The future of the NHS

Lord Darzi's report on the future of the NHS is now published.


See the summary or full report here.

And published alongside it, see:

National Health Service Constitution

A high quality workforce: NHS Next Stage review

To keep up to date with new Department of Health publications, see their Publications page: http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/index.htm

And to keep up on the debate on the future of the NHS, click here for responses to the Darzi Report from the BMA, King's Fund, and many more.

NHS Waiting Times

The Department of Health and the Statistics Authority have released the latest figures on waiting times for the NHS in England.

The key points, plus the full data, are available on the DH website here.

Statistics by Trust are available, so it's possible to find out how Stockport is doing compared to other Trusts, and compared to the avaerage in England.

Looking for evidence?

There are lots of places where you could do a quick search for evidence. But these are some of the best options:

UpToDate is only available on the hospital network. But it's easy to use, quick to search, and packed with reliable summaries of the evidence that can be found, read and digested in seconds.

DynaMed is available free, with no password to remember, from anywhere in the UK. Similarly, it's easy to use, and summarises the evidence on thousands of topics so that you can find it in a jiffy.

TripDatabase is a great resource that searches for evidence from dozens of sources: Medline, Guidelines, electronic textbooks, evidence synopses, top clinical journals and more. And it's free.

And finally, here a new one I've just come accross:

SumSearch also searches accross a number of sources. It's free, and will help you to develop your search strategy by making suggestions as you type.

Cervical cancer vaccine - where's the evidence?

The Department of Health has announced a vaccination programme for the human papillomavirus, which is due to start in September. The programme will use the Cervarix vaccine, which is made by GlaxoSmithKline, but there is upset that an alternative, Sanofi Pasteur’s Gardasil, was not chosen, eg. BMJ News and Rapid Responses.

So where could we find out more about these two products. You could try these:

The NLH Women's Health Specialist Library

Quick search in PubMed

The British National Formulary (BNF)

Disease Mongering and Drug Promotion

'Disease mongering is the selling of sickness that widens the boundaries of illness and grows the markets for those who sell and deliver treatments.'
Moynihan (2006)

To read more on disease mongering, and action being taking against it see:

Moynihan et al. (2008)

PLoS Medicine Theme Issue (2006)

Healthy Skepticism

National Dementia Strategy

A national strategy for the diagnosis and treatment of dementia will be published in October 2008.

The Department of Health is currently undertaking a public consultation on the plan.

For more information, see the Department of Health website : http://www.dh.gov.uk/en/SocialCare/Deliveringadultsocialcare/Olderpeople/NationalDementiaStrategy/index.htm

New NICE Guidelines, June 2008

Breast cancer (advanced & metastatic) - bevacizumab (terminated appraisal)


Colorectal cancer (metastatic) - cetuximab (terminated appraisal)



Glioma (recurrent) - carmustine implants (terminated appraisal)



Head and neck cancer - cetuximab



Implantation of multifocal (non-accommodative) intraocular lenses during cataract surgery



Lumbar infusion test for the investigation of normal pressure hydrocephalus


Lung cancer (non-small-cell) - bevacizumab (terminated appraisal)


Obesity - rimonabant



Psoriasis - adalimumab


Stent insertion for bleeding oesophageal varices



Surgical repair of vaginal wall prolapse using mesh



Transcatheter aortic valve implantation for aortic stenosis

NHS Reforms report from the Audit Commission

Since 2000 the NHS has been undergoing dramatic market-style reforms. Eight years on, is there evidence of improvements in efficiency and effectiveness of the NHS? The Audit Commission has recently published a report on these reforms.

The report is availble to read or download online here.

The Audit Commission is an independent watchdog, driving economy, efficiency and effectiveness in local public services to deliver better outcomes for everyone.

PsycBITE

PsycBITE is a database that catalogues evidence for the treatment of psychological problems and issues occurring as a consequence of acquired brain impairment (ABI).

The database is free to access, and rates the studies it includes by methodological quality, making it easy to decide what to trust.

PsycBITE is compiled by the Royal Rehabilitation Centre, Sydney, Australia.

Search the database yourself here : http://www.psycbite.com/

BMJ Case Reports

The BMJ are soon to launch a new service : BMJ Case Reports

The humble case report is often overlooked as a weak form of evidence, but they are frequently the only form of evidence available. BMJ Case Reports are currently looking for case reports to be submitted.

