Reading Well to improve your mental wellbeing

A series of free books to help people to improve their mental wellbeing are now available in libraries across Cumbria.

The books, published under a series called Reading Well, are aimed at adults experiencing common mental health problems have been endorsed by health professionals in partnership with Cumbria County Council Library Services.

Social care and the mental health forward view: ending out of area placements

This is the first in a series of briefings focusing on mental health and social care and it focuses on the human and operation costs of out of area placements. Using perspectives and experiences from Bradford Metropolitan District Council, it highlights how out of area placements and use of local private sector hospitals can be reduced.

• Briefing

FREED: A new, early intervention service for young adults with eating disorders

A trial which aims to ensure that young adults with eating disorders receive help and treatment sooner has launched in Leeds.

The Yorkshire Centre for Eating Disorders, run by Leeds and York Partnership NHS Foundation Trust, is one of only four sites in the country, and the first outside of London, to be involved in the national FREED study.

It went live in January, in association with South London and Maudsley NHS Foundation Trust (SLaM), the Health Foundation, and the Institute of Psychiatry, Psychology and Neuroscience, where the team is being led by Ulrike Schmidt.

FREED stands for ‘First Episode and Rapid Early Intervention Service for Young Adults with Eating Disorders’ and is for young people aged 18 to 25 who have developed an eating disorder within the last three years.

Dementia Friendly Dentistry in Cheshire and Merseyside

A review of dental service provision for people living with dementia in north Merseyside undertaken in 2014-15, highlighted a number of issues with access to dental services and dental care provision from the perspective of patients, carers and clinicians.

‘Dementia Friendly Dentistry’ was consequently identified as a priority for the NHS England (Cheshire and Merseyside) Commissioners and the Local Dental Networks and work of on the Dementia Friendly Dentistry programme has been continuing since 2015.

Diagnosing well – Memory Matters

Memory matters team receive recognition for innovative approach. The Memory and Later Life service at Cumbria Partnership NHS Foundation Trust (CPFT) based in Carlisle has been recognised for ‘Diagnosing Well’ at the 2017 Dementia Quality Improvement Awards, securing the runner up position.

Getting patients home for lunch

Getting patients home for lunch Sent in partnership with Cumbria County Council.

A drive to get people who are ready to leave hospital home in time for lunch is proving beneficial for patients and the local health system.

Cumbria Partnership NHS Foundation Trust (CPFT) has recently renewed a drive to get patients home from hospital in time for lunch and it’s showing great results.

53% of patients who left CPFT inpatient wards in February did so before lunch, compared to a national target of 33%.

The number of patients leaving before lunch has been steadily increasing and remained above the national target since July 2016.

Ward staff are working with teams in the community, partner organisations, patients and their families to get patients home as soon as it is safe to do so with the right support in place.

Read more HERE

Dream Placement recruitment initiative

A group of students from across Cumbria had a unique opportunity to spend a week behind the scenes of the NHS during their Dream Placement over half term.

Nine students were selected to complete a one week placement in one of three NHS Trusts; Cumbria Partnership NHS Foundation Trust (CPFT), University Hospitals of Morecambe Bay and North Cumbria University Hospitals. Students Hannah Young from The Nelson Thomlinson School, Holly Currie from Trinity School and Sophie Anderson from Caldew School spent the week with CPFT and all have aspirations of careers in clinical roles.

Read more NHS Dream Placement inspires the next generation

People with learning disabilities facing long waits for care reviews

Public accounts committee finds just 39% of learning disability inpatients received care and treatment reviews within six months.

Health services are struggling to deliver care reviews designed to make sure learning disabled people are not being inappropriately kept in hospital units, a group of MPs has warned.

The public accounts committee found just 39% of the estimated 2,500 patients affected had received care and treatment reviews within the six month timescale stipulated by NHS England policy. One in five who were in hospital as of February 2017 had received no review at all, although this had improved from 47% in January 2016.

Towards Interventions Across the Autism Spectrum

In recognition of Autism Awareness Month, NIMH’s efforts at improving understanding of autism spectrum disorder (ASD) and developing effective interventions and supports for individuals with ASD are discussed. ASD describes a heterogeneous group of conditions that share several core features, including difficulties with social communication and repetitive behaviors. This article looks at what NIMH are learning through research and what they are doing to try to find out more.

Four projects testing innovations to improve care for older people

Four projects, funded through The Health Foundation's Innovation for Improvement programme, are using new and interesting approaches to improve care for older people. Some of these projects are at the early stages of their development but have promising ways to improve care.

‘Ultimate’ guide for pharmacists working in urgent and emergency care

The Royal Pharmaceutical Society has published what it calls the ultimate guide for pharmacists working in or with urgent and emergency care.

Latest NHS sickness absence figures - December 2016

The latest figures released by the NHS Digital show that NHS staff sickness absence has increased from 4.39 per cent in December 2015 to 4.55 per cent in December 2016.

Nationally Contracted Products (NCP) programme: blunt-filled drawing up devices

NHS Improvement have launched the Nationally Contracted Products Programme (NCP), which aggregates national demand in order to purchase products on behalf of the whole of the NHS to deliver savings.

The latest products in the programme are blunt-filled drawing up devices.

Risk of associating ECG records with wrong patients

This patient safety alert has been issued following a recently reported patient safety incident where the ‘copy’ button had been pressed on the ECG machine in error instead of the ‘auto/start’ button.

This resulted in a copy of the previous patients’ ECG results being re-printed; staff did not immediately realise the error and labelled the ECG record incorrectly with the new patient’s identifiers. As a result, the patient underwent an unnecessary procedure and had a further complication.

Tackle poverty, improve mental health

Mental health discourse welcomed an unexpected participant this month. Prince Harry, the fifth in line to the throne, spoke publicly about seeking counselling following his mother’s sudden death in his pre-teen years. Rightly, mental health charities praised his intervention, highlighting as it did that even extreme privilege cannot shelter us from depression, anxiety or any other psychiatric illness. Our bodies are fragile, and our minds equally so: this message is increasingly accepted as people with mental health problems, campaigners and medics alike have fought to end stigma by building a national conversation on mental health, but we also need to tackle poverty.

Confidentiality: good practice in handling patient information

This guidance sets out the principles of confidentiality and respect for patients’ privacy that all doctors are expected to understand and follow. It also sets out the responsibilities of doctors for managing and protecting patient information.

• Guidance

GPhC launches consultation on revalidation

The General Pharmaceutical Council has launched a consultation on proposals to introduce revalidation for pharmacy professionals. 

The proposals have been developed through three years of research and development in collaboration with pharmacy professionals and involving members of the public. 

Assessing user acceptance towards automated and conventional sink use for hand decontamination using the technology acceptance model

Ergonomics. 2017 Apr 24:1-13. doi: 10.1080/00140139.2017.1316018. [Epub ahead of print]

The need to facilitate timely, effective hand hygiene to prevent illness has led to a rise in automated handwashing systems across different contexts. User acceptance is a key factor in system uptake. This paper applies the technology acceptance model as a means to explore and optimise the design of such systems.

UHCW Research: C. H. Dawson

DH publishes response to 'safe space'

The Department of Health (DH) has published a response to the providing a 'safe space' in healthcare safety investigations consultation.

The response outlines feedback received and next steps:

• The new Healthcare Safety Investigation Branch (HSIB) is expected (from 1 April 2017) to conduct investigations using the safe space principles set out in the NHS Trust Development Authority (Healthcare Safety Investigation Branch) Directions 2016.
• In the absence of legislation, the DH is currently unable to subject disclosure of material under HSIB investigations to a general prohibition. The government remains open to considering the option of legislation in the future.
• Only when 'safe space' has been tested and works effectively at a national level, will the DH consider extending 'safe space' to investigations undertaken by on behalf of commissioners and providers of NHS funded services. The DH has outlined three conditions for extension, one of which would be going out to further consultation.

