Friday, 30 September 2016
New case study on how Making Every Contact Count can improve staff wellbeing
This new case study from Lancashire Care NHS Foundation Trust showcases how the trust successfully implemented a Making Every Contact Count (MECC) strategy, which improves health and reduces health inequalities in the organisation.
Read more about how their accessible two tiered training programme helped improve staff member’s knowledge about behaviour change and increase their confidence and skills in having health chats as a result of the training
Read more about how their accessible two tiered training programme helped improve staff member’s knowledge about behaviour change and increase their confidence and skills in having health chats as a result of the training
Improving eye health through community optical practice
Local Government Association and Optical Confederation briefing to explain to those making policy and
commissioning decisions the contribution and
role that optical practices can play to help
improve eye health and general wellbeing in
their communities.
Ibuprofen-like painkillers linked to an increased risk of heart failure
"Ibuprofen could raise the risk of heart failure by up to 83%," claims the Daily Mirror. But this headline massively overstates the danger of this painkiller.
In fact, new research suggests that taking painkillers known as non-steroidal anti-inflammatory drugs (NSAIDs) – which includes ibuprofen – increases the risk of heart failure by less than 20% overall.
In fact, new research suggests that taking painkillers known as non-steroidal anti-inflammatory drugs (NSAIDs) – which includes ibuprofen – increases the risk of heart failure by less than 20% overall.
New TB report shows continuing decline in cases in England
The annual TB report presents new data to the end of 2015 and provides an update on trends and the impact of TB at a national and local level.
Overall the data shows there has been a year on year decline in the incidence of TB in England over the past 4 years, down to 10.5 cases per 100,000 (5,758 cases) in 2015, a reduction of one third since the peak of 15.6 cases per 100,000 (8,280) in 2011.
Overall the data shows there has been a year on year decline in the incidence of TB in England over the past 4 years, down to 10.5 cases per 100,000 (5,758 cases) in 2015, a reduction of one third since the peak of 15.6 cases per 100,000 (8,280) in 2011.
Association of depression and anxiety status with 10-year cardiovascular disease incidence among apparently healthy Greek adults: The ATTICA Study
Eur J Prev Cardiol. 2016 Sep 26. pii: 2047487316670918. [Epub ahead of print]
Chronic stress frequently manifests with anxiety and/or depressive symptomatology and may have detrimental cardiometabolic effects over time. As such, recognising the potential links between stress-related psychological disorders and cardiovascular disease (CVD) is becoming increasingly important in cardiovascular epidemiology research. The primary aim of this study was to explore prospectively potential associations between clinically relevant depressive symptomatology and anxiety levels and the 10-year CVD incidence among apparently healthy Greek adults.
Our findings indicate that standardised psychological assessments focusing on depression and anxiety should be considered as an additional and distinct aspect in the context of CVD preventive strategies that are designed and implemented by health authorities at the general population level.
UHCW Research: Kyrou I and Randeva HS
Chronic stress frequently manifests with anxiety and/or depressive symptomatology and may have detrimental cardiometabolic effects over time. As such, recognising the potential links between stress-related psychological disorders and cardiovascular disease (CVD) is becoming increasingly important in cardiovascular epidemiology research. The primary aim of this study was to explore prospectively potential associations between clinically relevant depressive symptomatology and anxiety levels and the 10-year CVD incidence among apparently healthy Greek adults.
Our findings indicate that standardised psychological assessments focusing on depression and anxiety should be considered as an additional and distinct aspect in the context of CVD preventive strategies that are designed and implemented by health authorities at the general population level.
UHCW Research: Kyrou I and Randeva HS
Improving The Health Of The Public By 2040: Optimising The Research Environment For A Healthier, Fairer Future
This report from the Academy of Medical Sciences explores how to organise our research environment to generate and translate the evidence needed to underpin strategies to secure and improve the health of the public as a whole. It concludes that while public health research has provided fundamental insights into human health, there remains much we do not know about the complex array of interlinking factors that influence the health of the public, and about how to prevent and solve the many health challenges we face as a population.
Creating Supportive Environments: Tackling Behaviours That Undermine a Culture of Safety
This report from the Academy of Medical Royal Colleges explores bullying and undermining within the medical workforce in the UK. It looks at current efforts to tackle problems and what further work is required.
NHS England launches frameworks to increase integration of health and care services
NHS England has published details of two more common frameworks for local health and care systems, organisations, communities and patients, wishing to develop and implement new ways of working.
The first of the frameworks, the primary and acute care system (PACS) can be defined as a population-based accountable care model, with general practice at its core. It is organised around patients’ needs and aims to improve the physical, mental and social health and wellbeing of its local population.
The second of the frameworks is the enhanced health care homes model. It lays out a clear vision for providing joined up primary, community and secondary, social care to residents of care and nursing homes, via a range of in reach services.
The first of the frameworks, the primary and acute care system (PACS) can be defined as a population-based accountable care model, with general practice at its core. It is organised around patients’ needs and aims to improve the physical, mental and social health and wellbeing of its local population.
The second of the frameworks is the enhanced health care homes model. It lays out a clear vision for providing joined up primary, community and secondary, social care to residents of care and nursing homes, via a range of in reach services.
Action On Cardiovascular Disease: Getting Serious About Prevention
This slide deck brings together PHE’s work in addressing cardiovascular disease, the second leading cause of premature death and ill health. It sets out the main programmes already underway and the next steps in tackling cardiovascular disease going forward. The publication is intended for those involved in the commissioning and provision of services for cardiovascular disease and its prevention.
Quick Guide: Discharge to Assess: Transforming Urgent and Emergency Care Services in England
This quick guide from NHS England aims to support local health and social care systems to reduce the time people spend in hospital, at the point that they no longer need acute care.
It provides practical tips and advice to commissioners and providers on discharge to assess (D2A) models, including best practice from across the country and should be read alongside the 2015 NICE guideline, Transition between inpatient hospital settings and community or care home settings for adults with social care needs.
"Brexit Means Brexit" But How Will It Impact The NHS?
This infographic from the NHS European Office explains some of the possible implications of Brexit on the NHS. It looks briefly at six possible areas of impact, including finance, workforce and research, and asks what should be the NHS' main priorities as the UK prepares to leave the European Union.
MenACWY and TdIPV vaccine uptake: user guidance
The user guide provides NHS England Local Teams and Screening and Immunisation Teams (SITs) with detailed guidance on how to submit data for the MenACWY and Td/IPV Vaccine Coverage Collection.
See also Meningococcal ACWY programme: information for healthcare professionals.
See also Meningococcal ACWY programme: information for healthcare professionals.
A third of people with dementia have treatable vision problems
New data shows that around a third of people with dementia have serious vision problems, such as cataracts or short sightedness, more than the general population of that age. Levels are higher still for people with dementia in care homes – about half have vision problems.
Yet this study showed that many of the people with dementia and vision impairment had not received the right treatment. This often involves simple measures. For many, spectacles could have improved poor sight. A quarter had cataracts, which surgery could have corrected. Quality of life is known to improve if visual impairment is corrected.
From the NIHR Dissemination Centre
Yet this study showed that many of the people with dementia and vision impairment had not received the right treatment. This often involves simple measures. For many, spectacles could have improved poor sight. A quarter had cataracts, which surgery could have corrected. Quality of life is known to improve if visual impairment is corrected.
From the NIHR Dissemination Centre
Bone-targeting drugs improve quality of life, but not survival in prostate cancer that has spread to bone
The drug zoledronic acid delayed the onset of bone complications by two months in men with prostate cancer that had spread to the bone. Though it did not increase overall survival, it improved quality of life by reducing important complications such as fractures and spinal cord compression.
From the NIHR Dissemination Centre
Rhythm control drugs after catheter ablation for atrial fibrillation give short-term but not long term benefits
When treating atrial fibrillation, short-term use of rhythm control drugs after catheter ablation reduced the risk of abnormal heart rhythms in the three months after the procedure. They were of no benefit in preventing recurrence of atrial fibrillation in the longer term.
From the NIHR Dissemination Centre
Potential alternative to painful blood tests in people with flare-ups of COPD
It may be possible to use venous blood and pulse oximeters to initially assess the severity of a flare up of chronic obstructive pulmonary disease (COPD). Blood gas levels were similar in people when testing blood from either arteries (the recommended test) or veins. Oxygen saturation using pulse oximeters – which attach to the end of the finger – were also reasonably accurate compared to testing arterial blood.
From the NIHR Dissemination Centre
From the NIHR Dissemination Centre
Vomiting is the most common adverse effect among children and young people sedated for emergency procedures
Vomiting is the most common adverse event when sedating a child or young person undergoing a procedure in the emergency department, occurring in 55.5 out of 1,000 cases. Agitation occurred in 17.9/1,000 cases, and hypoxia – lack of oxygen – in 14.8 out of 1,000 cases. Serious breathing problems needing intervention to provide ventilation were rare, but highlight the need for experienced staff when giving sedation to children.
From the NIHR Dissemination Centre
Moderate exercise does not increase risk of preterm birth in healthy pregnant women
Women with an uncomplicated pregnancy who exercise are no more likely to have a preterm birth than those who don’t exercise.
This systematic review pooled the findings of nine trials including 2059 healthy pregnant women who were assigned to exercise for 35 to 90 minutes, three to four times a week, or to no exercise. Despite previous concerns that exercise may increase risk of preterm birth, the review found no evidence for this. It also found that exercise might increase a woman’s chance of a vaginal delivery and reduce risk of pregnancy complications such as diabetes and high blood pressure.
This systematic review pooled the findings of nine trials including 2059 healthy pregnant women who were assigned to exercise for 35 to 90 minutes, three to four times a week, or to no exercise. Despite previous concerns that exercise may increase risk of preterm birth, the review found no evidence for this. It also found that exercise might increase a woman’s chance of a vaginal delivery and reduce risk of pregnancy complications such as diabetes and high blood pressure.
From the NIHR Dissemination Centre
Epidural anaesthesia helps return of bowel function after abdominal surgery
High quality evidence suggests that an epidural anaesthetic (with or without an opioid) promotes the return of gut function after abdominal surgery. This is when compared to an opioid based regimen, given either through an epidural or into the bloodstream.
From the NIHR Dissemination Centre
Belfast physios use prehab to improve quality of life for men with prostate cancer
Two band 7 physiotherapists, Thamra Ayton and Alison Robinson, are leading a service at Belfast City Hospital that has improved continence for patients and reduced the workload for consultants and a clinical nurse specialist.
Secukinumab for active ankylosing spondylitis after treatment with non-steroidal anti-inflammatory drugs or TNF-alpha inhibitors
New NICE Technology Appraisal Guidance:
This guidance recommends secukinumab for treating active ankylosing spondylitis that has not responded well enough to conventional therapy.
This guidance recommends secukinumab for treating active ankylosing spondylitis that has not responded well enough to conventional therapy.
