Appendix 4 Latest Publications - Guidance and Policies
The following guidance and policies have recently been issued by organisations such as the Department of Health, NHS England, Public Health England, Nuffield Trust, NHS Confederation, and Health & Social Care Information Centre amongst others. Department of Health
The new home on the web for the Department of Health is GOV.UK. www.gov.uk/dh Departments and agencies that have moved to GOV.UK are publishing their policies according to the outcome the government is trying to achieve The new place for corporate and policy information from the Department of Health and the Advisory Committee on Clinical Excellence Awards. https://www.gov.uk/government/news/the-new-home- on-the-web-for-the-department-of-health Winterbourne View Hospital: Department of Health review and response This final report into the events at Winterbourne View hospital sets out a programme of action to transform services, so that vulnerable people no longer live inappropriately in hospitals and are cared for in line with best practice. The government will publish a progress report on these actions by December 2013. https://www.gov.uk/government/publications/winterbourne-view-hospital- department-of-health-review-and-response
Policy - NHS Constitution for England
The constitution sets out rights for patients, public and staff. It outlines NHS commitments to patients and staff, and the responsibilities that the public, patients and staff owe to one another to ensure that the NHS operates fairly and effectively. All NHS bodies and private and third sector providers supplying NHS services are required by law to take account of this constitution in their decisions and actions. https://www.gov.uk/government/publications/the-nhs-constitution-for-england
Updated Policy April 2013 - Improving care for people with dementia
There are around 800,000 people with dementia in the UK, and the disease costs the economy £23 billion a year. By 2040, the number of people affected is expected to double - and the costs are likely to treble. A lot can be done to help people cope with the symptoms of dementia. But at the moment, the diagnosis rate in England is only 45% - lower than Scotland and Northern Ireland. The aim is to increase diagnosis rates so that they’re among the best in Europe by: •making sure that doctors give 65 to 74 year olds information about memory services as part of the NHS health check programme, and refer them for assessment if they need it (from April 2013) •making £1 million available for innovative NHS projects to increase diagnosis rates through the Innovation Challenge Prize for Dementia •launching a new toolkit to help GPs provide better support https://www.gov.uk/government/policies/improving-care-for-people-with-dementia
Policy - Reducing obesity and improving diet (published March 2013)
Helping people make healthier choices In England, most people are overweight or obese. This includes 61.3% of adults and 30% of children aged between 2 and 15. People who are overweight have a higher risk of getting type 2 diabetes,
heart disease and certain cancers. Health problems associated with being overweight or obese cost the NHS more than £5 billion every year. By 2020, the Department of Health want to see: •a downward trend in the level of excess weight in adults •a sustained downward trend in the level of excess weight in children https://www.gov.uk/government/policies/reducing-obesity-and-improving-diet
Policy - Helping people make informed choices about health and social care (published
Currently NHS patients can (in most circumstances) choose their GP or the hospital they’re referred to. And personal budgets are giving people more choice and control over their social care and support arrangements. Introducing more choice will help people get the care and support that’s right for them, and make services more responsive to their needs. The Department of Health want everyone to have access to the information and advice they need to make the right choices for them. https://www.gov.uk/government/policies/helping-people-make-informed-choices-about- health-and-social-care#bills-and-legislation Report highlights growing need to improve end of life care for minority ethnic groups. This report highlights that the end of life care needs of Black, Asian and minority ethnic communities are varied, growing and despite examples of good practice, overall not adequately met. A systematic review found that lack of knowledge about services, misunderstandings and mistrust, and a lack of cultural sensitivity on the part of service providers are identified as some of the reasons for low uptake of end of life care by BAME communities. https://www.gov.uk/government/news/report-highlights- growing-need-to-improve-end-of-life-care-for-minority-ethnic-groups Breastfeeding stats Q4 2012/13 https://www.gov.uk/government/statistical-data-sets/breastfeeding-statistics-q4-2012-to-2013 Six Lives progress report- The report demonstrates that more people