Sciana – New European health leaders network launched

The Sciana network, which will have its first meeting in Salzburg this week (26-29 April 2017), is an international collaboration between the Health Foundation, Careum Stiftung and the Robert Bosch Stiftung, and delivery partner Salzburg Global Seminar. It will see outstanding leaders in health and health care policy work together over the next two years to find solutions to shared challenges being faced in health and health care across Europe.

Advanced clinical practice apprenticeship is on the cards

The government has given the green light to plans for an advanced clinical practice (ACP) apprenticeship.

The future of HIV services in England

This report explores the challenges and opportunities facing HIV services in four areas in England, and makes recommendations on future development to those in national and local leadership roles.

New DBS check eligibility tool

This new DBS check eligibility tool from NHS Employers has been designed to:

• help HR practitioners determine whether a DBS check is required for a particular post 
• provide clarity on the level of check required 
• help to speed up the recruitment process
• help HR practitioners comply legally
• signpost HR to further useful resources.

New report shows rise in emergency hospital admissions for young children

A new report published by the Nuffield Trust and the Health Foundation has found that the number of babies and young children admitted to hospital in an emergency has grown by almost a third over the past decade, and many children are being admitted to hospital for conditions like asthma and tonsillitis – admissions that could potentially have been avoided with better care and support out of hospital.

How Poor Sleep Hinders Those With Anxiety & Depression

Sleep deficits can make focusing, finishing assignments, and coping with everyday stress seem daunting. To make matters worse, people with anxiety and depression often have sleep problems.

To date, little has been known about whether or how their poor sleep affects a specific region of the brain known to be involved in regulating negative emotional responses. But a new study from the University of Illinois at Chicago College of Medicine finds that the dorsal anterior cingulate cortex may have to work harder to overcome negative emotional responses in people with poor sleep who have depression or anxiety.

The grief can damage your mental health

Survivors say the pain of bereavement can easily push people into mental illness without proper support. Read more here about bereavement survivor groups and coping strategies.

Growing body of evidence supports use of mind-body therapies in breast cancer treatment

In newly updated clinical guidelines, researchers analyzed which integrative treatments are most effective and safe for patients with breast cancer. This systematic review adds to the growing literature on integrative therapies for patients with breast cancer and other cancer populations.

The impact of housing problems on mental health

This report reveals that over the last five years one in five adults suffer mental health problems due to housing pressures. The research also surveyed the experiences of 20 GPs who highlighted the number of patients diagnosed with anxiety or depression directly due to housing issues and that GPs required greater help to support patients with housing problems.

• Report

Patient death reveals 'no coordination' between mental health services

A coroner has raised concerns about the lack of coordination in mental health services for young people in Birmingham, after a patient under NHS care was found hanged. Read more HERE (subscription to HSJ required)

Four ways GP practices can become dementia friendly

Find out how one local Healthwatch has been showing GP practices how small changes can make a big difference to dementia patients’ experiences of visiting the doctor.

Differences in managing a 'significant polyp' which may harbour a cancer detected at bowel screening or in symptomatic patients: The significant polyp and early colorectal cancer (SPECC) program initial findings

Colorectal Disease. Conference: 11th Scientific andAnnual Meeting of the European Societyof Coloproctology. Italy. Conference Start: 20160928. Conference End:20160930. 18 (pp 75), 2016. Date of Publication: September 2016.

The benign to malignant polyp spectrum has been developed into a concept 'SignificantPolypEarlyColorectalCancer' (SPECC) with an English national MDT development program to improve diagnosis and treatment. The management of SPECC lesions within the Bowel Cancer Screening Programme (BCSP) compared with SPECC presenting in symptomatic patients (SP) is reported.

UHCW Research: Ward, S. T. and McCullough P.

Effect of endometrial injury on reproductive outcome in assisted reproduction: An observational study

Human Reproduction. Conference: 32nd Annual Meeting of the European Society of Human Reproduction and Embryology. Finland. Conference Start: 20160703. Conference End: 20160706. 31 (pp i284), 2016. Date of Publication: July 2016.

To analyse the effect of endometrial injury before IVF or ICSI on clinical pregnancy outcome. Summary answer: Endometrial scratching performed before IVF/ICSI increased clinical pregnancy outcome in the second attempt of IVF/ICSI, unlike overall comparison.

UHCW Research: Garg N.; Harthshone G.; Ghobara T.; Rai J.; Keay S.; Agarwal R.

Presenting ADAMTS13 antibody and antigen levels correlate with clinical course and prognosis in immune-mediated thrombotic thrombocytopenic purpura

British Journalof Haematology. Conference: 57th Annual Scientific Meeting of the BritishSociety for Haematology. United Kingdom. Conference Start: 20170327.Conference End: 20170329. 176 (pp 30), 2017. Date of Publication:March 2017.

Immune-mediated Thrombotic Thrombocytopenic Purpura (TTP) is a life-threatening disorder caused by antibodies directed against the von Willebrand factor cleaving protein ADAMTS13. Since 2009, the United Kingdom TTP registry has been collecting information on acute presentations of TTP. We undertook a prospective study investigating the impact of the presenting anti-ADAMTS13 IgG antibody level and ADAMTS13 antigen on mortality

UHCW Research: Chapman, O.

Long-term outcome of traumatic brain injury patients managed at a major trauma centre in England.

British Journalof Neurosurgery. Conference: 2016 Autumn Meeting of the Society ofBritish Neurological Surgeons, SBNS 2016. United Kingdom. Conference Start:20160921. Conference End: 20160923. 30 (5) (pp 503), 2016. Date ofPublication: 2016.

UHCW is the second busiest Major Trauma Centre in England according to TARN (Trauma Audit and Research Network). Managing patients with traumatic brain injury (TBI) constitutes a significant proportion of the workload. The objective of our study was to document the management and the long term outcome of TBI patients admitted to UHCW.

UHCW Research Talibi S., Land T. , McCullagh, C. Dardis R. and Siddique S.

Injuries in extreme sports

Journal of Orthopaedic Surgery & Research (J ORTHOP SURG RES), 4/18/2017; 12: 1-8. (8p)

Extreme sports (ES) are usually pursued in remote locations with little or no access to medical care with the athlete competing against oneself or the forces of nature. They involve high speed, height, real or perceived danger, a high level of physical exertion, spectacular stunts, and heightened risk element or death. Popularity for such sports has increased exponentially over the past two decades with dedicated TV channels, Internet sites, high-rating competitions, and high-profile sponsors drawing more participants. Recent data suggest that the risk and severity of injury in some ES is unexpectedly high. Medical personnel treating the ES athlete need to be aware there are numerous differences which must be appreciated between the common traditional sports and this newly developing area. These relate to the temperament of the athletes themselves, the particular epidemiology of injury, the initial management following injury, treatment decisions, and rehabilitation. The management of the injured extreme sports athlete is a challenge to surgeons and sports physicians. Appropriate safety gear is essential for protection from severe or fatal injuries as the margins for error in these sports are small. The purpose of this review is to provide an epidemiologic overview of common injuries affecting the extreme athletes through a focus on a few of the most popular and exciting extreme sports.

UHCW Research: Lior Laver

Reward in the NHS newsletter - April 2017

The first edition of NHS Employers' pay and reward newsletter is now available to download. It features the latest pay and reward news, developments and expert insight, including:

• the 1 per cent pay increase
• NHS Pension Scheme administration levy
• tax-free childcare
• changes to salary sacrifice
• Total Reward and annual benefit statements
• changes to the cash floor for some Foundation Year 2 doctors
• our latest resources to help you and your organisation.

Updated version of 2016 TCS for doctors and dentists in training

Amended version of the terms and conditions of service (TCS) for NHS doctors and dentists in training from NHS Employers.

A&E departments to get more funding

The Department of Health has today (21 April 2017) announced the allocation of £55.98 million of the £100 million A&E capital funding, outlined in the spring Budget by the Chancellor, to ease pressure on emergency departments in time for next winter.

