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Knowledge, Evidence & Insight

Strategy & Resources Nottingham City Council

Knowledge, Evidence and Insight News & Information Bulletin: August 2019

The News & Information Bulletin highlights news and developments relevant to health and social

care and partner professionals.

Recent issues can be accessed via the Knowledge, Evidence and Insight website.

In this issue—click any of the headings to link to

the relevant section or item.

Public Health

General

Cancer

Health Inequalities

Healthy Eating and Obesity

Infection Control and Immunisation

Long-term Conditions

Mental Health

Physical Activity

Stroke and CVD

Substance Use

Sustainable Development

Health and Social Care

General

Adult Social Care

Children and Young People

Commissioning

Data and Technology

Integrated Care

Learning Disability

NHS and Social Care Finances

Older People

Policy and Strategy

Pregnancy and Maternity Services

Primary Care and Community Services

Quality and Safety

Safeguarding

Workforce, Education and Training

NICE Guidelines

NICE-related News and Publications

This Month’s Highlights

CCG 360° Stakeholder Survey

Implementing health in all policies

Primary care networks: overview for general practice teams

Population health

Tackling loneliness

News

All Our Health e-learning

Flexible working

Measles and rubella vaccination uptake

NHS cash injection

NHS Digital consultation

NHS Health Checks review

Reducing long stays: Where best next?

We Are Undefeatable

Contact Details

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All Our Health e-learning Health Education England e-Learning for Healthcare (e-LfH) has worked with Public Health England to launch five new sessions as part of the All Our Health e-learning programme. All Our Health aims to improve the knowledge, confidence and skills of health and care professionals in preventing illness, protecting health and promoting wellbeing. The five new topics cover childhood obesity, mental health and wellbeing, workplace health, child oral health and alcohol.

Flexible working The Department of Health and Social Care has launched a new engagement exercise to understand what would help create the work-life balance that NHS and social care staff want.

Measles and rubella vaccination uptake Public Health England has updated the UK measles and rubella elimination indicators and status. Due to a small but steady decline in coverage in recent years, the UK has lost its ‘measles-free’ status with the World Health Organisation three years after the virus was eliminated in the country. As a result, the Prime Minister has ordered urgent action to improve measles vaccination uptake and sets out a series of actions to improve uptake.

Additional links: PHE press release PHE blog

NHS cash injection The Prime Minister has confirmed a new £1.8 billion NHS cash injection to help improve patient care. Twenty services will share £850 million of new funding to upgrade outdated facilities and equipment whilst there will be a £1 billion boost to NHS capital spending, allowing existing upgrade programmes to proceed and tackling the most urgent infrastructure projects. The beneficiaries include the South Yorkshire and Bassetlaw ICS and Leeds Teaching Hospitals.

Additional link: BBC News

NHS Digital prescribing and medicines statistical publications consultation NHS Digital has launched a consultation on changes to NHS Digital Prescribing and Medicines Statistical Publications. This consultation seeks views on the set of changes NHS Digital hopes to make to its statistical products in the near future and also to inform users of some medium to longer term plans for further improvements. The consultation closes on 20

th September 2019.

NHS Health Checks review The Department of Health and Social Care has announced there will be an evidence-based review of the NHS Health Check service. The review will explore new intelligent, predictive checks, taking age, risk factors and lifestyle into account. It will examine how to improve the system with a focus on offering personalised interventions. The review will also explore a special check-up for people approaching retirement age; increasing the range of advice the checks can offer; ways to increase the uptake of health checks; and the digitisation of health checks where appropriate.

Reducing long stays: Where best next? NHS England and NHS Improvement have launched a campaign to encourage NHS staff to take steps every day to help get patients closer to a safe discharge. The campaign, Where Best Next?, aims to save around 140,000 people every year having a hospital stay of three weeks or more. The drive could also free up more than 7,000 beds.

Additional links: NHS England/Improvement press release NHS England/Improvement blog

We Are Undefeatable In association with 15 leading health and social care charities (such as Mind, Diabetes UK and the British Lung Foundation), Sport England has launched the We Are Undefeatable campaign to inspire and support those with long-term health conditions (LTC) to build physical activity into their lives. Particularly targeting adults, the campaign aims to challenge the myths around getting active when living with an LTC. Active Notts is supporting the campaign, with a launch on 11

th September. Please note:

Knowledge, Evidence and Insight has a small quantity of materials (credit card-sized “conversation starters” and posters) to support this campaign; please contact us to request items.

