KNOWLEDGE ALERT Date: 21st June 2016

This bulletin highlights recently produced documents and items of interest that have appeared on websites (coverage may not be comprehensive). If you have any comments or suggestions regarding this Bulletin, please email the library library@sthk.nhs.uk. All links are correct at time of publishing. If a link is broken please email the library and we will send you the correct link/document. Some documents are large and may take time to open so please be patient when waiting for links to open. If you have received this bulletin from a third party and would like to receive it direct please email the library. Library Contact Details: Library and Knowledge Service, St Helens & Knowsley Health Informatics, Level 1 Nightingale House, Whiston Hospital, Warrington Road, Prescot, Merseyside L35 5DR www.knowledge-nw.nhs.uk

CONTENTS:

ALLIED HEALTH PROFESSIONALS ANAESTHESIA CANCER CARDIOLOGY CHILDREN & YOUNG PEOPLE COMMISSIONING EMERGENCY MEDICINE/CRITICAL CARE GENERAL MEDICINE GENERAL PRACTICE AND PRACTICE MANAGEMENT GENERAL SURGERY HEALTH SERVICES MANAGEMENT INFECTION CONTROL AND INFECTIOUS DISEASES INFORMATICS AND INFORMATION GOVERNANCE MATERNITY & GYNAECOLOGY MEDICINES MANAGEMENT/PHARMACY MENTAL HEALTH AND WELLBEING NEUROLOGY NURSING PRACTICE OPHTHALMOLOGY PALLIATIVE CARE PATHOLOGY PUBLIC HEALTH/HEALTH IMPROVEMENT RADIOLOGY RESEARCH RESPIRATORY RHEUMATOLOGY STROKE UROLOGY

ALLIED HEALTH PROFESSIONALS Getting the guidance right Professor David Haslam, Chair, National Institute for Health and Care Excellence (NICE), spoke to the Royal College of Physicians' Commentary magazine about NICE’s role and new developments. Further information: https://www.nice.org.uk/news/feature/david-haslam-getting-the-guidance-right

ANAESTHESIA Prevalence of chronic pain in the UK: a systematic review and meta-analysis of population studies Based on data from the best available published studies, the authors of this review conclude that chronic pain affects between one-third and one-half of the population of the UK, corresponding to just under 28 million adults. This figure is likely to increase further in line with an ageing population. Systematic review: http://bmjopen.bmj.com/content/6/6/e010364.full News: http://www.bbc.co.uk/news/health-36574299

CANCER New radiotherapy regime for prostate cancer could save NHS tens of millions per year A shorter course of prostate cancer radiotherapy, involving fewer hospital visits and higher individual doses of radiotherapy, is as effective as the current standard treatment for both survival and quality of life, a major new study reports. Researchers leading the 14-year trial believe the new treatment schedule would be more convenient for patients and could save the NHS tens of millions of pounds per year. News: http://www.icr.ac.uk/news-archive/new-radiotherapy-regime-for-prostate-cancer-could-save-nhs-tens-of-millions-per-year Abstract: http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(16)30102-4/abstract Full text article (PDF): http://www.thelancet.com/pdfs/journals/lanonc/PIIS1470-2045(16)30102-4.pdf Blog: http://scienceblog.cancerresearchuk.org/2016/06/20/prostate-cancer-trial-results-should-mean-fewer-hospital-trips-to-have-radiotherapy/ Are YOU at risk? People who have been to university ‘more likely’ to get BRAIN tumours People who are highly educated are at greater risk of brain tumours than non-university educated people, a study has revealed. Those who studied for at least three years at university were more at risk of the most malignant brain tumours known as gliomas. The large observational study analysed more than 4.3 million Swedes, all born between 1911 and 1961. They were monitored between 1993 and 2010 which showed 5,735 of the men and 7,101 of the women developed primary brain tumours. News: http://www.express.co.uk/life-style/health/681544/brain-tumour-gliomas-more-likely-university-education-three-years-scientists Abstract: http://jech.bmj.com/content/early/2016/05/25/jech-2015-207002.abstract Full text article (PDF): http://jech.bmj.com/content/early/2016/05/25/jech-2015-207002.full.pdf+html Expert reaction: http://www.sciencemediacentre.org/expert-reaction-to-study-on-socioeconomic-status-and-brain-tumours/ 'Holy grail' of breast cancer prevention in high-risk women may be in sight An existing medication could have promise in preventing breast cancer in women carrying a faulty BRCA1 gene, researchers have discovered. News: https://www.sciencedaily.com/releases/2016/06/160620120247.htm Abstract: http://www.nature.com/nm/journal/vaop/ncurrent/abs/nm.4118.html Expert reaction: http://www.sciencemediacentre.org/expert-reaction-to-study-looking-at-brca1-gene-breast-cancer-precursor-cells-in-lab-and-inhibitor-of-protein-called-rank/ Join in with the new Be Clear on Cancer campaign From 14 July-16 October 2016, Public Health England will launch the next national Be Clear on Cancer campaign, focusing on the key respiratory symptoms of a persistent cough and inappropriate breathlessness and encouraging people that if they experience these symptoms to see their doctor. News: http://www.rpharms.com/what-s-happening-/news_show.asp?id=4037

