NHS Library and Information Service North Staffordshire

Clinical Effectiveness Bulletin for NHS Primary Care in North Staffordshire

Issue No: 55 August 2011

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

Contact information

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

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

NHS Library and Information Service North Staffordshire

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:
Cancer.........................................................................................................................................4 Cardiovascular Diseases............................................................................................................5 Children and Young People........................................................................................................5 Commissioning............................................................................................................................6 Dementia.....................................................................................................................................7 Dental health...............................................................................................................................7 Diabetes......................................................................................................................................8 Emergencies...............................................................................................................................8 End of Life Care..........................................................................................................................8 General Practice.........................................................................................................................9 Guidance...................................................................................................................................10 Health Reforms.........................................................................................................................12 Health Visitors...........................................................................................................................13 Infections...................................................................................................................................14 Information and Records...........................................................................................................14 Long Term Conditions...............................................................................................................15 Maternal and Infant Health........................................................................................................16 Mental Health............................................................................................................................16 Nursing......................................................................................................................................17 Nutrition.....................................................................................................................................17 Offender Health.........................................................................................................................17 Older People.............................................................................................................................18 Patient Care and Safety............................................................................................................18 Pharmacy and Prescribing........................................................................................................19 Public Health.............................................................................................................................21 Service Management................................................................................................................22 Sexual Health............................................................................................................................23 Smoking....................................................................................................................................23 Stroke........................................................................................................................................24 Substance Misuse.....................................................................................................................24 Vaccination and Immunisation..................................................................................................25 Workforce..................................................................................................................................25

NHS Library and Information Service North Staffordshire Cancer

Adult cancers near overhead power lines: Interim Report Department of Health This study investigates the risk of adult cancers in relation to distance from high voltage overhead power lines. http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidanc e/DH_129159 Cancer Waiting Times: annual report 2010-11 Department of Health http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsStatistics/DH_128 618 The future of cancer networks: policy recommendations as a result of a joint seminar held at the Kings Fund Macmillan Cancer Support, Kings Fund http://www.macmillan.org.uk/Documents/GetInvolved/Campaigns/Campaigns/FutureOfCance rNetworksJuly2011.pdf Incidence and risk of congestive heart failure in patients with renal and nonrenal cell carcinoma treated with Sunitinib. Richards, CJ et al. The authors concluded that Sunitinib use is associated with increased risk of Congestive Heart Failure in patients with cancer. Journal of Clinical Oncology, August 1, 2011. doi: 10.1200/JCO.2010.34.4309 Nations divided? An assessment of variations in access to cancer treatments for patients in England, Scotland and Wales Rarer Cancers Foundation The report found that 23 cancer treatments are not routinely available in Scotland which may be available in England through the Cancer Drugs Fund, and 24 cancer treatments are not routinely available in Wales which may be available in England through the Cancer Drugs Fund. http://www.rarercancers.org/index.php? option=com_content&view=article&id=212:new-report-reveals-devastating-crossborder-divide-in-access-to-cancer-drugs Relevance of breast cancer hormone receptors and other factors to the efficacy of adjuvant tamoxifen: patient-level meta-analysis of randomised trials Early Breast Cancer Trialists' Collaborative Group (EBCTCG) The authors concluded that 5 years of adjuvant tamoxifen safely reduces 15-year risks of breast cancer recurrence and death. Oestrogen receptor status was the only recorded factor importantly predictive of the proportional reductions. The absolute risk reductions produced by tamoxifen depend on the absolute breast cancer risks (after any chemotherapy) without tamoxifen. The Lancet, Early Online Publication, 29 July 2011. doi:10.1016/S0140-6736(11)60993-8 4

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Risk of Solid Cancers following Radiation Exposure: Estimates for the UK Population. Health Protection Agency, Independent Advisory Group on Ionising Radiation This report gives information about risks of cancer following exposure to different sources of radiation, including medical X-rays. http://www.hpa.org.uk/Publications/Radiation/DocumentsOfTheHPA/RCE19SolidCancerRisk/ Sarcoma Measures for the Manual for Cancer Services Department of Health http://www.dh.gov.uk/en/Consultations/Responsestoconsultations/DH_129315 Vision for the future of cancer services. Cancer Campaigning Group This set of 6 documents covers: Public health and prevention; Early diagnosis; Treatment and services; Survivorship; Commissioning; Research. http://www.cancercampaigninggroup.org.uk/2011/08/25/ccg-publishes-vision-for-future-ofcancer-services/
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Cardiovascular Diseases
Heart Failure: Commissioning NHS Improvement This web page includes links to relevant guidelines and case studies. http://www.improvement.nhs.uk/heart/heartfailure/Home/Commissioning.aspx
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Children and Young People

Individual budgets for families with disabled children Department for Education This report presents a detailed assessment of the original two-year pilot. It focuses on how the pilots were set up and delivered, and resource and infrastructure requirements. The main reports are accompanied by: six case study reports; two thematic reports (on resource allocation and safeguarding); and a technical report. https://www.education.gov.uk/publications/RSG/AllPublications/Page1/DFE-RR145 National Child Measurement Programme: guidance for small area analysis National Obesity Observatory This paper explains why caution must be exercised when using NCMP data to provide information about small populations or local areas. It discusses the reliability of estimates of obesity prevalence at different levels of aggregation, and provides advice on approaches to ensure that any analysis is as robust as possible. Alternative ways to identify areas of high obesity prevalence within LA and PCT boundaries are also suggested. http://www.noo.org.uk/uploads/doc/vid_11853_NCMP_Guidanceforsmallarea %20analysisFINAL.pdf 5

