NHS Library and Information Service North Staffordshire

Clinical Effectiveness Bulletin for NHS Primary Care in North Staffordshire

Issue No: 74 March 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: 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

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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.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 Allied Health Professionals ....................................................................................................... 4 Cancer ...................................................................................................................................... 4 Cardiovascular Diseases .......................................................................................................... 5 Children and Young People ...................................................................................................... 5 Commissioning ......................................................................................................................... 6 Dementia .................................................................................................................................. 6 Diabetes.................................................................................................................................... 7 Diagnostic Services .................................................................................................................. 7 General Practice ....................................................................................................................... 8 Guidance .................................................................................................................................. 8 Health Reforms ....................................................................................................................... 11 Infection Control ...................................................................................................................... 11 Integrated Care ....................................................................................................................... 11 IT and Telehealth .................................................................................................................... 12 Kidney Disease ....................................................................................................................... 12 Learning Disabilities ................................................................................................................ 12 Liver Disease .......................................................................................................................... 13 Long Term Conditions............................................................................................................. 13 Mental Health.......................................................................................................................... 13 Nutrition .................................................................................................................................. 13 Obesity.................................................................................................................................... 14 Older People ........................................................................................................................... 14 Palliative Care ......................................................................................................................... 14 Patient Care and Safety .......................................................................................................... 14 Pharmacy and Prescribing ...................................................................................................... 15 Physical Activity ...................................................................................................................... 16 Public Health ........................................................................................................................... 16 Respiratory Conditions............................................................................................................ 17 Restless Legs Syndrome ........................................................................................................ 17 Safeguarding Children and Vulnerable Adults ........................................................................ 17 Service Management .............................................................................................................. 18 Sexual Health ......................................................................................................................... 20 Social Care ............................................................................................................................. 20 Substance Misuse .................................................................................................................. 21 Womens Health ..................................................................................................................... 21 Workforce ............................................................................................................................... 21

NHS Library and Information Service North Staffordshire Alcohol

Alcohol and cancer Alcohol Health Alliance UK This report explains the relationship between alcohol and cancer and why this is a problem the UK needs to tackle now. It calls for the implementation of strategies to lower the amount the UK population drinks as a whole and to support those who drink excessively to cut down. http://www.rcplondon.ac.uk/resources/alcohol-and-cancer-report-alcohol-health-alliance-uk Health First: An evidence-based alcohol strategy for the UK University of Stirling The strategy was developed by a group of experts independent from government and the alcohol industry under the auspices of the Alcohol Health Alliance. http://www.stir.ac.uk/news/news-archive/13/03/alcohol-pricing/
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Allied Health Professionals

Making the most of allied health professionals Centre for Workforce Intelligence The paper brought together a leadership group to consider how best to organize the allied health workforce across care pathways, considering factors such as optimum skill mix, and education and leadership. http://www.cfwi.org.uk/publications/making-the-most-of-allied-health-professionals

Cancer
Cancer Survival Briefings West Midlands Cancer Intelligence Unit These briefings present statistics on cancer survival in England and the West Midlands. Comparisons This briefing compares lung, bowel, prostate and breast cancer. http://www.wmciu.nhs.uk/publicationdetails.aspx?id=902 Cancer site http://www.wmciu.nhs.uk/publicationdetails.aspx?id=903 Trends This briefing looks at trends in 1 and 5 year survival rates. http://www.wmciu.nhs.uk/publicationdetails.aspx?id=904 Age profiles http://www.wmciu.nhs.uk/publicationdetails.aspx?id=905 Living With and Beyond Cancer: Taking Action to Improve Outcomes Department of Health This report sets out what has been learned about survivorship, including tested interventions. https://www.gov.uk/government/publications/living-with-and-beyond-cancer-taking-action-toimprove-outcomes 4

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Teenage and young adult cancer statistics Cancer Research UK The latest statistics are incidence 2010, mortality 2010, and survival 2001-2005. http://www.cancerresearchuk.org/cancer-info/cancerstats/teenage-and-young-adult-cancer/
Items in the Alcohol and General Practice sections may be of interest. [back to topics]