Additional link: Sport England News

News

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General:

Building healthier communities The Health Foundation has published Building healthier communities: the role of the NHS as an anchor institution. This report explores how NHS organisations act as anchor institutions. Anchor institutions are large, public sector organisations that are called such because they are unlikely to relocate and have a significant stake in a geographical area. It gives examples of what anchor practices look like in a health care context and how anchor institutions can maximise their influence on the wider determinants of health. Generation genome: opportunities for screening programme Public Health England has published Generation genome and the opportunities for screening programmes. The report briefly defines genome sequencing and how, by improving understanding of genetic activity, we can determine how best to use genetics in population screening. Implementing health in all policies The Health Foundation has published Implementing health in all policies: lessons from around the world. This collection of nine case studies offers insights into the practicalities of delivering a health in all policies approach in different contexts, sectors and levels of government. Topics covered include embedding social sustainability, improving air quality, tackling social exclusion, action on prisoner reoffending, access to healthy foods, targeting health inequalities, tackling obesity, coaching to boost cross-sector working and taxing unhealthy foods. Local healthy workplace accreditation Public Health England has published Local healthy workplace accreditation guidance. This document provides information for local authorities and their partners who are planning to, or are in the process of, setting up a Local Workplace Health Accreditation Scheme. It also provides practical examples and references to local authorities who are not setting up an accreditation scheme, but who are promoting workplace health in their local area. Population health The King’s Fund has produced an animation What is population health? The animation looks at what a ‘population health’ approach is and what role everyone can play in keeping communities healthy. Public Health Outcomes Framework consultation Public Health England has published Public Health Outcomes Framework (PHOF) 2019 to 2020: a consultation – Government response. This is the government response to the consultation reviewing the 2016 to 2019 PHOF. From 2019 to 2020, there will be 75 high-level indicator categories which include 161 individual indicators. Public health, prevention and health improvement The Local Government Association (LGA) has published Public health, prevention and health improvement. This prospectus sets out the programme of sector-led improvement support available through the LGA and partners; signposting to other support and resources available; and the early support arrangements for local authorities with performance challenges in public health. Screening in the UK Public Health England has published Screening in the UK: making effective recommendations 1 April 2018 to 31 March 2019. This report summarises the work of the UK National Screening Committee to review screening recommendations. Tackling loneliness The House of Commons Library has published a briefing paper Tackling loneliness. This paper examines the Government’s Loneliness Strategy published in October 2018 and outlines progress so far. It also looks at research into the causes and impact of loneliness and possible interventions. It is accompanied by a reading list. Statistics The following statistical releases have been published:

Public Health Outcomes Framework: August 2019 data update. Additional link: PHE blog

Public Health

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Cancer: National Cancer Registration and Analysis Service Public Health England has published a progress update on how the National Cancer Registration and Analysis Service is improving awareness of the national cancer registry in line with the findings from the 2016 Review of Informed Choice for Cancer Registration.

Health Inequalities: Health inequalities in ageing in rural and coastal areas Public Health England has published Health inequalities in older populations in coastal and rural areas. This review provides evidence on the health inequalities experienced by older populations in coastal and rural areas, together with a summary of key considerations to reduce inequalities and promote healthy ageing in these areas. It comprises a literature review supplemented with case studies and brings together a range of information with links to published research. Place-based approaches to reduce health inequalities Public Health England has published Place-based approaches for reducing health inequalities. This document and accompanying resources provide guidelines to support local action on health inequalities which aim to reinforce a common understanding of the complex causes and costs of health inequalities, as well as provide a practical framework and tools for places to reduce health inequalities.

Additional link: PHE blog

Healthy Eating and Obesity: Saturated fats and health The Scientific Advisory Committee on Nutrition (SACN) has published Saturated fats and health: SACN report. This report considers the relationship between saturated fats, health outcomes and risk factors for non-communicable diseases in the general UK population.

Additional links: Consultation responses on the draft report PHE press release

Infection Control and Immunisation: Preventing STIs Public Health England has published Health Matters: preventing STIs. This edition of Health Matters focuses on the prevention of five common sexually transmitted infections (STIs): gonorrhoea, chlamydia, syphilis, genital herpes and genital warts. It also covers the public health challenge of antimicrobial-resistant STIs, and the commissioning and improvement of sexual health services.

Additional link: PHE blog Vaccination information Public Health England has published the following information relating to vaccination:

Poster for the 2019 to 2020 flu season - shows the different types of flu vaccines available and the clinical risk groups to which they are applicable;

Vaccination of individuals with uncertain or incomplete immunisation status – single page reminder based on ‘Immunisation against infections disease: the Green Book’ to help health professionals vaccinate people correctly.