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National Child Measurement Programme: Operational guidance for the 2011/12 school year Department of Health http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidanc e/DH_129001 Outcomes versus Expenditure Tool Child and Maternal Health Observatory This tool enables comparison of expenditure and other aspects of services with a number of outcome measures at primary care trust (PCT) level. Registration with the Child and Maternal Health Observatory website required to access this tool. Registration is free http://atlas.chimat.org.uk/IAS/ovet Q&A on Health Services in Secure Childrens Homes (Youth Justice Commissioned) and Secure Training Centres in England Department of Health These Q&As follow the Department of Health's announcement of a phased project to transfer commissioning responsibility for health services in Secure Childrens Homes and Secure Training Centres in England to the NHS. http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidanc e/DH_129356 A rapid review of the National Child Measurement Programme Department of Health This review draws on existing research and evidence, and the views of local practitioners involved in the delivery of the NCMP http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidanc e/DH_129373
Items in the Nutrition, Obesity, Offender health and Vaccination and Immunisation sections may also be of interest. [back to topics]

Commissioning
Achieving Commissioning Excellence NHS Alliance This website aims to support the development of NHS clinically-led commissioning. http://www.nhsace.com/ Ask an Expert Primary Care Commissioning This service offers commissioners free access to a one-stop shop for commissioning intelligence. It brings together expertise in commissioning, evidence searches, data analysis and health intelligence in an easy-to-access format online. www.pcc-cic.org.uk/ask-an-expert 6

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Decommissioning: How to decommission public services delivered by civil society organisations and maintain value for money National Audit Office This guide seeks to provide practical advice on how to plan for and manage the decommissioning of public services delivered by civil society organisations and maintain value for money while doing so. It is designed for local commissioners. http://www.nao.org.uk/sectors/civil_society/decommission/home.aspx A simple guide to Payment by Results Department of Health This introduction for newcomers to PbR reflects changes to PbR arrangements in 2011-12. http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidanc e/DH_128862 Valuation Techniques for Social Cost-Benefit Analysis: Stated Preference, Revealed Preference and Subjective Well-Being Approaches: A Discussion of the Current Issues HM Treasury, Department of Work and Pensions This paper has been written with three main objectives in mind: 1. To demonstrate that the valuation of non-market goods, and specifically the measurement of well-being, is a live research issue 2. To provide an introduction to how analysts should apply these techniques in practice 3. To cover the strengths and weaknesses of the three methods in detail to enable analysts to appropriately use and interpret findings to provide decision makers with high quality advice. http://www.hm-treasury.gov.uk/data_greenbook_news.htm
Items in the Cancer, Health Reforms, Patient Care and Safety, Pharmacy and Service Management sections may also be of interest. [back to topics]

Dementia
Living well with dementia Design Council The Council are challenging teams to help people with dementia and their carers live easier, better planned and more enjoyable lives. Participating teams can win a share of 360,000 plus professional support to make their idea happen. http://www.designcouncil.org.uk/dementia
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Dental health
NHS Dental Statistics for England: 2010/11 NHS Information Centre http://www.ic.nhs.uk/statistics-and-data-collections/primary-care/dentistry/nhs-dentalstatistics-for-england-2010-11

NHS Library and Information Service North Staffordshire Diabetes

Magnesium Intake and Risk of Type 2 Diabetes: Meta-analysis of prospective cohort studies Dong, J et al. The authors concluded that magnesium intake is significantly inversely associated with risk of type 2 diabetes. Diabetes Care September 2011 vol. 34(9) p.2116-2122 Prescribing for Diabetes in England 2005/06 to 2010/11 NHS Information Centre This publication reports on prescribing trends for medicines prescribed in primary care for the treatment of diabetes for the period April 2005 to March 2011. http://www.ic.nhs.uk/pubs/prescribingfordiabetes05-11 Prevention of Type 2 Diabetes: Knowledge & Information Repository NHS Diabetes This document synthesises the latest key policy papers, national body statements, clinical or care guidelines and the latest key research and evaluation papers. http://www.diabetes.nhs.uk/document.php?o=2684
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Emergencies
Hospital emergency response checklist: an all-hazards tool for hospital administrators and emergency managers World Health Organisation Regional Office for Europe This tool is comprised of current hospital-based emergency management principles and best practices, and action required for rapid, effective response to a critical event. http://www.euro.who.int/en/what-we-do/health-topics/emergencies/disaster-preparednessand-response/publications/2011/hospital-emergency-response-checklist
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End of Life Care

Environments for care at the end of life: The King's Fund's Enhancing the Healing Environment Programme 2008-2010 Kings Fund This publication describes projects in 19 NHS trusts and one HM prison to improve the environment of care at the end of life. http://www.kingsfund.org.uk/publications/ehe_care_environment.html

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Local preferences and place of death in regions within England 2010 National End of Life Care Intelligence Network This report compares people's preferences for place of death with actual place of death as recorded by Office for National Statistics mortality data. A population based telephone survey was also used to explore people's preferences. http://www.endoflifecare-intelligence.org.uk/view.aspx?rid=157 Routes to success: achieving quality environments for care at end of life National End of Life Care Programme This guide identifies a number of key environmental principles to help improve privacy and dignity for patients and relatives. These principles can help to support the bereaved, whose memories live on once their loved one has died. http://www.endoflifecareforadults.nhs.uk/publications/routes-to-success-achieving-qualityenvironments-for-care-at-end-of-life VOICES (Views of Informal Carers - Evaluation of Services) Redesign and testing to inform a National End of Life Care survey Department of Health The NHS Outcomes Framework (2011/12) set out the intention to survey the bereaved to support the development of an end of life care indicator. The report sets out the learning from a pilot study to develop and test a revised VOICES questionnaire. The accompanying toolkit describes the principal processes and considerations for successfully undertaking a local survey of this type. http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidanc e/DH_128787
Items in the mental health section may also be of interest. [back to topics]

