Our International Health Service
The NHS relies on staff from all over the world. Over a quarter of NHS doctors – including almost half in some vital specialities – and almost one in six nurses, are from overseas. But following the Brexit referendum the NHS is finding it increasingly difficult to attract the clinical staff it needs from the EU. The number of EU nurses is already falling, and the proportio n of European doctors gaining a licence in the UK has fallen from 25% of the total in 2014 to just 16% in 2017. This is making the NHS increasingly dependent on staff from outside the EU, who are being refused entry into the UK in their hundr...
Source: Current Awareness Service for Health (CASH) - June 15, 2018 Category: Consumer Health News Source Type: news

Horizontal or Vertical: Which way to integrate? Approaches to community services integration and consequences for emergency hospital activity A case study based on the Transforming Community Services Policy
The paper seeks to answer the following question: Does structural integration of district nursing services with acute or other community health services have an impact on levels of emergency hospital admissions of older people? (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 15, 2018 Category: Consumer Health News Source Type: news

Diagnosis Critical Launching an inquiry into health and social care in England
This report contains new analysis which names 32 areas in England where you are 29% more likely to die of preventable causes, each of which having below average health outcomes and NHS trusts in deficit. The data also identifies 13'crunch zones'which may not be prepared for aging populations and where social care is currently underfunded. This is compounding pressure on the NHS and making trusts more likely to run deficits. Without urgent intervention these areas have the potential to become risk zones. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 15, 2018 Category: Consumer Health News Source Type: news

Frequency and nature of potentially harmful preventable problems in primary care from the patient's perspective with clinician review: a population-level survey in Great Britain
A total of 3975 of 3996 participants in a nationally representative survey completed relevant questions and 300 (7.6%) reported experiencing a potentially harmful preventable problem in primary care during past 12 months and 145 (48%) discussed their concerns within primary care. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 15, 2018 Category: Consumer Health News Source Type: news

Self management of patients with mild COPD in primary care:
RCT (n=577 with mild dyspnoea) found telephone health coaching intervention delivered by nurses, underpinned by social cognitive theory led to changes in self-management activities but did not improve health related quality of life vs. usual care group (leaflet about COPD). (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 15, 2018 Category: Consumer Health News Source Type: news

Driving improvement: Case studies from 10 GP practices
Interviews were conducted with 10 GP practices that had achieved a significant improvement on their rating, through measures such as strong leadership from a practice manager, addressing staffing and training issues, and involving patients and local community. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 15, 2018 Category: Consumer Health News Source Type: news

Horizontal or vertical: which way to integrate? Approaches to community services integration and consequences for emergency hospital activity
This report explores the impact this choice had on the level and growth in emergency hospital use in older people and considers the wider implications for the NHS as it develops new models of care and integrated care systems (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 14, 2018 Category: Consumer Health News Source Type: news

That age old question
This report reveals that ageist views are held across the generations, and that an ageing society is viewed by many as a challenge rather than an opportunity. It makes a number of recommendations aimed at addressing some of the key drivers and negative consequences of societal ageism, including a suggestion that health care professionals should be trained on the effects of ageism in clinical and care settings (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 14, 2018 Category: Consumer Health News Source Type: news

IPC and personal health budget support and development programme: learning and next steps
This report describes the role that the voluntary, community and social enterprise sector has to play in delivering personalised care, and shows what needs to happen at a local level to realise this potential. It sets out how personal health budgets are enabling people to make new choices and share responsibility for their own health and wellbeing, while helping them to be active citizens, included in the lives of their communities (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 14, 2018 Category: Consumer Health News Source Type: news

Primary care home: community pharmacy integration and innovation
A new guide has been published to inspire further integration of community pharmacy within primary care homes to improve patients'health and support them to manage their conditions. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 14, 2018 Category: Consumer Health News Source Type: news

System under strain: why demand pressures are more than a winter phenomenon
This report shows that increases in demand are not restricted to particular parts of the health and social care services or specific times of the year. It describes ways in which increasing demand in one part of the system can affect the performance of other NHS services elsewhere. It outlines how some NHS and social care providers have adapted their services to enable patients and service users to access care (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 14, 2018 Category: Consumer Health News Source Type: news

Supporting military veterans in residential care
This guide aims to help care home managers, care home staff and local authority commissioners to understand how to support veterans living in residential care, taking into account their military service and backgrounds, and addressing their specific needs and preferences in a more personalised way (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 14, 2018 Category: Consumer Health News Source Type: news

Fewer side-effects and similar benefits from shorter chemotherapy after bowel cancer surgery
This expert commentary is provided for an RCT which found a similar three year progression free survival for 3 months and 6 months of chemotherapy. Most guidelines recommend six months treatment, this study gives the potential to improve acceptability and uptake of treatment (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 14, 2018 Category: Consumer Health News Source Type: news

