NEWS NEWS IN BRIEF


STILLBIRTH A MAJOR PUBLIC HEALTH PROBLEM


Women who have experienced a stillbirth have up to a fourfold increased risk of stillbirth in a second pregnancy compared to those who had an initial live birth, finds a new major review of research, carried out by scientists at the University of Aberdeen.


Stillbirth rates have declined across most of Europe, but the UK still has a major public health problem. Ranked 33rd out of 35 for stillbirth rates among European countries, the UK recorded 3,286 stillborn babies in 2013.


“Stillbirth is one of the most common adverse obstetric outcomes and a traumatic experience for parents,” explain Dr Sohinee Bhattacharya and colleagues from the University of Aberdeen, Scotland. “Couples who have experienced a stillbirth need to understand why it happened and want to know the risk for future pregnancies.”


But there has not been sufficient information for the clinical management or to improve prevention of this traumatic outcome, they say.


Researchers undertook systematic review and meta-analysis to examine the link between stillbirth in an initial pregnancy and risk of stillbirth in a subsequent pregnancy.


They analysed 13 cohort and three case-control studies from high-income countries including Australia, Scotland, the US, Denmark, Israel, the Netherlands, Norway and Sweden. The definition of stillbirth was fetal death at more than 20 weeks’ gestation or a birth weight of at least 400g.


Data was collected for 3,412,079 women. Of these, 3,387,538 (99.3%) women had a previous live birth and 24,541 (0.7%) women had a stillbirth in an initial pregnancy. Stillbirths occurred in the subsequent pregnancy for 14,283 women: 606 of 24,541 (2.5%) in women with a history of stillbirth and 13,677 of 3,387,538 (0.4%) in women with no history.


Risks following an unexplained stillbirth may not be increased because there are few studies and the evidence remains inadequate, explain the authors.


16 - SCOTTISH PHARMACIST Standards of care for older people


New standards published for NHS Scotland aim to improve the care of older people in hospital. A key goal of the standards is strengthening the involvement of patients and carers in discussions and decisions about the care that is delivered.


2002, with a greater focus on initial assessment on admission and more complex aspects of care.


Aileen Bryson


The standards have been welcomed by Practice and Policy Lead for the Scottish Board of the Royal Pharmaceutical Society, who said, “Medicines play an important part in both the successful treatment and potential harm in the frail elderly. In particular we are pleased to see pharmaceutical care and the requirement for polypharmacy medication reviews acknowledged as an essential component of care.”


NHS boards in Scotland are now expected to work towards meeting these standards. Each standard includes a statement of the level of performance that NHS boards are to achieve. The new standards build on the previous standards from


Health boards across Scotland are being given a £4.05 million boost to help meet cancer waiting times, Health Secretary Shona Robison announced.


This comes as figures published today show that every NHS health board in Scotland has achieved the 95% target standard of patients receiving treatment within 31 days of the decision to treat being taken.


In total 96.5% of patients were seen within this timeframe for the quarter ending March 31.


The average length of time a patient in Scotland waits to start their cancer treatment is just six days, again from when a decision is made on what treatment is needed.


On average patients in Scotland start treatment within 38 days after urgent referral.


Standards 1 to 3 emphasise the principle of person-centred care: giving older people the opportunity to say what is important to them when they are cared for in hospital, treating them with dignity and respect, and involving them in decisions about their care. These principles should be applied throughout the patient journey.


Other standards cover the management of frailty, assessment of cognitive function, effective discharge planning and a standard to ensure that older people are cared for in the right place at the right time.


The standards have been developed in recognition of the recent integration of health and social care services (for example, through setting criteria for multi-agency working in discharge planning), and will be used to support future hospital inspections of the care of older people that are carried out by Healthcare Improvement Scotland.


£4m to tackle cancer waiting times


For the 62 day referral to treatment target, 91.8% of patients were seen within the timeframe – slightly higher than for the same period last year.


Today’s investment will help health boards to meet the 62 day cancer standard by building diagnostic and treatment capacity. All boards will receive funding towards improving waits, with further support for specific boards experiencing additional challenges.


Ms Robison said, “As today’s figures show we are consistently reaching the demanding 31 day target for treatment despite the fact that our NHS is treating more people than ever before and coping with the pressures of an aging population.


“They also reflect the challenging winter period experienced by health boards across Scotland, with a dip in performance usually experienced in


the first three months of the year due to the pressures of winter.


“Our cancer targets are rightly rigorous as patients deserve the best cancer care possible but there is no doubt that we must do more – especially on our 62 day target. While this has increased from 84.5% in 2007, we remain fully committed to once again reaching our standard of 95%.


“This is why today’s £4.05 million funding, which comes on top of the £8.5 million invested over the past three years to improve cancer services, is extremely important.


“This will help improve on diagnostic waits across the country as well as provide local support through the recruitment of a new consultant in the West of Scotland and additional resource for endoscopy services.”


Speaking of the standards, Dr Christine McAlpine, Geriatric Medicine Specialty Advisor to the Chief Medical Officer and Chair of the project group, said, “This new set of standards has been developed to support staff to provide the best care for older people in hospital, wherever healthcare is delivered. Each standard details what patients, their representatives and the public can expect of healthcare services in Scotland. We believe that the new standards once implemented will support continuing substantial improvement in the care that older people receive.”


Sara Twaddle, Director of Evidence for Healthcare Improvement Scotland, added, “These standards demonstrate the importance of getting care for older people in hospital right and our organisation’s commitment to driving improvements in this area. The standards complement our ongoing programme of inspections for older people in hospital, and our national improvement programme focused on delirium and the identification and management of frailty.”


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