Académique Documents
Professionnel Documents
Culture Documents
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/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 NHS
Outreach 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 on
the first page. Please suggest further useful sites.
Contact information
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Websites
Bandolier http://www.medicine.ox.ac.uk/bandolier/
Clinical Knowledge Summaries [NLH] http://cks.library.nhs.uk/
Cochrane Library http://www.library.nhs.uk/
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
Department of Health http://www.dh.gov.uk/en/index.htm
Health Technology Assessment (HTA) Database http://www.ncchta.org/
NICE http://www.nice.org.uk/
NHS Evidence Specialist Collections http://www.library.nhs.uk/specialistcollections/
SIGN http://www.sign.ac.uk/new.html
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Cancer
Draft teenagers and young adults cancer measures for the Manual for Cancer Services:
consultation
Department of Health
The purpose of this consultation is to make sure that the new 'Teenagers and Young Adults
Cancer Measures' are clear and comprehensive for inclusion in the Manual for Cancer Services
2008. All comments on the draft measures should be sent directly to the National Peer Review
Team using the attached template.
Draft and supporting documents accessible via:
http://www.dh.gov.uk/en/Consultations/Liveconsultations/DH_123365
Draft brain and CNS measures for consultation: Manual for Cancer services.
Department of Health
A draft version of the Brain and CNS measures for inclusion in the Manual for Cancer Services is
being issued for a three month consultation. Comments are invited by 31 March 2011.
Draft and supporting documents accessible via:
http://www.dh.gov.uk/en/Consultations/Liveconsultations/DH_123352
Bowel Cancer Resources for pilot campaign (GP Resource Pack, Factsheets and
Awareness Materials)
Bowel Cancer UK / Department of Health
The first ever Government cancer campaign to raise awareness of the key signs and symptoms
of bowel cancer, and to prompt those with the relevant symptoms to visit their GP, has been
launched. The pilot campaign hopes to raise awareness of the symptoms, encourage people to
visit their GP if they have had the symptoms for three weeks or more and gives reassurances that
these symptoms are likely to be nothing to worry about.
The GP Resources Pack, Factsheets and Awareness Materials can be downloaded from:
http://www.bowelcanceruk.org.uk/home/bowel-cancer/downloads
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Cardiovascular Diseases
The clinical and economic burden of non-adherence with antihypertensive and lipid-
lowering therapy in hypertensive patients
NHS Economic Evaluation Database (NHS EED)
Cherry S.B., Benner J.S., Hussein M.A., Tang S.S., Nichol M.B.
This study examined the cost-effectiveness of antihypertensive therapy and statin therapy for
hypertensive patients, with total cholesterol of 6.5mmol/L or less, considering their
treatment adherence. Low adherence reduced the benefits of treatment, but therapy was still
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cost-effective with real-world adherence. Greater cost-effectiveness was achieved with the
adherence found in clinical trials. The methods were valid and the extensive analysis of
uncertainty showed that the results were robust, which supports the authors’ conclusions.
http://www.crd.york.ac.uk/crdweb/ShowRecord.asp?LinkFrom=OAI&ID=22009102026
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Commissioning
Commissioning guide: The management of lower urinary tract symptoms in men
NICE
This commissioning guide provides support for the local implementation of NICE guidance
through commissioning, and is a resource for people involved in commissioning health and social
care services and public health programmes within the NHS and partner organisations in
England.
http://www.nice.org.uk/media/C58/73/LUTSCommissioningGuide.pdf
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Commissioners are increasingly under pressure to deliver improved services with fewer
resources and hard decisions need to be made in the current economic climate. Activists who
understand the commissioning process are in a strong position to influence decisions and protect
the interests of patients and RCN members. The earlier activists and nurses get involved in these
decision-making processes, the more likely it is that they will have a positive influence on behalf
of patients and nurses. This publication covers what commissioning is, who leads commissioning
and where it takes place, as well as detailing six keys to help activists and nurses in unlocking
and understanding the commissioning process.
http://www.rcn.org.uk/__data/assets/pdf_file/0010/359308/003853.pdf
Items in the Sexual Health and Service Management sections may also be of interest.
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Dementia
Living well with dementia: A National Dementia Strategy Good Practice Compendium – an
assets approach
Department of Health
This good practice compendium has been brought together from across the regions to support
local delivery of the national dementia strategy and improve outcomes for people with dementia
and their carers. It is an enabler for local change, as described in the Department of Health's
revised outcomes focused implementation plan.
http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_1234
75.pdf
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Guidance
NICE Clinical Guidelines
Generalised anxiety disorder and panic disorder (with or without agoraphobia) in adults
(partial update)
Clinical guideline: (CG113)
http://guidance.nice.org.uk/CG113
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Distal iliotibial band lengthening for refractory greater trochanteric pain syndrome
Interventional Procedure: (IPG375)
http://guidance.nice.org.uk/IPG375
Ambulight photodynamic therapy for the treatment of non-melanoma skin cancer: medical
technologies consultation
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Distal iliotibial band lengthening for refractory greater trochanteric pain syndrome
Interventional procedure guidance: (IPG375)
http://guidance.nice.org.uk/IPG375
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• Bedwetting (enuresis)
• Hyponatraemia (new)
Other Guidance
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Immunisations / Vaccinations
Seasonal influenza vaccine uptake and vaccine supply
Department of Health
This letter from Professor Dame Sally Davies, Interim Chief Medical Officer, provides an update
on the seasonal influenza vaccine uptake and vaccine supply.