General Practice
Community Pharmacy Services: briefing for GP practices Pharmaceutical Services Negotiating Committee, BMA, NHS Employers This briefing covers changes to the NHS Community Pharmacy Contractual Framework. http://www.psnc.org.uk/data/files/PharmacyContract/Contract_changes_2011/GP_guide_to_c ontract_changes_Aug_2011.pdf Its Your Practice: a patient guide to GP services Royal College of General Practitioners http://www.rcgp.org.uk/PDF/rcgp_iyp_full_booklet_web_version.pdf The quality of GP prescribing Kings Fund This paper examines what is known about the current quality of prescribing in general practice, including how quality varies from practice to practice. http://www.kingsfund.org.uk/document.rm?id=9215
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NHS Library and Information Service North Staffordshire Guidance

NICE Menu of Indicators NICE This set of proposed indicators for 2012/13 Quality and Outcomes Framework will help target resources where they are most needed and deliver the best patient outcomes. Each indicator has been piloted across a range of practices and is based on the most up-to-date evidence. NICE has also made recommendations on which existing QOF indicators should be retired or amended. http://www.nice.org.uk/aboutnice/qof/indicators.jsp NICE Quality Standards Alcohol dependence and harmful alcohol use Quality standard http://www.nice.org.uk/guidance/qualitystandards/alcoholdependence/home.jsp Chronic obstructive pulmonary disease (COPD) Quality standard http://www.nice.org.uk/guidance/qualitystandards/chronicobstructivepulmonarydisease/copdq ualitystandard.jsp National Quality Board engagement exercise on the library of NICE Quality Standard NHS healthcare topics This exercise is to allow those with an interest in Quality Standards to become involved in helping to ensure the library of topics is genuinely fit for purpose. Closing date for comments: 14 October 2011 http://www.nice.org.uk/getinvolved/currentniceconsultations/NQBEngagement.jsp NICE Clinical Guidelines Hypertension: management of hypertension in adults in primary care CG127 http://guidance.nice.org.uk/CG127
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NICE Technology Appraisals Abatacept for the treatment of rheumatoid arthritis after the failure of conventional disease-modifying anti-rheumatic drugs TA234 http://guidance.nice.org.uk/TA234
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NICE Consultation Documents Atrial fibrillation - dabigatran etexilate: appraisal consultation document Closing date for comments: 8 September 2011 http://guidance.nice.org.uk/TA/Wave21/10/Consultation/DraftGuidance

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Attention deficit hyperactivity disorder (ADHD): review proposal consultation To comment, contact the registered stakeholder organisation that most closely represents you interests. Closing date for comments: 12 September 2011 http://www.nice.org.uk/guidance/index.jsp?action=folder&o=56114 Breast cancer (metastatic) - fulvestrant: appraisal consultation document Closing date for comments: 13 September 2011 http://guidance.nice.org.uk/TA/Wave23/15/Consultation/DraftGuidance Induction of labour: review proposal consultation To comment, contact the registered stakeholder organisation that most closely represents you interests. Closing date for comments: 12 September 2011 http://www.nice.org.uk/guidance/index.jsp?action=folder&o=56107 Stroke rehabilitation: guideline consultation To comment, contact the registered stakeholder organisation that most closely represents you interests. Closing date for comments: 25 October 2011 http://www.nice.org.uk/guidance/index.jsp?action=folder&o=56128 Smoking cessation - acute and obstetric services: consultation on the draft scope To comment, contact the registered stakeholder organisation that most closely represents you interests. Closing date for comments: 29 September 2011 http://www.nice.org.uk/guidance/index.jsp?action=folder&o=56137 Smoking cessation - mental health services: draft scope consultation To comment, contact the registered stakeholder organisation that most closely represents you interests. Closing date for comments: 29 September 2011 http://www.nice.org.uk/guidance/index.jsp?action=folder&o=56145
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Other Guidance Atrial Fibrillation / Stroke Prevention Guidelines Yorkshire & Humber Strategic Health Authority http://system.improvement.nhs.uk/ImprovementSystem/ViewDocument.aspx?path=Cardiac %2fNational%2fWebsite%2fAF%20Website%2fResources%2fSHA%20AF%20Stroke %20Guideline%202011%20V15%20FINAL.doc.pdf Diagnosis and Management of Stable Chronic Obstructive Pulmonary Disease: A Clinical Practice Guideline Update American College of Physicians, American College of Chest Physicians, American Thoracic Society, and European Respiratory Society Annals of Internal Medicine. August 2, 2011 vol. 155(3) p.179-191 11

