NHS Library and Information Service North Staffordshire

Clinical Effectiveness Bulletin for NHS Primary Care in North Staffordshire

Issue No: 67 August 2012

About this Bulletin: It aims to draw attention to some of the key documents and reviews on clinical effectiveness that have been published in the previous month. Where possible, links to the full text documents are included. If the article is in a journal, you can contact the Health Library for a copy. Link to request form: http://www.keele.ac.uk/healthlibrary/usingthehealthlibrary/interlibraryloans/#d.en.27437 [Please note - a charge of 2 per request is payable for most copies] If you need further assistance, please contact the Health Library or the NHS Outreach Librarians, details below. The bulletin can be e-mailed to colleagues who may also find it useful. A list of websites checked in the production of this bulletin is on the first page. Please suggest further useful sites. Feedback is always welcomed to inform future issues of the bulletin.

Contact information

Bulletin produced by NHS Outreach Librarians Tel: FeatureNet 8429 (External calls 0300 123 1535 ext 8429) E-mail: lindsay.snell@northstaffs.nhs.uk clareh.powell@northstaffs.nhs.uk

North Staffs Health Library Tel: 01782 679500 Fax: 01782 679582 E-mail: health.library@keele.ac.uk

NHS Library and Information Service North Staffordshire

Sources for Clinical Effectiveness Bulletin Please suggest further sites that should be monitored in the production of this bulletin Websites Cochrane Library http://www.thecochranelibrary.com/ CRD Centre for Reviews and Dissemination http://www.crd.york.ac.uk/crdweb/ - DARE (Database of Abstracts of Reviews of Effects) - NHS Economic Evaluation Database Health Technology Assessment (HTA) Database http://www.hta.ac.uk Daily Health Bulletin http://www.sheffield.nhs.uk/healthbulletin/ Department of Health http://www.dh.gov.uk/en/index.htm Kings Fund http://www.kingsfund.org.uk/ NeLM (National Electronic Library for Medicines) news bulletin http://www.nelm.nhs.uk/en/ NICE http://www.nice.org.uk/ SIGN http://www.sign.ac.uk/new.html

NHS Library and Information Service North Staffordshire Contents in this issue:
Alcohol ...................................................................................................................................... 4 Cancer ...................................................................................................................................... 4 Cardiovascular Diseases .......................................................................................................... 5 Carers ....................................................................................................................................... 6 Children and Young People ...................................................................................................... 6 Commissioning ......................................................................................................................... 6 COPD ....................................................................................................................................... 8 Dentistry.................................................................................................................................... 8 Diabetes.................................................................................................................................... 9 End of Life Care ........................................................................................................................ 9 General Practice ..................................................................................................................... 10 Guidance ................................................................................................................................ 10 Health and Safety ................................................................................................................... 12 Health Reforms ....................................................................................................................... 12 Health Technology and Information ........................................................................................ 14 HIV .......................................................................................................................................... 14 Infection Control ...................................................................................................................... 15 Integrated care........................................................................................................................ 15 Kidney Disease ....................................................................................................................... 15 Learning Disabilities ................................................................................................................ 16 Maternal and Infant Health...................................................................................................... 16 Mental Health.......................................................................................................................... 17 Nursing ................................................................................................................................... 18 Neurological Conditions .......................................................................................................... 18 Obesity.................................................................................................................................... 18 Older People ........................................................................................................................... 19 Patient Care and Safety .......................................................................................................... 19 Pharmacy and Prescribing ...................................................................................................... 20 Physiotherapy ......................................................................................................................... 20 Public Health ........................................................................................................................... 20 Safeguarding Children and Vulnerable Adults ........................................................................ 21 Screening................................................................................................................................ 22 Service Management .............................................................................................................. 22 Sexual and Reproductive Health ............................................................................................ 23 Social Care ............................................................................................................................. 24 Tobacco .................................................................................................................................. 24 Vaccination and Immunisation ................................................................................................ 25 Workforce ............................................................................................................................... 25

NHS Library and Information Service North Staffordshire Alcohol

Local alcohol profiles for England North West Public Health Observatory The profiles have recently been updated with current data. http://www.lape.org.uk/index.html Local variations in youth drinking cultures Joseph Rowntree Foundation This study explores the lives of young people, aged 15-24, in two study areas located in regions of England where the harm caused by alcohol is markedly different. The aim of the research was to explore whether living in these places influenced young peoples drinking. http://www.jrf.org.uk/publications/local-variations-youth-drinking-cultures A positive choice: Young people who drink little or no alcohol Joseph Rowntree Foundation This study is based on interviews examining young peoples reasons for drinking little or no alcohol, and how they managed situations where they were drinking less than their peers. http://www.jrf.org.uk/publications/positive-choice-young-people
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Cancer
Adult survivorship pathway: Living with and beyond cancer NHS Improvement This interactive generic pathway demonstrates examples of care and support and also signposts to other relevant sources of information. http://www.improvement.nhs.uk/cancer/survivorship/adult_survivorship_pathway/ Cancer Patient Experience Survey 2011/12: national report Department of Health This report provides insights into the level of care received by nearly 72,000 inpatient and day case cancer patients. http://www.dh.gov.uk/health/2012/08/cancer-experience-survey/ There when you need it the most? The Cancer Drugs Fund: 2011-12 annual report Rarer Cancers Foundation This report evaluates the impact of the Cancer Drugs Fund on access to cancer drugs in England. It looks at the impact on patients, providers, and commissioners. http://www.rarercancers.org.uk/index.php?option=com_content&view=article&id=30 0:
Items in the General Practice sections may also be of interest. [back to topics]