Implementing shared decision making in the NHS: lessons from the MAGIC programme

This review summarises the MAGIC programme for adopting shared decision making, and details the common challenges associated with implementation. Key messages include the fact that skills and attitudes are more valuable than specific tools, and that organisation support is vital

BMJ 2017;357:j1744

Local Tariff Variation and Ophthalmology Commissioning

The Royal College of Ophthalmologists (RCOphth) has been working with NHS England to promote the local tariff variation option for ophthalmology. NHS England is highlighting this to all CCGs and RCOphth is publishing Local Tariff Variation and Ophthalmology Commissioning to help those who wish to consider future changes to their local tariff structure.

Integration and the development of the workforce

This working paper from Skills for Health reveals how integration of the fields of health and social care will require organisations to break down traditional barriers in how care is provided. It details how workforce development plays a crucial role in successful integration. Please note that free registration is required in order to download this publication.

Combatting antimicrobial resistance Educational approaches for the responsible prescribing of antimicrobials

This report presents the results of survey of higher education institutions about the extent to which antimicrobial prescribing and stewardship competencies have been embedded into their curricula. It also sets out recommendations for HEE, employers and healthcare providers to ensure that staff are well-trained in how to combat antimicrobial resistance.

Exploring surface cleaning strategies in hospital to prevent contact transmission of methicillin-resistant Staphylococcus aureus

This research article concludes that daily whole room cleaning, even with 100% cleaning efficiency, provides limited reduction in the number of MRSA transmitted to susceptible patients via the contact route; and should be supplemented with frequent targeted cleaning of high-touch surfaces, such as by a wipe or cloth containing disinfectant.
BMC Infectious Diseases201717:85. DOI: 10.1186/s12879-016-2120-z

Short-Course Radiation plus Temozolomide in Elderly Patients with Glioblastoma

This piece of research has led to a Practice Changing Update on DynaMed Plus. It concludes that in elderly patients with glioblastoma, the addition of temozolomide to short-course radiotherapy resulted in longer survival than short-course radiotherapy alone.

N Engl J Med. 2017 Mar 16;376(11):1027-1037. doi: 10.1056/NEJMoa1611977.

Obtain the full-text from the library.

Kissing Goodbye Sepsis at James Paget University Hospital

Case study from James Paget University about reducing length of stay for septic patients.

Ambulatory emergency care: reimbursement under the national tariff

This HFMA briefing aims to create a better understanding of the current approaches taken to the recording and reimbursement of ambulatory care. HFMA surveyed its members to establish some basic benchmarking information to see how the guidance is currently applied.

Giving antibiotics immediately reduces deaths from sepsis

Giving immediate antibiotics (defined as within one hour) when people present to emergency departments with suspected sepsis reduces their risk of dying by a third compared with later administration.

From the NIHR Dissemination Centre

Antimicrobial Resistance: resource handbook

This handbook from Public Health England collates national resources on antimicrobial resistance, antimicrobial stewardship and infection prevention and control.

Age And Utilities: Issues For HTA

This paper from the Office of Health Economics investigates whether and how age affects respondents’ Time Trade-Off (TTO) and Visual Analogue Scale valuations of hypothetical EQ-5D health states using data from the 1993 MVH UK valuation study. 

A key finding is the existence of an inverse U-shaped age-utility pattern, with respondents in their forties tending to provide the highest TTO values, and the oldest respondents valuing health profiles systematically (and significantly) lower than younger age groups. This trend is particularly visible for profiles describing problems in the mobility or the self-care dimensions.

Seven day hospital services: improving weekend care

Watch NHS improvement's new video ‘Challenging poorer weekend care' featuring NHS staff sharing their stories about how they've improved patient care and experience at weekends.

Nursing directors: we want to help you increase nurse/criteria led discharge

By October 2017 every NHS provider and their local health and social care partners must have adopted good practice to enable appropriate patient flow. This includes better and more timely hand-offs between A&E clinicians and acute physicians, 'discharge to assess', 'trusted assessor' arrangements, streamlined continuing healthcare processes, and seven day discharge capabilities.

NHS Improvement's analysis suggests that up to 25% of non-elective patients in hospital beds could be discharged immediately and a further 25% are in hospital because of delays that are within the gift of NHS providers.  It wants to help you tackle these delays in discharge, and would like to hear how NHS Improvement can support you to increase nurse/criteria led discharge and the challenges you’re facing in doing this.

Productivity Of The English NHS: 2014/15 Update

This report updates the Centre for Health Economics’ time-series of NHS productivity growth. It finds that the rate of NHS productivity growth since 2004/5 compares favourably with that achieved by the economy as a whole.

Report sets out progress on race equality standards for all NHS trusts in England

A second annual report into race equality across the NHS has been published by NHS England.

The Workforce Race Equality Standard (WRES) report publishes data from providers of NHS-funded care, including the voluntary and private sector, to demonstrate how they are addressing equality issues.

BMA and FPM guidance produced on analgesic prescribing and end of life pain management

The British Medical Association has released two guidance documents around the use of analgesics.

Chronic pain: supporting safer prescribing of analgesics
Improving analgesic use to support pain management at the end of life

Terminally ill children should have access to around-the-clock homecare, says NICE

NICE has published a draft standard aiming to improve end of life care for children in England.

It says families who are caring for terminally ill children at home should have 24-hour access to specialist medical support and advice.

Low-fat dairy linked to lower tendency towards depression

People who consume low-fat milk and yogurt, rather than whole-fat dairy products, are less likely to have depression, according to researchers in Japan and China.

Dairy consumption has long been linked to a wide range of physical health benefits, but its effect on emotional health has remained unclear. Now, a new study published in the journal Social Psychiatry and Psychiatric Epidemiology reveals that people who consume low-fat dairy products may be less prone to depression

Study suggests antidepressant use in early pregnancy does not increase autism, ADHD risk in kids

A study led by Indiana University suggests that mothers' use of antidepressants during early pregnancy does not increase the risk of their children developing autism or attention deficit hyperactivity disorder, conditions previously associated with these medications.

Campaign calls for update to NICE guidance on supporting people discharged from inpatient mental health care

People discharged from inpatient mental health care are waiting too long for follow-up support, according to Mind, who are calling for an urgent update to NICE guidelines.

Whilst current guidance states that people discharged from inpatient care should be followed up within seven days, Mind has highlighted that this is too long a wait for people who are extremely vulnerable.

CCGs face mounting 'aftercare' costs for mental health patients

Clinical commissioning groups are facing mounting costs for the care of people after they have been detained under the Mental Health Act, but many are not recording how many patients they have, HSJ can reveal.

An HSJ investigation has found the average cost per CCG of providing “aftercare” for mental health patients following their discharge has increased by 50 per cent since 2013-14, from £1.5m a year to £2.3m in 2016-17.

Mental health patients set to benefit from pioneering new digital services

Seven areas across England are set to trail-blaze digital services for mental health patients, which will include innovative apps to improve care and online access to ‘real-time’ patient records.

NHS England has announced new funding for seven mental health trusts to enable these organisations to pioneer world-class, digital services to improve care for patients experiencing mental health issues.
This will include, for the first time, all key professionals involved in a patient’s care having access to real-time records – from triage and initial assessment, through to admissions or referrals, as well as transfer between services and follow up care.

Online support: investigating the role of public online forums in mental health

This report was written by the Centre for the Analysis of Social Media at Demos in partnership with The King’s Fund. It looks at the large amounts of mental health related discussion taking place on public online forums, and explores whether computational techniques can provide robust, actionable insight from these conversations. It describes the collection and analysis of one million publicly available forum posts and addresses the technical and ethical challenges posed by the collection and analysis of online forum data.