Necitumumab for untreated advanced or metastatic squamous non-small-cell lung cancer
New NICE Technology Appraisal Guidance:
Evidence-based recommendations on necitumumab (Portrazza) for treating locally advanced or metastatic epidermal growth factor receptor (EGFR)-expressing squamous non-small-cell lung cancer in adults who have not had chemotherapy.
Evidence-based recommendations on necitumumab (Portrazza) for treating locally advanced or metastatic epidermal growth factor receptor (EGFR)-expressing squamous non-small-cell lung cancer in adults who have not had chemotherapy.
Pegaspargase for treating acute lymphoblastic leukaemia
New NICE Technology Appraisal Guidance:
Evidence-based recommendations on pegaspargase (Oncaspar) for treating acute lymphoblastic leukaemia.
Evidence-based recommendations on pegaspargase (Oncaspar) for treating acute lymphoblastic leukaemia.
Aflibercept for treating visual impairment caused by macular oedema after branch retinal vein occlusion
New NICE Technology Appraisal Guidance:
Evidence-based recommendations on aflibercept (Eylea) for treating visual impairment caused by macular oedema after branch retinal vein occlusion.
Evidence-based recommendations on aflibercept (Eylea) for treating visual impairment caused by macular oedema after branch retinal vein occlusion.
Crizotinib for untreated anaplastic lymphoma kinase-positive advanced non-small-cell lung cancer
New Technology Appraisal Guidance from NICE:
Evidence-based recommendations on crizotinib (Xalkori) for untreated anaplastic lymphoma kinase-positive advanced non-small-cell lung cancer in adults.
Evidence-based recommendations on crizotinib (Xalkori) for untreated anaplastic lymphoma kinase-positive advanced non-small-cell lung cancer in adults.
Talimogene laherparepvec for treating unresectable metastatic melanoma
New NICE Technology Appraisal Guidance:
Evidence-based recommendations on talimogene laherparepvec (Imlygic) for treating unresectable metastatic melanoma in adults when systemically administered immunotherapies are not suitable.
Evidence-based recommendations on talimogene laherparepvec (Imlygic) for treating unresectable metastatic melanoma in adults when systemically administered immunotherapies are not suitable.
Radium-223 dichloride for treating hormone-relapsed prostate cancer with bone metastases
New Technology Appraisal Guidance from NICE:
Evidence-based recommendations on radium‑233 dichloride (Xofigo) for treating hormone-relapsed prostate cancer with bone metastases in adults.
Evidence-based recommendations on radium‑233 dichloride (Xofigo) for treating hormone-relapsed prostate cancer with bone metastases in adults.
Miniature lens system implantation for advanced age-related macular degeneration
New Interventional Procedures Guidance from NICE:
NHS England involvement hub launched
NHS England has created a new involvement hub to provide a one-stop shop for tools, resources, best practice and training linked to patient and public participation.
2017/18 NHS standard contract - consultation
NHS England is consulting on the 2017/18 NHS Standard Contract.
The NHS if...
A collection of essays exploring hypothetical scenarios for the future of health and care:
The NHS and Society
- What if Beveridge were reporting today?
- What if the NHS were to go carbon neutral?
- What if ‘assisted dying’ were legalised?
- What if there were community services for older people 24/7?
Medicine, Data and Technology
- What if antibiotics were to stop working?
- What if every patient were to have their genome mapped?
- What if everyone over 55 was offered a pill to prevent heart attacks and strokes?
- What if people controlled their own health data?
How the NHS Works
Making Difficult Decisions: Commissioning Healthcare In Changing Times
This report by NHS Clinical Commissioners aims to support CCGs in making difficult decisions about prioritisation of resources and changes to local services.
It sets out factors that can enable CCGs to successfully command the confidence of the public, patients, local politicians and other key stakeholders when making changes.
Where to look: making savings in the NHS
NHS Improvement has put together the top ten ways to help make savings and cost improvements. These were discovered by the 16 trusts working on the Financial Improvement Programme launched in May.
Mental Capacity Act 2005, Deprivation of Liberty Safeguards (England), Annual Report 2015-16
Annual statistics have been released by NHS Digital on Deprivation of Liberty Safeguards (DoLS) applications made to councils in England.
105,055 completed applications were reported in 2015-16, compared to 62,645 in 2014-15. This represents an increase of 68 per cent and follows a 380 per cent increase in completed applications between 2013-14 and 2014-15 (from 13,040 in 2013-14).
105,055 completed applications were reported in 2015-16, compared to 62,645 in 2014-15. This represents an increase of 68 per cent and follows a 380 per cent increase in completed applications between 2013-14 and 2014-15 (from 13,040 in 2013-14).
Knowing you’re not alone: Understanding peer support for stroke survivors
Then Nuffield Trust's evaluation, which took place over 18 months, drew on the experiences and views of more than 200 stroke survivors and 100 carers from 30 local groups, as well as 20 Stroke Association staff and volunteers. The study included a questionnaire of stroke survivors and carers which captured self-reported measures of health and wellbeing; as well as interviews and focus groups with stroke survivors, carers, staff and volunteers.
Fourth wheelchair dataset published
NHS England has established a national data collection to enable the gathering and dissemination of data that can be used for benchmarking and improving the commissioning of wheelchair services and outcomes for wheelchair users. It has published the fourth wheelchair services dataset, including data from April to June 2016.
NHS England will work with eleven CCGs based in two localities to improve services for wheelchair users.
NHS England will work with eleven CCGs based in two localities to improve services for wheelchair users.
Growing older in the UK: a series of expert-authored briefing papers on ageing and health
This report from the BMA argues that the UK's ageing population and its families are being failed by a fragmented health and social support system. It highlights how the health and life changes of older people are being negatively affected by the holes in the safety net of health, social and other welfare services.
Co-production Model: Five values and seven steps to making this happen
Co-production is a way of working that involves people who use health and care services, carers and communities in equal partnership; and which engages groups of people at the earliest stages of service design, development and evaluation.
The King’s Fund is calling on every NHS organisation to commit to working with patients as partners. We could start with senior leaders in national NHS bodies modelling co-production with patient leaders in an open and transparent way, and then spreading this way of working throughout their organisations.
The King’s Fund is calling on every NHS organisation to commit to working with patients as partners. We could start with senior leaders in national NHS bodies modelling co-production with patient leaders in an open and transparent way, and then spreading this way of working throughout their organisations.
Workforce Disability Equality Standard (WDES)
The NHS Equality and Diversity Council (EDC) has recommended that a Workforce Disability Equality Standard (WDES) should be mandated via the NHS Standard Contract in England from April 2018, with a preparatory year from 2017-18. NHS England has agreed to do so. The EDC has also agreed to support a programme of work to explain and support it.
View further information about the Workforce Disability Equality Standard (WDES).
View further information about the Workforce Disability Equality Standard (WDES).
National Neonatal Audit Programme: 2016 Annual Report
This RCPCH report outlines the result of a national audit of neonatal services and finds an improvement in rates of two year follow-up for premature babies but that there was an increase in risk of illness and that some units were still failing to record timely consultation with parents. The report urges neonatal units to form partnerships with neighbouring hospitals in order to reduce variation and drive up standards of care for very sick babies.
Opportunities for technology to change the delivery of health care
This annual publication brings together articles from researchers at Reform alongside experts and key commentators in each field to provide an insight into the changes and challenges facing public services. The articles on the NHS and health services focus on the opportunities for technology to change the delivery of health care and how efficiency and productivity can be improved.
Improving Efficiency And Resource Allocation In Future Cancer Care
This report from the Office of Health Economics (OHE), written in partnership with the Institute for Health Economics in Sweden, evaluates the current burden of cancer and identifies opportunities for increased efficiency in cancer care. The evidence focuses specifically on the health and cancer care landscape in nine European countries, including the UK. The report found that significant opportunity for improved efficiency exists in prevention activities and early diagnosis, for example targeting unhealthy behaviours such as high alcohol consumption and smoking, and the implementation of quality screening programmes. The report also highlights the potential to achieve greater efficiencies in the way new treatments are evaluated and how to enhance their uptake.
Latest staff sickness absence figures - May 2016
The latest figures released by NHS Digital show that NHS staff sickness absence has increased slightly from May 2015, when it was 3.09 per cent, to 3.84 per cent in May2016.
Tuesday, 27 September 2016
A Novel Measure for Nuclear Pleomorphism in Lung Adenocarcinoma
Bioinformatics meets Digital Pathology Conference, September 3, 2016, The Hague, Zuid-Holland, Netherlands
In this study, we provide an automatic and objective method to measure the variability of nuclei shapes in tumour regions to overcome the limitations of the current clinical routine in nuclei scoring.
UHCW Research: David Snead
In this study, we provide an automatic and objective method to measure the variability of nuclei shapes in tumour regions to overcome the limitations of the current clinical routine in nuclei scoring.
UHCW Research: David Snead
Hospital admissions for poisoning by illicit drugs up by more than 50 per cent in a decade
The figures, released by NHS Digital, show that 45 per cent (6,490) of these admissions related to patients aged between 16 and 34.
Statistics on Drug Misuse, England 2016 also shows that in 2014/15 there were 74,800 hospital admissions with a primary or secondary diagnosis of drug-related mental health and behavioural disorders. This is 9 per cent more than in 2013/14, when there were 68,600 admissions.
Deaths related to misuse of illicit drugs in England and Wales are at their highest level since comparable records began in 1993. In 2014, there were 2,250 deaths related to the misuse of illicit drugs. This was an increase of 15 per cent on 2013 (1,960) and 44 per cent higher than in 2004 (1,570). Men accounted for 72 per cent of these deaths (1,620) and women, 28 per cent (624).
Statistics on Drug Misuse, England 2016 also shows that in 2014/15 there were 74,800 hospital admissions with a primary or secondary diagnosis of drug-related mental health and behavioural disorders. This is 9 per cent more than in 2013/14, when there were 68,600 admissions.
Deaths related to misuse of illicit drugs in England and Wales are at their highest level since comparable records began in 1993. In 2014, there were 2,250 deaths related to the misuse of illicit drugs. This was an increase of 15 per cent on 2013 (1,960) and 44 per cent higher than in 2004 (1,570). Men accounted for 72 per cent of these deaths (1,620) and women, 28 per cent (624).
Annual childhood immunisation statistics published
The NHS Digital annual report NHS Immunisation Statistics, England, 2015-16 includes coverage statistics on routine childhood vaccinations, which are offered to all children up to the age of five.
Seven insights for building integrated local public services
This discussion paper, Moving from the margins:
The challenges of
building integrated
local services has been produced jointly by Collaborate and Turning Point and it presents seven key insights for building integrated public services. It argues that local integrated services should be at the heart of strategies for social renewal and public service reform.
Helping people to ESCAPE the misery of chronic joint pain
Health Innovation Network (South London’s Academic Health Science Network) has been focusing on improving community management of osteoarthritis, or chronic joint pain, for the past couple of years.
It has paid particular attention to promoting the spread of the ESCAPE-pain programme – Enabling Self-Management and Coping with Arthritic Pain using Exercise. Visit the ESCAPE pain website.