CARDIOLOGY Millions of people may be needlessly taking statins every day: Study claims lowering cholesterol may NOT slash heart attack risk Millions of people may be needlessly taking statins every day, according to research which suggests lowering cholesterol below a certain level does nothing to reduce heart risk. Scientists questioned the ‘blanket’ medical assumption that lowering cholesterol reduces the risk of heart attacks, strokes and other cardiovascular problems. News: http://www.dailymail.co.uk/health/article-3650600/Millions-people-needlessly-taking-statins-day-Study-claims-lowering-cholesterol-NOT-slash-heart-attack-risk.html Abstract: http://archinte.jamanetwork.com/article.aspx?articleID=2528289 Expert reaction: http://www.sciencemediacentre.org/expert-reaction-to-study-looking-at-ldl-cholesterol-levels-and-heart-events-in-people-that-have-heart-disease-and-are-taking-statins/ Direct oral anticoagulants for stroke prevention in patients with atrial fibrillation: meta-analysis by geographic region with a focus on European patients The authors of this review found that direct oral anticoagulants (DOAC) did not provide additional benefit in reducing the risk of stroke/systemic embolic events (SEE) compared with warfarin in European patients with atrial fibrillation (AF), but were generally associated with a lower bleeding tendency than warfarin regardless of geographic region. Systematic review: http://onlinelibrary.wiley.com/doi/10.1111/bcp.13005/full Traditional Chinese medicines in the management of cardiovascular diseases: a comprehensive systematic review The authors of this review found that certain traditional Chinese medicines (TCM) compounds appear to have significant anti-hypertensive effects, and although some are associated in some studies with improved outcomes in coronary heart disease, heart failure and type 2 diabetes mellitus, the data are inconsistent and will require large-scale randomized-controlled trials to allow full evaluation of any potential therapeutic benefit in these areas. Systematic review: http://onlinelibrary.wiley.com/doi/10.1111/bcp.13013/abstract

CHILDREN & YOUNG PEOPLE Child Mental Health Horizon Scanning Bulletin 2015 Volume 4 Issue 3 Bringing together best practice, innovation and future risks to support the commissioning process and service redesign. Bulletin: https://childmentalhealthnwpctl.wordpress.com/category/child-mental-health/volume-4-issue-3/

COMMISSIONING Getting the guidance right Professor David Haslam, Chair, National Institute for Health and Care Excellence (NICE), spoke to the Royal College of Physicians' Commentary magazine about NICE’s role and new developments. Further information: https://www.nice.org.uk/news/feature/david-haslam-getting-the-guidance-right WEBINAR: Digital Primary Care Maturity Assurance module Webinar to outline this digital maturity assurance mechanism and the available functionality within the tool. Further information: https://www.england.nhs.uk/events/upcoming-webinars/ Related information: https://www.england.nhs.uk/digitaltechnology/info-revolution/digital-primary-care/ E-LEARNING: Bid-rigging The Competition and Markets Authority (CMA) and the Crown Commercial Service (CCS) have worked together with BuiltIntelligence to create this e-learning module which will help procurement professionals root out attempts to win contracts through anti-competitive conduct. Further information: http://builtintelligence.com/pages/learn-how-to-spot-bid-rigging Press release: https://www.gov.uk/government/news/procurement-tool-targets-bid-rigging-cheats Shining a light into dark corners Blog from: Professor Sir Malcolm Grant CBE, Chairman, NHS England.

Blog: https://www.england.nhs.uk/2016/06/malcolm-grant-3a/ Public Perceptions of the NHS Results of an online survey commissioned by the British Medical Association (BMA) to question 1240 adults, living in England, on their perceptions of the NHS. Survey results: https://www.bma.org.uk/-/media/files/powerpoint/events/arm%202016/arm2016-public-perception-of-nhs-survey-results-britainthinks.pptx?la=en News: https://www.bma.org.uk/news/2016/june/public-confidence-in-government-nhs-plan-hits-new-low-survey-reveals Breastfeeding and Maternal Health Horizon Scanning Bulletin 2015 Volume 7 Issue 5 Bringing together best practice, innovation and future risks to support the commissioning process and service redesign. Bulletin: https://breastfeedingnwpctl.wordpress.com/category/volume-7-issue-5/ Child Mental Health Horizon Scanning Bulletin 2015 Volume 4 Issue 3 Bringing together best practice, innovation and future risks to support the commissioning process and service redesign. Bulletin: https://childmentalhealthnwpctl.wordpress.com/category/child-mental-health/volume-4-issue-3/ Spotlighting continence needs First in a series of blogs to mark World Continence Week. Blog from: Sarah Elliott, Regional Chief Nurse, NHS England (South). Blog: https://www.england.nhs.uk/2016/06/sarah-elliott-2/ Overcoming the continence stigma Second in a series of blogs to mark World Continence Week. Blog from: Chloe Smit, who has grown up with bladder problems and now works as a continence nurse. Blog: https://www.england.nhs.uk/2016/06/chloes-story/ Simon Stevens speech to NHS Confederation Conference 2016 Transcript of the speech given by Simon Stevens, Chief Executive, NHS England at the recent NHS Confederation Conference held in Manchester. Transcript: https://www.england.nhs.uk/2016/06/simon-stevens-confed-speech/ The NHS needs a strong dose of tech investment The health service could do with an IT injection to help it bring its 1950s-style processes into the 21st century. Article: http://www.theguardian.com/healthcare-network/2016/jun/20/nhs-strong-dose-tech-investment

EMERGENCY MEDICINE/CRITICAL CARE EVENT: Improving A&E performance for 2016/17 Join Jim Mackey at one of these regional events for acute and ambulance providers, where he will set down the national and regional actions and expectations underpinning the A&E recovery plan for 2016/17. Further information: https://improvement.nhs.uk/events/improving-e-performance-201617/ New head scanning ultrasound technology could save soldier lives Soldiers' lives could be saved or improved by new technology which enables medics to scan for bleeding in the brain using ultrasound. Software being developed creates a 3D model of the brain on location which can then be sent to an expert for swift diagnosis. The technology is still at an early stage of development but has already been trialled on real hospital patients to test its viability. The software could also be helpful in civilian life, helping paramedics record head ultrasound to diagnose brain haemorrhage as a result of stroke or other causes. News: http://www.abdn.ac.uk/news/9321/ Hospice provides training to ambulance crews to reduce A&E admissions To help improve end of life care for everyone in its local community, Kent-based Hospices, ellenor is running training sessions for ambulance crew members to help them identify when a patient is dying.