Read more about the project, and submit your reports, here : http://casereports.bmj.com/

Annual Evidence Updates from the NLH

Annual Evidence Update on Multiple Sclerosis: An update of the evidence on this topic from the NLH Neurological Conditions Specialist Library

Annual Evidence Update on Age Related Macular Degeneration (AMD): The Age Related Macular Degeneration Annual Evidence Update 2008 presents a collection of evidence that has emerged in the past 12 months since the 2007 National Knowledge Week (NKW)

National Knowledge Week on Proteinuria and the Use of eGFR: An update of the evidence on this topic from the NLH Kidney Diseases Specialist Library

National Knowledge Week on Homeopathy: An update of the evidence on this topic from the NLH Complementary & Alternative Medicine Specialist Library

Developing leaders to improve patient care

The Health Foundation believes that encouraging better leadership from clinicians and managers is one of the most important ways to improve the quality of healthcare in the UK.

Developing leaders to improve patient care explains what we have learnt about leadership:

* leaders are key to improving patient care
* leaders need emotional intelligence
* leaders should learn in multidisciplinary teams
* leaders are required throughout an organisation
* leaders need support from their colleagues and their organisation
* careful recruitment to leadership schemes is important.

To find out more about the Health Foundation and its leadership scheme, click here

June 2008

Caption Competition!

Click on the 'comments' link to leave a caption.

Click on the image for a bigger view of the picture.

Fabulous prize to be won!

NICE Guidelines, May 2008

Anaemia (cancer-treatment induced) - erythropoietin (alpha and beta) and darbepoetin	Technology appraisals
Ankylosing spondylitis - adalimumab, etanercept and infliximab	Technology appraisals
Canaloplasty for primary open-angle glaucoma	Interventional procedures
Diabetes - type 2 (update)	Clinical guidelines
Endoaortic balloon occlusion for cardiac surgery	Interventional procedures
Lipid modification	Clinical guidelines
Promoting physical activity in the workplace	Public health intervention guidance
Single-incision sub-urethral short tape insertion for stress urinary incontinence in women	Interventional procedures

For more NICE Guidelines, Technology Appraisals and Interventional Procedures, see http://www.nice.org.uk

Search 2.0 Tips

At the end of June when you want to search Medline, Embase, Cinahl or one of the other healthcare databases to which the NHS subscribes, you have to use the new NLH Search 2.0 interface.

Keep an eye on the Library Newsletter for more drop in dates, and have a look at some quick tips.

National Library for Health Knowledge Weeks

The National Library for Health's numerous Specialist Libraries gather together the best evidence, guidance, patient information and resources for different subjects.

Another part of their work is to organise summaries of the best available evidence on topics on an annual basis. And here are some of those Annual Evidence Updates...

Heavy menstrual bleeding - from June 2nd

Oral Health

Rhinitis

Complementary and Alternative Medicine for asthma

Keep up to date with Annual Evidence Updates, and National Knowledge Weeks from the National Library for Health here: http://nlhnews.blogspot.com/

The Quality of Evidence

The BMJ this month has published an article explaining the importance of rating the quality of evidence being used by clinicians. The article focuses on writing a clinical guideline, but the same ideas would apply to any time a clinician uses information.

See http://www.bmj.com/cgi/content/full/336/7651/995

(you might need to sign in with your NHS Athens account)

To see an example of this in action, see how DynaMed put together their evidence summaries here: http://www.ebscohost.com/dynamed/content.php

And to see DynaMed itself, click here: https://www.cks-nhs.net/dynamed.aspx

New Official Statistics Website for the UK

The UK Statistics Authority is the body which gathers and publishes statistics on all aspects of society in the UK.

The Statistics Authority is independant of the government, a move designed 'to restore public trust in the quality and integrity of official statistics'

There is a considerable amount of information that can be found on this website, covering health care, demographics, the economy and more.

One very useful section is the Neighbourhood link, in which you can find detailed statistics on different geographical areas. Click the Neighbourhood link, and try putting in your postcode to see what you can find out!

The UK Statistics Authority: http://www.statistics.gov.uk/

And don't forget about the NHS Information Centre at http://www.ic.nhs.uk/

NHS North West Healthier Horizons

NHS North West have published a major review of the direction to be taken by the NHS in the region...