Cardiovascular Diseases
Cardiovascular Disease Outcomes Strategy: Improving outcomes for people with or at risk of cardiovascular disease Department of Health The strategy recommends: reducing premature mortality rates for CVD by improving prevention, diagnosis and treatment; managing CVD as a single family of diseases and develop a standardised template for community and hospital care; and improving its management in primary care. https://www.gov.uk/government/publications/improving-cardiovascular-disease-outcomesstrategy Making the case for cardiac rehabilitation: modelling potential impact on readmissions NHS Improvement This report summarises a short study which models the relationship between uptake of cardiac rehabilitation (CR) and unplanned cardiac readmission rates. It examines whether the benefits of CR outweigh the costs in terms of potential impact on readmissions alone. http://www.improvement.nhs.uk/documents/Case_for_CR.pdf
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Children and Young People

Child Health Profiles Child and Maternal Health Observatory These profiles have been updated recently. They include a snapshot of performance against 32 selected indicators compared with the rest of England; analysis and key findings about the situation in each top level local authority; and a summary of performance for each local authority in the region. http://www.chimat.org.uk/profiles Diet and nutrition survey of infants and young children, 2011 Department of Health This survey provides the only source of detailed information on the food consumption, nutrient intakes and nutritional status of infants and young children in the general UK population aged 4 to 18 months. It was conducted between January and August 2011. http://transparency.dh.gov.uk/2013/03/13/dnsiyc-2011/
Items in the Cancer and Physical Activity sections may also be of interest.

NHS Library and Information Service North Staffordshire Commissioning

2011-12 programme budgeting data NHS Networks This interactive benchmarking tool enables commissioners to identify: how they spend their allocation over 23 disease categories; how their disease category level expenditure is split across 12 care settings; and how their expenditure compares with other commissioners. http://www.networks.nhs.uk/nhs-networks/health-investment-network/news/2011-12programme-budgeting-data-now-available Commissioning high-quality care for people with long-term conditions Nuffield Trust This summary is based on an action research project, which studied the day-to-day experience of those involved in commissioning. http://www.nuffieldtrust.org.uk/publications/commissioning-high-quality-care-people-longterm-conditions Original research: http://www.netscc.ac.uk/hsdr/projdetails.php?ref=08-1806-264 High quality healthcare commissioning: Why race equality must be at its heart Race Equality Foundation This paper considers how commissioners can address ethnic inequalities in health and access to healthcare. http://www.better-health.org.uk/briefings/high-quality-healthcare-commissioning-why-raceequality-must-be-its-heart-0 Statutory guidance published on Joint Strategic Needs Assessments and Joint Health and Wellbeing Strategies Department of Health This document explains the duties and powers of Joint Strategic Needs Assessments (JSNAs) and Joint Health and Wellbeing Strategies (JHWSs). http://healthandcare.dh.gov.uk/jsnas-jhwss-guidance-published/
Items in the Diabetes, Long Term Conditions, Obesity, Public Health, Service Management and Sexual Health sections may be of interest. [back to topics]

Dementia
Care Update (Issue 2) Care Quality Commission This report looks at the quality of health and social care provided to people between April and December 2012, and highlights particular problems in the care of patients with dementia. http://www.cqc.org.uk/public/reports-surveys-and-reviews/reports/care-update-issue-2

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Withdrawal versus continuation of chronic antipsychotic drugs for behavioural and psychological symptoms in older people with dementia Declercq, T et al. This Cochrane review assessed whether withdrawal of antipsychotics harmed older people with dementia. The included studies were conducted in nursing homes and outpatient settings. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD007726.pub2/abstract

Diabetes
Best practice for commissioning diabetes services: An integrated care framework NHS Diabetes This document aims to help CCGs understand the nature of integrated diabetes care, why it is so important and to signpost other documents relevant to the commissioning process. http://www.diabetes.nhs.uk/commissioning/ Computer-based diabetes self-management interventions for adults with type 2 diabetes mellitus Pal, K This Cochrane review is based on 16 trials of a range of interventions, including brief interventions in the clinic, and mobile phone and internet interventions. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD008776.pub2/abstract
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Diagnostic Services
Directory of Diagnostic Services for Commissioning Organisations NHS Improvement This guide brings together in one place information about all of the diagnostic modalities to inform decisions about commissioning diagnostic services. http://system.improvement.nhs.uk/ImprovementSystem/ViewDocument.aspx?docId=22981&T itle=Diagnostic_Commissioners_Directory_-_March_2013 Top tips to overcome the challenge of commissioning diagnostic services NHS Improvement The document draws on the experience and expertise of NHS Improvement diagnostic teams over the last 10 years in piloting service redesign with clinical teams. http://system.improvement.nhs.uk/ImprovementSystem/ViewDocument.aspx?docId=22982&T itle=Top_Tips_March2013_Singles Reassurance After Diagnostic Testing With a Low Pretest Probability of Serious Disease: Systematic Review and Meta-analysis Rolfe, A This review assessed whether diagnostic tests were effective in reducing patient worry and anxiety. JAMA Intern Med. 2013;173(6):407-416. doi:10.1001/jamainternmed.2013.2762.
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NHS Library and Information Service North Staffordshire General Practice

