NHS Library and Information Service North Staffordshire

Clinical Effectiveness Bulletin for NHS Primary Care in North Staffordshire

Issue No: 76 May 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:
Alcohol ...................................................................................................................................... 4 Asthma...................................................................................................................................... 4 Cancer ...................................................................................................................................... 4 Children and Young People ...................................................................................................... 4 Commissioning ......................................................................................................................... 5 Dementia .................................................................................................................................. 6 Diabetes.................................................................................................................................... 6 Emergency Care ....................................................................................................................... 6 End of Life Care ........................................................................................................................ 6 General Practice ....................................................................................................................... 7 Guidance .................................................................................................................................. 7 Health Reforms ......................................................................................................................... 7 Infection Control ........................................................................................................................ 8 Integrated Care ......................................................................................................................... 8 Maternal and Infant Health........................................................................................................ 8 Mental Health............................................................................................................................ 8 Offender Health ........................................................................................................................ 9 Older People ............................................................................................................................. 9 Patient and Public Involvement ................................................................................................. 9 Patient Care and Safety .......................................................................................................... 10 Pharmacy and Prescribing ...................................................................................................... 10 Physical Activity ...................................................................................................................... 11 Public Health ........................................................................................................................... 11 Reablement ............................................................................................................................ 12 Safeguarding Children and Vulnerable Adults ........................................................................ 12 Service Management .............................................................................................................. 12 Social Care ............................................................................................................................. 13 Stroke ..................................................................................................................................... 14 Substance Misuse .................................................................................................................. 14 Vaccination and Immunisation ................................................................................................ 15 Workforce ............................................................................................................................... 15

NHS Library and Information Service North Staffordshire Alcohol

Items in the General Practice and Substance Misuse section may be of interest. [back to topics]

Asthma
Asthma Data Tool Interactive Health Atlas for Lung Conditions in England The INHALE Asthma Data Tool is a web-based portal that pulls together national asthma data and complements the INHALE Respiratory Data Tool which was released in February 2013. http://www.inhale.nhs.uk/think-pieces/commentary/asthma-data-tool-release.htm Allergen-Specific Immunotherapy for Pediatric Asthma and Rhinoconjunctivitis: A Systematic Review Kim, JM This review compares sublingual and subcutaneous immunotherapy. Pediatrics (doi: 10.1542/peds.2013-0343). Published online May 6, 2013

Cancer
Pattern of deaths in the year following diagnosis in cancer patients aged 15-24 years in England National Cancer Intelligence Network The report found that survival for this group of patients varies considerably by type of cancer and that they have worse five year survival as compared to the younger and older age groups for soft tissue sarcomas and bone tumours. http://www.ncin.org.uk/view?rid=2134 Update to national Cancer Drugs Fund list NHS England http://www.england.nhs.uk/2013/05/03/cdf-update/
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Children and Young People

Children and Young People's Health Outcomes Forum: Recommendations to improve children and young peoples health results Department of Health The current NHS and Public Health Outcomes Frameworks include a number of outcomes and indicators specific to children and young people, and others that are relevant and important. The Forum has therefore had to consider where these could and should be strengthened, and what gaps there are which need to be filled. https://www.gov.uk/government/publications/independent-experts-set-out-recommendationsto-improve-children-and-young-people-s-health-results 4

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Commissioning a good child health service RCGP This report aims to define a good child health service from the persp ectives of primary and secondary care. http://www.rcgp.org.uk/~/media/Files/CIRC/Child%20and%20Adolescent%20Health/RCGPChild-Health-Modelling-Task-Group-April-2013.ashx
Items in the Asthma and Cancer sections may also be of interest. [back to topics]

Commissioning
Interim CCG Assurance Framework NHS England This framework will help NHS England, patients and the public identify how well Clinical Commissioning Groups are performing in their role as the commissioners of local health services. http://www.england.nhs.uk/2013/05/07/interim-ccg-af/ PCT CCG Spend and Outcome Factsheets and Tool (SPOT) Yorkshire and Humber Health Intelligence All PCTs in England have submitted an annual programme budgeting return since 2003/4. The tool and factsheets use this Programme Budgeting data and overall indicators of health outcome by programme (where available) to present PCTs and CCGs with an analysis of the impact of their expenditure. http://www.yhpho.org.uk/default.aspx?RID=49488 Case scenarios on procurement, patient choice and competition Monitor

