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Poverty impacts negatively on children's health and future life chances. Access to the UK's National Health Service (NHS) is based on clinical need rather than the ability to pay but horizontal inequities in access exist. Children North East, a charity supporting children experiencing poverty, are working with partners to reduce the impacts of poverty on NHS access. This collaborative study aimed to understand barriers to healthcare access faced by families living on low incomes to validate and support further development of a Poverty Proofing© healthcare tool. Twenty-four parents and eight Voluntary Community Social Enterprise sector staff participated in qualitative interviews or focus groups. Data were analysed thematically, and three main themes were identified as impacting access to healthcare: hidden costs, securing appointments and developing relationships with healthcare providers. We conclude that low-income families experience both financial and other barriers to accessing NHS healthcare and that these barriers are exacerbated for low-income families living in remote/rural areas. [ABSTRACT FROM AUTHOR]

Children and young people's (CYP) life chances depend heavily on family resources. This paper reports a rapid review of qualitative/mixed method studies about Universal Credit undertaken with CYP in the UK; subsequently expanded to include additional descriptors of economic disadvantage. Sixteen studies were reviewed; narrative synthesis was used to explore themes. Most recruited CYP with experience of economic disadvantage; none explicitly reported perspectives of CYP experiencing disability or rurality. Findings show growing up in poverty has significant, negative impacts on health and well‐being, causing feelings of exclusion, shame and unfairness; raising important questions about the adequacy of welfare support in the UK. [ABSTRACT FROM AUTHOR]

Introduction During the UK Covid-19 lockdown, video consultations (telemedicine) were encouraged. The extent of usage, and to which concerns to earlier implementation were set aside, is unknown; this is worthy of exploration as data becomes available. Sources of data Sources of data are as follows: published case studies, editorials, news articles and government guidance. Areas of agreement Video can be clinically effective, especially where patients cannot attend due to illness or infection risk. Patients are positive, and they can benefit from savings in time and money. Adoption of telemedicine is hindered by a range of known barriers including clinician resistance due to technological problems, disrupted routines, increased workload, decreased work satisfaction and organizational readiness. Areas of controversy Despite policy impetus and successful pilots, telemedicine has not been adopted at scale. Growing points Increased use of telemedicine during the Covid-19 crisis presents opportunities to obtain robust evidence of issues and create service transformation effectively. Areas timely for developing research Examination of telemedicine use during the Covid-19 crisis to ensure that the benefits and usage continue into the post-lockdown, 'new normal' world. [ABSTRACT FROM AUTHOR]

The aim of this article is to present a discussion of the impact of telemedicine on professional practice, and the implications for the workforce. Telemedicine, or the use of video-conferencing for remote consultations between clinician(s) and patients, is now a mature technology. Many pilot studies have taken place, generally showing positive benefits to patients. There is emerging evidence that the impact on staff is more mixed; with concerns about changes to job role, skills development, and poor understanding of the organisational benefits. Evidence also highlights enablers of successful telemedicine implementation, including senior leadership, peer motivation, understanding of patient benefits, and time for safe experimentation. Following a review of qualitative data from four case study telemedicine projects undertaken within the authors' research group, evidence from published literature is discussed. The four projects explore telemedicine services provided between an acute hospital service and nursing homes (remote assessment of swallowing difficulties), an acute hospital service and home (video-link to renal patients undergoing home dialysis), between a specialist teaching hospital service and a district general hospital (fetal abnormalities ultrasound telemedicine clinic), and a survey of mental health professionals across acute and community services within a locality. The introduction of telemedicine at scale requires an organisational and system-level approach that recognises the specific challenges and issues for the workforce. Education and training need to be provided at all levels. In conclusion: there are significant opportunities to realise the benefits of remote consultations, to improve the patient experience and staff productivity, if workforce issues are addressed. [ABSTRACT FROM AUTHOR]

Purpose – Telemedicine has enabled speech and language therapists (SLTs) to remotely assess swallowing difficulties (dysphagia) experienced by nursing home residents. The new technique, “teleswallowing”, was designed by the Speech and Language Therapy Service at Blackpool Teaching Hospitals NHS Foundation Trust. It allows prompt assessment, avoiding potential risks of aspiration pneumonia, malnutrition, poor rehabilitation, increased hospital stays and reduced quality of life (Hinchey et al., 2005; Langmore et al., 1998). The purpose of this paper is to report on a second pilot of teleswallowing and the concomitant adoption study. Design/methodology/approach – The adoption study employed qualitative methods, including consultations with senior managers, semi-structured interviews with nursing home matrons/managers and nurses, two focus groups and semi-structured interviews with SLTs. The project clinical lead kept an activity log, which was used to estimate resource savings. Findings – Over a three-month period, six SLTs and 17 patients in five nursing homes participated in teleswallowing assessments. Teleswallowing benefited both patients and participating nursing homes. Better use of therapist time and cost savings were demonstrated and evidence showed that the service could be successfully scaled up. Despite this, a number of barriers to service transformation were identified. Originality/value – This is the first implementation of teleswallowing in the UK, but it has been used in Australia (Ward et al., 2012). The approach to engaging stakeholders to understand and address barriers to adoption is novel. The value lies in the lessons learned for future innovations. [ABSTRACT FROM AUTHOR]