Single routine offer of a blood test for prostate cancer did not save lives
Expert commentary is provided for a study which found no difference in rates of prostate cancer death for screening vs no screening. Screening may increase diagnoses but does not reduce deaths. Trials like this one challenge “advances” that appear common sense but may do harm. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 14, 2018 Category: Consumer Health News Source Type: news

Guide to reducing long hospital stays
This guide offers practical steps and tactics to support the NHS and partners to use an optimal approach to managing hospital length of stay. It is primarily aimed at acute and community trusts, but also makes reference to how system partners can play a supporting role (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 13, 2018 Category: Consumer Health News Source Type: news

Understanding the dynamics of sustainable change: A 20-year case study of integrated health and social care
The objective of this study was to gain insight into the dynamics of sustainable changes in integrated health and social care through an analysis of local actions that were triggered by a national policy (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 13, 2018 Category: Consumer Health News Source Type: news

Understanding change management: a clinical improvement programme to transform your practice.
Improving the patient experience often involves changing aspects of service delivery. Hollister Education organised a symposium designed to help clinical nurse specialists in urology implement vitally needed change. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 13, 2018 Category: Consumer Health News Source Type: news

Leading Change, Adding Value: can it do what it says on the tin?
The author comments on " Leading Change, Adding Value " (LCAV), a national framework for nursing, midwifery, and care staff in England released by the National Health Services (NHS). She discusses how these standards allow for nursing, midwifery, and care staff to become leaders in the medical services field. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 13, 2018 Category: Consumer Health News Source Type: news

Gross negligence manslaughter in healthcare
This independent rapid policy review, chaired by Professor Sir Norman Williams, was set up to look at the wider patient safety impact of concerns among health care professionals that simple errors could result in prosecution for gross negligence manslaughter, even if they happen in the context of broader organisation and system failings. The review makes recommendations to support a more just and learning culture in the health care system. It covers: the process for investigating gross negligence manslaughter; reflective practice of health care professionals; and the regulation of health care professionals (Source: Current...
Source: Current Awareness Service for Health (CASH) - June 13, 2018 Category: Consumer Health News Source Type: news

The Sepsis Manual: Responsible sanagement of sepsis severe infection and antimicrobial stewardship 4th ed. 2017-18
This manual concludes that whilst we have improved our recording of the number of cases of sepsis and understand better its impact on the NHS and society, we still have to estimate figures based on the best available data. Conservative estimates would suggest that we see at least 250,000 cases of sepsis in the UK each year, with at least 46,000 deaths and a direct cost to the NHS of at least £ 1.5 billion. The authors state that sepsis costs our society as much as £ 15.6 billion every year. It is highly likely that these numbers are significant under-estimates, since a proportion of the more than 1.5 million pa...
Source: Current Awareness Service for Health (CASH) - June 13, 2018 Category: Consumer Health News Source Type: news

The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)
These updated definitions and clinical criteria should replace previous definitions, offer greater consistency for epidemiologic studies and clinical trials, and facilitate earlier recognition and more timely management of patients with sepsis or at risk of developing sepsis. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 13, 2018 Category: Consumer Health News Source Type: news

Sepsis 2018: Definitions and Guideline Changes
This review discusses new definitions for sepsis and septic shock. TheThird International Consensus Definitions for Sepsis and Septic Shock [Sepsis-3] have been developed. A new screening tool for sepsis (quick Sequential Organ Failure Assessment [qSOFA]) has been proposed to predict the likelihood of poor outcome in out-of-intensive care unit (ICU) patients with clinical suspicion of sepsis. The Surviving Sepsis Campaign Guidelines were recently updated and include greater evidence-based recommendations for treatment of sepsis in attempts to reduce sepsis-associated mortality. The review discusses the new Sepsis-3 definit...
Source: Current Awareness Service for Health (CASH) - June 13, 2018 Category: Consumer Health News Source Type: news

NICE Bites; Respiratory Tract Infections (acute) antimicrobial prescribing
This monthly prescribing bulletin summarises key recommendations from NICE guidance. The latest topics are acute sore throat and otitis media. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 13, 2018 Category: Consumer Health News Source Type: news

A recipe for action: using wider evidence for a healthier UK
Collection of essays illustrate how different disciplines and professional practices conceptualise evidence and how they reason about moving from evidence to taking action, with problem of childhood obesity used as a shared focal point. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 12, 2018 Category: Consumer Health News Source Type: news

Making money work in the health and care system
This report explores how financial flows could be redesigned to make money work better in the health and care system. It sets out why change is necessary and proposes a number of radical reforms so that benefits to patients are maximised and resources put to their best use. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 12, 2018 Category: Consumer Health News Source Type: news

Investigation into NHS spending on generic medicines in primary care
This report sets out the possible causes of the price increases and responses to maintain supply and manage spend. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 12, 2018 Category: Consumer Health News Source Type: news

