NHS Library and Information Service North Staffordshire

Clinical Effectiveness Bulletin for NHS Primary Care in North Staffordshire

Issue No: 77 June 2013

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, NHS and Public Health staff in Stoke and North Staffordshire 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: 01782 679564 or 0300 123 1535 ext/FeatureNet 8429 E-mail: clareh.powell@northstaffs.nhs.uk

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

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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.gov.uk/dh Kings Fund http://www.kingsfund.org.uk/ NICE Medicines awareness service http://www.nice.org.uk/mpc/MedicinesPrescribingAlerts.jsp Social Care Institute for Excellence http://www.scie.org.uk/ Inside Government local government alerts https://www.gov.uk/government/email-signup 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:
Cancer ...................................................................................................................................... 4 Children and Young People ...................................................................................................... 4 Commissioning ......................................................................................................................... 5 Diabetes.................................................................................................................................... 6 Emergency Care ....................................................................................................................... 7 End of Life Care ........................................................................................................................ 7 General Practice ....................................................................................................................... 7 Guidance .................................................................................................................................. 8 Health Reforms ......................................................................................................................... 9 Infection Control ...................................................................................................................... 10 Integrated Care ....................................................................................................................... 10 Maternal and Infant Health...................................................................................................... 11 Mental Health.......................................................................................................................... 11 Older People ........................................................................................................................... 12 Patient and Public Involvement ............................................................................................... 13 Patient Care and Safety .......................................................................................................... 13 Pharmacy and Prescribing ...................................................................................................... 13 Physical Activity ...................................................................................................................... 13 Public Health ........................................................................................................................... 14 Safeguarding Children and Vulnerable Adults ........................................................................ 14 Service Management .............................................................................................................. 14 Social Care ............................................................................................................................. 16 Stroke ..................................................................................................................................... 16 Substance Misuse .................................................................................................................. 16 Vaccination and Immunisation ................................................................................................ 16 Workforce ............................................................................................................................... 17

NHS Library and Information Service North Staffordshire Cancer

Cancer Mortality Trends: 1992 2020 MacMillan Cancer Support This report projects that by 2020 almost one in two people in UK but almost four in ten of those will not die from it http://www.macmillan.org.uk/Documents/AboutUs/Newsroom/Mortality-trends-2013executive-summary-FINAL.pdf Endoscopy referral rates and cancer outcomes University of Liverpool Patients from GP practices with low endoscopy referral rates are at increased risk of poor outcomes from oesophageal and gastric cancers according to research presented by University of Liverpools Department of Gastroenterology at Public Health England's National Cancer Intelligence Network annual conference. https://www.gov.uk/government/news/poorer-outcomes-for-oesophageal-and-gastric-cancerlinked-to-huge-variation-in-endoscopy-referral-rates-between-gp-practices NICE recommends preventative drugs for women at risk of breast cancer NICE Updated guidance by NICE recommends that the NHS give tamoxifen or raloxifene to particular groups of women with a family history of cancer because the drugs can help stop them getting breast cancer if they are taken for five years. http://publications.nice.org.uk/familial-breast-cancer-cg164 Oesophageal Cancer Statistics Cancer Research UK Cancer Research UK has issued incidence statistics for oesophageal cancer by country in the UK. The data include age and trends over time, lifetime risk, distribution of cases, morphology, geographic variation, socio-economic variation, and prevalence. http://www.cancerresearchuk.org/cancer-info/cancerstats/types/oesophagus/incidence/
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Children and Young People

Bright futures: local children, local approaches Local Government Association This publication outlines case studies showing how councils up and down the country are using children's centres to help deliver early intervention through integrated health provision http://www.local.gov.uk/web/guest/publications//journal_content/56/10171/4026929/PUBLICATION-TEMPLATE Opening the door to better healthcare: ensuring general practice is working for children and young people National Childrens Bureau

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This report reviews the available evidence on how well general practice is delivering for children and young people, including their experiences of the services and any particular challenges they face in accessing them. http://www.ncb.org.uk/media/972611/130603_ncb_opening_the_door_gp_finalweb1.pdf
Items in the General Practice section may be of interest [back to topics]