Bloating and Other Abdominal Symptoms: Could it be Ovarian Cancer? RCGP This online learning module aims to assist GPs in identifying ovarian cancer in its early stages. http://elearning.rcgp.org.uk/course/view.php?id=121 Changes to QOF 2013/14 NHS Employers This web page summarises changes made by the Department of Health to the Quality and Outcomes Framework, which have been made as part of the 2013/14 GMS contract changes. http://www.nhsemployers.org/PayAndContracts/GeneralMedicalServicesContract/QOF/Pages /ChangestoQOF201314.aspx Patient Online: The Road Map RCGP This road map looks at the types of services which can be offered on Patient Online, and what might be available in the future. It also considers issues practices will need to consider when implementing Patient Online. http://www.rcgp.org.uk/patientonline
Items in the IT and Telehealth, Respiratory Conditions, and Workforce sections may be of interest. [back to topics]

Guidance
NICE Guidance Conduct disorders in children and young people CG158 http://guidance.nice.org.uk/CG158 Hyperphosphataemia in chronic kidney disease CG157 http://guidance.nice.org.uk/CG157 NICE Technology Assessments Cystic fibrosis (pseudomonas lung infection) - colistimethate sodium and tobramycin TA276 http://guidance.nice.org.uk/TA276 Interventional Procedures Guidance Electrochemotherapy for primary basal cell carcinoma and primary squamous cell carcinoma IPG447 http://guidance.nice.org.uk/IPG447

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Percutaneous electrical nerve stimulation for refractory neuropathic pain IPG450 http://guidance.nice.org.uk/IPG450 Peripheral nerve-field stimulation for chronic low back pain IPG451 http://guidance.nice.org.uk/IPG451
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NICE Quality Standards Diagnosis and management of venous thromboembolic diseases QS29 http://guidance.nice.org.uk/QS29 Hypertension QS28 http://guidance.nice.org.uk/QS28
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NICE Consultation Documents Delaying the onset of disability, frailty and dementia in later life: scope consultation To comment, register as a stakeholder, or contact the registered stakeholder organisation that most closely represents your interests. Closing date for comments: 18 April 2013 http://www.nice.org.uk/guidance/index.jsp?action=folder&o=63206 Implantation of a duodenal-jejunal bypass sleeve for the management of obesity and/or type 2 diabetes : consultation document Closing date for comments: 19 April 2013 http://www.nice.org.uk/guidance/index.jsp?action=article&o=63268 Autism - management of autism in children and young people: guideline consultation To comment, register as a stakeholder, or contact the registered stakeholder organisation that most closely represents your interests. Closing date for comments: 10 May 2013 http://www.nice.org.uk/guidance/index.jsp?action=folder&o=63399 Patient group directions: draft good practice guidance consultation To comment, register as a stakeholder, or contact the registered stakeholder organisation that most closely represents your interests. Closing date for comments: 29 April 2013 http://www.nice.org.uk/mpc/goodpracticeguidance/PatientGroupDirectionsGuidanceConsultati on.jsp

