Quantifying the gap between policy and practice in cardiovascular risk reduction: a review of evidence from recent cardiovascular and diabetes audits in the UK

As part of CHD NSF implementation, a pilot project is being undertaken under the auspices of the National Screening Committee to test the practical implications and outcomes of implementing a systematic programme of cardiovascular risk reduction in primary care, initially identifying those at high risk due to pre-existing cardiovascular disease or diabetes. To assist in assessing the magnitude of the challenge faced by the pilot programmes, the UK National Screening Committee (NSC) commissioned a review of current practice based on recent cardiovascular and diabetes audits in the UK. This report details the findings of the review, providing 6 key recommendations for future cardiovascular audits.

Regional Advisory Committee on Cancer - Report on Endocrine Cancer (September 2004) (PDF 144 KB)

There is already a good infrastructure for the management of endocrine cancer in Northern Ireland but to develop and strengthen it we recommend the following: • Increasing the already close cooperation between the individual parts of the service for endocrine cancer by use of shared protocols for assessment and follow up: • The main hub of management should remain at the RGH focussed on The Regional Centre for Endocrinology and Diabetes and the Endocrine Surgery department where there has been a long-term interest in the management of these patients. This includes a close working relationship between the endocrinologists and surgeon at the Belfast City Hospital. • This does not suggest that current developments of shared follow-up should not be encouraged. They should but with the provision of adequately resourced registers to allow adequate audit and to ensure adequate assessment of follow-up attendance. The issues regarding informed consent for such registers are currently being discussed for all forms of cancer. In the rarer conditions follow-up should remain central to allow adequate numbers and experience to maintain internationally recognisable outcomes and to allow training of future specialists to continue åÊ

PHA supports World Hospice and Palliative Care Day

Saturday 8 October 2011 marks World Hospice and Palliative Care Day. The Public Health Agency would like to celebrate and support hospice and palliative care around the world by raising awareness and understanding of the needs - medical, social, practical and spiritual - of people living with a life-limiting illness, and their families.This year's World Hospice and Palliative Care Day theme is 'Many diseases, manylives, many voices - palliative care fornon-communicableconditions'.The theme will focus on how people living with conditions thatare notinfectious can benefit from palliative care.Non-communicable diseases (NCDs), which include cardiovascular diseases, cancers, chronic respiratory conditions and diabetes, make up60% of deaths worldwide. The majority of thesedeaths occur in low and middle income countries, where palliative care is often not available. To get involved in World Hospice and Palliative Care Day, log on to www.worldday.org/get-involved/ which gives you ideas and suggestions on what you can do on the day to support people living with life-limiting illnesses, and their families.Mary Hinds, Director of Nursing and Allied Health Professions, PHA, and Chair of the Implementation Process for End of Life Care in Northern Ireland, said: "Good quality palliative and end of life care will be important for us all. 'Living Matters, Dying Matters' is a five year strategy for palliative and end of life care in Northern Ireland, established to ensure that any person living with a life-threatening illness lives well and dies well, irrespective of their condition or care setting. "It has been encouraging to see the plans being taken forward by the Health and Social Care Trusts in partnership with local hospices and other providers, and involving local people."We aim to ensure that people receiving palliative care, their families and carers, are provided with high quality care across all settings and conditions, and are supported to enjoy a good quality of life, maximising their potential through the course of their illness."There is still some progress to be made within the context of the review of health and social services. We are looking for statutory and voluntary services to work together to make a significant difference in improving access to high quality services for those with life-limiting conditions, and to develop innovative approaches to care."

Healthy eating for people with Type 2 diabetes

This booklet has been prepared for those who have recently been diagnosed with Type 2 Diabetes. Type 2 Diabetes is a very common medical condition. While it is a condition that is on the increase, a lot is now known about Type 2 Diabetes and it can be successfully treated and managed so that the person with Diabetes can live a long and healthy life.

Supporting the health of the over 50s

To address diet and lifestyle issues and improve the health of the over 50s in Gilford. Outcome: Health related issues for example heart disease, osteoporosis and diabetes were raised and members became more aware of their health, lifestyle and specifically diet through individual consultations with pharmacist and nutritionist and through group sessions. The pharmacist has worked well with the GP and is broadening links with other support agencies eg CAB. The GP / Pharmacist relationship has strengthened.