It has paid particular attention to promoting the spread of the ESCAPE-pain programme – Enabling Self-Management and Coping with Arthritic Pain using Exercise. Visit the ESCAPE pain website.
ESCAPE-pain is a group-based, six week rehabilitation programme which combines exercise and education. It has now been implemented at 27 sites in England, both in clinical physiotherapy departments, and in leisure centres. Participants learn how to manage chronic joint pain using exercise and coping techniques, and we have seen just how powerful the learning and interactions of the group are in changing health beliefs and increasing physical activity. The programme is both clinically and cost effective, is endorsed by NICE, QIPP and has received Best Practice Awards from the British Society of Rheumatology and Royal Society of Public Health.
Cataract patients face postcode lottery of waiting times for NHS cataract treatment
NHS patients in England face waiting up to 15 months for desperately needed cataract treatment, a new RNIB report has revealed.
RNIB’s research found significant differences in waiting times for NHS cataract treatment – from first outpatient appointment to cataract surgery itself – across England’s Clinical Commissioning Groups (CCGs) in 2015/16.
RNIB’s research found significant differences in waiting times for NHS cataract treatment – from first outpatient appointment to cataract surgery itself – across England’s Clinical Commissioning Groups (CCGs) in 2015/16.
Monday, 26 September 2016
Lessons from altitude: cerebral perfusion insights and their potential translational clinical significance
Experimental Physiology. 101 (9) (pp 1167-1172), 2016. Date of Publication: 01 Sep 2016.
The long-held assumption that transcranial Doppler middle cerebral artery velocity is a surrogate for cerebral blood flow has been questioned in certain circumstances, particularly where tissue oxygenation changes.
This report provides new perspectives and potential mechanisms to account for the maintenance of cerebral oxygen delivery at high and extreme altitude. In particular, the long-held assumption that transcranial Doppler middle cerebral artery velocity is a surrogate for cerebral blood flow has been shown to be incorrect in certain circumstances
UHCW Research: Imray, C.
The long-held assumption that transcranial Doppler middle cerebral artery velocity is a surrogate for cerebral blood flow has been questioned in certain circumstances, particularly where tissue oxygenation changes.
This report provides new perspectives and potential mechanisms to account for the maintenance of cerebral oxygen delivery at high and extreme altitude. In particular, the long-held assumption that transcranial Doppler middle cerebral artery velocity is a surrogate for cerebral blood flow has been shown to be incorrect in certain circumstances
UHCW Research: Imray, C.
A cadaveric study on subjective feel of injection pressure-are we getting it right?.
Regional Anesthesia and Pain Medicine. Conference: 35th Annual European Society of Regional Anaesthesia and Pain Therapy Congress, ESRA 2016. Netherlands. Conference Start: 20160907. Conference End: 20160910. 41 (5 Supplement 1) (pp e72), 2016. Date of Publication: September - October 2016.
Nerve injury remains a serious risk of peripheral nerve blockade. High opening injection pressures (OIP) may indicate direct needle nerve contact and/or intrafascicular needle placement. Subjective syringe hand-feel technique may not reflect the actual pressures in the system. This study demonstrates that subjective hand-feel of injection pressure is not an accurate confirmation of the actual pressure within the system. Subjective hand-feel and ultrasound visualisation methods on its own are unreliable indicators for intraneural needle placement. (Figure Presented).
UHCW Research: Sadasivan R.
Nerve injury remains a serious risk of peripheral nerve blockade. High opening injection pressures (OIP) may indicate direct needle nerve contact and/or intrafascicular needle placement. Subjective syringe hand-feel technique may not reflect the actual pressures in the system. This study demonstrates that subjective hand-feel of injection pressure is not an accurate confirmation of the actual pressure within the system. Subjective hand-feel and ultrasound visualisation methods on its own are unreliable indicators for intraneural needle placement. (Figure Presented).
UHCW Research: Sadasivan R.
Quadratus lumborum block for laparoscopic appendectomy
Regional Anesthesia and Pain Medicine. Conference: 35th Annual European Society of Regional Anaesthesia and Pain Therapy Congress, ESRA 2016. Netherlands. Conference Start: 20160907. Conference End: 20160910. 41 (5 Supplement 1) (pp e135), 2016. Date of Publication: September - October 2016.
Laparoscopic abdominal procedures such as appendectomy are very common nowadays, however adequate pain control can sometimes be difficult and of ten these patients require opiates. We present the case of a 53 year-old patient who underwent a laparoscopic appendectomy under general anaesthetic with a bilateral quadratus lumborum block requiring no morphine.
Laparoscopic abdominal procedures such as appendectomy are very common nowadays, however adequate pain control can sometimes be difficult and of ten these patients require opiates. We present the case of a 53 year-old patient who underwent a laparoscopic appendectomy under general anaesthetic with a bilateral quadratus lumborum block requiring no morphine.
UHCW Research: Gorecha M. and Price C.
Sub-sartorial block for post-operative pain relief following knee surgeries
Regional Anesthesia and Pain Medicine. Conference: 35th Annual European Society of Regional Anaesthesia and Pain Therapy Congress, ESRA 2016. Netherlands. Conference Start: 20160907. Conference End: 20160910. 41 (5 Supplement 1) (pp e97), 2016. Date of Publication: September - October 2016.
Pain relief following knee surgery is vital as the severity of pain is extremely high and it does often impede functional recovery of the patient. Methods: We performed a prospective audit on postoperative pain relief following knee surgeries. All our patients received a sub-sartorial block with 30mls of 0.5% chirocaine following a GA or a spinal anaesthetic. All the patients were randomly selected. They were followed up at six hours & 24 hours after their discharge from recovery. Their knee movements, VAS pain scores, analgesia received, time when the first dose of morphine was administered as well as total morphine requirement in the first 24 hours were noted. Results: Knee movements were possible with mild to moderate pain. The average first dose of morphine was administered seven hours after discharge from recovery and the total morphine consumption in the first 24 hours was 30mg. This is much less than the dosage used for standard enhanced care programs for knee replacement surgeries where a BD dose of 20mg MST morphine is used. Conclusions: Our audit shows that there was no incidence of severe pain on movement. The morphine consumption is comparable to other nerve blocks for knee surgeries based on meta-analysis available in literature with an added advantage of sparing of quadriceps that aids in knee movement and physiotherapy along with pain relief
UHCW Research: Vaidyanath C. and Sadasivan R.
Pain relief following knee surgery is vital as the severity of pain is extremely high and it does often impede functional recovery of the patient. Methods: We performed a prospective audit on postoperative pain relief following knee surgeries. All our patients received a sub-sartorial block with 30mls of 0.5% chirocaine following a GA or a spinal anaesthetic. All the patients were randomly selected. They were followed up at six hours & 24 hours after their discharge from recovery. Their knee movements, VAS pain scores, analgesia received, time when the first dose of morphine was administered as well as total morphine requirement in the first 24 hours were noted. Results: Knee movements were possible with mild to moderate pain. The average first dose of morphine was administered seven hours after discharge from recovery and the total morphine consumption in the first 24 hours was 30mg. This is much less than the dosage used for standard enhanced care programs for knee replacement surgeries where a BD dose of 20mg MST morphine is used. Conclusions: Our audit shows that there was no incidence of severe pain on movement. The morphine consumption is comparable to other nerve blocks for knee surgeries based on meta-analysis available in literature with an added advantage of sparing of quadriceps that aids in knee movement and physiotherapy along with pain relief
UHCW Research: Vaidyanath C. and Sadasivan R.
Royal College of Nursing G635(P) Regional diabetes awareness education for schools – regional study day
With the increase in incidence of Type 1 diabetes in children and young people (CYP) and the use of intensive insulin therapies, paediatric diabetes teams are under increasing pressure to support school staff with the day to day management of their pupils with diabetes. The aims of this project have been to provide school staff with an awareness of:
- All stakeholders responsibilities of managing a CYP with diabetes in school
- The difference between Type 1 and 2 diabetes
- Causes, signs and symptoms of diabetes
- Treatment options
- How to manage acute complications – hypo and hyperglycaemia
- Dietary requirements – carbohydrate counting
- Insulin pump therapy
- Have a basic understanding of the practicalities of insulin administration and blood glucose/ketone monitoring.
Ernährungsempfehlungen zur Behandlung des Diabetes mellitus – Empfehlungen zur Proteinzufuhr
Diabetologie und Stoffwechsel 2016; 11(04): 272-282. DOI: 10.1055/s-0042-111088
Nutritional recommendations for the treatment of diabetes mellitus – recommendations for protein intake.
UHCW Research: M. O. Weickert
Nutritional recommendations for the treatment of diabetes mellitus – recommendations for protein intake.
UHCW Research: M. O. Weickert
A randomised, controlled trial of a 4% cutaneous emulsion of sodium cromoglicate in treatment of atopic dermatitis in children
Journal of Dermatological Treatment Volume 26, 2015 - Issue 3
Atopic dermatitis (AD) is a chronic inflammatory skin disease. Sodium cromoglicate (SCG) is a chromone with anti-inflammatory, anti-itch and anti-allergic activity. This trial is a 12-week comparison (RCT) of a 4% SCG cutaneous emulsion with its vehicle in AD
UHCW Research: John Berth-Jones
Atopic dermatitis (AD) is a chronic inflammatory skin disease. Sodium cromoglicate (SCG) is a chromone with anti-inflammatory, anti-itch and anti-allergic activity. This trial is a 12-week comparison (RCT) of a 4% SCG cutaneous emulsion with its vehicle in AD
UHCW Research: John Berth-Jones
NICE referral guidelines for suspected cancer: colorectal cancer and faecal occult blood testing
Ann Clin Biochem. 2016 Jan;53(Pt 1):7-9. doi: 10.1177/0004563215612507. Epub 2015 Oct 5
In short, the new NICE guidance on referral for suspected cancer is ill-judged. Our advice to those responsible for routine clinical biochemistry laboratories is to resist calls to introduce or re-instate gFOBT. In the future, laboratories may wish to consider offering a FIT service for which there is already reasonable evidence that absence of detectable blood has an extremely high NPV for bowel cancer notwithstanding uncertainty as to precisely what cut-off levels should be used. If new evidence does continue to support the use of FIT in symptomatic patients, then the algorithm proposed by NICE is more likely to be robust.
UHCW Research: Smith, S.
In short, the new NICE guidance on referral for suspected cancer is ill-judged. Our advice to those responsible for routine clinical biochemistry laboratories is to resist calls to introduce or re-instate gFOBT. In the future, laboratories may wish to consider offering a FIT service for which there is already reasonable evidence that absence of detectable blood has an extremely high NPV for bowel cancer notwithstanding uncertainty as to precisely what cut-off levels should be used. If new evidence does continue to support the use of FIT in symptomatic patients, then the algorithm proposed by NICE is more likely to be robust.
UHCW Research: Smith, S.
