Clinical Effectiveness Bulletin 32 - September 2009

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NHS Library and Information Service North Staffordshire

Clinical Effectiveness Bulletinfor PCTs in North Staffordshire

Issue No: 32 September 2009

About this Bulletin:

It aims to draw attention to some of the key documents and reviews on clinicaleffectiveness that have been published in the previous month.

Where possible, links to the full text documents are included. If the article is in ajournal, you can contact the Health Library for a copy.Link to request form:http://www.keele.ac.uk/depts/li/hl/illjournal.htm[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 NHSOutreach Librarians, details below.

The bulletin can be e-mailed to colleagues who may also find it useful.

A list of websites that are checked in the production of this bulletin are listed onthe first page. Please suggest further useful sites.

Feedback is always welcomed to inform future issues of the bulletin.

Contents in this issueCancerCardiovascular DiseasesCommissioningDiabetesGuidanceInfection ControlLong Term Conditions

MedicinesMental HealthMusculoskeletalPatient Safety and CareService ManagementStatisticsWorkforce

Contact information

Bulletin produced by NHS Outreach Librarians

Tel: 07834 115958 [please leave a message]E-mail: [email protected]

North Staffs Health LibraryTel: 01782 556565Fax: 01782 556582

E-mail:[email protected]

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Sources for Clinical Effectiveness Bulletin

Please suggest further sites that should be monitored in the production of this bulletin

Websites

Bandolier - http://www.jr2.ox.ac.uk/bandolier/index.htmlClinical Knowledge Summaries [NLH] http://cks.library.nhs.uk/Cochrane Library http://www.library.nhs.uk/CRD Centre for Reviews and Dissemination http://www.york.ac.uk/inst/crd/

- DARE (Database of Abstracts of Reviews of Effects)http://www.york.ac.uk/inst/crd/crddatabases.htm#DARE

- NHS Economic Evaluation Databasehttp://www.york.ac.uk/inst/crd/nhsdnew.htm

- Health Technology Assessment (HTA) Databasehttp://www.ncchta.org/

DOH [bulletins] http://www.dh.gov.uk/en/Publicationsandstatistics/Bulletins/theweek/index.htmKINGS Fund http://www.kingsfund.org.uk/index.htmlNICE http://www.nice.org.uk/

NHS Evidence Cancer http://www.library.nhs.uk/cancer/NHS Evidence Cardiovascular http://www.library.nhs.uk/cardiovascular/NHS Evidence Diabetes http://www.library.nhs.uk/diabetes/NHS Evidence Respiratory http://www.library.nhs.uk/respiratory/SDO Reports [National Institute for Health Research] http://www.sdo.nihr.ac.uk/

SIGNhttp://www.sign.ac.uk/new.html

List of other Public Health and Primary Care update services published in StaffordshireTitle Focus Contact &

OrganisationTel Email and website

Daily Health Bulletin Daily e-mail update onnew publications fromthe DH and NHS

Sheffield HealthInformatics ServiceOr contact Jayne

Hickton to be added tocirculation list

0114 271 1167 [email protected]

[email protected]

Health InequalitiesBulletin

Bi Monthly update ofkey documents andresearch on healthequality issues

Jayne Hickton NHSOutreach LibraryService North Staffs

07834 115958 [email protected]

HP Source Monthly news andupdate on healthpromotion issues withemphasis on evidencebased information

Health ImprovementLibrary

01782 298193 Issues of HP Source are publishedon the Health Promotion website:http://www.hpns.nhs.uk/library-resources/index.htm

Health ManagementBulletin

Weekly update of newsand information relatingto health management

Kelly Danks-HydenSouth Staffs HealthManagement Library


New@Networks Weekly news digestincludes news items,new documents suchas toolkits or reports

NHS Networks http://www.networks.nhs.uk/newsletter.php

Public Health Bulletin Weekly update of newsand information relatingto public health issues