with learning disabilities have taken up the opportunity of an annual health check to improve their health and enable preventive interventions to stop potential health crises. https://www.gov.uk/government/publications/six-lives- department-of-health-second-progress-report Government response to the Confidential Inquiry into premature deaths of people with learning disabilities https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/212077/Governm ent_Response_to_the_Confidential_Inquiry_into_Premature_Deaths_of_People_with_Learning_Dis abilities_-_full_report.pdf Review of Liverpool Care Pathway for dying patients https://www.gov.uk/government/publications/review-of-liverpool-care-pathway-for-dying-patients NHS England The Keogh Review. Eleven hospitals are being placed in special measures because of major failings the government has announced. Health Secretary Jeremy Hunt said the 11 trusts, among 14 investigated for high death rates, had problems so entrenched that tough action was needed. He cited examples of staffing problems, poor care and weak leadership. At both a local and national level, key findings have been collated and examined and recommendations have been made http://www.nhs.uk/NHSEngland/bruce-keogh-review/Documents/outcomes/keogh-review-final- report.pdf
Putting Patients First: The NHS England Business Plan for 2013/14 – 2015/16
NHS England’s business plan for 2013/14 – 2015/16, called Putting Patients First, explains how its commitment to transparency and increasing patients’ voice are fundamental to improving patient care http://www.england.nhs.uk/pp-1314-1516/
Everyone counts: Planning for Patients 2013/14
Outlines the incentives and levers used to improve services in the first year of the new NHS, where improvement is driven by clinical commissioners. http://www.england.nhs.uk/everyonecounts/
Medicines Optimisation: Helping patients to make the most of medicines
NHS England is supporting its call for health professionals and patients to work together to ensure better use of medicines. Medicines play a crucial role in maintaining health, preventing illness, managing chronic conditions and curing disease. In an era of significant economic, demographic and technological challenge it is crucial that patients get the best quality outcomes from medicines. http://www.rpharms.com/promoting-pharmacy-pdfs/helping-patients-make-the-most-of-their-medicines.pdf
'A guide for Paediatricians: Children's Epilepsy Surgery Service (CESS) Guidelines for
children's epilepsy brain surgery referrals in England'
Epilepsy Action, in association with NHS England, has developed new guidelines to help more children with epilepsy benefit from surgical procedures. This has been developed for paediatricians and will help to increase the number of children referred for epilepsy surgery. The guidelines have been produced following the introduction of a new Children's Epilepsy Surgery Service (CESS) last year. http://www.england.nhs.uk/wp-content/uploads/2013/05/cess-pract-booklet-170513.pdf NHS England announces new technical guidance to improve patient care The guidance for GP practices explaining how better use of anonymised patient information from general practice will help commissioners improve the quality, efficiency, and equity of health care services. GP practices will be contacted directly with further details and materials in June http://www.england.nhs.uk/2013/05/29/nhs-england-annou-tech-guide/ NHS England announces new technical guidance to improve patient care http://www.england.nhs.uk/2013/05/29/nhs-england-annou-tech-guide/ guidance has been published for GP practices explaining how better use of anonymised patient information from general practice will help commissioners improve the quality, efficiency, and equity of health care services. The document explains the process of how data from general practice will be collected, anonymised and used to improve patient care. NHS England is committed to making more information available about how services and professionals are performing. The aim is to drive up the quality of care in the NHS and help people choose the treatment that suits them best. This initiative is a central part of NHS England’s ambition to ensure every patient gets high quality care, and to build improved services for the future. On NHS Choices you’ll find links to information about individual consultants in a number of clinical areas. You can look at their results for a range of operations and treatments to help you make decisions about your care. http://www.england.nhs.uk/consu-treat-outc/ Public Health England