Poots launches £18m state-of-the-art Telemonitoring NI service

Health Minister Edwin Poots today marked the roll-out of a ground-breaking hi-tech scheme which will enable more patients to monitor their health in their own homes. Following funding of £18m from the Department of Health, the newly named Centre for Connected Health and Social Care (CCHSC), part of the Public Health Agency, worked in partnership with business consortium TF3to establish the innovative Telemonitoring NI service. The service is now being delivered by the TF3 consortium in partnership with the Health and Social Care Trusts.Remote telemonitoring combines technology and services that enable patients with chronic diseases to test their vital signs such as pulse, blood pressure, body weight, temperature, blood glucose and oxygen levels at home on a daily basis. The service will now be rolled out to 3,500 patients across Northern Ireland per annum for a period of six years.Mr Poots today visited the home of Larne pensioner Michael Howard who has Chronic Pulmonary Obstructive Disorder (COPD) to hear how Telemonitoring NI has changed his life.During the visit Mr Poots said: "Chronic diseases such as heart disease, diabetes and COPD affect around three quarters of people over the age of 75. This is the generation from whom transport and mobility pose the biggest problems. The Telemonitoring NI service will allow thousands to monitor their vital signs without having to leave their own homes."It means that patients are able to understand and manage their condition better. Many say it has improved their confidence and given them peace of mind. With a health professional monitoring each patient's health on a daily basis, there is less need for hospital admission. Carers are also better informed with the pro-active support provided. It means earlier intervention in, and the prevention of, deterioration of condition, acute illness and hospital admissions."Telemonitoring NI is an excellent example of how the Health Service can innovateusing modern technology to deliver a better service for our patients."Eddie Ritson, Programme Director of CCHSC, PHA, said: "The roll-out of Telemonitoring NI represents a significant step towards providing quality care for the growing number of people with heart disease, stroke, some respiratory conditions and diabetes who want to live at home while having their conditions safely managed."This new service will give people more information which combined with timely advice will enable patients to gain more control over their health while supporting them to live independently in their own homes for longer."A patient will take their vital sign measurements at home, usually on a daily basis. and these will automatically be transmited to the Tf3 system. The resulting readings are monitored centrally by a healthcare professional working in the Tf3 triage team. If the patient's readings show signs of deterioration to an unacceptable level, they will be contacted by phone by a nurse working in a central team and if appropriate a healthcare professional in the patient's local Trust will be alerted to enable them to take appropriate action."Families and carers will also benefit from the reassurance that chronic health conditions are being closely monitored on an ongoing basis. The information collected through the service can also be used by doctors, nurses and patients in making decisions on how individual cases should be managed. "Using the service, Mr Howard, 71, who has emphysema - a long-term, progressive disease of the lungs that primarily causes shortness of breath - monitors his vital signs using the new technology every weekday morning. The information is monitored centrally and if readings show signs of deterioration to an unacceptable level, Mr Howard's local healthcare professional is alerted."Taking my readings is such a simple process but one that gives me huge benefits as it is an early warning system to me and also for the specialist nurses in charge of my care. Without the remote telemonitoring I would be running back and forward to the GPs' surgery all the time to have things checked out," he explained."Having my signs monitored by a nurse means any changes in my condition are dealt with immediately and this has prevented me from being admitted to hospital - in the past I've had to spend six days in hospital any time I'm admitted with a chest infection."The telemonitoring is not only reassuring for me, it also gives me more control over managing my own condition and as a result I have less upheaval in my life, and I'm less of a cost to the health care system. Most importantly, it gives me peace of mind and one less thing to worry about at my age."Patients seeking further information about the new telemonitoring service should contact their healthcare professional.

Watching your Weight in Pregnancy

Pregnant women in the Southern Health and Social Care Trust area are learning how to manage their weight as a result of a project being funded by the Public Health Agency.The 'Watching your Weight in Pregnancy' project, being delivered by the Southern Health and Social Care Trust, got underway in December 2011 to address the rising levels of obesity across the southern area. It also aims to reduce the impact that obesity can have on the health of women and their unborn children during pregnancy and birth.Two pilot programmes are currently underway in the Kilkeel area teaching both antenatal and post natal women that feeling good about yourself and your baby is important during pregnancy.The programmes provide information about managing weight during and after pregnancy and include advice on good nutrition along with opportunities to take part in appropriate physical activities. As part of the project, there have also been training sessions for midwives in the Southern HSC Trust on healthier eating and physical activity during pregnancy.Patricia McStay, Southern Trust Head of Midwifery, explained why there was a need for this project: "Every woman wants a healthy baby and we are supporting the women to improve their own health and wellbeing. We have been seeing increasing numbers of women who are overweight or obese at their first contact with the midwife. We want to support these women to manage their weight gain in pregnancy to reduce the risk of experiencing health complications such as high blood pressure, and diabetes in pregnancy."Angela McComb, Health and Social Wellbeing Improvement Manager, for the PHA, said: "The southern office of the PHA recognised the many risks associated with obesity in pregnancy, both to the mother and her baby, and allocated funding for this pilot project to test out ways in which these health risks can be reduced. "We look forward to seeing the results of the evaluation which will inform the further development of effective approaches to support pregnant women to manage their weight both locally and across Northern Ireland."