NHS Library and Information Service North Staffordshire

Clinical Effectiveness Bulletin for NHS Primary Care in North Staffordshire

Issue No: 66 July 2012

About this Bulletin: It aims to draw attention to some of the key documents and reviews on clinical effectiveness that have been published in the previous month. Where possible, links to the full text documents are included. If the article is in a journal, you can contact the Health Library for a copy. Link to request form: http://www.keele.ac.uk/healthlibrary/usingthehealthlibrary/interlibraryloans/#d.en.27437 [Please note - a charge of 2 per request is payable for most copies] If you need further assistance, please contact the Health Library or the NHS Outreach Librarians, details below. The bulletin can be e-mailed to colleagues who may also find it useful. A list of websites checked in the production of this bulletin is on the first page. Please suggest further useful sites. Feedback is always welcomed to inform future issues of the bulletin.

Contact information

Bulletin produced by NHS Outreach Librarians Tel: FeatureNet 8429 (External calls 0300 123 1535 ext 8429) E-mail: lindsay.snell@northstaffs.nhs.uk clareh.powell@northstaffs.nhs.uk

North Staffs Health Library Tel: 01782 679500 Fax: 01782 679582 E-mail: health.library@keele.ac.uk

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Sources for Clinical Effectiveness Bulletin Please suggest further sites that should be monitored in the production of this bulletin Websites Cochrane Library http://www.thecochranelibrary.com/ CRD Centre for Reviews and Dissemination http://www.crd.york.ac.uk/crdweb/ - DARE (Database of Abstracts of Reviews of Effects) - NHS Economic Evaluation Database Health Technology Assessment (HTA) Database http://www.hta.ac.uk Daily Health Bulletin http://www.sheffield.nhs.uk/healthbulletin/ Department of Health http://www.dh.gov.uk/en/index.htm Kings Fund http://www.kingsfund.org.uk/ NeLM (National Electronic Library for Medicines) news bulletin http://www.nelm.nhs.uk/en/ NICE http://www.nice.org.uk/ SIGN http://www.sign.ac.uk/new.html

NHS Library and Information Service North Staffordshire Contents in this issue:
Asthma...................................................................................................................................... 4 Autism ....................................................................................................................................... 4 Cancer ...................................................................................................................................... 4 Cardiovascular Diseases .......................................................................................................... 5 Children and Young People ...................................................................................................... 5 Commissioning ......................................................................................................................... 6 COPD ....................................................................................................................................... 7 Dementia .................................................................................................................................. 7 Diabetes.................................................................................................................................... 7 Disaster Planning ...................................................................................................................... 7 Epilepsy .................................................................................................................................... 8 Equipment................................................................................................................................. 8 Eye Health ................................................................................................................................ 8 Falls .......................................................................................................................................... 8 General Practice ....................................................................................................................... 9 Guidance .................................................................................................................................. 9 Health Reforms ....................................................................................................................... 11 Health Visitors ......................................................................................................................... 12 Infections ................................................................................................................................ 12 Information and Data .............................................................................................................. 13 Long Term Conditions............................................................................................................. 13 Mental Health.......................................................................................................................... 14 Midwifery................................................................................................................................. 15 The NHS ................................................................................................................................. 15 Nutrition .................................................................................................................................. 15 Obesity.................................................................................................................................... 16 Occupational Health ............................................................................................................... 16 Offender Health ...................................................................................................................... 16 Olympics ................................................................................................................................. 17 Palliative and End of Life Care ................................................................................................ 17 Patient Care and Safety .......................................................................................................... 17 Pharmacy and Prescribing ...................................................................................................... 18 Public Health........................................................................................................................... 19 Safeguarding Children and Vulnerable Adults ........................................................................ 20 Service Management .............................................................................................................. 20 Social Care ............................................................................................................................. 22 Stroke ..................................................................................................................................... 23 Substance Misuse .................................................................................................................. 23 Tobacco .................................................................................................................................. 24 Tuberculosis ........................................................................................................................... 24 Vaccination and Immunisation ................................................................................................ 25 Womens Health ..................................................................................................................... 25 Workforce ............................................................................................................................... 25

NHS Library and Information Service North Staffordshire Asthma

Fasting and asthma Asthma UK This leaflet outlines ways for people with asthma to protect their health while fasting. http://www.asthma.org.uk/about-asthma/living-with-asthma/fasting-and-asthma/
Items in the Children and Young People section may also be of interest. [back to topics]

Autism
Memorandum: Progress in implementing the 2010 Adult Autism Strategy National Audit Office This memorandum outlines the considerable progress that has been made in the two years since the Strategy was published, and areas where less progress has been made. http://www.nao.org.uk/publications/1213/adult_autism_strategy_progress.aspx

Cancer
Gynaecological Cancer Hub National Cancer Intelligence Network The hub includes Gynaecological Cancer Profiles; helpful links to organisations offering advice and support to those concerned about a gynaecological cancer; details of current gynaecological cancer projects; and resources for each type of gynaecological cancer, including key facts, briefings, posters, evidence, and guidance for health professionals. http://www.ncin.org.uk/cancer_type_and_topic_specific_work/cancer_type_specific_work/gyn aecological_cancer/gynaecological_cancer_hub/default.aspx National Oesophago- Gastric Cancer Audit 2012: An audit of the care received by people with Oesophago-Gastric Cancer in England and Wales Healthcare Quality Improvement Partnership This years report focuses on the results of an organisational audit and on longer-term followup and in-depth analysis of data collected in the First NOGCA. The organisational audit highlights that patients have good access to key diagnostic services and therapeutic procedures, although early detection and diagnosis remains a key issue. Improvements are also required in appropriate planning of palliative care. http://www.hqip.org.uk/national-oesophago-gastric-cancer-audit/ The Price We Pay for Progress: A Meta-Analysis of Harms of Newly Approved Anticancer Drugs Niraula, S et al. This meta-analysis looks at deaths, discontinuation of treatment and adverse events related to anticancer drugs. Published online before print July 16, 2012, doi: 10.1200/JCO.2011.40.3824
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NHS Library and Information Service North Staffordshire Cardiovascular Diseases