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Position statement on the introduction of new oral anticoagulants for stroke prevention in atrial fibrillation UK Clinical Pharmacy Association http://www.ukcpa.org/docs/FINAL%20UKCPA%20Position%20statement%20on%20NOACs %20for%20SPAF%20Aug%202011.pdf Sickle Cell Disease in Pregnancy, Management of Royal College of Obstetricians and Gynaecologists http://www.rcog.org.uk/womens-health/clinical-guidance/sickle-cell-disease-pregnancymanagement-green-top-61
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Other Health Technology Assessments Development and evaluation by a cluster randomised trial of a psychosocial intervention in children and teenagers experiencing diabetes: the DEPICTED study Gregory J, et al. This study found that training diabetes health-care professionals to improve their consultation skills did not achieve short-term impacts on HbA1c level and quality of life. Further modification of this training and reinforcement is required to produce a benefit on outcomes. Health Technol Assess 2011:15(29) A study of the safety and harms of antidepressant drugs for older people: a cohort study using a large primary care database Coupland C et al. This study found associations between use of antidepressant drugs and a number of adverse events in older people, but there was no evidence that selective serotonin reuptake inhibitors or other antidepressant drugs were associated with a reduced risk of any of the adverse outcomes compared with tricyclic and related antidepressants. They may, however, be associated with increased risks for some adverse events. Health Technol Assess 2011:15(28)
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Health Reforms
A development tool to support emerging Clinical Commissioning Groups with their governance arrangements NHS National Leadership Council This tool is designed to support all those with responsibility for shaping the development of Clinical Commissioning Groups. It aims to inform the debate about how to ensure the effective governance of Clinical Commissioning Groups. http://www.nhsleadership.org/images/library/files/Commissioning/Development_Tool_to_supp ort_Clinical_Commissioning_Groups_with_Governance_FINAL_v1_0.pdf

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Diagnostic tool for emerging clinical commissioning groups Department of Health This tool is designed to enable emerging clinical commissioning groups (CCGs) to understand and reflect upon their values, culture, behaviours and wider organisational health. http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidanc e/DH_129124 HealthWatch Pathfinders Staffordshire is one of 75 Local HealthWatch Pathfinders. These new learning networks will champion patients views and experiences, promote the integration of local services and improve choice for patients through advice and access to information. http://www.dh.gov.uk/en/MediaCentre/Pressreleases/DH_128981 NHS Commissioning Board: Q & A Department of Health These brief Q&As look at the role of the Commissioning Board and how it will operate. http://healthandcare.dh.gov.uk/nhs-commissioning-board-qa/
Items in the Commissioning, Information and Records, and General Practice sections may also be of interest. [back to topics]

Health Visitors
Educating health visitors for a transformed service Department of Health A suggested approach, for education commissioners and higher education institutions and lecturers, to aligning education with the new service vision for health visiting. http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidanc e/DH_129682 Health visitor implementation plan: summary NHS Employers http://www.nhsemployers.org/PlanningYourWorkforce/childrensandfamilesworkforce/LatestNe ws/Pages/Healthvisitorimplementationplan-ataglancesummary.aspx Health visitor return to practice framework: a guide for education providers Department of Health http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidanc e/DH_129697
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NHS Library and Information Service North Staffordshire Infections

Antiretroviral therapy for prevention of HIV transmission in HIV-discordant couples Anglemyer, A et al. The authors of this Cochrane Review conclude that ART is a potent intervention for prevention of HIV in discordant couples in which the index partner has 550 CD4 cells/L. They highlight additional issues to be considered when designing services. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD009153.pub2/abstract Deaths involving Clostridium difficile: England and Wales, 2006 to 2010 Office for National Statistics http://www.ons.gov.uk/ons/rel/subnational-health2/deaths-involving-clostridium-difficile/2006to-2010/statistical-bulletin.html Deaths involving MRSA: England and Wales, 2006 to 2010 Office for National Statistics http://www.ons.gov.uk/ons/rel/subnational-health2/deaths-involving-mrsa/2006to-2010/statistical-bulletin.html Topical steroid for chronic rhinosinusitis without polyps Snidvongs, K et al. The authors of this Cochrane Review concluded that topical steroid is a beneficial treatment for chronic rhinosinusitis without polyps and the adverse effects are minor. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD009274/abstract
Items in the Offender Health section may also be of interest. [back to topics]

Information and Records

Access to person-level data in health care: Understanding information governance Nuffield Trust This review and accompanying research summary explore the current information governance regulations and reflect on the social values that underpin them. http://www.nuffieldtrust.org.uk/publications/access-person-level-data-health-careunderstanding-information-governance Guide to UK Health and Health Care Statistics Office of Health Economics This publication provides both up-to-date statistics and a guide to finding and using health statistics from the UK and, to some extent, other OECD countries. Four areas are covered: demographics; health care expenditure; hospital services; and primary care services. http://www.ohe.org/publications/recent-publications/list-by-date-20/detail/date////ohe-guide-touk-health-and-health-care-statistics.html

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Knowledge Management in Transition NHS Connecting for Health A key challenge at this time of transition is enabling business continuity. A key enabler will be the transfer of the corporate memory of SHAs and PCTs to their successors. These pages aim to support NHS organisations to preserve, transfer and acquire corporate memory. http://www.connectingforhealth.nhs.uk/systemsandservices/icd/knowledge/transition The National Programme for IT in the NHS: an update on the delivery of detailed care records systems House of Commons Public Accounts Select Committee The Committee concluded that the Department of Healths intention to provide a national integrated care records system has proved beyond its capacity to deliver. It argues that the Department could have avoided some of the pitfalls if they had consulted at the start of the process with health professionals, and outlines areas to consider to ensure the Department and NHS Trusts get the best value for money from the remainder of the project. http://www.publications.parliament.uk/pa/cm201012/cmselect/cmpubacc/1070/107002.htm
Items in the Commissioning section may also be of interest.