Kelly Danks-HydenSouth Staffs HealthManagement Library


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Cancer

New pilot scheme will use football to promote awareness of cancer symptoms in menDepartment of HealthA new scheme supported by football clubs across England will help educate men about thesymptoms and risks of male cancers and encourage them to present earlier with their

symptoms. The one year pilot initiative Ahead of the Game Organise Your Defence will use theappeal of football to improve mens knowledge of the signs and symptoms of lung, bowel andprostate cancers in men aged 55 and over who are most at risk of dying from these cancers.http://nds.coi.gov.uk/clientmicrosite/Content/Detail.aspx?ClientId=46&NewsAreaId=2&ReleaseID=407001&SubjectId=36

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Cardiovascular Diseases

European cardiovascular disease statistics 2008European Heart NetworkThe European Heart Network has published a new edition of European cardiovascular disease

statistics, which brings together all the available sources of information about the burden of CVDin Europe.http://www.ehnheart.org/files/statistics%202008%20web-161229A.pdf

Closing the gap: tackling cardiovascular disease and health inequalities by prescribingstatins and stop smoking servicesCare Quality CommissionThis report calls for a renewed drive to cut numbers of people with cardiovascular disease (CVD),which is responsible for one in three deaths in England. It highlights health inequalities betweenpeople in deprived areas and other parts of the country, of which CVD is the biggest cause. Thereport suggests that while the government target of cutting total deaths among people under 75by at least 40 per cent by 2010 has been met, improvements must be made in the prescribing ofdrugs (statins) that lower cholesterol levels in people with or at risk of cardiovascular disease;

cholesterol management; and the targeting of these improvements at the poorest areas within thecountry.http://www.cqc.org.uk//newsandevents/newsstories.cfm?cit_id=35290&FAArea1=customWidgets.content_view_1&usecache=false[back to topics]

Commissioning

World class commissioning assurance launch of Year 2Department of Health16 September 2009 marked the launch of the second year of WCC assurance, the nationalsystem that holds PCTs to account whilst providing support for them as they start to become

world class commissioners. This is a guide for PCTs and SHAs that explains WCC assurance indetail.http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_105117

World class commissioning: September updateDepartment of HealthThis letter from Claire Whittington gives a world class commissioning (WCC) progress report,including the launch of WCC assurance Year 2, the PBC national clinical network, new support

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and development resources including datapacks, and an update on the programme of IntegratedCare Pilots.http://www.dh.gov.uk/en/Publicationsandstatistics/Lettersandcirculars/Dearcolleagueletters/DH_105166

Opportunity LocatorNHS InstituteThe Opportunity Locator is a data tool to support the commissioning priorities of local healthcommunities. The purpose of the Opportunity Locator tool is to stimulate ideas on wherecommissioners should focus their attention in re-designing and shifting services away from thetraditional setting of the hospital and out towards community based care.http://www.institute.nhs.uk/opportunitylocator/default.aspx

Commissioning for carersIDeAThe guide was funded by the Department of Health and serves as blueprint for bettercommissioning for carers. Accompanying the main guide is a shorter action guide for decision-makers which is aimed at directors of adult services, chief executives of primary care trusts andelected members.http://www.idea.gov.uk/idk/core/page.do?pageId=13255730

The challenges of commissioning healthcare: a discussion paperPeskett,S.International Journal of Health Planning and Management 2009 24(2), 95-112The UK's Department of Health Independent Sector Programme to procure healthcare for NHSpatients from the independent sector revealed many of the challenges of commissioning,particularly assessing governance arrangements and identifying the organisational attributes ofhigh quality healthcare providers. These issues were first discussed in a workshop at the BritishAssociation of Medical Managers (BAMM) Medical Directors Conference in Dublin in November2007 (Dale, et al., 2009). The more difficult challenges of achieving effective clinical engagement,including motivational factors, organisational environment and systems and partnership working,in the complex field of commissioning healthcare in the UK are also explored here with particularreference to systems in other countries.

http://dx.doi.org/10.1002/hpm.987(Article available from the Health Library)