Lay perspectives on hypertension and drug adherence: systematic review of qualitative research Marshall, IJ et al. BMJ 2012;344:e3953 doi: 10.1136/bmj.e3953 (Published 9 July 2012) The Stroke Prevention in Atrial Fibrillation Expert Report: SAFE This report looks at the prevalence of atrial fibrillation, and variations in management of AF patients across the UK. It makes recommendations for improvement. http://www.atrialfibrillation.org.uk/files/file/AFA%20Online/sAFe%20report/120703-BH-1The%20sAFe%20report%20030712.pdf
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Children and Young People

Arrangements for the inspection of services for children looked after and care leavers Ofsted This is a consultation document on proposals for the inspection of services (including health services) for children looked after and care leavers. http://www.ofsted.gov.uk/resources/arrangements-for-inspection-of-services-for-childrenlooked-after-and-care-leavers Disease Management Information Toolkit ChiMat This good practice toolkit is designed to help increase the efficiency of services for children with long-term conditions. It provides a summary report of key data and information on trends over time and potential cost savings. Data is available for asthma, diabetes and epilepsy. http://www.chimat.org.uk/resource/view.aspx?QN=CHMTDMIT Good practice resource: Effective Child and Adolescent Mental Health Services: Buckinghamshire County Council Ofsted This example illustrates improving outcomes for children through good commissioning practices and pooling budgets to re-commission Tier 2 and 3 Child and Adolescent Mental Health Services (CAMHS) at Buckinghamshire Country Council (BCC). http://www.ofsted.gov.uk/resources/good-practice-resource-effective-child-and-adult-mentalhealth-services-buckinghamshire-county-counc Report of the children and young peoples Health Outcomes Forum Department of Health The Forum was asked to: identify the health outcomes that matter most for children and young people; consider how well these are supported by the NHS and Public Health Outcomes Frameworks; and set out the contribution that each part of the new health system needs to make in order that these health outcomes are achieved. http://www.dh.gov.uk/health/2012/07/cyp-report/
Items in the Midwifery, Obesity and Substance Misuse sections may also be of interest.

NHS Library and Information Service North Staffordshire Commissioning

Commissioning fact sheet for clinical commissioning groups NHS Commissioning Board This fact sheet sets out the services to be commissioned by clinical commissioning groups (CCGs) from April 2013. It also sets out the complementary services to be commissioned by the NHS Commissioning Board (NHS CB), local authorities and Public Health England (PHE). http://www.commissioningboard.nhs.uk/files/2012/07/fs-ccg-respon.pdf A consultation on the draft mandate to the NHS Commissioning Board Department of Health This consultation seeks views on a draft of the first mandate to the NHS Commissioning Board, including a draft choice framework which illustrates the Governments intended approach to explaining the choices that will be available for people using NHS services in England. Closing date for comments: 26 September 2012 http://consultations.dh.gov.uk/nhs-commissioning-unit/mandate/consult_view Code of Conduct: Managing conflicts of interest where GP practices are potential providers of CCG-commissioned services NHS Commissioning Board The Code sets out additional safeguards that CCGs are advised to use when commissioning services for which GP practices could be potential providers. The NHS Commissioning Board anticipate incorporating the Code into guidance for CCGs on managing conflicts of interest. http://www.commissioningboard.nhs.uk/files/2012/07/c-of-c-conflicts-of-interest.pdf Related resources at: http://www.commissioningboard.nhs.uk/resources/resources-for-ccgs/ Health impact assessment Drawing on the work of NHS South of Tyne and Wear, this document outlines the key stages of the Health Impact Assessment process and provides a case study which demonstrates how this process might be used to influence decision-making and service delivery. http://www.networks.nhs.uk/news/health-impact-assessment-recommended-for-health-andwellbeing-boards Payment by Results data assurance framework 2012/13: Guidance for commissioners and their providers Audit Commission The programme this year will allow for more flexibility for commissioners to focus audits on specific areas of local risk to PbR data quality. This year, members of the central PbR assurance team will act as client managers, working with PCT clusters to define the scope of the local audit work. http://www.auditcommission.gov.uk/health/paymentbyresults/reportsandstudies/Pages/pbrdaf201213guidance .aspx
Items in the Cancer, Children and Young People, Diabetes, Midwifery, Mental Health, NHS, Older People, Stroke and Substance Misuse sections may also be of interest. [back to topics]

NHS Library and Information Service North Staffordshire COPD

Inhaled corticosteroids for stable chronic obstructive pulmonary disease Yang, IA et al. This Cochrane review considers the benefits and side effects of inhaled corticosteroids. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD002991.pub3/abstract Tiotropium versus placebo for chronic obstructive pulmonary disease Karner, C et al. This Cochrane review looked at the effectiveness of tiotropium, and the impact of tiotropium delivered by a dry powder or soft mist inhaler. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD009285.pub2/abstract

Dementia
National Dementia and Antipsychotic Prescribing Audit National Summary Report: Key findings on the prescription of antipsychotics for people with dementia in England Report for the audit period 2006 to 2011 NHS Information Centre This report looks at the numbers and age of people diagnosed with dementia, and highlights the decrease in antipsychotic prescribing for people with dementia. http://www.ic.nhs.uk/services/national-clinical-audit-support-programme-ncasp/auditreports/dementia

Diabetes
A guide to diabetes management during Ramadan NHS Diabetes This guide brings together guidance and links to support health care professionals understand how to support their service users living with diabetes who wish to fast during Ramadan. http://www.diabetes.nhs.uk/ramadan/
Items in the Children and Young People section may also be of interest. [back to topics]

Disaster Planning
Assessment of health-system crisis preparedness: England World Health Organisation This report describes the level of preparedness of the English health system to deal with crises, regardless of cause. It also examines risk-prevention and risk-mitigation initiatives. http://www.euro.who.int/en/what-we-do/health-topics/emergencies/disaster-preparednessand-response/publications/2012/assessment-of-health-system-crisis-preparedness-england Resource pack published for local health resilience partnerships Department of Health New arrangements for local health emergency preparedness, resilience and response will start from 1 April 2013 as part of changes the Health and Social Care Act 2012 makes to the 7

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health system. This pack aims to support Local Health Resilience Partnerships (LHRPs). LHRPs will be strategic forums for joint planning for emergencies and to support the health sectors contribution to multi-agency planning through local resilience fora (LRFs). http://www.dh.gov.uk/health/2012/07/resilience-partnerships/

Epilepsy
Items in the Children and Young People section may be of interest.

