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Interconnected health

What condition are you treating? It used to be a simple question with a simple answer. Patients went to opticians or dentists, to physiotherapists or osteopaths, or to one of a number of other health professions depending on their prime need.

In recent years, there has been a growing recognition of the need for a more holistic approach, looking to provide all round support for conditions which may well be interconnected. Whilst that doesn’t diminish the importance of specialist care, treatments now also look beyond the specific. For example, optimising physiotherapy outcomes may also require some attention to lifestyle, diet and nutrition; whilst those with heart disease may also require some help with oral hygiene.

The importance of understanding the interconnectedness of health conditions has been highlighted by two new studies. The first, published on The Lancet Global Health website, reported the results of a systematic review of the association between vision impairment and mortality. The study’s authors concluded that there was a direct link between vision and impairment and all-cause mortality; with the magnitude of the effect increasing with more sever vision impairment. And whilst it might be reasonable to assume that problems with sight could lead to factors such as an increased risk of falls, the authors also highlighted a link between vision and areas such as cognitive impairment, dementia, and depression.

The second study by the Health Foundation looked at the challenges faced by those living with multiple conditions. That research revealed a link between the way in which an individual’s health needs are being met and the overall health of others in their household.  

In the UK a quarter of people have two or more long term health conditions; with their care accounting for more than half of the country’s health care costs. Interestingly the study has found that where these individuals live with others who also have two or more long term health conditions, each of them require higher care costs, greater numbers of GP visits and higher levels of community care than if they were to live with individuals with no long term conditions. This study not only highlights the interdependence of care within the family but also highlights the way in which those planning care packages need to take into account overall household situations rather than simply the health of the individual.

In a way neither of these studies reveals anything which could not be deduced by those who see patients on a day to day basis. And yet, sometimes it takes studies such as these to confirm what health professionals already suspected; the importance of stepping outside of a narrow band to take a more holistic view of treatment programmes.

It’s a viewpoint which can also be taken into the day to day running of health practices. Appointment and diary management, electronic filing of patient notes, call answering; whatever the process, there could be scope for streamlining or optimising practices by taking a more holistic viewpoint. Particularly so, when client flow is seen as a continuous interconnected process rather than as a series of discrete points. For example, when appointment reminders are seen as an integral element of  the appointment process then diary management and a reduction in no-shows could follow, helping the practice to optimise its treatment times.

A healthy mind in a healthy body

The idea of the connection between a healthy mind and a healthy body was further strengthened recently with the release of a research paper via the British Journal of Sports Medicine. The research, which reviewed thirty-nine existing studies, focused on the way in which staying fit and healthy could help to stave off brain degeneration, particularly in the over 50s.

Interestingly, optimal levels of exercise identified consisted of a mix of aerobic and muscle training activities. Apparently muscle training helps to improve both memory and the brain’s ability to plan and organise whilst aerobic exercise helps areas such as thinking and reasoning.

Before you sign up to those gym classes, it’s worth noting that carrying out the required amount of exercise to help brain power needn’t be all that taxing. For example, simply carrying a heavy shopping bag could count towards muscle training, whilst walking or cycling to work could be enough to tick the aerobic box. Of course that does depend on individual circumstances so if you work from home and have groceries delivered you may have to think again about your exercise regime.

Commenting on the survey Dr Justin Varney from Public Health England highlighted the way in which even ten minutes of exercise can prove beneficial. However, he also pointed out that we’d be better off undertaking 150 minutes of exercise each week as this has been shown to cut the risk of dementia and depression by a third.

Whilst exercise is good at any age, the report’s authors highlight the particular link between exercise and brain health in the over 50s. One of the authors from the University of Canberra commented that the results were ‘convincing enough to enable both types of exercise to be prescribed to improve brain health in the over-50s.’

Apparently exercise can be good for brain health even in those who have already started to show evidence of cognitive decline, perhaps making it a complimentary treatment for those who are suffering in the early stages of dementia. Adding to the mix is the fact that physical activity has also been shown to help to reduce the risk of certain conditions including some cancers and type II diabetes.

Having said that, the level of exercise undertaken has to be appropriate for the individual. Suddenly moving from a sedentary lifestyle into marathon running whilst dressed as a weightlifter may not be the best of ideas! Starting out with a health check up or taking advice from a health professional such as a sports physiotherapist may help to identify what options would best suit an individual.

Another option may be to contact local sports clubs, many of which now offer social sporting activities for older people. Sports such as walking football, kick golf and rambling rugby are all growing in popularity and can be a great way of getting fit whilst maintaining an active social life; another identified brain booster. The importance of staying fit in order to help to boost brain health shouldn’t really be a surprise; but when studies such as these come along to highlight the benefits to be gained from even a moderate amount of exercise, perhaps a time that we all looked to stepping up the desire to stay fit.

