Resources

People experiencing homelessness are generally not seen in traditional models of intermediate care. An out-of-hospital care model for those experiencing homelessness has been established in Leeds. This offers good quality accommodation in community settings with a multidisciplinary team to assess people’s health and social care needs and offer step up or step down from hospital care. This has demonstrated a reduction in emergency department attendances and unplanned hospital stays, as well as an opportunity for people to be included in a home first model. Unexpected outcomes include a reduction in street sex work for the women who have been engaged on the project, less engagement with the criminal justice system, a place to facilitate prison releases, and an environment where end-oflife care can be delivered and achieve preferred place of death. Future investment is needed for out-of-hospital care to be an equitable offer in the city available to all.

The Mediterranean Diet (MedDiet) is one that has been followed by certain populations from warmer climates for thousands of years. Many of these people seem to live in good health to an advanced age. Is this due to where they live and maybe a more laid-back
lifestyle, or is their diet also responsible for this rude health? More recently, the popularity and publicity of the MedDiet seems to have grown exponentially. Will it end up being just another diet craze or is there something behind it so that we can be confident  about advising patients to adapt their diet to being more Med like? This article explores what this diet actually is and whether there is any scientific proof for the claims made about it. From the research presented, it certainly seems that the MedDiet can offset many ‘socalled’ Western diseases. This paper also looks at which elements of the diet are likely to have this effect.

Several crucial documents have identified the need for integrated care to meet patient requirements in the current financial climate, developed from the concepts of self-care and joining up care to improve health outcomes. These include the Five Year Forward View (2014), Next Steps on the Five Year Forward View (2017), NHS Long Term Plan (2019) and now the introduction of the Health and Care Act (2022) — all of which provide a contextualised approach to care. Integrated care is aimed at the way that organisations work together to support self-care (which incorporates the principles of holistic care considering physical, emotional, social, spirtual and ecomonc health [Mills, 2017]), with a commitment to improve patient outcomes by avoiding confusion and repetition. It  enhances comprehensive care planning by listening to patients — perhaps best summed up by the phrase, ‘No decision about me, without me’ (Department of Health [DH], 2012).

This article is a call to action for those involved with children and young people (CYP) who have (or might have) asthma. The evidence has been clear for some time that there is an identified peak in asthma attacks in mid-September, the ‘week 38’ phenomenon (Transformation partners in healthcare, 2022). However, what is often not discussed is that there is a time when we can perhaps pre-emptively act to avoid attack — and that time is now.

Winter is often seen to be the time to consider respiratory health. However, for patients who wheeze, entering autumn with healthy lungs is key to resilience to winter viruses and triggers. ‘Pre-emptive medicine’ is one of the key focuses in recent national
guidance (NHS England, 2021) and has been a pillar of best practice in both the National Institute for Health and Care Excellence (NICE, 2021) and British Thoracic Society/Scottish Collegiate Guidelines Network (BTS/SIGN, 2019) guidance for some time. It is known that many asthma deaths are avoidable, and that there are many
so-called modifiable factors that can contribute to mortality in asthma (Royal College of Physicians [RCP], 2015).

Taking a holistic approach and actively listening to patients is crucial in all patient encounters. It can allow you to understand patients’ concerns, values and the impact that certain behaviours or conditions might be having on their lives. Gambling disorder, often referred to as a ‘hidden addiction’ is, as Charles and Liz Ritchie point out (pp. 8–10), an extremely serious issue which can have devastating consequences for indiviuals and their families. As community nurses visiting patients in their own homes, we have a unique opportunity to identify signs of gambling harm and offer support. Clearly, it’s a topic that needs to be approached sensitively and without judgement, but recognising gambling disorder as a public health concern and addressing it within the context of a patient’s overall wellbeing can make a significant difference to their lives and the lives of those
around them.

When our son Jack told my husband and I that he was gambling, we had no idea his life was at risk. As parents, we thought we knew all the dangers to warn our children about — drinking, drugs, smoking, road safety, sexual predators. 

In This Together (ITT) is an informative magazine, now in its sixth year, for people with conditions that require long-term  management with compression therapy. We are excited to also launch the In This Together website so that we can offer more frequent education, resources and updates in between issues of the magazine.

The Queen’s Nursing Institute has been working for the past two years on a project to encourage more internationally educated nurses to look at community nursing roles in England. The project is supported by NHS England, hence the geographical focus on that country.

Last November I was proud and privileged to be joined by over a thousand nurses, speakers and leaders across the country for the live launch of the new nursing version of our ShinyMind mental health and wellbeing app — available now, free of charge to all NHS nurses, midwives, nursing associates, and healthcare support workers in England.

There is a wealth of evidence to demonstrate that racial inequalities persist in the UK in health, housing, employment, and the justice system. Some of this evidence is presented on the government’s ‘Ethnicity facts and figures’ website, which provides experience and outcome data for people from a variety of backgrounds (www.ethnicity-factsfigures.service.gov.uk/).