Equipment
Building a business case for investing in adaptive technologies in England LSE Health and Social Care This report uses a quantitative model to estimate the value of equipment and adaptations to help people live independently in their own homes. http://blogs.lse.ac.uk/healthandsocialcare/2012/07/13/building-a-business-case-for-investingin-adaptive-technologies-in-england/
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Eye Health
Atlas of Optical Variation - Enhanced Eye Health Services in England Local Optical Committee Support Unit This map shows which community eye care pathways are available where, according to the current arrangement of PCT clusters. http://www.locsu.co.uk/enhanced-services-pathways/enhanced-services-map Undetected sight loss in care homes: an evidence review International Longevity Centre UK and Thomas Pocklington Trust This review of sight testing and sight loss in care homes argues that eye care and sight testing are both seriously neglected in care homes, leading to potential discrimination against those living in them compared to those who are cared for in the community. http://www.pocklingtontrust.org.uk/Resources/Thomas%20Pocklington/Documents/PDF/Research%20Publications/I LC%20UK%20Undetected%20sight%20loss%20in%20care%20homes.pdf
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Falls
FallSafe Prevention Resources RCP This website contains the learning from the project, care bundle information and templates, a falls prevention e-learning course and other resources. http://www.rcplondon.ac.uk/resources/falls-prevention-resources
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NHS Library and Information Service North Staffordshire General Practice

Heatwave Plan for England 2012: An overview of the challenges for primary care arising from heatwaves RCGP This document is a prcis of Department of Health heatwave plans relevant to General Practitioners. It identifies the threat a heatwave represents to health, helps identify which groups of patients are most at risk and explores strategies those providing Primary care services should consider in order to prevent premature death and morbidity. http://www.rcgp.org.uk/pdf/Heatwave%202012%20FINAL.pdf Medical Generalism: Why expertise in whole person medicine matters RCGP The report describes how medical generalists provide care that is both focused on individual wellbeing and delivers wider benefits, helping to ensure that the NHS remains one of the most cost-effective health systems in the world. http://www.rcgp.org.uk/policy/commissn_on_generalsm.aspx
Items in the Commissioning section may also be of interest. [back to topics]

Guidance
NICE Clinical Guidelines Spasticity in children and young people CG145 http://guidance.nice.org.uk/CG145 Preventing type 2 diabetes: risk identification and interventions for individuals at high risk PH38 http://guidance.nice.org.uk/PH38 NICE Technology Appraisals Venous thromboembolism (treatment and long term secondary prevention) rivaroxaban TA261 http://guidance.nice.org.uk/TA261
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NICE Briefings Physical activity http://publications.nice.org.uk/physical-activity-phb3 Tobacco http://publications.nice.org.uk/tobacco-phb1 9

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Workplace health http://publications.nice.org.uk/workplace-health-phb2
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NICE Consultation Documents SeHCAT (tauroselcholic [75selenium] acid) for the investigation of diarrhoea due to bile acid malabsorption: diagnostics consultation document Closing date for comments: 21 August 2012 http://guidance.nice.org.uk/DT/8/Consultation/DraftGuidance Heart failure (chronic): ivabradine: appraisal consultation document Closing date for comments: 29 August 2012 http://guidance.nice.org.uk/TA/Wave26/10/Consultation/DraftGuidance Other Guidance Guidance on Prevention of Viral Hepatitis B and C Among People Who Inject Drugs World Health Organisation http://www.who.int/hiv/pub/guidelines/hepatitis/en/index.html Practice standards for young people with substance misuse problems Royal College of Psychiatrists http://www.rcpsych.ac.uk/press/pressreleases2012/substanceusepracticestandards.aspx Professional standards for hospital pharmacy services; optimising patient outcomes from medicines. Royal Pharmaceutical Society http://www.rpharms.com/unsecure-support-resources/professional-standards-for-hospitalpharmacy.asp Remote prescribing via telephone, fax, video-link or online GMC http://www.gmc-uk.org/guidance/ethical_guidance/13594.asp Other Health Technology Assessments Interventions to reduce or prevent obesity in pregnant women: a systematic review Thangaratinam, S et al. This study found that dietary and physical activity interventions in pregnancy are effective at reducing maternal weight gain in pregnancy and the incidence of large-for-gestational-age infants, with dietary interventions also effective at reducing gestational hypertension, preeclampsia, gestational diabetes and shoulder dystocia, and that there are no changes in other neonatal morbidity or mortality outcomes with the interventions. Health Technol Assess 2012:16(31) Developing and testing methods for deriving preference-based measures of health from condition-specific measures (and other patient-based measures of outcome). Brazier J, et al. This report found that condition-specific preference-based measures of health can have an important role in ensuring that the benefits of health-care interventions are properly reflected 10