A happy and healthy Easter break

The Easter bank holiday weekend is upon us and with it comes the usual crop of warnings about staying healthy over the long weekend.  Apart from common sense advice such as ensuring that repeat prescriptions are filled and collected in advance of the weekend and that medicine cabinets are well-stocked, health boards have also been reminding people about the importance of choosing the right pathway should healthcare be required over the weekend.

The prime message which health boards are trying to convey is that accident and emergency departments are there for serious and life-threatening emergencies, and should not therefore be used as a first port of call for minor injuries and ailments which could be treated elsewhere. In many instances sprains and strains, cuts and grazes could be treated at home whilst local pharmacies may be the best port call for other minor ailments.

A quick internet trawl of the advice arising from health boards also highlights the importance of telephoning 111 for advice or downloading the HANDi App which provides advice and support to parents and carers in respect of children’s illnesses. However, it has to be said that prevention is better than cure and it is therefore important that people take care of themselves in order to reduce the burden on health services.

For example, if the weather should turn fine this bank holiday weekend then keeping to the shade, staying covered up and making sure you are well hydrated could help to prevent heatstroke or sunburn. On the other side of the coin, a small amount of sun is good for us as it helps our bodies to produce vitamin D, a vital ingredient in the development of healthy bones and teeth. With 700 cases of rickets diagnosed in 2013/14, shunning the sun altogether may not be the best solution for long-term health.

Then there’s the other bank holiday tradition of indulging in a sudden spurt of gardening or DIY. For those of us who spend most of our lives sitting in front of a computer screen, suddenly indulging in heavy exercise may not be the best idea for the health of our muscles and ligaments this Easter. So whilst you may not be taking part in organised sport, taking time to warm up before attacking that vegetable patch could help to prevent muscle damage. Then it’s a case of taking regular rest breaks to give tired bodies a chance to recover before they are stretched too far.

And while we’re on the subject don’t neglect the importance of following correct procedures when lifting heavy objects. It’s all too tempting to lean forward to pick up that bag of potting compost but if you do you may well be putting your back in danger. So standard advice says to bend your hips and knees as you squat down to the object you want to move, keep it close to your body and straighten your legs to lift. And when you are lifting or holding heavy object avoid turning or twisting your body.

Following best practice advice may help people to avoid that other bank holiday tradition, the after holiday trip to the physiotherapist, chiropractor or osteopath. Yes being sensible may mean that you take two days to do something that you thought you could achieve in one; but don’t forget we have got two more bank holidays coming up in May so there’s plenty of time to spread the workload this Easter and stay healthy.

Time for a clear out

If you missed ‘national clear your clutter day’ don’t worry – there is still plenty of time to make a difference.  With a nod to the allegedly diminishing practice of spring cleaning, clear your clutter day on 11th March 2017 was billed as a chance to clear unwanted items either for profit or a sense of positive change.

The day’s organisers recommended using a simple four box sorting system as a way of identifying which items could be sold, upcycled, swapped or recycled. And the message wasn’t just aimed at decluttering households, businesses too were urged to join in and have a good sort out and tidy.

There were also some handy hints for those of us who may find the notion of a mass tidy-out a little intimidating.  These included breaking down the area to be tidied into manageable chunks, either by room or even by cupboard or drawer. If even that seems insurmountable, the organisers suggest getting into the habit of clearing one item per day. It may not seem much but over the course of the year that makes 365 unwanted items cleared out of the home or business and into a charity shop or recycling facility.

Interestingly the clear your clutter campaigners don’t stop at suggesting we declutter only physical items.  Finances and even the contents of our in boxes also come under scrutiny. For example, we may not have much control over the inward flow of e-mails but do we really need to keep all of those sent ones which merely say ‘thanks’ or ‘have a happy birthday’?  And then there is the delete box. If we have already identified an e-mail as no longer required why leave it lingering and taking up space in the delete folder?  There may be a good business reason why some e-mails need to be kept but identifying which ones we really need helps us to rethink our business priorities as we clear.

Other suggestions include sitting down with all that paperwork which is cluttering up the office or home and having a good sort out.  Whilst there is some paperwork which needs to be kept in physical form (property deeds or passport come to mind here) there is much which could be scanned and filed electronically.  Not only does that declutter the office, by making use of a good indexing system it becomes much easier to find documents quickly when needed.

This is a practice which health professionals are increasingly adopting for patient records.  Electronic filing is safe and secure and not only allows for instant retrieval it also helps to speed up treatment in cases where records may need to be shared across different specialists.

When it comes to decluttering finances, there are a few simple things which you can do which can make a measurable difference.  Here again having paperwork and outstanding invoices lying around can add to stress levels so moving to electronic system could make a difference to the way in which finances are approached. Keeping a simple spreadsheet will help individuals to identify when key bills are due whilst for businesses moving to a form of electronic payment can smooth cash flow.