Long Term Conditions

Advice for employees on working with a long-term medical condition NHS Choices http://www.nhs.uk/Livewell/workplacehealth/Documents/ChronicConds_Employees_Factshee t_A4.pdf Advice for line managers on supporting employees with long-term medical conditions NHS Choices http://www.nhs.uk/Livewell/workplacehealth/Documents/ChronicConds_LineManagers_Facts heet_A4.pdf Bulking agents, antispasmodics and antidepressants for the treatment of irritable bowel syndrome (IBS) Ruepert, L et al. The authors of this Cochrane Review found that bulking agents are not effective, but antidepressants and some antispasmodics are effective, for treating IBS. Side effects were not evaluated. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD003460.pub3/abstract Managing COPD as a Long Term Condition: Emerging Learning from the National Improvement Projects NHS Improvement: Lung This report looks at practical issues around improving peoples ability to self-manage, managing COPD (e.g. through reviews and medication), and using data to make a difference. http://system.improvement.nhs.uk/ImprovementSystem/ViewDocument.aspx?path=Cancer %2fNational%2fNational%20Project%2fLung%20Publication %2fLungChronicManagement.pdf
Items in the Mental Health section may also be of interest.

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Maternal and Infant Health

A step by step guide to making a powdered formula feed Department of Health This has been developed to help Health Professionals working with new mums and sits alongside the 'Guide to bottle feeding'. http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidanc e/DH_129344 Unexplained deaths in infancy: England and Wales, 2009 Office for National Statistics Provisional data are given for both sexes and for neonatal, post-neonatal and infant deaths. http://www.statistics.gov.uk/StatBase/Product.asp?vlnk=14127&Pos=&ColRank=1&Rank=272
Items in the Nutrition section may also be of interest. [back to topics]

Mental Health
Community mental health services survey 2011 Care Quality Commission This survey asked over 17,000 service users about their experiences. http://www.cqc.org.uk/aboutcqc/howwedoit/involvingpeoplewhouseservices/patientsurveys/co mmunitymentalhealthservices.cfm Personal health budgets: the views of service users and carers NHS Confederation This report outlines the frustration people feel with the level of involvement that mental health services offer, but shows that their opinions of personal health budgets are mixed. There is scepticism over how national policy can effectively change current culture on the ground. http://www.nhsconfed.org/Publications/reports/Pages/Personal-health-budgets.aspx Risk of bias from inclusion of patients who already have diagnosis of or are undergoing treatment for depression in diagnostic accuracy studies of screening tools for depression: systematic review Thombs, BD et al. The authors concluded that studies of the accuracy of screening tools for depression rarely exclude patients who already have a diagnosis of or are receiving treatment for depression, a potential bias that is not evaluated in systematic reviews and meta-analyses. This could result in inflated estimates of accuracy on which clinical practice and preventive care guidelines are often based. BMJ 2011; 343:d4825 doi: 10.1136/bmj.d4825 (Published 18 August 2011) The truth about suicide Demos This pamphlet investigates suicide and serious physical illness. It finds that at least 10 per cent of suicides in the UK are by people who are chronically or terminally ill. It also finds wide 16

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variation in how coroners record verdicts of suicide. It recommends that Government consider making local suicide audits compulsory, and that coroners duty to share information be formalised. http://www.demos.co.uk/publications/thetruthaboutsuicide
Items in the Offender Health and Stroke sections may also be of interest. [back to topics]

Nursing
Items in the Older People sections may also be of interest.

Nutrition
Consultation to seek views on European Commission's proposal for a regulation on food intended for infants and young children and on food for special medical purposes Department of Health The proposal is likely to have a significant impact on the way in which dietetic / PARNUT foods are notified, labelled and regulated. It limits the definition of PARNUT foods to three categories - infant and follow-on formula, foods intended for infants and young children aged up to 3 years and medical foods. Closing date for comments: 30 September 2011 http://www.dh.gov.uk/en/Consultations/Liveconsultations/DH_129207 Quality Food for a Sustainable Healthcare Service NHS Sustainable Development Unit This brief position paper summarises the Units views. http://www.sdu.nhs.uk/documents/publications/Position_Paper_Quality_Food_for_a_Sustaina ble_Healthcare_Service.pdf
Items in the Patient Care and Safety section may also be of interest. [back to topics]

Offender Health
Prevention of infection and communicable disease control in prisons and places of detention Health Protection Agency This manual provides advice on specific infections and dealing with outbreaks; immunisation and vaccination; and guidance on infection prevention and control. It is intended to complement other resources, such as Department of Health guidance and local IPC policies. http://www.hpa.org.uk/Publications/InfectiousDiseases/InfectionControl/1108Infectioncontrolin prisonsforHCW/

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Procedure for the transfer from custody of children and young people under the Mental Health Act 1983 in England Department of Health http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidanc e/DH_128853 Re:Actions: A third review of healthcare in the community for young people who offend Care Quality Commission and HMI Probation The report concluded that considerable progress has been made since the last review of inspections to effectively identify and address health needs for children and young people who have offended, or are likely to offend. The report also makes recommendations for PCTs and their successor organisations. http://www.justice.gov.uk/downloads/publications/inspectorate-reports/hmiprob/reactions-3rdreview-of-yot-healthcare.pdf
Items in the Children and Young People section may also be of interest. [back to topics]

Older People
Older people in care homes: sex, sexuality and intimate relationships Royal College of Nursing This publication aims to facilitate learning, support best practice and help nurses and care staff address older service users needs in a professional, sensitive, legal and practical way. http://www.rcn.org.uk/__data/assets/pdf_file/0011/399323/004136.pdf
[back to topics]