"Healthier Horizons for the North West marks the culmination of a wide ranging clinical review of health services across the region. The review has not only been informed by our clinicians and NHS staff but also by the views of our partners, patients and members of the public across the region, all who have played an important role in shaping this vision.

We are proud of the considerable progress that has been made in the North West towards a healthier future for residents of the region. We must now target the unacceptable health inequalities which result in many people living in poor general health and with shorter life expectancies than those in other areas of the country. We must shift the focus much more towards the promotion of health and the prevention of illness.

Healthier Horizons for the North West outlines how we are proposing to tackle this."

See http://www.northwest.nhs.uk/healthierhorizons/ for the full report

Clinical Knowledge Summaries - updated topics

Clinical Knowledge Summaries constantly updates its content, based on new evidence which is published.

This month, the updated topics are

Anal fissure
Blepharitis
Dyspepsia - pregnancy-associated
Haemorrhoids
Nausea/vomiting in pregnancy

Keep an eye on the CKS homepage for more new and updated topics: http://cks.library.nhs.uk

Medicins Sans Frontieres research free to all

Medicins Sans Frontieres have launched a new website to give free access to their published research.

You can access the website here: http://fieldresearch.msf.org

The research by MSF is based on their field experience with vulnerable populations, and is made available via this site through permissions gain from various publishers.

This site is a good example of an institutional respository, an online archive which makes research freely accessible. Most UK Universities have taken this approach, and the NHS may well do so in the future.

Professional development opportunities

Here's an opportunities to attend a free one-day course for any health professionals entitled,

"Raise your game: personal development activities to benefit you, your organisation and patients"

Salford University are also offering a Professional Doctorate in Health and Social Care.

Click the links above for more details.

New code for nurses and midwives

On 1 May 2008 the new Code for nurses and midwives in the UK came into effect. It addresses standards of conduct, performance and ethics for nurses and midwives.

Click here for details

May 2008

Information helps us to kick bad habits

The King's Fund has launched a programme of work to investigate what the NHS can do to improve the public's health.

See the Kicking Bad Habits section for more.

The programme will look at

• the impact of financial incentives


• the effectiveness of targeting low socio-economic groups


• the role of information-led strategies


• the impact of personal skills, capabilities and confidence to change


• strategies for identifying and targeting interventions

Thermal injuries on children

The NSPCC has published guidelines for clinicians to assist in identidying scalds and burns which may be the result of abuse.

See more information, and download the advice here.

This advice is one of a series produced by the Welsh Child Protection Systematic Review Group. For their other projects and publications, see the CORE-INFO website.

How can you rate the quality of evidence?

There are a number of different systems in place to help clinicians to rate the quality of evidence that they find. The BMJ this month promotes one such system - Grading of Recommendations Assessment, Development and Evaluation (GRADE). This is the system which the BMJ asks its authors to use.

You can read the article, after signing in with your NHS Athens account, here.

Or find out more about the GRADE system on their website.

National Library for Public Health

The National Library for Health's most recently launched specialist library is that for Public Health. This new website is designed to be the best source of information and evidence for those working in the public health field.

See the Public Health Specialist Library here: www.library.nhs.uk/publichealth

The Public Health Specialist Library is kicking off with an Obesity Knowledge Week.

The Public Health Specialist Library is one of over thirty specialist libraries produced by the National Library for Health. Each one focuses on a particular area, offering guidance, evidence and expert information on a clinical topic, a type of health service, or a specific group of patients.

New to the Cochane Library

The new issue of the Cochrane Library is now available.

The Cochrane Library is the best source of excellent quality clinical evidence - from systematic reviews and randomised controlled trials.

For more information and help on using the Cochrane Library, try:

the Cochrane Library's help page

the Stockport Multidisciplinary Education Centre Library's runs training sessions

one of these short videos (in English, and seven other languages)

NICE Guidelines for April 2008

In April 2008, NICE published six pieces of Guidance:


Allogeneic pancreatic islet cell transplantation for type 1 diabetes mellitus

Colitis (ulcerative) - infliximab

Interstitial photodynamic therapy for malignant parotid tumours

Intraoperative red blood cell salvage during radical prostatectomy or radical cystectomy

Perioperative hypothermia (inadvertent)

Rheumatoid arthritis (refractory) - abatacept

The Guidance on abatacept promoted responses from a number of groups.

To keep up to date with newly published NICE guidance, click here.