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Smoking cessation acute, maternity and mental health services: consultation on the draft guidance To comment, register as a stakeholder, or contact the registered stakeholder organisation that most closely represents your interests. Closing date for comments: 5 June 2013 http://www.nice.org.uk/guidance/index.jsp?action=folder&o=63458
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Other Health Technology Assessments Study of the use of antidepressants for depression in dementia: the HTA -SADD trial - a multicentre, randomised, double-blind, placebo-controlled trial of the clinical effectiveness and cost-effectiveness of sertraline and mirtazapine. Banerjee S, et al. This study finds no evidence to support the use of antidepressants as a first-line treatment for people with depression in Alzheimer's disease who are referred to old-age psychiatry services, as many cases will resolve with usual care. Health Technol Assess 2013;17(7). Adjunctive colposcopy technologies for examination of the uterine cervix - DySIS, LuViva Advanced Cervical Scan and Niris Imaging System: a systematic review and economic evaluation. Wade R, et al. This report finds that, for examination of the uterine cervix, DySIS (a digital video colposcope), particularly in combination with colposcopy, has higher sensitivity than colposcopy alone; DySIS plus colposcopy appears to be less costly and more effective than both the DySISmap alone and colposcopy alone. No reliable evidence was found on the clinical effectiveness or cost-effectiveness of LuViva Advanced Cervical Scan and Niris Imaging System. Health Technol Assess 2013;17(8). Evaluation of mammographic surveillance services in women aged 40-49 years with a moderate family history of breast cancer: a single-arm cohort study. Duffy S, et al. This study found annual mammography in women aged 40-49 years with a significant family history of breast or ovarian cancer is both clinically effective in reducing breast cancer mortality and cost-effective. Health Technol Assess 2013;17(11).
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Other Guidance Brain injury rehabilitation in adults SIGN http://www.sign.ac.uk/guidelines/fulltext/130/index.html The Diagnosis and Management of Acute Otitis Media American Academy of Pediatrics Pediatrics Vol. 131(3) March 1, 2013 e964-e999 10

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Long term follow up of survivors of childhood cancer SIGN http://www.sign.ac.uk/guidelines/fulltext/132/index.html

Health Reforms
Clinical Commissioning Group Authorisation: review of waves 1, 2 and 3 NHS England This report outlines how far CCGs authorised in the first 3 waves are discharging the conditions needed for full authorisation. http://www.england.nhs.uk/blog/2013/03/27/gp-commissioning/ Fourth and final wave of clinical commissioning groups established NHS England http://www.commissioningboard.nhs.uk/blog/2013/03/14/wave4-auth/ The health and care system explained Department of Health This document outlines the new health and care system. https://www.gov.uk/government/publications/the-health-and-care-system-explained Local Healthwatch Regulations Explained Department of Health This document aims to explain and provide clarity in relation to lay person and volunteer involvement in local Healthwatch and restrictions on activities of a political nature. http://healthandcare.dh.gov.uk/local-healthwatch-regulations-explained/
Items in the Public Health section may also be of interest. [back to topics]

Infection Control
Chief Medical Officer annual report: volume 2 Department of Health This publication provides a comprehensive overview of the threat of antimicrobial resistance and infectious diseases. https://www.gov.uk/government/publications/chief-medical-officer-annual-report-volume-2
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Integrated Care
Making integrated care happen at scale and pace: Lessons from experience Kings Fund This paper is intended to support the process of converting policy intentions into meaningful and widespread change on the ground. The authors summarise 16 steps that need to be 11

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taken to make integrated care a reality and draw on work by The Kings Fund and others to provide examples of good practice. http://www.kingsfund.org.uk/publications/making-integrated-care-happen-scale-and-pace

IT and Telehealth
Cost effectiveness of telehealth for patients with long term conditions (Whole Systems Demonstrator telehealth questionnaire study): nested economic evaluation in a pragmatic, cluster randomised controlled trial Henderson, C et al. This economic evaluation compared telehealth in addition to usual care with usual care only. http://www.bmj.com/content/346/bmj.f1035 Health apps library NHS Choices This website links to a range of apps to help patients manage their health. Apps are assessed by NHS Choices. http://apps.nhs.uk/ Making Connections: A transatlantic exchange to support the adoption of digital health between the US VHA and Englands NHS 2020Health This report makes recommendations for implementing telehealth successfully, based on comparison of the NHS and the US Veterans Health Administration. http://www.2020health.org/2020health/Press/latest-news/Making-Connections.html Social Media Highway Code RCGP This code is a practical and encouraging guide for doctors and other healthcare professionals who use social media and want to ensure they get the most out of their online communications, while ensuring they meet their professional obligations and protect their patients. http://www.rcgp.org.uk/policy/rcgp-policy-areas/social-media-highway-code.aspx
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Kidney Disease
Youre not alone: Peer support for people with long term conditions NHS Kidney Care This report outlines what is needed to set up and maintain effective peer support programmes for people with kidney disease. http://www.kidneycare.nhs.uk/document.php?o=1729

Learning Disabilities
Items in the Palliative Care section may be of interest.