It also reminds of who is and is not eligible for flue vaccinations.
http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_1233
41.pdf
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A summary of HPV vaccination coverage across England at PCT, SHA and Description national
level for the second year of the programme. This includes additional data from Devolved
Authorities and comparisons with available international equivalent programmes.
http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_1238
26.pdf
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Influenza
(Increase in co-infections with flu)
Influenza, meningococcal infection and other bacterial co-infection including
pneumococcal and invasive Group A streptococcal Infection (iGAS)
Daily Health Bulletin / Central Alerting System – Department of Health
The Chief Medical Officer, via the Central Alerting System, has issued a letter which contains an
alert to an increase in a number of significant bacterial infections such as those caused by
Neisseria meningitidis (meningococcal disease) and others that may occur as co-infections with
flu.
https://www.cas.dh.gov.uk/ViewandAcknowledgment/ViewAlert.aspx?AlertID=101528
Access via the link to the letter at the bottom of the page.
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Health and Social Care Bill - Amendments to the Mental Health Act 1983
Department of Health
The Health and Social Care Bill currently before Parliament includes a number of proposed small
amendments to the Mental Health Act. This letter summarises these amendments.
http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_1237
16.pdf
Learning from the past – setting out the future: developing learning disabilities nursing in
the United Kingdom
Royal College of Nursing
The population of children, adults and older people with learning disabilities is increasing and
there is a higher number of people living into adulthood with a range of complex needs. This is
resulting in children, young people and adults presenting with patterns of complex learning
disabilities unlike those experienced by existing services and healthcare services will experience
higher demand from this group in the future. Learning disability nurses play a central role in the
lives of people with learning disabilities, from developing and implementing care plans to
providing advice, education and support to people throughout their care journey. This publication
sets out the key issues and actions required, both now and in the future, to enable learning
disability nursing to develop and progress in line with the increased demand on its services. It
also details areas of priority for the RCN.
http://www.rcn.org.uk/__data/assets/pdf_file/0006/359367/003871.pdf
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Obesity
Obesity and ethnicity
National Obesity Observatory (NOO)
This paper provides an overview of the current evidence on the relationship between obesity and
ethnicity for adults and children in the UK - summarising evidence on:
- variations in obesity prevalence between and within minority ethnic groups;
- differences in obesity-related disease prevalence between minority ethnic groups, with particular
reference to cardiovascular disease and type 2 diabetes;
- measures of obesity including the issue of central adiposity and the use of BMI; and
- the role of potential determinants of obesity for minority ethnic groups such as migration, cultural
variations in diet, socioeconomic status, local area characteristics and physical activity levels.
http://www.noo.org.uk/uploads/doc/vid_9444_Obesity_and_ethnicity_270111.pdf
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Older People
How can local authorities with less money support better outcomes for older people?
Joseph Rowntree Foundation
Research shows that older people want and value low-level support - 'that bit of help' - but the
benefits of investing in this are realised over many years, making it harder to prove impact and
protect funding in the face of severe pressure on spending. This document provides examples of
imaginative, affordable and effective ways of supporting older people’s health, well-being, social
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engagement and independence. It highlights projects with some local authority involvement
whether as lead commissioner, subsidiary partner, or through small grants or seed-funding.
The projects demonstrate the importance of: involving people who use support and services in
shaping them; investing in collective solutions, small grants or seed-funding for self-help groups,
and developing local markets to provide the support people want and value; greater emphasis on
the assistance that older people need and choose, and their experiences rather than on
conventional social care and/or services; developing place-based approaches that reflect the
whole of people's lives, and delivering value for money, for example by including transport,
leisure, and fire and rescue services to co-ordinate support.
http://www.jrf.org.uk/sites/files/jrf/authorities-supporting-older-people-summary.pdf
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Palliative Care
Annual Evidence Update 2011: Patient and carer involvement in chronic disease
NHS Evidence Specialist Collections – Supportive and Paliative Care
This is the third Annual Evidence Update on patient and carer engagement in chronic disease
management. NHS Evidence have continued to broaden the scope of the literature accessed, in
order to reflect the widening field of supportive and end of life care. In this update, they have
included literature mainly from 2010 but also included a few publications of note from earlier
years which were not included in the previous updates.
http://www.library.nhs.uk/PALLIATIVE/ViewResource.aspx?resID=401513
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Public Health
Please see the Mental Health/Learning Disabilities section.
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Research
A new pathway for the regulation and governance of health research
The Academy of Medical Sciences
The report was prepared by a working group convened in response to an invitation from
Government to review the regulation and governance of UK health research involving human
participants, their tissue or their data. The report proposes four key principles that should
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underpin the regulation and governance framework around health research in the UK, and makes
recommendations to:
- Create a new Health Research Agency (HRA) to rationalise the regulation and
governance of all health research.