Let's Get Moving: A new physical activity care pathway for the NHS - CommissioningguidanceDepartment of HealthThe commissioning guidance sets out an evidence-based behaviour charter model Lets GetMoving encouraging local commissioning of physical activity interventions in primary care.http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_105945

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DiabetesPrescribing for Diabetes in England: Supplement - January 2002 to March 2009NHS Information CentreThis report presents national level trends in prescribing for diabetes in England. It looks atinformation on primary care prescribing for diabetes from January 2002 to March 2009. Thenumber of prescription items and Net Ingredient Cost (NIC) are used to analyse volume,expenditure and trends in the prescribing of insulin and anti-diabetic drugs. The data presented in

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the report covers prescriptions issued in primary care in England and dispensed in the communityin the United Kingdom.http://www.ic.nhs.uk/statistics-and-data-collections/primary-care/prescriptions/prescribing-for-diabetes-in-england:-supplement--january-2002-to-march-2009[back to topics]

Guidance

NICE Technology Appraisals

Sunitinib for the treatment of gastrointestinal stromal tumoursTechnology appraisal: (TA179)http://guidance.nice.org.uk/TA179

Ustekinumab for the treatment of adults with moderate to severe psoriasisTechnology appraisal: (TA180)http://guidance.nice.org.uk/TA180

Pemetrexed for the first-line treatment of non-small-cell lung cancerTechnology appraisal: (TA181)http://guidance.nice.org.uk/TA181

NICE Public Health Guidance

Promoting young people's social and emotional wellbeing in secondary educationPublic health guidance: (PH20)http://guidance.nice.org.uk/PH20

Guidance on differences in the uptake of immunisations (including targeted vaccines) inpeople younger than 19 yearsPublic health guidance: (PH21)

http://guidance.nice.org.uk/PH21

NICE Interventional Procedure Guidance

Hysteroscopic sterilisation by tubal cannulation and placement of intrafallopian implantsInterventional procedure guidance: (IPG315)http://guidance.nice.org.uk/IPG315

Extracorporeal albumin dialysis for acute liver failureInterventional procedure guidance: (IPG316)http://guidance.nice.org.uk/IPG316

Individually magnetic resonance imaging-designed unicompartmental interpositionalimplant insertion for osteoarthritis of the kneeInterventional procedure guidance: (IPG317)http://guidance.nice.org.uk/IPG317

NICE Consultation Documents

Rheumatoid arthritis - tocilizumab: appraisal consultationClosing date for comments is 22 October 2009http://www.nice.org.uk/guidance/index.jsp?action=folder&o=45549

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Quitting smoking in pregnancy and following childbirth: consultation on the evidenceClosing date for comments is 22 October 2009http://www.nice.org.uk/guidance/index.jsp?action=folder&o=45536

Neonatal jaundice: draft guideline consultationClosing date for comments is 22 October 2009http://www.nice.org.uk/guidance/index.jsp?action=folder&o=45285

Male lower urinary tract symptoms (LUTS): guideline consultationClosing date for comments is 23 October 2009http://www.nice.org.uk/guidance/index.jsp?action=folder&o=45292

Hypertensive disorders during pregnancy: draft guideline consultationClosing date for comments is 29 October 2009http://www.nice.org.uk/guidance/index.jsp?action=folder&o=45335

Identification and care pathways for common mental health disorders: draft scopeconsultationClosing date for comments is 30 October 2009http://www.nice.org.uk/guidance/index.jsp?action=folder&o=45612

Clinical Knowledge Summaries updated in September 2009

Angina - stable

Candida - oral

Diarrhoea - antibiotic associated

Diarrhoea - prevention and advice for travellers

Gastroenteritis

Gonorrhoea (new)

