NHS Library and Information Service North Staffordshire

Clinical Effectiveness Bulletin for NHS Primary Care in North Staffordshire

Issue No: 75 April 2013

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

Contact information

Bulletin produced by NHS Outreach Librarians Tel: 01782 679564 or 0300 123 1535 ext/FeatureNet 8429 E-mail: lindsay.snell@northstaffs.nhs.uk clareh.powell@northstaffs.nhs.uk

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

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

NHS Library and Information Service North Staffordshire Contents in this issue:
Asthma...................................................................................................................................... 4 Cancer ...................................................................................................................................... 4 Cardiovascular Diseases .......................................................................................................... 4 Children and Young People ...................................................................................................... 5 Commissioning ......................................................................................................................... 5 COPD ....................................................................................................................................... 6 Crohns Disease ....................................................................................................................... 6 Dementia .................................................................................................................................. 7 General Practice ....................................................................................................................... 7 Guidance .................................................................................................................................. 7 Health Reforms ......................................................................................................................... 9 HIV ............................................................................................................................................ 9 Infection Control ...................................................................................................................... 10 Kidney Disease ....................................................................................................................... 10 Mental Health.......................................................................................................................... 10 Nutrition .................................................................................................................................. 10 Nursing ................................................................................................................................... 11 Older People ........................................................................................................................... 11 Patient and Public Involvement ............................................................................................... 11 Patient Care and Safety .......................................................................................................... 11 Pharmacy and Prescribing ...................................................................................................... 12 Public Health ........................................................................................................................... 13 Research ................................................................................................................................ 14 Safeguarding Children and Vulnerable Adults ........................................................................ 14 Service Management .............................................................................................................. 14 Social Care ............................................................................................................................. 15 Tobacco .................................................................................................................................. 16 Travel Health .......................................................................................................................... 16 Vaccination and Immunisation ................................................................................................ 16

NHS Library and Information Service North Staffordshire Asthma

Combination formoterol and budesonide as maintenance and reliever therapy versus current best practice (including inhaled steroid maintenance), for chronic asthma in adults and children Cates, C et al. This Cochrane review is based on 13 trials involving 13,152 adults. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD007313.pub3/abstract Swimming training for asthma in children and adolescents aged 18 years and under Beggs, S et al. This Cochrane review looked at the impact of swimming training on the amount of exercise children were able to do. However, the authors concluded the evidence on asthma control and quality of life was not statistically significant. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD009607.pub2/abstract
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Cancer
The Cancer Drugs Fund NHS England This web page outlines the current role and structure of the Fund. http://www.england.nhs.uk/ourwork/cdf/ Geographic Patterns of Cancer Survival in England, Patients followed up to 2011 Office for National Statistics These statistics include one-year and five-year net survival estimates for adult patients diagnosed with one of eight cancers in England. Results are presented by Region, Strategic Health Authority and Cancer Network. http://www.ons.gov.uk/ons/rel/cancer-unit/cancer-survival-by-gor--sha-and-cancernetwork/patients-followed-up-to-2011/index.html Use of medications to reduce risk for primary breast cancer: a systematic review for the U.S. Preventive Services Task Force Nelson, HD et al. This review is based on 7 trials of tamoxifen and raloxifene. Ann Intern Med. 2013 vol158(8) p.604-614. doi:10.7326/0003-4819-158-8-201304160-00005
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Cardiovascular Diseases
Items in the Nutrition section may be of interest.

NHS Library and Information Service North Staffordshire Children and Young People
Child well-being in rich countries UNICEF This report compares child well-being in 21 different countries. http://www.unicef.org.uk/Latest/Publications/Report-Card-11-Child-well-being-in-richcountries/ Early intervention: decision-making in local authority childrens services Social Care Institiute for Excellence The study seeks to gain a better understanding of the factors that facilitate and hinder delivery of improved outcomes for children and families over the longer-term. It is based on interviews, a literature review, and expert opinion. http://www.scie.org.uk/publications/reports/report65.asp Measuring National Well-being - Children's well-being, 2013 Office for National Statistics http://www.ons.gov.uk/ons/rel/wellbeing/measuring-national-well-being/children-s-wellbeing/art-children-s-well-being.html Routine immunisations for children: information on vaccines and timing Department of Health This poster provides guidance on when children are usually given specific vaccinations, which diseases routine vaccines protect against and where on the body injections are given. https://www.gov.uk/government/publications/routine-childhood-immunisation-from-november2010 School Health Service: briefing for local council members Department of Health This briefing summarises the School Health Service and how school nurses can support its delivery. https://www.gov.uk/government/publications/school-health-service-briefing-for-local-councilmembers
Items in the Asthma section may also be of interest. [back to topics]

