NHS Library and Information Service North Staffordshire

Clinical Effectiveness Bulletin for NHS Primary Care in North Staffordshire

Issue No: 81 October 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: Andrew.Hough@northstaffs.nhs.uk or 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 Diabetes Type 2 Horizon Scanning Health Technology Assessment (HTA) Database http://www.hta.ac.uk Daily Health Bulletin http://www.sheffield.nhs.uk/healthbulletin/ Department of Health http://www.gov.uk/dh Kings Fund http://www.kingsfund.org.uk/ NICE Medicines awareness service http://www.nice.org.uk/mpc/MedicinesPrescribingAlerts.jsp Social Care Institute for Excellence http://www.scie.org.uk/ Inside Government local government alerts https://www.gov.uk/government/email-signup 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:
Alcohol ...................................................................................................................................... 4 Cancer ...................................................................................................................................... 4 Children and Young People ...................................................................................................... 4 Commissioning ......................................................................................................................... 5 Dementia .................................................................................................................................. 5 Diabetes.................................................................................................................................... 6 General Practice ....................................................................................................................... 6 Guidance .................................................................................................................................. 7 Health Reforms ......................................................................................................................... 8 Infection Control ........................................................................................................................ 9 Integrated Healthcare ............................................................................................................... 9 Mental Health.......................................................................................................................... 10 Older People ........................................................................................................................... 10 Palliative Care 12 Patient Care and Safety .......................................................................................................... 11 Pharmacy and Prescribing ...................................................................................................... 12 Public Health........................................................................................................................... 12 Service Management .............................................................................................................. 14 Social Care ............................................................................................................................. 15 Substance Misuse .................................................................................................................. 16 Tobacco Cessation ................................................................................................................. 17 Vaccination and Immunisation ................................................................................................ 17 Workforce ............................................................................................................................... 17

NHS Library and Information Service North Staffordshire Alcohol

Biological testing in drug and alcohol treatment NTA The National Treatment Agency for Substance Misuse, part of Public Health England, has published a third briefing in the Turning evidence into practice series 'Biological testing in drug and alcohol treatment'. The briefings looks at testing's role as an integral part of treatment. It can help keyworkers and services make best use of the most appropriate tests and use test results effectively to improve treatment and outcomes. The content is drawn from published evidence and guidance, and service provider feedback. http://www.nta.nhs.uk/uploads/teip_testing_2013.pdf Screening tests for alcohol disorders British Journal of General Practice Khadjesari Z, et al. Following the publication of research relating to alcohol screening, NICE has called on GPs to use NICE-recommended screening tests in primary care to help ensure people with alcoholuse disorders are identified and offered appropriate treatment. The research study 'Alcohol consumption screening of newly-registered patients in primary care' has been published in the British Journal of General Practice, and compares the number of people with alcohol-use disorders reported in primary care with those reported under official figures. http://europepmc.org/articles/PMC3782804/pdf/bjgp-oct2013-63-615-e706.pdf

Cancer
Time to choose: making choice at the end of life a reality Macmillan Cancer Support This report calls for social care to be made free for everyone at the end of life. It found that almost three quarters of cancer patients in England who die in hospital beds wanted to die at home. It sets out new recommendations for improving choice at end of life for cancer patients. http://www.macmillan.org.uk/Documents/GetInvolved/Campaigns/Endoflife/TimeToChoose.pd f
Items in the guidance section may be of interest

Children and Young People

Chief Medical Officers annual report Department of Health The Chief Medical Officer has published volume 2 of her annual report which focuses on children's and young people's health. 'Our children deserve better: protection pays' highlights that more needs to be done to improve UK childrens health and calls on government, the whole health service, social care and education professionals to take action and make improvements now. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/255237/290130 4_CMO_complete_low_res_accessible.pdf

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Childhood flu programme Q&A for healthcare professionals Public Health England Healthcare professionals have a role in promoting increased uptake of flu vaccination in children.
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/251466/PHE_Extension_of_the_s easonal_influenza_vaccination_programme_to_children_aged_2_to_under_17_years_of_age__4___2_.pdf