Urethritis - male

Department of Health Guidance

A(H1N1) swine influenza: revised planning assumptions publishedDepartment of HealthThis contains revised planning assumptions in relation to the current A(H1N1) Swine Flupandemic. The assumptions are intended to provide a common agreed basis for planning acrossall public and private sector organisations.http://www.dh.gov.uk/en/Publicationsandstatistics/Lettersandcirculars/Dearcolleagueletters/DH_104846Pandemic influenza paediatric clinical pathways: information for health care professionalsworking in primary care and the communityDepartment of HealthThis guidance should be used with the adult modules and provides additional paediatricinformation suitable for clinical staff in locations where acute medical care may be provided to

children.http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_104962Critical care strategy: managing the H1N1 flu pandemicDepartment of HealthThis strategy sets out the DH's approach to managing critical care during the swine flu pandemicby increasing the number of available critical care beds and preventing people becomingseriously ill as a result of swine flu.

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http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_104977Exercise PrometheusHealth Protection Agency for Department of HealthThis is a Department of Health funded exercise for the social care sector to assess and developits resilience planning in readiness for a second wave of the pandemic swine flu. Designed as an'off the shelf' package primarily for use by local authorities in partnership with their local providersof social care, the exercise has been developed by the Health Protection Agency from experiencegained in previous pandemic influenza exercises.http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_104969Authorisation of antiviral medicines - Guidance on the use of FP10SS forms and AntiviralAuthorisation Vouchers during the H1N1 (swine flu) pandemic in EnglandDepartment of HealthThis is a new guidance document on the use of Antiviral Authorisation Vouchers. This guidancehas been issued for two reasons. Authorisation of antiviral medicines using Antiviral AuthorisationVouchers as well as specifically endorsed FP10SS forms has now been enabled and a change inthe recommended dose for oseltamivir for children 6 months and over and up to 1 year of age

from 2mg/kg to 3mg/kg has been announced by the European Commission.http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_105998

Delivering high quality midwifery care: the priorities, opportunities and challenges formidwivesDepartment of HealthThis report has been produced from work undertaken by the Quality of Midwifery Care Projectsteering group, its subgroups of midwives, lay representatives and other stakeholders, supportedby the Department of Health in response to the NHS Next Stage Review and reflecting the policydirection of Maternity Matters.http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_106063

Same-sex accommodation toolkitNational Patient Safety AgencyThis a diagnostic tool to aid investigation into areas where there are high levels of SSA mixed-sexoccurrences. Alternatively, it can be used to investigate an actual mixed-sex occurrence. Theprovides a systematic and evidence-based method of finding out what factors or events lead toSSA mixed-sex occurrences. The results will help organisations both to gain a betterunderstanding of the causes and contributory factors associated with SSA mixed-sexoccurrences and to take action to reduce the risk of them occurring elsewhere in the future.http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_104970

Other Guidance

Recognition and assessment of acute pain in childrenRCNThis revised and updated guideline was launched on 11 September 2009. It is available as part ofan online resource which provides information to supplement the guideline and support itsimplementation.http://www.rcn.org.uk/development/practice/pain

NICE cost saving guidance to support NHS through financial uncertaintySource: NICE

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In recognition of the challenging financial situation that the NHS is facing NICE have reviewed thenational cost estimates they have made and produced a list summarising that which theyconsider deliver savings.http://www.nice.org.uk/usingguidance/benefitsofimplementation/costsavingguidance.jsp

Health Technology Assessments

Rehabilitation of older patients: day hospital compared to rehabilitation at home. Arandomised controlled trial (Parker)Health Technol Assess 2009; 13.39

Breastfeeding promotion for infants in neonatal units: a systematic review and economicanalysis (Renfrew)Health Technol Assess 2009; 13.40

The clinical effectiveness and cost-effectiveness of bariatric (weight loss) surgery forobesity: a systematic review and economic evaluation (Picot)Health Technol Assess 2009; 13.41

Rapid testing for group B streptococcus during labour: a test accuracy study with

evaluation of acceptability and cost-effectiveness (Daniels)Health Technol Assess 2009; 13.42