Commissioning
Ambition, challenge, transition: reflections on a decade of NHS commissioning NHS Confederation This report has been produced to mark the end of a significant period of transition for NHS commissioning. It explores the achievements and challenges experienced over more than a decade of commissioning through the voices of those who lived it on the ground. http://www.nhsconfed.org/Publications/reports/Pages/ambition-challenge-transition.aspx

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Clinical Policies and Statements for Specialised Services Commissioning NHS England These policies aim to ensure specialised services are commissioned consistently across England. http://www.england.nhs.uk/ourwork/d-com/spec-serv/policies/ Guidance for commissioners on ensuring the continuity of health care services Monitor This document outlines the process for deciding on the range of services that local commissioners believe should continue to be provided locally if any individual provider is at risk of failing financially. http://www.monitor-nhsft.gov.uk/home/news-events-publications/our-publications/monitorsnew-role/guidance-commissioners-ensuring-the Interim generic policies for direct commissioning NHS England The 14 policies, which cover all aspects of directly commissioned services, including specialised, primary care, screening, military and offender health. http://www.england.nhs.uk/ourwork/d-com/policies/ Transforming our health care system: Ten priorities for commissioners Kings Fund This paper was originally published in March 2011. It has been updated to reflect the changes in the NHS from 1 April 2013. http://www.kingsfund.org.uk/publications/articles/transforming-our-health-care-system-tenpriorities-commissioners
Items in the COPD, General Practice and Health Reforms sections may be of interest. [back to topics]

COPD
A Guide to Performing Quality Assured Diagnostic Spirometry Primary Care Commissioning This guide details how spirometry should be performed, the interpretation and reporting of results, and methods for quality assurance. The guide also illustrates common technical errors and offers top tips for reporting spirometry results. http://www.pcc-cic.org.uk/article/guide-quality-assured-diagnostic-spirometry
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Crohns Disease
Azathioprine or 6-mercaptopurine for induction of remission in Crohn's disease Chande, N et al. This Cochrane review is based on 13 RCTs which included 1211 patients. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD000545.pub4/abstract 6

NHS Library and Information Service North Staffordshire Dementia

Dementia 2013: The hidden voice of loneliness Alzheimers Society This report is based on surveys, interviews, and published research. It looks at the lives of people with dementia, and the support they receive. http://alzheimers.org.uk/site/scripts/download_info.php?fileID=1677

General Practice
Enhanced services 2013/14 NHS Employers summary http://www.nhsemployers.org/PayAndContracts/GeneralMedicalServicesContract/DirectedEn hancedServices/Pages/EnhancedServices201314.aspx Primary Care Commissioning summary http://www.pcc-cic.org.uk/article/new-enhanced-services-201314 NHS Primary Medical Services Directions 2013 Department of Health https://www.gov.uk/government/publications/nhs-primary-medical-services-directions-2013
Items in the Patient Care and Safety section may also be of interest. [back to topics]

Guidance
NICE Technology Assessments Asthma (severe, persistent, patients aged 6+, adults) omalizumab (TA278) http://guidance.nice.org.uk/TA278 Idiopathic pulmonary fibrosis - pirfenidone (TA282) http://guidance.nice.org.uk/TA282 Rheumatoid arthritis - abatacept (2nd line) (rapid review of TA234) (TA280) http://guidance.nice.org.uk/TA280 NICE Quality Standards Health and wellbeing of looked-after children and young people (QS31) http://guidance.nice.org.uk/QS31 Supporting people to live well with dementia (QS30) http://guidance.nice.org.uk/QS30 7