Vaccine Update Public Health England has published the following edition of Vaccine Update:

Issue 298, August 2019

Long-term Conditions: National Diabetes Insulin Pump Audit NHS Digital has published National Diabetes Insulin Pump Audit 2017/18: England and Wales. This audit collects information on the number and characteristics of people with diabetes using an insulin pump, the reasons for going on an insulin pump and the outcomes achieved since starting on the pump. Analysis performed on the Type 1 Specialist Diabetes Insulin Pump Services Structures Survey (2018) is included in this publication.

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Mental Health: Early intervention in psychosis spotlight audit The Healthcare Quality Improvement Partnership has published National Clinical Audit of Psychosis: National report for the Early Intervention in Psychosis Spotlight Audit 2018/2019. This report provides national and organisation-level findings on the treatment of patients by Early Intervention Psychosis Teams in England. It shows improvements in the provision of timely access to evidence-based treatments for people experiencing First Episode Psychosis. Eating disorders NHS England and NHS Improvement have published the following guidance which supports the development and implementation of commissioner, provider and STP/ICS plans to deliver effective community eating disorder services that are integrated with day and/or inpatient care to reduce admissions, length-of-stay and improve outcomes for users, families and carers:

Adult Eating Disorders: Community, Inpatient and Intensive Day Patient Care – Guidance for commissioners and providers

Addendum – Inpatient and Intensive Day Care Extension to the Community Eating Disorder Guidance (children and young people)

Appendices and Helpful Resources for Inpatient and Intensive Day Care – Addendum to the Community Eating Disorder Guidance (children and young people)

Eating disorders inquiry: government response The Department of Health and Social Care has published Government response to the recommendations of the Public Administration and Constitutional Affairs Committee's Seventeenth Report of Session 2017-19: Ignoring the Alarms follow-up: Too many avoidable deaths from eating disorders. This document sets out the government’s response to the conclusions and recommendations made in the PACAC report ‘Ignoring the Alarms follow-up’. Mental health implementation plan The Healthcare Financial Management Association has published Summary of the NHS mental health implementation plan 2019/20 – 2023/24. This briefing sets out the key points from the mental health implementation plan. Towards equality for mental health The Mental Health Policy Group has published Towards equality for mental health: developing a cross-government approach. This report considers the steps that must be taken if the ambition of ‘parity of esteem’ for mental hea lth is to be achieved in England. Its starting point is the belief that improving the nation’s mental health cannot be achieved through a focus on health services alone and that a more ambitious, cross-government approach to mental health is also required.

Physical Activity: Physical activity and lifestyle toolkit / Active Practice Charter The Royal College of General Practitioners in partnership with Sport England has produced a Physical activity and lifestyle toolkit. This toolkit is designed to be used by primary care health professionals to enable them to provide preventative advice to patients. In addition, the Active Practice Charter has been launched to inspire GP practices to increase activity and reduce sedentary behaviour in their patients and staff.

Additional link: RCGP press release

Stroke and CVD: Acute stroke The Oxford Academic Health Science Network has published Mechanical thrombectomy for acute ischaemic stroke: an implementation guide for the UK. This implementation guide aims to accelerate the uptake of mechanical thrombectomy (MT) emergency treatment for acute stroke by distilling the best available expertise within the UK into a single definitive volume.

Substance Use: National intelligence network on drug health harms briefing Public Health England has published the following update of the National intelligence network on drug health harms briefing:

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Smoking, drinking and drug use among young people NHS Digital has published Smoking, Drinking and Drug Use among Young People in England 2018. This report contains results from a biennial survey of secondary school pupils in England in years 7 to 11 (mostly aged 11 to 15) focusing on smoking, drinking and drug use. It covers a range of topics including prevalence, habits, attitudes and, for the first time in 2018, wellbeing. Suicide by people in contact with substance misuse services The Healthcare Quality Improvement Partnership has published Suicide by people in contact with substance misuse services in the UK: a feasibility study. This one-year study by the National Confidential Inquiry into Suicide and Safety in Mental Health looks into the feasibility of establishing a clinical investigation into the frequency and nature of contact with substance misuse services prior to suicide. Support to quit smoking The National Institute for Health Research has published an NIHR Signal Adding behavioural support to drug treatment helps more people quit smoking. This research summary found that among people using drug treatment to stop smoking, adding telephone or face-to-face behavioural support boosts their chances of success. Adding support increases the proportion of people quitting from around 17% on average to about 20%. Statistics The following statistical releases have been published:

Local Alcohol Profiles for England: August 2019 data update

Smoking, Drinking and Drug Use among Young People in England 2018. Additional link: BBC News

Sustainable Development:

Environmental Sustainability The Healthcare Financial Management Association (HFMA) has produced the first edition of its new Environmental sustainability round-up (August 2019). It introduces readers to the various organisations and projects working to influence the way the NHS impacts on the environment, as well as providing information on events, courses and available tools.