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Commissioning
Closing the NHS funding gap Monitor A report from Monitor which makes recommendations for changes with the NHS to remain viable. http://monitor.gov.uk/sites/default/files/publications/ClosingTheGap091013.pdf Commissioning for value NHS England NHS England is committed to giving CCGs practical support in gathering data, evidence and tools to help them transform the way care is delivered for their patients and populations. Working with Public Health England and NHS Right Care, NHS England has provided every CCG with a comprehensive data pack to support effective commissioning for value. http://www.england.nhs.uk/2013/10/24/comm-val-data-pcks/ Ending 15-minute care: Department of Health response Department of Health The Department of Health has issued a response to Leonard Cheshire Disabilitys campaign about its report 'Ending 15-minute Care'. The report and campaign have effectively highlighted the problem of poor local authority commissioning practices. https://www.gov.uk/government/news/ending-15-minute-care-department-of-health-response Framework of Excellence in Clinical Commissioning NHS England The framework in excellence aims to set out what excellent practice looks like in CCG clinical commissioning. It has been developed in collaboration with CCGs with nearly 90% of CCGs taking the opportunity to review and contribute to its development. http://www.england.nhs.uk/resources/resources-for-ccgs/dev-insight/

Dementia
Funny things happen at the Grange: Introducing comedy activities in day services to older people with dementia-innovative practice Hafford-Letchfield, Trish (Middlesex University) An innovative study published in the journal Dementia; which evaluates a community project that employs comedy activities to engage older people to reflect on aspects of their care and environment. http://dem.sagepub.com/content/early/2012/07/09/1471301212454357.abstract 5

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Mind the gap: mapping London's dementia advocacy services Dementia Advocacy Network
This report includes the findings from DANs recent mapping project of dementia advocacy services in all 33 London boroughs. 142 organisations were contacted, with 26 identified as currently providing some level of advocacy for people with dementia in 27 of the 33 boroughs. There were also variations in the level of capacity of those 26 organisations due to eligibility criteria or workforce limitations.

http://dan.advocacyplus.org.uk/data/files/2013_Conference/Mind_the_Gap_Final_Report.pdf [back to topics]

Diabetes
Can Diabetes Be Surgically Cured? Long-Term Metabolic Effects of Bariatric Surgery in Obese Patients with Type 2 Diabetes Mellitus Brethauer Stacy A, et al. (Annals of Surgery; 2013, October, Vol 258(4) 628-36 The findings of a clinical study published recently in the Annals of Surgery Found a quarter of all patients that had undertaken bariatric surgery remained cured of diabetes six years after surgery. http://journals.lww.com/annalsofsurgery/Abstract/publishahead/Can_Diabetes_Be_Surgically_ Cured__Long_Term.98314.aspx National diabetes audit 2011-2012: report 1 care processes and treatment Healthcare quality improvement partnership This report shows wide variation in achieving the 140/80 blood pressure target between CCGs and local health boards (LHBs). Some CCGs and LHBs met this target in 53 per cent of cases but in others it was met in less than 44 per cent of cases. The figures show over 1.2 million patients had not met the blood pressure target of less than 140/80 for the 2.3 million patients with diabetes in England and Wales whose blood pressure was recorded. http://www.hqip.org.uk/assets/NCAPOP-Library/NCAPOP-2013-14/NDA-2011-2012CareProcessesTreatmentTargets.pdf

General Practice
Walk-in centre services Monitor Monitor has published 'Walk-in centre review: preliminary report' In May 2013, following reports of walk-in centre closures, Monitor decided to review the provision of walk-in centre services in England. http://www.monitor.gov.uk/sites/default/files/publications/Walk%20in%20centres%20report%2 011%2011%2013_0.pdf

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Setting out a vision for general practice BMA The BMA has published a report entitled Developing general practice today, providing healthcare solutions for the future The report considers the current situation facing GPs and discusses how the service can respond to future challenges. http://bma.org.uk/working-for-change/negotiating-for-the-profession/bma-generalpractitioners-committee/priorities/gpc-vision [back to topics]

