NHS Library and Information Service North Staffordshire

Clinical Effectiveness Bulletin for NHS Primary Care in North Staffordshire

Issue No: 83 December 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: Andrew.Hough@northstaffs.nhs.uk or 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 Diabetes Type 2 Horizon Scanning 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 ....................................................................................................................... 4 Dementia .................................................................................................................................. 5 Diabetes.................................................................................................................................... 6 Guidance .................................................................................................................................. 6 Infection Control ........................................................................................................................ 8 Integrated Healthcare ............................................................................................................... 9 Mental Health.......................................................................................................................... 10 Nutrition .................................................................................................................................. 12 Older People ........................................................................................................................... 11 Palliative Care 12 Patient Care and Safety .......................................................................................................... 12 Pharmacy and Prescribing ...................................................................................................... 13 Public Health ........................................................................................................................... 15 Service Management .............................................................................................................. 16 Social Care ............................................................................................................................. 18

NHS Library and Information Service North Staffordshire Cancer

*Routes to diagnosis: cancer of unknown primary National Cancer Intelligence Network (NCIN) This research shows that more than half (57%) of newly diagnosed cases of cancer of unknown primary - around 25,000 in England between 2006 and 2010 - were presented as an emergency compared to 23% for all cancers. http://ncin.org.uk/publications/data_briefings/routes_to_diagnosis_cancer_of_unknown_prima ry
Items in the guidance section may be of interest

Children and Young People

*Children's centres National Childrens Bureau (NCB) The National Children's Bureau (NCB) has published a new essay series 'Partnerships for a Better Start: perspectives on the role of children's centres' to encourage a wide-ranging debate on how children's centres support children and families from conception to school entry. To inform the debate, NCB is carrying out a survey to find out what the public and early years sector value most about children's centres and what they feel their future purpose should be. http://www.ncb.org.uk/childrenscentres [back to topics]

Commissioning
*Commissioning for Value - Doncaster CCG NHS Right Care A new Right Care Casebook shows how Doncaster Clinical Commissioning Group applied the insight from the 'Commissioning for Value pack' to develop an intelligence-driven plan focused on improving outcomes. 'Commissioning for Value: successes and challenges in creating energy for change' describes the actions taken, the results of the actions and sets out what was learned from using the Right Care Commissioning for Value approach for respiratory care and mental health services. http://www.rightcare.nhs.uk/index.php/2013/12/document-of-the-week-dec-16th-successesand-challenges-in-creating-energy-for-change-a-right-care-casebook/

NHS Library and Information Service North Staffordshire

*How CCGs are changing the face of the NHS NHS Clinical Commissioners NHS Clinical Commissioners has published a suite of CCGs success stories in 'Taking the lead: how Clinical Commissioning Groups are changing the face of the NHS'. The report describes how a number of CCGs from across the country are working with local government, the voluntary sector, and others to improve services and change lives. The report contains sixteen cases studies from across the country including: developing a minor ailments serviceBarnsley CCG; seven-day consultant care - Bassetlaw CCG; and Improving health services for care home residents - Leeds South and East CCG. http://www.nhscc.org/wp-content/uploads/2014/01/NHSCC-Taking-the-lead-How-CCGs-arechanging-the-NHS-Jan-2014.pdf * Making best use of the Better Care Fund: spending to save? Kings Fund This evidence summary briefing offers an evidence-based guide to aid the discussions between clinical commissioning groups, local authorities and health and wellbeing boards. It presents evidence from The Kings Fund and others in a number of differen t areas for example, primary prevention; self-care; case management and emphasises that this evidence must be interpreted and used with a sound understanding of the key local challenges and the underlying issues that need to be addressed. http://www.kingsfund.org.uk/publications/making-best-use-better-care-fund