General: Attitudes towards emergency care The National Centre for Social Research has published the results from the British Social Attitudes Survey relating to attitudes towards emergency care. These results consider whether people share policy makers’ concerns about over-use of emergency services and whether public attitudes and perceptions suggest strategies put forward to tackle this issue might be successful. They reveal significant differences in perspectives by a range of socio-demographic factors, such as area deprivation, age, young children in the household and gender.

Additional links: BSA Survey press release NIHR press release

Barriers to prescribing of cannabis-based products for medicinal use NHS England and NHS Improvement have published Barriers to accessing cannabis-based products for medicinal use on NHS prescription. This document provides information on the findings and recommendations following NHS England and NHS Improvement’s review of the barriers to prescribing of cannabis-based products for medicinal use. DHSC usage of Charities Act The Department of Health and Social Care has published Report on the usage of section 70 of the Charities Act 2006 by the Department of Health and Social Care. This report details the grants awarded by the DHSC in 2018/19, under the provisions of section 70 of the Charities Act 2006.

Hospital food review The Government has announced a review of hospital food. The government will work with the NHS to improve food quality in hospitals and provide consistently safe, nutritious and tasty food. Alongside this, new national standards for healthcare food for patients, staff and visitors will be developed by NHS England, NHS Improvement and Public Health England.

Additional link: BBC News

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NHS Oversight Framework NHS England and NHS Improvement have published documents relating to the NHS Oversight Framework 2019/20. These documents outline the joint approach NHS England and NHS Improvement will take to oversee organisational performance and identify where commissioners and providers may need support. This framework replaces the provider Single Sight Framework and the CCG improvement and Assessment Framework.

Additional links: NHS Improvement resources NHS Providers’ On the day briefing: NHS Oversight Framework for 2019/20

NIHR Signals The following research summaries have been added to the National Institute for Health Research website:

Antibiotics reduce complications after assisted vaginal delivery

Non-invasive brain stimulation may improve outcomes for children with brain injury

Mucus-thinning drugs slightly reduce COPD symptom flare-ups

Routine engagement in end of life planning can improve health outcomes for people with heart failure

Robot-assisted training offers little useful improvement in severe arm weakness and function after stroke

Cardiac rehabilitation for heart failure can improve quality of life and fitness

Reminders to assess clotting risk increase the use of preventive measures

On balance, antiplatelet drugs may be restarted for stroke survivors who have bled into the brain

Virtual reality can help reduce the pain and anxiety of stressful medical procedures for children

Closer links between police and health services can improve experiences for people in mental health crisis

Packages of care interventions ‘not effective’ to reduce repeat admissions for COPD

Surgery for a deviated nasal septum improves quality of life more than non-surgical approaches

Personalised care handbook NHS England and NHS Improvement have published Personalised care: finance, commissioning and contracting handbook. This handbook for the NHS England Comprehensive Model for Personalised Care provides finance, commissioning and contracting staff with the information required to implement personalised care locally. Using health services with a sensory impairment Healthwatch has produced a short summary of what people have told them it is like using NHS services when you have a sensory impairment or loss. The summary also sets out the steps professionals can take to improve people’s experiences of care and includes a link to an accessibility checklist for general practices. Progressive Neurological Conditions Toolkit NHS RightCare has produced the Progressive Neurological Conditions Toolkit. This guidance aims to help CCGs deliver faster diagnosis and treatment for progressive neurological conditions, better join-up the different health professionals and organisations supporting each individual, and improve access to specialist physical and mental health care.

Additional links: NHS Rightcare press release NHS England press release

Using the Directory of Services to improve patient access to Urgent Treatment Centres NHS England has published Quick Guide – Improving Access to Urgent Treatment Centres using the Directory of Services. This guide provides information to Urgent Care Providers, Commissioners, Directory of Services (DoS) Leads and NHS 111 contact centres/Integrated Urgent Care services on how they can use the DoS to improve access for patients to Urgent Treatment Centre (UTC) services and other services expected to meet the UTC standards.

Adult Social Care: Preparing for Brexit: adult social care providers The Department of Health and Social Care has published Actions for adult social care providers to prepare for Brexit. This information sets out what adult social care providers and local authorities need to do to prepare for a no-deal Brexit. SCIELine The Social Care Institute for Excellence has published the following edition of its SCIELine e-bulletin:

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Social care priorities The Health Foundation has published What should be done to fix the crisis in social care? This ‘long read’ sets out five messages for government about priorities and options for social care reform in England, based on an assessment of the evidence and analysis of the costs of reform. It focuses primarily on changes to the funding system rather than other policy questions such as the relationship between the NHS and social care. Strengths and asset-based outcomes in social care The Social Care Institute for Excellence has published Evidence for strengths and asset-based outcomes: quick guide for social workers. This quick guide is based on recommendations from a range of NICE guidelines and quality standards that focus on identifying and supporting an individual’s strengths and assets.