Guidance
NICE Public Health Guidance Managing overweight and obesity in Children and young people (PH47) http://guidance.nice.org.uk/PH47 NICE Clinical guidance Myocardial infarction: secondary prevention http://guidance.nice.org.uk/CG172 NICE Evidence Updates Urinary tract infection in children https://www.evidence.nhs.uk/about-evidence-services/bulletins-and-alerts/evidenceupdates/evidence-updates-by-date NICE Quality Standards Surgical site infection (QS49) http://publications.nice.org.uk/surgical-site-infection-qs49 Care Leaver strategy UK Government (Cross departmental publication) A cross-departmental strategy, 'Care leaver strategy', has been published which includes a wide range of commitments from government to improve the help and support available to young people leaving care across all areas of life. It sets out the governments commitment to remove some of the practical barriers that care leavers face as they progress into adulthood. https://www.gov.uk/government/publications/care-leaver-strategy DVLA Current medical guidance for professionals Driver and Vehicle licensing agency This guide is for medical professionals to help with any enquiries from the general public about driving with various conditions. Only applies to England, Scotland and Wales. Conditions A-C: https://www.gov.uk/current-medical-guidelines-dvla-guidance-for-professionals-conditions-ato-c (Other conditions can be reached by scrolling to the bottom of the above linked page and clicking on the appropriate link.) 7

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Epithelial ovarian cancer SIGN Guideline The Scottish Intercollegiate Guidelines Network has updated its guideline on epithelial ovarian cancer (SIGN 135) to reflect the most recent evidence available. http://www.sign.ac.uk/guidelines/fulltext/135/index.html Irritable bowel disorder standards IBD Standards Revised UK irritable bowel disorder (IBD) standards have been published to improve levels and consistency of care nationwide. IBD clinicians and patient organisations have come together to revise the standards following signif icant improvements in the quality of care for people with Crohns Disease and Ulcerative Colitis since the UK IBD Standards were first issued four years ago. http://www.ibdstandards.org.uk/uploaded_files/IBDstandards.pdf Sexual Health: clinical governance Department of Health The Department of Health has published an additional document relating to the public health services non mandatory contract suite of documents. 'Sexual Health: clinical governance' provides key principles to assist service commissioners and providers to operate clinical governance systems in sexual health services. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/252975/Sexual _Health_Clinical_Governance_final.pdf

Health Reforms
Delayed discharge directions Department of Health As part of the National framework for NHS continuing healthcare and NHS funded care, the Department of Health has issued 'Delayed Discharges (Continuing Health Care) Directions' which come into effect on 11 November 2013. https://www.gov.uk/government/publications/national-framework-for-nhs-continuinghealthcare-and-nhs-funded-nursing-care Equality Delivery System refresh NHS England A refreshed Equality Delivery System (EDS2) is now available to help local NHS organisations, in discussion with local partners including local populations, review and improve their performance for people with characteristics protected by the Equality Act 2010. http://www.england.nhs.uk/ourwork/gov/edc/eds/

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Overseas visitors and migrant use of the NHS: Extent and costs Department of Health Two published documents relating to overseas visitors and migrant use of the NHS: - Qualitative assessment of visitor and migrant use of the NHS in England - Quantitative assessment of visitor and migrant use of the NHS in England these two reports provide evidence of the impact overseas visitors and migrants are having in GP practices and NHS hospitals. They give a first set of estimates for the number and costs of that care. https://www.gov.uk/government/publications/overseas-visitors-and-migrant-use-of-the-nhsextent-and-costs Transforming urgent and emergency care services in England NHS England This report is the findings of a review team led by Sir Bruce Keogh on the current emergency service provision and recommendations for improving patient care and service delivery. http://www.nhs.uk/NHSEngland/keogh-review/Documents/UECR.Ph1Report.FV.pdf