Dementia
*Dementia-friendly Yorkshire: first steps on the journey Joseph Rowntree Foundation This collection contains 20 examples of inspiring grassroots dementia-friendly projects transforming communities across Yorkshire. These projects are taking place in shops, churches, mosques, gurdwaras, legal services and cafes, and in public services such as transport, museums, hospitals, trading standards, schools, libraries, and sports centres. Local champions are behind most of this work, and show how we can each play our role in making our own community or organisation a welcoming and supportive place for people with dementia. http://www.jrf.org.uk/sites/files/jrf/dementia-communities-yorkshire-summary.pdf *Improving the identification of people with dementia in primary care BMJ Open 2013 Vol 3 (12) Russell P, et al. This research reveals how practices are able to substantially increase the number of patients on their lists recorded as having dementia simply by cleaning up their records, shows a new study that researchers claim highlights uncertainties over the Governments promotion of GP case-finding to boost diagnoses. http://bmjopen.bmj.com/content/3/12/e004023.full

NHS Library and Information Service North Staffordshire

*The triangle of care - carers included: a guide to best practice for dementia care Royal College of Nursing The triangle of care is a model for dementia care that supports a partnership approach between the person with dementia (the patient), the staff member and carer. It is designed to ensure that carers are appropriately included and involved in the care of people with dementia, particularly in hospital settings. http://www.rcn.org.uk/__data/assets/pdf_file/0009/549063/Triangle_of_Care__Carers_Included_Sept_2013.pdf [back to topics]

Diabetes
*NHS England vision for tackling diabetes NHS England 'Action for Diabetes' has been published which outlines how it would like to plan prevention of Type 2 diabetes, earlier diagnosis of all diabetes, and support for people to manage their diabetes better and improve their quality of life. This document has been produced in response to the Public Accounts Committee report on adult diabetes services, published in 2012. It is for CCGs as a reference on the work that is going on across NHS England, and for the wider community interested in diabetes care to see what action NHS England is taking in this area http://www.england.nhs.uk/2014/01/10/tackling-diabetes-2014/

Guidance
NICE Evidence updates *Organ donation for transplantation (Evidence update-51) *Prevention of cardiovascular disease (Evidence-update-50) https://www.evidence.nhs.uk/about-evidence-services/bulletins-and-alerts/evidenceupdates/evidence-updates-by-date *Updated guidance on HIV post-exposure prophylaxis Department of Health The Department of Health has issued updated guidance for post-exposure prophylaxis (PEP) following occupational injuries resulting from needles, syringes and other sharp instruments contaminated with HIV. This supplements the 2008 guidance 'HIV post-exposure prophylaxis: guidance from the UK Chief Medical Officers Expert Advisory Group on AIDS'. Both should be read in conjunction with local policy on managing incidents in occupational settings where workers are accidentally exposed to blood or body fluids. https://www.gov.uk/government/publications/eaga-guidance-on-hiv-post-exposure-prophylaxis

NHS Library and Information Service North Staffordshire

NICE Clinical Guidlines *Head injury: NICE guideline (CG 176) http://www.nice.org.uk/nicemedia/live/14355/66330/66330.pdf *Prostate Cancer (CG175) http://guidance.nice.org.uk/CG175 NICE Interventional Procedures *Arthroscopic trochleoplasty for patellar instability (IPG474) http://guidance.nice.org.uk/IPG474 *Insertion of prostatic urethral lift implants to treat lower urinary tract symptoms secondary to benign prostatic hyperplasia (IPG475) http://guidance.nice.org.uk/IPG475 *Radiofrequency ablation of the soft palate for snoring (IPG476) http://guidance.nice.org.uk/IPG476 *Transcranial magnetic stimulation for treating and preventing migraine (IPG477) http://guidance.nice.org.uk/IPG477 NICE Public Health Guidance *Behaviour change: individual approaches (PH49) http://guidance.nice.org.uk/PH49 NICE Quality Standards *Autism quality standard (QS51) http://guidance.nice.org.uk/QS51 *Peripheral arterial disease (QS52) http://guidance.nice.org.uk/QS52 NICE Technology Appraisals *Multiple sclerosis (relapsing) - teriflunomide (TA303) http://guidance.nice.org.uk/TA303