Monitor has published "case scenarios" that highlight issues commissioners and others may face under the regulations governing procurement, patient choice and competition.
http://www.monitornhsft.gov.uk/sites/default/files/publications/ToPublishIllustrativeCaseStudies20May2013.pdf
Items in the Children and Young People, Mental Health and Substance Misuse sections may be of interest. [back to topics]

NHS Library and Information Service North Staffordshire Dementia

Dementia Prevalence Calculator (v2) NHS England The Calculator enables health and care communities to gain a better understanding of their local estimated prevalence of dementia in the community, and among people living in local care homes. http://www.dementiaprevalencecalculator.org.uk/ The Prime Minister's Challenge on Dementia: Annual report of progress Department of Health This report looks at progress in care for patients with dementia, public awareness and understanding of the condition, and research. https://www.gov.uk/government/publications/the-prime-ministers-challenge-on-dementiaannual-report-of-progress

Diabetes
Items in the Integrated Care section may be of interest.

Emergency Care
The drive for quality: How to achieve safe, sustainable care in our Emergency Departments College of Emergency Medicine The report, based upon the results of a comprehensive survey of 131 Emergency Departments (EDs) in the UK between 2011 and 2012, recommends urgent action in a number of key areas of: system redesign to manage workloads and decongest the ED; expansion and sustainable working practices for staff; a radical change to the way in which emergency care is funded; and a better system to measure the success of improvement rather than 4hr system performance alone. http://secure.collemergencymed.ac.uk/ShopFloor/Professional%20Standards/Quality%20in%20the%20Emergency%20Department/

End of Life Care

Dying well at home: the case for integrated working Social Care Institute for Excellence This guide is about enabling people who want to die at home to do so and improving the quality of care they receive. http://www.scie.org.uk/publications/guides/guide48/

NHS Library and Information Service North Staffordshire General Practice

Alcohol: Management in Primary Care RCGP This e-learning module covers the physical and mental health impact of problem drinking. It also considers care for this patient group, using cases studies. http://www.elearning.rcgp.org.uk/course/info.php?id=119 Quality imaging services for primary care: a good practice guide RCGP This guide makes recommendations for improving the quality and efficiency of imaging services. http://www.rcgp.org.uk/news/2013/may/creating-better-access-for-patients-needingscans.aspx 2013/14 PATIENT PARTICIPATION AND EXTENDED HOURS DIRECTED ENHANCED SERVICE GUIDANCE NHSCB This guidance applies in England only and is intended to assist NHS England area teams and GP practices in understanding this service and how it will operate in 2013/14 http://www.nhsemployers.org/Aboutus/Publications/Pages/2013-14-GMS-contract-Guidanceand-audit-requirements.aspx
[back to topics]

Guidance
NICE Public Health Guidance Physical activity: brief advice for adults in primary care (PH44) http://guidance.nice.org.uk/PH44 NICE Clinical Guidelines Social anxiety disorder: recognition, assessment and treatment of social anxiety disorder (CG159) http://guidance.nice.org.uk/CG159
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Health Reforms
Supporting structures: a soft intelligence report on CSUs Campden Health This report is based on interviews with CSU Managing Directors. http://www.campden.com/article/campden-health-press-release-report-new-nhs-structureslaunched 7

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Items in the Public Health section may also be of interest. [back to topics]

Infection Control
Questions and answers - novel coronavirus Public Health England This series of Q & As include symptoms, travel advice and information about how infectious the virus is. http://www.hpa.org.uk/Topics/InfectiousDiseases/InfectionsAZ/NovelCoronavirus2012/Genera lInformation/respqandanovelcoronavirus2013/
[back to topics]

Integrated Care
Evaluation of the first year of the Inner North West London Integrated Care Pilot Nuffield Trust This pilot aimed to develop new forms of care for older people and those with diabetes. http://www.nuffieldtrust.org.uk/publications/evaluation-first-year-inner-north-west-londonintegrated-care-pilot