Patient Care and Safety

Data on Written Complaints in the NHS 2010-11 NHS Information Centre http://www.ic.nhs.uk/statistics-and-data-collections/audits-and-performance/complaints/dataon-written-complaints-in-the-nhs-2010-11 Dignity and nutrition reports Care Quality Commission The final batch of reports in this programme of inspections has been published. They focus on whether people are treated with dignity and respect and get food and drink that meets their needs. CQC will publish a national report detailing overall findings in September. http://www.cqc.org.uk/newsandevents/newsstories.cfm? widCall1=customWidgets.content_view_1&cit_id=37390 Equality and human rights scheme: Review of our progress in 2010/11 Care Quality Commission This report includes an updated action plan. http://www.cqc.org.uk/publications.cfm?fde_id=18581 Implementation of patient safety alerts 18

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Action against Medical Accidents (AvMA) This report is based on Patient Safety Alert information published on the National Patient Safety Agency website. AvMA analyse information on which NHS trusts declared that they had or had not completed the required actions in all relevant patient safety alerts by the given deadline. This report pays particular attention to Rapid Response Report alerts. http://www.avma.org.uk/data/files/patient_safety_alerts_aug_11_full_report.pdf NHS Equality Delivery System (EDS) NHS East Midlands The EDS has been designed to help NHS organisations to meet the requirements of the public sector Equality Duty, and equality aspects of the NHS Constitution; the NHS Outcomes Framework; CQC's Essential Standards; and the Human Resources Transition Framework. http://www.eastmidlands.nhs.uk/about-us/inclusion/eds/ The Patient-Centred Care project: Evaluation report Kings Fund This project aimed to use evidence-based co-design (EBCD) to improve the experience and quality of care for patients receiving treatment for breast cancer and lung cancer. http://www.kingsfund.org.uk/current_projects/the_point_of_care/ebcd_evaluation.html Patient Environment Action Team (PEAT) - results 2011, England NHS Information Centre These are the results from annual assessments undertaken by NHS and independent healthcare providers in respect of hospitals with 10 or more in-patient beds. This assessment focusses on the environment in which care is provided and the quality of non-clinical services such as food and privacy and dignity. http://www.ic.nhs.uk/statistics-and-data-collections/facilities/patient-environment-action-teampeat/patient-environment-action-team-peat--results-2011-england
Items in the Evidence and Information and Mental Health sections may also be of interest [back to topics]

Pharmacy and Prescribing

Healthy Living Pharmacy Pathfinder Sites Pharmaceutical Services Negotiating Committee North Staffordshire PCT, NHS Stoke-on-Trent and South Staffordshire PCT are some of the 30 PCTs involved in Pathfinder Sites. http://www.psnc.org.uk/news.php/1104/twenty_healthy_living_pharmacy_pathfinder_sites_an nounced NHS Community Pharmacy Contractual Framework 2011/12 Service Developments: Latest Information NHS Employers, Pharmaceutical Services Negotiating Committee http://www.nhsemployers.org/PayAndContracts/CommunityPharmacyContract/CPCFserviced evelopments2011/Pages/August-2011-implementation-update.aspx New Medicine Service - NMS 19

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National Pharmacy Association This website contains resources and tools to help NPA members successfully implement the New Medicine Service, including a comprehensive Standard Operating Procedure; mini guidance on each of the target conditions; tips on how to communicate with GPs/ practitioners; a patient information leaflet and a summary of the NMS. www.npa.co.uk/NMS Operationalising Value Based Pricing of Medicines: A Taxonomy of Approaches Office of Health Economics The authors describe means by which value based pricing (VBP) might be operationalised, and provide an initial assessment of each method. They review how a medicines value might be assessed, and then linked to the maximum price the health service is willing to reimburse. Finally, they review means by which VBP is currently operationalised in several countries. http://www.ohe.org/publications/recent-publications/list-bydate-20/detail/date////operationalising-value-based-pricing-of-medicines-a-taxonomy-ofapproaches.html Registration required to access this document. Registration is free. Procalcitonin algorithms for antibiotic therapy decisions: a systematic review of randomized controlled trials and recommendations for clinical algorithms Schuetz, P et al. The authors conclude that procalcitonin algorithms can reduce use of antibiotics. Arch Intern Med. 2011 vol.171(15) p.1322-1331. doi:10.1001/archinternmed.2011.318 Safe custody of controlled drugs: new guidance on professional practice Royal Pharmaceutical Society This guidance explains which Controlled Drugs (CDs) require safe custody, including patient returns and out-of-date or obsolete CDs. It also contains information on which standards for CD cabinets, safes and rooms and guidance on key responsibilities and a key log. http://www.rpharms.com/what-s-happening-/news_show.asp?id=235 The safer management of controlled drugs: Annual report 2010 Care Quality Commission This report makes recommendations on how chief executives and accountable officers could better aid the safer management of controlled drugs. http://www.cqc.org.uk/_db/_documents/Controlled_Drugs_Annual_Report__2010_FINAL_we b.pdf Standards for the design of hospital in-patient prescription charts Academy of Medical Royal Colleges, Royal College of Nursing This set of standards aim to guide the design of prescription charts. It is hoped they will be used by hospitals to benchmark local charts, and to inform the development of a national UK prescription chart. http://www.rcn.org.uk/__data/assets/pdf_file/0009/398700/Standards_for_the_design_of_hos pital_in-patient_prescription_charts_-_Apr_2011_AoMRC,_RCN,_RC_Pharm.pdf
Items in the Diabetes and General Practice section may also be of interest. [back to topics]

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NHS Library and Information Service North Staffordshire Public Health