Commissioning
CCG Outcomes Tool NHS England An interactive version of the CCG information packs (first launched in December 2012), this tool allows users to view maps, charts and tables of individual outcome indicators across CCGs and compare one or more. You can also explore relationship between two outcomes or demographic information and outcomes. http://www.england.nhs.uk/resources/resources-for-ccgs/ccg-out-tool/ Engaging with Black and Minority Ethnic communities: insights for impact NHS Confederation This report highlights ways in which providers and commissioners have developed innovative solutions and approaches to better cater for and engage with BME communities. http://www.nhsconfed.org/Publications/Documents/Engaging-BME-communities-insights-forimpact.pdf Guidance for Commissioners of Mental Health Care Joint Commissioning Panel for Mental Health Care Four guides have been published for Commissioners of Mental Health Care: Acute care - inpatient and crisis home treatment Older People's Mental Health Service Mental Health Services for people with learning disabilities Community Specialist Mental Health Services http://www.jcpmh.info/resource/guidance-for-commissioners-of-acute-care-inpatient-andcrisis-home-treatment/ http://www.jcpmh.info/resource/guidance-for-commissioners-of-older-peoples-mental-healthservices/ http://www.jcpmh.info/resource/guidance-for-commissioners-of-mental-health-services-forpeople-with-learning-disabilities/ http://www.jcpmh.info/resource/guidance-for-commissioners-of-community-specialist-mentalhealth-services/ Information Governance and Risk Stratification: Advice and Options for CCGs and GPs NHS England This document sets out the role that risk stratification (RS) can play in managing the health of a population, explains how RS arrangements in England were affected by the implementation of the Health and Social Care Act 2012, and considers how RS may be conducted lawfully. http://www.england.nhs.uk/wp-content/uploads/2013/06/ig-risk-ccg-gp.pdf 5

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Interim Specifications for specialised commissioning NHS England NHS England has published the interim specifications it has adopted for the commissioning of specialised services. http://www.england.nhs.uk/npc-crg/ National Tariff 2014/15: An Engagement Document Monitor/NHS England These three documents detail the proposals for the 2014/15 national tariff: the tariff engagement document; proposals for local payment variations; and proposals for enforcement of the tariff by Monitor and the NHS Trust Development Authority. There are three questionnaires asking for views by the 9th July 2013. http://www.monitor.gov.uk/home/news-events-publications/our-publications/browsecategory/guidance-health-care-providers-and-co-43 Towards commissioning excellence: a strategy for commissioning support services NHS England This strategy aims to enable CCGs to exercise informed choice of how they source their commissioning support and from whom; build a strong cohort of excellent commissioning support providers; and to strengthen collaboration between NHS CSUs and the voluntary sector. http://www.england.nhs.uk/wp-content/uploads/2013/06/towa-commis-exc.pdf
Items in the Substance Misuse section may be of interest. [back to topics]

Diabetes
Are health and wellbeing boards taking account of diabetes? A review of JSNAs and health and wellbeing strategies Diabetes UK This report argues that health and wellbeing boards risk overlooking the need to improve diabetes care in their local area. The study reviewed 50 health and wellbeing boards and found that too many of them did not recognise the priority and impact of diabetes in their Joint Strategic Needs Assesments (JSNA) and health and wellbeing strategies. http://www.diabetes.org.uk/Documents/Reports/jsnas-health-wellbeing-strategies-report0513.pdf Short-term intensive insulin therapy in type 2 diabetes mellitus: a systematic review and meta-analysis. Kramer et al. This review concluded that short-term intensive insulin therapy can improve the underlying pathophysiology in early type 2 diabetes mellitus, and therefore might offer a potential treatment strategy. http://www.thelancet.com/journals/landia/article/PIIS2213-8587(13)70006-8/abstract

NHS Library and Information Service North Staffordshire Emergency Care

Access to primary care and visits to emergency departments in England: a crosssectional, population-based study Imperial College, London This study examines the association between access to primary care and emergency department visits in England. Findings show that the number of visits to hospital emergency departments in England has increased by 20% since 2007-08, placing unsustainable pressure on the NHS. http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0066699

End of Life Care

Patient Activity Data for Specialist Care Services The National Council for Palliative Care and Public Health England The report- National Survey of Patient Activity Data for Specialist Palliative Care Services, Minimum Data Set for 2011-2012 (MDS), shows that the mean number of patients seen in inpatient units is at its highest level in more than 10 years, with the average number of available beds also at a high. http://www.endoflifecare-intelligence.org.uk/resources/publications/survey Effectiveness and cost-effectiveness of home palliative care services for adults with advanced illness and their caregivers Gomes et al. This systematic review of 23 studies, concludes that there is reliable evidence that home palliative care services increase the patients chance of dying at home and reduce symptom burden, particularly among those suffering cancer, without impacting upon caregiver grief. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD007760/pdf