NHS Library and Information Service North Staffordshire Infection Control

*Enteric fever cases decrease for the second year Public Health England New figures from Public Health England ( PHE ) published in 'Enteric Fever (typhoid and paratyphoid) in England, Wales and Northern Ireland: 2012' show that 354 cases of enteric fever were reported among returning travellers in England, Wales and Northern Ireland in 2012, which is 26% lower than the 480 cases reported in 2011. London continues to report the largest proportion of cases in England, although there has been a 38% decrease in cases reported from London in 2012 compared to 2011. In 2012, 93% of all cases were presumed acquired abroad with 70% of these having visited friends and relatives in India, Pakistan or Bangladesh. Just over a fifth of cases were in children aged 16 years and under. http://www.hpa.org.uk/webc/HPAwebFile/HPAweb_C/1317140635485 *Healthcare associated infections (HCAIs) - litigation and reputation MindMetre Research This research finds that two thirds of Britons would sue a hospital if they contracted a serious HCAI while undergoing treatment. It suggests that the reputational/litigation risk to hospitals with higher HCAI rates, and the possible consequential loss of patient volumes, is an incentive to focus on reducing HCAIs. http://www.mindmetreresearch.com/wp-content/uploads/2014/01/MindMetre-HCAI-LitigiousReport-Jan14.pdf *Gastrointestinal infections Public Health England Public Health England has published 'Gastrointestinal infections: 2011 and 2012 report'. This report summarises developments in the surveillance and investigations of infectious intestinal disease (IID) that occurred during 2011 and 2012. It has been compiled by the Gastrointestinal Infections Section of the Department of Gastrointestinal, Emerging and Zoonotic Infections (GEZI). http://www.hpa.org.uk/Publications/InfectiousDiseases/GastrointestinalOutbreaksAndIllnessR eports/1312Gastointestinalreport2011to2012/

*Standards for the management of sexually transmitted infections British Association for Sexual Health and HIV (BASHH)/Medical Foundation for AIDS and Sexual Health (MedFASH) The British Association for Sexual Health and HIV (BASHH) and Medical Foundation for AIDS and Sexual Health (MedFASH) have revised their 'Standards for the management of sexually transmitted infections'. The standards have been developed with the aim of supporting commissioners and providers in achieving high quality services for the populations they serve. They also specify what the public can expect of the services they access. The standards represent current best practice and are intended for use in all services commissioned by local authorities or the NHS including those provided by the independent and third sectors. They are also strongly recommended for use in independent services not commissioned by the public sector. http://www.bashh.org/BASHH/About_BASHH/BASHH_Publications/BASHH/About_BASHH/B ASHH_Publications.aspx 8

NHS Library and Information Service North Staffordshire

Integrated Healthcare
*Delivering integrated care and support Association of Directors of Social Work (ADSW) This paper presents a review of the evidence base on the factors that underpin best health and social care integrated practice. The original document, An evidence base for the delivery of adult services, published in 2011, presented the evidence for considering factors beyond those of structural change when planning to improve integrated outcomes for individuals. This paper further adds to the knowledge base by focusing on the key dimensions for effective implementation of change. http://www.iriss.org.uk/sites/default/files/01913_delivering_integrated_care_and_support.pdf *Delivering integration at pace and scale Reform This report contains the transcript of the Reform-Novo Nordisk seminar on "Delivering integration at pace and scale" with Bill McCarthy, National Director of Policy at NHS England, in October 2013. The aim of the seminar was to explore how policymakers can facilitate integration that benefits patients. http://www.reform.co.uk/resources/0000/1120/Delivering_Integration.pdf *Liaison psychiatry for every acute hospital Royal College of Psychiatrists The Royal College of Psychiatrists has published 'Liaison psychiatry for every acute hospital: integrated mental and physical healthcare'. The report suggests that liaison psychiatry is a critical service that should be integral to all acute hospitals. Services comprise multidisciplinary teams skilled to integrate mental and physical healthcare in people whose mental health problems arise in, or have an impact on management of, physical illness and symptoms. http://www.rcpsych.ac.uk/usefulresources/publications/collegereports/cr/cr183.aspx *Measuring peoples experiences of integrated care Picker Institute Europe The Picker Institute Europe has published two linked research reports describing how patients, service users and carers perspectives can be used to measure integration within and between health and social care services. Both were commissioned by the Department of Health. Together, the reports describe a robust and efficient approach to measuring peoples experiences of integrated care, and provide valuable resources for those evaluating local and national initiatives. http://www.pickereurope.org/integrated-care/ *Think integration, think workforce: three steps to workforce integration Centre for workforce intelligence (CFWI)
This paper identifies three steps for workforce leaders to promote integration from a workforce perspective and outlines the benefits of an integrated workforce.