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NHS Library and Information Service North Staffordshire Liver Disease

The NHS Atlas of Variation in Healthcare for People with Liver Disease NHS RightCare This Atlas reveals widespread variation: in the prevalence of risk factors for liver disease, including Hepatitis infection, obesity and alcohol abuse; in emergency admissions and routine treatments and operations; and in the expenditure on liver disease services across the NHS http://www.rightcare.nhs.uk/index.php/atlas/liver-disease-nhs-atlas-of-variation-in-healthcarefor-people-with-liver-disease/

Long Term Conditions

Items in the Commissioning and Kidney Disease sections may be of interest. [back to topics]

Mental Health
Whole-Person Care: From Rhetoric to Reality Royal College of Psychiatrists This report highlights the significant inequalities that exist between physical and mental health care, including preventable premature deaths, lower treatment rates for mental health conditions and an underfunding of mental healthcare relative to the scale and impact of mental health problems. It describes the strong relationship between mental and physical health, and demonstrates how parity between mental and physical health can be achieved. http://www.rcpsych.ac.uk/mediacentre/pressreleases2013/achievingparityreport.aspx

Nutrition
Nutrient Analysis Department of Health Samples were analysed for energy and a range of nutrients including fat, fatty acids, protein, carbohydrate, fibre and a full range of vitamins and minerals. Eggs https://www.gov.uk/government/publications/nutrient-analysis-of-eggs Fish https://www.gov.uk/government/publications/nutrient-analysis-of-fish Processed foods https://www.gov.uk/government/publications/nutrient-analysis-of-processed-foods-includingtrans-fats Fruit and vegetables https://www.gov.uk/government/publications/nutrient-analysis-of-fruit-and-vegetables
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NHS Library and Information Service North Staffordshire Obesity

Developing a Specification for Lifestyle Weight Management Services: Best Practice Guidance for Tier 2 Services Department of Health This document includes two best practice example specifications, one for adults and one for children, and information on the outcomes commissioners should expect from a tier 2 service. https://www.gov.uk/government/publications/best-practice-guidance-for-weight-managementservices

Older People
Dignity and nutrition for older people Care Quality Commission This report is based on an inspection programme of care homes and NHS hospitals in Summer 2012. The programme focused on whether older people are treated with respect and dignity and get the food and drink that meets their needs. http://www.cqc.org.uk/public/reports-surveys-and-reviews/themed-inspections/dignity-andnutrition-older-people First Report: Ready for Ageing? House of Commons Select Committee on Public Service and Demographic Change The Committee focused on the implications of an ageing population for individuals and public policy in the near future, the decade 2020-2030. Their report looks at the benefits of an ageing population, and also how public services, including health and social care, will need to change to support an ageing population. http://www.publications.parliament.uk/pa/ld201213/ldselect/ldpublic/140/14002.htm
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Palliative Care
Widening access to palliative care for people with learning disabilities: Guidance and resources for professionals Help the Hospices This report includes sections on: cognition and communication; consent; advance care planning; pain and symptom control; psychosocial care; carer issues and bereavement. It also includes case studies and links to other useful resources and organisations. http://www.helpthehospices.org.uk/our-services/publications/caring-learning-disabilities/

Patient Care and Safety

Mid Staffordshire NHS Foundation Trust: Recommendations Monitor Contingency Planning Team This report makes recommendations for reconfiguring services at Mid Staffordshire NHS Foundation Trust. http://www.monitor-nhsft.gov.uk/home/news-events-and-publications/our-publications/browsecategory/reports-nhs-foundation-trusts/rep-1 14

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Patient-led assessments of the care environment (PLACE) NHS England These documents include assessment forms and guidance on recruiting and training patient assessors. They also include training materials and guidance for anyone wishing to become a patient assessor. http://www.commissioningboard.nhs.uk/ourwork/qual-clin-lead/place/ Patients First and Foremost: the Initial Government Response to the Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry Department of Health This response outlines a number of actions the government is taking to improve care. The government aims to create a system that is much more responsive to feedback from staff, patients, service users and their families and to foster a climate of openness, where staff are supported to do the right thing and where people are put first at all times. https://www.gov.uk/government/publications/government-initial-response-to-the-mid-staffsreport Quality and Outcome Data: March 2013 NHS Partners Network The data gives a comprehensive overview of many different aspects of NHS care, and compares NHS and independent sector providers to enable patients and GPs to make informed decisions about care. http://www.nhsconfed.org/Networks/NHSPartners/Pages/Data.aspx Rating providers for quality: a policy worth pursuing? Nuffield Trust This report was commissioned by the Department of health. It suggests that ratings may be useful for social care and GP practices, but that it may be harder to develop meaningful ratings for hospitals. http://www.nuffieldtrust.org.uk/publications/rating-providers-quality
Items in the General Practice, IT and Telehealth, Mental Health and Older People sections may also be of interest. [back to topics]

