Last year, Centre for Mental Health was commissioned by NHS England to help the Mental Health Taskforce to explore what helps and what hinders the implementation of policies and strategies relating to mental health in England.
From a review of literature and interviews and focus groups with people who have been responsible for policy implementation over the last 20 years, we identified 12 factors that influence the implementation of strategies. They are:
On March 24th, Public Health England (PHE) celebrated world TB day by detailing the strong progress made towards implementing the national strategy in collaboration with NHS England and other major stakeholders.
One year ago, PHE and NHS England jointly launched the 5-year strategy to eliminate TB as a public health problem, and announced an £11.5 million investment as part of a collaborative initiative to decrease TB cases and reduce health inequalities.
A significant step has been the formation of 7 regional TB control boards across England, which bring together PHE, local authority public health, the NHS, NHS England, local commissioners and charities to work collaboratively to control TB in their area, ‘uniting to end TB’.
A key intervention from NHS England and PHE was the launch of a fully funded national testing and treatment programme for latent TB infection for persons who recently arrived from areas of the world where TB is common.
All 59 of the high TB burden areas in England have now signed up to this programme, which is based on evidence that treatment of people with dormant (‘latent’) TB prevents progression to the active TB disease.
NHS England have announced that they are providing a further £10 million to fund on-going testing and treatment programmes for latent TB infection in new entrants in the next year.
BMJ Evidence-Based Medicine blog. Published online: 28th March 2016
An English study tested two strategies to achieve smoking cessation: a gradual vs abrupt approach (see doi:10.7326/M14-2805). The background is that most guidelines recommend abrupt cessation (“setting a quit date and then stopping cold turkey”), though many smokers report stopping more gradually.
Results, comparing the gradual vs abrupt quit rates:
At 4 weeks, 39.2% (34.0-44.4%) vs 49.0% (43.8-54.2%); RR 0.80 (0.66-0.93)
At 6 months, 15.5% (12.0-19.7%) vs 22.0% (18.0-26.6%); RR 0.71 (0.446-0.91)
Fewer people made a quit attempt (>24 hours of self-reported abstinence) in the gradual cessation group (61.4% vs 71% in the abrupt group; though in the gradual group, they had reduced their cigarette consumption by 48% by the end of the first pre-cessation week (target 50%) and by 68% by the end of the second week (target 75%)
And, participants who preferred gradual vs abrupt cessation prior to randomization were less likely to be abstinent at 4 weeks (38.3% vs 52.2%)
The Health Foundation has published ‘Making the change: Behavioural factors in person- and community-centred approaches for health and wellbeing’.
Drawing on studies of what influences behaviour, this report sets out a number of factors that can lead to greater involvement in self-care. It provides a framework for understanding the drivers of behaviour and includes examples and case studies to illustrate how the theories work in practice.
This report provides an accessible introduction to the theories of change behind a series of action-focused guides that will be published as part of the Realising the Value programme in Autumn 2016.
It is aimed at policymakers, commissioners, service designers and organisations working to promote more person- and community-centered approaches for health and wellbeing.
Average salt consumption for adults in 2014 was 8.0 grams per day. This has decreased from 8.5 grams in 2011 and 8.8 grams in 2005/06. Overall salt intake has fallen by 11% since the 2005 to 2006 survey.
Public Health England commissioned an assessment of the salt content of 24-hour urine collections made from May to September 2014. A random sample of 689 adults aged 19 to 64 years, designed to be representative of adults in England, took part in the study.
This report continues the series of urinary sodium surveys across the general adult population in United Kingdom countries since 2005/06. The results are used by government to monitor progress towards the recommended maximum salt intake for adults of no more than 6 grams per person per day.
Fenton, K. PHE Blog. Published online:22 March 2016.
As waistlines continue to expand across the country (62% of adults are overweight or obese), diagnoses of Type 2 diabetes are also rising. The cost of treating diabetes, and associated complications such as heart disease and stroke, is costing the NHS around £10bn every year.
Trends are only going one way – with one in ten adults expected to be diagnosed with Type 2 diabetes by 2034.
The programme aims to identify those at high risk and refer them into evidence-based behavioural interventions to help them reduce that risk through achieving and/or maintaining a healthy weight, recommended levels of activity and a healthy, balanced diet.
We published a systematic review in August last year that examined the effectiveness of ‘real-world’ interventions for the prevention of Type 2 diabetes in high risk populations. The review looked closely at the following areas:
The effectiveness of diabetes prevention programmes on reducing cases of Type 2 diabetes and reducing weight in high risk populations
The population groups that see the greatest effect from diabetes prevention programmes by age, gender, body mass index (BMI) and ethnicity
The key elements that might constitute a successful diabetes prevention programme
Data from 36 studies were included in this review, which revealed an average 26% reduction in new cases of Type 2 diabetes in those participating in a diabetes prevention programme, compared with usual care, although some studies achieved greater reductions. The strongest elements of the programmes we studied (for example, a greater number of sessions over a longer period of time) have been taken forward into our programme.