http://www.cfwi.org.uk/publications/think-integration-think-workforce-three-steps-to-workforceintegration-1/@@publication-detail 9

NHS Library and Information Service North Staffordshire

Mental Health
* Anti-social behaviour and mental health London Councils Tackling anti-social behaviour (ASB) is a priority for many community safety partnerships in London. Boroughs have raised the point that a sizable proportion of their ASB cases have a mental health dimension. London Councils conducted a survey of all heads of community safety exploring the issues and challenges around mental health and ASB, finding out what practical responses are delivering results on the ground and listening to what the professionals feel they need to improve work in this area in the future. This report presents the results of this survey and also includes examples of practice where available. http://www.londoncouncils.gov.uk/policylobbying/crime/publications/asbmentalhealth.htm *Closing the gap: priorities for essential change in Mental Health Department of Health This government report sets out the government strategy for mental health. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/273649/Closing _the_gap.pdf?dm_i=4O5,24MKC,BRKCPX,7OOHP,1 *Monitoring the use of the Mental Capacity Act (MCA) Deprivation of Liberty Safeguards (DoLS) in 2012/13 Care Quality Commission (CQC) This report into how the Deprivation of Liberty Safeguards have been applied during 2012/13 cites concern that the MCA is not understood and implemented consistently across health and social care services. It announces that checks on implementation of the MCA will become a routine part of hospital and care home inspection. It also recommends that NHS England should include an expectation on the effective use of the DoLS into the standard contract for providers. http://www.cqc.org.uk/sites/default/files/media/documents/dols_2014.pdf *Parenting programmes to support for children with behavioural problems Centre for Mental Health The Centre for Mental Health has published two documents examining parenting support for children with behavioural problems: - 'Building a better future' reports that children with severe behavioural problems are growing up with poorer chances in life even though cost-effective parenting programmes can help to improve their future prospects. The report points to the many benefits of early intervention and highlights a number of major disadvantages in life for children with the most serious behavioural problems. - 'Wanting the best for my children: parents' voices' looks at the experiences of 44 parents and shows how parenting programmes can be better managed and promoted to support more families in managing early behavioural difficulties. http://www.centreformentalhealth.org.uk/news/2014_Buildingabetterfuture.aspx

10

NHS Library and Information Service North Staffordshire

*Psychological wellbeing and work: Improving service provision and outcomes Department of Health/ Department of Work and Pensions This report, commissioned by the Department of Health and the Department of Work and Pensions, explores how to improve employment and health outcomes for people with common mental health problems. It makes a number of recommendations including the use of evidence-based models that combine employment and mental health support; the integration of existing treatment and employment services; and the timely provision of services. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/273433/psychol ogical-wellbeing-and-work.pdf *Suicide prevention report Public Health England The following suicide prevention strategy report has been published. https://www.gov.uk/government/publications/suicide-prevention-report

Items in the Dementia and Guidance sections may be of interest.