NHS Library and Information Service North Staffordshire Cardiovascular Diseases

Adherence to drugs that prevent cardiovascular disease: meta-analysis on 376,162 Patients Naderi, S et al. This article considers causes of nonadherence, and makes recommendations for improving adherence. American Journal of Medicine 125(9), September 2012, p.882887.e1 Blood pressure targets in patients with coronary artery disease: observations from traditional and Bayesian random effects meta-analysis of randomised trials Bangalore, S et al. This review is based on 15 RCTs involving 66,504 participants. Heart online first doi:10.1136/heartjnl-2012-301968 Comparative effectiveness of warfarin and new oral anticoagulants for the management of atrial fibrillation and venous thromboembolism: a systematic review Adam, S et al. This review is based on 6 good quality trials. Ann Intern Med. Online first, 28 August 2012 Lipid-Modifying Therapies and Risk of Pancreatitis: A Meta-analysis Preiss, D et al. This meta-analysis looks at risks associated with statin therapy and fibrate therapy. JAMA. 2012;308(8) p.804-811. doi:10.1001/jama.2012.8439 Low sodium versus normal sodium diets in systolic heart failure: systematic review and meta-analysis DiNicolantonio, J et al. This article reviews the impact of dietary sodium on morbidity and mortality in systolic heart failure patients. Heart doi:10.1136/heartjnl-2012-302337 Pharmacotherapy for mild hypertension Diao, D et al. This Cochrane review assesses the benefits and harms of antihypertensive drug therapy for mild hypertension. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD006742.pub2/abstract
Items in the Diabetes and Kidney Disease sections may also be of interest. [back to topics]

NHS Library and Information Service North Staffordshire Carers

Psychological interventions for parents of children and adolescents with chronic illness Eccleston, C et al. This Cochrane review looked at the impact of psychological interventions on a range of aspects of the lives of parents of children and young people with chronic conditions. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD009660.pub2/abstract Review of national arrangements for providing information and advice to carers Department of Health This review of the Carers Direct information service looks at the arrangements for delivery of the service with a view to informing the fit within wider Departmental developments as well as changes in health and social care. The review suggests a way forward towards ensuring a coherent, cost effective approach to services that is aligned with developing policy and delivers a quality service to carers. http://www.dh.gov.uk/health/2012/08/review-of-carers-direct/
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Children and Young People

Items in the Alcohol, Carers, Nursing and Obesity sections may be of interest.

Commissioning
CCG Quality Profiles Midlands and East Quality Observatory These Profiles provide an assessment of quality across the 5 domains of the NHS Outcomes Framework. A sixth domain, "Organisational Context," has been created, which contains a number of metrics which look at organisational behaviour and measures useful in interpreting other metrics in the Dashboard. http://www.meqo.nhs.uk/OurProjects/PracticeQualityProfiles/CCGQualityProfiles.aspx Stoke CCG profile: http://www.meqo.nhs.uk/portals/1/practice%20profiles/CCG/Q34_05W_QP.pdf North Staffordshire CCG Profile: http://www.meqo.nhs.uk/portals/1/practice%20profiles/CCG/Q34_05G_QP.pdf A consultation on guidance for commissioners: Ensuring continuity of health services and designating Commissioner Requested Services and Protected Services Monitor This guidance sets out a process from initiating the process of designating services as Commissioner Requested Services under Monitor's provider licence, through to finalising their decision about which services to protect in the rare event of provider failure. Closing date for comments: 8 November 2012 http://www.monitor-nhsft.gov.uk/home/news-events-and-publications/ourpublications/consultations/consultations-and-engagement-monito-1 6

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Economies of scale and scope in healthcare markets Monitor This project was designed to establish where there is robust evidence that individual services rely on the delivery of high volumes or interdependent services to be cost efficient. Closing date for comments: 18 October 2012 http://www.monitor-nhsft.gov.uk/economiesofscaleandscope A guide to commissioning for equality RCN This brief introduction looks at links between the Equality Act 2010 and the Public Sector Equality Duty and commissioning. http://www.rcn.org.uk/__data/assets/pdf_file/0011/472466/004222.pdf How to measure for improving outcomes: a guide for commissioners Kings Fund These two slide sets look at choosing indicators and measuring quality along care pathways. http://www.kingsfund.org.uk/current_projects/gp_commissioning/improving_outcomes.html Looking for value in hard times: how a new approach to priority setting can help improve patient care while making savings The Health Foundation This report describes a new approach to priority setting called Star (socio-technical allocation of resources). It works by producing simple visual models, developed with stakeholders, so that everyone involved can understand the nature of the choices to be made. http://www.health.org.uk/publications/looking-for-value-in-hard-times/ Reforming payment for health care in Europe to achieve better value Nuffield Trust This report compares different payment systems for health care used across Europe and examines their role in improving the efficiency and quality of care. http://www.nuffieldtrust.org.uk/publications/reforming-payment-health-care Specialist Services: A Guide for Commissioners Voice4Change England and NAVCA Specialist services are designed and delivered by and for the users and communities they aim to serve. This briefing focuses on BME voluntary organisations, which often work across multiple disadvantages. In order to meet the complex needs of many individuals within our community, a holistic approach is often required. Specialist services provide a proven means through which to deliver this. http://www.navca.org.uk/news/view-article/equalities-new-report Supporting Commissioning Information Centre for Health and Social Care This web page brings together a range of useful information, tools, data and other resources to support commissioning. http://www.ic.nhs.uk/commissioning