Infection Control
Advisory Group on Hepatitis annual report 2012 Department of health The tenth annual report from the Advisory Group on Hepatitis (AGH), covering the period 1 January 2012 to 31 December 2012, has been published. The report describes: the committees role and remit, work undertaken by the committee in 2012 and issues discussed during the years 3 meetings. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/253532/PHEAGH_AnnualReport2012_3_acc.pdf
Items in the Vaccination and Immunisation section may be of interest

Integrated Healthcare
Co-ordinated care for people with complex chronic conditions Kings Fund The King's Fund has published 'Co-ordinated care for people with complex chronic conditions'. This report presents the findings from a two-year research project which aimed to understand the key components of effective strategies employed by studying five UK-based programmes to deliver co-ordinated care for people with long-term and complex needs. http://www.kingsfund.org.uk/sites/files/kf/field/field_publication_file/co-ordinated-care-forpeople-with-complex-chronic-conditions-kingsfund-oct13.pdf

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Developing community resource teams Kings Fund The King's Fund has published a case study 'Developing community resource teams in Pembrokeshire, Wales: integration of health and social care in progress'. The study looks at integrated teams of health and social care professionals, known as community resource teams (CRTs), who work to co-ordinate care for people living at home in the largely rural county of Pembrokeshire.
http://www.kingsfund.org.uk/sites/files/kf/field/field_publication_file/pembrokeshire-coordinated-care-casestudy.pdf

Mental Health
Feel better outside, feel better inside: ecotherapy for mental wellbeing, resilience and recovery Mind This report includes new findings from the University of Essex showing the many benefits of ecotherapy for mental wellbeing. It finds that ecotherapy has been proven to improve mental health, boost self esteem, help people with mental health problems return to work, improve physical health, and reduce social isolation. http://www.mind.org.uk/about-us/policies-issues/ecotherapy/resources/ Post-legislative scrutiny of the Mental Health Act 2007: response to the report of the Health Committee of the House of Commons Department of Health This report contains the Department of Health response to the 11 Health Select Committee recommendations following the Mental Health Act 2007. It covers: independent mental health advocate services; supervised community treatment and places of safety; and deprivation of liberty safeguards. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/252876/33736_ Cm_8735_Web_Accessible.pdf
Items in the Dementia, Guidance and Tobacco section may be of interest.

Older People
Focus on hip fracture Smith, P; Ariti, C; Bardsley, M. A Quality Watch report which focuses on the care and outcome of hip fractures, a health issue which is prevalent to older people. http://www.nuffieldtrust.org.uk/publications/focus-hipfracture?gclid=CIyN_6zz_7oCFdHItAodzAsAEA Living well in care homes College of Occupational Therapists This toolkit helps share expertise, in a practical way,that can raise standards of activity in care homes. http://www.cot.co.uk/living-well-care-homes

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NHS Library and Information Service North Staffordshire Palliative Care

Improvements in end of life care Public Health England A new report published by Public Health Englands National End of Life Care Intelligence Network ( NEoLCIN ), suggests the proportion of people dying at home or in care homes increased from 38% in 2008 to 44% in 2012. What We Know Now suggests that around 24,000 more people died at home or in care homes in 2012 compared to 4 years ago, reflecting the desires of many people to stay at home to die. http://www.endoflifecareintelligence.org.uk/resources/publications/what_we_know_now_2013

