we are delighted to present a guest post by Zameel Panthakkalakath which looks at the uses of smartphones as a way of dealing with the current A&E crisis.  What do you think?  Share your thoughts in the comments section below!

With hospitals reportedly at breaking point due to record numbers of emergency admissions, arguments rage about the root cause of the problems. And as the election approaches, chances of anything more than soundbyte analysis are becoming increasingly slim: apparently, with a sufficient dose of money and staff, all will be well.



What’s not well publicised is that in fact, spending on healthcare is continually increasing, and we’re not seeing the problems being solved. Public expenditure on the NHS doubled between 1997 and 2012, in real terms, yet we’re seeing increasingly poor value for money. The current A&E crisis is just one symptom of this. More cash will act as a sticking plaster providing temporary relief, but it won’t heal the underlying ailment – which is that healthcare delivery systems haven’t kept pace with advances in treatment capabilities and changes in demand. This makes for huge amounts of inefficiency and waste within the system, no matter how hard staff are working and how many hours they put in.

The good news is that the problems are fixable. By redesigning services and processes from scratch to reflect current day needs and incorporate new technologies, we can make resources go much, much further.

The A&E situation gives us some clues about where to start. In 2012-2013, 34.4% of patients visiting A& E received guidance/advice only. Before accusing people of going to A&E unnecessarily, it’s important to remember few people set off to spend hours in a hospital waiting room unless they are genuinely worried. What’s needed is a system that gives people practical alternatives. How many of these 6.3 million people could, for example, have been dealt with more quickly and cheaply had they been able to talk to a doctor over the phone or online?

Whilst some symptoms clearly need hands-on investigation, others do not. Computers and smartphones are bringing us a range of new ways to communicate that don’t require doctor and patient to be face-to-face in the same room. Ofcom figures, for example, show us that at the end of March 2013, 51% of UK adults owned a smartphone and that this rose rapidly over the year to reach a figure of 61% by the end of March 2014. Smartphones offer both internet access and the option to take and send high quality photos and video that doctors could be using for diagnosis.  A short phone or online consultation could very easily give people the information and reassurance they need at far less cost to the NHS than a visit to A&E would involve.

It’s time to look at radical infrastructure reforms that use resources more effectively and look forward to further advances rather than continuing to patch up old systems.  Reorganize the way we deal with non-emergency cases and we’ll achieve two very important goals. One, faster help for those non-emergency patients, and two, safer, high quality care from less pressurized emergency services for those who are in urgent need of hospital care.

 

Zameel Panthakkalakath is a healthcare entrepreneur and consultant committed to improving the patient experience through innovative healthcare delivery.

Having gained practical experience as a medical doctor earlier in his career, his focus is now on finding ways for healthcare services to improve efficiency and cut waste. He believes smartphone medical photography has a key role to play in this, as one of the many elements in emerging mobile health technologies.

He’s keen to share knowledge and help both patients and doctors make the most of the potential of smartphone photography for improved healthcare.

Connect with Zameel and iPhone Medical Photography:

Website | Facebook | Twitter  | Google+

Are you at risk from the ‘flu this winter? Read our interview with Dr Jonathan Pittard



Do you need a flu jab?

Do you need a flu jab?

More than half of Doctors think the main reason at-risk patients do not take up flu vaccination is because they are concerned the vaccine itself could give them flu-like symptoms, according to results of a recent survey.

53 per cent of professionals polled rated this as the top reason why they think at-risk patients – including over 65s, pregnant women and those with weakened immune systems because of other diseases – miss out on vaccination. It ranked in the top five reasons among 94 per cent of respondents.

The next biggest concern for HCPs was that patients who have not previously had flu do not consider themselves at risk, with 86 per cent placing this in the top five reasons patients miss the jab. And 76 per cent said patients being unaware of the increased risk of complications from flu were among the top five reasons.

Flu is an infectious viral illness spread by coughs and sneezes. It is different from the common cold because it is caused by different viruses and tends to result in more severe and long-lasting symptoms. Flu can be prevented through good hygiene, vaccination and, in some cases, antiviral medication.