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in quality-adjusted-life-year estimates for economic evaluation for all patient groups when generic measures are not sensitive to potentially important differences. Health Technol Assess 2012:16(32)
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Health Reforms
Consultation on joint strategic needs assessment and joint health and wellbeing strategy guidance Department of Health The draft guidance provides a framework for NHS and local government to work together to undertake joint strategic needs assessments (JSNA) and joint health and wellbeing strategies (JHWS). Closing date for comments: 28 September 2012 http://www.dh.gov.uk/health/2012/07/consultation-jsna/ Consultation on local authority health scrutiny The consultation seeks views on the requirements for health service reconfiguration and referrals, in terms of local authority involvement and agreement, timescales, and NHS Commissioning Board involvement Closing date for comments: 7 September 2012 http://www.dh.gov.uk/health/2012/07/health-scrutiny/ Commissioning assembly NHS Commissioning Board The assembly will bring together leaders from all CCGs and the NHSCB. Its purpose and roles will include: to create shared leadership at national level across all clinical commissioners; to be the infrastructure through which CCGs and the NHSCB can co-produce national strategy and direction; and to be a learning network through which leaders of NHSCB and CCGs can develop commissioning to be the best it can be http://www.commissioningboard.nhs.uk/2012/07/05/ccg-com-ass/ A new development tool for health and wellbeing boards Local Government Association This tool aims to assist boards to explore their strengths and opportunities to improve and to inspire their ambition to develop a clear sense of purpose and an approach which will help transform services and outcomes for local people. http://www.local.gov.uk/web/guest/health/-/journal_content/56/10171/3638628/ The new NHS provider licence consultation document Monitor The Health and Social Care Act 2012 makes changes to the way NHS service providers will be regulated, and gives Monitor new duties and powers. These changes include the introduction of a Monitor licence for providers of NHS services. This is the statutory consultation on the new provider licence. Closing date for comments: 23rd October 2012

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http://www.monitor-nhsft.gov.uk/home/news-events-and-publications/ourpublications/consultations/consultations-and-engagement-monito-0 Strategic clinical networks NHS Commissioning Board The NHS Commissioning Board Authority has set out its plan for a small number of national networks to improve health services for specific patient groups or conditions. These organisations will build on the success of network activity in the NHS which, over the last 10 years, has led to significant improvements in the delivery of patient care. http://www.commissioningboard.nhs.uk/2012/07/26/strat-clin-networks/
Items in the Disaster Planning and Mental Health sections may also be of interest. [back to topics]

Health Visitors
Health Visitor Implementation Plan Quarterly Progress Report: April-June 2012 Department of Health This report looks at training and recruitment and early implementer sites (including Stoke-onTrent). http://www.dh.gov.uk/health/2012/07/health-visitors/ Health Visitor Teaching in Practice: A Framework Intended for Use for Commissioning, Education and Clinical Practice of Practice Teachers (PTs) Department of Health The framework aims to improve understanding of the role and importance of the practice teacher, their preparation and responsibilities, in order to deliver improved outcomes for children, families and communities. http://www.dh.gov.uk/health/2012/07/hv-teaching/
Items in the Midwifery section may also be of interest. [back to topics]

Infections
Developing and Sustaining a Practice Based Strategy for Reducing Healthcare Associated Infections Programme: Evaluation report Foundation of Nursing Studies This report expands on the participants experience of the programme, outcome for practice, and key learning that has relevance for a wide range of practice areas seeking to develop, change and improve practice. http://www.fons.org/resources/documents/Programmes/LSHAEvaluationJuly2012.pdf Management of Hazard Group 4 viral haemorrhagic fevers and similar human infectious diseases of high consequence Department of Health

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The guidance replaces previous guidance issued in 1996 and provides advice on how patients suspected of being infected with a VHF should be comprehensively assessed, rapidly diagnosed and safely managed within the NHS, to ensure the protection of public health. http://www.dh.gov.uk/health/2012/07/vhf-guidance/ Hepatitis C in the UK: 2012 report Health Protection Agency This report looks at numbers of people with Hepatitis C in the UK, and related hospital admissions and deaths. It also describes public health programmes working to increase awareness and prevention. http://www.hpa.org.uk/Publications/InfectiousDiseases/BloodBorneInfections/HepatitisCInThe UK/1207HepCintheUK2012/ Whooping cough (gypsy and traveller communities) Health Protection Agency This factsheet outlines what whooping cough is, what the risks are, and what members of the public should do if they think they have whooping cough. http://www.hpa.org.uk/webc/HPAwebFile/HPAweb_C/1317135120210 Whooping cough in older children, adolescents and adults Health Protection Agency This factsheet outlines what whooping cough is, what the risks are, and what members of the public should do if they think they have whooping cough. http://www.hpa.org.uk/webc/HPAwebFile/HPAweb_C/1317134480075
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Information and Data

Informatics: The future - An organisational summary Department of Health This summary gives an overview of the future system for informatics, as set out in the information strategy, and a description of the roles of the key organisations. http://www.dh.gov.uk/health/2012/07/informatics-future/ Guide to Health Records Access Patient Information Forum This guide gives a vision for the future of Personal Health Records, and an understanding of some of the challenges and barriers which must be overcome in order to realise their full potential. It points to solutions to these barriers and is, in effect, a call to action. http://www.pifonline.org.uk/themes/pif-publications/guide-to-records-access/

Long Term Conditions

Telehealth: Better for Less NHS Yorkshire and the Humber Telehealth enables healthcare professionals to provide patient care from a remote location. 13

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Patients with a long term condition can be supported through monitoring, advice and interventions to manage their condition and reduce exacerbations. It improves patients quality of life, reduces use of healthcare facilities and frees nurses and GPs time spent taking routine measurements. Some telehealth pilot schemes have seen a 50% reduction in the number of unplanned hospital admissions, if replicated this would equates to a saving of more than 520m across Yorkshire and the Humber, or over 22m for the average sized CCG in the region. http://www.healthyambitions.co.uk/Uploads/BetterForLess/BETTER%20FOR%20LESS_TEL EHEALTH.pdf