Outcome Performance Measure Development for Persons with Multiple Chronic Conditions

This report from the RAND Corporation summarises analyses to assess the reliability and validity of a patient-reported outcome performance measure: the Veterans RAND twelve-item health survey (VR-12). The report makes recommendations towards the future use of performance measures and argues for the need for evaluation of the psychometrics of these measures at practice level.

How Cultural Alignment and the Use of Incentives Can Promote a Culture of Health

This report from the RAND Corporation discusses how concepts of cultural identity (e.g. ethnicity, religion or sexuality) and organisational culture can be harnessed to create a culture of health and how incentives can be used to promote wellbeing.

Resources to support delivery of ‘Reducing the impact of serious infection’ CQUIN

NHS Improvement and Public Health England have developed resources to support providers and commissioners in the delivery of the national ‘Reducing the impact of serious infections (Antimicrobial Resistance and Sepsis)’ CQUIN.

The resources include a series of FAQs, tools for data collections and baseline data, and are available via the NHS Improvement website or on the CQUIN webpage.

Hand exercises for patients with rheumatoid arthritis: an extended follow-up of the SARAH randomised controlled trial

BMJ Open 7(4), 2017.  DOI: http://dx.doi.org/10.1136/bmjopen-2016-013121

Participants undertaking the SARAH exercise programme had improved hand function compared with baseline >2 years after randomisation. This was not the case for the control group. However, scores were no longer statistically different between the groups indicating the effect of the programme had diminished over time. This reduction in hand function compared with earlier follow-up points coincided with a reduction in self-reported performance of hand exercises. Further intervention to promote long-term adherence may be warranted.

Collaborating Site in Research: UHCW

Ultra Wide-Field Laser Scanning Imaging of an Unusually Bullous Retinoschisis: Retinoschisis vs Detachment

JAMA Ophthalmol. 2017;135(4):e165479. doi:10.1001/jamaophthalmol.2016.5479

An asymptomatic, hypermetropic man in his 40s with a suspected macula-on retinal detachment underwent ultra wide-field laser scanning imaging (California P200DTx; Optos). This revealed a bullous right supero-temporal retinoschisis with “honeycomb” degeneration, dark inner layer vessels, and a rolled edge containing an outer leaf break extending posteriorly (Figure). The left eye had a long-term inferotemporal schisis detachment, which was treated with barrier laser retinopexy at its posterior border.

UHCW Research: Osama Makhzoum and Mark Hero

Renal peer support: how do we put theory into practice?

Journal of Kidney Care 2(2) 2017 pp 104-7

Peer support offers renal patients the invaluable chance to share their experiences with other people in the same or similar positions. This can improve patient outcomes, both in terms of mental health and general wellbeing. Kate McCarthy describes a recent study into peer support programmes and discusses the challenges in their successful implementation

UHCW Research: Kate McCarthy

PET-NECK: a multicentre randomised Phase III non-inferiority trial comparing a positron emission tomography-computerised tomography-guided watch-and-wait policy with planned neck dissection in the management of locally advanced (N2/N3) nodal metastases in patients with squamous cell head and neck cancer

Health Technol Assess. 2017 Apr;21(17):1-122. doi: 10.3310/hta21170.

PET-CT-guided active surveillance showed similar survival outcomes to ND but resulted in considerably fewer NDs, fewer complications and lower costs, supporting its use in routine practice.

UHCW Research: Fresco, L.

Pilot trusts using real-time technology to increase bed capacity

Five NHS providers will be piloting new technology that uses 'fitbit' style bracelets to track beds, staff and patients, giving trusts real-time information on bed status, patient pathway tracking and asset management.

The real-time technology, called TeleTracking Technologies, detects electronic badges and bracelets attached to patients, staff and equipment. It provides staff with visibility to all beds, patients, assets and equipment across their trust. Similar to air traffic control centres, staff have a real-time view of:

• bed status
• which patients need to be allocated to a bed
• where specific types of equipment are
• the nearest housekeeping or portering staff available to clean a bed or help transport a patient

Physiotherapy-led rehab unit celebrates success in cutting hospital readmission rates

An innovative NHS-led physiotherapy service designed to reduce readmission to hospital has celebrated a successful first 12 months of work.

The short-stay rehab unit based at a Nottingham care home has managed to cut 90-day hospital readmission rates to just five per cent.

Integration and Better Care Fund policy framework 2017 to 2019

This DH document sets out how health, social care and other public services will integrate and provides an overview of related policy initiatives and legislation. It includes the policy framework for the implementation of the statutory Better Care Fund in 2017 to 2019.

NHS Property and Estates: Why the estate matters for patients

Sir Robert Naylor was commissioned to carry out an independent review of NHS property and estates and how to make the best use of the NHS estate. It highlights the opportunities available to support sustainability and transformation plans and optimise the use of NHS land and buildings.

New innovation scorecard platform launched

NHS Digital has launched a new web platform for the Innovation Scorecard. The scorecard reports on the use of medicines and medical technologies in the NHS in England, specifically those which have been positively appraised by the National Institute for Health and Care Excellence (NICE) since 2012.

Users can now:

• compare commissioning organisations’ uptake of medicines
• view information without having to download data
• share results more easily and securely
• look at overall levels of prescribing by medicine

Integrated health and social care 2020: research

The government wants to see the integration of health and social care, in every area of England, by 2020. The Department of Health’s initial thinking included the concept of an Integration Standard with associated metrics that enable qualitative and quantitative data to measure the performance of each area, giving a clear picture of progress toward integration.

This report presents the findings from a programme of scoping research and engagement to
better understand what excellent integrated health and social care should look like in 2020

NICE says head and neck cancer drug is not cost effective

NICE has published draft guidance saying the cost of using nivolumab to treat head and neck cancer is too high for routine NHS use.

Molecular targeted therapies in adrenal, pituitary and parathyroid malignancies

Endocr Relat Cancer. 2017 Apr 11. pii: ERC-16-0542. doi: 10.1530/ERC-16-0542. [Epub ahead of print]

Tumourigenesis is a relatively common event in endocrine tissues. Currently, specific guidelines have been developed for common malignant endocrine tumours which also incorporate advances in molecular targeted therapies (MTT), as in thyroid cancer and gastrointestinal neuroendocrine malignancies. However, there is little information regarding the role and efficacy of MTT in the relatively rare malignant endocrine tumours mainly involving the adrenal medulla, adrenal cortex, pituitary and parathyroid glands. Due to the rarity of these tumours and the lack of prospective studies, current guidelines are mostly based on retrospective data derived from surgical, loco-regional and ablative therapies, and studies with systemic chemotherapy. In addition, in many of these malignancies the prognosis remains poor with individual patients responding differently to currently available treatments, necessitating the development of new personalised therapeutic strategies. Recently, major advances in the molecular understanding of endocrine tumours - based on genomic, epigenomic, and transcriptome analysis - have emerged, resulting in new insights into their pathogenesis and molecular pathology. This in turn has led to the use of novel MTTs in increasing numbers of patients. In this review we aim to present currently existing and evolving data using MTT in the treatment of adrenal, pituitary and malignant parathyroid tumours, and explore the current utility and effectiveness of such therapies and their future evolution.

UHCW Research: G Dimitriadis

Breast screening: imaging women with breast implants

This PHE document explains how to screen women with breast implants in the NHS Breast Screening Programme.

A best practice guide for consultant job planning

Advice for trusts from NHS Improvement to ensure that their approach to consultant job planning is consistent with best practice.

Mainstreaming primary and acute care systems and multispecialty community providers: Sharing the learning

This event focused on sharing the learning coming out of the multidisciplinary community providers and primary and acute care systems new care model vanguards. It looked at what is working well and what can be replicated in other areas around the United Kingdom.