During the last flu season, uptake of the flu vaccine varied in at risk groups with just around 40% of pregnant women and 73% of over 65s being immunised across England.


To find out more we contacted an interview with Dr Jonathan Pittard, a UK based family doctor.

PATENTTALK.ORG: Thanks for taking time to talk us Dr Pittard, can you start by telling us what influenza is?

DR PITTARD: Well influenza is a viral illness of several different strengths but you only get one at a time. Essentially it gives you a very high fever, and a very bad headache and a very bad muscle ache. So essentially for 4 or 5 days you are sneezing and snuffling a bit, you can hardly stand up, you can get to the bathroom and back to your bed and you feel pretty dreadful. It is a bit like having malaria so it is way worse than a cold.

PATENTTALK.ORG: And, what are the different types of flu and how do they infect people?

DR PITTARD: There are two classifications; there is A influenza and B influenza.  B has by reputation to be slightly more severe. The most recent A one that people will be familiar with would be swine flu, which came out in 2009-10.  We vaccinated a lot of pregnant women then because it was worst in pregnancy.  The actual illness I had in April of that year and happily it was just for the Friday, Saturday, Sunday so I didn’t miss any work but the current vaccine has a 2009 strain in and two from 2012.  One of A vaccine and one of B virus and they were identified in the States. In the case of Swine flu it came up from Mexico from pigs to humans and that’s how it has picked up.  So the World Health Organisation keeps an eye out for this like Sherlock Holmes and spots what the trends would be; the virus strains that we haven’t had in Europe and it will put the manufacturers on advice to make the vaccine to anticipate the ones we haven’t had.

PATENTTALK.ORG: Could you just tell us a little bit about the particular danger posed by the different strains of flu,  such as bird flu.

DR PITTARD: Well the biology of it seems that these viruses, similar with the Ebola virus, they seem to get into animal systems and seem to mutate there. And then there are places in China in case of bird flu there are a lot of poorer Chinese who will live with chickens in their house and because chickens are kind of valuable they keep them under their beds, you can well imagine if you stay with a chicken long enough it may share one of its viruses with you, and when the jump is made from avian bird flu to a human often the human system reacts very badly to it, and there have been one or two deaths.  So it is quite interesting biology.  In the case of the Ebola virus, it was bush meat and people were eating these animals and getting these animal viruses.

PATENTTALK.ORG: Can you just briefly outline how the flu jab works?

DR PITTARD: What happens is the myth that the survey shows, people object to the flu vaccine on the one ground is maybe that they think it will give them the flu.  Some viruses are actively vaccinated into us.  Polio used like that – it was audited in a way that it didn’t make you ill but it gave you immunity for life.  With the flu vaccine they extract the infectious part and they just give you the virus ‘skin’, to give it to you in simpler terms and it then prompts your immune system to look out for that virus when you meet it live in the future. So after about ten days you meet the live virus your immune system won’t take a hold because it will recognise the skin, the armour if you like, and will destroy it before it starts with the  Interferon that is the body’s anti-viral.  So it is a dead vaccine, it won’t give you the flu.

PATENTTALK.ORG: So is it a myth, then – that you may develop symptoms of flu by having the jab?

DR PITTARD: Yes, I think what happens is when people go to the doctors they pick up a virus in winter, they are incubating it they get hit in the waiting room or the supermarket on the way home, and it coincides with the flu vaccine and for a few patients they say “Oh, well that is what has given me the flu, I should not have had the flu vaccine”, and so they become adverse to it.  Most of our patients don’t subscribe to that but that is what the survey, Ipsos Moray GSK Survey showed.  And so we are really keen to expose that as a myth.

PATENTTALK.ORG: Are there any possible complications from having the flu vaccine?

DR PITTARD: Well the headline objection that’s very rare is that if a patient has true intolerance to eggs, and you might not like eggs, you might not like egg soufflé or egg fried rice or omelettes but that is not an allergy an allergy is where your tongue swells up, your eyes close, you need adrenalin, and you get very asthmatic I mean that is very rare to eggs it is probably as rare as being allergic to milk but because the vaccine is prepared using live hens eggs which is un-purified there is a theoretical objection to that, but that is the only headline issue. If for example you are very allergic to rare ingredients in the flu vaccine, the preservatives in the other vaccines you have had a reaction to tetanus, you have had a reaction to pneumonia vaccine, then possibly your doctor will know that.  These are very rare 1 in 10,000 or 1 in 1,000,000 cases.  For the bulk of us, none of that applies. If you can tolerate eggs, you can tolerate the flu vaccine.