News: http://www.ehospice.com/uk/articleview/tabid/10697/articleid/19735/language/en-gb/hospice-provides-training-to-ambulance-crews-to-reduce-a-e-admissions.aspx

GENERAL MEDICINE Getting the guidance right Professor David Haslam, Chair, National Institute for Health and Care Excellence (NICE), spoke to the Royal College of Physicians' Commentary magazine about NICE’s role and new developments. Further information: https://www.nice.org.uk/news/feature/david-haslam-getting-the-guidance-right Prevalence of chronic pain in the UK: a systematic review and meta-analysis of population studies Based on data from the best available published studies, the authors of this review conclude that chronic pain affects between one-third and one-half of the population of the UK, corresponding to just under 28 million adults. This figure is likely to increase further in line with an ageing population. Systematic review: http://bmjopen.bmj.com/content/6/6/e010364.full News: http://www.bbc.co.uk/news/health-36574299 Journal review – 20 June 2016 Blog from: Richard Lehman, GP, Oxfordshire. Blog: http://blogs.bmj.com/bmj/2016/06/20/richard-lehmans-journal-reviews-20-june-2016/ Too many drugs, too few medicines—the translational failure of animal research Blog from: Emily Sena, research fellow, specialised in the validity of preclinical studies, Centre for Clinical Brain Sciences, University of Edinburgh. Blog: http://blogs.bmj.com/bmj/2016/06/20/emily-sena-too-many-drugs-too-few-medicines-the-translational-failure-of-animal-research/ Paperwork drawers – Keep it simple and standardise Hospital at night team, new doctors and visiting teams often find it difficult to find key items of paperwork such as continuation sheets, anaesthetic chart and fluid prescription charts. The solution was to standardise a column of drawers on each ward with yellow numbered labels for paperwork frequently used by medical staff. Further information: http://www.fabnhsstuff.net/2016/06/20/paperwork-drawers-keep-simple-standardise/

GENERAL PRACTICE AND PRACTICE MANAGEMENT Getting the guidance right Professor David Haslam, Chair, National Institute for Health and Care Excellence (NICE), spoke to the Royal College of Physicians' Commentary magazine about NICE’s role and new developments. Further information: https://www.nice.org.uk/news/feature/david-haslam-getting-the-guidance-right Asthma hospital admissions linked to poor general practice access Asthma sufferers with poor access to primary care are more likely to experience an emergency hospital admission – according to University of East Anglia research. New findings published today show that Asthma sufferers with better access to primary care experience less emergency hospital admissions. News: https://www.uea.ac.uk/about/-/asthma-hospital-admissions-linked-to-poor-general-practice-access Abstract: http://bjgp.org/content/early/2016/06/20/bjgp16X686089.abstract Royal College of General Practitioners response: http://www.rcgp.org.uk/news/2016/june/gps-highly-trained-to-care-for-patients-with-asthma-says-rcgp.aspx Prevalence of chronic pain in the UK: a systematic review and meta-analysis of population studies Based on data from the best available published studies, the authors of this review conclude that chronic pain affects between one-third and one-half of the population of the UK, corresponding to just under 28 million adults. This figure is likely to increase further in line with an ageing population. Systematic review: http://bmjopen.bmj.com/content/6/6/e010364.full News: http://www.bbc.co.uk/news/health-36574299

Collaborative Care and Support Planning – The clinical perspective Blog from: David Paynton, National Clinical Lead for the Royal College of General Practitioners (RCGP) Centre for Commissioning. Blog: http://coalitionforcollaborativecare.org.uk/david-paynton/collaborative-care-and-support-planning-the-clinical-perspective/ Cranberry juice 'useful' for women with recurring UTIs, claims study Behind the Headlines critiques a story that appears in the media. Further information: http://www.nhs.uk/news/2016/06June/Pages/Cranberry-juice-useful-for-women-with-recurring-UTIs-claims-study.aspx Journal review – 20 June 2016 Blog from: Richard Lehman, GP, Oxfordshire. Blog: http://blogs.bmj.com/bmj/2016/06/20/richard-lehmans-journal-reviews-20-june-2016/ Millions of people may be needlessly taking statins every day: Study claims lowering cholesterol may NOT slash heart attack risk Millions of people may be needlessly taking statins every day, according to research which suggests lowering cholesterol below a certain level does nothing to reduce heart risk. Scientists questioned the ‘blanket’ medical assumption that lowering cholesterol reduces the risk of heart attacks, strokes and other cardiovascular problems. News: http://www.dailymail.co.uk/health/article-3650600/Millions-people-needlessly-taking-statins-day-Study-claims-lowering-cholesterol-NOT-slash-heart-attack-risk.html Abstract: http://archinte.jamanetwork.com/article.aspx?articleID=2528289 Expert reaction: http://www.sciencemediacentre.org/expert-reaction-to-study-looking-at-ldl-cholesterol-levels-and-heart-events-in-people-that-have-heart-disease-and-are-taking-statins/ Campaign promotes use of IT to access primary care A new initiative promising to improve the provision of care and increase access to general practice through digital awareness is being launched by Lambeth GP federations. Further information: http://primarycaretoday.co.uk/news/campaign-promotes-use-it-access-primary-care Shining a light into dark corners Blog from: Professor Sir Malcolm Grant CBE, Chairman, NHS England. Blog: https://www.england.nhs.uk/2016/06/malcolm-grant-3a/ Public Perceptions of the NHS Results of an online survey commissioned by the British Medical Association (BMA) to question 1240 adults, living in England, on their perceptions of the NHS. Survey results: https://www.bma.org.uk/-/media/files/powerpoint/events/arm%202016/arm2016-public-perception-of-nhs-survey-results-britainthinks.pptx?la=en News: https://www.bma.org.uk/news/2016/june/public-confidence-in-government-nhs-plan-hits-new-low-survey-reveals SURVEY: Indemnity costs The Royal College of General Practitioners (RCGP) has opened a survey on indemnity costs to get views from members in order to inform response to NHS England's consultation, expected in July. Survey: https://www.surveymonkey.co.uk/r/39XJ6MP News: http://www.rcgp.org.uk/news/2016/june/rcgp-announces-survey-on-indemnity-costs.aspx Spotlighting continence needs First in a series of blogs to mark World Continence Week. Blog from: Sarah Elliott, Regional Chief Nurse, NHS England (South). Blog: https://www.england.nhs.uk/2016/06/sarah-elliott-2/ Overcoming the continence stigma Second in a series of blogs to mark World Continence Week. Blog from: Chloe Smit, who has grown up with bladder problems and now works as a continence nurse. Blog: https://www.england.nhs.uk/2016/06/chloes-story/ Too many drugs, too few medicines—the translational failure of animal research