For example, healthcare providers such as physiotherapists or chiropractors may wish to consider taking card details at the time of appointment booking. Not only does this help to smooth cash flow; having provided card details patients are less likely to miss an appointment, particularly if a no-show fee is clearly highlighted on the appointment terms and conditions.

Busy lives make it all too easy to let clutter build up. We may intend to clear this when we’ve done that but then something else comes up and the clearing never gets done.  Taking time to step back and re-evaluate can force us to stop and not only clear but also plan a less cluttered future.

Supporting health in the workplace

In our last article we examined the challenges facing the baby boomer generation and the way in which employers can help them to remain in the workplace. Now we are moving on to look at some of the ways in which employers can help all employees to stay on top of their game.

Our article has been prompted by a workplace mental health review which has recently been launched by Prime Minister Theresa May. The review which is to be led by Lord Dennis Stevenson, formerly chair of HBOS, and Paul Farmer who is the Chief Executive of Mind aims to promote best practice concerning mental health issues within the workplace, reduce discrimination, and work with industry to remove the stigma surrounding mental health issues.

The workplace review is part of a wider package of measures which also aims to improve mental health provision for young people within schools and colleges as well as improving the way in which mental health issues are approached within the NHS. Facing up to mental health problems within the workforce is vital if we are to remove stigma and help people to receive the treatment and support which they need. As the Prime Minister commented “mental well-being doesn’t just improve the health of employees, it improves their motivation, reduces their absence and drives better productivity too.”

But mental health is only one area in which employers can better support employees. Health and safety regulations may require employers to ensure the safe provision of equipment, including desks and chairs, but there are plenty of other ways in which employers can help employees to stay fit and healthy.

For example, the Chartered Society of Physiotherapy has recently highlighted a January fitness programme launched by physios at the South Warwickshire NHS trust. Following on from an earlier initiative in which they produced a thirty minute workout which staff working at the trust could use to boost their fitness over the period of one month, the new Workout at Work programme aims to help staff to stay fit through the busy winter period.

Of course the South Warwickshire NHS trust has the benefit of physiotherapists on the premises but other organisations could follow their lead by organising a staff fitness program in conjunction with a local physiotherapist or fitness trainer. Other options could include the provision of a chiropractor for those staff who are on their feet for lengthy periods of time or even simply providing staff with access to a health nutritionist who could provide guidance on the link between nutrition and physical and mental well-being.

Finally, never underestimate the importance of basic hygiene practices such as sanitising shared equipment and deep cleaning restrooms and kitchens on a regular basis. This, taken alongside the policy of ensuring that staff who are sick stay at home to avoid infecting others can make a measurable difference to the overall health of the workforce.

It’s only January and already we’ve had reports of health resources being stretched well beyond capacity with the government looking at removing the four hour A&E treatment limit for non-urgent cases. Supporting health in the workplace is one way in which employers can play their part in helping to improve the overall health of the nation and reduce the strain on the health system.

Combining therapies

We are constantly reminded about the way in which regular exercise can improve our overall health.  Now researchers in America have published the results of a survey of 10,000 people into the benefits of exercise, for those taking statins to lower cholesterol and prevent heart disease.

The researchers found that middle aged people who take regular exercise, such as 150 minutes of brisk walking or cycling per week, are 50% less likely to die in the next ten years than those who take statins and don’t exercise.  Those who combined exercise with statins were 70% less likely to die in a ten year period than those who simply took statins.

The results add to a growing body of evidence on the way in which even modest amounts of exercise can help to lower cholesterol and prevent diseases such as diabetes from developing.  In commenting on the study, Natasha Stewart, senior cardiac nurse at the British Heart Foundation told the Daily Telegraph that the results showed that combining exercise and statins could “provide a winning combination to further improve your heart health, with higher intensity exercise possibly offering more protection.”

It is generally recommended that anyone with high levels of cholesterol or who has lived a sedentary lifestyle take advice from a health practitioner before starting on an exercise programme.  This may not necessarily be the local GP, with many GP practices offering support services for a range of conditions.  As with any health issue it is important to call on the service which is most appropriate and indeed the NHS Choose Well campaign is designed to help patients to choose the service which will meet their needs.

The aim of the Choose Well campaign is to free up A&E departments to concentrate on those who have a critical or life-threatening need whilst ensuring that all patients receive speedy treatment.  For health practitioners such as osteopaths and physiotherapists this may result in patients taking more responsibility for their treatment and calling direct for appointments.

This is where a virtual appointment service such as Clinic Appointments can come in handy. With Clinic Appointments’ trained receptionists taking calls and making appointments, health practitioners can maximise treatment times whilst eliminating missed calls.  So, whether you are treating patients who have responded to Choose Well and made appointments direct or coping with the aftermath of a sudden rise in exercise by the middle aged, you know you can concentrate on what you do best without worrying about diary management or missed calls.

Contact us today to discover how Clinic Appointments can help your clinic. Book your free demo call now to learn more.