General Practice
Changing NHS: A Patients Guide BMA This guide is designed to help GPs explain key changes to the NHS and how these impact upon patients and public http://bma.org.uk/about-the-bma/what-we-do/public-and-patient-informationsources/supporting-general-practice Ensuring general practice is working for children and young people National Childrens Bureau This report from Children's charity the National Children's Bureau is calling on Government to ensure GP reforms put children's health first by providing better paediatric expertise in GP practices and opening hours that meet the needs of working parents and their children. http://www.ncb.org.uk/media/972611/130603_ncb_opening_the_door_gp_finalweb1.pdf

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General Practice 2022 RCGP The report: The 2022 GP: a vision for general practice in the future NHS outlines the RCGP's aspiration for the future of general practice and patient care - along with what will be needed to deliver it. http://www.rcgp.org.uk/~/media/Files/Policy/A-Z%20policy/The-2022-GP-A-Vision-forGeneral-Practice-in-the-Future-NHS.ashx Investigation into closure of walk in centres MONITOR The health regulator will examine to what extent the closure of walk-in centres has limited people's ability to choose where and when they access routine or urgent primary health care services without appointment. http://www.monitor.gov.uk/home/news-events-publications/our-publications/browsecategory/guidance-health-care-providers-and-co-40 New Technical Guidance to Improve Patient Care BMA/RGCP These guidelines explain how GP Practices can make more effective use of patient information to improve quality, efficiency and equity of health care services http://www.pcc-cic.org.uk/article/nhs-england-announces-new-technical-guidance-improvepatient-care Survey of GPs RGCP A survey commissioned by the Royal College of General Practitioners indicates that 48% of family doctors think that patients now have to wait longer for a GP appointment, while four in five GPs are more likely to want to quit the profession than they were five years ago. http://www.rcgp.org.uk/news/2013/june/85-percent-of-family-doctors-say-general-practice-incrisis.aspxg
Items in the Children and Young People, Commissioning and Vaccination and Immunisation sections may be of interest. [back to topics]

Guidance
Domestic Violence Guidance Department of Health This guidance helps health professionals to recognize factors that may indicate domestic violence and abuse and describes steps to ensure appropriate support and referral where necessary it highlights best practice, information and learning resources. https://www.gov.uk/government/publications/guidance-for-health-professionals-on-domesticviolence

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NICE Clinical Guidelines Familial breast cancer: Classification and care of people at risk of familial breast cancer and management of breast cancer and related risks in people with a family history of breast cancer (CG164) http://publications.nice.org.uk/familial-breast-cancer-cg164 NICE Clinical Guidelines Stroke rehabilitation: long term rehabilitation after stroke (CG162) http://guidance.nice.org.uk/CG162 NICE Clinical Guidelines The Assessment and Prevention of falls in older people (CG161) http://guidance.nice.org.uk/CG161 NICE Clinical Guidelines Stroke rehabilitation: Long-term rehabilitation after stroke (CG162) http://www.nice.org.uk/nicemedia/live/14182/64098/64098.pdf NICE Public Health Guidance Tobacco: harm-reduction approaches to smoking (PH45) http://guidance.nice.org.uk/PH45
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Health Reforms
Changing care, improving quality: reframing the debate on reconfiguration NHS Confederation This report identifies six principles to consider as a foundation for most reconfiguration plans, and aims to support those engaged locally in making a decision as to whether to reconfigure services and, if so, how to make change happen. http://www.nhsconfed.org/Publications/Documents/Changing-care-improving-quality.pdf Commission on the Future of Health and Social Care in England The Kings Fund This Commission will consider whether the post-war settlement, which established separate systems for health and social care, remains fit for purpose. http://www.kingsfund.org.uk/sites/files/kf/field/field_document/commission-health-social-careengland-jun13.pdf Making a Local difference: State of play and challenges ahead for health and wellbeing boards NHS Confederation 9

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This report aims to give all those involved in leading and supporting the work of health and wellbeing boards an insight into the opportunities and challenges ahead http://www.nhsconfed.org/Publications/Documents/making-a-local-difference.pdf
Items in the Public Health section may also be of interest. [back to topics]

Infection Control
Accepting patients from overseas Department of Health This letter reminds healthcare professionals to perform a health risk assessment when accepting patients from abroad, to ensure that any possible infectious hazard has been identified. http://www.hpa.org.uk/AboutTheHPA/WhatTheAgencyDoes/PortHealth/PortHealthMedicalTra nsfersFromOverseas/ Pandemic Influenza Risk Management World Health Organisation This interim guidance replaces the 2009 Pandemic Influenza Preparedness and Response: a WHO guidance document. http://www.who.int/influenza/preparedness/pandemic/influenza_risk_management/en/index.ht ml
Items in the Guidance section may be of interest [back to topics]