Pharmacy and Prescribing

Learning module on benzodiazepines Medicines and Healthcare Products Regulatory Agency The self-directed module outlines the key risks of this widely prescribed class of medicines. http://www.mhra.gov.uk/NewsCentre/CON249628 Pharmaceutical needs assessments: right service in the right place Primary Care Commissioning This briefing explains the statutory obligations on health and wellbeing boards and the risks of leaving the PNA to chance. http://www.pcc-cic.org.uk/article/pharmaceutical-needs-assessments-right-service-right-place 15

NHS Library and Information Service North Staffordshire Physical Activity

Health Impact of Physical Inactivity (HIPI) South West Public Health Observatory This tool has been developed to estimate how many cases of certain diseases could be prevented in each local authority in England, if the population aged 40-79 were to engage in recommended amounts of physical activity. http://www.apho.org.uk/resource/item.aspx?RID=123632 Interpreting the physical activity guidelines for children British Heart Foundation National Centre for Physical Activity and Health This document will help you to understand what the guidelines are, what types and amounts of physical activity children and young people should do and why this is important. http://www.bhfactive.org.uk/homepage-resources-and-publications-item/367/index.html
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Public Health
Commissioning public health services from primary care Primary Care Commissioning This briefing is a response to a number of recent queries regarding the transfer of public health services delivered in primary care under existing local enhanced service arrangements. It is not intended as a detailed guide, but to reinforce the key messages in current policy and signpost the reader to the relevant guidance. http://www.pcc-cic.org.uk/article/commissioning-public-health-services-primary-care Health Improvement in Local Government: Challenges and Opportunities Royal Society for Public Health This briefing sheet is part of a series of studies undertaken by the Royal Society for Public Health reviewing changes in commissioning public health in England. http://www.rsph.org.uk/en/about-us/latest-news/press-releases/pressrelease1.cfm/pid/08B8CF2C-58A0-400C-A4C3BCC2B3925309 Health profiles for England at a glance Department of Health Health Profiles give an overview of health for each local authority in England, to help improve local peoples health and reduce inequality. https://www.gov.uk/government/news/at-a-glance-health-profiles-for-england Lifecourse tracker Wave 1 Spring 2012: Interim summary report Department of Health The report is the first of a series of twice yearly surveys which track core health behaviours, their interactions and influences, and how these vary across key life stages. https://www.gov.uk/government/publications/health-behaviours-through-lifecourse-baselinereport

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Role of local authorities in health issues House of Commons Health Select Committee This report welcomes the transfer of public health responsibilities to local councils. It also raises concerns over the complex accountability mechanisms of the reformed system. http://www.parliament.uk/business/committees/committees-a-z/commons-select/communitiesand-local-government-committee/news/role-of-local-authorities-in-health-issues---report/
Items in the Liver Disease and Nutrition sections may also be of interest. [back to topics]

Respiratory Conditions
Managing multi-morbidity in practice what lessons can be learnt from the care of people with COPD and co-morbidities? NHS Improvement This document summarises the learning from a project to find out how UK general practices have risen to the challenge of organizing chronic care of patients with multimorbidity in practice. It provides practical examples, key learning points about what works and why, and suggestions for the way forward. http://www.improvement.nhs.uk/documents/COPD_MultiMorbidities.pdf Partners in Delivery: Working in partnership with industry to support the implementation of the Outcomes Strategy for COPD and asthma Primary Care Commissioning This practical guide sets out various models of partnership working with pharmaceutical and the wider healthcare industry with case studies from the DH respiratory programme. http://www.pcc-cic.org.uk/article/industry-partnerships-respiratory-health
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Restless Legs Syndrome

Pharmacologic Therapy for Primary Restless Legs Syndrome: A Systematic Review and Meta-analysis Wilt, TJ This review compared dopamine agonists to placebo, and calcium channel alpha-2-delta ligands to placebo. JAMA Intern Med. 2013;():1-10. doi:10.1001/jamainternmed.2013.3733.
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Safeguarding Children and Vulnerable Adults