Polycystic ovary syndrome: insight into pathogenesis and a common association with insulin resistance
Clin Med (Lond). 2015 Dec;15 Suppl 6:s72-6. doi: 10.7861/clinmedicine.15-6-s72.
Polycystic ovary syndrome (PCOS) is a common condition that typically develops in reproductive-age women. The cardinal clinical and biochemical characteristics of PCOS include reproductive dysfunction and hyperandrogenic features. PCOS is also strongly associated with obesity based on data from epidemiological and genetic studies. Accordingly, PCOS often becomes manifest in those women who carry a genetic predisposition to its development, and who also gain weight. The role of weight gain and obesity in the development of PCOS is mediated at least in part, through worsening of insulin resistance. Compensatory hyperinsulinaemia that develops in this context disrupts ovarian function, with enhanced androgen production and arrest of ovarian follicular development. Insulin resistance also contributes to the strong association of PCOS with adverse metabolic risk, including dysglycaemia, dyslipidaemia and fatty liver. Conversely, modest weight loss of just 5% body weight with improvement in insulin sensitivity, frequently results in clinically meaningful improvements in hyperandrogenic, reproductive and metabolic features. Future developments of novel therapies for obese women with PCOS should focus on promotion of weight loss and improvement in insulin sensitivity. In this context, therapies that complement lifestyle changes such as dietary modification and exercise, particularly during the maintenance phase of weight loss are important. Putative novel targets for therapy in PCOS include human brown adipose tissue.
UHCW Research: Barber TM, Dimitriadis GK and Andreou A
Polycystic ovary syndrome (PCOS) is a common condition that typically develops in reproductive-age women. The cardinal clinical and biochemical characteristics of PCOS include reproductive dysfunction and hyperandrogenic features. PCOS is also strongly associated with obesity based on data from epidemiological and genetic studies. Accordingly, PCOS often becomes manifest in those women who carry a genetic predisposition to its development, and who also gain weight. The role of weight gain and obesity in the development of PCOS is mediated at least in part, through worsening of insulin resistance. Compensatory hyperinsulinaemia that develops in this context disrupts ovarian function, with enhanced androgen production and arrest of ovarian follicular development. Insulin resistance also contributes to the strong association of PCOS with adverse metabolic risk, including dysglycaemia, dyslipidaemia and fatty liver. Conversely, modest weight loss of just 5% body weight with improvement in insulin sensitivity, frequently results in clinically meaningful improvements in hyperandrogenic, reproductive and metabolic features. Future developments of novel therapies for obese women with PCOS should focus on promotion of weight loss and improvement in insulin sensitivity. In this context, therapies that complement lifestyle changes such as dietary modification and exercise, particularly during the maintenance phase of weight loss are important. Putative novel targets for therapy in PCOS include human brown adipose tissue.
UHCW Research: Barber TM, Dimitriadis GK and Andreou A
Toolkit on the risks of valproate medicines in female patients
Information from the MHRA about the toolkit to ensure female patients are better informed about the risks of taking valproate medicines during pregnancy.
Acute Limb Compartment Syndrome Observation Chart
New Acute Limb Compartment Syndrome Observation Chart from the Royal College of Nursing and the British Orthopaedic Association.
Health and Care Professional Council proposes changes to support raising concerns
The Health and Care Professions Council (HCPC) has launched a consultation on proposed changes to the standards of education and training and supporting guidance. One of the proposed changes is to support learners raising public interest concerns.
New Insulin Delivery Recommendations
Many primary care professionals manage injection or infusion therapies in patients with diabetes. Few published guidelines have been available to help such professionals and their patients manage these therapies. Herein, are presented new, practical, and comprehensive recommendations for diabetes injections and infusions.
Brexit: impact across policy areas
Briefing paper on Brexit impacts from the House of Commons Library. See section 14 for Health Policy and Medicines Regulation.
Safe sustainable and productive staffing: case studies
Earlier this year, the National Quality Board (NQB) published a safe staffing resource for NHS provider boards to help assure the delivery of compassionate, effective, safe and sustainable high quality patient care.
The case studies cross over different themes and are linked to the three expectations set out in the NQB guidance; right staff, right skills, right place and time.
The case studies cross over different themes and are linked to the three expectations set out in the NQB guidance; right staff, right skills, right place and time.
Reducing reliance on medical locums: a practical guide for medical directors
This guide from NHS Improvement provides a list against which medical directors can check they're taking the necessary action to reduce their reliance on medical locums.
Never Events policy and framework review 2016
The Never Events framework explains that the occurrence of a Never Event may highlight potential weaknesses in how an organisation manages fundamental safety processes.
NHS Improvement need to understand if the current Never Events policy and framework can be further improved to meet its main objective of improving safety culture.
It is also seeking to understand if the current list of incidents defined as Never Events (e.g. wrong side block, dental extractions) is correct or if we need to redefine this list in line with the overall principles of the policy and framework.
NHS Improvement need to understand if the current Never Events policy and framework can be further improved to meet its main objective of improving safety culture.
It is also seeking to understand if the current list of incidents defined as Never Events (e.g. wrong side block, dental extractions) is correct or if we need to redefine this list in line with the overall principles of the policy and framework.
Managing risk in social media
Social media is a powerful marketing tool for organisations but it is not without risk. These risks can have a major impact on you, your career and your organisation. And they can happen whether or not you are using social media.
Managing risk in social media helps you analyse and prepare your organisation for the problems that may occur when using social media. It helps you understand how to handle internal social accounts and deal with external social media activity which your organisation may become involved in.
This e-learning course will not only help you to understand, identify and manage risks, but will also guide you in preparing to protect your organisation from damage that may be caused.
Managing risk in social media helps you analyse and prepare your organisation for the problems that may occur when using social media. It helps you understand how to handle internal social accounts and deal with external social media activity which your organisation may become involved in.
This e-learning course will not only help you to understand, identify and manage risks, but will also guide you in preparing to protect your organisation from damage that may be caused.
New model of midwifery supervision: call for pilot sites
The NHS England supervision taskforce is responsible for developing a new model of midwifery supervision for England which will be implemented in spring 2017, subject to a change in legislation.
The taskforce is calling for pilot sites to test the proposed new model of midwifery supervision in England. Invitations are welcome from large, small, urban, rural and independent providers that have the capacity to support the pilot while maintaining their current supervision arrangements. Queries can be directed to england.midwiferysupervision@nhs.net. The closing date for applications is 30 September 2016.
New whistleblowing protection for doctors in training
Health Education England has released details of the enhanced protection on whistleblowing for doctors in training.
Contractual claims can now be made directly against HEE if circumstances arise in which an individual suffers negative consequences as a result of raising concerns.
All issues should be raised formally so that they can be addressed by the employer and/or HEE. If this is not done, not possible, or the trainee feels the issue remains unresolved, this new right allows the trainees to make a claim against HEE.
Trainees can now pursue claims for up to six months after they become aware of any perceived negative consequences, which is the same as the limitation period for bringing claims to the employment tribunal.
Contractual claims can now be made directly against HEE if circumstances arise in which an individual suffers negative consequences as a result of raising concerns.
All issues should be raised formally so that they can be addressed by the employer and/or HEE. If this is not done, not possible, or the trainee feels the issue remains unresolved, this new right allows the trainees to make a claim against HEE.
Trainees can now pursue claims for up to six months after they become aware of any perceived negative consequences, which is the same as the limitation period for bringing claims to the employment tribunal.
Progress Into The Implementation Of The England Cancer Strategy: One Year On
The All Party Parliamentary Group on Cancer's inquiry finds that, one year on from the publication of the England Cancer Strategy, there remains broad consensus amongst witnesses and respondents to the inquiry on its recommendations. This report outlines three recommendations on funding, transparency and accountability, and involvement of organisations with expertise and interest in cancer.
NICE says yes to another hepatitis C drug
NICE has published new draft guidance which recommends sofosbuvir-velpatasvir – an anti-viral drug that offers patients with chronic hepatitis C a potential cure.
Leeds’ progress as an integrated care pioneer
NHS England's integrated care pioneer programme supports 25 pioneers who are developing and testing new ways to deliver person-centred integrated health and social care services across England. As part of the new care models programme, the pioneers have been working on addressing the care and quality gap identified in the NHS Five Year Forward View.
Leeds Pioneer hosted the Assembly and Rebecca Charlwood, Chair of their Health and Wellbeing Board talks about the work they have been doing in Leeds.
Leeds is the second largest city in the UK outside London, with a diverse population of over 770,000 people. We experience significant health, wealth and wellbeing inequalities, for example, travel just four miles between the areas of Scarcroft and Seacroft and life expectancy for the local population reduces by around seven years. Earlier this year we launched the city’s new Health and Wellbeing Strategy , setting out a bold ambition to make Leeds the best city in which to live a healthy, happy life. Our strategy has five outcomes, 12 priorities and a selection of performance measures to guide and monitor our progress. We’ve been using the national focus on sustainability and transformation to bring our strategy to life, developing clear, joined-up plans, alongside our West Yorkshire partners, so we all understand the changes we need to make.
Leeds is the second largest city in the UK outside London, with a diverse population of over 770,000 people. We experience significant health, wealth and wellbeing inequalities, for example, travel just four miles between the areas of Scarcroft and Seacroft and life expectancy for the local population reduces by around seven years. Earlier this year we launched the city’s new Health and Wellbeing Strategy , setting out a bold ambition to make Leeds the best city in which to live a healthy, happy life. Our strategy has five outcomes, 12 priorities and a selection of performance measures to guide and monitor our progress. We’ve been using the national focus on sustainability and transformation to bring our strategy to life, developing clear, joined-up plans, alongside our West Yorkshire partners, so we all understand the changes we need to make.
NICE to recommend new drug to treat rare inherited bone disorder in children
NICE has published draft guidance recommending the drug asfotase alfa for children with perinatal- and infantile-onset hypophosphatasia – a very rare inherited condition affecting between one and seven babies each year in England.
Safety of neonatal phototherapy lamp exposure
, , http://dx.doi.org/10.1088/0952-4746/36/4/N46
A routine review of light exposure within a neonatal intensive care unit is described following the introduction of a new model of neonatal phototherapy lamp.
UHCW Research: Douglas McG Clarkson, P Satodia and Ian Hadley
A routine review of light exposure within a neonatal intensive care unit is described following the introduction of a new model of neonatal phototherapy lamp.
UHCW Research: Douglas McG Clarkson, P Satodia and Ian Hadley
Friday, 23 September 2016
Ophthalmic Special Order Products
The Royal College of Ophthalmologists and the UK Ophthalmic Pharmacy Group have issued updated guidance to reflect changes to the Ophthalmic Special Order Products list.
Long Term conditions Commissioning Handbook
This handbook is the main output of the NHS England Long Term Conditions Year of Care Commissioning Programme, which worked to change the way services are both commissioned and provided to offer meaningfully person-centred coordinated care.
The handbook describes the experiences of five care economies as they work towards developing capitated budgets for some patients and services. It provides practical advice and guidance on capitated budgets, population segmentation, leadership, co-production, planning for service change, and evaluation.