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Working with local government: a guide for GP commissioners NHS Confederation This briefing includes information on what councils do, how they are structured and how they work across tiers. Its purpose is to help commissioners understand more about local government and suggest ways of bridging structural and cultural differences to build strong, productive local partnerships. A similar guide for local councillors and officers is also available. http://www.nhsconfed.org/priorities/latestnews/Pages/New-briefings-for-health-and-wellbeingboards-published.aspx
Items in the Cancer, COPD, Diabetes, Health Reforms, HIV, Maternal and Infant Health, Service Management and Sexual Health sections may also be of interest. [back to topics]

COPD
COPD Commissioning Toolkit: A Resource for Commissioners Department of Health This toolkit aims to make it easier to commission better outcomes for people with COPD by bringing together the clinical, financial and commercial aspects of commissioning in one place. http://www.dh.gov.uk/health/2012/08/copd-toolkit/
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Dentistry
Dental Earnings and Expenses, England and Wales, 2010/11 Health and Social Care Information Centre This report provides a detailed study of the earnings and expenses of full and part time selfemployed primary care dentists who carried out some NHS work. http://www.ic.nhs.uk/statistics-and-data-collections/primary-care/dentistry/dental-earningsand-expenses-england-and-wales-2010-11 Dental Working Hours, England and Wales, 2010/11 and 2011/12 Health and Social Care Information Centre This report provides information on dental working hours for dentists who performed some NHS activity. Information on average weekly hours, weekly NHS hours, weeks of annual leave and the division of time between NHS and private dentistry, and clinical and non-clinical work, is presented. http://www.ic.nhs.uk/statistics-and-data-collections/primary-care/dentistry/dental-workinghours-england-and-wales-2010-11-and-2011-12
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NHS Library and Information Service North Staffordshire Diabetes

The care of people with diabetes to support SHA clusters Yorkshire and Humber Public Health Observatory These packs provide an overview of diabetes care and outcomes for each Strategic Health Authority cluster. http://www.yhpho.org.uk/resource/browse.aspx?RID=145942 End of Life Diabetes Care: A Strategy Document Diabetes UK This guidance builds on the Department of Healths End of Life Strategy (published in July 2008) but focuses on the special issues and challenges provoked by end of life care for patients with diabetes. It is hoped that this new diabetes-related guidance will contribute to the development of consistent approaches in the delivery of this care at the end of life. http://www.diabetes.nhs.uk/news_and_events/new_end_of_life_diabetes_care_strategy/ Intensive and Standard Blood Pressure Targets in Patients with Type 2 Diabetes Mellitus: Systematic Review and Meta-analysis McBrien, K et al. This systematic review assesses the impact of intensive and standard blood pressure control on mortality, myocardial infarction and stroke. Arch Intern Med. Published online August 06, 2012. doi:10.1001/archinternmed.2012.3147 Prescribing for Diabetes in England: 2005/6 to 2011/12 Health and Social Care Information Centre This report looks at trends in numbers of prescriptions for diabetes, and associated costs. http://www.ic.nhs.uk/statistics-and-data-collections/primary-care/prescriptions/prescribing-fordiabetes-in-england-2005-6-to-2011-12 Safe Use of Non-Insulin Therapies e-learning module NHS Diabetes The aim of the module is to improve patient safety by reducing the number of patients who experience medication errors and/or poorly controlled blood sugar levels while utilising noninsulin therapies, both of which are potentially life threatening. http://www.diabetes.nhs.uk/safe_use_of_insulin/safe_use_of_noninsulin_therapies_elearning _module/
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End of Life Care

End of Life Care Local Authority Profiles 2012 NHS National End of Life Care Programme These Profiles present over 50 indicators for each local authority in England. They include social care indicators for the first time. The web page also links to a guide describing the issues and limitations of the social care data. http://www.endoflifecare-intelligence.org.uk/end_of_life_care_profiles/la_profiles_2012.aspx
Items in the Diabetes section may be of interest.

NHS Library and Information Service North Staffordshire General Practice

EPS: GP-Pharmacy Engagement Checklist Pharmaceutical Services Negotiating Committee This checklist is designed to support GP surgeries and pharmacies in working together to implement release 2 of the electronic prescriptions service as smoothly as possible. http://www.psnc.org.uk/news.php/1400/eps_gp_pharmacy_engagement_checklist_published General Practice Profiles for Cancer National Cancer Intelligence Network These profiles give information about key indicators relating to cancer services for most GP practices in England. They are intended to help GP practices think about the services they offer to their patients, in particular services related to recognising symptoms and diagnosing cancer earlier. http://www.ncin.org.uk/cancer_information_tools/profiles/gp_profiles.aspx
Items in the Commissioning and Maternal and Infant Health section may also be of interest. [back to topics]