- Include within the HRA a new National Research Governance Service to facilitate timely
approval of research studies by NHS Trusts.
- Improve the UK environment for clinical trials.
- Provide access to patient data that protects individual interests and allows approved
research to proceed effectively.
-Embed a culture that values research within the NHS.
The report is the first link at the bottom of the webpage.
http://www.acmedsci.ac.uk/index.php?pid=47&prid=88
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Service Management
Briefing: The operating framework for the NHS in England 2011/12
NHS Confederation
This Briefing from the NHS Confederation outlines the key points from the operating framework
for the NHS in England for 2011/12 which was published in mid-December.
http://www.nhsconfed.org/Publications/Documents/Operating_framework_2011_12_final_for_web
site.pdf
NHS Confederation login might be required.
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http://www.dh.gov.uk/en/Publicationsandstatistics/Lettersandcirculars/Dearcolleagueletters/DH_1
23460
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Sexual Health
Commissioning for sexual health – Better for Less Update Briefing
NHS Yorkshire and the Humber
Commissioning effective sexual health services can significantly reduce physical and emotional ill
health whilst providing over £16m of cost savings to the NHS in our region. This document
includes recommendations for commissioners which will help improve quality and reduce cost
including:
• Health professionals having the knowledge and skills to offer women seeking contraception an
informed choice and access to long-acting reversible methods
• Prevention and early diagnosis of sexually transmitted infections including HIV
• Effective measures to reduce rates of repeat abortions.
http://www.healthyambitions.co.uk/Uploads/BetterForLess/22%20BETTER%20FOR%20LESS%2
0Sexual%20Health.pdf
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Smoking
Reducing smoking – a comprehensive approach – Better for Less Update Briefing
NHS Yorkshire and the Humber
Prevention of smoking has more potential for improving public health, and to do so quickly,
than any other clinical intervention. A comprehensive ‘whole systems’ approach to reducing
smoking provides an immediate return on investment, with significant reductions in NHS
healthcare resource expenditure. Robust research has identified that no one intervention will
reduce smoking. A comprehensive approach including a range of evidence based strategies
implemented simultaneously aimed at both the micro and macro level provides the quickest,
greatest and most sustainable impact on smoking prevalence.
http://www.healthyambitions.co.uk/Uploads/BetterForLess/19%20BETTER%20FOR%20LESS%2
0Reducing%20Smoking.pdf
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Stroke
Supporting life after stroke: A review of services for people who have had a stroke and
their carers
Care Quality Commission
This review looked at the 'pathway' of care provided to people who experienced a stroke or a
'mini-stroke' (called a transient ischemic attack) and their carers. The review was conducted
throughout 2010, and focused on care from the point where people prepared to leave hospital, to
the ongoing care and support in their homes. Both health and adult social care, as well as other
relevant services, were reviewed during this period. PCTs are the main organisations responsible
for commissioning health care for people who have had a stroke. Local councils, particularly the
adult social services departments, also have an important role in assessing peoples’ social needs
and commissioning a range of community based support, care and advice services.
http://www.cqc.org.uk/_db/_documents/CQC_Stroke_review_national_report.pdf
Cilostazol versus aspirin for secondary prevention of vascular events after stroke of
arterial origin
A.K. Kamal, I. Naqvi, M.R. Husain, B.A. Khealani
Cochrane Database of Systematic Reviews
Background: Aspirin is widely used for secondary prevention after stroke. Cilostazol has shown
promise as an alternative to aspirin in Asian people with stroke. Authors' conclusions: Cilostazol
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is more effective than aspirin in the prevention of vascular events secondary to stroke. Cilostazol
has more minor adverse effects, although there is evidence of fewer bleeds.
http://onlinelibrary.wiley.com/o/cochrane/clsysrev/articles/CD008076/frame.html
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Substance Abuse
Statistics on Drug Misuse: England, 2010
NHS Information Centre for Health and Social Care
This annual statistical report presents information on drug misuse among both adults and
children. It includes a focus on young adults. The topics covered include:
- Prevalence of drug misuse, including the types of drugs used;
- Trends in drug misuse over recent years;
- Patterns of drug misuse among different groups of the population; and
- Health outcomes related to drug misuse including hospital admissions, drug treatment and
number of deaths.
- The bulletin also summarises Government plans and targets in this area.
http://www.ic.nhs.uk/webfiles/publications/003_Health_Lifestyles/Statistics_on_Drug_Misuse%20
_England_2010.pdf
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Urology
2011 Annual Evidence Update on Male Urinary Incontinence
NHS Evidence Specialist Collections – Kidney Diseases and Male Urogential Disorders
Thus Update provides a critical update of the latest information and looks at ongoing randomised
control trials
http://www.library.nhs.uk/kidney/ViewResource.aspx?resID=401615
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Women’s Health
Acupuncture for period pain
Cochrane Database of Systematic Reviews
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