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Infection Control

Working together to prevent and control infections: a study of the arrangements forinfection prevention and control between hospitals and care homesCare Quality CommissionThis report sets out the CQC's concerns around the lack of communication between care homesand hospitals in preventing infections passing between these two settings. It found that there wasa need for hospitals and care homes to provide information about infections to each other tomake sure that people with, or recovering from, an infection are cared for properly and to reducethe chances of other people being infected. However, the report highlights that this information isnot provided in a coordinated way with 17% of the care homes participating in the study sayingthat they received no information on infections at all when people were discharged from a hospitalto their care. Even when information was received, this could be weeks late, incomplete orillegible.http://www.cqc.org.uk/_db/_documents/Working_together_to_prevent_and_control_infections.pdf

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Long Term Conditions

Your health, your way: a guide to long term conditions and self care - communicationstoolkitDepartment of HealthThis toolkit provides all of the assets to enable the implementation of a communicationscampaign for Your health, your way at a local level.http://www.dh.gov.uk/en/Healthcare/Longtermconditions/yourhealth/DH_105073

Hyperthyroidism Annual Evidence UpdateNHS Evidence

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The update aims to present a comprehensive collection of up-to-date research evidence,including new systematic reviews, additional resources and therapeutic uncertainties.http://www.library.nhs.uk/ENT/ViewResource.aspx?resID=324634&tabID=289&catID=7712

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MedicinesSafety in doses: improving the use of medicines in the NHSNational Patient Safety AgencyThe report identifies risks and areas for action based on a detailed analysis of 72,482 medicationincidents. The incidents were reported to the NPSA by frontline NHS staff in acute, mental healthand primary care sectors between January and December 2007. The report analyses trends inthese incidents and translates this into actions and safety opportunities for frontline services.http://www.npsa.nhs.uk/corporate/news/tackling-medication-incidents-and-increasing-patient-safety/Review of MHRADepartment of Health

This report and recommendations has been published following a review of the Medicines andHealthcare products Regulatory Agency which was carried out between October 2008 and March2009.http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_104926[back to topics]

Mental Health & Learning Disabilities

Information sharing and mental healthDepartment of HealthThis guidance sets out some of the issues relating to the exchange of information between

mental health trusts and outside organisations and individuals. It sets out when, why and howinformation can safely be exchanged for the benefit of the individual and the public.http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_104949Implementing recovery: a new framework for organisational changeSainsbury Centre for Mental Health (SCMHThis document sets out what SCMH believes to be the ten major challenges for mental healthservices to put recovery at the heart of their everyday practice.http://www.scmh.org.uk/news/2009_implementing_recovery.aspx

Alzheimer's Disease and Dementia Annual Evidence UpdateNHS EvidenceThe Annual Evidence Update aims to provide healthcare professionals with a clear path to themost important recent evidence surrounding the 5 types of dementia: alzheimer's, vasculardementia, dementia with lewy bodies, frontotemporal dementia, and mixed dementia.http://www.library.nhs.uk/laterlife/viewResource.aspx?resid=319931&code=ded7f5f2689f7a4f607afcc0fe0c03d9World Alzheimer Report 2009Alzheimer's Disease InternationalThis is a global prevalence study of dementia and looks at levels of mortality, disability, strain oncarers and dependency. The report also offers examples of good national dementia plans and

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information on health service responses. The report also includes eight recommendations that willprovide a global framework for action on dementia.http://www.alz.co.uk/research/worldreport/

2009 survey of mental health acute inpatient servicesCare Quality CommissionThe survey collected responses from over 7,500 people who had recently had an inpatient stayfor acute mental health problems. It asked people about their experiences of acute inpatientmental health services along the pathway from admission to leaving hospital, including the careand treatment they received, day-to-day activities, and relationships with staff. The results arepresented nationally and broken down by Trust.http://www.cqc.org.uk/usingcareservices/healthcare/patientsurveys/mentalhealthservices.cfm