Biopsy-proven hypersensitivity pneumonitis caused by a fluorocarbon waterproofing spray

Occup Med (Lond). 2017 Apr 8. doi: 10.1093/occmed/kqx039. [Epub ahead of print]

We present the case of a 35-year-old male who developed a chronic hypersensitivity pneumonitis (HP) following inhalational exposure to a fluorocarbon waterproofing aerosol spray, caused by his work for an upholstery and soft furnishings retailer. This is the first case report from inhalational fluorocarbon exposure with histological evidence of chronic HP. This is then discussed in the context of previous reports of interstitial lung disease and lung injury, caused by similar occupational and non-occupational exposures.

UHCW Research: Trotter, S. and Sinha, B.

Updates to the Model Hospital

NHS Improvement has made some changes to the Model Hospital including new compartments, features and a self-registration function for providers.

It's added pathology and doctor productivity to the list of compartments, and refreshed data to the following compartments:

• pharmacy and medicines
• nursing and midwifery
• allied health professionals
• visitor cost recovery

Electrical services supply and distribution (HTM 06-01)

Guidance from the Department of Health on the design, installation and testing of all fixed wiring and integral electrical equipment used for electrical services.

Reducing the risk of oxygen tubing being connected to air flowmeters

A stage three patient safety alert has been issued by NHS Improvement to support NHS providers that supply medical air using medical gas pipeline systems (MGPSs) to reduce the risk of harm from oxygen tubing being connected to air flowmeters.

Watch the 2-minute video to support this Patient Safety Alert.

The importance of mealtime structure for reducing child food fussiness

Maternal and Child Nutrition, 13(2) April 2017. DOI: 10.1111/mcn.12296

The aim of this study was to explore how the structure of mealtimes within the family setting is related to children's fussy eating behaviours. Seventy-five mothers of children aged between 2 and 4 years were observed during a typical mealtime at home. The mealtimes were coded to rate mealtime structure and environment as well as the child's eating behaviours (food refusal, difficulty to feed, eating speed, positive and negative vocalisations). Mealtime structure emerged as an important factor which significantly distinguished children with higher compared with lower levels of food fussiness. Children whose mothers ate with their child and ate the same food as their child were observed to refuse fewer foods and were easier to feed compared with children whose mothers did not. During mealtimes where no distractors were used (e.g. no TV, magazines or toys), or where children were allowed some input into food choice and portioning, children were also observed to demonstrate fewer fussy eating behaviours. Findings of this study suggest that it may be important for parents to strike a balance between structured mealtimes, where the family eats together and distractions are minimal, alongside allowing children some autonomy in terms of food choice and intake.

UHCW Research: Caroline Meyer

Quality Principles for NHS Apprenticeships

A set of principles to help employers in health care organisations deliver quality apprenticeships have been developed by National Skills Academy for Health and Health Education England.

The Quality Principles for NHS Apprenticeships has been designed as a self-assessment and planning guide, which those leading on the development and delivery of apprenticeships can use to evaluate where they sit against each of the principles, and plan for any improvements needed.

Older People’s Care in Acute Settings Benchmarking 2016

This report from the NHS Benchmarking Network explores the pathway that older people take through the acute hospital, including A&E and assessments units, inpatient wards and supported discharge teams. Forty seven acute hospitals took part in the 2016 project collecting 2015/16 data.

Referral-To-Treatment Waiting Times And Forecasts

This report from the NHS Confederation estimates that the number of people waiting longer than 18 weeks for planned operations could exceed 800,000 by 2020. The analysis finds that demand for elective operations is rising, with the number of people waiting for treatment forecast to hit 5 million in 2020.

NHS Complaints Procedures In England

This briefing paper from the House of Commons Library provides information on the standard NHS complaints procedures and also the other options available to patients.

What social workers need to know about ADHD, trauma and neglect

Social workers need more understanding of how trauma impacts behaviour to help prevent maltreated children being misdiagnosed with ADHD.

Children in the child protection system are three times more likely to have a diagnosis of attention deficit hyperactivity disorder (ADHD) than the general population. Why is this the case? It’s possible that children with ADHD are more vulnerable to parental abuse and neglect because of their challenging behaviour and the socioeconomic backgrounds most commonly associated with ADHD.

Green Spaces May Benefit Aging Brain

Walking between busy urban environments and green spaces triggers changes in levels of excitement, engagement and frustration in the brain, according to a new study of older people. It is the latest study to document the psychological benefits of natural environments.

Researchers at the Universities of York and Edinburgh in the U.K. say the findings have important implications for architects, planners and health professionals as we deal with an ageing population.

Mental health: disabled and deaf people

This report makes recommendations to improve access to mental health services for disabled people and deaf people in London. It argues for pan-London communications support for those who are deaf or have learning disabilities and an investigation into the issues around employment, housing, crime and transport to enable disabled people and deaf people to live independent lives.

• Report

Parental strategies used in the family meal session of family-based treatment for adolescent anorexia nervosa: Links with treatment outcomes

Int J Eat Disord. 2017 Apr;50(4):433-436. doi: 10.1002/eat.22647. Epub 2016 Nov 7.

Parental verbal eating prompts during the family meal may be effective in promoting short-term weight gain. During the family meal session, parents should be encouraged to maintain a direct focus on their adolescent child's eating behaviour which may assist their child with food consumption and potential weight gain. Further research examining food-based interactions among parents and their adolescent child with AN is needed. © 2016 Wiley Periodicals, Inc.(Int J Eat Disord 2017; 50:433-436).

UHCW Research: Meyer, C.

Can Tibial Cementation Be Enhanced in Knee Arthroplasty Surgery?

J Knee Surg. 2016 Jul;29(5):391-5. doi: 10.1055/s-0035-1564595. Epub 2015 Sep 26.

Aseptic loosening of the tibial component continues to be a significant mode of failure in total knee arthroplasty surgery. Surface cemented components preserve tibial bone stock, but are reliant on a strong bone-cement interface. This study compares standard surface cemented tibial component design to a tibial component with the addition of an undersurface cement containment skirt. The hypothesis was that the addition of a 2-mm underside skirt would allow cement containment and pressurization during implantation, which might improve the overall survival. Two identical tibial components were used, out of which one had the 2-mm underside skirt removed for the purposes of this study. Overall, 12 tibial Sawbones were prepared identically and transducers placed in the medial and lateral plateau. Each component was implanted six times, according to the manufacturer's operative technique. The series of implantation experiments showed no difference in cement pressurization (p = 0.86) regardless of the tibial component design used, with a wide variation in pressure measurements occurring in both groups. The tibial component skirt has not demonstrated any enhancement in cement pressurization. The cement containment skirt might still be advantageous by increasing the cement mantle thickness without causing excessive bone penetration; however, the biological effects cannot be predicted without further clinical evaluation.

UHCW Research: Westerman RW.

New employment checks cross-referencing tool

NHS Employers has developed a new resource to help recruiting managers see at a glance which approved documents can be used for identity, right to work and criminal record checks.

The tool should be used alongside the identity, right to work and criminal record checks standards. Combinations of documents needed for each check can be found on page one. The documents and the check that they are applicable to can be found on page two.

Diabetic Eye Screening: Collection Of Demographic Information

This guidance explains how diabetic eye screening (DES) services can record demographic information on people registered with them. DES services can record information on the nine protected characteristics described in the Equality Act 2010.

Breast Screening: Consolidated Programme Standards

This document from Public Health England sets out the national standards for the NHS Breast Screening Programme.

Dementia best practice now online

NHS England has developed a “best practice repository” as part of its online Learning Environment for examples of good dementia care.

Degree apprenticeship standard for healthcare science practitioner

The degree apprenticeship standard and end-point assessment for healthcare science practitioners is now available for delivery. Approved as a level 6 apprenticeship, the training will typically take a minimum of 36 months to complete and will lead to a BSc (Honours) degree in Healthcare Science. The standard, which sets out the skills, knowledge and behaviours required in the role, also outlines the competencies the apprentices will need to demonstrate.

£3.5million funding available from the Health Foundation

The Health Foundation has £3.5 million funding available for up to seven teams under their Scaling Up Improvement programme which supports project teams to take successful health care interventions or approaches and deliver them at scale, to improve health services in the UK.