Behaviour Change: 2nd Report of Session 201012 House of Lords Science and Technology Committee The committee investigated the policy implications of recent developments in research on behaviour change, whether current government behaviour change interventions are evidencebased, and the relationship between government, industry and the voluntary sector in promoting behaviour change. The Sub-Committee also considered social and ethical issues surrounding the use of behaviour change interventions by government. http://www.parliament.uk/business/committees/committees-a-z/lords-select/science-andtechnology-sub-committee-i/inquiries/behaviour/ Scroll to the bottom of the page to view the report. Impact on Health of Emissions from Landfill Sites Health Protection Agency The HPA concludes that there has been no new evidence to change the previous advice that living close to a well-managed landfill site does not pose a significant risk to human health. http://www.hpa.org.uk/Publications/Radiation/DocumentsOfTheHPA/RCE18ImpactonHealthof EmissionsfromLandfillSites/ The performance of the health sector in meeting the Public Sector Equality Duties Equality and Human Rights Commission The research found that although progress was made on delivering the race, disability and gender equality duties, significant work still needs to be done by health bodies to ensure that their efforts lead to identifiable changes to health outcomes for different groups. http://www.equalityhumanrights.com/advice-and-guidance/public-sector-equalityduty/research-and-policy-papers-on-theduty/#The_performance_of_the_health_sector_in_meeting_the_Public_Sector_Equality_Duti es Physical Activity Network: Delivering our collective pledges Department of Health This document provides advice, guidance and resources to support Responsibility Deal partners in delivering the physical activity collective pledges. http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidanc e/DH_128844 Population Growth and a Sustainable NHS NHS Sustainable Development Unit This brief position paper summarises the Units views. http://www.sdu.nhs.uk/documents/publications/Position_Paper_Population_growth_and_a_su stainable_NHS.pdf The Public Sector Equality Duty: a way forward for the health sector Equality and Human Rights Commission This paper gives recommendations as to how health bodies can meet their obligations under the new equality duty. Effective implementation of the new duty can assist healthcare 21

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providers in reducing health inequalities, creating a more effective workforce, and improving the life chances and wellbeing of millions of people in the UK. http://www.equalityhumanrights.com/advice-and-guidance/public-sector-equalityduty/research-and-policy-papers-on-theduty/#The_performance_of_the_health_sector_in_meeting_the_Public_Sector_Equality_Duti es
Items in the Cancer section may also be of interest. [back to topics]

Service Management
Community services governance indicators: Monitor's requirements for 2011/12 Monitor http://www.monitor-nhsft.gov.uk/home/our-publications/browse-category/guidance-foundationtrusts/mandatory-guidance/community-servic Experience-based co-design: working with patients to improve health care Kings Fund This toolkit outlines a powerful and effective way of improving patients experience of services, and enables you to assess how it can help you to meet your aims. http://www.kingsfund.org.uk/ebcd/index.html NHS Financial Year 2010/11: A summary of auditors' work Audit Commission This report summarises the audit of the 2010/11 accounts for SHAs, NHS trusts and PCTs, and looks at auditors' conclusion on value for money arrangements in each organisation. It also reviews progress made by PCTs and Trusts in delivering cost improvement programmes. http://www.auditcommission.gov.uk/nationalstudies/health/financialmanagement/Pages/20110811nhsfinancial year1011.aspx Social enterprise in health care: promoting organisational autonomy and staff engagement Kings Fund This report explores the organisational and leadership changes that will be needed to support the development of social enterprises. It makes recommendations of particular interest to policy-makers and health care providers. http://www.kingsfund.org.uk/publications/social_enterprise_in.html
Items in the Children and Young People, Commissioning, Mental Health, Patient Care and Safety Pharmacy and Public Health sections may also be of interest. [back to topics]

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NHS Library and Information Service North Staffordshire Sexual Health

Interventions for prevention and treatment of vulvovaginal candidiasis (VVC) in women with HIV infection Ray, A et al. The authors of this Cochrane Review found no trials on treatment of VVC. The findings of two trials indicated that in comparison to placebo, fluconazole is an effective preventative intervention. The authors also discuss other considerations to be taken into account in prevention and treatment of VVC. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD008739.pub2/abstract
Items in the Infections and Older People sections may also be of interest. [back to topics]

Smoking
Cigarette smoking as a risk factor for coronary heart disease in women compared with men: a systematic review and meta-analysis of prospective cohort studies Huxley, R et al The authors concluded that women who smoke are more at risk of coronary heart disease than men who smoke, and that this should be taken into account by tobacco control programmes. The Lancet, Early Online Publication, 11 August 2011. doi:10.1016/S0140-6736(11)60781-2 Local Tobacco Control Profiles for England London Health Observatory These profiles provide a snapshot of the extent of tobacco use, tobacco related harm, and measures being taken to reduce this harm at a local level. They have been designed to help local government and health services to assess the effect of tobacco use on their local populations. They will inform commissioning and planning decisions to tackle tobacco use and improve the health of local communities. http://www.lho.org.uk/lho_topics/analytic_tools/tobaccocontrolprofiles.aspx Statistics on NHS Stop Smoking Services: England, April 2010 March 2011 NHS Information Centre This report includes information on the number of people setting a quit date and the number who successfully quit at the 4 week follow-up. It also presents in depth analyses of the key measures of the service including pregnant women, breakdowns by ethnic groups and type of pharmacotherapy received and presents the results of regional analyses at Strategic Health Authority (SHA) and Primary Care Trust (PCT) levels. http://www.ic.nhs.uk/statistics-and-data-collections/health-and-lifestyles/nhs-stop-smokingservices/statistics-on-nhs-stop-smoking-services-england-april-2010-march-2011 Statistics on Smoking: England, 2011 NHS Information Centre The report aims to present a broad picture of health issues relating to smoking in England and covers smoking habits, behaviours and attitudes among adults (aged 16 and over) and school 23