Patient Care and Safety

Health and wellbeing boards one year on Humphries, R; Galea, A The King's Fund has published 'Health and Wellbeing Boards: one year on'. This report builds on a previous report 'Health and wellbeing boards: system leaders or talking shops?' which was published shortly after the shadow boards were established http://www.kingsfund.org.uk/publications/health-and-wellbeing-boards-one-year-on Maternity services in England report National Audit Office The National Audit Office has published 'Maternity Services in England'. Since the Department of Health's 2007 Maternity Matters strategy, there has been improvement in maternity services, with more midwifery-led units, greater consultant presence on labour wards, and progress against the governments commitment to increase midwife numbers. However, the latest report highlights that there is wide variation between trusts in performance in respect of quality and safety, cost and efficiency http://www.nao.org.uk/report/maternity-services-england/. Patient apps for improved healthcare: from novelty to mainstream IMS Institute for Health Informatics This study looks at the current state of consumer mobile apps in healthcare - the range of apps available and their functionality, the barriers that exist to their broad use, and what is needed to move apps to a more significant role in improved and cost-effective healthcare systems. (you will need to register; free online to access the report) http://www.imshealth.com/portal/site/imshealth/menuitem.762a961826aad98f53c753c71ad8c 22a/?vgnextoid=e0f913850c8b1410VgnVCM10000076192ca2RCRD&vgnextchannel=7 36de5fda6370410VgnVCM10000076192ca2RCRD&vgnextfmt=default Right to start consultant-led treatment within 18 weeks Department of Health The Department of Health have published 'Referral to treatment consultant-led waiting times rules suite: revised for 2014' Only services commissioned by the NHS are included. https://www.gov.uk/government/publications/right-to-start-consultant-led-treatment-within-18weeks [back to topics] 11

NHS Library and Information Service North Staffordshire Pharmacy and Prescribing
Antimicrobial prescribing and stewardship competencies Department of Health and Public Health England A document published to improve the quality of antimicrobial treatment and stewardship and so reduce the risks of inadequate, inappropriate and ill-effects of treatment. The framework is intended for any independent prescriber, doctor, dentist or non-medical. https://www.gov.uk/government/publications/antimicrobial-prescribing-and-stewardshipcompetencies Community pharmacy contribution to public health Local Government Association The Local Government Association has published a public health resource sheet on the contribution of community pharmacy to local public health services. It includes information on local government statutory responsibilities for community pharmacy and several case studies that illustrate the potential of community pharmacy as a key public health resource. http://www.local.gov.uk/documents/10180/11463/Community+Pharmacy++local+government%27s+new+public+health+role/01ca29bf-520d-483e-a703-45ac4fe0f521 Evidence summaries: new medicines Rivaroxaban NICE NICE has published a new medicines evidence summary 'Secondary prevention in acute coronary syndrome: rivaroxaban' (ESNM27). 'Evidence summaries: new medicines' provide a summary of the published evidence for selected new medicines, or for existing medicines with new indications or formulations, that are considered to be of significance to the NHS. The strengths and weaknesses of the relevant evidence are critically reviewed within the summary, but the summaries are not formal NICE guidance. http://www.nice.org.uk/mpc/evidencesummariesnewmedicines/ESNM27.jsp Now or never: shaping pharmacy for the future Royal Pharmaceutical Society
This report suggests that people across England should expect pharmacists to offer far more than just medicines. It looks at how pharmacists are providing easy access to medicines, advice, and care; as well as improving the self-management of long-term conditions and supporting people to make lifestyle changes.

http://www.rpharms.com/promoting-pharmacy-pdfs/moc-report-full.pdf

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Public Health
E-learning introduction to the NHS Primary Care Commissioning An on-line course which provides an overview of the NHS, including its history, structure and the challenges it faces. http://www.pcc-cic.org.uk/news/e-learning-introduction-nhs 12