Mental Health
Citalopram versus other anti-depressive agents for depression Cipriani, A et al. This review included thirty-seven trials of citalopram and other anti-depressants. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD006534.pub2/abstract Community Mental Health Profiles North East Public Health Observatory The CMHP are designed to give an overview of mental health risks, prevalence and services at a local, regional and national level using an interactive mapping tool. http://www.nepho.org.uk/cmhp/ Investment in mental health: working age adults and older adults Department of Health These reports compare levels of investment in different areas of mental health services over time. http://www.dh.gov.uk/health/2012/07/investment-mental-health/ Mental Capacity Act 2005, Deprivation of Liberty Safeguards assessments - England, 2011-12, Third report on annual data NHS Information Centre http://www.ic.nhs.uk/pubs/mentalcapacity1112annual The National Confidential Inquiry into Suicide and Homicide by People with Mental Illness: annual report 2012 Centre for Mental Health and Risk. University of Manchester. This report provides an in-depth analysis of the changing patterns and risk factors behind cases of suicide and homicide by people in contact with mental health services along with cases of sudden unexplained death amongst psychiatric in-patents. http://www.medicine.manchester.ac.uk/cmhr/centreforsuicideprevention/nci/reports/ No health without mental health: implementation framework Department of Health This framework sets out what employers, schools, businesses, local authorities, housing organisations, voluntary groups and health and care organisations can do to promote good mental health. http://www.dh.gov.uk/health/2012/07/mentalhealthframework/ 14

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NHS Confederation have produced a briefing on the Framework which is available at http://www.nhsconfed.org/Publications/briefings/Pages/mhn-briefing-247.aspx
Items in the Children and Young People sections may also be of interest. [back to topics]

Midwifery
Family Nurse Partnership Programme Information Leaflet Department of Health This revised and updated leaflet covers the main features of the programme, as well as information for commissioners. http://www.dh.gov.uk/health/2012/07/family-nurse-partnership-programme-information-leaflet/ Innovation and Improvement in Midwifery Services RCM This report concludes that it is possible to deliver high quality, safe and effective care when midwives are engaged and lead on innovation and emphasises the important role that clinical leadership plays in enabling innovation and improvement to take place. http://www.rcm.org.uk/college/policy-practice/government-policy/ipa/
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The NHS
Health Secretarys annual report on the NHS and public health Department of Health This report aims to enable Parliament and the public to see in what direction the NHS is going. http://www.dh.gov.uk/health/2012/07/annual-report/ Report on the effect of the NHS Constitution Department of Health The report considers whether, and to what extent, the Constitution has made a difference to patients, staff, carers and the public, and examines the degree to which it is succeeding in its aims. http://www.dh.gov.uk/health/2012/07/nhs-constitution/ Securing the future financial sustainability of the NHS National Audit Office This audit found that the NHS delivered a 2.1bn surplus in 2011-12 but there is some financial distress in NHS trusts with some very large deficits. http://www.nao.org.uk/publications/1213/nhs_financial_sustainability.aspx
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Nutrition

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National Diet and Nutrition Survey: Headline Results from Years 1, 2 and 3 (combined) of the Rolling Programme 2008/09 2010/11 Department of Health This survey is a continuous cross-sectional survey, designed to assess the diet, nutrient intake and nutritional status of the general population aged 18 months upwards living in private households in the UK. http://transparency.dh.gov.uk/2012/07/25/ndns-3-years-report/

Obesity
Adult Weight Data Factsheet National Obesity Observatory This factsheet presents key data about obesity by gender, age, ethnicity, and deprivation. http://www.noo.org.uk/uploads/doc/vid_16201_AdultWeightFactsheetJuly2012_v2.pdf Child Weight Data Factsheet National Obesity Observatory This factsheet presents key data about obesity by gender, age, ethnicity, and deprivation. http://www.noo.org.uk/uploads/doc/vid_16006_ChildWeightFactsheet-July2012.pdf Memorandum: An update on the government's approach to tackling obesity National Audit Office The government outlined its ambitions in October 2011, to tackle excess weight in adults by 2020. Current trends suggest that achieving these ambitions will be challenging. http://www.nao.org.uk/publications/1213/tackling_obesity_update.aspx Obesity and the environment: fast food outlets National Obesity Observatory This one page summary include a map and tables showing the relationship between density of fast food outlets and deprivation by local authority. http://www.noo.org.uk/uploads/doc/vid_15683_FastFoodOutletMap2.pdf
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Occupational Health
Service level agreement (SLA) template for occupational health NHS Employers This template can be adapted locally for occupational health units to use with their providers. http://www.nhsemployers.org/HealthyWorkplaces/LatestNews/Pages/TemplateSLALaunched. aspx
Items in the Workforce section may be of interest. [back to topics]

Offender Health
National survey of hepatitis C services in prisons in England Department of Health 16

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This survey shows that diagnosis and treatment for chronic hepatitis C infection is available to prisoners in most prisons in England, but that care models available vary between in-reach service and out-reach based services. http://www.dh.gov.uk/health/2012/07/hepc-prisons/
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Olympics
First Report: Sport and exercise science and medicine: building on the Olympic legacy to improve the nation's health House of Lords Science and Technology Committee This enquiry asked two questions: how robust is the research and evidence base for improving the performance of elite and non-elite athletes; and how can this knowledge be translated into treatments and preventative interventions to improve the nation's health? http://www.publications.parliament.uk/pa/ld201213/ldselect/ldsctech/33/3302.htm
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Palliative and End of Life Care

Dont let me down: ensuring a good transition for young people with palliative care needs Marie Curie Cancer Care This report makes recommendations on assessing young peoples needs, and providing appropriate support and services as they transition to adult services. http://www.mariecurie.org.uk/Documents/press-and-media/News-Comment/Dont-Let-MeDown.pdf The route to success in end of life care: achieving quality for social work National NHS End of Life Care Programme Following the nationally-recognised six-step end of life care pathway, the guide includes key issues and actions for social workers and their managers, reflective questions, examples of good practice and anonymised case studies. http://www.endoflifecareforadults.nhs.uk/publications/rts-socialwork
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Patient Care and Safety

Helping people share decision making Health Foundation This report looks at the benefits of shared decision making, and how this can be achieved and developed. http://www.health.org.uk/publications/helping-people-share-decision-making/ Patient Environment Action Team (PEAT) - results 2012, England NHS Information Centre 17

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These are the 2012 results from annual assessments undertaken by NHS and independent healthcare providers in respect of hospitals with 10 or more in-patient beds. This assessment focusses on the environment in which care is provided and the quality of non-clinical services such as food and privacy and dignity. http://www.ic.nhs.uk/pubs/peatresults2012