Maternal and Infant Health

Long-term effects of breastfeeding: a systematic review World Health Organisation This document updates a systematic review first published in 2007. http://www.who.int/maternal_child_adolescent/documents/breastfeeding_long_term_effects/e n/index.html Patterns of Maternity Care in English NHS Hospitals 2011/12 RCOG The report presents a series of eleven indicators that can be used to compare the performance of English maternity units. http://www.rcog.org.uk/our-profession/research-and-audit/clinical-indicators-project

Mental Health
Guidance for commissioners of forensic mental health services Joint Commissioning Panel for Mental Health This guide is about the commissioning of high, medium, and low secure forensic mental health services for working-age adults. http://www.jcpmh.info/resource/guidance-for-commissioners-of-forensic-mental-healthservices/ Independent investigation into the healthcare and treatment of Ronald Dixon The published findings of an independent investigation into the healthcare and treatment of Ronald Dixon are now available. Dixon, who was receiving care from Northumberland Tyne 8

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and Wear NHS Foundation trust (Mental Health Services) killed Charity support worker, Ashley Ewing when she visited his home in Newcastle, in 2006. http://www.england.nhs.uk/2013/05/28/indep-invest-ronald-dixon/ Let's Get Physical Mental Health Foundation This booklet is a pocket guide to using physical activity to boost your wellbeing. http://www.mentalhealth.org.uk/publications/lets-get-physical-booklet-2013/ The NHS Mandate and its implications for mental health Centre for Mental Health The briefing outlines key actions for NHS England and clinical commissioning groups including expanding IAPT services, addressing access and waiting times for mental health care and commissioning integrated support for people with co-existing physical and mental health conditions. http://www.centreformentalhealth.org.uk/news/2013_briefing_sets_out_steps.aspx
Items in the Guidance section may also be of interest. [back to topics]

Offender Health
Items in the Mental Health section may be of interest. [back to topics]

Older People
Getting On... with life: Baby boomers, mental health and ageing well Mental Health Foundation The purpose of the review is to identify what will help protect the mental health and promote mental wellbeing of this new older generation. http://www.mentalhealth.org.uk/publications/getting-on-full-report/
Items in the Integrated Care section may also be of interest.

Patient and Public Involvement

Learning from the LINks: resources for Healthwatch Regional Voices These resources are brought together on one website, and cover the themes Leadership and Governance; Representation; Engagement; and Influencing. http://www.regionalvoices.org/node/119

NHS Library and Information Service North Staffordshire Patient Care and Safety
Delivering High Quality Care for Patients: The Accountability Framework for NHS Trust Boards NHS Trust Development Authority This Framework sets out a clear set of rules, underpinned by clear principles which should guide Boards judgement, both on the day-today decisions they take as well as the long term strategic ambitions they drive forward. http://www.ntda.nhs.uk/2013/05/03/delivering-high-quality-care-for-patients-the-accountabiltyframework-2/ NHS Safety Thermometer Report: April 2012 to April 2013 Health and Social Care Information Centre The NHS Safety Thermometer is a local improvement tool for measuring, monitoring, and analysing patient harms and 'harm free' care. http://www.hscic.gov.uk/catalogue/PUB10837
[back to topics]

Pharmacy and Prescribing

Medicines Optimisation: helping patients make the most of medicines Royal Pharmaceutical Society This document contains four principles for health professionals to help them ensure patients are getting the best outcomes, and that medicines are being used effectively. http://www.rpharms.com/what-s-happening-/news_show.asp?id=847 Pharmaceutical Needs Assessments: Information Pack Department of Health Each health and wellbeing board (HWB) must assess needs for pharmaceutical services in its area, and publish a statement of its first assessment and of any revised version. This publication supports local authority health and wellbeing boards to develop and update pharmaceutical needs assessments (PNAs). https://www.gov.uk/government/publications/pharmaceutical-needs-assessments-informationpack Systemic antibiotics after incision and drainage of simple abscesses: a meta-analysis Singer, AJ et al. This systematic review assessed the use of antibiotics in patients treated in emergency departments and outpatient clinics. Emerg Med J doi:10.1136/emermed-2013-202571 (Online First) A systematic review and meta-analysis of pharmacist-led fee-for-services medication review Hatah, E et al. This study found that fee-for-service pharmacist-led medication reviews had positive benefits on patient outcomes. http://onlinelibrary.wiley.com/doi/10.1111/bcp.12140/abstract 10

