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Why you should read this article: • To understand the complexity of the needs of people with delirium superimposed on dementia • To enhance your knowledge of second-generation activity theory • To recognise the consequences of the separation of physical health and mental healthcare. Background: Delirium superimposed on dementia (DSD) affects the physical, mental and cognitive well-being of the person. The separation of physical health and mental health means that the care of people with DSD is at odds with the multifaceted aetiology and presentation of the condition. There is a lack of research on DSD from a mental health perspective. Aim: To explore UK mental health nurses’ experiences of providing care for people with DSD. Method: Individual semi-structured interviews were conducted with seven mental health nurses from one NHS trust in England. Participants’ experiences were considered through the lens of second-generation activity theory. Data were analysed using framework analysis. Findings: Six themes were identified: awareness of guidance and tools; guidance or tools as ‘paper exercises’; knowing the patient; the multidisciplinary team; care burden; and mental health versus physical health. Conclusion: When providing care for people with DSD, mental health nurses use their skills in knowing patients as individuals. However, this aspect of ‘knowing’ cannot be readily translated into the use of a numerical scoring tool. An integrated approach is required to support the care of people with DSD. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To recognise some of the factors that can make it challenging for nurses to access training and maintain competence in using medical devices • To learn about development of an electronic medical device training passport that aims to better identify nurses' training needs • To understand the benefits of an electronic medical device training passport for nurses, nurse managers and clinical leaders Background: All nurses, particularly those working in critical care settings, are required to use medical devices when providing patient care. However, inconsistent practice and variations in documentation can make it challenging for nurses and nurse managers to identify what medical device training is required and when. Aim: To develop and evaluate the use of an electronic medical device training passport to identify the training needs of nurses in intensive care units (ICUs). Method: A pilot study was conducted in a multi-unit critical care department in London, England, to determine if the passport could make it easier to identify ICU nurses' medical device training needs compared with existing practice. Nine participants were first asked to identify their needs using existing spreadsheets or paper records, then asked to identify them using the passport. The participants were also interviewed to identify their training requirements before and after using the passport. The data were analysed quantitatively and qualitatively. Findings: The electronic passport significantly improved identification of medical device training needs compared with paperwork or spreadsheets for all device groups, except for medical devices used on high dependency units (P≤0.005). However, there may be issues related to nurses' behaviours and expectations, particularly that staff do not always recognise their need for training. Conclusion: The findings of this pilot study suggest that the use of an electronic medical device training passport has many benefits and could make it easier to identify ICU nurses' training needs in clinical practice. [ABSTRACT FROM AUTHOR]

Aim: To provide a template for developing a national mentoring scheme to enhance the contribution practitioner researchers can make to the quality of health care in England. Background: The authors describe the background to and organisation of a mentorship scheme to support those awarded National Institute for Health Research (NIHR) fellowships as part of the Clinical Academic Training (CAT) scheme for nurses, midwives and the allied health professionals in England. Data sources: The paper draws on relevant policy documents to explain the development of the NIHR mentorship scheme. It also reviews the literature regarding mentoring in nursing and the health professions. Review methods: The review was conducted systematically using keywords: mentorship, clinical academic careers, research, nursing research, clinical academic careers, evidence, health care. Databases included PubMed, CINAHL and Google Scholar. An integrated approach was adopted. Discussion: Kirkpatrick’s (2006) four-level evaluation model provided a framework to evaluate the scheme and explore the role of mentorship in supporting NIHR fellows. Preliminary findings from baseline and end-of-year evaluations revealed mentees’ expectations of mentorship and its effects on their professional development. Developing a career as a clinical academic can be a challenging journey for novice researchers. In addition, there is a vital need to integrate research with clinical practice. Conclusion: Mentoring appears valuable in enabling NIHR fellows to navigate the challenges of demanding clinical roles in England’s National Health Service while making a high-level contribution to research. The importance of preparing mentors for their role is well documented in the literature but mentees also need preparation and guidance to manage this important relationship. Implications for research/practice The evaluation has implications for embedding similar schemes across nursing, midwifery and the allied health professions to promote capacity and leadership in clinical academic careers. This study has uniquely identified the need to support mentees as well as mentors in such programmes to ensure the optimal benefit of the programme reaches all participants. [ABSTRACT FROM AUTHOR]