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Emergency admissions to hospital National Audit Office A report published by the National Audit Office has concluded that many emergency admissions to hospital are avoidable and many patients stay in hospital longer than is necessary. 'Emergency admissions to hospital: managing the demand' examined how well emergency admissions are managed and found that the number of emergency admissions to hospitals that are not planned and happen at short notice because of perceived clinical need continues to rise at a time when NHS budgets are under pressure. http://www.nao.org.uk/report/emergency-admissions-hospitals-managing-demand/ Keep warm, Keep well leaflet Public Health England Public Health England has updated its leaflet giving advice on staying well in cold weather, covering issues such as financial help, healthy lifestyle, flu jabs and heating. 'Keep warm keep well: information for over 60s, low-income families and people living with a disability' is part of Public Health Englands cold weather plan, which aims to protect peoples health and reduce harm from severe cold. https://www.gov.uk/government/publications/keep-warm-keep-well-leaflet-gives-advice-onstaying-healthy-in-cold-weather National pain audit: 3rd Report Healthcare quality improvement partnership This audit has found that safety protocols need to be reviewed in many specialist pain services to ensure that mental health risk assessment and full case reviews of missed diagnoses are routinely performed. It recommended that specialist training is given to staff so they can better identify and manage those at risk. http://www.hqip.org.uk/assets/NCAPOP-Library/NCAPOP-2013-14/Pain-Audit-Report2013.pdf Patient experience: Experience-based co-design toolkit Kings Fund The King's Fund has produced an updated toolkit which aims to provide and effective way of improving patient's experiences of services. As well as step-by-step guidance, the toolkit includes videos of people who have taken part in experience-based co-design (EBCD) projects. http://www.kingsfund.org.uk/projects/ebcd Seven day services BMA A new BMA position paper, '7-day services' sets out what the association understands to be the drivers for the move to more seven-day services, what this means in practical terms for doctors, and the BMAs views. The BMA is preparing to work with stakeholders across the NHS to try and understand the practical implications for working patterns and develop a model that can deliver seven-day care. http://bma.org.uk/working-for-change/the-changing-nhs/nhs-culture/seven-day-services

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Shale gas extraction emissions report Public Health England Public Health England (PHE) has published a draft report 'Review of the potential public health impacts of exposures to chemical and radioactive pollutants of shale gas extraction'. http://www.hpa.org.uk/Publications/Environment/PHECRCEReportSeries/1310Reviewofthepo tentialhealthimpactsshalegas/ [back to topics]

Service Management
Final SHA and PCT annual reports and accounts 2012 to 2013 Department of Health The Department of Health has published the final annual report and accounts for strategic health authorities (SHAs) and primary care trusts (PCTs). After final audit of their accounts, annual reports and accounts for each SHA and PCT were submitted to the Department of Health by the legacy teams who remained in place to close down the business of the bodies. https://www.gov.uk/government/collections/sha-and-pct-annual-reports-and-accounts-2012to-2013 Information, Communication and Technology in the NHS Academy of medical royal colleges A new report published by the academy of medical royal colleges suggests that the NHS must radically overhaul the way it collects and shares data if patients are to be treated safely and effectively, 'i-care: Information, Communication and Technology in the NHS' sets out seven key challenges for achieving the technology revolution within the NHS. http://www.aomrc.org.uk/?forwardOutdatedBrowser=1 NHS clinical and financial engagement best practice Department of Health The Department of Health have published 'Effective Clinical and Financial Engagement: a best practice guide' The guide is to enable individuals and teams to take a systematic and objective approach to improving the levels of engagement between clinical and financial colleagues in provider organisations. https://www.gov.uk/government/publications/nhs-clinical-and-financial-engagement-bestpractice

NHS Procurement Department of Health The Department of Health have published the 'NHS Procurement Dashboard', which provides a set of core metrics that NHS healthcare provider organisations can use to measure their procurement practice and performance against. https://www.gov.uk/government/publications/nhs-procurement-improving-transparency-andunderstanding-performance

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Proactive case management Kings Fund The King's Fund has published 'South Devon and Torbay: proactive case management using the community virtual ward and the Devon Predictive model'. This case study explores community virtual wards based in GP practices within South Devon and Torbay Clinical Commissioning Group (CCG). http://www.kingsfund.org.uk/publications/south-devon-and-torbay Quality through regulation NHS Confederation The NHS Confederation has published 'Lessons from Europe: assuring quality through regulation'. This briefing highlights approaches to quality assurance taken in Germany and the Netherlands.
http://www.nhsconfed.org/Publications/briefings/Pages/Lessons-Europe-assuring-quality-regulation.aspx Items in the Commissioning and Workforce sections may also be of interest.

