With all political eyes now on the NHS, the relentless rise in patients using A&E as a first port of call has even more significance. Recent research shows that one of the main reasons people head straight for A&E rather than any of the other NHS urgent services is that they simply do not understand how they work.
Research done by Resonant-a London based agency specialising in behaviour change and social marketing recently worked across three major South London hospitals to try and find a solution. What they found was that parents in particular do not know the difference between urgent care, walk in services and minor injury units. More importantly they found that this patient group do not know why and when to use them. In fact the only services universally understood were GPs and A&E.
Resonant devised an intervention called Get It Right which tackled this problem head on and delivered an 18% drop in demand on A&E services in this area of London. After much collaboration with local people and a variety of community groups Resonant came up with a simple and engaging guide to local services which gave local families across southwest London the confidence and capability to use other parts of the urgent and primary care network to access the care they needed.
John Isitt, Director of Resonant says: “Local NHS organisations have not learned that it is not enough to tell people not to go to A&E. Instead it is vital to address people’s underlying motivations, anxieties by making the system simpler for them. Managing demand is not the answer to the whole problem but it is an effective, evidenced and good return on investment”.
I am now officially a dementia friend. Dementia Friends is a joint initiative between Alzheimer’s Society and Dementia UK to try and raise awareness of what exactly Dementia is. I duly registered online and turned up at the local library where Josette Simon (a very beautiful and talented actor) was ready to tell us all about how we could help.
I was a little bit nervous I would be asked to befriend someone with dementia. Both my parents lived with the condition and it was a very difficult time for all the family. However Josette had a lively way of describing why ‘there is more to a person than the dementia’.
She explained the five things we should all know about dementia. Firstly it is NOT a natural part of ageing. It is caused by diseases of the brain, the most common of which is Alzheimer’s. Dementia is more than just losing memory, it can affect thinking, communication and undertaking everyday tasks.
However, it is possible to live well with dementia-especially if everyone in society plays their part in being more understanding of those who have it and trying to make people with dementia feel included in their communities.
Josette, being a brilliant actor, had a fabulous way with words. She explained how dementia affects two main parts of the brain-the Hippocampus which is where we store our memories and the Amygdala which is really ‘who we are’.
She compared the Hippocampus to a rather shoddily built bookcase which when dementia strikes rocks back and forth displacing all the books. The books on the top shelves represent the most recent memories and the bottom bookshelf represents childhood memories.
She then compared the Amygdala to an extremely well built and solid oak bookcase which represents the ‘who we are’ bit. That does not change when dementia strikes. She then told a poignant story about someone whose mother was living with Alzheimer’s. Often she would wonder if it was worth visiting because her mother would soon forget her visit.
But once she understood about the ‘bookcase’ she realised that although her mum may have forgotten her visit she she still knew her daughter and what she meant to her. So although her memory might have been going she never forgot her family and the warm feelings they all evoked.
If I took away one thing from that meeting it was that dementia is not the frightening thing I once thought but that with a little help and understanding we can all be ‘dementia friends’.
Occasionally at the surgery I get the chance to read through old newspaper articles. I just came across this one by Dr Haroun Gajraj a vascular consultant based in Dorset who had recently been prescribed statins for high cholesterol.
For eight years he faithfully popped his pills without side effects until one day last year he stopped. Not because of side effects but because he had a good look at the research. He concluded that statins would not save him from a heart attack and that his cholesterol levels were pretty irrelevant anyway.
Why this bolt from the blue? Gajraj had discovered the amazing Norwegian Hunt 2 Study which I wrote about last year. The study came out in 2011 and followed 52,000 men and women aged between 20 ad 74 for 10 years. It showed that contrary to all the hype, the lower a woman’s total cholesterol, the greater her risk of dying, either of heart disease or anything else including cancer. The study backed up others which have linked high cholesterol levels with increased longevity in older people.
He, like many other experts such as Dr Aseem Malhotra, are not convinced by the idea that cholesterol is the baddie in the heart disease story but believe it might simply be an innocent bystander. In fact, these experts are beginning to believe that sugar is emerging as the true villain and after years of demonisation, saturated fat is fast being acquitted of causing heart disease.
In a recent survey by Pulse, six in 10 GPs opposed the recent draft proposal to lower the risk level at which patients are prescribed statins. And 55 per cent said they would not take statins themselves or recommend them to a relative based on the proposed new guidelines. Surely this must say something about these horrendous drugs?