A new online therapy for PTSD, ICS's in more deprived areas exceeding expectations, trust's fatal failure to give inmate vital medication and doctors questioning the narrative on menopause – this week's Friday Five

New remote-delivered cognitive therapy for PTSD found to be just as effective as face-to-face

A pilot study by Cardiff University has found that online delivered therapy for Post Traumatic Stress Disorder (PTSD) is just as effective as face to face cognitive therapy.

The type of therapy tested was just 1/3rd of the length of a standard cognitive therapy course for PTSD, and involved a few face to face sessions with the remainder delivered online. Patients on the waiting list to access therapy for PTSD were invited to participate in the trial. Half of participants trialled the online version of the therapy and the other half received standard face to face cognitive therapy. After 16 weeks more than 80% of patients in both groups no longer had symptoms of PTSD, suggesting that the online approach was just as effective in treating the disorder as the treatment as usual option. The positive results of this trial could lead to savings of time and money for the NHS, as well as cutting waiting lists to access potentially life-changing treatment.

Professor Jon Bisson of Cardiff University who led the study says “What we believe is if this treatment was introduced to the NHS we could treat more people in a shorter amount of time therefore the waiting list for such treatments could reduce.”

Read the full story in BBC News.

ICS’s in Yorkshire performing highly on integration measures despite high levels of deprivation

New research has discovered a cluster of ICS’s with higher levels of socioeconomic deprivation that scored better on integration metrics than more affluent regions.

The metrics assessed factors such as A&E attendance rates, performance on waiting times for cancer treatment and adolescent mental healthcare. Generally, the research found that service integration and outcomes vary strongly with deprivation, with some ICSs performing better or worse than what would be expected given their level of deprivation.The ICSs performing better than would be expected given their level of deprivation include South Yorkshire & Bassetlaw, North Yorkshire & Humber, and West Yorkshire. Leaders from these areas have said that these findings reflect an established culture of integrated working.

Ben Richardson, part of the team at Carnall Farrar who led the research says “Just because you have a level of deprivation that’s high, doesn’t mean that it’s impossible to improve”.

Trust failed to give essential HIV medication to inmate

Essex Partnership University Trust failed for months to give vital medication to 21-year old prison inmate with a long-standing diagnosis of HIV.

An inquest jury identified five failures in the care of Thokozani Shiri, 21-year old prison inmate, concluding that these series of failures and neglect contributed to his death in April 2019. Shiri was a prisoner at HMP Chelmsford, where EPUT provided some services at the time. During his first of two stays in the prison, from November 2017 until mid-March 2018, he did not receive any HIV medication and was not seen at a HIV clinic until five days before his release. During his second stay, from October 2018 until mid-April 2019, he did not receive HIV medication or attend a HIV clinic until March. When Shiri became ill on 7th April 2019 he alerted a prison officer, expressing that he needed to go to hospital, but an ambulance was not called until five days later. He died of a HIV-related infection later at Broomfield Hospital.

His family said in a statement: “As a family we had great hopes that this [time in prison] would allow him to reflect and look to a brighter future. This was not to be, as a short-term prison sentence turned into a death sentence. Thoko was denied very basic care that would have enabled him to live his life, despite his long-term condition.”

Read the full story in Health Service Journal.

Doctors warn against what they see as the over-medicalisation of menopause

Doctors have warned that framing the menopause as a hormone deficiency instead of a natural event could increase women’s anxiety.

An urgent need to reframe the narrative on menopause and actively challenge the idea that menopause signals an inevitable decline in women’s wellbeing has been called for by Doctors writing in the British Medical Journal. They highlighted a recent review which found that negative expectations before menopause increased the likelihood of women experiencing negative symptoms.

Martha Hickey, professor of obstetrics and gynaecology explains: ‘Menopause is a natural event for half of humankind. While media attention in the UK may give the impression that growing numbers of women are struggling to cope with menopausal symptoms and are seeking hormonal treatment, there is no universal experience and most women prefer not to take medication unless their symptoms are severe.’

Read the full story in The Guardian.

Quote of the week

There has been a jump in child type 2 diabetes referrals in England and Wales of 50%. Health leaders describe this as a ‘perfect storm’ amid rising obesity levels and the cost of living crisis.

‘The chief executive of Diabetes UK, Chris Askew said “The UK government is letting our children down. With soaring numbers of children now living with obesity, and numbers diagnosed with type 2 diabetes on a very concerning climb, we are facing a perfect storm, which risks irreversible harm to the health of young people.’