Blog from: Emily Sena, research fellow, specialised in the validity of preclinical studies, Centre for Clinical Brain Sciences, University of Edinburgh. Blog: http://blogs.bmj.com/bmj/2016/06/20/emily-sena-too-many-drugs-too-few-medicines-the-translational-failure-of-animal-research/ CASE STUDY: Community pharmacists reduce workload for GPs in Sheffield Further data on a community pharmacy service pilot designed to develop joint working with GP practices has shown that patient care has been enhanced. This joint working initiative has led Community Pharmacy Sheffield to win C&D’s GP Partnership of the Year Award 2016. Case study: http://psnc.org.uk/our-news/lpc-case-study-community-pharmacists-reduce-workload-for-gps-in-sheffield/ Simon Stevens speech to NHS Confederation Conference 2016 Transcript of the speech given by Simon Stevens, Chief Executive, NHS England at the recent NHS Confederation Conference held in Manchester. Transcript: https://www.england.nhs.uk/2016/06/simon-stevens-confed-speech/ BMA warning over family doctor shortage The lack of GPs in Scotland has been described as "extremely concerning" by the British Medical Association (BMA). A survey found 28.5% of Scottish practices had at least one GP vacancy as of 1 June, up 2.5% in three months. The BMA said vacancies were putting more strain on remaining GPs who have to cover staffing gaps as well as facing increased service demands. News: http://www.bbc.co.uk/news/uk-scotland-36572484 Obesity and smoking 'reduce chances of successful arthritis treatment' People with rheumatoid arthritis would be well advised to quit smoking and get in shape in order to maximise their chances of being treated successfully. This is according to a new study which indicated that the likelihood of achieving sustained remission in early rheumatoid arthritis is significantly lower in patients who smoke and who are obese. News: http://www.arthritisresearchuk.org/news/general-news/2016/june/obesity-and-smoking-reduce-chances-of-successful-arthritis-treatment.aspx Abstract: http://www.abstracts2view.com/eular/view.php?nu=EULAR16L_OP0173&terms Join in with the new Be Clear on Cancer campaign From 14 July-16 October 2016, Public Health England will launch the next national Be Clear on Cancer campaign, focusing on the key respiratory symptoms of a persistent cough and inappropriate breathlessness and encouraging people that if they experience these symptoms to see their doctor. News: http://www.rpharms.com/what-s-happening-/news_show.asp?id=4037 Direct oral anticoagulants for stroke prevention in patients with atrial fibrillation: meta-analysis by geographic region with a focus on European patients The authors of this review found that direct oral anticoagulants (DOAC) did not provide additional benefit in reducing the risk of stroke/systemic embolic events (SEE) compared with warfarin in European patients with atrial fibrillation (AF), but were generally associated with a lower bleeding tendency than warfarin regardless of geographic region. Systematic review: http://onlinelibrary.wiley.com/doi/10.1111/bcp.13005/full Traditional Chinese medicines in the management of cardiovascular diseases: a comprehensive systematic review The authors of this review found that certain traditional Chinese medicines (TCM) compounds appear to have significant anti-hypertensive effects, and although some are associated in some studies with improved outcomes in coronary heart disease, heart failure and type 2 diabetes mellitus, the data are inconsistent and will require large-scale randomized-controlled trials to allow full evaluation of any potential therapeutic benefit in these areas. Systematic review: http://onlinelibrary.wiley.com/doi/10.1111/bcp.13013/abstract The NHS needs a strong dose of tech investment The health service could do with an IT injection to help it bring its 1950s-style processes into the 21st century. Article: http://www.theguardian.com/healthcare-network/2016/jun/20/nhs-strong-dose-tech-investment

GENERAL SURGERY ESNM77 Moderate to severe acute post-operative pain: fentanyl transdermal system This National Institute for Health and Care Excellence (NICE) evidence summary is based on 3 of

the active‑controlled, open‑label trials that compared the fentanyl transdermal system with IV

morphine patient‑controlled analgesia (PCA) in adults requiring opioids for moderate or severe

post‑operative pain. Evidence summary: https://www.nice.org.uk/advice/esnm77/chapter/Key-points-from-the-evidence Getting the guidance right Professor David Haslam, Chair, National Institute for Health and Care Excellence (NICE), spoke to the Royal College of Physicians' Commentary magazine about NICE’s role and new developments. Further information: https://www.nice.org.uk/news/feature/david-haslam-getting-the-guidance-right