Nutrition
*Future diets Overseas Development Institute The Overseas Development Institute has published 'Future diets: implications for agriculture and food prices'. Diets are increasingly important in a world of economic growth and rising incomes and two concerns, in particular, are emerging: the effect of diet on health; and the demands made by changing diets on agriculture. This report addresses three sets of questions: what is known about the reasons for the marked differences seen in diets between countries?; are there examples of public policies that have had a real impact on choice of diet, and if so, which polices have been most effective and under what conditions?; and how big will the gap be between the food available and the food that is needed in the future, if diets shift to match those recommended by nutritionists? http://www.odi.org.uk/sites/odi.org.uk/files/odi-assets/publications-opinion-files/8776.pdf

Older People
*Preventing abuse and neglect in institutional care Comic Relief has launched the final PANICOA (Preventing Abuse and Neglect in Institutional Care of Older Adults) report 'Respect and Protect' which draws together findings of 11 individual research studies looking at institutional care and the steps that can be taken to help prevent the mistreatment of staff, residents and patients. http://www.panicoa.org.uk/sites/assets/Final_Main_PANICOA_Report_web.pdf

11

NHS Library and Information Service North Staffordshire Palliative Care

*Care home at night, evening and weekend - making residents' choice happen Foundation of Nursing Studies (FONS) This project took place in a care home located in a large West Yorkshire city which provides social and nursing care for 40 residents. It outlines the implementation process of which results included a positive acceptance of the advanced care planning process; ensuring documentation such as Do Not Attempt Resuscitation Orders are in place and early recognition of potential deterioration using the Stop and Watch tool and SBAR communication tool. http://fons.org/Resources/Documents/Project%20Reports/PFLeedsCareAtNight.pdf
*Raising the profile of preferred priorities at the end of life with patients at St Nicholas' Hospice

Foundation of Nursing Studies (FONS) This project set out to conduct an explorative project to est ablish patients preferred priorities of care within a hospice setting. The project findings are supported by current literature and highlight that patients want to have the opportunity to explore their end of life wishes but there are many perceived barriers to starting this process. http://fons.org/Resources/Documents/Project%20Reports/PFEndOfLifeDec2011.pdf

Patient Care and Safety

*Breathlessness resources published Improving and Integrating Respiratory Services in the NHS (IMPRESS) A respiratory network has published resources to support those treating long term adult breathlessness. Improving and Integrating Respiratory Services in the NHS (IMPRESS) has produced an interactive tool and tips for clinicians, public health, commissioners and patients. The resources draw on international evidence about the causes of breathlessness and related conditions. Breathlessness is a common problem affecting up to 10% of the total adult population rising to 30% in older people. http://www.networks.nhs.uk/nhs-networks/impress-improving-and-integratingrespiratory/news/impress-breathlessness-resources *Confidentiality clauses and special severance payments: thirty-sixth report of session 2013-14 House of Commons Committee of Public Accounts This report concludes that 'gagging' clauses could be used to stop whistle blowers speaking out about patient care and child safety. It also raises concerns about the use of compromise agreements and special severance payments to terminate employment in the public sector. http://www.publications.parliament.uk/pa/cm201314/cmselect/cmpubacc/477/477.pdf

12

NHS Library and Information Service North Staffordshire

*NHS safe staffing: not just a number Policy Analysis Centre This analysis highlights the risks to patient care when hospital ward staffing falls short of the roster. Despite developments in electronic rostering hospitals have resisted using automated systems to track their staff. Recent unannounced hospital inspections have found serious staff shortfalls against rosters. This report highlights the potential benefits of implementing robust systems to track the deployment of hospital staff in real time, to patients, to the workforce, and to hospital management. http://www.policy-centre.com/downloads/NHS%20Safe%20Staffing%20Jan%202014.pdf *Prevention of stroke in patients with atrial fibrillation guide Healthcare Improvement Scotland Healthcare Improvement Scotland and The Scottish Intercollegiate Guidelines Network has published 'Prevention of stroke in patients with atrial fibrillation: a guide for primary care'. The guide summarises the current evidence available to support the management of AF in primary care. The guide was developed by collating existing recent advice and guidance, including evidence based guidelines and consensus recommendations for practice in NHS Scotland. http://www.sign.ac.uk/pdf/AF_publication.pdf

[back to topics]