Public health emergency contacts https://www.gov.uk/public-health-emergency-contacts--2 Public Health England (PHE) is a Category 1 Responder (Civil Contingencies Act 2004), and provides specialist advice and support to the emergency services and NHS. A new website ‘Longer Lives’ developed by Public Health England, providing easy access to data on how local areas are performing on premature deaths from the five major killers – cancer, stroke, heart, lung and liver disease. http://longerlives.phe.org.uk/ World’s largest cancer database launched by Public Health England This new service will deliver near real-time cancer data and contain detailed clinical information on all 350,000 cancers diagnosed each year across the 50 million people in England. Cancer specialists across the country will have instant access to detailed clinical data, including the way tumours respond to different types of treatment, which will speed up work to deliver personalised cancer medicine to patients in the future https://www.gov.uk/government/news/worlds-largest-cancer- database-launched-by-phe Updated guidance on the management and treatment of Clostridium difficile infection http://www.hpa.org.uk/Publications/InfectiousDiseases/InfectionControl/1306CDImanagementrevis ed/ Nuffield Trust Evaluating integrated and community-based care: how do we know what works? This Nuffield Trust report presents key learning from evaluations of 30 community-based interventions designed to reduce emergency hospital admissions http://www.nuffieldtrust.org.uk/publications/evaluating-integrated-and-community-based-care- how-do-we-know-what-works NHS Confederation
Putting patients at the centre of care - the experiences of some of the independent sector organisations that have reviewed the total package of care they provide in order to ensure they continue to meet the changing needs and demands of their patients. http://www.nhsconfed.org/Publications/Documents/Help-I-need-somebody.pdf Engaging with Black and Minority Ethnic communities - http://www.nhsconfed.org/Publications/Documents/Engaging-BME-communities-insights-for- impact.pdf Health & Social Care Information Centre NHS Safety Thermometer is a local improvement tool for measuring, monitoring, and analysing patient harms and 'harm free' care. NHS Safety Thermometer report May2012-2013 http://www.hscic.gov.uk/catalogue/PUB11011 Ambulance Services 2012/13 This bulletin contains information about the ambulance services provided by the NHS in England. The information is collected from individual ambulance trusts and shows volume of activity and
performance levels against required standards (eg responses within 8 or 19 minutes). This includes information on emergency and urgent calls, response times and patient destinations http://www.hscic.gov.uk/catalogue/PUB11062 New method for gathering patient feedback on individual doctors goes live. The Picker Institute has worked with consultants at the University Hospital of South Manchester NHS Foundation Trust (UHSM), Stockport NHS Foundation Trust, and several general practices, to develop a robust method for gathering patient feedback. http://www.pickereurope.org/new-method-for-gathering-patient- feedback-on-individual-doctors-goes-live.html Care Quality Commission
CQC Hospital inspection plans The Care Quality Commission has announced changes to the way it inspects hospitals and is introducing the changes to 18 NHS trusts by the end of next month. The CQC will carry out a mixture of announced and unannounced inspections of hospitals. The inspection teams will be led by the Chief Inspector of Hospitals and include: a senior NHS clinician or executive; professional and clinical staff; Experts by Experience; patients; carers and other experts. http://www.cqc.org.uk/public/about-us/our-inspections/methodology-behind-first-wave- inspections-under-new-model NICE has published the following guidance: in Quarter 1
Ref: TA 278 Technology appraisals NICE recommends omalizumab as possible additional treatment to standard asthma therapy for some people aged 6 years and over with severe persistent allergic asthma. http://publications.nice.org.uk/omalizumab-for-treating-severe-persistent-allergic-asthma-review-of-technology-appraisal-guidance-ta278 Ref: IPG 455 Interventional procedures
Corneal inlay implantation for correction of Presbyopia The National Institute for Health and Care Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on Corneal inlay implantation for correction of Presbyopia. http://publications.nice.org.uk/corneal-inlay-implantation-for-correction-of-presbyopia-ipg455 Ref: TA 281 Terminated appraisal NICE is unable to recommend the use in the NHS of canakinumab for treating gouty arthritis attacks and reducing the frequency of subsequent attacks because no evidence submission was received from the manufacturer of the technology http://publications.nice.org.uk/canakinumab-for-treating-gouty-arthritis-attacks-and-reducing-the-frequency-of-subsequent-attacks-ta281 Ref: QS 31 Quality Standards Health and wellbeing of looked-after children and young people The health and wellbeing of looked-after children and young people – that is, their physical health, and social, educational and emotional wellbeing – is influenced by nearly all aspects of their lives and the care they receive. Experiences early in life may have long-term consequences for health and social development