In 2012, the Department of Health published Compassion in Practice, which included six areas for action. Action area four suggests that ward managers and leaders should be supervisory, and not included in ward staff numbers. The recommendation has recently been changed to promote black and minority ethnic (BME) leadership in the NHS. This article examines the literature on supervisory nurse leader roles between 2007 and 2017 to identify what, if any, progress has been made. Although supervisory status can improve care at ward level, and was endorsed by the Francis Report, it seems that few care providers in England have invested in this, possibly because it is voluntary, rather than a statutory requirement. The article argues that, rather than focusing on BME leadership, commissioners and providers should consider implementing the original action four to support the lessons learned in the Francis Report. [ABSTRACT FROM AUTHOR]

Cancer incidence is increasing year on year; survivorship rates are also increasing, as is the use of novel agents and additional treatment lines. These factors, along with evidence that suggests people are struggling to cope with the long-term effects of their diagnosis and its treatment, suggest we need to transform our approach to care and make better use of primary care, community assets and self-management. Transforming Care After Treatment (TCAT) was launched in 2013. A partnership between the Scottish Government, Macmillan Cancer Support, NHS Scotland and local authorities, it is intended to support and enable cancer survivors to live as healthy a life as possible for as long as possible. NHS Ayrshire and Arran worked with local patients and other partners to develop an action plan to meet TCAT's aims. In 2014, the TCAT team began to introduce initiatives that would support holistic care throughout the extended cancer pathway. One such initiative was a treatment summary. The approach to its implementation and patients' and GPs' perspectives of its initial effect are outlined in this paper. [ABSTRACT FROM AUTHOR]

The research available on the use of positive risk-taking in clinical practice is surprisingly limited. The purpose of this article is to highlight the limitations and make recommendations about how risk-taking could shape future practice in mental health services. A search of databases including CINAHL and PsycINFO for papers that included the keywords recovery, risk management, positive risk-taking and risk management found that mental health practitioners were keen to promote positive risk-taking with patients to enable their recovery. Barriers to this included a culture of blame should a negative outcome arise, and the need for more support and guidance from management. As positive risk-taking has been shown to be an important part of successful recovery, there is a need for more research to support its application in clinical practice. [ABSTRACT FROM AUTHOR]

The article features the Clatterbridge Cancer Centre in Liverpool, England.

Why you should read this article: • To enhance your knowledge of personalised cancer care and support planning for patients living with cancer • To increase your awareness of methods of delivering personalised care virtually to patients living with cancer • To contribute towards revalidation as part of your 35 hours of CPD (UK readers) • To contribute towards your professional development and local registration renewal requirements (non-UK readers) Many people with cancer experience long-term physical and emotional challenges resulting from the disease and its treatment. Personalised care enables people to exercise choice and control over how their care is planned and delivered. The principles of personalised care are based on healthcare professionals focusing on what matters to people living with cancer. Personalised care enables people to use their individual strengths to ensure that they can have an active role in decisions about their care if they so choose. This article explores personalised nursing care in the context of people living with and beyond cancer. The author examines how nurses can adopt a personalised care model and how this supports improved quality of life and outcomes for patients with cancer. Additionally, the author explores how personalised care interventions have been affected by the coronavirus disease 2019 pandemic and how these might be delivered virtually. [ABSTRACT FROM AUTHOR]

There is evidence that people with learning disabilities, particularly those with behaviour that challenges, are prescribed psychotropics even when they do not have a mental health condition. The STOMP programme was launched in 2016 in England and Wales with the aim of reducing the use of psychotropics in adults with learning disabilities and/or autism. This article describes how the STOMP programme was implemented in a community learning disability service for adults at Cheshire and Wirral Partnership NHS Foundation Trust. The article briefly discusses the overuse of psychotropics in people with learning disabilities and describes the local service's strategy to reduce its clients' use of psychotropics, highlighting some of the beneficial effects this had on clients' quality of life. [ABSTRACT FROM AUTHOR]