Summary Hospital-level Mortality Indicator (SHMI) - Deaths associated with hospitalisation: England, January 2011 - December 2011, Experimental Statistics NHS Information Centre http://www.ic.nhs.uk/statistics-and-data-collections/hospital-care/summary-hospital--levelmortality-indicator-shmi/summary-hospital-level-mortality-indicator-shmi--deaths-associatedwith-hospitalisation-england-january-2011--december-2011-experimental-statistics Survey of bereaved people: key findings report Department of Health The survey was run by the Office for National Statistics, on behalf of the Department of Health. http://www.dh.gov.uk/health/2012/07/voices/ When doctors and patients talk: making sense of the consultation Health Foundation This report analyses the consultation, and looks at how doctors and patients fears and invisible structures may affect it. It looks at how the consultation can be developed and improved through support for both doctors and patients. http://www.health.org.uk/publications/when-doctors-and-patients-talk-making-sense-of-theconsultation/
Items in the Commissioning, Health Reforms, Information and Data and Social Care sections may also be of interest. [back to topics]

Pharmacy and Prescribing

Combination pharmacotherapy for the treatment of neuropathic pain in adults Chaparro, LE et al. This Cochrane review looks at studies of a wide range of combinations of drugs. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD008943.pub2/abstract The evaluation of the electronic prescription service in primary care: interim report on the findings from the evaluation in early implementer sites University College London This report looks at the impact of electronic prescriptions on patients, GP practices and pharmacies. It also considers the benefits for the Department of Health and the NHS. http://www.ucl.ac.uk/news/news-articles/1207/120709-first-evaluation-of-electronicprescription-service

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The safer management of controlled drugs: Annual report 2011 Care Quality Commission This report looks at the use of controlled drugs in health and social care organisations and partner organisations. It also covers recent trends in the use of controlled drugs, and makes recommendations for accountable officers and others. http://www.cqc.org.uk/sites/default/files/media/documents/20120611_cdar_2011_final.pdf Summary: http://www.cqc.org.uk/sites/default/files/media/documents/20120725_cd_annual_report_2011 _summary_final.pdf
Items in the Cardiovascular Diseases and Dementia sections may also be of interest. [back to topics]

Public Health
2011 Census, Population and Household Estimates for England and Wales Office for National Statistics http://www.ons.gov.uk/ons/rel/census/2011-census/population-and-household-estimates-forengland-and-wales/index.html Births and Deaths in England and Wales (provisional), 2011 Office for National Statistics http://www.ons.gov.uk/ons/rel/vsob1/death-reg-sum-tables/2011--provisional-/sb-births-anddeaths-first-release--2011.html PHOs in England Tools Directory and Guide to Key Data Sources Association of Public Health Observatories This resource aims to give quick and easy access to key public health intelligence resources. Most of the tools listed are produced by public health observatories, however some are nonPHO tools used regularly by public health analysts. Some key data sources are also listed. http://www.apho.org.uk/resource/view.aspx?RID=96907 Public Health Responsibility Deal Annual Updates Department of Health This website lists the Public Health Responsibility Deal partners, and their pledges and plans for implementation. 180 partners (out of 390 partner organisations) have recently provided an annual update. http://responsibilitydeal.dh.gov.uk/our-partners/ Vision for Public Health England Department of Health 19

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This document outlines Public Health Englands Chief Executives approach to creating Public Health England, and gives some information about roles in the senior leadership team. http://healthandcare.dh.gov.uk/vision-phe/ The Structure of Public Health England is available at http://healthandcare.dh.gov.uk/phestructure/
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Safeguarding Children and Vulnerable Adults

Consultation on a new adult safeguarding power Department of Health This consultation sets out a new specific power of entry, and the circumstances in which it could give an opportunity to offer timely information and advice, and ensure that people who are unable or unwilling to ask for help can have their voices heard. Closing date for comments: 12 October 2012 http://www.dh.gov.uk/health/2012/07/safeguardingadults/ Proposals for the joint inspection of multi-agency arrangements for the protection of children Ofsted Ofsted, (CQC), Her Majestys Inspectorate of Constabulary, Her Majestys Inspectorate of Probation and Her Majestys Inspectorate of Prisons are committed to the introduction of a new joint inspection of multi-agency arrangements for the protection of children in England. These inspections will focus on the effectiveness of local authority and partners services for children who may be at risk of harm. Closing date for comments: 2 October 2012 http://www.ofsted.gov.uk/resources/proposals-for-joint-inspection-of-multi-agencyarrangements-for-protection-of-children Protecting children and young people: The responsibilities of all doctors GMC The guidance includes advice on: identifying children and young people at risk of, or suffering, abuse or neglect; meeting the communication needs of children, young people and parents; confidentiality and sharing information; child protection examinations; and giving evidence in court. The guidance comes into effect 3 September 2012 http://www.gmc-uk.org/guidance/ethical_guidance/13257.asp
Items in the Mental health section may also be of interest. [back to topics]

Service Management
Consultation on future of audit staff in trusts Department of Health The focus of this consultation is the role and function of audit staff in trusts. It aims to help facilitate and support the contribution that audit staff in trusts make in the future. http://www.dh.gov.uk/health/2012/07/audit-staff/ 20