HEALTH SERVICES MANAGEMENT Getting the guidance right Professor David Haslam, Chair, National Institute for Health and Care Excellence (NICE), spoke to the Royal College of Physicians' Commentary magazine about NICE’s role and new developments. Further information: https://www.nice.org.uk/news/feature/david-haslam-getting-the-guidance-right SURVEY: Quality standard service improvement template The National Institute for Health and Care Excellence (NICE) would like to gain feedback on views and experiences of using the Quality Standard service improvement template. Your responses will be completely confidential and will help NICE redesign the template to better meet your needs in the future. Survey: https://www.snapsurveys.com/wh/s.asp?k=146315596335 Further information: https://www.nice.org.uk/about/what-we-do/into-practice/audit-and-service-improvement Endless winter in NHS 'puts patients at risk' The NHS is stuck in an "endless winter" with hospitals left in chaos struggling to cope, doctors and nurses say. The warnings have been made at the Royal College of Nursing and British Medical Association conferences. Delegates at each explained how pressures have got so bad that patients are being put at risk. But ministers in England rejected the claims, saying investment was making the NHS the safest health system in the world. News: http://www.bbc.co.uk/news/health-36579900 Hospital readmission app could save healthcare industry billions Hospitals and healthcare providers are penalized for readmitting patients within a 30-day time period. An award-winning app developed by graduate students at Binghamton University, State University of New York, could help reduce these readmission rates and save the healthcare industry billions. Press release: http://www.eurekalert.org/pub_releases/2016-06/bu-hra062016.php Software documentation: https://www.binghamton.edu/watson/news/SoftwareDesignDocument_SUNY_at_Binghamton.pdf E-LEARNING: Bid-rigging The Competition and Markets Authority (CMA) and the Crown Commercial Service (CCS) have worked together with BuiltIntelligence to create this e-learning module which will help procurement professionals root out attempts to win contracts through anti-competitive conduct. Further information: http://builtintelligence.com/pages/learn-how-to-spot-bid-rigging Press release: https://www.gov.uk/government/news/procurement-tool-targets-bid-rigging-cheats Shining a light into dark corners Blog from: Professor Sir Malcolm Grant CBE, Chairman, NHS England. Blog: https://www.england.nhs.uk/2016/06/malcolm-grant-3a/ Public Perceptions of the NHS Results of an online survey commissioned by the British Medical Association (BMA) to question 1240 adults, living in England, on their perceptions of the NHS. Survey results: https://www.bma.org.uk/-/media/files/powerpoint/events/arm%202016/arm2016-public-perception-of-nhs-survey-results-britainthinks.pptx?la=en

News: https://www.bma.org.uk/news/2016/june/public-confidence-in-government-nhs-plan-hits-new-low-survey-reveals Spotlighting continence needs First in a series of blogs to mark World Continence Week. Blog from: Sarah Elliott, Regional Chief Nurse, NHS England (South). Blog: https://www.england.nhs.uk/2016/06/sarah-elliott-2/ Overcoming the continence stigma Second in a series of blogs to mark World Continence Week. Blog from: Chloe Smit, who has grown up with bladder problems and now works as a continence nurse. Blog: https://www.england.nhs.uk/2016/06/chloes-story/ Simon Stevens speech to NHS Confederation Conference 2016 Transcript of the speech given by Simon Stevens, Chief Executive, NHS England at the recent NHS Confederation Conference held in Manchester. Transcript: https://www.england.nhs.uk/2016/06/simon-stevens-confed-speech/ NHS Workforce Bulletin Issue 522, 20 June 2016 Tips, tools, guidance and information on NHS workforce issues from NHS Employers. Bulletin: http://www.nhsemployers.org/?sc_itemid={E7CE407E-E839-42D8-8A39-0E55BDBD7AAB}&sc_lang=en&sc_pd_view=1&ec_as=EC8F658AFC1E4EB8A00945867A22C1C8 Our-NHS News and Comment from Roy Lilley. Newsletter: http://campaign.r20.constantcontact.com/render?m=1102665899193&ca=1bf7b08e-aa24-42df-b433-d3d0a788e78d The NHS needs a strong dose of tech investment The health service could do with an IT injection to help it bring its 1950s-style processes into the 21st century. Article: http://www.theguardian.com/healthcare-network/2016/jun/20/nhs-strong-dose-tech-investment

INFECTION CONTROL AND INFECTIOUS DISEASES Notifications of Infection Diseases (NOIDs) causative agents: week 24 (week ending 19 June 2016) Weekly data from UK laboratories on the number of cases of notifiable bacteria and viruses. It compares the current week’s data on statutory notifications of causative agents to that of the previous 5 weeks. Latest data: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/530205/NOIDS_OrganismsReport20062016.pdf Previous data: https://www.gov.uk/government/publications/notifiable-diseases-causative-agents-report Cranberry juice 'useful' for women with recurring UTIs, claims study Behind the Headlines critiques a story that appears in the media. Further information: http://www.nhs.uk/news/2016/06June/Pages/Cranberry-juice-useful-for-women-with-recurring-UTIs-claims-study.aspx Contaminated Gloves Increase Risks of Cross-Transmission of Pathogens Research presented at the recent American Society for Microbiology (ASM) Microbe research meeting provides clear evidence that the gloves of healthcare workers contaminate hospital surfaces with bacteria. The researchers' data also suggest that types of bacteria may affect cross-transmission rates among contaminated gloves and the hospital surfaces. News: http://www.infectioncontroltoday.com/news/2016/06/contaminated-gloves-increase-risks-of-crosstransmission-of-pathogens.aspx Abstract: http://www.abstractsonline.com/pp8/#!/4060/presentation/12749

Hand Hygiene, personal protective equipment (PPE) are Effective Practices Against Middle East Respiratory Syndrome Coronavirus (MERS-CoV) Researchers report on a hospital-associated outbreak of MERS-CoV and assess the effectiveness of infection control measures among healthcare workers (HCWs) who were exposed to a MERS patient and/or his body fluids in their institute. News: http://www.infectioncontroltoday.com/news/2016/06/hand-hygiene-ppe-use-are-effective-practices-against-mers.aspx Full text article: http://aricjournal.biomedcentral.com/articles/10.1186/s13756-016-0120-9

INFORMATICS AND INFORMATION GOVERNANCE Hospital readmission app could save healthcare industry billions Hospitals and healthcare providers are penalized for readmitting patients within a 30-day time period. An award-winning app developed by graduate students at Binghamton University, State University of New York, could help reduce these readmission rates and save the healthcare industry billions. Press release: http://www.eurekalert.org/pub_releases/2016-06/bu-hra062016.php Software documentation: https://www.binghamton.edu/watson/news/SoftwareDesignDocument_SUNY_at_Binghamton.pdf The NHS needs a strong dose of tech investment The health service could do with an IT injection to help it bring its 1950s-style processes into the 21st century. Article: http://www.theguardian.com/healthcare-network/2016/jun/20/nhs-strong-dose-tech-investment