Guidance
NICE Clinical Guidelines Antibiotics for early-onset neonatal infection CG149 http://guidance.nice.org.uk/CG149 Lower limb peripheral arterial disease CG147 http://guidance.nice.org.uk/CG147 Osteoporosis fragility fracture CG146 http://guidance.nice.org.uk/CG146 Urinary incontinence in neurological disease CG148 http://guidance.nice.org.uk/CG148 NICE Technology Appraisals Bevacizumab in combination with capecitabine for the first-line treatment of metastatic breast cancer TA263 http://guidance.nice.org.uk/TA263
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NICE Diagnostics Guidance Adjunctive colposcopy technologies for examination of the uterine cervix - DySIS and the Niris Imaging System DG4 http://guidance.nice.org.uk/DG4 NICE Quality Standards Colorectal cancer quality standard QS20 http://publications.nice.org.uk/quality-standard-for-colorectal-cancer-qs20 Stable angina quality standard QS21 http://publications.nice.org.uk/quality-standard-for-stable-angina-qs21
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NICE Consultation Documents Autologous blood injection for plantar fasciopathy: consultation document Closing date for comments: Closing date for comments: 18 September 2012 http://www.nice.org.uk/guidance/index.jsp?action=article&o=60674 Conduct disorders in children and young people: guideline consultation To comment, register as a stakeholder organisation, or contact the registered stakeholder organisation that most closely represents your interests. Closing date for comments: 26 September 2012 http://www.nice.org.uk/guidance/index.jsp?action=folder&o=60584 Dementia - supporting people to live well with dementia: consultation on draft quality standard To comment, register as a stakeholder organisation, or contact the registered stakeholder organisation that most closely represents your interests. Closing date for comments: 16 October 2012 http://www.nice.org.uk/guidance/qualitystandards/socialcare/CareOfPeopleWithDementiaCon sultation.jsp Interventional procedures consultation document: deep dermal injection of nonabsorbable gel polymer for HIV-related facial lipoatrophy Closing date for comments: 18 September 2012 http://www.nice.org.uk/guidance/index.jsp?action=article&o=42588 Looked-after children and young people: consultation on draft quality standard To comment, register as a stakeholder organisation, or contact the registered stakeholder organisation that most closely represents your interests. Closing date for comments: 16 October 2012 http://www.nice.org.uk/guidance/qualitystandards/socialcare/LookedAfterChildrenAndYoungP eopleConsultation.jsp

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NICE implementation toolkits The National Institute for Health and Clinical Excellence (NICE) is running a series of workshops to explore the accessibility of NICE's Implementation tools and services. The sessions will take place between 17-28 September 2012 in London and Manchester. http://www.nice.org.uk/usingguidance/niceimplementationprogramme/NICEImplementationTo olsUserResearchWorkshops.jsp Psychosis and schizophrenia in children and young people: guideline consultation To comment, contact the registered stakeholder organisation that most closely represents your interests and pass your comments to them. Closing date for comments: 27 September 2012 http://www.nice.org.uk/guidance/index.jsp?action=folder&o=60474 WatchBP Home A for diagnosing and monitoring hypertension and detecting atrial fibrillation: guidance consultation Closing date for comments: 9am, 12 September 2012 http://www.nice.org.uk/guidance/index.jsp?action=folder&o=60599 Other Health Technology Assessments Non-pharmacological interventions to reduce the risk of diabetes in people with impaired glucose regulation: a systematic review and economic evaluation. Snaith A, et al. This systematic review found that dietary change to ensure weight loss, coupled with physical activity, is clinically effective and cost-effective in reducing progression to diabetes in people with impaired glucose tolerance Health Technol Assess 2012;16(33).
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Health and Safety

Consultation on proposed regulations to implement Council Directive 2010/32/EU on preventing sharps injuries in the hospital and healthcare sector Health and Safety Executive The consultation seeks views on: whether the proposed regulations enable healthcare businesses and workers to identify what they need to do; the initial assessment of the costs and benefits of the proposed changes; and how the regulations should be supported by guidance and who is best placed to provide that guidance. Closing date for comments: 8 November 2012 http://www.hse.gov.uk/consult/condocs/cd244.htm

Health Reforms
HealthWatch website HealthWatch This website gives information about HealthWatch at local and national levels. http://www.healthwatch.co.uk/

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Quality in the new health system: Maintaining and improving quality from April 2013: A draft report National Quality Board This report focuses on how the new system should prevent, identify and respond to serious failures in quality. Closing date for comments: 30 September 2012 http://www.dh.gov.uk/health/2012/08/quality-new/ Protecting and promoting patients interests: licensing providers of NHS services Department of Health The issues covered by the proposals include: who will be required to hold a licence from Monitor? how can providers challenge proposed changes to licence conditions? what is the maximum fine that Monitor could impose for breach of licence conditions? Closing date for comments: 22 October 2012 http://www.dh.gov.uk/health/2012/08/consultation-licensing/ Securing best value for NHS patients: Requirements for commissioners to adhere to good procurement practice and protect patient choice Department of Health The consultation sets out proposals for requirements to: ensure good procurement practice by commissioners; ensure that commissioners enable patients to exercise their rights to choose as set out in the NHS Constitution; prohibit commissioners from taking actions that restrict competition where this is against patients interests; and ensure that commissioners manage conflicts of interest and that particular interests do not influence their decision-making. Closing date for comments: 26 October 2012 http://www.dh.gov.uk/health/2012/08/consultation-commissioners/ Steering or Rowing? Report from a simulation event which tested how CCGs might utilise CSSs NHS Commissioning Board The purpose of the event was to explore the relationships between CCGs and CSSs, and to anticipate some of the likely challenges for CCGs and CSSs so that the NHS Commissioning Board Authority and partners can focus developmental activities appropriately to effectively in the coming months. http://www.commissioningboard.nhs.uk/files/2012/08/ccg-css-report.pdf Summary Report: Issues relating to local Healthwatch regulations Department of Health This report sets out the key issues that arose from discussions with stakeholders and the public in April-June 2012, and provides information on the Departments approach to the drafting of the regulations. http://www.dh.gov.uk/health/2012/07/healthwatch-engagement/
Items in the Commissioning, Neurological Conditions, Public Health and Vaccination and Immunisation sections may also be of interest. [back to topics]