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Engaging people in sustainable healthcare: Guide to resources NHS Sustainable Development Unit This Guide provides practical advice, suggestions for action, examples of good practice and evidence of what works. http://www.sdu.nhs.uk/about-us/public-and-patient-engagement.aspx English hospitals can improve their use of resources: analysis of costs and length of stay for ten treatments Centre for Health Economics. University of York. This report looked at costs of 10 different procedures, including childbirth, and assessed the possible causes of variations. http://www.york.ac.uk/che/news/research-paper-78/ Guides to monitoring quality during transition Department of Health This series of How to guides aims to assist current NHS organisations, and their supervisory and regulatory bodies, to respond to quality risks and failures within a simple and single framework during this transition year. The guides are: How to: organise and run a rapid responsive review; How to: quality impact assess provider cost improvement plans; and How to: organise and run a risk summit. http://www.dh.gov.uk/health/2012/07/nqb-transition-guides/ The home cure Demos This report examines whether, through changes to structure and delivery, out-patient home care programmes can achieve better outcomes, for example through facilitating swifter discharge. It recommends that reablement services have a wider focus on activities outside the home and that they endeavour to build networks to sustain their initial positive impact. It also argues that social housing providers are an untapped resource in addressing these priorities. http://www.demos.co.uk/publications/thehomecure Improved NHS Services Through New Perspectives: a toolkit for Doctors and Managers to improve quality for patients Centre for Innovation in Health Management. Leeds University. This toolkit offers a way of improving productive working between doctors and managers. The process will develop a better shared agenda, a better understanding of how to work together and a better working relationship between doctors and managers. http://www.cihm.leeds.ac.uk/new/2012/07/improved-nhs-services-through-new-perspectives%E2%80%93-a-toolkit/ Registration required to access this resource. Registration is free. The NHS Change Model NHS Improvement The model has been created to support the NHS to adopt a shared approach to leading change and transformation. It brings together collective improvement knowledge and experience from across the NHS into eight key components. It is intended to be relevant to all NHS staff, as a way of making sense at every level of the how and why for delivering improvement. 21

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http://www.changemodel.nhs.uk/pg/dashboard/ Registration of healthcare at children's homes (July 2012 update) CQC and Ofsted This document is agreed joint guidance about the registration of childrens settings under the Care Standards Act 2000 and the Health and Social Care Act 2008, including childrens homes that provide health activities. It clarifies what childrens settings will need to register and how Ofsted and CQC will manage this registration process. http://www.ofsted.gov.uk/resources/cqc-and-ofsted-guidance-registration-of-healthcarechildrens-homes Report of the Commission on the Future of Local Government This report lists five propositions for helping meet the big economic, social, environmental and democratic challenges facing the UK in the 21st century. Proposition 4, Devising a new social contract, looks at delivery of services, including health and social care. http://civicenterpriseuk.org/commission-final-report/
Items in the Children and Young People, Commissioning, Health Reforms and Mental Health sections may also be of interest. [back to topics]

Social Care
Focus Report: learning the lessons from complaints about adult social care providers registered with the Care Quality Commission Local Government Ombudsman This report highlights trends in complaints, and makes recommendations for improving care and resolving complaints locally. http://www.lgo.org.uk/news/2012/jul/lgo-reports-key-emerging-trends-adult-social-carecomplaints/ Caring for our future: reforming care and support Department of Health This white paper sets out the vision for a reformed care and support system. http://www.dh.gov.uk/health/2012/07/careandsupportwhitepaper/ Draft Care and Support Bill: http://careandsupportbill.dh.gov.uk/home/ Progress report on funding reform: http://www.dh.gov.uk/health/2012/07/scfunding/ Fair care for the future: why social care matters for deafblind people Sense This report is based upon a survey of deafblind peoples experiences of social care in England and Wales. http://www.sense.org.uk/campaigns/walk_with_me/walk_with_me_fair_care.htm Fingertips: adult social care Eastern Region Public Health Observatory The outcomes data has been updated to include 2010/11 data, and to reflect the Social Care Outcomes Framework. 22

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http://fingertips.erpho.org.uk/adultsocialcare/england/westmidlands Shaping the choreography of care and support for older people in Glasgow This project aimed to foster innovative strategies and actions for the development of future support for older people's well-being. It involved multidisciplinary teams (comprising designers, social service practitioners and users). The objective was to match the future expectations and aspirations of living a good older life to the resources that will be available to deliver it. http://www.iriss.org.uk/resources/shaping-choreography-care-and-support-older-peopleglasgow
Items in the Palliative and End of Life Care section may also be of interest.

Stroke
Stroke rehabilitation in the community - commissioning for improvement: An information resource for providers and commissioners of stroke rehabilitation and early supported discharge services in the community NHS Improvement This document is a comprehensive guide to the development of effective community rehabilitation services. Together with detailed examples of good practice and information about early supported discharge (ESD) service models implemented in England, it explores factors which influence local commissioning, and identifies tools to assist with commissioning and funding rehabilitation. http://www.improvement.nhs.uk/documents/Stroke_Rehab.pdf
Items in the Cardiovascular Diseases section may also be of interest. [back to topics]

Substance Misuse
Drug and Alcohol Recovery Pilots: Lessons learnt from Co-Design and commissioning with payment by results Department of Health The document includes: reasons for adopting payment by results; the basic model for the pilots; design details for the national outcomes; decisions on pricing and weighting; and resource and support. http://recoverypbr.dh.gov.uk/2012/07/17/lessonslearnt/ Exploring the Treatment Integrity of Custodial Addiction Therapeutic Communities Ministry of Justice The aims of the study were to explore current delivery in four prison addiction therapeutic communities (TCs) in England. While there is good international evidence that addiction TCs are effective in facilitating positive change in drug using offenders, there is limited evidence of their effectiveness in the UK. Concerns have also been raised over the difficulties of maintaining treatment integrity in such regimes. It is therefore important to establish whether communities are functioning as intended and adhering to their model of change. 23

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http://www.justice.gov.uk/publications/research-and-analysis/moj/exploring-the-treatmentintegrity-of-custodial-addiction-therapeutic-communities

Smoking, drinking and drug use among young people in England in 2011 NHS Information Centre This report contains results from an annual survey of secondary school pupils in England in years 7 to 11 (mostly aged 11 to 15). 6,519 pupils in 219 schools completed questionnaires in the autumn term of 2011. http://www.ic.nhs.uk/statistics-and-data-collections/health-and-lifestyles-relatedsurveys/smoking-drinking-and-drug-use-among-young-people-in-england/smoking-drinkingand-drug-use-among-young-people-in-england-in-2011
[back to topics]

Tobacco
Weight gain in smokers after quitting cigarettes: meta-analysis Aubin, H et al. This review looked at levels of weight gain in smokers 1, 2, 3, 6 and 12 months after quitting. BMJ 2012; 345 doi: 10.1136/bmj.e4439 (Published 10 July 2012)