The handbook describes the experiences of five care economies as they work towards developing capitated budgets for some patients and services. It provides practical advice and guidance on capitated budgets, population segmentation, leadership, co-production, planning for service change, and evaluation.
Delivering The Forward View: NHS Operational Planning Guidance For 2017/18 And 2018/19
This NHS England guidance aims to provide NHS trusts and commissioners with tools they need to plan for the years ahead. For the first time, the guidance covers two financial years, to provide greater stability, underpinned by a two-year tariff for NHS patients and a two-year NHS Standard Contract.
See also Technical guidance for NHS planning 2017/18 and 2018/19
See also Technical guidance for NHS planning 2017/18 and 2018/19
A False Economy: Cuts To Continuing Professional Development Funding For Nursing, Midwifery And The Allied Health Professions
This report from the Council of Dean's Health highlights the risk posed to the NHS by the funding cuts and calls for the Department of Health to lead a discussion to address the disconnect between the funding decisions and national strategic priorities. It also warns about the potential consequences of the cuts for the Government’s push to expand student numbers as part of plans to reduce staff shortages.
Thursday, 22 September 2016
UK IBD audit highlights potential huge cost savings of using new biosimilar medicine
A new report into the use of biological therapies to treat inflammatory bowel disease (IBD) has found that new biosimilar medicines, which work in the same way as the more expensive existing treatments, are safe and effective for patients and if adopted could reduce the cost of treatment by half.
The audit is the first to include data on new Infliximab ‘biosimilar’ drugs Inflectra and Remsima, now being used on patients as alternatives to the original Remicade in the treatment of IBD.
Dementia nursing: vision and strategy
Policy paper from the Department of Health setting out the role and responsibilities for nurses providing care and support for people with dementia.
SMI V 28: Cytomegalovirus serology
UK Standards for Microbiology Investigations (SMIs) V 28: Cytomegalovirus serology from Public Health England.
Little or no benefit from progesterone to prevent preterm birth
In this trial, vaginal progesterone given to women at high risk of preterm delivery did not reduce the risk of premature birth compared to a placebo. The consequences for the baby in the first 28 days of life, and children at two years’ old, were also similar when looked at as a whole.
From the NIHR Dissemination Centre
SIGN 153: British guideline on the management of asthma (2016 update)
This updated SIGN guideline provides recommendations based on current evidence for best practice in the management of asthma. It makes recommendations on management of adults, including pregnant women, adolescents, and children with asthma.
British HIV Association guidelines for the routine investigation and monitoring of adult HIV-1-positive individuals 2016
This guideline is an update of that produced in 2011 to reflect the advances in knowledge made in the last 5 years.
As with the previous monitoring guideline, the aim is to present a consensus regarding the standard assessment and investigation of HIV infection from the time of diagnosis and to describe the appropriate monitoring of HIV-positive individuals both on and off ART. This guideline does not address the investigation and management of specific conditions related to HIV infection nor does it look at the choice of ART as these are all covered in other specific BHIVA guidelines.
A digital NHS? An introduction to the digital agenda and plans for implementation
In recent years, the digital agenda in health care has been the subject of an array of promises and plans. But have expectations been set too high? And is there sufficient clarity about the funding available to achieve this vision?
This report looks at the key commitments made and what we know about progress to date, grouped under three broad themes:
This report looks at the key commitments made and what we know about progress to date, grouped under three broad themes:
- interoperable electronic health records
- patient-focused digital technology
- secondary use of data, transparency and consent.
Quality Outcomes Framework (QOF) Recorded Dementia Diagnoses
Quality Outcomes Framework (QOF) Recorded Dementia Diagnoses, August 2016, from NHS Digital.
Create a culture and leadership programme: Phase 1 Discover
Diagnose your trust's current culture and target the right areas for your collective leadership strategy.
This guide covers setting up your culture and leadership programme. It will help you diagnose your current culture using existing data, board, staff and stakeholder perceptions, and workforce analysis. You will then be ready to target the right areas for your collective leadership strategy.
New presentation to help you make the case for health and wellbeing
NHS Employers' health and wellbeing team have been working with board and clinical leads from the NHS to create a new presentation for health and wellbeing leaders.
This presentation is a tool to help you persuade your board of the benefits of a robust wellbeing strategy and highlight some of the key challenges your staff are facing. The presentation is editable so you can amend it to suit your individual needs.
This presentation is a tool to help you persuade your board of the benefits of a robust wellbeing strategy and highlight some of the key challenges your staff are facing. The presentation is editable so you can amend it to suit your individual needs.
Sexually transmitted infections (STIs): surveillance, data, screening and management
The surveillance and epidemiology of sexually transmitted infections (STIs) from Public Health England.
Skin cancer: Quality Standard
This new quality standard from NICE covers the prevention, assessment, diagnosis and management of skin cancer (malignant melanoma and non-melanoma) in children, young people and adults
Underfunded, Underdoctored, Overstretched: The NHS In 2016
This report from the Royal College of Physicians argues that the NHS in 2016 needs a new plan, designed to meet the UK’s health and care needs in the long term, and to value, support and motivate NHS staff. This would include an increase in the amount of funding and an increase in the number of medical students and doctors training to be hospital specialists.
Multimorbidity: clinical assessment and management
This guideline from NICE covers optimising care for adults with multimorbidity (multiple long-term conditions) by reducing treatment burden (polypharmacy and multiple appointments) and unplanned care. It aims to improve quality of life by promoting shared decisions based on what is important to each person in terms of treatments, health priorities, lifestyle and goals. The guideline sets out which people are most likely to benefit from an approach to care that takes account of multimorbidity, how they can be identified and what the care involves.
New draft quality standard to improve treatment of head and neck cancer.
NICE is consulting on a new draft quality standard to improve treatment of head and neck cancer.
Current practice, when scans can’t detect if cancer has spread to the lymph nodes in patients with early oral cavity cancer is to have major surgery to remove them in case it has.
The draft quality standard recommends those patients instead have a biopsy to remove the main lymph gland linked to the cancer to establish if it has spread and if further surgery is needed.
Current practice, when scans can’t detect if cancer has spread to the lymph nodes in patients with early oral cavity cancer is to have major surgery to remove them in case it has.
The draft quality standard recommends those patients instead have a biopsy to remove the main lymph gland linked to the cancer to establish if it has spread and if further surgery is needed.
Patients should be more involved in decisions about their care, says NICE
A new collaborative, made up of the UK’s leading health care organisations including NICE, has set out plans that will help get patients more involved in decisions about their care.
The ‘Shared Decision Making Collaborative’will work together to ensure shared decisions about care become a reality in everyday clinical practice. A consensus statement and action plan outlines each collaborative organisation’s intentions and commitments to promote a move away from paternal medicine, so that care is delivered with the patient, not at the patient.
As part of the collaborative, NICE will look at its guidance to identify points in a clinical pathway where a decision about care needs to be made. Evidence to support that decision will be made available to both the patient and health care professional. Tools to help patients make a decision, such as options grids or patient decision aids, will also be embedded into existing guidance.
As part of the collaborative, NICE will look at its guidance to identify points in a clinical pathway where a decision about care needs to be made. Evidence to support that decision will be made available to both the patient and health care professional. Tools to help patients make a decision, such as options grids or patient decision aids, will also be embedded into existing guidance.
Wednesday, 21 September 2016
Readers’ panel - Is the government’s childhood obesity strategy too weak?
Nursing Standard. 31, 3, 31-31. http://dx.doi.org/10.7748/ns.31.3.31.s35
Request this article from the library.
UHCW Research: Daniel Athey
Request this article from the library.
UHCW Research: Daniel Athey
The Warwick Agreement on femoroacetabular impingement syndrome (FAI syndrome): an international consensus statement
The 2016 Warwick Agreement on femoroacetabular impingement (FAI) syndrome was convened to build an international, multidisciplinary consensus on the diagnosis and management of patients with FAI syndrome.
UHCW Research: Griffin, D. R and Dickinson, E. J.
MERS-CoV: infection control for possible or confirmed cases
Infection control guidance from Public Health England for possible and confirmed cases of Middle East respiratory syndrome coronavirus (MERS-CoV).
Tuesday, 20 September 2016
Time For A Turnaround On Turnaround Time
This briefing from MindMetre Research contains an assessment of the importance and impact of improving laboratory test turnaround time in the acute care sector. The authors consider whether this is an area that should be better funded and prioritised?
Who Knows Best? Older People’s Contribution To Understanding And Preventing Avoidable Hospital Admissions
The authors of this report, from the University of Birmingham, interviewed 104 older people, exploring their experiences of emergency admissions. The research focused on whether the older people felt it was appropriate to be admitted to hospital and whether they thought anything could have prevented their admission. The findings of this study confirm the belief that older people have an important role to play in helping understand the nature of emergency admissions and to devise appropriate responses to their rising numbers. The report concludes that ignoring this expertise could be detrimental to ensuring older people get the appropriate care they need.
Protocol for a single-centre randomised controlled trial of multimodal periarticular anaesthetic infiltration versus single-agent femoral nerve blockade as analgesia for total knee arthroplasty: Perioperative Analgesia for Knee Arthroplasty (PAKA)
BMJ Open. 2015;5(12):e009898
Total knee arthroplasty (TKA) surgery causes postoperative pain. The use of perioperative injections around the knee containing local anaesthetic, opiates and non-steroidal anti-inflammatory drugs has increased in popularity to manage pain. Theoretical advantages include reduced requirements for analgesia and earlier mobilisation. We propose a single-centre randomised controlled trial of multimodal periarticular anaesthetic infiltration versus femoral nerve anaesthetic blockade as analgesia for TKA. The aim is to determine, in patients undergoing TKA, if there is a difference in patient-reported pain scores on the visual analogue scale (VAS) prior to physiotherapy on day 1 postoperatively between treatment groups. METHODS AND ANALYSIS: Patients undergoing a primary unilateral TKA at University Hospitals Coventry and Warwickshire Hospitals will be assessed for eligibility.
UHCW Research: Wall, P. D., Snowson, A. P. and Balasubramanian, S.
Total knee arthroplasty (TKA) surgery causes postoperative pain. The use of perioperative injections around the knee containing local anaesthetic, opiates and non-steroidal anti-inflammatory drugs has increased in popularity to manage pain. Theoretical advantages include reduced requirements for analgesia and earlier mobilisation. We propose a single-centre randomised controlled trial of multimodal periarticular anaesthetic infiltration versus femoral nerve anaesthetic blockade as analgesia for TKA. The aim is to determine, in patients undergoing TKA, if there is a difference in patient-reported pain scores on the visual analogue scale (VAS) prior to physiotherapy on day 1 postoperatively between treatment groups. METHODS AND ANALYSIS: Patients undergoing a primary unilateral TKA at University Hospitals Coventry and Warwickshire Hospitals will be assessed for eligibility.
UHCW Research: Wall, P. D., Snowson, A. P. and Balasubramanian, S.