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NHS Library and Information Service North Staffordshire Health Technology and Information
Digital technology essentials guide: If your organisation is not using these digital technologies you could be spending more than you need NHS Networks This guide provides a brief summary of a wide range of enabling digital technologies most of which are quick wins and should be considered by all organisations. It includes details of savings achieved in individual NHS Trusts by using these technologies. http://www.networks.nhs.uk/nhs-networks/qipp-digital-technology-andvision/documents/QIPP_DT_Technology_Essentials_Guide.pdf/view Information sharing challenge fund Department of Health The fund is looking for innovative ideas that change the way information is currently used and shared between different organisations. Closing date for submission: 5 October 2012 http://www.dh.gov.uk/health/2012/08/information-sharing-challenge/ Technology Briefing Packs NHS Technology Adoption Centre The packs feature technology chosen by the Department of Health that have a clear evidence base and are believed will deliver Quality, Innovation, Productivity and Prevention (QIPP) benefits. These briefing packs provide structured and practical information about a wide range of products which can be used in primary care, community hospitals, GP practices and district nursing, e.g. HbA1C analysers, catheters, and disposable water filters. http://www.ntac.nhs.uk/Publications/TechnologyBriefingPacks/Technology_Briefing_Packs_H omepage.aspx Free registration is required to access this resource. The registration page is at http://www.ntac.nhs.uk/NTACRegistration.aspx
Items in the Infection Control, Nursing, Obesity and Service Management sections may also be of interest. [back to topics]

HIV
HIV outpatient pathway factsheets Department of Health These four factsheets provide guidance on the HIV outpatients pathway for clinicians, commissioners and finance personnel. http://www.dh.gov.uk/health/2012/08/hiv-outpatient-factsheets/
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NHS Library and Information Service North Staffordshire Infection Control

Deaths involving Clostridium difficile, 2011 Office for National Statistics This report looks at numbers of deaths, and breaks the data down by age and sex. http://www.ons.gov.uk/ons/rel/subnational-health2/deaths-involving-clostridiumdifficile/2011/index.html Deaths involving MRSA, 2007 to 2011 Office for National Statistics This report looks at numbers of deaths, and breaks the data down by age, sex and neighbourhood level of deprivation. http://www.ons.gov.uk/ons/rel/subnational-health2/deaths-involving-mrsa/2007-to2011/index.html Efficacy and Safety of Telavancin in Clinical Trials: A Systematic Review and MetaAnalysis Polyzos, KA et al. This article evaluates the effectiveness of telavancin for treating gram-positive infections. http://www.plosone.org/article/info:doi/10.1371/journal.pone.0041870 Smartphone application for antibiotic prescribing Department of Health The objective of this document is to help Directors of Infection Prevention and Control and other staff to decide whether they should consider using smartphone technology as a means of disseminating policy and guidelines in order to improve practice at point of care. It aims to highlight the potential for using the existing infrastructure of mobile technology for costeffective point of care access to medical information and policy. http://www.dh.gov.uk/health/2012/08/smartphone-antibiotic-prescribing/
Items in the Vaccination and Immunisation section may also be of interest. [back to topics]

Integrated care
Items in the Patient Care and Safety section may be of interest. [back to topics]

Kidney Disease
Benefits and Harms of Statin Therapy for Persons with Chronic Kidney Disease: A Systematic Review and Meta-analysis Palmer, SC et al. This article assessed the impact of statins on cardiovascular outcomes and mortality for patients with CKD. Ann Intern Med. 21 August 2012;157(4) p.263-275 15

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Chronic Kidney Disease in England: The Human and Financial Cost NHS Kidney Care NHS Kidney Care commissioned this health economics report to assess the burden and impact of chronic kidney disease (CKD). http://www.kidneycare.nhs.uk/our_work_programmes/preventing_ill_health/chronic_kidney_di sease_in_england_the_human_and_financial_cost/ Lipid-Lowering Therapy in Persons with Chronic Kidney Disease: A Systematic Review and Meta-analysis Upadhyay, A et al. This review looked at the impact of lipid lowering therapy on cardiac death and other cardiovascular events in patients with CKD. Ann Intern Med. 21 August 2012;157(4) p.251-262

Learning Disabilities
Out of sight: Stopping the neglect and abuse of people with a learning disability Mencap This report follows the investigation into events at Winterbourne View. It gives the stories of 4 people with learning disabilities and challenging behaviour who experienced poor care. It makes recommendations for improvements. http://www.mencap.org.uk/outofsight-report Winterbourne View South Gloucestershire Council This Serious Case Review follows reports of patient abuse at Winterbourne Private Hospital last year. http://www.southglos.gov.uk/NR/exeres/DDE51D39-E8AC-4343-8DDA-7F08B03CBA10 A related CQC internal review is available at http://www.cqc.org.uk/public/news/our-rolewinterbourne-view-and-changes-we-will-make-protect-people-abuse
Items in the Mental Health section may also be of interest. [back to topics]

Maternal and Infant Health

Guide to bottle feeding: how to prepare infant formula and sterilise feeding equipment to minimise the risks to your baby Department of Health The booklet will support midwives, health visitors and GPs giving information to anyone who is bottle feeding their baby. http://www.dh.gov.uk/health/2012/08/guide-to-bottle-feeding/ Making sense of commissioning Maternity Services in England: some issues for Clinical Commissioning Groups to consider Royal College of Obstetricians and Gynaecologists http://www.rcog.org.uk/news/making-sense-commissioning-maternity-services-england 16