This article discusses the knowledge management skills required by nurses in the context of the government's information strategy for England and Wales, which highlights the importance of managing data in providing efficient health care. It also reports on a study that looked at whether employers' job descriptions and person specifications include the need for basic information and communication technology skills outlined in the NHS knowledge and skills framework (Agenda for Change Project Team 2004), and the degree to which these skills are regarded as important to good nursing care. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To learn about the differences between psychiatric intensive care, low secure and locked rehabilitation units • To understand how service provision in psychiatric intensive care, low secure and locked rehabilitation units has changed since 2006 • To gather information on the types of interventions offered by the different psychiatric intensive care facilities Psychiatric intensive care can take place in a variety of settings, including psychiatric intensive care units (PICUs), low secure units (LSUs) and locked rehabilitation units (LRUs). These units have a range of referral, admission and discharge care pathways, staffing profiles and core interventions. The aim of this service evaluation was to compare present provision in PICUs and LSUs with results from the first national survey of PICUs and LSUs in 2006. The service evaluation also aimed to define the role of LRUs. The authors used a cross-sectional, 'census day' questionnaire with six-month follow-up design. Overall, 111 NHS units participated in the evaluation. Results included that PICUs were smaller and usually had a mixed-sex distribution of service users; LSUs mostly comprised single-sex facilities; and LRUs mostly comprised single-sex units with a significantly longer mean length of stay than the other types of unit. PICUs primarily cared for service users exhibiting acute behavioural disturbance, first-episode psychosis or psychotic crisis and, compared with the other types of unit, more often used high-dose medication and electroconvulsive therapy. [ABSTRACT FROM AUTHOR]

The article discusses research on the role of non-medical prescribers (NMP) in treating patients with opiate analgesia dependence in primary care. The study describes the approach of a Benzodiazepine and Opiate Withdrawal Service (BOWS) to illustrate the role of NMPs in treating patients and the advantages of using NMPs. It outlines treatment and management options including stabilising medication, switching to and reducing dosage of diazepam and cognitive behavioural therapy.

Background: This article offers a reflection by a novice researcher undertaking an integrated clinical academic internship with the National Institute for Health Research and Health Education England. Aim: To offer insight into research internships, and demonstrate the benefits and challenges encountered. Discussion: Exposure to research while remaining in clinical practice gives nurses the opportunity to increase their knowledge, develop research skills and network. Associated challenges include feeling like a novice, balancing the demands of clinical practice and research, and the development of new skills. Conclusion: Internship programmes can create health systems in which practitioners also undertake research but there are associated challenges. Implications for practice: Research internships offer nurses insight and exposure to a world of research that may previously have been invisible to them; they can act as a platform for nurses to develop clinical academic careers. [ABSTRACT FROM AUTHOR]

A clearer picture of the pressures facing England's emergency departments (EDs) is now available following the release of new data. The Royal College of Emergency Medicine (RCEM) has long campaigned for 12-hour waits to be measured from the point when a patient arrives rather than when a decision is made to admit them. [ABSTRACT FROM AUTHOR]

In April 2009, a patient at Brighton and Sussex University Hospitals NHS Trust had a fall. Data-wise, there is little unusual about that; falls are common. In hospitals and at home, there were more than 230,000 emergency admissions related to falls among people over 65 in England in 2019-20. [ABSTRACT FROM AUTHOR]

Nurses and other health professionals are expected to ask patients about sexual orientation at every face-to-face contact across the NHS from 2019. However, there are concerns about the need for, and relevance of, sexual orientation disclosure, and the potential for discomfort and embarrassment. This article reports findings from qualitative interviews with 15 lesbian, gay and bisexual patients about how experiences of cancer care are mediated by disclosure. Three themes emerged: identifying the barriers to disclosure; approaches to, and facilitators of, coming out; and nurses' responses to disclosure. The findings suggest that disclosure should be situated in a model of holistic care in which patients' individual needs are recognised as one of the eight principles of quality nursing. By treating the whole person, nurses can ensure that patients are more likely to engage in positive health behaviours; acquire greater knowledge about their health, an [ABSTRACT FROM AUTHOR]

The latest results of the National Cancer Patient Experience survey, which asks people about the care they received in 2022, made some enlightening, as well as sometimes difficult, reading. Of the 61,268 people who responded, just 78% said the amount of time they waited for their test results was okay and the same percentage said their results were explained in a way that they could fully understand. [ABSTRACT FROM AUTHOR]

The Nightingale, a critical care temporary hospital, was created in just nine days at London's ExCeL centre in response to the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Aim To examine the role of members of the NHS England Youth Forum (NHSEYF) and the strategies used to influence health service provision for children and young people. Method An evaluative mixed-methods study was commissioned by NHS England and undertaken by the University of Hertfordshire between July 2015 and September 2016. Data collection comprised activity logs, a form of questionnaire, and semi-structured interviews. Findings The analysis of the activity logs revealed that the young people were undertaking a wide range of activities across England. Seven themes emerged from the interviews: the young people; motivation; commitment; community (the local area as well as a community spirit); knowledge experts; youth workers; and funding. In summary, the members of the NHSEYF were committed to their role and their work was having a positive effect on health service provision. Conclusion The NHSEYF has developed rapidly and successfully. It is enabling the voice of young people to be heard. [ABSTRACT FROM AUTHOR]