Children and Young People: Children’s oral health The Faculty of Dental Surgery at the Royal College of Surgeons of England has issued a position statement on Children’s oral health. This statement updates the FDS position on children’s oral health in light of developments since 2015, and sets out a series of recommendations that describe how the government can build upon what has already been achieved. It focuses on three key areas central to eliminating child tooth decay: prevention, access and education. Preventing offending and re-offending by children Public Health England has published Collaborative approaches to preventing offending and re-offending by children (CAPRICORN). This resource outlines how health, education, social care, criminal justice, voluntary sector services and others can work together to stop children and young people offending. Stability of lives of children in care The Children’s Commissioner has published the Stability Index 2019, which is an annual measure of the stability of the lives of children in care. This report provides the national overview of the latest data analysis (relating to 2017/18) and findings and is accompanied by a technical report. In addition, Children’s voices: children’s experiences of instability in the care system summarises the experiences of children in care (or who have been in care in the past) about their experiences of instability while in care, to understand what effect it had on their lives and what might have made it easier to deal with.

Additional link: Children’s Commissioner press release Tackling family homelessness The Children’s Commissioner has published Bleak houses: tackling the crisis of family homelessness in England. This report shines a light on the children who are living in homeless families and those children who are at risk of becoming homeless. It summarises visits to children and families living in temporary accommodation and some of the frontline professionals working with them. It also analyses new data to identify the scale of the problem.

Additional link: Children’s Commissioners press release

Commissioning: CCG 360° Stakeholder Survey NHS England has published CCG 360° Stakeholder Survey National Report 2018/19. This report presents findings from the CCG360 Stakeholder Survey used as part of the CCG assessment process. Also published are five case studies of high performing CCGs, one of which is from Rotherham CCG. A key aim of the survey is to enable NHS England to assess whether CCGs are operating effectively in partnership with key organisations in the local health system to commission safe, high quality and sustainable services. Dental care for people with diabetes NHS England has published Commissioning Standard: Dental care for people with diabetes. This document supports the implementation of a standardised framework for the local commissioning of dental services for people with diabetes (type 1 and type 2) and people with non-diabetic hyperglycaemia (NDH). Emicizumab for haemophilia A NHS England has published Clinical Commissioning Policy: Emicizumab as prophylaxis in people with severe congenital haemophilia A without factor VIII inhibitors (all ages). This document outlines the arrangements for the funding of Emicizumab as prophylaxis in people with severe congenital haemophilia A without factor VIII inhibitors.

Additional link: NHS England news release

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Sexual and reproductive health commissioning The Local Government Association has published Collaboration and cooperation: sexual and reproductive health commissioning. This report sets out details of councils that have led the way in shaping a modern, responsive and proactive sexual health service through the creation of strong commissioning networks and expert groups. Service specification / Clinical Commissioning Policy NHS England and NHS Improvement have published the following documents:

Service specification: Adult Highly Specialist Pain Management Services - covers the provision of adult highly specialist pain management services; there are significant overlaps in relation to young people and the transition from children to adult services

Interim Clinical Commissioning Policy – Vasectomy - aims to ensure that male Armed Forces patients are able to access NHS vasectomy services wherever they live or receive their services in England.

Data and Technology: Electronic patient records: accredited suppliers NHS England and NHSX have published a list of accredited suppliers of electronic patient record solutions. The new section on the Health Systems Support Framework is designed to help organisations and ICS get best value for money when buying new digital services, software and infrastructure. The successful eight suppliers are Allscripts, Cerner, DXC, IMS Maxims, Nervecentre, Meditech, TPP and System C. National Data Guardian annual report The National Data Guardian has published National Data Guardian 2018-19 report. This report looks back over the work of Dame Fiona Caldicott as National Data Guardian for Health and Social Care in England, picking up where her December 2017 progress report left off. She describes the progress made against the eight work priorities set in her 2017 report and outlines the NDG’s new priorities for 2019 onwards - her first set of work commitments since the NDG role became statutory on 1st April 2019. NHS Digital developments NHS Digital has released the following press releases setting out uses for technology in health care:

Nine new tools and services to use NHS login - NHS login, the service providing patients with a secure, simple way to identify themselves and match them to their records, will be used by nine more services

CCG leads way with latest electronic prescription upgrade live in all GP practices - Portsmouth has become the first area in the country where prescriptions for all patients can be sent electronically

Primary Care Networks: data sharing and processing NHS England and NHS Improvement have published Network Contract Directed Enhanced Service data templates. These documents are templates for the purposes of facilitating discussions within a Primary Care Network in relation to data sharing and data processing to support delivery of the Network Contract Directed Enhanced Service.