Abuse of Vulnerable Adults in England - 2011-12, Final report, Experimental statistics NHS Information Centre for Health and Social Care http://www.ic.nhs.uk/catalogue/PUB10430

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Safeguarding Vulnerable People in the Reformed NHS: Accountability and Assurance Framework NHS England This document updates and replaces Arrangements to secure childrens and adult safeguarding in the future NHS: The new accountability and assurance framework interim advice issued by the NHS Commissioning Board Authority in September 2012. http://www.commissioningboard.nhs.uk/wp-content/uploads/2013/03/safeguarding-vulnerablepeople.pdf Winterbourne View Hospital: Department of Health review and response Department of Health The Department of Health (DH) has published its final report into the events at Winterbourne View hospital and has set 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/publications/winterbourne-view-hospital-department-ofhealth-review-and-response Working together to safeguard children Department for Education This guidance sets out how organisations and individuals should work together to safeguard and promote the welfare of children and how practitioners should conduct the assessment of children. http://www.education.gov.uk/aboutdfe/statutory/g00213160/working-together-to-safeguardchildren
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Service Management
Changing of the guard: lessons for the new NHS from departing health leaders Nuffield Trust This report is based on interviews with 12 NHS leaders who are about to leave, or have recently left, the NHS. http://www.nuffieldtrust.org.uk/publications/changing-of-the-guard NHS Constitution for England Department of Health The Constitution establishes the principles and values of the NHS, and has recently been updated. https://www.gov.uk/government/publications/the-nhs-constitution-for-england Public expenditure on health and care services: Eleventh Report House of Commons Health Select Committee This report considers what NHS organisations are doing to meet the Nicholson Challenge. It argues that sustainable long term savings will be achieved only by integrating services, and highlights problems with short term savings. http://www.publications.parliament.uk/pa/cm201213/cmselect/cmhealth/651/65102.htm

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Service redesign case studies NHS Confederation The case studies are part of an NHS Confederation programme to help local NHS organisations effectively communicate and engage with staff, patients, local communities and stakeholders around changes to local services. The Southern Health acquisition of Ridgeway This case study features the merger between Ridgeway Partnership and Southern Health NHS FT's learning disability division. http://www.nhsconfed.org/Publications/reports/Pages/Case-study-Southern-Health.aspx Healthier Together: the Greater Manchester experience Healthier Together is a service-change initiative encompassing primary and community care, hospital services and elements of social care. http://www.nhsconfed.org/Publications/reports/Pages/Case-study-Greater-Manchester.aspx Better Healthcare in Bucks This programme sought to reshape services to deliver better, more cost-effective and sustainable care in the most appropriate setting. http://www.nhsconfed.org/Publications/reports/Pages/service-reconfiguration-bucks.aspx Tough times, tough choices: being open and honest about NHS finance NHS Confederation This report looks at options for dealing with the financial challenges facing the NHS. http://www.nhsconfed.org/Publications/reports/Pages/Tough-times-open-honest-financereport.aspx Transforming local care: community healthcare rises to the challenge NHS Confederation This briefing shows how the community health sector is driving the transformation of local care systems. It also details the challenges that need to be overcome to build upon this work and drive forward the necessary shift of care into the community. http://www.nhsconfed.org/Publications/briefings/Pages/Transforming-local-care.aspx Working with the voluntary and community sector: A guide for health and wellbeing boards Regional Voices This guide describes the value of health and wellbeing boards working closely with the voluntary sector and discusses different ways to access the sectors expertise and networks. http://www.regionalvoices.org/node/111
Items in the Health Reforms, Patient Care and Safety, Respiratory Conditions, Social Care and Workforce sections may also be of interest. [back to topics]

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NHS Library and Information Service North Staffordshire Sexual Health