The deadline for applications is 12:00 noon, on Wednesday 17 May 2017.

Gender pay gap reporting - what you need to know

From 31 March 2017 it is mandatory for public sector organisations with over 250 employees to report annually on their Gender Pay Gap.

BME representation in fitness to practise cases

The Nursing and Midwifery Council (NMC) has published the findings of research exploring the progress and outcomes of BME nurses and midwives going through their fitness to practice (FtP) process.

There were a number of key findings within the report, the most significant being that BME nurses and midwives are more likely to be referred than their white counterparts. The report also highlighted that employers were the largest source of referrals and these referrals were most likely to progress through to the later stages of the FtP process.

NHS England Funding and Resource 2017-19: supporting ‘Next Steps for the NHS Five Year Forward View’

This document from NHS England forms an annex to Next Steps on the NHS Five Year Forward View and contains important information about its funding in 2017/18.

Stroke patients in England set to receive revolutionary new treatment

NHS England has announced that it will commission mechanical thrombectomy so it can become more widely available for patients who have certain types of acute ischaemic stroke.

See the RCR response.

Deep Brain Stimulation Can Ease Tics in Severe Tourette’s

Thalamic deep brain stimulation (DBS), a surgical technique that sends electrical impulses to the brain’s medial thalamus, has been shown to reduce tics, or involuntary movements and vocal outbursts, in severe cases of Tourette syndrome, according to a new study at New York University (NYU) Langone Medical Center. Read more HERE.

Maternity choice and personalisation pioneers

This updated set of FAQs provides guidance and information on the pioneers who are testing ways of improving choice and personalisation for women accessing maternity services.

Physical inactivity and sedentary behaviour report 2017

British Heart Foundation - 
This report finds that more than 20 million adults in the UK are physically inactive and estimates that this increase risk of heart disease may cost the NHS £1.2 billion annually. The report provides an overview of the levels of physical inactivity and sedentary behaviour in adults across the UK.

• Report

Remote health management: reducing bed blocking in the NHS

Institution of Mechanical Engineers (IMechE) - 
This report highlights the potential for remote monitoring technology to ease delayed discharges in the NHS and estimates that the widespread implementation of digital health could have already saved the NHS over £1 billion over the last five years. The report calls for the Department of Health to create a standardised remote health management network by 2020 which would enable acute and social care providers to have access to patient data and remote monitoring.

• Report

Testing times: restrictions accessing test strips and meters for people with diabetes

Diabetes UK - 
This report highlights the difficulties that patients have been experiencing in accessing blood sugar monitoring equipment. The survey of patients found that a quarter of respondents had experienced restrictions and that over half of those who had experienced restrictions have type 1 diabetes.

• Report

The Apprenticeship Levy goes live

Changes to the way apprenticeships are funded come into effect from today (6 April 2017).
All employers with an annual pay bill of £3 million or more will now have to pay the Apprenticeship Levy. Funds to pay for apprenticeship training will then be available through an online account system managed by the Apprenticeship Service.

Under the changes training providers will no longer receive funding direct from government, instead employers will negotiate contracts for the delivery the apprenticeship training and assessments they need, giving them more control in the process. 

Care and Treatment Reviews for Learning Disabilities

Care and Treatment Reviews (CTRs) are part of NHS England’s commitment to transforming services for people with learning disabilities, autism or both. CTRs are for people whose behaviour is seen as challenging and/or for people with a mental health condition. They are used by commissioners for people living in the community and in learning disability and mental health hospitals.

NMC increases flexibility of overseas application process

The Nursing and Midwifery Council (NMC) has announced changes to its application process for nurses and midwives trained outside EU/EEA. These changes will provide additional flexibility by increasing the number of times a nurse or midwife can sit a key component of the test they need to pass in order to practise in the UK.

Read more HERE.

Number of ambulance diverts from A&E doubled this winter

Analysis finds A&E units closed to ambulances almost 500 times in just three months this winter.

Urgent response time targets only met in six out of last 49 months

The number of times hospital A&E units in England have had to close their doors to ambulances has almost doubled this winter compared with the previous three, new research from the Nuffield Trust health think-tank reveals. The authors say that the extra time paramedics are having to spend on the road as a result is a factor in the service’s inability to meet its targets for urgent requests for an ambulance.

What can the UK learn from Finland's approach to mental health?

An online therapy service for depression, anxiety and substance misuse is cheap and effective and could provide inspiration for the NHS

Antibiotic May Improve Care for PTSD

New research suggests the common antibiotic doxycycline can disrupt the formation of negative associations in the brain, mitigating or even preventing post-traumatic stress disorder (PTSD).

Investigators from University College London (UCL) and the University of Zurich discovered the relationship in a pre-registered, placebo-controlled, double-blind randomized controlled trial among 76 healthy volunteers.

The study appears in the journal Molecular Psychiatry.

Making a trip to the doctor easier for people with autism

In the report, Children and young people with autism, we heard from over 1,000 people about their experiences of using autism services and the improvements they’d like to see.

Although most people are happy with the care they receive from their GP, we heard that for many a visit to the doctor can be stressful for both people with autism and their families.

In West Sussex, Healthwatch spoke to over 100 members of Autism Support Crawley to understand what changes could be made to help improve services for children with autism. Based on their findings Healthwatch West Sussex created six ways staff in GP surgeries can improve patient experience.

Patients receiving pedometers by post increased their physical activity for at least 12 months

Use of pedometers, received by post, resulted in a sustained increase in walking of around 650 steps a day, equivalent to about one km or 30 minutes of moderate to vigorous physical activity per week. The study was set in London general practices and achieved similar results whether or not people had additional support from a practice nurse.

Community pharmacists gave 37% more flu jabs 2016/17

Community pharmacy teams administered at least 221,000 more flu vaccinations in 2016/17 than in the previous year, an increase of more than 37%.

The total number of vaccines provided under the national flu vaccination service rose from 595,467 in 2015/16 to over 817k vaccinations last year, according to the Pharmaceutical Services Negotiating Committee.

Men find self-testing acceptable to test for sexually transmitted infections

Sexually transmitted infections (STIs) are common and treatable but men are more reluctant than women to have a test. Self-testing is known to be accurate, but can men use this more?

Most men aged 18-35 would be willing to collect and send off a urine sample using a kit to test for STIs, according to a national survey. GP surgeries were the most popular place to collect kits, followed by pharmacies and sexual health clinics.

Other venues might be useful extra places to distribute testing kits and increase their use. About half of young men play football, and half of them are willing to collect kits from the club they play at. Extra advice from a health advisor or team captain does not seem to increase the use of these tests. However, none of the 90 men tested in this study had an infection, so football clubs may not be the best place to find men with undetected STIs.

Dengue and severe dengue

World Health Organization Fact sheet.

Dengue is a mosquito-borne viral disease that has rapidly spread in all regions of WHO in recent years. Dengue virus is transmitted by female mosquitoes mainly of the species Aedes aegypti and, to a lesser extent, Ae. albopictus. This mosquito also transmits chikungunya, yellow fever and Zika infection. Dengue is widespread throughout the tropics, with local variations in risk influenced by rainfall, temperature and unplanned rapid urbanization.

Autism spectrum disorders (ASD) update

World Health Organization fact sheet

ASD refers to a range of conditions characterised by some degree of impaired social behaviour, communication and language, and a narrow range of interests and activities that are both unique to the individual and carried out repetitively.

ASDs begin in childhood and tend to persist into adolescence and adulthood. In most cases the conditions are apparent during the first 5 years of life.

Individuals with ASD often present other co-occurring conditions, including epilepsy, depression, anxiety and attention deficit hyperactivity disorder (ADHD). The level of intellectual functioning in individuals with ASDs is extremely variable, extending from profound impairment to superior levels.