Integrated Care: Integrated Care Provider Contract NHS England and NHS Improvement have published the following documents relating to the Integrated Care Provider Contract:

NHS Standard Contract: Integrated Care Provider 2019/20

CCG roles where ICPs are established

Whole Population Models of Provision: Establishing Integrated Budgets

Procurement and Assurance approach: ICP Contract package

NHS Standard Contract (Integrated Care Provider) Template ICP/Local Authority Integration Agreement

NHS Standard Contract (Integrated Care Provider) Template Integration Agreement for Partially Integrated ICPs

ICP Contract: Questions and Answers

GP Participation in an Integrated Care Provider

GP Integration Agreement FAQs

Template ICP/Local Authority Integration Agreement – FAQs

Explanatory Notes to the Integrated Care Provider Contract

About the Integrated Care Provider Contract – Easy Read

Contracting Arrangements for ICPs: Equality and Health Inequalities Analysis

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Meanwhile, NHS Providers has published a briefing for the Integrated Care Provider contract. It summaries the ICP contract’s explanatory documents and provides an overview of those documents focused on CCGs, commissioning a procurement, primary care integration and local government integration.

Learning Disability: Improving care for patients with a learning disability NHS Digital is piloting a reasonable adjustment flag on patient records, which will let doctors, nurses and other health and care staff know that a patient has a learning disability and has specific needs that require adjustments to the services provided so they get the best care. The pilot will run to the end of September to test the technology behind the flag and gather feedback from staff, patients and carers. NHS Digital will then explore a potential expansion. Preventing falls in people with a learning disability Public Health England has published Preventing falls in people with learning disabilities: making reasonable adjustments. This guide contains information to help staff in public health, health services and social care to prevent falls in people with learning disabilities. It is also intended to help falls prevention services to provide support that is accessible to people with learning disabilities. It may also be of use to family, carers and friends of people with learning disabilities.

NHS and Social Care Finances: Drivers of health care expenditure The Centre for Health Economics has published Drivers of health care expenditure: final report. This report examines the drivers of past trends in health care expenditure and how much each has contributed to past increases in expenditure. It also examines how much each type of health service has contributed to past trends in health care expenditure and why there have been different trends for different types of care. It presents four lessons that could inform decisions on building a projections model of health care expenditure. Social care funding The King’s Fund has published the following resources relating to social care funding:

A short history of social care funding reform in England: 1997 to 2019 – this timeline outlines the history of the past 22 years of attempts to reform how social care is funded.

How do you solve a problem like social care funding? This podcast looks back at previous attempts at social care funding reform and explores why this has proved so challenging for successive governments.

Social care funding reform: more haste, less speed – this blog explores whether the Prime Minister’s commitment to ‘fix the social care crisis’ will be more successful than attempts by previous administrations.

Tackling social care funding NHS Confederation has published A chink of light? Tackling the under-funding of social care. This briefing looks to identify the factors that have been placing a strain on adult social care in recent years and what the future pressures could be. It analyses the anticipated adult social care funding gap in 2019/20, concluding that to maintain the status quo, the cash injection required is between £1.1 billion and £2.5 billion.

Additional link: NHS Confederation press release

Older People: Older people’s medicines Age UK has published More harm than good: why more isn’t always better with older people’s medicines. This report highlights the ways that older people can end up taking medicines that do them no benefit and may put them at risk of harm. It also looks at the risk of undertreating older people who miss out on beneficial treatments because of assumptions about their age and health status. It calls for every older person to be treated as an individual with their care optimised to best meet need.

Policy and Strategy: NHS providers’ licence requirements The Department of Health and Social Care has updated Protecting and promoting patients’ interests: licence exemptions: guidance for providers. This guidance helps providers of NHS services to understand whether they need a licence from Monitor or are exempt. The licence sets out the conditions that licence holders have to meet in order to provide NHS services.

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Reducing length of stay NHS England has produced a series of reducing length of stay action cards. The six action cards, aimed at different groups of health professionals, highlight the most important things that healthcare professionals should be doing each day to reduce long hospital stays.

Additional link: NHS England case studies

Pregnancy and Maternity Services: The Tommy’s National Centre for Maternity Improvement Tommy’s, The Royal College of Midwives and the Royal College of Obstetricians and Gynaecologists have formed an alliance to launch The Tommy’s National Centre for Maternity Improvement, which will be established from 1

st September 2019. The

three-year programme of work will involve the creation of a digital tool to personalise and improve maternity care for women as well as support the government’s objectives to reduce stillbirth and preterm birth.

