A systematic review of economic analyses of psychological interventions and therapies in health-related settings.

BACKGROUND: This review aims to synthesise evidence on the economic impact of psychological interventions and therapies when applied to a broad range of physical health conditions. METHODS: The following bibliographic databases were searched for relevant articles: MEDLINE (Ovid), EMBASE (Ovid) and PsycINFO (Ebsco). As this review was intended to update an earlier review, the date range for the search was restricted to between January 2012 and September 2018. Reference lists from the review articles were also searched for relevant articles. Study quality was evaluated using the Scottish Intercollegiate Network Guidelines (SIGN) appraisal checklists for both economic studies and Randomised Controlled Trials (RCTs). When the economic analyses did not provide sufficient detail for quality evaluation, the original RCT papers were sought and these were also evaluated. Half of the papers were quality rated by a second author. Initial agreement was high and all disagreements were resolved by discussion. RESULTS: This yielded 1408 unique articles, reduced to 134 following screening of the title and abstract. The full texts of the remaining articles were reviewed by at least one team member and all exclusions were discussed and agreed by the team. This left 46 original research articles, alongside five systematic reviews. Fifty-seven per cent of the articles were deemed to be of high quality, with the remainder of acceptable quality. Fifteen different medical conditions were covered, with chronic pain (10 articles) and cancer (9 articles) being the two most investigated health conditions. Three quarters of the papers reviewed showed evidence for the cost-effectiveness of psychological interventions in physical health, with the clearest evidence being in the field of chronic pain and cancer. CONCLUSIONS: This paper provides a comprehensive integration of the research on the cost-effectiveness of psychological therapies in physical health. Whilst the evidence for cost-effectiveness in chronic pain and cancer is encouraging, some health conditions require further study. Clearly, as the primary research is international, and was therefore conducted across varying health care systems, caution must be exercised when applying the results to counties outside of those covered. Despite this, the results are of potential relevance to service providers and funders.

Supervision and assessment: the new Nursing and Midwifery Council standards.

In the UK, mentors of pre-registration nurses must achieve the stage 2 outcomes of the Nursing and Midwifery Council (NMC) ( 2008 ) standards to support learning and assessment in practice. Approval for new standards for student supervision and assessment was granted at the NMC meeting in March 2018 ( NMC 2018a ). The introduction of the new standards will see the dissolution of mentorship and the emergence of new roles to support students in academic and practice environments. This article gives an overview of these standards and, drawing on the recommendations from a collaborative event hosted by NHS Education for Scotland and some of the findings from a rapid literature review undertaken for that event, provides nurse managers with information to help inform their discussions as they work in partnership with approved education institution colleagues to realise, support and sustain the roles outlined in the new standards. The article concludes with some questions to consider during these collaborative discussions.

Neglected user perspectives in the design of an online hospital bed-state system: implications for the National Programme for IT in the NHS.

Technical aspects of the National Programme for IT in the National Health Service have run ahead of genuine engagement with front-line users. We have explored with front-line NHS staff the factors which limit their contribution to management information from operational systems. Staff place psychological distance between 'the real job' and the reporting of information. Even where accurate reporting is heavily incentivized, and operational control is shared between staff and shift leader, the reporting of information to the computer represents a division between caregiving and computer input, and between information openly declared and that waiting to be disclosed. The Programme needs to reconsider how clinicians are to be engaged. Equally, information systems designers, if they expect to obtain management information and want to understand the limitations of that process, need to be socialized into the fields where systems are to be deployed.

An international comparison of information in adverse events.

PURPOSE: Aims to describe the growing importance of information and its governance within public services. The paper starts by considering how scandals in three national public health systems have focused public attention on information issues. It describes a theoretical framework for improving information governance, and its practical implementation as a management tool. The paper concludes with a discussion of the benefits of the approach, and the consequences of not improving information governance. DESIGN/METHODOLOGY/APPROACH: The framework brings together a number of existing methodological approaches, principally the maturity model approach to process improvement, first described in the Software Engineering Institute's capability maturity model, and the novice-to-expert approach to competency. FINDINGS: The paper describes how these approaches can be synthesised into an integrated framework to manage organisational change and how that can be used to improve information governance within public sector organisations. RESEARCH IMPLICATIONS: The paper compares the framework and its practical implementation with existing solutions, arguing that existing solutions provide only partial solutions. ORIGINALITY/VALUE: Considers how plans for future service improvements will be restricted unless information governance issues can be addressed.