Non-cystic fibrosis bronchiectasis: inhaled tobramycin

This evidence summary includes 3 randomised controlled trials that investigated the efficacy of nebulised tobramycin, 300 mg twice daily compared with placebo for treating infective exacerbations caused by P aeruginosa in people with non-cystic fibrosis bronchiectasis. The treatment duration varied across the studies from 4 weeks to 6 months.

Consolidated guideline on sexual and reproductive health and rights of women living with HIV

The starting point for this WHO guideline is the point at which a woman has learnt that she is living with HIV, and it therefore covers key issues for providing comprehensive sexual and reproductive health and rights-related services and support for women living with HIV. As women living with HIV face unique challenges and human rights violations related to their sexuality and reproduction within their families and communities, as well as from the health-care institutions where they seek care, particular emphasis is placed on the creation of an enabling environment to support more effective health interventions and better health outcomes.

NHS foundation trusts: financial accounting guidance

NHS foundation trust finance staff should use this guidance, which is updated regularly, to do their work.

Organisation patient safety incident reports

Data workbooks and explorer tool based on incidents reported by NHS providers in England to the National Reporting and Learning System (NRLS).

Red2Green approach

Mark Cubbon discusses how the Red2Green approach is helping reduce unnecessary delays for patients across the Midlands and East of England and why it's gaining momentum on social media.

Supporting the safety of girls and women being treated with valproate

A resource alert has been issued jointly by NHS Improvement and the Medicines and Healthcare products Regulatory Agency (MHRA) to support the safety of girls and women of childbearing potential being treated with valproate.

Skilled and committed workforce is crucial for NHS survival

Staff are essential to the future sustainability of the NHS, says a new report from the Lords Select Committee on the long-term sustainability of the NHS.


The report, published today, claims that the lack of a comprehensive long-term strategy to secure appropriately skilled, well-trained and committed workforce is ‘the biggest internal threat to the sustainability of the NHS.’ It recommends that the government takes steps to retain overseas-trained staff working in the NHS and social care, and provides reassurances about their future.

Sickness absence in the labour market: 2016

The Office of National Statistics (ONS) recently published its analysis on sickness absence rates of workers in the UK labour market for 2016.

An estimated 137.3 million working days were lost due to sickness or injury in the UK in 2016. This is equivalent to 4.3 days per worker (the lowest recorded since the series began in 1993, when it was at 7.2 days per worker, the highest level over the reference period). Since 2003, there has been a general decline in the number of days lost to sickness absence, particularly during the economic downturn and the number of people entering the labour market.

Integration and Better Care Fund policy framework 2017 to 2019

This document sets out how health, social care and other public services will integrate and provides an overview of related policy initiatives and legislation. It includes the policy framework for the implementation of the statutory Better Care Fund in 2017 to 2019 and also sets out our proposals for going beyond the Fund towards further integration by 2020.

• Framework

General ophthalmic service fees and voucher values from April 2017

Department of Health (DH) - 
This letter details the changes to the general ophthalmic fees and optical voucher values for 2017-18 and is intended for all staff dealing with general ophthalmic services, hospital eye services, optometrists and ophthalmic medical practitioners.

• Letter
• Associated guidance

Encouraging healthier 'out of home' food provision

Public Health England (PHE) - 
This toolkit helps local authorities and businesses to provide and promote healthier options for food eaten away from home. The healthier catering guidance, which accompanies the toolkit, provides tips for business on how to provide and promote healthier food and drink for children and families and reflects the latest government dietary recommendations for sugars.

• Toolkit
• Catering guidance
• Associated documentation

Adult social care

House of Commons Communities and Local Government Committee - This report finds that inadequate funding very seriously affects the quantity and quality of adult social care provision, impacting on those receiving care, the NHS, care staff, carers and providers. It urges the government to urgently review how social care is funded long-term and to address serious threats to the provision of care in England. Whilst the committee welcomes the government's commitment to providing an additional £2 billion for social care over the next three years, it highlights that this amount falls short of the amount needed to close the funding gap. 

• Report
• Summary

Employment and mental health

The Royal College of Psychiatrists has for many years highlighted the importance of mental health and employment.

UK national policy is paying increasing attention to health, mental health and employment. Responding to a growing number of national policies and initiatives, the College has enhanced its coverage of relevant concerns of social psychiatry, mental health and employment.

This report outlines the main priorities and activities of the College in the area of mental health and employment.

NHS property and estates: Naylor review

The report examines how the NHS can make the best use of its estate to support NHS England’s Five Year Forward View.

It highlights the opportunities available to support sustainability and transformation plans (STPs) and optimise the use of NHS land and buildings.

The government is already acting on some of the recommendations by:

• creating a new NHS property body
• making a £325 million capital investment over the next 3 years to develop local STPs - as announced in this year’s Budget
• developing an incentive scheme to guarantee that proceeds of sales are available for reinvestment

The government will consider a further multi-year capital programme in the autumn.
The government welcomes the review and will consider the recommendations carefully and respond in due course.

Mobilising Communities: Insights on Community Action for Health and Wellbeing

This report explores insights taken from three community sites on how to implement a people powered approach to health and wellbeing. It focuses on helping people help themselves; creating opportunities for people to help one another; and creating value between the professional and social spheres. 

This report gathers a wide range of insights taken from three community sites on how to implement a people powered approach to health and wellbeing.
Key findings

These three main insights were found to be the most important to making a difference on the ground:

• Helping people help themselves
• Creating opportunities for people to help one another
• Creating value between the professional and social spheres - helping health and care

Mobilising Communities was a short, experimental programme aimed at exploring the practical applications of the idea of ‘social movements’ in health in three communities in England.

- See more at: http://www.nesta.org.uk/publications/mobilising-communities-insights-community-action-health-and-wellbeing#sthash.tj0xeVJX.dpuf

This report gathers a wide range of insights taken from three community sites on how to implement a people powered approach to health and wellbeing.
Key findings

These three main insights were found to be the most important to making a difference on the ground:

• Helping people help themselves
• Creating opportunities for people to help one another
• Creating value between the professional and social spheres - helping health and care

Mobilising Communities was a short, experimental programme aimed at exploring the practical applications of the idea of ‘social movements’ in health in three communities in England.

- See more at: http://www.nesta.org.uk/publications/mobilising-communities-insights-community-action-health-and-wellbeing#sthash.tj0xeVJX.dpuf

This report gathers a wide range of insights taken from three community sites on how to implement a people powered approach to health and wellbeing.
Key findings

These three main insights were found to be the most important to making a difference on the ground:

• Helping people help themselves
• Creating opportunities for people to help one another
• Creating value between the professional and social spheres - helping health and care

Mobilising Communities was a short, experimental programme aimed at exploring the practical applications of the idea of ‘social movements’ in health in three communities in England.

- See more at: http://www.nesta.org.uk/publications/mobilising-communities-insights-community-action-health-and-wellbeing#sthash.tj0xeVJX.dpuf

This report gathers a wide range of insights taken from three community sites on how to implement a people powered approach to health and wellbeing.
Key findings

These three main insights were found to be the most important to making a difference on the ground:

• Helping people help themselves
• Creating opportunities for people to help one another
• Creating value between the professional and social spheres - helping health and care

Mobilising Communities was a short, experimental programme aimed at exploring the practical applications of the idea of ‘social movements’ in health in three communities in England.

- See more at: http://www.nesta.org.uk/publications/mobilising-communities-insights-community-action-health-and-wellbeing#sthash.tj0xeVJX.dpufff

This report gathers a wide range of insights taken from three community sites on how to implement a people powered approach to health and wellbeing.
Key findings

These three main insights were found to be the most important to making a difference on the ground:

• Helping people help themselves
• Creating opportunities for people to help one another
• Creating value between the professional and social spheres - helping health and care

Mobilising Communities was a short, experimental programme aimed at exploring the practical applications of the idea of ‘social movements’ in health in three communities in England.