Pharmacy and Prescribing

*360 degrees of health data: harnessing big data for better health Association of the British Pharmaceutical Industry (ABPI) The ABPI in partnership with the National Institute for Health Research jointly held a conference in November 2013 on health data. The objectives of the conference were to hear about the evolving data boom and its impact on the biopharmaceutical industry and the NHS; highlight data needs and the opportunities to improve R&D productivity; and drive forward health research excellence through partnership working for patient benefit. This report contains a summary of the proceedings. http://www.abpi.org.uk/our-work/library/medical-disease/Pages/360%CB%9A-of-Health-Dataharnessing-big-data-for-better-health.aspx *Consolidating and developing the evidence base and research for community pharmacys contribution to public health Public Health England In July 2011 Ministers established the Pharmacy and Public Health Forum to bring together pharmacy and public health interests. One of the initial priorities for the Forum was to evaluate and strengthen the evidence base for community pharmacys potential contribution to public health. This report provides an update on progress made. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/271682/201401 10-Community_pharmacy_contribution_to_public_health.pdf

13

NHS Library and Information Service North Staffordshire

*Drug strategy annual review Home Office The Home Office has published the second annual review of the drug strategy, 'Delivering within a new landscape', which updates progress on the strategy since May 2012. It highlights the actions taken and the priorities for the year ahead on reducing demand, restricting supply and building recovery. Case studies are also provided. Accompanying the review is the evaluation framework. The framework was developed to assess the drug strategys effectiveness and value for money. This document outlines the evaluation stages, the approach to evaluation and the next steps. https://www.gov.uk/government/publications/drug-strategy-annual-review-2012-to-2013 *Evidence summaries: new medicines Triptorelin National Institute for Clinical Excellence (NICE) NICE has published a new medicines evidence summary 'ESNM30 Prostate cancer: triptorelin (Decapeptyl SR)'. Evidence summaries: new medicines' provide a summary of the published evidence for selected new medicines, or for existing medicines with new indications or formulations, that are considered to be of significance to the NHS. The strengths and weaknesses of the relevant evidence are critically reviewed within the summary, but the summaries are not formal NICE guidance. http://www.nice.org.uk/mpc/evidencesummariesnewmedicines/ESNM30.jsp *Evidence summaries: unlicensed or off-label medicines National Institute for Clinical Excellence (NICE) NICE has published three new unlicensed or off-label medicine evidence summaries. 'Evidence summaries: unlicensed or off-label medicine' present the published evidence for selected unlicensed or off-label medicines that are considered to be of significance to the NHS, where there are no clinically appropriate licensed alternatives. The summaries provide information for clinicians and patients to inform their decision-making and support the construction and updating of local formularies. The strengths and weaknesses of the relevant evidence are critically reviewed within this summary, but this summary is not NICE guidance. - ESUOM23 Transient ischaemic attack: clopidogrel http://www.nice.org.uk/mpc/evidencesummariesunlicensedofflabelmedicines/ESUOM23.jsp - ESUOM24 Critical limb ischaemia in peripheral vascular disease: intravenous iloprost http://www.nice.org.uk/mpc/evidencesummariesunlicensedofflabelmedicines/ESUOM24.jsp - ESUOM25 Non-cystic fibrosis bronchiectasis: colistimethate sodium http://www.nice.org.uk/mpc/evidencesummariesunlicensedofflabelmedicines/ESUOM25.jsp *Supervision in community pharmacy: final report to Pharmacy Research UK Centre for Pharmacy Workforce Studies This research investigates current arrangements for supervision, role delegation and skill mix in community pharmacy and aimed to seek stakeholders perceived risk levels associated with different types of pharmacy activities and services, and views on potential changes to supervision requirements. It identified those activities that pharmacists and pharmacy technicians agreed can be undertaken during the pharmacists absence. http://www.pharmacyresearchuk.org/waterway/wp-content/uploads/2014/01/Supervision-inCommunity-Pharmacy-Full-Report-070114.pdf [back to topics] 14