MATERNITY & GYNAECOLOGY Breastfeeding and Maternal Health Horizon Scanning Bulletin 2015 Volume 7 Issue 5 Bringing together best practice, innovation and future risks to support the commissioning process and service redesign. Bulletin: https://breastfeedingnwpctl.wordpress.com/category/volume-7-issue-5/

MEDICINES MANAGEMENT/PHARMACY ESNM77 Moderate to severe acute post-operative pain: fentanyl transdermal system This National Institute for Health and Care Excellence (NICE) evidence summary is based on 3 of

the active‑controlled, open‑label trials that compared the fentanyl transdermal system with IV morphine patient‑controlled analgesia (PCA) in adults requiring opioids for moderate or severe

post‑operative pain. Evidence summary: https://www.nice.org.uk/advice/esnm77/chapter/Key-points-from-the-evidence Millions of people may be needlessly taking statins every day: Study claims lowering cholesterol may NOT slash heart attack risk Millions of people may be needlessly taking statins every day, according to research which suggests lowering cholesterol below a certain level does nothing to reduce heart risk. Scientists questioned the ‘blanket’ medical assumption that lowering cholesterol reduces the risk of heart attacks, strokes and other cardiovascular problems. News: http://www.dailymail.co.uk/health/article-3650600/Millions-people-needlessly-taking-statins-day-Study-claims-lowering-cholesterol-NOT-slash-heart-attack-risk.html Abstract: http://archinte.jamanetwork.com/article.aspx?articleID=2528289 Expert reaction: http://www.sciencemediacentre.org/expert-reaction-to-study-looking-at-ldl-cholesterol-levels-and-heart-events-in-people-that-have-heart-disease-and-are-taking-statins/ CASE STUDY: Community pharmacists reduce workload for GPs in Sheffield Further data on a community pharmacy service pilot designed to develop joint working with GP practices has shown that patient care has been enhanced. This joint working initiative has led Community Pharmacy Sheffield to win C&D’s GP Partnership of the Year Award 2016. Case study: http://psnc.org.uk/our-news/lpc-case-study-community-pharmacists-reduce-workload-for-gps-in-sheffield/

Join in with the new Be Clear on Cancer campaign From 14 July-16 October 2016, Public Health England will launch the next national Be Clear on Cancer campaign, focusing on the key respiratory symptoms of a persistent cough and inappropriate breathlessness and encouraging people that if they experience these symptoms to see their doctor. News: http://www.rpharms.com/what-s-happening-/news_show.asp?id=4037 CONSULTATION: Medicines Optimisation: key therapeutic topics for 2017 The National Institute for Health and Care Excellence (NICE) are in the process of updating the medicines optimisation: key therapeutic topics document and are now consulting on the topics to be included in the January 2017 update. Consultation: https://www.nice.org.uk/Media/Default/About/what-we-do/NICE-advice/Key-therapeutic-topics/KTT-topic-consultation-Jun-16.pdf Further information: https://www.nice.org.uk/About/What-we-do/Our-Programmes/NICE-Advice/Key-therapeutic-topics Direct oral anticoagulants for stroke prevention in patients with atrial fibrillation: meta-analysis by geographic region with a focus on European patients The authors of this review found that direct oral anticoagulants (DOAC) did not provide additional benefit in reducing the risk of stroke/systemic embolic events (SEE) compared with warfarin in European patients with atrial fibrillation (AF), but were generally associated with a lower bleeding tendency than warfarin regardless of geographic region. Systematic review: http://onlinelibrary.wiley.com/doi/10.1111/bcp.13005/full Traditional Chinese medicines in the management of cardiovascular diseases: a comprehensive systematic review The authors of this review found that certain traditional Chinese medicines (TCM) compounds appear to have significant anti-hypertensive effects, and although some are associated in some studies with improved outcomes in coronary heart disease, heart failure and type 2 diabetes mellitus, the data are inconsistent and will require large-scale randomized-controlled trials to allow full evaluation of any potential therapeutic benefit in these areas. Systematic review: http://onlinelibrary.wiley.com/doi/10.1111/bcp.13013/abstract

MENTAL HEALTH AND WELLBEING Child Mental Health Horizon Scanning Bulletin 2015 Volume 4 Issue 3 Bringing together best practice, innovation and future risks to support the commissioning process and service redesign. Bulletin: https://childmentalhealthnwpctl.wordpress.com/category/child-mental-health/volume-4-issue-3/ The Zero Suicide Policy challenges Blog from: Dr David Fearnley, Medical Director, Mersey Care NHS Foundation Trust and Associate National Clinical Director for Secure Mental Health, NHS England. Blog: https://www.england.nhs.uk/2016/06/david-fearnley/

NEUROLOGY New head scanning ultrasound technology could save soldier lives Soldiers' lives could be saved or improved by new technology which enables medics to scan for bleeding in the brain using ultrasound. Software being developed creates a 3D model of the brain on location which can then be sent to an expert for swift diagnosis. The technology is still at an early stage of development but has already been trialled on real hospital patients to test its viability. The software could also be helpful in civilian life, helping paramedics record head ultrasound to diagnose brain haemorrhage as a result of stroke or other causes. News: http://www.abdn.ac.uk/news/9321/

NURSING PRACTICE Getting the guidance right Professor David Haslam, Chair, National Institute for Health and Care Excellence (NICE), spoke to the Royal College of Physicians' Commentary magazine about NICE’s role and new developments.