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Maternal mental health pathway Department of Health The pathway sets out the benefits and principles for health visitors, midwives, specialist mental health services and GPs working together in pregnancy and the first postnatal year, as the basis for the detailed local pathway to meet the physical and mental health and wellbeing needs of parents, babies and families. http://www.dh.gov.uk/health/2012/08/maternal-mental-health/ Rapid versus stepwise negative pressure application for vacuum extraction assisted vaginal delivery Suwannachat, B This Cochrane review is based on two trials including 754 participants. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD006636.pub3/abstract Unexplained deaths in infancy, England and Wales, 2010 Office for National Statistics These statistics present data on sudden infant deaths, unascertained deaths and unexplained infant deaths. It also contains data on sex and age at death plus analyses by some of the key risk factors affecting sudden infant death such as birthweight, mothers age, mothers country of birth and fathers NS-SEC (socio-economic classification). http://www.ons.gov.uk/ons/rel/child-health/unexplained-deaths-in-infancy--england-andwales/2010/index.html
Items in the Nursing section may also be of interest. [back to topics]

Mental Health
Mental Capacity and the Mental Capacity Act 2005: a literature review Mental Health Foundation This review has collated a broad range of literature investigating various issues relating to mental capacity and the implementation of the Act with the aim of identifying consistent themes, problem areas and any gaps in the existing literature. http://www.mentalhealth.org.uk/publications/mca-lit-review/ Peer Support in mental health and learning disability Mental Health Foundation This briefing paper provides a short descriptive overview of peer support in mental health (including dementia) and learning disabilities, based on some of the recent literature, and highlights key messages from work being undertaken across the UK by the Mental Health Foundation. This work looks at how peer support can help people to recover, or get more control over their condition, and live fulfilling lives in their communities. http://www.mentalhealth.org.uk/content/site/publications/184633
Items in the Carers and Maternal and Infant Health sections may also be of interest. [back to topics]

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NHS Library and Information Service North Staffordshire Nursing

Further evaluation of Family Nurse Partnership programme Department of Health There are 3 new evaluation reports: 1. Summary of the formative evaluation of the first phase of the group-based FNP programme: This is a variant of the programme. The evaluation focused on acceptability to participants and Family Nurse facilitators, practical issues and indications of impact on child and maternal health and parenting behaviours. 2. Eligibility Criteria for the FNP: testing new criteria explores the issues relating to alternative eligibility criteria for vulnerable first time mothers aged 20-22, and first time mothers aged 19 and under with additional vulnerabilities. This work also looked at the delivery of FNP through an interpreter. 3. Issues emerging from the first 10 pilot sites implementing the FNP home-visiting programme in England identifies national and local system contributions to effective delivery of FNP, the emerging expertise of FNP practitioners and the influence of FNP practice on universal service provision. http://www.dh.gov.uk/health/2012/08/fnp-evaluation-reports/ Nursing staff using personal mobile phones for work purposes RCN This guidance sets out some of the uses and risks of mobile phones, and considers issues including patient confidentiality and safety of lone workers. http://www.rcn.org.uk/__data/assets/pdf_file/0009/472464/004259.pdf
Items in the Commissioning sections may also be of interest. [back to topics]

Neurological Conditions
Intelligent outcomes: applying the health and social care reforms to improve outcomes for people with neurological conditions Neurological Alliance This report is intended to illustrate how the levers of the new NHS can be applied to improving outcomes for patients with neurological conditions. Its recommendations are aimed at ensuring that NHS resources are directed towards investing in quality and not paying for the cost of failure, as has happened in the past. http://www.neural.org.uk/updates/205-Improving-neurological-outcomes-in-the-new-NHS

Obesity
Interactive computer-based interventions for weight loss or weight maintenance in overweight or obese people Wieland, LS et al This Cochrane review compared computer based interventions to no intervention and inperson interventions. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD007675.pub2/abstract 18

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Slide sets for adult and child obesity National Obesity Observatory Powerpoint slides presenting key data and information on adult and child obesity in clear, easy to understand charts and graphics. These can be used freely with acknowledgement to NOO. http://www.noo.org.uk/slide_sets
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Older People
Explaining variation in use of emergency hospital beds by patients over 65 Kings Fund This report considers the contribution made by patient-based factors, hospital factors, the availability of community services and resources, and broader system relationships in driving the observed variation in length of stay and rate of admission. Its conclusions are based on analysis by The Kings Fund of Hospital Episode Statistics (HES) and local population -based data. http://www.kingsfund.org.uk/publications/emergency_beds.html
Items in the Social Care section may be of interest. [back to topics]

Patient Care and Safety

All about personal health budgets: Getting the healthcare you need Department of Health This easy read leaflet is for people being offered a personal health budget, and can be used by healthcare professionals, commissioners, and support organisations. It explains what a personal health budget is, and includes answers to frequently asked questions, personal stories and further sources of information. http://www.dh.gov.uk/health/2012/08/personal-health-budgets/ Data on Written Complaints in the NHS 2011-12 Health and Social Care Information Centre This annual collection is a count of written complaints made by (or on behalf of) patients, received between 1 April 2011 and 31 March 2012 and also now includes experimental information on upheld complaints. http://www.ic.nhs.uk/statistics-and-data-collections/audits-and-performance/complaints/dataon-written-complaints-in-the-nhs-2011-12 Interim Measures for Patient Experience at the interfaces between NHS services Department of Health This note highlights the data sources already available that can help NHS organisations assess experience of integrated care locally. http://www.dh.gov.uk/health/2012/08/patient-experience-integration/
Items in the Health Reforms section may also be of interest.