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[back to topics]

Physical Activity
Active travel briefings for Local Authorities Public Health England These short PowerPoint presentations bring together all the latest evidence, policy and ideas on active travel. http://www.noo.org.uk/slide_sets/activity

Public Health
2011 Census, Detailed Characteristics for Local Authorities in England and Wales Office for National Statistics http://www.ons.gov.uk/ons/rel/census/2011-census/detailed-characteristics-for-localauthorities-in-england-and-wales/index.html Health Protection in Local Government Department of Health This document gives guidance on health protection arrangements in the new public health system for local authorities and public health professionals. https://www.gov.uk/government/publications/health-protection-in-local-government Healthy Lives, Healthy People: A Public Health Workforce Strategy Public Health England The strategy sets out actions for various partners in the new public health system to support and develop the public health workforce. https://www.gov.uk/government/publications/healthy-lives-healthy-people-a-public-workforcestrategy Health and wellbeing: introduction to the directorate Public Health England This document outlines the programmes, priorities and approach of the directorate. https://www.gov.uk/government/publications/health-and-wellbeing-introduction-to-thedirectorate PHE Bulletin: 30 April 2013 Public Health England The first edition of PHE Bulletin includes news of Public Health Englands 7 prio rities and a toolkit for local authorities and businesses. https://www.gov.uk/government/publications/phe-bulletin-30-april-2013 Public Health Functions to be Exercised by NHS England: Variation to the 2013 to 2014 Agreement Department of Health This agreement sets out outcomes to be achieved and funding provided for NHS England to commission public health services. https://www.gov.uk/government/publications/public-health-commissioning-in-the-nhs-from2013 11

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Public Health Outcomes Framework 2013 to 2016 and technical updates Department of Health This document sets out the desired outcomes for public health and how they will be measured. https://www.gov.uk/government/publications/healthy-lives-healthy-people-improvingoutcomes-and-supporting-transparency
[back to topics]

Reablement
Maximising the potential of reablement Social Care Institute for Excellence Based on evidence from research and practice, this guide provides recommendations for maximising the potential of reablement in improving peoples outcomes and delivering a cost effective service across health and social care. http://www.scie.org.uk/publications/guides/guide49/ Related e-learning module: http://www.scie.org.uk/publications/elearning/reablement/index.asp
[back to topics]

Safeguarding Children and Vulnerable Adults

Adult safeguarding: statement of government policy Department of Health This updated policy statement covers safeguarding adults who are vulnerable to abuse and neglect. https://www.gov.uk/government/publications/adult-safeguarding-statement-of-governmentpolicy-10-may-2013

Service Management
Guide to the Healthcare System in England Department of Health This guide explains organisations in the healthcare system and how they work together and includes the Statement of NHS Accountability. https://www.gov.uk/government/publications/guide-to-the-healthcare-system-in-england How can the NHS payment system do more for patients? Monitor and NHS England This discussion paper asks for views on the future of the payment system. It also sets out possible improvements and presents early thinking on setting objectives and designing the NHS payment system. http://www.monitor-nhsft.gov.uk/home/news-events-publications/our-publications/browsecategory/guidance-health-care-providers-and-co-34