Integrated Care
Evaluating Integrated Care and community based care: how do we know what works? Nuffield Trust The report outlines the key findings from the evaluations of 30 community-based interventions and identifies nine points that may help those designing, implementing and evaluating such interventions in future. http://www.nuffieldtrust.org.uk/sites/files/nuffield/publication/evaluation_summary_final.pdf

Integrated care: promoting better workforce decisions Centre For Workforce Intelligence The Department of Health has commissioned CfWI to analyse the workforce implications of integrating health and social care. This briefing paper outlines more details about this project.
http://www.cfwi.org.uk/publications/integrated-care-promoting-better-workforce-decisions

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NHS Library and Information Service North Staffordshire Maternal and Infant Health
Anaemia, prenatal iron use, and risk of adverse pregnancy outcomes: systematic review and meta-analysis Batool et al. This review and meta-analysis of 48 RCTs and 44 cohort studies found that use of iron in women during pregnancy may be used as a preventive strategy to improve maternal haematological status and birth weight. http://www.bmj.com/content/346/bmj.f3443 Chemical exposures during pregnancy RCOG This paper argues that while the consumption of herbal remedies or medicines, such as paracetamol, and use of household cleaning products, such as pesticides, are welldocumented sources of chemical exposure, the lesser recognised sources could accumulate with the mixture posing potential harm http://www.rcog.org.uk/womens-health/clinical-guidance/chemical-exposures-duringpregnancy-scientific-impact-paper-37 Does early life exposure to antibiotics increase the risk of eczema? A systematic review. Tsasok et al. This systematic review and meta-analysis of observational studies involving children or young adults 0-25 years old, concluded that children with eczema are more likely to have been exposed to antibiotics in their first year of life (but not prenatally). http://onlinelibrary.wiley.com/doi/10.1111/bjd.12476/abstract
Items in the Mental Health section may be of interest.

Mental Health
All Babies Count: spotlight on perinatal mental health NSPCC This report calls on health ministers to address gaps in mental health services for pregnant women and new mothers. http://www.nspcc.org.uk/Inform/resourcesforprofessionals/underones/spotlight-mentalhealth_wdf96656.pdf A Voice and a choice: a showcase for four years of new ideas and practice Brown, M. This report explores the need for new ways of supporting young peoples mental health, as well as what commissioners are looking for in an ideal support service http://www.right-here.org.uk/home/assets/pdf/a-voice-and-a-choice.pdf

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Lithium in the prevention of suicide in mood disorders: updated systematic review and meta-analysis Cipriani et al. This review of 48 Randomised controlled trials found that Lithium is an effective treatment for preventing suicide in people with mood disorders. When compared with placebo it was more effective at reducing the number of suicides (odds ratio 0.13, 95% confidence interval). http://www.bmj.com/content/346/bmj.f3646 Mental Health Network review 2013/14. NHS Confederation This review looks at some of the highlights from the Mental Health Network's work programme over the last 12 months, and outlines the network's ambitions for 2013/14. http://www.nhsconfed.org/Publications/annual-reports/Pages/MHN-in-2013-14.aspx http://www.nhsconfed.org/Publications/Documents/Mental-Health-Network-in-2013-14.pdf Peer support workers in mental health recovery Centre for Mental Health New research suggests that using peer support workers to support the recovery of people with mental illness can add significant value to mental health services, sometimes at no extra cost. http://www.centreformentalhealth.org.uk/news/2013_peer_support_workers.aspx Personal health budgets in England - making them work in mental health MIND This report is the result of research conducted with people with mental health problems to find out what they want from the services and support that they use to manage their mental health, and what role personal health budgets might play in improving their experience of care and their health and wellbeing outcomes http://www.mind.org.uk/assets/0002/4641/PHB_A4_WEB.pdf Recovery: a carers perspective Centre for Mental Health This briefing paper examines what recovery means for the families and friends of people with mental health conditions. It suggests ways in which these informal carers can support recovery, and looks at how mental health services can give the best possible help to do this. http://www.centreformentalhealth.org.uk/pdfs/ImROC_briefing_carers.pdf
Items in the Guidance section may be of interest. [back to topics]