Primary Care and Community Services: Delegated CCG ratings NHS England and NHS Improvement have published Primary Medical Care Commissioning Internal Audit Ratings for Delegated CCGs as of 31 June (stet) 2019. This document is the first cohort of new ratings on delegated CCGs, highlighting where internal audits are finding CCGs are performing delegated primary medical care commissioning really well, but also helping to identify where improvements can be made. Primary care networks: network contract directed enhanced services NHS England and NHS Improvement have published Network Contract Directed Enhanced Services: additional roles reimbursement scheme guidance. This guidance document provides information on the additional roles reimbursement scheme, including the process by which Primary Care Networks (PCNs) can claim reimbursement for additional staff. Primary care networks: overview for general practice teams Primary Care Commissioning has published a slidepack, Primary care networks: an overview for general practice teams. This pack collates some of the latest information about PCNs, covering the policy background to PCNs and explains where they fit in the wider integrated care systems. Provider bulletin NHS Improvement publishes this weekly bulletin:

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Quality and Safety: Complaints about the NHS in England The Parliamentary and Health Service Ombudsman has published Complaints about the NHS in England Quarter 4 2018-19. This report provides statistics on complaints about the NHS in England. It presents data about the NHS complaints received, assessed and investigated by the Ombudsman from January to March 2019, and the recommendations made. Healthcare Safety Investigation Branch feedback The Healthcare Safety Investigation Branch has launched a new online feedback form so that anyone involved or interested in healthcare safety investigations can tell the HSIB what they think about national investigations in general, specific national investigations, maternity investigations and the HSIB in general. Patient experience QualityWatch has published its latest indicator update, which looks at how patient experience of NHS and social care services has changed over time. It uses data from national patient surveys to compare the experience of different NHS and social care services. Overall, access to GP services has worsened, experience of inpatient services has improved, and satisfaction with adult social care services has remained stable. In general, people report their experiences of children and young people’s services and maternity services more positively than their experiences of emergency departments and community mental health services.

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Safeguarding: Safeguarding accountability and assurance framework NHS England and NHS Improvement have revised the NHS Safeguarding Accountability and Assurance Framework (SAAF). This framework has been updated to reflect the safeguarding reforms that have passed through government since the last publication in 2017. It sets out the safeguarding roles and responsibilities of all individuals working in providers of NHS funded care settings and NHS commissioning organisations.

Additional link: NHS England/Improvement blog

Workforce, Education and Training: Children and young people’s mental health services workforce NHS Benchmarking Network has produced Children and Young People’s Health Service workforce report for Health Education England. This report outlines the findings from the second national stocktake of the Children and Young People’s mental health workforce. The study indicates a trend of growth, particularly in NHS employed staff, where numbers have increased by almost a quarter in the two years from 2016 to 2018.

Additional link: HEE press release Clinical workforce scenarios The Strategy Unit has published Black Country LWAB Scenario Analysis: part one: exploring the contextual environment. This document, produced for the Local Workforce Action Board for the Black Country and West Birmingham STP, provides an analysis of key forces likely to affect clinical services and the associated workforce in 2020-2030. It is accompanied by a scenario toolkit. General Practice Nurse Education Network The Queen’s Nursing Institute has developed a new network to support General Practice Nurses. The General Practice Nurse Education Network is one of a number of initiatives arising from the General Practice Nursing 10 point plan. The aim of the network is to: offer information to nurses interested in becoming a General Practice Nurse; provide an A-Z of clinical skills, with links for nurses who need quick access to contemporary information; and offer educational resources for professional development.

Additional link: Queen’s Nursing Institute press release Managing violence towards NHS staff RAND Europe has published Reviewing the Evidence Base for De-escalation Training: a Rapid Evidence Assessment. As a way to help staff manage, reduce or prevent violence from occurring, NHS Improvement commissioned RAND Europe to conduct an analysis of de-escalation training to support the development of such training within health settings. The study found that training might help staff manage patient violence and aggression, although de-escalation training may not in itself reduce the number of violent or aggressive incidents. NHS Workforce Bulletin NHS Employers has published the following editions of its NHS Workforce Bulletin:

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August Professionalism and cultural transformation (PACT) toolkit NHS Employers has published Professionalism and cultural transformation (PACT) toolkit. This toolkit aims to help educate and empower staff to improve professionalism within their organisation and helps organisations move towards making the NHS the best place to work. Social work recording The Social Care Institute for Excellence has produced a resource Social work recording. This resource aims to support social workers and other social care staff to improve recording skills, i.e. how they write down what they have seen and done, an analysis of that, and what they plan to do as a result. It is based on the concept of PARTNERSHIP – that recording should be done, as much as possible, in conjunction with the person you are working with. The resource sets out 11 top tips to consider when recording, whether that be daily case notes or more formal reports or assessments. It includes scenarios to enable people to practise their recording skills. TEL News Health Education England has published the July 2019 edition of its Technology Enhanced Learning (TEL) News.