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children (aged 11 to 15), smoking-related ill health and mortality, affordability of tobacco and smoking-related costs. http://www.ic.nhs.uk/statistics-and-data-collections/health-and-lifestyles/smoking/statistics-onsmoking-england-2011-%5Bns%5D
[back to topics]

Stroke
Psychological care after stroke: Improving stroke services for people with cognitive and mood disorders NHS Improvement: Stroke This practical guide aims to support the establishment and development of evidence based services for psychological care of people following stroke. It brings together summaries of national guidance, standards, and related evidence and shares the learning from seven national projects to assist stroke providers to implement and improve these services. http://www.improvement.nhs.uk/LinkClick.aspx?fileticket=RJk4n5%2fG6wk%3d&tabid=56
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Substance Misuse
Consultation on consolidation and review of the misuse of drugs regulations 2001 Home Office Closing date for comments: 28 October 2011 http://www.homeoffice.gov.uk/publications/about-us/consultations/misuse-drugs-regulations/ Drug Misuse Declared: Findings from the 2010/11 British Crime Survey England and Wales Home Office This bulletin examines illicit drug use among 16 to 59 year olds. It is based on results from the 2010/11 British Crime Survey (BCS), including trends since 1996. http://www.homeoffice.gov.uk/publications/science-research-statistics/researchstatistics/crime-research/hosb1211/ A summary of the health harms of drugs Department of Health This guide for drug and treatment professionals provides the most up to date scientific evidence on the health harms arising from licit and illicit substance misuse. It outlines acute and chronic problems associated with each substance. It also considers new drugs, such as novel synthetic drugs, and takes a more in-depth look at the potential harms of using more than one drug and the adulterants commonly added to illegal drugs. http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidanc e/DH_129624
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NHS Library and Information Service North Staffordshire Vaccination and Immunisation
Call for evidence on vaccinations for adolescents Department of Health The sub-committee on adolescent vaccinations welcomes submissions from interested parties of good quality scientific, medical, or economic evidence. Closing date for comments: 30 September 2011. http://www.dh.gov.uk/ab/JCVI/DH_128726 Consultation response: a review of the procurement of seasonal flu vaccine Pharmaceutical Services Negotiating Committee (PSNC), Pharmacy Voice (PV) and Royal Pharmaceutical Society (RPS) http://www.npa.co.uk/Resources/Press-Releases/Consultation-responses/PSNC-RPS-andPharmacy-Voice-issue-joint-response-to-the-review-of-the-procurement-of-seasonal-fluvaccines/ Immunisation against infectious disease: 'The Green Book' Department of Health Chapters on influenza, vaccine safety, varicella and tuberculosis have been updated. http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidanc e/DH_079917
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Workforce
Embedding inclusion and diversity into the NHS at board level: Outcomes and recommendations arising from the Pilot Board Development Programmes NHS National Leadership Council This report looks at outcomes from six different NHS pilot sites. http://www.nhsleadership.org.uk/workstreams-inclusion-boarddevelopment.asp Equal pay toolkit NHS Employers This toolkit gives NHS HR professionals a quick, but detailed overview of their organisations so they can assess if they are meeting their requirements under the Equality Act. http://www.nhsemployers.org/EmploymentPolicyAndPractice/EqualityAndDiversity/atest-eand-d-news/Pages/NHSequalpaytoolkitavailableforemployers.aspx Mobile Health Worker Project: progress report Department of Health This project set out to capture quantifiable evidence to support the case for investment in the use of mobile devices in clinical care. A team of technical and clinical specialists selected 11 pilot sites to examine the technical and business change aspects of mobile working deployment. http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidanc e/DH_129399

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NHS National Graduate Management Training Scheme: Payback Return on Investment for the NHS Graduate Scheme NHS Institute for Innovation and Improvement The first section of the report produces data on the retention and progression of trainees. The second section looks at return on investment of trainees whilst on the Scheme. It includes case studies showing how trainee projects are designed to support the quality, innovation, productivity and prevention (QIPP) agenda. http://www.institute.nhs.uk/news/leadership/%E2%80%98payback_ %E2%80%93_return_on_investment_for_the_nhs_graduate_scheme %E2%80%99_august_2011.html NHS Staff Management and Health Service Quality Department of Health The researchers analysed how the experience of NHS staff at work links with performance measures that illustrate quality of care, using NHS staff survey results. The research shows that: "Good management of NHS staff leads to higher quality of care, more satisfied patients and lower patient mortality. Good staff management offers significant financial savings for the NHS". It also suggests a model for good management and staff engagement. http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidanc e/DH_129643 Shape of the medical workforce: Informing medical specialty training numbers Centre for Workforce Intelligence The report makes recommendations to inform recruitment to medical training over the medium term. The recommendations include a view on the nature and pace of any change needed, and geographical imbalances that need to be addressed. http://www.cfwi.org.uk/intelligence/projects/shape-of-the-medical-workforce-informingmedical-training-numbers Sustainable Conferences and Meetings NHS Sustainable Development Unit This brief position paper summarises the Units views. http://www.sdu.nhs.uk/documents/publications/Position_Paper_NHS_Sustainable_Conferenc es_and_Meetings.pdf
Items in the Mental Health, Nursing, Patient Care and Safety, Public Health and Service Management sections may also be of interest. [back to topics]

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