NHS Library and Information Service North Staffordshire Public Health

*Care Bill factsheet: Better Care Fund Department of Health The Department of Health has published a new factsheet to accompany the Care Bill. Factsheet 19 'Better Care Fund' describes how the Care Bill will facilitate a Better Care Fund to promote closer working between the NHS and Care and Support. https://www.gov.uk/government/publications/the-care-bill-factsheets *CQC report for Bradford Teaching Hospitals Care quality commission The Care Quality Commission has published its inspection report for Bradford Teaching Hospitals NHS Foundation Trust. The report identifies that the Trust was failing to meet four of the six national standards reviewed. CQC found staff shortages across a number of wards and departments particularly in A&E. There were also concerns in relation to staffing skill mix in some areas. The inspectors raised concerns that this was impacting directly on the Trusts ability to provide safe and effective care that fully met patients needs. http://www.cqc.org.uk/directory/rae01 *Life after death: six steps to improve support in bereavement Dying Matters This report outlines benefits for improving support for people who are recently bereaved: reducing the use of acute health and social care services, lessening the number of days lost to the economy, and improving the wellbeing of those facing such a significant change in their lives. It includes a call for clarity about who is responsible locally for commissioning and providing bereavement support, with better coordination and information about services. http://dyingmatters.org/sites/default/files/Life%20After%20Death%20FINAL(1).pdf *NHS co-payments: how popular are they among healthcare users? Patients Association This report discusses the results of a survey of patients and their opinions on the use of copayments and top-up fees in the NHS. http://www.patients-association.org.uk/Portals/0/NHS%20CoPayments%20How%20popular%20are%20they%20among%20healthcare%20users.pdf *NHS waiting times report National Audit Office The National Audit Office (NAO) has published 'NHS waiting times for elective care in England' which reports that patients in England cannot rely on information on waiting times for non-emergency operations, such as knee and hip replacements. The NAO found wrong and inconsistent recording after reviewing 650 cases in seven trusts. The watchdog said it was unable to discern whether this was deliberate, but says it should be investigated. The government says waiting times are "low and stable" but it will work with the NHS to ensure accurate reporting. The NAO said that overall there was a tendency for the practices to conceal delays rather than over-record waits. http://www.nao.org.uk/report/nhs-waiting-times-elective-care-england/

15

NHS Library and Information Service North Staffordshire

*Productivity of the English National Health Service from 2004/5: updated to 2011/12 Centre for Health Economics (CHE) This report finds that productivity growth in 2010/11 2011/12 was around 2.13% to 2.38% depending on the choice of mixed or indirect input index used. Over the whole time series we find that quality adjusted output has increased by 40%. Inputs have increased by 28% using the mixed input measure and by 26% using the indirect measure, leading to a total factor productivity growth over the entire period of 10% and 11% respectively. http://www.york.ac.uk/media/che/documents/papers/researchpapers/CHERP%2094_NHS_pr oductivity_update2011-12.pdf
*Public health grants to local authorities 2013 to 2014 and 2014 to 2015

Department of Health This local authority circular outlines the public health grants to local authorities. The ring fenced grants for 2013 to 2014 and 2014 to 2015 provide local authorities with 2.66 billion and 2.79 billion to spend on public health services for their local populations. The grant conditions and reporting arrangements that will apply to the grant from April 2013 have also been published. https://www.gov.uk/government/publications/ring-fenced-public-health-grants-to-localauthorities-2013-14-and-2014-15 *State of maternity services report 2013 Royal College of Midwives This report looks at a number of indicators of the pressures on maternity care and the resources available to cope in England, Scotland, Wales and Northern Ireland. It focuses on the latest available statistics, revealing what is happening on the frontline of care. http://www.rcm.org.uk/college/policy-practice/government-policy/state-of-maternity-services/ *State of the nation's waistline - obesity in the UK: analysis and expectations National Obesity Forum
This report aims to audit the situation in the UK, to identify what initiatives and policy exists, and to assess their effectiveness in tackling obesity and weight management issues. It highlights a lack of support and guidance for those who are obese or morbidly obese as well as a deficiency in GP knowledge of support services.

http://www.nationalobesityforum.org.uk/media/PDFs/StateOfTheNationsWaistlineObesityinthe UKAnalysisandExpectations.pdf [back to topics]

