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Vaping is often seen as a lessharmful alternative to smoking cigarettes, and while this may
be true in some respects, it is not without its dangers. Understanding how this relatively new phenomenon of vaping could develop into a health concern and even an addiction was of real importance to the author’s team at the UK Addiction Treatment (UKAT) Group, hence the launch of an addiction prevalence survey towards the end of 2022.

There is a rising demand for health services due to an ageing population with  increasingly complex healthcare needs. Across the country, there are substantial  pressures on hospital beds, with people experiencing lengthy waits to be admitted and ambulances facing difficulties handing patients to emergency departments. Contributing
to this is the large number of people remaining in hospital despite being clinically ready to leave — referred to as a ‘delayed discharge’. In December 2022, an average of 13,440 patients a day remained in hospital despite no longer meeting the criteria to stay. This is 30% more than the daily average for December 2021 (House of Commons Library, 2023). As well as increasing pressures on hospital capacity, delayed discharges can lead to poorer outcomes for individuals and ontribute to a loss of independence. Having a method of discharging patients and preventing bed blocking is therefore essential in
managing patient flow and subsequently enhancing patient quality of life. The Care Act (2014) placed a statutory responsibility on local authorities to provide services which prevent or delay the need for care and support, or minimise the need for additional care and support (Department of Health, 2014). One such initiative that was reported to be commonplace among local authorities during this period is ‘singlehanded care’.

In 2012, the National Early Warning Score (NEWS) was introduced to standardise monitoring of vital signs and improve patient safety in acute hospitals. By 2017 around two-thirds of NHS hospitals were using NEWS and an updated version, NEWS2, was released. In 2019 all acute hospital trusts and ambulance services were required to use NEWS2. Now NEWS2 is being used increasingly in care homes and community settings. People living in care homes are often frail and have multiple healthcare conditions. NEWS was never designed to monitor the health of older people, but it has the potential to improve care by enabling staff to identify people who are becoming unwell and to provide care within care homes and the person’s own home. However, if it is not introduced with care, it could lead to an increase in the number of people attending accident and emergency departments. This article examines the emerging evidence base and concludes that appropriate support and advanced care planning are of crucial importance.