http://publications.nice.org.uk/quality-standard-for-the-health-and-wellbeing-of-looked-after-children-and-young-people-qs31 Ref: TA 282 Technology appraisals NICE recommends pirfenidone as a possible treatment for some people with idiopathic pulmonary fibrosis http://publications.nice.org.uk/pirfenidone-for-treating-idiopathic-pulmonary-fibrosis-ta282 Ref: IPG 454 Interventional procedures The National Institute for Health and Care Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on Insertion of a subcutaneous implantable cardioverter defibrillator for prevention of sudden cardiac death http://publications.nice.org.uk/insertion-of-a-subcutaneous-implantable-cardioverter-defibrillator-for-prevention-of-sudden-cardiac-ipg454 Ref: IPG 452 Interventional procedures The National Institute for Health and Care Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on Occipital nerve stimulation for intractable chronic migraine. http://publications.nice.org.uk/occipital-nerve-stimulation-for-intractable-chronic-migraine-ipg452 Ref: IPG 453 Interventional procedures Prostate artery embolisation for BPH involves injecting small particles into the blood vessels that supply the prostate. This blocks the blood supply, with the aim of shrinking the prostate. http://publications.nice.org.uk/prostate-artery-embolisation-for-benign-prostatic-hyperplasia-ipg453 Ref: TA 280 Technology appraisals NICE recommends abatacept taken with methotrexate as a possible treatment option for some adults with rheumatoid arthritis http://publications.nice.org.uk/abatacept-for-treating-rheumatoid-arthritis-after-the-failure-of-conventional-disease-modifying-ta280 Ref: QS 30 Quality Standards This quality standard covers the care and support of people with dementia. It applies to all social care settings and services working with and caring for people with dementia. This guidance has been
incorporated into the NICE Pathways, along with other related guidance and products. http://publications.nice.org.uk/quality-standard-for-supporting-people-to-live-well-with-dementia-qs30 Ref: TA 279 Technology appraisals NICE recommends vertebroplasty and kyphoplasty (without stenting) as possible treatment options for some people with spinal compression fractures caused by osteoporosis http://publications.nice.org.uk/percutaneous-vertebroplasty-and-percutaneous-balloon-kyphoplasty-for-treating-osteoporotic-vertebral-ta279
Ref: TA 284 NICE does not recommend bevacizumab given with gemcitabine and carboplatin for treating adults with the first recurrence of platinum-sensitive advanced ovarian cancer (including fallopian tube or primary peritoneal cancer) that has not been previously treated with bevacizumab or other vascular endothelial growth factor inhibitors. - Technology appraisal: Bevacizumab in combination with paclitaxel and carboplatin for first-line treatment of advanced ovarian cancer (TA284) Guidance Ref: CG 160 Clinical guideline: Feverish illness in children (CG160) Guidance This clinical guideline updates and replaces NICE clinical guideline 47 ‘Feverish illness in children’ (published May 2007). It offers evidence-based advice on the care of young children with feverish illness. Ref: TA 283 NICE recommends ranibizumab as a possible treatment for some people who have sight problems because of macular oedema caused by retinal vein occlusion - Technology appraisal: Ranibizumab for treating visual impairment caused by macular oedema secondary to retinal vein occlusion (TA283) Guidance Ref: TA 285 NICE has advised the NHS against funding the drug bevacizumab (Avastin, manufactured by Roche) for advanced ovarian cancer[1]. In two separate pieces of final guidance published for the health service, NICE concludes that funding the treatment on the NHS does not represent the best use of taxpayers' money. http://publications.nice.org.uk/bevacizumab-in-combination-with-gemcitabine-and-carboplatin-for-treating-the-first-recurrence-of-ta285 Ref: PH 44 Physical activity: brief advice for adults in primary care http://publications.nice.org.uk/physical-activity-brief-advice-for-adults-in-primary-care-ph44 Ref: TA286 Technology appraisal: Loxapine inhalation for treating acute agitation and disturbed behaviours associated with schizophrenia and bipolar disorder (terminated appraisal) (TA286) NICE is unable to recommend the use in the NHS of loxapine inhalation for treating acute agitation and
disturbed behaviours associated with schizophrenia and bipolar disorder because no evidence submission was received from the manufacturer of the technology. Ref: CG 159 Clinical guideline: Social anxiety disorder: recognition, assessment and treatment (CG159) This clinical guideline offers evidence-based advice on the recognition, assessment and treatment of social anxiety disorder in children and young people (from school age to 17 years) and adults (aged 18 years and older). It includes a recommendation on the treatment of specific phobias that updates and replaces the section of NICE technology appraisal guidance 97 that deals with phobia.