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Social Care
Four nations united: critical learning from four different systems for the successful integration of social care and health services Association of directors of adult social services This paper originated from discussions on best practice which took place at an ADASS seminar. It aims to provide staff across key services with an accessible and practical overview of best approaches to the challenge of successful integration. http://www.adass.org.uk/images/stories/Publications/Miscellaneous/FourNationsUnitedOct13. pdf Loneliness resource pack Joseph Rowntree Foundation This set of resources aims to help individuals, groups, communities and neighbourhoods take a closer look at and to reduce loneliness. It includes a briefing on the causes of loneliness; guidance; and session plans. http://www.jrf.org.uk/publications/loneliness-resource-pack

New website comparing adult social care services launched Department of Health The Department of Health has worked with the Health and Social Care Information Centre to produce a website that allows people to access, understand and use the Adult Social Care Outcomes Framework (ASCOF) data. https://www.gov.uk/government/news/new-website-comparing-adult-social-care-serviceslaunched

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Responses to CQC consultation on inspection changes Care Quality Commission The Care Quality Commission has published the responses to its consultation on changes to the way CQC regulates, inspects and monitors care services. This document analyses what people told the CQC during the consultation and puts forwards the CQCs responses to those views. http://www.cqc.org.uk/public/news/support-our-inspection-changes Social care and obesity Local Government Association The Local Government Association and Public Health England have jointly published 'Social care and obesity: a discussion paper' The paper considers the impact that obesity has on social care and the challenges facing social care now and in the future. http://www.local.gov.uk/publications/-/journal_content/56/10180/5610298/PUBLICATION Winterbourne View joint improvement programme: stocktake of progress report Local Government Association The report is an analysis of a questionnaire that covers all 152 health and wellbeing board areas, and is designed to enable local areas to assess their progress against commitments in the Winterbourne View concordat, share good practice and identify development needs. It demonstrates that health and social care systems in local areas across the country are universally engaged in, and working on the concordat commitments. http://www.local.gov.uk/documents/10180/12137/Winterbourne+View+Joint+Improvement+Pr ogramme+-+full+stocktake+report/6cdf21b5-6a3a-4633-bef4-a82d29801db0
Items in the Integrated Care and Workforce sections may be of interest

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Substance Misuse
Food Standards Agency warning Food Standards Agency

Following the recent deaths of young people after they have taken the fat burning substance 2,4-dinitrophenol, known as DNP, the Food Standards Agency is urgently warning the public not to take any tablets or powders containing this ingredient
http://www.food.gov.uk/news-updates/news/2013/oct/dnp
Items in the Alcohol Section may be of interest.

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NHS Library and Information Service North Staffordshire Tobacco Cessation

Stoptober challenge Public Health England Public Health England has reported that nearly a quarter of a million people in England and Wales stopped smoking this month as a result of the mass 28-day stop smoking challenge, Stoptober. Last year saw over 160,000 people successfully complete the 4-week challenge. https://www.gov.uk/government/news/stoptober-challenge-reaches-new-high-as-countrysbiggest-mass-quit-attempt [back to topics]

Vaccination and Immunisation

Flu poster Public Health England

Public Health England has published a poster highlighting the importance of adults with long term health conditions having the flu vaccination. https://www.gov.uk/government/publications/flu-serious-if-you-have-a-long-termhealth-condition
Vaccine update issue 208 Public Health England A publication produced for immunisation practitioners, which reviews current developments in vaccines, vaccination policies and procedures. https://www.gov.uk/government/publications/vaccine-update-issue-208-october-2013 [back to topics]

Workforce
The medical registrar on call Royal College of Physicians
This acute care toolkit aims to help medical registrars improve their workload, training opportunities and supervision. It includes case studies of good practice that enhance the training and working experience of medical registrars.

http://www.rcplondon.ac.uk/sites/default/files/act8_registrars.pdf Senior salaries review body (SSRB) review for 2014 Department of Health
This document provides evidence from the Department of Health to SSRB. Pay raises for very senior managers employed by the Department of Health's arms length bodies and by ambulance trusts that have not attained foundation trust status are determined by the government in light of recommendations made by the SSRB. The SSRB takes evidence from the Department of Health and the Managers in Partnership trade union before making its recommendations.

https://www.gov.uk/government/publications/very-senior-managers-pay-2014-dh-evidence-topay-review-body

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