Further information: https://www.nice.org.uk/news/feature/david-haslam-getting-the-guidance-right Spotlighting continence needs First in a series of blogs to mark World Continence Week. Blog from: Sarah Elliott, Regional Chief Nurse, NHS England (South). Blog: https://www.england.nhs.uk/2016/06/sarah-elliott-2/ Overcoming the continence stigma Second in a series of blogs to mark World Continence Week. Blog from: Chloe Smit, who has grown up with bladder problems and now works as a continence nurse. Blog: https://www.england.nhs.uk/2016/06/chloes-story/ Paperwork drawers – Keep it simple and standardise Hospital at night team, new doctors and visiting teams often find it difficult to find key items of paperwork such as continuation sheets, anaesthetic chart and fluid prescription charts. The solution was to standardise a column of drawers on each ward with yellow numbered labels for paperwork frequently used by medical staff. Further information: http://www.fabnhsstuff.net/2016/06/20/paperwork-drawers-keep-simple-standardise/

OPHTHALMOLOGY Injectable Medicines Guide (IMG) ocular injection project – access for RCOphth Members The UK Ophthalmic Pharmacy Group (UKOPG) co-ordinates a scheme for the IMG to write monographs on commonly used and / or high risk ocular injections. The monographs reflect current practice in ophthalmic centres throughout the UK. News: https://www.rcophth.ac.uk/2016/06/injectable-medicines-guide-img-ocular-injection-project-access-for-rcophth-members/

PALLIATIVE CARE Hospice provides training to ambulance crews to reduce A&E admissions To help improve end of life care for everyone in its local community, Kent-based Hospices, ellenor is running training sessions for ambulance crew members to help them identify when a patient is dying. News: http://www.ehospice.com/uk/articleview/tabid/10697/articleid/19735/language/en-gb/hospice-provides-training-to-ambulance-crews-to-reduce-a-e-admissions.aspx

PATHOLOGY Notifications of Infection Diseases (NOIDs) causative agents: week 24 (week ending 19 June 2016) Weekly data from UK laboratories on the number of cases of notifiable bacteria and viruses. It compares the current week’s data on statutory notifications of causative agents to that of the previous 5 weeks. Latest data: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/530205/NOIDS_OrganismsReport20062016.pdf Previous data: https://www.gov.uk/government/publications/notifiable-diseases-causative-agents-report Cranberry juice 'useful' for women with recurring UTIs, claims study Behind the Headlines critiques a story that appears in the media. Further information: http://www.nhs.uk/news/2016/06June/Pages/Cranberry-juice-useful-for-women-with-recurring-UTIs-claims-study.aspx Best Practices for Using Polymerase Chain Reaction (PCR) to Diagnose Haemophilus influenzae and Neisseria meningitidis and Identify Serotype or Serogroup The Centers for Disease Control and Prevention (CDC) have issued a Health Advisory for laboratories to enable them to identify potential outbreaks and determining appropriate public health responses. Guidance: http://emergency.cdc.gov/han/han00391.asp

'Holy grail' of breast cancer prevention in high-risk women may be in sight An existing medication could have promise in preventing breast cancer in women carrying a faulty BRCA1 gene, researchers have discovered. News: https://www.sciencedaily.com/releases/2016/06/160620120247.htm Abstract: http://www.nature.com/nm/journal/vaop/ncurrent/abs/nm.4118.html Expert reaction: http://www.sciencemediacentre.org/expert-reaction-to-study-looking-at-brca1-gene-breast-cancer-precursor-cells-in-lab-and-inhibitor-of-protein-called-rank/ Contaminated Gloves Increase Risks of Cross-Transmission of Pathogens Research presented at the recent American Society for Microbiology (ASM) Microbe research meeting provides clear evidence that the gloves of healthcare workers contaminate hospital surfaces with bacteria. The researchers' data also suggest that types of bacteria may affect cross-transmission rates among contaminated gloves and the hospital surfaces. News: http://www.infectioncontroltoday.com/news/2016/06/contaminated-gloves-increase-risks-of-crosstransmission-of-pathogens.aspx Abstract: http://www.abstractsonline.com/pp8/#!/4060/presentation/12749

PUBLIC HEALTH/HEALTH IMPROVEMENT Notifications of Infection Diseases (NOIDs) causative agents: week 24 (week ending 19 June 2016) Weekly data from UK laboratories on the number of cases of notifiable bacteria and viruses. It compares the current week’s data on statutory notifications of causative agents to that of the previous 5 weeks. Latest data: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/530205/NOIDS_OrganismsReport20062016.pdf Previous data: https://www.gov.uk/government/publications/notifiable-diseases-causative-agents-report Asthma hospital admissions linked to poor general practice access Asthma sufferers with poor access to primary care are more likely to experience an emergency hospital admission – according to University of East Anglia research. New findings published today show that Asthma sufferers with better access to primary care experience less emergency hospital admissions. News: https://www.uea.ac.uk/about/-/asthma-hospital-admissions-linked-to-poor-general-practice-access Abstract: http://bjgp.org/content/early/2016/06/20/bjgp16X686089.abstract Royal College of General Practitioners response: http://www.rcgp.org.uk/news/2016/june/gps-highly-trained-to-care-for-patients-with-asthma-says-rcgp.aspx Sugar and Health Policy This Parliamentary Office of Science and Technology (POST)note summarises the health risks associated with eating a diet high in sugar and outlines the policy options that might best enable people to limit their sugar consumption. Briefing: http://researchbriefings.files.parliament.uk/documents/POST-PN-0530/POST-PN-0530.pdf Prevalence of chronic pain in the UK: a systematic review and meta-analysis of population studies Based on data from the best available published studies, the authors of this review conclude that chronic pain affects between one-third and one-half of the population of the UK, corresponding to just under 28 million adults. This figure is likely to increase further in line with an ageing population. Systematic review: http://bmjopen.bmj.com/content/6/6/e010364.full News: http://www.bbc.co.uk/news/health-36574299 Are YOU at risk? People who have been to university ‘more likely’ to get BRAIN tumours People who are highly educated are at greater risk of brain tumours than non-university educated people, a study has revealed. Those who studied for at least three years at university were more at risk of the most malignant brain tumours known as gliomas. The large observational study analysed more than 4.3 million Swedes, all born between 1911 and 1961. They were monitored between 1993 and 2010 which showed 5,735 of the men and 7,101 of the women developed primary brain tumours. News: http://www.express.co.uk/life-style/health/681544/brain-tumour-gliomas-more-likely-university-education-three-years-scientists