- See more at: http://www.nesta.org.uk/publications/mobilising-communities-insights-community-action-health-and-wellbeing#sthash.tj0xeVJX.dpuf

This report gathers a wide range of insights taken from three community sites on how to implement a people powered approach to health and wellbeing.
Key findings

These three main insights were found to be the most important to making a difference on the ground:

• Helping people help themselves
• Creating opportunities for people to help one another
• Creating value between the professional and social spheres - helping health and care

Mobilising Communities was a short, experimental programme aimed at exploring the practical applications of the idea of ‘social movements’ in health in three communities in England.

- See more at: http://www.nesta.org.uk/publications/mobilising-communities-insights-community-action-health-and-wellbeing#sthash.tj0xeVJX.dpuf

This report gathers a wide range of insights taken from three community sites on how to implement a people powered approach to health and wellbeing.
Key findings

These three main insights were found to be the most important to making a difference on the ground:

• Helping people help themselves
• Creating opportunities for people to help one another
• Creating value between the professional and social spheres - helping health and care

Mobilising Communities was a short, experimental programme aimed at exploring the practical applications of the idea of ‘social movements’ in health in three communities in England.

- See more at: http://www.nesta.org.uk/publications/mobilising-communities-insights-community-action-health-and-wellbeing#sthash.tj0xeVJX.dpuf

This report gathers a wide range of insights taken from three community sites on how to implement a people powered approach to health and wellbeing.
Key findings

These three main insights were found to be the most important to making a difference on the ground:

• Helping people help themselves
• Creating opportunities for people to help one another
• Creating value between the professional and social spheres - helping health and care

Mobilising Communities was a short, experimental programme aimed at exploring the practical applications of the idea of ‘social movements’ in health in three communities in England.

- See more at: http://www.nesta.org.uk/publications/mobilising-communities-insights-community-action-health-and-wellbeing#sthash.tj0xeVJX.dpuf

Does the primary care home make a difference?

Thousands of patients benefit from NAPC’s Primary Care Home programme: new report shows drop in emergency hospital admissions and waiting times for GP appointments

The Primary Care Home (PCH) programme is delivering a range of benefits for patients, staff and the wider health system, according to a new report released today (Friday 31 March).

Key findings from an early analysis of three rapid test sites show significant reductions in A&E attendances, emergency hospital admissions and GP referrals to hospital.

Rapid improvement guide: trusted assessors

Use this guide to learn how adopting a trusted assessor model can improve the experience for the patient and reduce delayed transfers of care.

Survey finds children with communication problems are not getting the support they need

The Royal College of Speech and Language Therapists (RCSLT) is calling on the government to guarantee that local authorities and clinical commissioning groups (CCGs) commission speech and language therapy services for children and young people as many are not getting the support they need.

Almost half (45%) of speech and language therapists, recently surveyed by the RCSLT, said that they lack the time and resources to provide services to children and young people with communication problems who do not have an education, health and care (EHC) plan. This legal document describes a child or young person’s special educational, health and social care needs and how local agencies must support them.

Inclusive leadership in the NHS part two

Second podcast on inclusive leadership.  Jackie Daniel, Chief Executive at University Hospitals of Morecambe Bay NHS Foundation Trust (UHMBT), talks frankly about the practical steps they are taking to tackle behaviours that are not aligned with the organisations values.

Voted 11th in the 2016 inclusive top 50 UK employers and the most inclusive employer in the NHS, Jackie talks about the importance of being courageous enough to have difficult conversations, and her team at UHMBT tell us what being part of an inclusive workforce means to them.

Delivering mental health transformation

This report focuses on progress and challenges in improving children and young people’s mental health services in England, particularly for minority or vulnerable groups.

It is based on the views of 49 professionals working with children and young people, primarily from the voluntary, community and social enterprise sector (VCSE) who responded to an online survey in autumn 2016.

Stress a common seizure trigger in epilepsy, study affirms

The relationship between stress and seizures has been well documented over the last 50 years. A recent review article looks at the stress-seizure relationship and how adopting stress reduction techniques may provide benefit as a low risk form of treatment.

Worcestershire's NHS trust to get mental health leadership role in latest forward plan

WORCESTERSHIRE'S health trust is set to lead the country in the digital delivery of mental health services over the next few years. 

A new report, Next Steps on the NHS, sets out how health services are set to meet the priorities of patients and the public across the West Midlands.

Reducing ambulance handover delays

Advice to improve the quality and timeliness of ambulance handover for individual patients and for people in the community requiring an emergency ambulance.

This resource will help you achieve:

• safe transfer of high quality handover-information from paramedics directly to ED nurses/clinicians
• timely care for patients to get the best outcomes
• improved patient experience

by:

• effective patient handover from the ambulance team within 15 minutes of arrival at ED
• ambulances being back on the road, ready to respond to further calls, 15 minutes later

Epic3 guidelines for preventing healthcare-associated infections

These guidelines (epic3) provide comprehensive recommendations for preventing HCAI in hospital and other acute care settings based on the best currently available evidence. National evidence-based guidelines are broad principles of best practice that need to be integrated into local practice guidelines and audited to reduce variation in practice and maintain patient safety.

NHS retirement booklet

The latest version of our Retirement Booklet (version 19) is now available to download from our website and can be ordered from our stationery stores. The latest version covers small updates to Trivial Commutation and 2015 Scheme information.

To make the booklet easier to read we have removed the glossary of terms and incorporated explanations of words and phrases into the content of the booklet, an approach we will be introducing within our other guides when they are next reviewed.

Next steps on the NHS Five Year Forward View

This document reviews the progress made since the launch of the NHS Five Year Forward View in October 2014 and sets out a series of practical and realistic steps for the NHS to deliver a better, more joined-up and more responsive NHS in England.

• Report

GMC unveils blueprint for better medical training

Rigid training that adapts too slowly needs radical overhaul to provide trainees with more flexibility and patients with doctors who can care for multiple health conditions, the GMC’s plan for training tells health leaders today.

The plan follows a review of training which the Secretary of State for Health asked the GMC to carry out during the contract dispute in 2016, an analysis which heard from trainees, trainers, patients and the medical colleges and faculties.

Roads to recovery: Organisation and quality of stroke services

Stroke is a devastating disease affecting many people as well as being an area of substantial health and care spend. It represents around 5% of total NHS costs and is the fourth largest cause of death in the UK. Recent years have seen huge improvements in the clinical management of people with stroke with early assessment, use of thrombolysis and better organisation of services into acute stroke units. Over the last twenty years, stroke mortality rates have halved.

Yet providing the right care over many years to those living with stroke and their families remains a challenge. Roads to Recovery brings together recent NIHR evidence relevant to those planning and delivering stroke services, those delivering treatments to people with stroke and to those living with stroke.

Consultation launched on prescribing of gluten-free foods

The consultation follows NHS England’s announcement this week of new guidance on the prescription of low value items such as travel vaccines, painkillers, and gluten-free (GF) foods.
It will consider ending the prescription of all gluten-free foods in primary care, with estimates suggesting this could save £25.7 million a year for the health service. An additional £10 million could be saved through patients no longer needing to attend GP appointments in order to get their gluten-free prescriptions.

New study to look at improving rehabilitation of older people following discharge from hospital

Researchers funded by the NIHR are conducting a five year national study looking at how rehabilitation can be improved for older people with frailty following discharge from hospital after an acute illness or injury.

The study, known as HERO (Home-based Extended Rehabilitation of Older people), Led by Dr Andrew Clegg (the Academic Unit of Elderly Care and Rehabilitation (AUECR), University of Leeds based at Bradford Teaching Hospitals), will involve 718 older people with frailty admitted to hospital following acute illness or injury. Participants will be recruited across 10 hospitals within Yorkshire and the South West of England over 23 months in total, with recruitment staggered to accommodate an internal pilot. The overall aim is to investigate whether an extended rehabilitation programme using a home-based exercise intervention developed for older people with frailty improves health-related quality of life.