Older People
A good life in old age? Monitoring and improving quality in long-term care OECD This report argues that providing long-term care that is safe, effective, and responsive to needs is increasingly a policy priority for governments as a growing number of frail old people are in need of care http://www.oecd.org/els/health-systems/good-life-in-old-age.htm 12

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Items in the Guidance section may be of interest

Patient and Public Involvement

Care Quality Commission consultation CCQ The Care Quality Commission has launched a consultation to obtain feedback on the plans they have developed to help ensure that people receive high-quality care. http://www.cqc.org.uk/public/news/give-us-feedback-way-we-should-inspect-services
Items in the Mental Health section may be of interest

Patient Care and Safety

Making the case for information: The evidence for investing in high quality health information for patients and the public Patient Information Forum This report highlights how providing information to patients and their carers improves outcomes, reduces costs and gives people a better experience of care. http://www.pifonline.org.uk/wp-content/uploads/2013/05/PiF-full-report-FINAL-new.pdf
Items in the Safeguarding Children and Vulnerable adults section may be of interest [back to topics]

Pharmacy and Prescribing

Consultations on revisions to the statutory scheme to control the prices of branded NHS medicines Department of Health The Department of Health has launched a consultation to strengthen the statutory pharmaceutical pricing scheme, which covers the prices the NHS pays for branded drugs not covered by the voluntary PPRS. The consultation is seeking views on a price cut of between 10 to 20% https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/207885/consult ation_prices_nhs_medicines.pdf
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Physical Activity
Physical Activity: Brief Advice for Adults in Primary Care Primary Care Commissioning This guidance aims to support routine provision of brief advice on physical activity in primary care practice http://www.pcc-cic.org.uk/article/physical-activity-brief-advice-adults-primary-care

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NHS Library and Information Service North Staffordshire Public Health

Delivering accident prevention at a local level in the new public health system Royal Society for the Prevention of Accidents/Public Health England This handbook aims to give local authorities guidance on how to reduce the burden of accidents by encouraging people to take responsibility for their own safety, health and wellbeing. http://www.rospa.com/about/currentcampaigns/publichealth/info/delivering-accidentprevention-context.pdf Eatwell plate resources Public Health England Public Health England has updated the eatwell plate resources. The resources (consisting of a booklet, A3 poster and A5 postcard) are aimed at the general public. The eatwell plate makes healthy eating easier to understand by giving a visual representation of the types and proportions of foods needed for a healthy and well balanced diet. https://www.gov.uk/government/publications/the-eatwell-plate-resources Longer Lives Public Health England This website contains a range of data that, for the first time, allows people to easily compare an areas mortality performance against those with similar populations, incomes and levels of health. http://longerlives.phe.org.uk/
Items in the Guidance section may be of interest [back to topics]

Safeguarding Children and Vulnerable Adults

Transforming Care: A National response to Winterbourne View Hospital Department of Health This final report into the events at Winterbourne View hospital sets out a programme of action to transform services so that vulnerable people no longer live inappropriately in hospitals and are cared for in line with best practice https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/127310/finalreport.pdf.pdf

Service Management
Arms length bodies Department of Health This corporate report provides information on the arms length bodies within the Department of Health. It outlines the role of each organisation; what they achieved in 2012-13; and their business priorities for 2013-14 https://www.gov.uk/government/publications/arms-length-bodies/our-arms-length-bodies

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Department of Health Corporate Plan Department of Health This plan contains information about: our ministers, non executive directors and leadership team; the department; themes; priorities; roadmap for the year ahead; total expenditure budget for 2013-14; resources; achievements in 2012-13; arm's length bodies; and departmental leaders talk about the role of their directorates. https://www.gov.uk/government/publications/department-of-health-corporate-plan-2013-14 How is the health and social care system performing? Quarterly monitoring report June 2013. Kings Fund The report finds that for the final quarter of 2012/13, nearly 6 per cent of patients waited four hours or longer in A&E, the highest level since 2004. The growing pressure on hospitals is also reflected in a survey of NHS finance directors carried out for the report. This suggests that, although the NHS will end 2012/13 in a healthy financial position, the outlook for the next two years is bleak http://www.kingsfund.org.uk/publications/how-health-and-social-care-system-performing-june2013 Measuring Patient Experience Health Foundation This evidence scan addresses the following questions: How has the experience of patients and carers been measured in healthcare and what are the pros and cons of different approaches for measuring improvement over time? http://www.health.org.uk/publications/measuring-patient-experience/ NHS Health Check Local Government Association/Public Health England This FAQ addresses a number of transitional issues relating to the transfer of responsibility for delivering the NHS health check programme, which moved from PCTs to local government in April 2013. http://www.pcc-cic.org.uk/article/nhs-health-check-frequently-asked-questions NHS Standards of Procurement Department of Health This document sets out the standards for NHS healthcare provider organisations to assess and benchmark procurement performance and identify areas for improvement https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/207364/nhs_st andards_procurement.pdf
Items in the Workforce sections may also be of interest. [back to topics]