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NHS Library and Information Service North Staffordshire Pharmacy and Prescribing
Financial Reinforcers for Improving Medication Adherence: Findings from a Metaanalysis Petry, N et al. This article looked at the effectiveness of a range of incentives in encouraging medication adherence. The American Journal of Medicine 125(9) p.888-96 Guidance published alongside the NHS (Pharmaceutical Services) Regulations 2012 Department of Health This guidance aims to help primary care trusts in the assessment and determination of applications to provide NHS pharmaceutical services under the new market entry test and the new performance sanctions regime. http://www.dh.gov.uk/health/2012/08/guidance-pharmaceutical-services/
Items in the Cardiovascular Diseases, Diabetes, General Practice and Infection Control sections may also be of interest. [back to topics]

Physiotherapy
Musculoskeletal physiotherapy: patient self-referral QIPP This case study outlines the benefits of the self-referral process, and how barriers to implementation were overcome. http://arms.evidence.nhs.uk/resources/qipp/29492/attachment Physiotherapy versus placebo or no intervention in Parkinson's disease Tomlinson, C et al. This Cochrane review assessed a range of physiotherapy interventions. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD002817.pub3/abstract
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Public Health
Clustering of unhealthy behaviours over time: Implications for policy and practice Kings Fund This report reviews the current evidence on multiple lifestyle risks and analyses data from the Health Survey for England on the distribution of these risks in the adult population and how this is changing over time. http://www.kingsfund.org.uk/publications/unhealthy_behaviours.html Health Expectancies at birth and age 65 in the United Kingdom, 2008-10 Office for National Statistics This report presents the latest figures on male and female health expectancy, for the UK and its four constituent countries. While life expectancy (LE) provides an estimate of average 20

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expected life-span, healthy life expectancy (HLE) divides total LE into years spent in good or not good health. Disability-free life expectancy (DFLE) divides LE into years lived with and without a limiting persistent illness or disability. http://www.ons.gov.uk/ons/rel/disability-and-health-measurement/health-expectancies-atbirth-and-age-65-in-the-united-kingdom/2008-10/index.html Health protection and local government Department of Health This document describes the arrangements for preventing, planning for and responding to health protection incidents and outbreaks within the new system, focusing on those which do not require mobilisation of a multi-agency response under the Civil Contingencies Act 2004. It complements the Departments publications on emergency preparedness, resilience and response (EPRR) arrangements. http://www.dh.gov.uk/health/2012/08/health-protection-guidance/ Measuring National Well-being: Health Office for National Statistics This article explores the headline measures in the health domain of well-being in more detail and puts them into the context of other objective and subjective measures of health and wellbeing. It starts with self-reported health and its relationship to the Office for National Statistics measures of subjective well-being, which indicate how people think and feel about their lives. The subsequent sections will examine life expectancy, mortality, disease and physical ill health, mental health and some lifestyles which can affect health. There is also a short section on social care which covers those with specific needs. http://www.ons.gov.uk/ons/rel/wellbeing/measuring-national-well-being/health/art-measuringnational-well-being---health.html
Items in the Health Reforms section may also be of interest. [back to topics]

Safeguarding Children and Vulnerable Adults

National action plan to tackle child abuse linked to faith or belief Department for Education This action plan was created to help raise awareness of the issue of child abuse linked to faith or belief and to encourage people to take practical steps to prevent such abuse. It looks at tackling abuse linked to faith or belief from the perspective of the child, parent, community and faith group members and child practitioners. https://www.education.gov.uk/publications/standard/publicationDetail/Page1/DFE-00094-2012 Protecting disabled children: thematic inspection Ofsted This report looks at the effectiveness of work intended to protect children in different authorities and Local Safeguarding Boards. http://www.ofsted.gov.uk/resources/protecting-disabled-children-thematic-inspection

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Regulated activity (adults): the definition of regulated activity (adults) as defined by the Safeguarding Vulnerable Groups Act 2006 from 10th September 2012 Department of Health This guidance reflects recent changes to legislation. http://www.dh.gov.uk/health/2012/08/new-disclosure-and-barring-services-definition-ofregulated-activity/ Safeguarding adults: multi-agency policy and procedure for the West Midlands Social Care Institute for Excellence The policy and procedures are aimed at different agencies and individuals involved in safeguarding adults, including managers, professionals, volunteers and staff working in public, voluntary and private sector organisations. http://www.scie.org.uk/publications/reports/report60/
Items in the Learning Disabilities section may also be of interest. [back to topics]

Screening
Items in the Vaccination and Immunisation section may be of interest.

Service Management
Adaptation to Climate Change for Health and Social Care organisations: Co-ordinated, Resilient, Prepared NHS Sustainable Development Unit This document summarises the current knowledge on adapting to climate change in NHS organisations. It describes what climate change adaptation is, why it is a priority for the NHS and how organisations can include adaptation in their Sustainable Development Management Plans. http://www.sdu.nhs.uk/publications-resources/108/Adaptation-to-Climate-Change-for-Healthand-Social-Care-organisations/ Current use, future trends and opportunities in public sector social media Cogitamus for the NHS Confederation This report is based on a survey and interviews. It focuses on health organisations. http://www.nhsconfed.org/AboutUs/Pages/social-media.aspx Overview of the programme budgeting methodology Department of Health This document is intended for those who are new to the concept of programme budgeting. It includes the key facts relating to programme budgeting and an overview of the process for mapping services to programme budgeting categories. http://www.dh.gov.uk/health/2012/08/programme-budgeting-methodology/