Autism Spectrum Disorders in adults living in households throughout England - reportfrom the Adult Psychiatric Morbidity Survey 2007NHS Information CentreThis report presents data on the presence of autism spectrum disorders, based on the datacollected at phases one and two of the 2007 survey. These findings were not included in theinitial survey report. Estimated disorder prevalence is presented by age, sex, ethnic group, maritalstatus, highest educational qualification, equivalised household income, economic activity status,

receipt of benefits, housing tenure, area level deprivation and predicted verbal IQ. The level andnature of treatment and service use is considered, although the sample size means that thiscannot be explored in detail.http://www.ic.nhs.uk/pubs/asdpsychiatricmorbidity07

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Musculoskeletal

Osteoarthritis Annual Evidence UpdateNHS Evidencehttp://www.library.nhs.uk/musculoskeletal/viewResource.aspx?resid=324800&code=5d394294e3ae534645fd1f5f22e2a1d0A systematic review of the effects of dynamic exercise in rheumatoid arthritisAndrew P. Cairns and Joseph G. McVeighRheumatology International 2009 Published online: 22 August 2009This systematic review suggests that the majority of patients with RA should be encouraged toundertake aerobic and/or strength training exercise. Exercise programmes should be carefullytailored to the individual, particularly for patients with underlying large joint damage or pre-existingcardiovascular disease.http://www.ncbi.nlm.nih.gov/pubmed/19701638(Article available from the Health Library)

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Patient Safety and Care

The right information, in the right place, at the right time: a study of how healthcareorganisations manage personal dataCare Quality CommissionThis report calls for better patient care by ensuring the right patient information is in the rightplace, at the right time and states that healthcare organisations should meet the individual careneeds of patients by making better use of the patient information they collect. It covers: thepolicies and practices that ensure patient records are kept confidential and secure; the quality of

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information about patients and their care; how information is shared between healthcareorganisations and patients and their carers; and how information about individual patients is usedto shape their care.http://www.cqc.org.uk/_db/_documents/Info_governance_FINAL_PDF.pdf

Putting patients at the heart of careDepartment of HealthHealth and care services are committed to being better at listening, understanding andresponding to the needs of patients. This document sets out the vision for patient and publicengagement. It explains what it means and the role it can play in driving up the efficiency, qualityand productivity of services.http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_106038

Helping the NHS put patients at the heart of careDepartment of HealthThis guidance demonstrates that the Government is committed to help services become better atlistening, understanding and responding to the needs and wishes of patients and the public. Itdescribes the Department of Health support programme to help services engage patients and thepublic.

http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_106046

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Service Management

PbR data assurance framework 2008/09Audit CommissionThe key findings and analysis of the 2008/09 national clinical coding audit programme managedby the Audit Commission under the Payment by Results (PbR) Data Assurance Framework arepresented in this report. The number of errors made by NHS trusts under the Payment by Results(PbR) system is falling, but there are continuing concerns about the poor quality of some medicalrecords.http://www.audit-commission.gov.uk/health/nationalstudies/pbr/pbrdataassuranceframework200809/Pages/default

_copy.aspxThe Quarter: quarter 1, 2009/10Department of HealthThis report covers NHS finance and service performance during the period April to June 2009.http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsStatistics/DH_104975

The use of 084 telephone numbers in the NHS: Department of Health response toconsultationDepartment of Health

The DoHs response to the recent consultation document which sought views from all interestedparties on the use of 084 numbers in the NHS. This document sets out proposed action as aresult of the consultation.http://www.dh.gov.uk/en/Consultations/Responsestoconsultations/DH_105089

Improving care, reducing cost: helping the NHS meet its 21st

century challengeManagement Consultancies AssociationThis report contains analysis of how much the NHS spends on management consultancy and thetypes of work that management consultants do. It is based on research with members of the

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Management Consultancies Association and contains a series of case studies.http://www.mca.org.uk/reports/insight/improving-care-reducing-cost