PATENTTALK.ORG: Who is particularly at risk from believing in these myths?

DR PITTARD: The best way to answer that is the “at risk” population. Most GPs are concerned with the over 65’s because you tolerate flu worse and worse as you get older.  The rest of your biology is compromised by aging; heart, lungs and so on.  You are more likely to get pneumonia and you are less likely to be able to look after yourself.  Younger patients that battle on are a bit stronger I guess.  So the national policy is to vaccinate the over 65’s and also vaccinate people with pneumonia and bronchitis risks, diabetic risks, heart disease risks and one of the two groups like care workers and ambulance drivers.  These are the people that need the vaccine and they are the ones that are likely to object for grounds of getting the flu from the flu vaccine, which is not true.  The other objections that the survey showed is they thought that they never got the flu so they didn’t need it. Of course eventually, it is like Russian roulette, they will get it.

PATENTTALK.ORG: Final question, what is your advice to anyone who might be worried about getting the flu?

DR PITTARD: Well, the national policy which had thousands of patients seeing their GP’s in October / November and the GP’s keep the flu vaccine in their surgery, their special clinics, and kept in touch with their practice, if you have moved area just talk to the reception staff and they will make it very easy for you to get your vaccine.  If you are concerned that you may have a particular risk then you can have a consultation with your GP by phone for example, and they can often phone you back, book an appointment to talk about it or if you are outside of the risk group that the NHS will vaccinate you then you can still go to pharmacy chains and buy the vaccine for about £10, maybe less, and have it yourself. There are very few contraindications of having this, it is a very safe procedure.

 

One third of the planet do not have basic sanitation say WHO. Is this a major health threat?


Is basic sanitation a human right?

Is basic sanitation a human right?

Years ago I was at a conference having a conversation with a potential client. The conversation moved on from boring market research to rather more interesting topics.

He asked me a very interesting question. Did I know what was the increase in average human lifespan from beginning to end of the Twentieth Century and why?

Well he explained that it was on average 30 years per person. And the two reasons for this he suggested were antibiotics and clean water.

So I was very interested to cast my beady eyes over a report published by the World Health Organisation, published yesterday, The UN-Water Global Analysis and Assessment of Sanitation and Drinking-Water. Granted an uninspiring title but from a worldwide health perspective one of great importance.

I thought I’d share some of the key finds. I don’t suggest you read the stuff WHO have produced because NGOs indulging in self-justification of their own existence in an unedifying sight!

WHO states “2.5 billion men, women and children around the world lack access to basic sanitation services. About 1 billion people continue to practice open defecation. An additional 748 million people do not have ready access to an improved source of drinking-water. And hundreds of millions of people live without clean water and soap to wash their hands, facilitating the spread of diarrhoeal disease, the second leading cause of death among children under five.


Many other water-borne diseases, such as cholera, typhoid and hepatitis, are prone to explosive outbreaks. Poor sanitation and hygiene can also lead to debilitating diseases affecting scores of people in the developing world, like intestinal worms, blinding trachoma and schistosomiasis.”

So we are looking at around one third of our planet’s population which is more than concerning. This is particularly the case in rural areas. They share “While a vast majority of people who lack access to basic sanitation live in rural areas, the bulk of financing continues to benefit urban residents.”

They go on “Investments in water and sanitation yield substantial benefits for human health and development. According (their) estimates, for every dollar invested in water and sanitation, there is a $4.3 return in the form of reduced healthcare costs for individuals and society. Millions of children can be saved from premature death and illness related to malnutrition and water-borne diseases. Adults can live longer and healthier lives”.

All of which may be true but my question is how can we deliver clean water and sanitation to fellow global citizens? It is a serious question and I would be keen to hear your answers in the comments section below.

Many thanks in advance!