Latest Review of new and emerging technologies for treatment of corneal disorder
The NIHR Horizon Scanning Reseach and Intelligence Centre has completed a horizon scanning review that identifies new and emerging technologies and procedures for the treatment of corneal disorders, including keratoconus, keratitis, abrasion, and congenital disorders.
CQC launches an updated code of practice on confidential personal information
The CQC has updated the code its staff follow to obtain, handle, use and disclose confidential personal information.
The code explains how CQC makes decisions relating to people’s confidential personal information. This includes how we decide whether we need to look at medical or care records during an inspection, and whether we need to share personal information that we hold.
The code explains how CQC makes decisions relating to people’s confidential personal information. This includes how we decide whether we need to look at medical or care records during an inspection, and whether we need to share personal information that we hold.
Large ten-year trial on treatment of localised prostate cancer will aid management decisions
New, long-term research indicates that active monitoring, with prompt treatment if needed, may be a better option than radical surgery or radiotherapy for many men who have prostate cancer if it’s confined to the prostate gland. In the ProtecT trial, after an average of ten years, few men died of prostate cancer and there was no difference in survival between men receiving active monitoring and those who had radical treatments (which caused unpleasant side effects). But active monitoring did increase the risk of cancer progressing or spreading to other parts of the body. Longer follow-up will help to fully understand the balance between treatments.
From the NIHR Dissemination Centre
From the NIHR Dissemination Centre
New technique for repairing the bowel inside the body is safe
After removal of a section of cancerous bowel the ends need to be stitched back together. In endoscopic (keyhole) surgery this is usually done by pulling both ends out through a small hole in the skin and stitching them outside the body, before pushing the joined bowel back inside. This is called extracorporeal anastamosis.
Alternatively stitching the bowel inside the body, intracorporeal anastomosis, may reduce the risk of damage, but is technically demanding.
This review found that stitching the bowel inside, rather than outside the body did not increase the risk of death or complications and reduced infection rates, length of hospital stay and the time it took for bowels to start working again.
Alternatively stitching the bowel inside the body, intracorporeal anastomosis, may reduce the risk of damage, but is technically demanding.
This review found that stitching the bowel inside, rather than outside the body did not increase the risk of death or complications and reduced infection rates, length of hospital stay and the time it took for bowels to start working again.
From the NIHR Dissemination Centre.
Betahistine may be worth trying for people with undiagnosed vertigo
Taking the drug betahistine could reduce the feeling of vertigo, even when the cause hasn't been found. Vertigo is a feeling that the environment is moving around when it is not. It can be caused by problems in the ear or the brain. Regardless of the cause, this study found that if 100 people with vertigo are treated with betahistine, 60 will report improvement.
Side effects reported in this Cochrane review were uncommon and usually mild.
Side effects reported in this Cochrane review were uncommon and usually mild.
From the NIHR Dissemination Centre
“Triptans” can relieve migraines in children and adolescents
Triptans, a migraine medication, relieve migraine headache completely within two hours compared toplacebo. Ibuprofen was also effective but less well studied. This review was also reassuring in that any side effects of treatment were mild.
Most evidence identified in this Cochrane review was for sumatriptan, a commonly prescribed treatment for adults, compared to placebo or dummy pills. A few studies examined other triptans or other painkillers, such as ibuprofen or paracetamol against placebo in children and adults.
The findings support current guideline recommendations to prescribe nasal triptans for migraine in adolescents. Only nasal preparations are currently licensed for adolescents, whereas oral administration and use for children under 12 years, is an ‘off-label’ use. There were some mild adverse effects in the triptan groups that highlight the need for an informed discussion between clinicians and parents or patients and monitoring in this group.
Most evidence identified in this Cochrane review was for sumatriptan, a commonly prescribed treatment for adults, compared to placebo or dummy pills. A few studies examined other triptans or other painkillers, such as ibuprofen or paracetamol against placebo in children and adults.
The findings support current guideline recommendations to prescribe nasal triptans for migraine in adolescents. Only nasal preparations are currently licensed for adolescents, whereas oral administration and use for children under 12 years, is an ‘off-label’ use. There were some mild adverse effects in the triptan groups that highlight the need for an informed discussion between clinicians and parents or patients and monitoring in this group.
From the NIHR Dissemination Centre
Paracetamol is a weak painkiller for regular tension headaches
Paracetamol is only slightly more effective than dummy tablets (placebo) at relieving pain in people who experience regular tension-type headaches.
A Cochrane review found that 24 out of 100 people who took paracetamol for regular tension-type headaches were pain free at two hours, compared with 19 out of 100 who took an inactive placebo.
There was no difference in risk of side effects between paracetamol and placebo.
From the NIHR Dissemination Centre
A Cochrane review found that 24 out of 100 people who took paracetamol for regular tension-type headaches were pain free at two hours, compared with 19 out of 100 who took an inactive placebo.
There was no difference in risk of side effects between paracetamol and placebo.
From the NIHR Dissemination Centre
Progress report on the UK 5 year AMR strategy: 2015
The second annual progress report on the UK 5 year antimicrobial resistance (AMR) strategy including future plans.
Maternity Care Failing Some Disabled Women
Research published by Bournemouth University and commissioned by Birthrights highlights how maternity care may not be meeting the needs of some pregnant disabled women.
A survey of women with physical or sensory impairment or long term health conditions highlighted how – despite most women rating the support they received from maternity health carers positively – only 19% of women thought that reasonable adjustments or accommodations had been made for them. Some found birth rooms, postnatal wards and their maternity notes and scans “completely inaccessible”, while a quarter of women reported that they felt they were treated less favourably because of their disability. Most strikingly, more than half (56%) felt that health care providers did not have appropriate attitudes to disability.
A survey of women with physical or sensory impairment or long term health conditions highlighted how – despite most women rating the support they received from maternity health carers positively – only 19% of women thought that reasonable adjustments or accommodations had been made for them. Some found birth rooms, postnatal wards and their maternity notes and scans “completely inaccessible”, while a quarter of women reported that they felt they were treated less favourably because of their disability. Most strikingly, more than half (56%) felt that health care providers did not have appropriate attitudes to disability.
Improving the quality of diagnostic spirometry in adults
The Association for Respiratory Technology and Physiology (ARTP) and partner agencies have published Improving the quality of diagnostic spirometry in adults: the National Register of certified professionals and operators. This document, aimed at commissioners and providers of diagnostic spirometry, sets out a framework for assessing and certifying the competence of healthcare professionals and operators who perform and/or interpret diagnostic spirometry.
Anaesthetists and surgeons reach agreement on front of neck emergency techniques in life-threatening ‘CICO’ situations
A new research paper, jointly published today by the British Journal of Anaesthesia and Clinical Otolaryngology, recommends the scalpel-bougie cricothyroidotomy technique as the most efficient and reliable method of obtaining emergency front of neck access to the trachea in a situation where the patient’s airway is blocked and routine methods fail.
Monday, 19 September 2016
Systematic review of approaches to using patient experience data for quality improvement in healthcare settings
Explores how patient-reported experience measures (PREMs) are collected, communicated and used to inform quality improvement (QI) across healthcare settings.
BMJ Open 2016;6:e011907 doi:10.1136/bmjopen-2016-011907
Neuroimaging and outcome of isolated fetal ventriculomegaly
Journal of Maternal-Fetal and Neonatal Medicine. Conference: 25th European Congress of Perinatal Medicine Netherlands. Conference Start: 20160615 Conference End: 20160618. 29 (pp 252)
The study aim was to evaluate the fetal and postnatal neuroimaging and short term outcome in a cohort of isolated fetal ventriculomegaly in our hospital.
UHCW Research: Seso Blazic, Farrall Mukherjee and Satodia, P
Blood hyperlactaemia as a predictor of morbidity and mortality in infants with hypoxic ischaemic encephalopathy
Journal of Maternal-Fetal and Neonatal Medicine. Conference: 25th European Congress of Perinatal Medicine Netherlands. Conference Start: 20160615 Conference End: 20160618. 29 (pp 239-240)
Hypoxic ischaemic encephalopathy (HIE) remains a significant challenge with high levels of morbidity and mortality. Accurate prognostication remains difficult. Hyperlactaemia may offer a potential biomarker to predict short and long term mortality and morbidity. The aim of this study is to assess the relationship of blood hyperlactaemia with short and long term mortality and morbidity in infants with neonatal encephalopathy due to hypoxic ischaemic injury.
Hypoxic ischaemic encephalopathy (HIE) remains a significant challenge with high levels of morbidity and mortality. Accurate prognostication remains difficult. Hyperlactaemia may offer a potential biomarker to predict short and long term mortality and morbidity. The aim of this study is to assess the relationship of blood hyperlactaemia with short and long term mortality and morbidity in infants with neonatal encephalopathy due to hypoxic ischaemic injury.
UHCW Research: Panjwani Satodia
Personalised Hip Therapy: development of a non-operative protocol to treat femoroacetabular impingement syndrome in the FASHIoN randomised controlled trial
Br J Sports Med. 2016 Oct;50(19):1217-23. doi: 10.1136/bjsports-2016-096368.
Femoroacetabular impingement (FAI) syndrome is increasingly recognised as a cause of hip pain. As part of the design of a randomised controlled trial (RCT) of arthroscopic surgery for FAI syndrome, we developed a protocol for non-operative care and evaluated its feasibility.
UHCW Research: Hughes, I and Realpe, A
Femoroacetabular impingement (FAI) syndrome is increasingly recognised as a cause of hip pain. As part of the design of a randomised controlled trial (RCT) of arthroscopic surgery for FAI syndrome, we developed a protocol for non-operative care and evaluated its feasibility.
UHCW Research: Hughes, I and Realpe, A
Addition or Switch to Insulin Therapy in People Treated with GLP-1 Receptor Agonists: A Real World Study in 66,583 Patients
Diabetes Obes Metab. 2016 Sep 15. doi: 10.1111/dom.12790. [Epub ahead of print]
Aim: To evaluate the benefits of adding insulin therapy, or switching to insulin, in type 2 diabetes (T2DM) patients treated with Glucagon-like peptide-1 Receptor Agonist (GLP-1RA) with inadequately controlled hyperglycaemia.
Conclusion: Significant delay in intensification of treatment by addition of insulin is observed in patients with T2DM inadequately controlled with GLP-1RA. Earlier addition of insulin is associated with better glycaemic control, while switching to insulin is not clinically beneficial during 2 years of treatment. Non-responding patients on GLP-1RA would benefit by adding insulin therapy, rather than switching to insulin.
Aim: To evaluate the benefits of adding insulin therapy, or switching to insulin, in type 2 diabetes (T2DM) patients treated with Glucagon-like peptide-1 Receptor Agonist (GLP-1RA) with inadequately controlled hyperglycaemia.
Conclusion: Significant delay in intensification of treatment by addition of insulin is observed in patients with T2DM inadequately controlled with GLP-1RA. Earlier addition of insulin is associated with better glycaemic control, while switching to insulin is not clinically beneficial during 2 years of treatment. Non-responding patients on GLP-1RA would benefit by adding insulin therapy, rather than switching to insulin.