A Framework for Sexual Health Improvement in England Department of Health This document aims to provide the information, evidence base and support tools to enable those involved in sexual health improvement to work together effectively; and should ensure that accessible high quality services and support are available to everyone. https://www.gov.uk/government/publications/a-framework-for-sexual-health-improvement-inengland Commissioning Sexual Health Services and Interventions: Best Practice Guidance for Local Authorities Department of Health This document provides guidance on the legal requirements to provide comprehensive, open access sexual health services for contraception and testing and treatment of sexually transmitted infections. It includes references to other resources. https://www.gov.uk/government/publications/commissioning-sexual-health-services-andinterventions-best-practice-guidance-for-local-authorities
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Social Care
The economic value of the adult social care sector in England Skills for Care This study provides estimates of: the annual GDP generated directly by the adult social care sector in England (direct impact); productivity per worker for the adult social care sector in England; the supply chain multiplier for the adult social care sector in England (indirect impact); and the wage multiplier for the adult social care sector in England (induced impact). http://www.skillsforcare.org.uk/EIreport2013/ A Problem Shared: Making best use of resources in adult social care Think Local, Act Personal This report is supported by a self-assessment toolkit to help local councils assess how effectively they are using resources. http://www.thinklocalactpersonal.org.uk/Browse/UseOfResources/ Understanding and measuring outcomes: the role of qualitative data Institute for Research and Innovation in Social Services This guide has been developed to support the collection and use of personal outcomes data. Personal outcomes data refers to information gathered from people supported by health and social services and their unpaid carers about what's important to them in their lives and the ways in which they would like to be supported. http://www.iriss.org.uk/resources/understanding-and-measuring-outcomes
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NHS Library and Information Service North Staffordshire Substance Misuse

Driving under the influence of drugs Department for Transport This report makes recommendations on the drugs to be covered in the new drug driving offence and the limits to be set for each drug. https://www.gov.uk/government/publications/driving-under-the-influence-of-drugs--2 Falling drug use: the impact of treatment National Treatment Agency for Substance Misuse This commentary looks at declining numbers of heroin and crack users, and considers the reasons for the decline. Press release: http://www.nta.nhs.uk/news-2013-prevalence.aspx Commentary: http://www.nta.nhs.uk/uploads/prevalence-commentary.pdf
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Womens Health
Human papillomavirus testing versus repeat cytology for triage of minor cytological cervical lesions Arbyn, M This Cochrane review compares repeating the cytological test, and DNA testing for high-risk types of the human papillomavirus (hrHPV), for women with abnormal cervical smear results. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD008054.pub2/abstract
Items in the General Practice section may be of interest.

Workforce
The anatomy of health spending 2011/12: a review of NHS expenditure and labour productivity Nuffield Trust This report analyses spending and productivity among commissioning and provider bodies across the English NHS. It also considers the factors that influence productivity. http://www.nuffieldtrust.org.uk/publications/anatomy-health-spending-201112-review-nhsexpenditure-and-labour-productivity Education outcomes framework for healthcare workforce Department of Health The outcomes in the framework are set in terms of the impact for patients, users of services and carers. The framework will be used to measure improvements in education, training and workforce development and the impact on the quality and safety of services for patients. https://www.gov.uk/government/publications/education-outcomes-framework-for-healthcareworkforce

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Effective governance to support medical revalidation: a handbook for boards and governing bodies GMC This handbook helps the boards and governing bodies of healthcare providers check the strength and effectiveness of systems that exist within their organisations to support the delivery of quality care for patients and the revalidation of doctors. http://www.gmc-uk.org/doctors/revalidation/12395.asp Fit enough for patients? An audit of workplace health and wellbeing services for NHS staff Chartered Society of Physiotherapists This report looks at the levels of sick pay in Trusts with and without a staff health and wellbeing strategy. It also looked at the availability of physiotherapy services for staff. http://www.csp.org.uk/publications/fit-enough-patients Good medical practice GMC This document sets out the high level principles of good practice expected of all doctors. It is published alongside explanatory guidance which provides more detail on various topics. This includes new guidance on doctors use of social media. http://www.gmc-uk.org/guidance/news_consultation/20477.asp Sickness absence savings calculator NHS Employers This calculator allows organisations to calculate the current cost of sickness absence and see what potential savings could be released by achieving their target sickness absence rate. http://www.nhsemployers.org/HealthyWorkplaces/LatestNews/Pages/Sicknessabsencesaving scalculator.aspx Volunteering in health and care: Securing a sustainable future Kings Fund This report considers the role and value of volunteers in health and social care. It looks at the important part that volunteers play in improving patient experience, addressing health inequalities, and building a closer relationship between services and communities. http://www.kingsfund.org.uk/publications/volunteering-health-and-care
Items in the Allied Health Professionals section may be of interest. [back to topics]

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