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Workplace exchange NHS England and NHS Improvement has published The Wessex Model – How to set up and run a workplace exchange. This document sets out how to run a workplace exchange using the Wessex Exchange Model. The model was developed to overcome challenges with fragmented working and ineffectual delegation of workload by building trust and relationships between professionals and creating time for professionals to find solutions mutually towards providing joined-up care for patients.

The National Institute for Health and Care Excellence (NICE) has issued the following guidance (NG), clinical guidance (CG), diagnostic guidance (DS) and quality standards (QS):

Preterm labour and birth (NG25 updated)

Type 2 diabetes in adults: management (NG28 updated)

Venous thromboembolism in over 16s: reducing the risk of hospital-acquired deep vein thrombosis or pulmonary embolism (NG89 updated)

Alcohol interventions in secondary and further education (NG135)

Hypertension in adults: diagnosis and management (NG136)

Caesarean section (CG132 updated)

Preterm labour and birth (QS135 updated)

Coexisting severe mental illness and substance misuse (QS188) NICE consultations:

Flu vaccination: increasing uptake: quality standard consultation. Closing date for comments: 3rd

September 2019.

Rheumatoid arthritis in over 16s (QS update): quality standard consultation. Closing date for comments: 3rd

September 2019.

Cannabis-based medicinal products: draft guidance consultation. Closing date for comments: 5th

September 2019.

Mental wellbeing at work: draft scope consultation. Closing date for comments: 9th

September 2019.

Impetigo: antimicrobial prescribing: draft guidance consultations. Closing date for comments: 11th

September 2019.

Hip fracture: management: surveillance consultation. Closing date for comments: 12th

September 2019.

Carers: provision of support for adult carers: draft guidance consultation. Closing date for comments: 13th September

2019.

Colorectal cancer: diagnosis and management (update): draft guidance consultation. Closing date for comments: 13th

September 2019.

Reducing sexually transmitted infections: draft scope consultation. Closing date for comments: 18th

September 2019.

Fever in under 5s: assessment and initial management: draft guidance consultation. Closing date for comments: 19th

September 2019.

Intrapartum care: women with existing medical conditions or obstetric complications and their babies: quality standard consultation. Closing date for comments: 23

rd September 2019.

Safe prescribing and withdrawal management of prescribed drugs associated with dependence and withdrawal: draft scope consultation. Closing date for comments: 26

th September 2019.

Myalgic encephalomyelitis (or encephalopathy)/chronic fatigue syndrome: diagnosis and management: call for evidence. Closing date for evidence: 4

th October 2019.

NICE shared learning:

Dudley Falls Prevention Service – a multi-agency service

Enabling Intermediate Care – Royal Devon and Exeter NHS FT

A focus on health: applying NICE guidance to a local authority led adults quality service provider framework – Hull CCG

NICE Guidelines

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NICE surveillance reports:

Alcohol-use disorders: prevention (PH24, 2010) - surveillance decision: NICE will update the guideline.

Alcohol-use disorders: diagnosis, assessment and management of harmful drinking and alcohol dependence (CG115, 2011) - surveillance decision: NICE will not update the guideline.

NICE News NICE has published the August 2019 edition of NICE News. NICE in Social Care NICE has published the August 2019 edition of NICE in Social Care. NICE Update for Primary Care NICE has published the August 2019 edition of NICE Update for Primary Care.

This monthly current awareness bulletin is edited and produced by: The Knowledge, Evidence and Insight team (formerly, Knowledge Resources)

Strategy & Resources, Nottingham City Council Standard Court, 1 Park Row, Nottingham NG1 6GN

Tel: 0115 8834205

E-mail: knowledge.resources@nottinghamcity.gov.uk Website: https://kei.nottinghamcity.nhs.uk/

Disclaimer and Acknowledgements: The content and links in this Bulletin are provided for information only (and are only valid at time of publication) and do not imply endorsement by Knowledge, Evidence and Insight of the site or the information displayed there. Thanks to all the various sources for help with the content of the Bulletin, including the National Child and Maternal Health Intelligence Network, the West Midlands Health & Planning Group updates, NHS Management and Policy alerts from King’s Fund library and the Daily Bulletin alerts from EMBED Health Consortium, posted on the Current Awareness Service for Health (CASH) website by Derbyshire County Council Public Health colleagues.

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