Implementation of the Recovery Package is a priority in the recent NHS England cancer strategy, but information on local workforce readiness to implement the package was unavailable. Therefore, a survey of the lead cancer clinician and lead clinical nurse specialist for each cancer multidisciplinary team across Sheffield Teaching Hospitals NHS Foundation Trust was undertaken to measure understanding of the Recovery Package, good practice and gaps in service provision. This article reports on the results of the survey, which found that the Recovery Package's terminology -- particularly the word 'recovery', which implies the package is relevant only for those treated curatively -- has led to misunderstandings and that implementation has been variable across cancer teams. The article also discusses proposed solutions, which include improving medical staff awareness, reviewing nurse specialist workload and considering different ways of working. [ABSTRACT FROM AUTHOR]

Aim This article offers nurse managers guidance on analysing, managing and addressing a potentially dissatisfied nursing workforce, focusing on three priority shortage specialties: emergency care, paediatrics and cardiology. The aim of the study was to explore to what extent registered nurses and healthcare assistants, referred to collectively here as 'nursing staff', are satisfied with teamworking opportunities, continuing professional development (CPD) opportunities and workplace autonomy. Method A survey questionnaire was developed to evaluate three derived determinants of nurse satisfaction: team working, CPD and autonomy. The NHS West Midlands region was the focus given that it is among the poorest performing regions outside London in filling nursing posts. Findings Overall, nursing staff respondents were satisfied with teamworking, CPD and autonomy, which challenges the perception that nurses in NHS England are dissatisfied with these satisfaction determinants. The findings give a complex picture of nurse satisfaction; for example a large minority of respondents were dissatisfied with their ability to carry out duties as they see fit. Conclusion When developing management systems to investigate, manage and enhance nurse satisfaction, nurse managers must recognise the complexity and subtleties of determining factors. This will increase as nursing becomes more specialised. Subsequently, nurse managers need to work closely with staff at higher education institutions and other professional agencies to commission appropriate professional development. [ABSTRACT FROM AUTHOR]

How often have you heard, read or even spoken the words: 'We must keep children and their families at the heart of everything we do?' Last month saw the publication of two reports each of which cast a critical eye over the experience of young people with complex health needs as they transition from children's to adult services. [ABSTRACT FROM AUTHOR]

This article describes one learning disability nurse's experience of being seconded to work on a research project in a university setting. The nurse Tracey Rose and her academic manager Irene Tuffrey-Wijne argue that the benefits of such a secondment go beyond the obvious advantages for the nurse, who gained research skills. The delivery of evidence-based care and support is enhanced when learning disability nurses are engaged in research. Creating opportunities for a secondment can support nurses' career progression and may also help promote staff retention. For the academic partner, a close link with clinical practice can keep the research grounded and help to clarify the impact of research on practice. The authors also discuss the challenges in making this type of secondment work. [ABSTRACT FROM AUTHOR]

The article reports that the British government has allocated 12 million British pounds to be used for providing liaison and diversion services for people who need mental health support after being arrested by police or while in custody to face court proceedings.

Bowel cancer is the fourth most common cancer in England, and with one in 20 people developing the condition, it is the second highest cause of cancer deaths. If diagnosed early, treatment can be more effective and bowel cancer screening programmes can reduce these mortality figures, yet for people with learning disabilities, the uptake of screening is significantly lower than the rest of the population. Aims To describe the process of co-production when working with a group of people with learning disabilities to explore why they may be reluctant to access bowel cancer screening. Methods A consultation meeting was held with one of the authors, six people with learning disabilities, an advocate and two specialist nurses. A feedback session was organised and a report using clear information was written in conjunction with the participants. Findings Participants discussed what gets in the way of attending for bowel screening and what might help to increase uptake, including awareness, support and clear information. Conclusion Working in co-production proved mutually beneficial as local clinicians also learned how to communicate more effectively with people who have learning disabilities. [ABSTRACT FROM AUTHOR]

NHS walk-in centres (WICs) were opened in 2000 to modernise the NHS and increase accessibility to healthcare. They developed rapidly and are used successfully by the public. But little is known about the clients presenting and even less about health promotion and disease prevention strategies adopted by WICs. This review aims to explore, through client profiling, whether there is an opportunity for health promotion service delivery in WICs and minor injuries/illness units. The findings indicate that clients attending these units are similar in profile to those presenting to GPs and emergency departments, and that there is an opportunity to use these centres more effectively for health promotion. [ABSTRACT FROM AUTHOR]