UHCW Research: Kumar S.
Outpatient endometrial ablation
Answer to the question, 'What is the evidence regarding the safety, and patient satisfaction of outpatient endometrial ablation (EA) techniques?' added to the RCOG Query Bank.
Postmenopausal thick endometrium
Answer to question, 'Are there guidelines for the management of a postmenopausal patient who has the incidental finding of thickened endometrium on ultrasound (i.e. a patient without complaint of bleeding or discharge)?' added to the RCOG Query Bank.
HRT and breastfeeding
Answer to the question, 'What advice can I give to a pregnant lady who asks about taking HRT and breastfeeding?' added to the RCOG Query Bank.
Does left ventricular diastolic dysfunction progress through stages? Insights from a community heart failure study
International Journal of Cardiology 221 (October 15, 2016) pp 850-854
We performed a retrospective pilot study on a group of symptomatic patients attending our community heart failure clinic with left ventricular diastolic dysfunction (LVDD), rising or elevated LV end diastolic pressure, elevated brain natriuretic peptide (BNP), but with no clinical or radiographic evidence of heart failure; a group we hypothesised may be in the pre-HFPEF stage. Those with LVEF >45% and LV diastolic dysfunction were included and divided into two groups: E/e' <15 and E/e' ≥15 corresponding with rising and raised LVEDP, respectively. Clinical events (deaths and hospital admissions) were compared at 1year and were grouped into all-cause events or cardiovascular events. The total numbers of all-cause and cardiovascular events of the individual groups and the entire cohort were assessed at 1year. Out of 584 screened, 80 patients were included. Thirty five patients had E/e' <15 and 45 had E/e' ≥15. At 1year follow-up the 1year all-cause events in the E/e' ≥15 group was higher compared to the E/e' <15 group (p=0.03). At 12months, in the entire cohort there were a total of 45 clinical events (39 hospital admissions and 6 deaths) out of which 20 events were cardiovascular. Patients in the pre-HFPEF stage had many events and those with elevated E/e' ≥15 had a poor 1year outcome. As this was strongly influenced by comorbidities we suggest close monitoring of these patients in dedicated HFPEF clinics along with vigorous management of comorbidities.
UHCW Research: Banerjee, Prithwish, Mustafa, Hanif Muhammad, Gani, Mohammed Akil, Fourali, Samih and Ali, Danish
Fetuin A is a Predictor of Liver Fat in Preoperative Patients with Nonalcoholic Fatty Liver Disease
Journal of Investigative Surgery 29(5) October 2016 pp. 266-274
Nonalcoholic fatty liver disease (NAFLD) and steatohepatitis (NASH) are frequent comorbidities in perioperative patients. However, the predictive role of the hepatokine fetuin A was not evaluated in this collective. To study fetuin A as predictor of NAFLD/NASH in preoperative patients. 58 subjects were included. Fetuin A was studied in patients undergoing open abdominal surgery and in a subset with acute liver failure. Blood and liver specimens were sampled. NAFLD was histologically evaluated. Liver fat was additionally analyzed by an enzymatic approach, circulating fetuin A by enzyme linked-immunosorbent assay, fetuin A mRNA by reverse-transcription PCR. Univariate correlation studies linked fetuin A to liver steatosis (r = 0.40, p = .029) and hepatocellular ballooning degeneration (r = 0.34, p = .026). Compared to non-NAFLD subjects fetuin A was increased in NAFLD (p = .009) and in NASH (p = .029). However, when corrected for main confounders by linear modeling, fetuin A remained related to hepatic steatosis, but not to ballooning degeneration or other NAFLD features. In support of this, biochemically analyzed liver lipids correlated with fetuin A in plasma (r = 0.34, p = .033) and with hepatic fetuin A mRNA (r = 0.54, p < .001). In addition, plasma fetuin A was related to hepatic mRNA (r = 0.32, p = .036), while circulating levels were reduced by 64% with acute liver failure (p < .001), confirming the liver as main fetuin A source. Fetuin A is suggested as noninvasive biomarker of hepatic steatosis in preoperative settings.
UHCW Research: Weickert, M O
Nonalcoholic fatty liver disease (NAFLD) and steatohepatitis (NASH) are frequent comorbidities in perioperative patients. However, the predictive role of the hepatokine fetuin A was not evaluated in this collective. To study fetuin A as predictor of NAFLD/NASH in preoperative patients. 58 subjects were included. Fetuin A was studied in patients undergoing open abdominal surgery and in a subset with acute liver failure. Blood and liver specimens were sampled. NAFLD was histologically evaluated. Liver fat was additionally analyzed by an enzymatic approach, circulating fetuin A by enzyme linked-immunosorbent assay, fetuin A mRNA by reverse-transcription PCR. Univariate correlation studies linked fetuin A to liver steatosis (r = 0.40, p = .029) and hepatocellular ballooning degeneration (r = 0.34, p = .026). Compared to non-NAFLD subjects fetuin A was increased in NAFLD (p = .009) and in NASH (p = .029). However, when corrected for main confounders by linear modeling, fetuin A remained related to hepatic steatosis, but not to ballooning degeneration or other NAFLD features. In support of this, biochemically analyzed liver lipids correlated with fetuin A in plasma (r = 0.34, p = .033) and with hepatic fetuin A mRNA (r = 0.54, p < .001). In addition, plasma fetuin A was related to hepatic mRNA (r = 0.32, p = .036), while circulating levels were reduced by 64% with acute liver failure (p < .001), confirming the liver as main fetuin A source. Fetuin A is suggested as noninvasive biomarker of hepatic steatosis in preoperative settings.
UHCW Research: Weickert, M O
Amnioinfusion for meconium in liquor
Answer to the question, 'What is the role of amnioinfusion in meconium in liquor and cardiotocography (CTG) abnormalities in labour?' added to the RCOG Query Bank.
Meconium and length of labour
Answer to the question, 'At term for thick meconium stained liquor is there a relation between duration of labour and fetal outcomes e.g. Meconium aspiration syndrome?', added to the RCOG Query Bank.
Guidance on inter-departmental dispatch of cellular pathology material for referral and clinical trials
New guidance from the Royal College of Pathologists relating to the referral of cellular pathological specimens (including cytopathologicaland post-mortem specimens) for specialist opinions for the benefit of the patient, for clinical trials and
for some research work in the context of the UK National Health Service.
Tackling bullying and harassment in the NHS
NHS Employers has produced a new podcast, the first in a two-part series, discussing bullying and harassment in the NHS.
In the first edition Bernadette El-Hadidy, NHS Employers' London area head of engagement, talks to Jon Restell, Jon Lenney and Dr Madeline Carter to find out what the issues are and how we can tackle them.
In the first edition Bernadette El-Hadidy, NHS Employers' London area head of engagement, talks to Jon Restell, Jon Lenney and Dr Madeline Carter to find out what the issues are and how we can tackle them.
SMI B 60: Detection of bacteria with carbapenem hydrolysing β lactamases (carbapenemases)
UK Standards for Microbiology Investigations B 60: Detection of bacteria with carbapenem hydrolysing β lactamases (carbapenemases).
Sepsis Toolkit
This sepsis toolkit from the Royal College of General Practitioners provides a collection of tools, knowledge, and current guidance to support the identifying and appropriate management of patients with sepsis.
It is aimed at GPs and healthcare professionals assessing people in the community with acute infection. The resources also include information for patients and those close to them to look for when concerned about a sudden deterioration in a person's health in the presence of infection
It is aimed at GPs and healthcare professionals assessing people in the community with acute infection. The resources also include information for patients and those close to them to look for when concerned about a sudden deterioration in a person's health in the presence of infection
NHS Indicators: England, September 2016
House of Commons briefing paper on NHS Indicators for September 2016.
Number of written complaints about NHS falls by 4 per cent
Data on Written Complaints in the NHS 2015-16 from NHS Digital contains new details on who complained; what the complaints were about; where they were made; and whether the complaints were upheld.
There were 198,739 written complaints received over the last financial year(2) - the equivalent of around 544 per day - which was 8,668 (4.2 per cent) fewer than in 2014-15.
There were 198,739 written complaints received over the last financial year(2) - the equivalent of around 544 per day - which was 8,668 (4.2 per cent) fewer than in 2014-15.
Thursday, 15 September 2016
Health and Care Innovation Expo 2016
Simon Stevens used his keynote address to update Expo audiences on various key delivery programmes, including an expansion of the NHS Diabetes Prevention Programme (DPP), designed to help people at risk of Type 2 Diabetes, to 17 additional areas across the country, and for the first time, a digital DPP, enabling more individuals to get the kind of support and education they need to prevent this avoidable and high cost condition.
In his keynote speech, Health Secretary Jeremy Hunt outlined measures to create “smartphone-ready” services in a new NHS technology drive.
In his keynote speech, Health Secretary Jeremy Hunt outlined measures to create “smartphone-ready” services in a new NHS technology drive.
CQC launches an updated code of practice on confidential personal information
The code explains how CQC makes decisions relating to people’s confidential personal information. This includes how we decide whether we need to look at medical or care records during an inspection, and whether we need to share personal information that we hold.
We need patients and the public to shape local health plans, say NHS leaders
Patients and the public across England are set to be asked to help the local NHS make decisions about how best to develop services.
The NHS in England is today (Thursday) publishing national advice for local health and social care leaders preparing what are known as local Sustainability and Transformation Plans (STPs).
Local plans for local people:communicating change - NHS Confederation
NHS England have produced a guide for local areas to use, which is intended to support them in involving and engaging with local people in the development of Sustainability and Transformation Plans (STPs).
‘Engaging local People’ is specifically aimed at STP communications leads and footprint leaders and also clarifies the level of patient and public participation expected of STP.
‘Engaging local People’ is specifically aimed at STP communications leads and footprint leaders and also clarifies the level of patient and public participation expected of STP.
CQC - Our review of how NHS trusts investigate and learn from deaths
We're looking at how NHS acute, community healthcare and mental health trusts investigate deaths and learn from their investigations. We also want to assess whether opportunities to prevent deaths have been missed.
Receive an alert when this report is published.
We aim to publish our findings in December.
NIHR Signal Paracetamol is a weak painkiller for regular tension headaches
Paracetamol is only slightly more effective than dummy tablets (placebo) at relieving pain in people who experience regular tension-type headaches.
A Cochrane review found that 24 out of 100 people who took paracetamol for regular tension-type headaches were pain free at two hours, compared with 19 out of 100 who took an inactive placebo.
A Cochrane review found that 24 out of 100 people who took paracetamol for regular tension-type headaches were pain free at two hours, compared with 19 out of 100 who took an inactive placebo.
NICE advice [MIB80]: FLEXISEQ for osteoarthritis
NICE has developed a medtech innovation briefing (MIB) on FLEXISEQ for osteoarthritis.