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Healthcare groups: an alternative to merger-mania? NHS Confederation This Briefing summarises key learning from those who have already had involvement in developing healthcare groups and considers what might be done to take the concept further. http://www.nhsconfed.org/Publications/briefings/Pages/Healthcare-groups-alternative-mergermania.aspx Patient-centred leadership: Rediscovering our purpose Kings Fund This report summarises the main findings of the Francis Inquiry into the failings of care at Mid Staffordshire in relation to NHS leadership and culture. It sets out what needs to be done to avoid similar failures in future, for clinical teams, NHS boards, and national organisations responsible for overseeing the commissioning, regulation and provision of care. http://www.kingsfund.org.uk/publications/patient -centred-leadership Public payment and private provision: the changing landscape of health care in the 2000s. Institute for Fiscal Studies/Nuffield Trust This report from the Institute for Fiscal Studies and the Nuffield Trust examining the changing relationship between the public and private sector in the provision of NHS funded care in the past decade. http://www.nuffieldtrust.org.uk/publications/public-payment-private-provision-2000s The regulation and oversight of NHS trusts and NHS foundation trusts Department of Health This joint statement outlines changes proposed in response to the Francis report. https://www.gov.uk/government/publications/regulation-of-nhs-hospitals
Items in the Workforce sections may also be of interest. [back to topics]

Social Care
The Care Bill: Factsheets Department of Health The Care Bill was introduced into Parliament on 9 May 2013, and published on 10 May 2013. Factsheets have been produced to accompany the Bill. https://www.gov.uk/government/publications/the-care-bill-factsheets Care Bill: http://www.publications.parliament.uk/pa/bills/lbill/2013-2014/0001/lbill_201320140001_en_1.htm Older people with high support needs in housing with care Joseph Rowntree Foundation This Round-up covers key messages and practice examples from JRF studies into three aspects of HWC: promoting supportive and positive relationships; boundaries of roles and responsibilities; and affordability, choices and quality of life. http://www.jrf.org.uk/publications/older-people-high-support-needs-housing-care 13

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Adult Social Care: Choice Framework Department of Health This Framework sets out the choices people are able to make in relation to their care and support. https://www.gov.uk/government/publications/the-adult-social-care-choice-framework Paying for social care: beyond Dilnot Kings Fund This paper considers the planning and funding needed to meet the social care needs of the future and calls for the total quantity of resources to be assessed to ensure that people have access to the right level of support. http://www.kingsfund.org.uk/publications/paying-social-care
Items in the End of Life and Reablement section may be of interest.

Stroke
Feeling overwhelmed: the emotional impact of stroke Stroke Association This report is based on a survey of survivors, carers and their families, completed in late 2012. An associated patient information booklet is available. http://www.stroke.org.uk/involved/feeling-overwhelmed-report

Substance Misuse
Guidance for commissioners of drug and alcohol services Joint Commissioning Panel for Mental Health This guide has been written to provide practical advice on developing and delivering local plans and strategies to commission the most effective and efficient drug and alcohol services for adults.
http://www.jcpmh.info/resource/guidance-for-commissioners-of-drug-and-alcohol-services/

Performance of Payment by Results Pilot Areas: April 2012 to February 2013 Department of Health This document provides an overview of the performance to date of the drugs and alcohol recovery Payment by Results (PbR) pilots.
https://www.gov.uk/government/publications/performance-of-payment-by-results-pilot-areasapril-2012-to-february-2013
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NHS Library and Information Service North Staffordshire Vaccination and Immunisation
Meningococcal update: the green book, chapter 22 Department of Health https://www.gov.uk/government/publications/meningococcal-the-green-book-chapter22 Immunisation schedule update: the green book, chapter 11 Department of Health https://www.gov.uk/government/publications/immunisation-schedule-the-green-bookchapter-11
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Workforce
Healthier staff, higher quality care: A pledge to work to improve the health and wellbeing of staff who work in healthcare NHS Employers, Chartered Society of Physiotherapy This pledge promises to foster a culture that promotes better physical and mental health and wellbeing among staff and to work on strengthening staff engagement in this bid. http://www.csp.org.uk/news/2013/05/02/nhs-employers-pledge-act-staff-wellbeing Protecting healthcare workers from sharps injuries NHS Confederation Regulations implementing EU law (the Sharps Directive) come into force across the UK on 11 May 2013. All NHS employers and employees need to be aware of and act upon the additional requirements (over and above existing health and safety legislation) resulting from the new regulations. This Briefing outlines the key changes and their implications for the NHS. http://www.nhsconfed.org/Publications/briefings/Pages/protecting-workers-fromsharps-injuries.aspx

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