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NHS Library and Information Service North Staffordshire Social Care

Update to charging arrangements for adult social care services Department of Health The DOH has published an update to the Fairer Charging guidance for non-residential social services and the Charging for Residential Accommodation Guide (CRAG). https://www.gov.uk/government/publications/lacdh201302-charging-for-residential-and-nonresidential-social-care

Stroke
Items in the guidance section may be of interest

Substance Misuse
New commissioning guidance for addiction to medicines Public Health England PHE have published commissioning guidance for the NHS and local authorities on how to respond to the needs of people who are addicted to medicines.
http://www.nta.nhs.uk/uploads/pheatmcommissioningguide.pdf
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Vaccination and Immunisation

2013/14 SHINGLES AND CHILD FLU VACCINATION SPECS NHS NHS Employers, the General Practitioners Committee of the BMA and NHS England have jointly published the shingles catch-up vaccination programme and the 2013/14 childhood (two and three year olds) influenza vaccination programme service specifications. Effective from September 1 to 31st August 2014.
http://www.pcc-cic.org.uk/article/201314-shingles-and-child-flu-vaccination-specs

Flu Immunisation Programme 2013/14 Department of Health

https://www.gov.uk/government/publications/flu-immunisation-programme-2013-to-2014

Influenza vaccine uptake amongst GP patient groups in England for winter season 2012 to 2013 Public Health England
This report describes the uptake of influenza vaccine amongst eligible GP patient groups during the 2012/13 winter season https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/207134/Influen za_vaccine_uptake_amongst_GP_patient_groups_in_England_for_winter_season_2012_201 3.pdf 16

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MMR Action Plan Department of Health This plan outlines local and national actions to significantly increase MMR (Measles, Mumps and Rubella) vaccine coverage amongst high risk groups https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/206243/ PHE_MMR_Action_Plan_June_2013.pdf
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Workforce
Consultation on guidance for registrants about the statutory requirement to have appropriate professional indemnity cover as a condition of registration
http://www.hcpcuk.org/assets/documents/10004051Consultationonimplementinganindemnitycoverrequiremen t.pdf

GMC National Training Survey 2013 GMC This survey shows that though, overall, doctors in training report positive experiences, for the second year running concerns have been raised about long working hours and poor handover arrangements before and after night duty. Response rate to survey was impressive with 97.7 % response rate from a potential 54,000. http://www.gmc-uk.org/education/surveys.asp Health workforce information review Department of Health The report- Workforce information architecture in the Reformed NHS landscape sets out findings and recommendations from a review of the arrangements for handling health workforce data and intelligence. Health Education England will take forward the implementation of the recommended actions, publishing further details during 2013 to 2014. https://www.gov.uk/government/publications/health-workforce-information-review NHS Working Longer Review: audit of existing research NHS This review audits existing research into the impact of working beyond 60 years on employees and employers. http://www.nhsemployers.org/SiteCollectionDocuments/NHS%20WLR%20%20Audit%20of%20existing%20research.pdf Reforming the social work bursary: government consultation Department of Health This consultation reviewed the social work bursary scheme in order to ensure it continues to attract sufficient high quality candidates to come forward to study and
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work as social workers. The government response sets out how and why the bursary is being reformed. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/200151/ Social-Work-Bursary-Consultation-document.pdf

Report on district nurse education in England, Wales and Northern Ireland 2012/13 The Queens Nursing Institute This report reveals concerns around the number of new district nurses currently being educated, particularly in England. http://www.qni.org.uk/docs/Report%20on%20District%20Nurse%20Education%20201 2-13.pdf Workforce planning guide Health Education England This guidance sets out the milestones and timelines for the planning process to be operated in 2013/14 to produce 2014/15 workforce investment plans. It aims to secure the future supply of workforce, in a way that both maintains safe staffing levels for patients and supports the transformation of services necessary to drive quality improvement. http://hee.nhs.uk/wp-content/blogs.dir/321/files/2012/08/Workforce-Planning-GuideFinal-June-2013.pdf

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