The technology described in this briefing is FLEXISEQ, a topically applied drug-free gel indicated for treating the symptoms of osteoarthritis. A potential innovative aspect is that it is described as having a novel, physical mode of action and contains no active drug. It consists of an aqueous gel containing hydrophilic, nanoscale lipid vesicles made from phospholipid bilayer (Sequessome vesicles), which are designed to pass through the skin into the joint. FLEXISEQ is regulated as a medical device.
The technology described in this briefing is FLEXISEQ, a topically applied drug-free gel indicated for treating the symptoms of osteoarthritis. A potential innovative aspect is that it is described as having a novel, physical mode of action and contains no active drug. It consists of an aqueous gel containing hydrophilic, nanoscale lipid vesicles made from phospholipid bilayer (Sequessome vesicles), which are designed to pass through the skin into the joint. FLEXISEQ is regulated as a medical device.
NIHR Signal “Triptans” can relieve migraines in children and adolescents
Triptans, a migraine medication, relieve migraine headache completely within two hours compared to placebo. Ibuprofen was also effective but less well studied. This review was also reassuring in that any side effects of treatment were mild.
Most evidence identified in this Cochrane review was for sumatriptan, a commonly prescribed treatment for adults, compared to placebo or dummy pills. A few studies examined other triptans or other painkillers, such as ibuprofen or paracetamol against placebo in children and adults.
Most evidence identified in this Cochrane review was for sumatriptan, a commonly prescribed treatment for adults, compared to placebo or dummy pills. A few studies examined other triptans or other painkillers, such as ibuprofen or paracetamol against placebo in children and adults.
NICE advice [MIB79]: VitalPAC for assessing vital signs of patients in hospital
NICE has developed a medtech innovation briefing (MIB) on VitalPAC for assessing vital signs of patients in hospital.
The technology described in this briefing is the VitalPAC mobile clinical software system. It analyses manually entered, or samples automatically captured, patient vital sign data to identify deterioration in a patient’s health. The software operates on the Apple iPod touch, iPad and iPhone and is designed to integrate with hospital clinical systems.
The technology described in this briefing is the VitalPAC mobile clinical software system. It analyses manually entered, or samples automatically captured, patient vital sign data to identify deterioration in a patient’s health. The software operates on the Apple iPod touch, iPad and iPhone and is designed to integrate with hospital clinical systems.
What do people think about proposed patient data standards?
The Government has been consulting on new standards to strengthen the security of patient information and to help people make informed choices about how their data is used.
To help with our response to this consultation, we collected people’s views on some of the broad principles behind the proposals. Find out what people said and download our consultation response.
To help with our response to this consultation, we collected people’s views on some of the broad principles behind the proposals. Find out what people said and download our consultation response.
TUC congress: Raise awareness about invisible impairments, says CSP
Employers need a better understanding of how ‘hidden conditions’ such as dyslexia, arthritis and mental illness can affect staff.
This was one of the messages from the CSP in a motion raised at the TUC conference in Brighton on 13 September. Speaking on behalf of the society, Alex Mackenzie, who chairs the CSP's national group of regional stewards, told delegates that ‘invisible’ impairments could take many forms.
This was one of the messages from the CSP in a motion raised at the TUC conference in Brighton on 13 September. Speaking on behalf of the society, Alex Mackenzie, who chairs the CSP's national group of regional stewards, told delegates that ‘invisible’ impairments could take many forms.
TUC congress: Safeguard the NHS by increasing investment and pay for staff, says CSP
Speaking at the TUC conference in Brighton on 13 September, CSP director Claire Sullivan moved a motion that highlighted risks to the sustainability of the NHS.
She told delegates that the health service was experiencing an ever-worsening financial situation. The CSP motion said NHS England was facing a deficit of £550 million by the end of this financial year.
She told delegates that the health service was experiencing an ever-worsening financial situation. The CSP motion said NHS England was facing a deficit of £550 million by the end of this financial year.
Call for political parties to address the increasing demands of an ageing healthcare workforce
The single biggest challenge facing the NHS is to respond to the vastly increased demands of an ageing patient population and workforce, says an editorial accompanying a new report, Age and the Anaesthetist to be presented today at the AAGBI’s Annual Congress meeting in Birmingham, by the report’s working party Chair, Professor Peter Hutton.
Nine per cent in England have diabetes
New data from PHE reveals 3.8 million people in England aged over 16 had diabetes in 2015, around 9% of the adult population.
The new Diabetes Prevalence Model, produced by the Public Health England (PHE) National Cardiovascular Intelligence Network (NCVIN) and launched today at the PHE Conference at Warwick University, estimates the total number of adults with both Type 1 and Type 2 diabetes in England.
WHO - Women’s Health And Well-Being In Europe: Beyond The Mortality Advantage
Women are in focus as the 66th session of the Region Committee considers a strategy for women’s health and well-being in Europe. This report supports the strategy with key facts about women’s health and well-being in different parts of the region, it shows the impact of gender based inequalities interacting with social, economic and environmental determinants and it looks at the how people-centered health systems can respond to women’s needs across the life-course.
Birds of a feather: an uncommon cause of pneumonia and meningoencephalitis.
BMJ Case Rep. 2016 Sep 12;2016
A 61-year-old man was admitted with a 1-week history of influenza-like symptoms during a period of increased influenza virus activity. He soon developed type 2 respiratory failure and became increasingly drowsy. He later suffered a convulsive episode in the intensive care unit (ICU) which self-terminated. Initial clinical findings suggested community-acquired pneumonia and meningoencephalitis. However, a detailed history revealed that he was a pet bird-keeper, which raised a suspicion of ornithosis. Chlamydia psittaci DNA was detected in sputum by PCR. He was started on appropriate antibiotics and made a full recovery. We present this uncommon cause of pneumonia as an example of the importance of accurate history-taking to ensure a correct diagnosis for optimal management.
UHCW Research: Ionescu AM, Khare D, Kavi J
Four Case Studies To Explore The Added Value Of Oxford Academic Health Science Network (AHSN)
Office of Health Economics (OHE) -
The Oxford AHSN commissioned OHE Consulting and RAND Europe to explore the value of the various projects and programmes that the network has developed and implemented since it was established in 2013. In order to do this four case study projects were analysed: anxiety and depression clinical network; maternity clinical network; energy project; and intermittent pneumatic compression. The four case studies were chosen as examples of areas in which the Oxford AHSN has played a crucial role in improving patient care, and areas in which analysis of added value is feasible.
The Oxford AHSN commissioned OHE Consulting and RAND Europe to explore the value of the various projects and programmes that the network has developed and implemented since it was established in 2013. In order to do this four case study projects were analysed: anxiety and depression clinical network; maternity clinical network; energy project; and intermittent pneumatic compression. The four case studies were chosen as examples of areas in which the Oxford AHSN has played a crucial role in improving patient care, and areas in which analysis of added value is feasible.
NHS Improvement: Provider bulletin: 14 September 2016
This fortnightly newsletter is sent to NHS trust and foundation trust chairs, chief executives, finance, medical and nursing directors, and foundation trust board secretaries.
Latest pharmacological technology briefings now available
Our latest batch of briefings on pharmacological technologies in development is now available. These include briefings in the following specialties:
Cancer
Cancer
- ATIR101
- Carfilzomib (Kyprolis) in combination with Melphalan and Prednisone
- Dabrafenib (Tafinlar) with trametinib (Mekinist)
- Nivolumab (Opdivo )
New £816 million investment in health research
Leading NHS clinicians and universities will benefit from new world class facilities and support services built by the 5-year funding package totalling £816 million – the largest ever investment into health research.
Mental health research will see funding increase to nearly £70 million, dementia to over £45 million, deafness and hearing problems will receive over £15 million and antimicrobial resistance research rises to around £45 million.
Health Secretary Jeremy Hunt said:
Mental health research will see funding increase to nearly £70 million, dementia to over £45 million, deafness and hearing problems will receive over £15 million and antimicrobial resistance research rises to around £45 million.
Health Secretary Jeremy Hunt said:
RCOphth host refractive surgery engagement days for public and industry
Following on from work on standardised patient information and professional standards in refractive surgery, RCOphth are inviting both industry and members of the public to discuss, at an early stage, the feasibility of addressing two additional goals for UK refractive surgery: A national data set As electronic patient record systems become more widespread in refractive surgery...
Philip Dunne MP responds to Parliamentary question on refractive surgery
The Royal College of Ophthalmologists was mentioned in the response by Mr Dunne, ‘As the professional body for setting the standards of practice for refractive procedures, The Royal College of Ophthalmologists are leading on work to improve the delivery, safety and standards for patient information for laser eye surgery. The GMC expect a doctor to be up to date with the latest medical guidance, including any new guidance published by the Royal College of Ophthalmologists on laser eye surgery.’
Next steps to meeting new national standards – Congenital Heart Disease
Will Huxter's latest blog about the CHD implementation programme.
He will be using this blog to keep everyone up-to-date with activities during the pre-consultation and consultation period on proposals for meeting the national standards on CHD, so if you want to receive a blog alert...
Two million+ records in the National Joint Registry provides a rich dataset for joint replacement surgery – Martyn Porter
Established in 2002, The National Joint Registry (NJR) ensures that the most robust evidence is available to monitor the performance of implants, the effectiveness of different types of surgery and to improve clinical standards – all with an absolute focus on patient outcomes. For example, over the life of the registry several orthopaedic implants have been identified as having potentially worse than expected performance when compared to similar devices.
Tuesday, 13 September 2016
Authentication and characterisation of a new oesophageal adenocarcinoma cell line: MFD-1
Scientific Reports 6, Article number: 32417 (2016). doi:10.1038/srep32417
New biological tools are required to understand the functional significance of genetic events revealed by whole genome sequencing (WGS) studies in oesophageal adenocarcinoma (OAC). The MFD-1 cell line was isolated from a 55-year-old male with OAC without recombinant-DNA transformation. Somatic genetic variations from MFD-1, tumour, normal oesophagus, and leucocytes were analysed with SNP6. WGS was performed in tumour and leucocytes. RNAseq was performed in MFD-1, and two classic OAC cell lines FLO1 and OE33. Transposase-accessible chromatin sequencing (ATAC-seq) was performed in MFD-1, OE33, and non-neoplastic HET1A cells. Functional studies were performed. MFD-1 had a high SNP genotype concordance with matched germline/tumour. Parental tumour and MFD-1 carried four somatically acquired mutations in three recurrent mutated genes in OAC: TP53, ABCB1 and SEMA5A, not present in FLO-1 or OE33. MFD-1 displayed high expression of epithelial and glandular markers and a unique fingerprint of open chromatin. MFD-1 was tumorigenic in SCID mouse and proliferative and invasive in 3D cultures. The clinical utility of whole genome sequencing projects will be delivered using accurate model systems to develop molecular-phenotype therapeutics. We have described the first such system to arise from the oesophageal International Cancer Genome Consortium project.
UHCW Research: OCCAMS consortium (Shamila Sothi & Sari Suortamo)
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