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NICE Consultation Documents Smoking cessation acute, maternity and mental health services: consultation on the draft guidance To comment, register as a stakeholder, or contact the registered stakeholder organisation that most closely represents your interests. Closing date for comments: 5 June 2013 http://www.nice.org.uk/guidance/index.jsp?action=folder&o=63458 Diabetic footcare (update): scope consultation To comment, register as a stakeholder, or contact the registered stakeholder organisation that most closely represents your interests. Closing date for comments: 16 May 2013 http://www.nice.org.uk/guidance/index.jsp?action=folder&o=63623 Overweight and obese children and young people - lifestyle weight management services: guideline consultation To comment, register as a stakeholder, or contact the registered stakeholder organisation that most closely represents your interests. Closing date for comments: 18 June 2013 http://www.nice.org.uk/guidance/index.jsp?action=folder&o=63652 Anaemia management in chronic kidney disease (update): scope consultation To comment, register as a stakeholder, or contact the registered stakeholder organisation that most closely represents your interests. http://www.nice.org.uk/guidance/index.jsp?action=folder&o=63718
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Other Health Technology Assessments Systematic review of the psychological consequences of false-positive screening mammograms Bond M, et al. This study found that the experience of having a false-positive screening mammogram can cause breast cancer-specific psychological distress, that may endure for up to 3 years and reduce the likelihood of returning for screening the next time. Health Technol Assess 2013;17(13). A systematic review and cost-effectiveness analysis of specialist services and adrenaline auto-injectors in anaphylaxis. Armstrong N, et al. This study found a lack of good data to inform the effectiveness of anaphylaxis intervention but concluded that both referral to a specialist service (SS) and prescription of adrenaline injectors are likely to be cost-effective, and so consideration of randomised controlled trials of the components of care in SSs was recommended. Health Technol Assess 2013;17(17).
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Other Guidance Sexually Transmitted Infections in Primary Care RCGP http://www.rcgp.org.uk/clinical-and-research/clinical-resources/sexually-transmitted-infectionsin-primary-care.aspx Vitamin D and Bone Health: A Practical Clinical Guideline for Patient Management National Osteoporosis Society http://www.nos.org.uk/document.doc?id=1352
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Health Reforms
Compliance Framework 2013/14 Monitor This framework outlines Monitors approach to monitoring risks to foundation trusts' compliance with their financial and governance licence conditions and for triggering further investigation. http://www.monitor-nhsft.gov.uk/home/news-events-and-publications/our-publications/browsecategory/guidance-foundation-trusts/mandat-7 Consultations on safeguarding choice and preventing anti-competitive behaviour Monitor http://www.monitor-nhsft.gov.uk/about-monitor/feed-back-your-views-our-latest-consultations Enforcement Guidance Monitor This guidance explains the action Monitor can take to enforce compliance with the provider licence and other regulatory obligations on providers and others required to provide Monitor with information needed to perform its functions. http://www.monitor-nhsft.gov.uk/node/2622
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HIV
Commissioning HIV Testing Services in England: A practical guide for Commissioners National AIDS Trust This guide outlines useful sources of information, and some of the types of services commissioners might want to commission. http://www.nat.org.uk/media/Files/Publications/March_2013-Commissioners_Guide.pdf
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NHS Library and Information Service North Staffordshire Infection Control

HCAI Reporting within Independent Sector healthcare organisations HPA The latest publication includes 6 months counts of MRSA, MSSA and E. coli bacteraemia and CDI within those IS organisations who reported between April 2012 and September 2012. http://www.hpa.org.uk/web/HPAweb&HPAwebStandard/HPAweb_C/1272032580726 Investigation & management of possible human cases of avian inuenza A/H7N9, in returning travellers HPA This guidance covers the assessment and investigation of patients with severe flu-like illness who have recently (within seven days) returned from China. http://www.hpa.org.uk/Topics/InfectiousDiseases/InfectionsAZ/AvianInfluenza/Guidelines/influ aAvianInfluenzaGuidanceandAlgorithms/ vCJD and transfusion of blood components: updated risk assessment Department of Health https://www.gov.uk/government/publications/vcjd-and-transfusion-of-blood-componentsupdated-risk-assessment
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Kidney Disease
Items in the Nutrition section may be of interest.

Mental Health
Items in the Tobacco section may be of interest. [back to topics]

Nutrition
Effect of increased potassium intake on cardiovascular risk factors and disease: systematic review and meta-analyses Aburto, NJ et al. This systematic review assessed the effect of increased potassium intake on cardiovascular disease and renal function. BMJ 2013; 346 doi: http://dx.doi.org/10.1136/bmj.f1378 (Published 4 April 2013) Effect of longer-term modest salt reduction on blood pressure Feng, JH et al. This Cochrane review makes recommendations for a suggested daily maximum salt intake. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004937.pub2/abstract

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Effect of lower sodium intake on health: systematic review and meta-analyses Aburto, NJ et al. This systematic review assessed the effect of reduced sodium intake on cardiovascular disease and renal function. BMJ 2013; 346 doi: http://dx.doi.org/10.1136/bmj.f1326 (Published 4 April 2013) Food statistics pocketbook 2012 Department for Environment, Food and Rural Affairs https://www.gov.uk/government/publications/food-statistics-pocketbook-2012
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Nursing
Compassion in Practice implementation plans NHS England These plans outline how Compassion in Practice will be implemented, using 6 action areas to focus activity. http://www.england.nhs.uk/nursingvision/actions/
Items in the Children and Young People section may be of interest.