Abstract: http://jech.bmj.com/content/early/2016/05/25/jech-2015-207002.abstract Full text article (PDF): http://jech.bmj.com/content/early/2016/05/25/jech-2015-207002.full.pdf+html Expert reaction: http://www.sciencemediacentre.org/expert-reaction-to-study-on-socioeconomic-status-and-brain-tumours/ Public Perceptions of the NHS Results of an online survey commissioned by the British Medical Association (BMA) to question 1240 adults, living in England, on their perceptions of the NHS. Survey results: https://www.bma.org.uk/-/media/files/powerpoint/events/arm%202016/arm2016-public-perception-of-nhs-survey-results-britainthinks.pptx?la=en News: https://www.bma.org.uk/news/2016/june/public-confidence-in-government-nhs-plan-hits-new-low-survey-reveals The World Health Organization (WHO)/Pan American Health Organization (PAHO) and partners set out Zika strategic response plan for the next 18 months WHO/PAHO and partners have set out their strategic response to Zika which will place a greater focus on preventing and managing medical complications caused by Zika virus infection. To date, US$121.9 million are necessary to effectively implement the Zika Strategic Response Plan, July 2016 to December 2017. Further information: http://www.who.int/mediacentre/news/notes/2016/zika-response/en/ Obesity and smoking 'reduce chances of successful arthritis treatment' People with rheumatoid arthritis would be well advised to quit smoking and get in shape in order to maximise their chances of being treated successfully. This is according to a new study which indicated that the likelihood of achieving sustained remission in early rheumatoid arthritis is significantly lower in patients who smoke and who are obese. News: http://www.arthritisresearchuk.org/news/general-news/2016/june/obesity-and-smoking-reduce-chances-of-successful-arthritis-treatment.aspx Abstract: http://www.abstracts2view.com/eular/view.php?nu=EULAR16L_OP0173&terms Deaths registered in England and Wales, provisional: week ending 10 June 2016 Weekly death figures provide provisional counts of the number of deaths registered in England and Wales in the latest weeks for which data are available. Statistics: https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/datasets/weeklyprovisionalfiguresondeathsregisteredinenglandandwales

RADIOLOGY New head scanning ultrasound technology could save soldier lives Soldiers' lives could be saved or improved by new technology which enables medics to scan for bleeding in the brain using ultrasound. Software being developed creates a 3D model of the brain on location which can then be sent to an expert for swift diagnosis. The technology is still at an early stage of development but has already been trialled on real hospital patients to test its viability. The software could also be helpful in civilian life, helping paramedics record head ultrasound to diagnose brain haemorrhage as a result of stroke or other causes. News: http://www.abdn.ac.uk/news/9321/

RESEARCH Too many drugs, too few medicines—the translational failure of animal research Blog from: Emily Sena, research fellow, specialised in the validity of preclinical studies, Centre for Clinical Brain Sciences, University of Edinburgh. Blog: http://blogs.bmj.com/bmj/2016/06/20/emily-sena-too-many-drugs-too-few-medicines-the-translational-failure-of-animal-research/

RESPIRATORY Asthma hospital admissions linked to poor general practice access

Asthma sufferers with poor access to primary care are more likely to experience an emergency hospital admission – according to University of East Anglia research. New findings published today show that Asthma sufferers with better access to primary care experience less emergency hospital admissions. News: https://www.uea.ac.uk/about/-/asthma-hospital-admissions-linked-to-poor-general-practice-access Abstract: http://bjgp.org/content/early/2016/06/20/bjgp16X686089.abstract Royal College of General Practitioners response: http://www.rcgp.org.uk/news/2016/june/gps-highly-trained-to-care-for-patients-with-asthma-says-rcgp.aspx

RHEUMATOLOGY Obesity and smoking 'reduce chances of successful arthritis treatment' People with rheumatoid arthritis would be well advised to quit smoking and get in shape in order to maximise their chances of being treated successfully. This is according to a new study which indicated that the likelihood of achieving sustained remission in early rheumatoid arthritis is significantly lower in patients who smoke and who are obese. News: http://www.arthritisresearchuk.org/news/general-news/2016/june/obesity-and-smoking-reduce-chances-of-successful-arthritis-treatment.aspx Abstract: http://www.abstracts2view.com/eular/view.php?nu=EULAR16L_OP0173&terms

STROKE Direct oral anticoagulants for stroke prevention in patients with atrial fibrillation: meta-analysis by geographic region with a focus on European patients The authors of this review found that direct oral anticoagulants (DOAC) did not provide additional benefit in reducing the risk of stroke/systemic embolic events (SEE) compared with warfarin in European patients with atrial fibrillation (AF), but were generally associated with a lower bleeding tendency than warfarin regardless of geographic region. Systematic review: http://onlinelibrary.wiley.com/doi/10.1111/bcp.13005/full

UROLOGY Cranberry juice 'useful' for women with recurring UTIs, claims study Behind the Headlines critiques a story that appears in the media. Further information: http://www.nhs.uk/news/2016/06June/Pages/Cranberry-juice-useful-for-women-with-recurring-UTIs-claims-study.aspx Spotlighting continence needs First in a series of blogs to mark World Continence Week. Blog from: Sarah Elliott, Regional Chief Nurse, NHS England (South). Blog: https://www.england.nhs.uk/2016/06/sarah-elliott-2/ Overcoming the continence stigma Second in a series of blogs to mark World Continence Week. Blog from: Chloe Smit, who has grown up with bladder problems and now works as a continence nurse. Blog: https://www.england.nhs.uk/2016/06/chloes-story/