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Review of NHS foundation trusts' annual plans (2012/13) Monitor The effectiveness with which trusts plan for the future forms an important part of Monitors assessment of Trusts risks of breaching the terms of their authorisation. This annual review of foundation trusts three-year plans enables Monitor to determine their regulatory approach towards each trust. http://www.monitor-nhsft.gov.uk/home/browse-category/reports-nhs-foundationtrusts/reviews-nhs-foundation-trusts-annual-plans/review Right data, right payment: Annual report on the Payment by Results data assurance programme 2011/12 Audit Commission This report is based on a review of commissioner arrangements to secure good quality information; an audit of clinical coding, and updates on progress made on Payment by Results data assurance by individual Trusts. http://www.auditcommission.gov.uk/health/paymentbyresults/reportsandstudies/pages/rightdatapbr2012.aspx United Lincolnshire Hospitals Trust: Reducing agency locum costs NHS Employers The trust introduced a pilot locum booking system aimed at reducing locum costs and improving management control issues. This report explains the process. http://www.nhsemployers.org/PlanningYourWorkforce/Flexibleworkforce/AgencyWorkers/ReducingAgencySpend/FiveHighImpactActions/highimpactcasestu dies/Pages/UnitedLincolnshireHospitalsTrust.aspx
Items in the Commissioning, General Practice, Health Technology and Information, Integrated Care, Maternal and Infant Health, Patient Care and Safety, Physiotherapy, Social Care and Workforce sections may also be of interest. [back to topics]

Sexual and Reproductive Health

Interventions for emergency contraception Cheng, L et al. This Cochrane review compared several contraceptive drugs and the IUD. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD001324.pub4/abstract Sexual Health Balanced Scorecard 2012 update Association of Public Health Observatories The 2012 update includes a new local authority version of the tool, with 20 indicators relating to: teenage conceptions, sexually transmitted infections and HIV, sexual assaults, and other related issues. There have also been updates to the PCT tool, including for: abortions, GP prescribed contraception, and HPV vaccine uptake. The LA and PCT tools are designed to be used together for the best understanding of local variation and need. http://www.apho.org.uk/default.aspx?QN=SBS_DEFAULT

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Steroidal contraceptives and bone fractures in women: evidence from observational studies Lopez, LM et al. This Cochrane review is based on cohort and case control studies. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD009849.pub2/abstract
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Social Care
Care for the elderly: the limitations of the Dilnot proposals Centre for Policy Studies This document suggests that reforms to social care should focus on the experience of those in care, and considers how best value for money can be achieved in social care. http://www.cps.org.uk/publications/reports/care-for-the-elderly/ Reducing the cost of assessments and reviews: an adult social care briefing for councils Audit Commission This briefing considers changes in councils' expenditure on assessments and reviews over time, and examines how some councils have managed to keep their costs low while continuing to meet vulnerable people's needs. http://www.auditcommission.gov.uk/nationalstudies/localgov/Pages/assessmentsandreviews.aspx Registered Managers Survey. National Skills Academy: Social Care This survey looked at managers attitudes to their role, issues for development, and the training attended by managers (mandatory, non-mandatory, and in their own time). https://www.nsasocialcare.co.uk/registered_managers/new Registration is required to access this title. Registration is free.

Tobacco
Statistics on Smoking: England, 2012 Health and Social Care Information Centre This report presents a broad picture of health issues relating to smoking in England and covers topics such as smoking prevalence, habits, behaviours and attitudes among adults and school children, smoking-related ill health and mortality and smoking-related costs. http://www.ic.nhs.uk/statistics-and-data-collections/health-and-lifestyles/smoking/statistics-onsmoking--england-2012
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NHS Library and Information Service North Staffordshire Vaccination and Immunisation
National screening and immunisation programmes Department of Health This letter sets out the agreement between the Department of Health, Public Health England and the NHS Commissioning Board on their roles and respective accountabilities in relation to national screening and immunisation programmes post April 2013. http://www.dh.gov.uk/health/2012/08/screening-immunisation-programmes Update to Green Book Chapter 19 Influenza Department of Health http://www.dh.gov.uk/health/2012/08/gb-chapter-19-updat/
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Workforce
CIPD Employee Outlook Report NHS Employers This quarterly report looks at a range of aspects of employee experiences, including job seeking, employee attitudes and pressure at work. The Summer 2012 report shows a significant link between employee engagement and well-being. http://www.nhsemployers.org/HealthyWorkplaces/LatestNews/Pages/CIPDEmployeeOutlook Report.aspx A guide for responsible officers on making revalidation recommendations. GMC The protocol describes what revalidation recommendations are clarifies the roles and responsibilities of ROs and their delegates in making and sending recommendations sets out the GMCs expectations of what will underpin RO recommendations provides ROs with statements and criteria for the three recommendation categories. http://www.gmc-uk.org/doctors/revalidation/13631.asp Implementing NICE public health guidance for the workplace: Staff health improvement project. Interim report Royal College of Physicians This report is based on interviews with 22 acute and mental health Trusts. It aims to collect examples of good practice in implementing NICE guidance for the workplace in the NHS. http://www.rcplondon.ac.uk/projects/staff-health-improvement-project Modernising Scientific Careers (MSC) Updated training pathways NHS Employers This factsheet is a useful summary of the training routes that are currently available and those that are under development for the healthcare science workforce. http://www.nhsemployers.org/PlanningYourWorkforce/Modernising-Scientific-Careers/MSClatest-news/Pages/MSCTrainingPathwaysFactsheet.aspx 25

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Recognition and approval of trainers GMC This web page, and implementation plan and other supporting material at the bottom of the page, outline forthcoming changes to recognition and approval of trainers in four specific roles in undergraduate and postgraduate training. http://www.gmc-uk.org/education/10264.asp Training Survey GMC The survey gives a snapshot of the quality of medical education and training at a national level and is an important part of how GMC make sure medical education and training is meeting the relevant standards. http://www.gmc-uk.org/education/surveys.asp
Items in the Nursing and Service Management sections may also be of interest. [back to topics]

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