Older People
Improving personal budgets for older people: A research overview Social Care Institute for Excellence This short report aims to give an overview of the main themes of research findings which help to identify the challenges and solutions to improving choice and control for older people (including those living with dementia) through the use of personal budgets and direct payments. http://www.scie.org.uk/publications/reports/report63.asp
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Patient and Public Involvement

Bring it on: 40 ways to support Patient Leadership NHS Midlands and East Centre for Patient Leadership This guide explains what patient leadership means and the role and purpose of patient leaders. It aims to help NHS organisations foster patient leadership and Patient Leaders. http://centreforpatientleadership.com/resources/links/

Patient Care and Safety

Implementing shared decision making Health Foundation This report looks at 7 examples of teams in primary care and other settings implementing shared decision making. It looks at the benefits and challenges of this approach. http://www.health.org.uk/publications/implementing-shared-decision-making/ 11

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The measurement and monitoring of safety The Health Foundation This report suggests 5 dimensions which should be taken into account when measuring safety in an organisation. http://www.health.org.uk/publications/the-measurement-and-monitoring-of-safety/ Information: To share or not to share? The Information Governance Review Department of Health This independent review of information sharing was carried out to ensure that there is an appropriate balance between the protection of patient information and the use and sharing of information to improve patient care. https://www.gov.uk/government/publications/the-information-governance-review Patient experience statistics: England Department of Health The statistics use responses from the national patient survey programme to measure patient views on the care they receive in the NHS. Supporting documents, including tools to help with understanding the statistics, are also available from this web page. https://www.gov.uk/government/organisations/department-of-health/series/patient-experiencestatistics Quality Governance: How does a board know that its organisation is working effectively to improve patient care? Monitor This guidance allows trusts to satisfy themselves, patients and Monitor that effective arrangements are in place to continuously monitor and improve the quality of health care provided. http://www.monitor.gov.uk/home/news-events-publications/our-publications/browsecategory/guidance-foundation-trusts/mandatoryWhat to expect from your doctor: a guide for patients GMC This guide explains how patients can help to create a partnership with their doctor. It is based on the GMC guidance Good medical practice. http://www.gmc-uk.org/guidance/patients.asp
Items in the Nursing and Service Management sections may also be of interest. [back to topics]

Pharmacy and Prescribing

Evaluation of the Healthy Living Pharmacy pathfinder work programme 2011-2012 National Pharmacy Association After a Healthy Living Pharmacy programme in Portsmouth in 2010 showed improved outcomes, this practice-based evaluation assessed whether the HLP programme would have the same impact in other places. http://www.npa.co.uk/Resources/Press-Releases/About-the-Association/HLP/ 12

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Interventions to improve antibiotic prescribing practices for hospital inpatients Davey, P et al. This Cochrane review compared interventions which restricted prescribing with interventions that aimed to persuade prescribers to change their behaviour. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD003543.pub3/abstract Nebuliser systems for drug delivery in cystic fibrosis Daniels, T et al. This Cochrane review is based on 20 studies, which looked at a range of different drugs and nebulisers. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD007639.pub2/abstract Prescription Cost Analysis - England, 2012 Health and Social Care Information Centre These statistics provide details of the number of items and the net ingredient cost of all prescriptions dispensed in the community in England. The drugs dispensed are listed by British National Formulary (BNF) therapeutic class. http://www.hscic.gov.uk/catalogue/PUB10610
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Public Health
The central governments concept of operations Cabinet Office The central governments concept of operations sets out the UK arrangements for responding to and recovering from emergencies. https://www.gov.uk/government/publications/the-central-government-s-concept-of-operations Our priorities for 2013/14 Public Health England This document suggests that local action will drive sustainable change in the publics health, but PHE are committed to taking action on a national scale where it makes sense, and when it is needed https://www.gov.uk/government/publications/public-health-englands-priorities-for-2013-to2014 Primary Care Organisation Population Estimates, Mid-2011 Final (Census Based) Office for National Statistics This product includes estimates of the usually resident population as at 30 June of the reference year for Primary Care Organisations in England by age and sex. These estimates are consistent with the Census based local authority, regional and national population estimates. Estimates reflect the administrative boundaries in place on 30 June 2011. http://www.ons.gov.uk/ons/rel/sape/pco-pop-est-exp/mid-2011-final--census-based/index.html