This is the first in a short series that presents case study examples of the positive work achieved by trusts who participated in the Royal College of Nursing's development programme to improve dementia care in acute hospitals. When a person with dementia is in hospital, poor understanding of individual needs and preferences can contribute to a lack of person-centred care. Similarly, the needs of family carers can often be overlooked and staff do not always appreciate these needs at such a stressful time. This article illustrates how three NHS trusts have addressed these issues. To help staff get to know patients with dementia, Salford Royal NHS Foundation Trust has implemented a patient passport. Similarly, The Shrewsbury and Telford Hospital NHS Trust has implemented a carer passport that overcomes the restrictions imposed by hospital visiting hours. Royal Devon and Exeter NHS Foundation Trust also focused on carers, holding a workshop to elicit feedback on what was important to them. This was a useful means of engaging with carers and helped staff to realise that even simple changes can have a significant effect. [ABSTRACT FROM AUTHOR]

The article reports on an approach introduced by Barnet, Enfield and Haringey Mental Health National Health Service Trust in London, England known as the enablement programme to improve outcomes for people needing to improve their mental well-being.

Aim To gather evidence to support the implementation of standard six of the National Service Framework for Children, Young People and Maternity Services (Department of Health and Department for Education and Skills 2004), which states that care should be provided as close to home as possible. Methods A mixed methods study comprising of a systematic review, a national survey of provision of care closer to home (CCTH), four in-depth, qualitative case studies and a cost analysis. Findings The systematic review suggests that CCTH is no less clinically effective than hospital care. Services identified by the survey fall into three distinct models of provision. Case study data show that families preferred CCTH, but staff face difficulties at organisational and practice levels. Cost analysis suggests there can be cost savings with CCTH, but several factors influence these. Conclusion CCTH may be an effective and feasible option for children and young people who are ill. [ABSTRACT FROM AUTHOR]

Many service users would like their spiritual needs to be taken into account during treatment and doing so has been shown to have positive benefits. However, this rarely happens in practice. Barriers to healthcare professionals providing spiritual care include embarrassment, lack of awareness and training, fear and lack of time. This article describes the development of a spirituality care pathway as part of a wider organisational initiative to offer spiritual support in mental health services. The process highlighted the importance of developing awareness and ownership of the need for spiritual care in all service areas and among service users. A range of spiritual interventions were identified and a process of monitoring and review introduced. The approach was appreciated by service users and staff, and was developed within existing professional and management processes. [ABSTRACT FROM AUTHOR]

A well educated and trained workforce is central to the development of quality care for people with learning disabilities. Unsure of the demand for educational programmes for pre-registration learning disability nursing, South Central Strategic Health Authority commissioned the Valued People Project to undertake a detailed review of educational commissioning and the specialist learning disability health workforce. The project provided an evidence-based evaluation of the future direction of education commissioning and leadership in specialist learning disability services, as well as the wider NHS workforce. This article reports on one aspect of the project; the semi-structured interviews and focus group work with commissioners, managers and practitioners of learning disability services about the specialist health workforce needed to support this group and their families in the future. It identifies strong support for a specialist NHS workforce, mirroring findings from people with learning disabilities and their parents. [ABSTRACT FROM AUTHOR]

The article explores the effectiveness of the adopted practice of zero tolerance by the British National Health Service (NHS) as a strategy to tackle violence against healthcare workers in London, England. It evaluates and determines the critical failures in the implementation of zero tolerance. It also probes on the apparent reasons behind the adoption of the NHS in England.

The article reports that the National Audit Office (NAO) published a report on the British government's failure to move people with learning disabilities and challenging behavior from hospital to a more appropriate accommodation in Great Britain before the June 2014 deadline. Topics include Care minister Norman Lamb's move to take responsibility for the closure program. Also mentioned is the average time for a person with learning disability to stay in an assessment and treatment facility.

This article describes the career of a learning disability physiotherapist between 1988 and 2012. During this period, many people with learning disabilities moved from long-term institutions to supported living accommodation. Meanwhile, practitioners adopted a holistic approach to mobility management that involved physiotherapy. The article explains how this development and other changes to government policy affected the lives of clients and service providers. [ABSTRACT FROM AUTHOR]

The article discusses the Care and Quality Commission's (CQC) health and social care report in Great Britain as of December 2018. Topics covered include the provision of high-quality care, with access challenges, in most services, possible delivery of fragmented care due to ineffective coordination of services, and problems in navigating the health system which have some confusing services. Also noted is the main role of system failure in cases where quality fails.