Tuberculosis
Tackling the prevalence of Tuberculosis amongst poorly housed minority ethnic communities in London Race Equality Foundation This briefing argues that the spread of tuberculosis (TB) is exacerbated in urban communities where overcrowding, inadequate ventilation, and the presence of mould and smoke in the home are rife. Focussing on the transmission of TB among migrant groups, it explores the need to address factors that make black and minority ethnic communities particularly vulnerable to infection, and discusses measures to improve the provision of housing services targeted specifically at these groups. http://www.better-housing.org.uk/briefings/tackling-prevalence-tuberculosis-amongst-poorlyhoused-minority-ethnic-communities-london Tuberculosis in the UK: 2012 report Health Protection Agency This report records that although levels of TB in the UK were higher in 2011 than in 2010, the trend is stabilising. It analyses which groups of patients are most likely to get TB, and looks at problems of drug-resistant strains of the disease. http://www.hpa.org.uk/webw/HPAweb&HPAwebStandard/HPAweb_C/1317134916916
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NHS Library and Information Service North Staffordshire Vaccination and Immunisation
Green Book Department of Health Several chapters have been updated: Chapter 4: Immunisation Procedures http://immunisation.dh.gov.uk/green-book-chapters/chapter-4/ Chapter 18a: Human Papilloma Virus (HPV) http://immunisation.dh.gov.uk/green-book-chapters/chapter-18a/ Chapter 35: Yellow Fever http://immunisation.dh.gov.uk/green-book-chapters/chapter-35/ Quality criteria for an effective immunisation programme Health Protection Agency This document defines the key elements for the implementation and delivery of a safe, equitable, high quality, efficient immunisation service which is responsive to the needs of vaccine recipients and/or their carers. http://www.hpa.org.uk/Publications/InfectiousDiseases/Immunisation/1207Qualitycriteriaforim mprogramme/
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Womens Health
Findings of termination of pregnancy inspections Care Quality Commission These inspections, which took place in March, looked specifically for evidence of pre-signed HSA1 forms. They followed a letter from the Chief Medical Officer in February to all providers of termination of pregnancy services making clear their responsibilities under the Abortion Act. http://www.cqc.org.uk/media/findings-termination-pregnancy-inspections-published Long term hormone therapy for perimenopausal and postmenopausal women Marjoribanks, J et al. This Cochrane review assesses whether HRT can prevent a range of diseases, including cardiovascular diseases and dementia. It also considers adverse effects of HRT. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004143.pub4/abstract
Items in the Cancer section may be of interest. [back to topics]

Workforce
Ensuring education reform enhances patient outcome NHS Employers This briefing looks at how the creation of Health Education England (HEE) and Local Education and Training Boards (LETBs) provides the opportunity for employers to ensure that 25

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the 5 billion annual national investment in education and training delivers the best possible patient outcome. http://www.nhsemployers.org/PlanningYourWorkforce/Nursing/Latestnews/Pages/EnsuringEducationReformEnhancesPatientOutcomeBriefing.aspx

How to use shift systems and workforce planning to effectively reduce agency spend NHS Employers This briefing looks at various factors which contribute to reducing spending on agency staff while ensuring high quality patient care. http://www.nhsemployers.org/PlanningYourWorkforce/Flexibleworkforce/AgencyWorkers/ReducingAgencySpend/HowToGuides/Pages/Howtouseshiftsyste ms.aspx Model staff engagement policy NHS Employers The policy is based on good examples that exist already, and learning from those organisations who already have a policy in place. http://www.nhsemployers.org/EmploymentPolicyAndPractice/staffengagement/Pages/Modelstaffengagementpolicy.aspx Performance review 2011/12 Council for Healthcare Regulatory Excellence The performance review is CHREs annual check on how effective the regulators have been in protecting the public and promoting confidence in health professionals and themselves. They assess the regulators performance in their four regulatory functions: guidance and standards, education and training, registration and fitness to practise http://www.chre.org.uk/satellite/479 A picture of health and education Universities UK This reports illustrates the virtuous partnership between health providers and universities in supplying and developing the healthcare workforce. It also summarises the education of healthcare staff in terms of demand, supply, and funding and commissioning landscapes. http://www.universitiesuk.ac.uk/Publications/Pages/Apictureofhealthandeducation.aspx Rapid access to treatment and rehabilitation for NHS staff NHS Employers Rapid access is a system which will secure rehabilitation and occupational health treatment for NHS employees with a view to facilitating a return to work which is as fast as practical and reasonable. This will benefit the employee, the employer and patients. This guidance is intended for trust boards making decisions about how to manage rapid access services for staff in their organisation. http://www.nhsemployers.org/Aboutus/Publications/Pages/RapidAccesstoTreatmentandReha bilitationforNHSstaff.aspx Revalidation: specialty guidance 26

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Association of Medical Royal Colleges The guidance has been devised to simplify the appraisal process and the supporting information doctors need in order to revalidate. The specialty guidance frameworks have been produced based on the Academys core framework (agreed by all member Colleges and Faculties) to ensure commonality in appraisal for revalidation regardless of a doctors specialty. http://www.aomrc.org.uk/revalidation/item/speciality-frameworks-and-speciality-guidance.html Sector regulation: an update on plans for consultation and implementation Department of Health This document describes what the Department will consult on and when. It is designed to ensure that all those with an interest are aware of and able to read and respond to the consultations. The document also sets the consultations in context by recapping the aims and key components of the health and care modernisation programme as a whole, and of sector regulation in particular. http://www.dh.gov.uk/health/2012/07/sector-regulation-update/ Sickness Absence Rates in the NHS: January - March 2012 and Annual Summary 200910 to 2011-12 NHS Information Centre http://www.ic.nhs.uk/statistics-and-data-collections/workforce/sickness-absence/sicknessabsence-rates-in-the-nhs-january--march-2012-and-annual-summary-2009-10-to-2011-12
Items in the Health Visitors and Occupational Health sections may also be of interest. [back to topics]

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