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Public Health England Marketing Plan 2013-14 Public Health England This report looks at the marketing interventions Public Health England will use to promote healthy lifestyles. https://www.gov.uk/government/publications/public-health-england-marketing-plan-2013-14
Items in the Cancer and Children and Young People sections may also be of interest. [back to topics]

Research
Attributing the costs of health and social care research Department of Health This document establishes a new mechanism for the department to meet some of the costs of charity-funded research in the NHS. https://www.gov.uk/government/publications/guidance-on-attributing-the-costs-of-health-andsocial-care-research
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Safeguarding Children and Vulnerable Adults

Identifying and Supporting Victims of Human Trafficking: Guidance for Health Staff Department of Health This guidance provides information that will help staff identify potential victims of trafficking and advises on how to respond in a way that will not put the potential victim in further danger. https://www.gov.uk/government/publications/identifying-and-supporting-victims-of-humantrafficking-guidance-for-health-staff
Items in the Patient Care and Safety and Service Management sections may also be of interest.

Service Management
Managing Healthcare Fire Safety Department of Health This guidance (HTM 05-01) sets out the Department of Healths policy on fire safety in the NHS in England. It includes best practice guidance on management arrangements for fire safety. https://www.gov.uk/government/publications/managing-healthcare-fire-safety National Framework for NHS Continuing Healthcare and NHS Funded Nursing Care Department of Health This guidance replaces the previous version of the National Framework, published in July 2009, and comes into force on 1 April 2013. It also incorporates the Practice Guidance, Frequently Asked Questions (FAQs) and Refunds Guidance. https://www.gov.uk/government/publications/national-framework-for-nhs-continuinghealthcare-and-nhs-funded-nursing-care 14

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Ordinary Residence: Guidance on the Identification of the Ordinary Residence of People in Need of Community Care Services, England Department of Health This guidance was updated on 28 March 2013 to take account of the NHS reforms, which take effect from 1 April 2013. https://www.gov.uk/government/publications/identifying-the-ordinary-residence-of-people-inneed-of-community-care-services NHS Outcomes Framework Indicators: March 2013 release Health and Social Care Information Centre http://www.hscic.gov.uk/catalogue/PUB10585 Rights, risks and responsibilities in service redesign for vulnerable groups RCN This guidance contains some general principles for service redesign. It then looks at service redesign for specific groups, including older people, and children and young people. http://www.rcn.org.uk/__data/assets/pdf_file/0005/518099/004378.pdf
Items in the Patient Care and Safety sections may also be of interest. [back to topics]

Social Care
Adult Social Care Outcomes Framework 2013 to 2014 Department of Health This document sets out the indicators for measuring adult social care outcomes in 2013-2014. https://www.gov.uk/government/publications/the-adult-social-care-outcomes-framework-2013to-2014 NICE social care quality standards and the quality landscape NICE This briefing describes what NICE social care quality standards are, outlines the benefits of using them and explains how they will fit into the existing regulatory frameworks and other quality systems. It also shows how NICEs social care guidance and quality standards relate to the work of other organisations in the sector and how they can be used to improve the quality of care for service users and inform the planning and delivery of social care services. http://www.nice.org.uk/socialcare/SocialCareQualityStandardsQualityLandscape.jsp Using NICE guidance and quality standards to improve practice NICE This guide aims to support health and social care professionals and managers in providing care of the highest quality and the best value for money. The guide suggests what an organisation can put in place, and what staff can do to use NICE evidence-based guidance and quality standards to improve practice. http://publications.nice.org.uk/using-nice-guidance-and-quality-standards-to-improve-practicepg1
Items in the Children and Young People section may be of interest.

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NHS Library and Information Service North Staffordshire Tobacco

Smoking and mental health Royal College of Physicians This document outlines how smoking affects people with mental health conditions, and makes recommendations for supporting smoking cessation in this group.

http://www.rcplondon.ac.uk/publications/smoking-and-mental-health
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Travel Health
Items in the Infection Control section may be of interest.

Vaccination and Immunisation

Contraindications and special considerations: the green book, chapter 6 Department of Health https://www.gov.uk/government/publications/contraindications-and-special-considerationsthe-green-book-chapter-6 Calculating MMR coverage: ready reckoner tool 2013 Department of Health https://www.gov.uk/government/publications/calculating-mmr-coverage-ready-reckoner-tool2013 National immunisation programme: planned changes for 2013 to 2014 Department of Health This document includes details of the specific programme for rotavirus for babies at 2 and 3 months. https://www.gov.uk/government/publications/national-immunisation-programme-plannedchanges-for-2013-to-2014
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