Service Management
*High-impact leadership: improve care, improve the health of populations, and reduce costs Institute for healthcare improvements (IHI) This white paper presents three interdependent dimensions of leadership that together define high-impact leadership in health care: new mental models; high-impact leadership behaviours; and IHI high-impact leadership framework. The white paper also includes examples from a variety of health care leaders, to help illustrate high-impact leadership behaviours in real-world practice http://www.ihi.org/knowledge/Pages/IHIWhitePapers/HighImpactLeadership.aspx 16

NHS Library and Information Service North Staffordshire

*Invited reviews Royal College of Obstetricians and Gynaecologists (RCOG) This document sets out the RCOG's approach to requests for invited reviews of obstetric and/or gynaecology services, or individual clinical practice. It defines the governance, structure and operational process to be followed when a request is received by the College, the rationale for determining the appropriate response and how this response is followed through, including the process for review and follow-up. http://www.rcog.org.uk/files/rcog-corp/RCOG_Invited_reviews-a_guide.pdf *New evidence on management and leadership National Institute for Health Research This paper presents a digest of recent research and evidence on healthcare management and leadership. The studies discussed aim to help organisations and individuals to understand better the ways in which effective managers improve services for patients. http://www.nets.nihr.ac.uk/programmes/hsdr/New-Evidence-on-Management-andLeadership.pdf *Staff care: how to engage staff in the NHS and why it matters The point of care foundation This report shows that the way healthcare staff feel about their work has a direct impact on the quality of patient care as well as on an organisations efficien cy and financial performance. It argues that it is not only necessary for healthcare providers to encourage staff engagement but to accelerate it. http://www.pointofcarefoundation.org.uk/Downloads/Staff-Report-2014.pdf *Variations in outcome and costs among NHS providers for common surgical procedures Centre for Health Economics The Centre for Health Economics has published 'Variations in outcome and costs among NHS providers for common surgical procedures: econometric analyses of routinely collected data'. The report examines the relationship between the cost of hospital care with the associated improvement in patient-reported outcome measures (PROMs) as measured both by a generic instrument, the EuroQol-5D questionnaire and a condition-specific instrument for each of four surgical procedures: unilateral hip replacement, unilateral knee replacement, groin hernia repair and varicose vein surgery. The analysis includes measures of the variability in outcomes and resources across hospitals, and considers the sensitivity of the results to choices of outcome instrument and measure of resource use. http://www.journalslibrary.nihr.ac.uk/hsdr/volume-2/issue-1
Items in the Commissioning section may also be of interest.

[back to topics]

17

NHS Library and Information Service North Staffordshire Social Care

*An evaluation of the Department of Healths Health and Social Care Volunteering Fund Leeds Metropolitan University Institute for Health and Wellbeing
This report shows that the Department of Healths Health and Social Care Volunteering Fund (HSCVF) has successfully strengthened volunteering in local communities. It presents evidence on the extent to which, how and in what ways the HSCVF programme has built organisational and community capacity across the national and local HSCVF projects, as well as on the health and social outcomes that resulted.

http://www.leedsmet.ac.uk/HSCVF_Evaluation_Report_-_Full_%2868_pages%29.pdf * Developing new standards for social care The Department of Health has now published the responses it received in relation to its consultation on the identifying potential future topics for NICE quality guidance/standards. As a result of the consultation, the following 5 topics have been identified for formal referral to NICE: falls - regaining independence for older people who experience a fall; care and support of older people with learning disabilities; medicines management - managing the use of medicines in community settings for people receiving social care; regaining independence short term interventions to help people to regain independence; and adult social care - service users and carer experience of adult social care. The report highlights the departments next steps are for this work. https://www.gov.uk/government/consultations/developing-new-standards-for-social-care *How is the health and social care system performing? Kings Fund: Quarterly Monitoring Report Our latest quarterly monitoring report shows that the NHS is holding up well against winter pressures so far, but financial pressures are increasing for hospitals.The report suggests that 1 in 5 hospitals will be in deficit by the end of the financial year and also highlights concerns over low staff morale. http://www.kingsfund.org.uk/sites/files/kf/field/field_publication_file/quarterly-monitoringreport-january-2014.pdf
Items in the Integrated Care section may be of interest

[back to topics]

18