Ref: QS32 Quality Standards This quality standard covers the care of women who plan for or may need a caesarean section. http://publications.nice.org.uk/quality-standard-for-caesarean-section-qs32
Ref: CG161 Clinical guidance: Falls: assessment and prevention of falls in older people (CG161)
This clinical guideline extends and replaces NICE clinical guideline 21 (published November 2004). It offers evidence-based advice on preventing falls in older people. New recommendations have been added about preventing falls in older people during a hospital stay.
Familial breast cancer: Classification and care of people at risk of familial breast cancer and management of breast cancer and related risks in people with a family history of breast cancer: (CG 164) http://publications.nice.org.uk/familial-breast-cancer-cg164
Pegloticase for treatment severe debilitating chronic tophaceous gout (TA 291) http://publications.nice.org.uk/pegloticase-for-treating-severe-debilitating-chronic-tophaceous-gout-ta291
Hepatitis B (chronic): Diagnosis and management of chronic hepatitis B in children, young people and adults (CG 165) http://publications.nice.org.uk/hepatitis-b-chronic-cg165
Ref: CG 163 - Clinical guidance: Idiopathic pulmonary fibrosis: the diagnosis and management of suspected idiopathic pulmonary fibrosis (CG163) This clinical guideline offers evidence-based advice on the diagnosis and management of suspected idiopathic pulmonary fibrosis in adults. Idiopathic pulmonary fibrosis is a chronic, progressive disease in which the lungs become scarred.
Ruxolitinib for disease-related splenomegaly or symptoms in adults with myelofibrosis (TA289) http://publications.nice.org.uk/ruxolitinib-for-disease-related-splenomegaly-or-symptoms-in-adults-with-myelofibrosis-ta289
Mirabegron for treating symptoms of overactive bladder (TA 290) http://publications.nice.org.uk/mirabegron-for-treating-symptoms-of-overactive-bladder-ta290
Rivaroxaban for treating pulmonary embolism and preventing recurrent venous thromboembolism (TA 287)http://publications.nice.org.uk/rivaroxaban-for-treating- pulmonary-embolism-and-preventing-recurrent-venous-thromboembolism-ta287
Ref: QS 33 Quality Standards This quality standard covers the diagnosis and management of rheumatoid arthritis in adults (16 years and older). http://publications.nice.org.uk/quality-standard-for-rheumatoid-arthritis-qs33 Ref: QS 34 Quality Standards This quality standard covers the initial management of self-harm and the provision of longer-term support for children and young people (aged 8 years and older) and adults (aged 18 years and older) who self-harm. http://publications.nice.org.uk/quality-standard-for-selfharm-qs34 Ref: CG 162 Clinical guidance: Stroke rehabilitation: Long-term rehabilitation after stroke (CG162) This guideline offers evidence-based advice on the care of adults and young people aged 16 years and older who have had a stroke with continuing impairment, activity limitation or participation restriction.
Tobacco: harm reduction approaches to smoking (PH 45) http://publications.nice.org.uk/tobacco-harm-reduction-approaches-to-smoking-ph45
Dapagliflozin in combination therapy for treating type 2 diabetes (TA 288) http://publications.nice.org.uk/dapagliflozin-in-combination-therapy-for-treating-type-2-diabetes-ta288
Ulcerative colitis: Management in adults, children and young people (CG 166) http://publications.nice.org.uk/ulcerative-colitis-cg166
The Fountain of Youth: Looking Young at any Age Skin Changes with Age The skin is the largest and most visible organ of It protects your other organs, warms you up and cools you down, and reflects how healthy you are inside. Natural Aging Process Continuous process that normally begins in our mid-20s Fine wrinkles, thin and transparent skin Loss of underlying fat, l
I AM YOUR LIVER. .and these are just som e of the things I do for you! I store the iron reserves you need, as well as a lot of vitam ins and other m inerals. I m ake bile to help digest your food and help get rid of som e of your dietary cholesterol. I detoxify poisonous chem icals you give m e, and that includes alcohol, beer, wine and drugs- prescribed and over-the-counter as well as ill