National Clinical Assessment Service casework the first eight yearsNational Clinical Assessment Service (NCAS)The NCAS was set up in 2001 to receive referrals regarding concerns about medical and dentalperformance and to help local healthcare managers to understand, manage and prevent theseperformance concerns. This report analyses cases referred to NCAS since 2001 (a total of almost5,000). It identifies which groups of practitioners are more likely to be referred to NCAS and whatcan be learnt from these referral patterns. It also examines episodes of suspension and exclusionof individual practitioners. And, for more than 1,400 cases dealt with by NCAS since the end of2007, the report analyses in depth the nature of concerns which led to referral.http://www.ncas.npsa.nhs.uk/resources/publications/caseworkanalyses/

Practice Management NetworkA new network for general practice mansgers has been launched through a website promising toraise the profile of practice managers and increase their influence on the policy agenda. Thenetwork, started with support from the DH and several stakeholder organisations, is keen to workwith PCTs both at a practical level to support the registration drive, and in the wider sense tofoster more productive working relationships and better communications. Managers need to

register for the network before getting access to all areas of the site, which includes a nationalmap of local networks.http://www.practicemanagement.org.uk/

General practice in England: an overviewKing's FundThis briefing paper sets out how general practice is organised, contracted and financed; analysesthe impact of recent government policy; and looks at future trends.http://www.kingsfund.org.uk/research/publications/briefings/general_practice_in.html

The Quality and Outcomes Framework 2008/09NHS Information CentreThe Quality and Outcomes Framework (QOF), is a voluntary annual reward and incentive

programme for all GP surgeries in England which is part of GP contracts. Results of GP practices'achievement against the QOF are published each year. The QOF is not about performancemanagement, but resourcing and then rewarding good practice. For 2008-2009, a total of 8,229GP practices in England are included in the published results, covering almost 100 per cent ofregistered patients in England.http://www.ic.nhs.uk/statistics-and-data-collections/audits-and-performance/the-quality-and-outcomes-framework/the-quality-and-outcomes-framework-2008-09

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Statistics

NHS Immunisation Statistics England 2008-09

NHS Information Centrehttp://www.ic.nhs.uk/statistics-and-data-collections/health-and-lifestyles/immunisation/nhs-immunisation-statistics-england-2008-09

Trends in consultation rates in General Practice - 1995-2009NHS Information Centrehttp://www.ic.nhs.uk/statistics-and-data-collections/primary-care/general-practice/trends-in-consultation-rates-in-general-practice--1995-2009

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Provisional Monthly Hospital Episode Statistics for Admitted patient care and outpatientdata, April 2008 - May 2009NHS Information Centrehttp://www.ic.nhs.uk/pubs/provisionalmonthlyhes

Statistics on Smoking, England 2009NHS Information Centrehttp://www.ic.nhs.uk/statistics-and-data-collections/health-and-lifestyles/smoking/statistics-on-smoking-england-2009

Investment in General Practice 2003/04 to 2008/09 England, Wales, Northern Ireland andScotlandNHS Information Centrehttp://www.ic.nhs.uk/statistics-and-data-collections/primary-care/general-practice/investment-in-general-practice-2003-04-to-2008-09-england-wales-northern-ireland-and-scotlandGP Earnings and Expenses 2007/08 Provisional ReportNHS Information Centrehttp://www.ic.nhs.uk/statistics-and-data-collections/primary-care/general-practice/gp-earnings-and-expenses-2007-08-provisional-report

Use of NICE appraised medicines in the NHS in England - Experimental StatisticsNHS Information Centrehttp://www.ic.nhs.uk/pubs/niceappmed

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Workforce

RN+RN = better care. What do we know about the association between Registered Nursestaffing levels and patient outcomes?Policy+There is considerable evidence of an association between nurse staffing levels and patientoutcomes. The evidence has been used to support calls for mandatory nurse patient ratios butthe precise significance of the relationship remains unclear. This Policy+ report examines theevidence in order to establish what is known, and crucially, what is not known?http://www.kcl.ac.uk/content/1/c6/02/56/58/PolicyIssue20NurseStaffing.pdf

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