Reducing emergency admissions
This report finds that 24% of the 5.8 million emergency admissions in England during 2016-17 (nearly 1.5 million) could have been avoided if hospitals, GPs, community services and social care had worked together more effectively. A number of recommendations are made. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 12, 2018 Category: Consumer Health News Source Type: news

From prison to work: a new frontier for individual placement and support
This report discusses a pilot programme in the West Midlands to support prisoners with mental health difficulties into employment when they are released. It calls on the government to invest in a larger scale trial for former prisoners and to reform existing employment services in the criminal justice system. It also found that few of the people who had been in contact with prison mental health services as a result of complex needs and vulnerabilities were supported by community mental health services after their release. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 11, 2018 Category: Consumer Health News Source Type: news

Mental health, human rights and standards of care
This report assesses the quality of institutional care for adults with psychosocial and intellectual disabilities in the WHO European region. Out of all the quality ratings made, only 25 per cent showed compliance with international standards, suggesting that long-term institutional care in the region has room for improvement. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 11, 2018 Category: Consumer Health News Source Type: news

Facing the Future - standards for children and young people in emergency care settings
These seventy standards aim to ensure that urgent and emergency care is fully integrated to ensure children are seen by the right people, at the right place and in the right setting. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 11, 2018 Category: Consumer Health News Source Type: news

Making the money work in the health and care system
This document explores how financial flows could be redesigned to find a better way to make money work in the health and care system. It sets out why change is necessary and proposes a number of radical financial reforms so that benefits to patients are maximised and resources are put to their most effective use. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 11, 2018 Category: Consumer Health News Source Type: news

Adding value, reducing research waste, the role of the NHS research and development management community.
A project undertaken between May 2016 and May 2017 explored the perspective, and contribution, towards reducing research waste amongst the research and development management community. The study identified those categories of research waste the community felt were the most important and of the most value to address. It also examined spheres of influence and barriers to addressing research waste. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 11, 2018 Category: Consumer Health News Source Type: news

Innovative models of general practice
This report looks at innovative models of general practice from the UK and other countries and identifies key design features that will be important in designing effective GP services in the future. It makes recommendations for general practice, system leaders and commissioners, and national policymakers (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 11, 2018 Category: Consumer Health News Source Type: news

Breaking down barriers to better health and care
This guide summarises how NHS organisations and local councils in England are moving from fragmented services to local partnerships and integrated care systems in order to meet the health needs of the population. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 11, 2018 Category: Consumer Health News Source Type: news

Patient experience improvement framework
This framework is aimed at supporting healthcare providers with an increased focus on empowering patients to fully participate in decisions about their care and treatment. It enables trusts to carry out an organisational diagnostic to establish how far patient experience is embedded in its leadership, culture and its operational processes (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 11, 2018 Category: Consumer Health News Source Type: news

Inhaled anti-pseudomonal antibiotics for long-term therapy in cystic fibrosis
This review of 18 RCTs (n=3,042) found that inhaled anti-pseudomonal antibiotic treatment probably improves lung function and reduces exacerbation rate, but pooled estimates of the level of benefit were very limited. The best evidence is for inhaled tobramycin (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 8, 2018 Category: Consumer Health News Source Type: news

Bezlotoxumab for prevention of recurrence of Clostridium difficile infection
This evidence review states that Bezlotoxumab is a monoclonal antibody that neutralises C. difficile toxin B, licensed for prevention of infection recurrence in those at high risk. The authors conclude that due to limitations of the evidence and the high cost of treatment, it is difficult to see a place in therapy for this agent. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 8, 2018 Category: Consumer Health News Source Type: news

Long-Term Effects of Omitting Antibiotics in Uncomplicated Acute Diverticulitis
This research article finds that in patients with a first episode of uncomplicated acute diverticulitis (n=528), omitting antibiotics was not associated with a higher incidence of complicated diverticulitis, recurrent diverticulitis or sigmoid resection compared with antibiotic treatment, at 24 months'follow up (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 8, 2018 Category: Consumer Health News Source Type: news

Immune recognition of somatic mutations leading to complete durable regression in metastatic breast cancer
This research article is the science behind the headline " Remarkable therapy beats terminal cancer " . The research presents a patient with chemorefractory hormone receptor (HR)-positive metastatic breast cancer who was treated with tumor-infiltrating lymphocytes (TILs) reactive against mutant versions of four proteins —SLC3A2, KIAA0368, CADPS2 and CTSB. Adoptive transfer of these mutant-protein-specific TILs in conjunction with interleukin (IL)-2 and checkpoint blockade mediated the complete durable regression of metastatic breast cancer, which is now ongoing for>22 months. The authors state it represe...
Source: Current Awareness Service for Health (CASH) - June 8, 2018 Category: Consumer Health News Source Type: news

Mycoplasma pneumoniae
This guidance, covering the characteristics and epidemiology of Mycoplasma pneumonia, was updated in May 2018, when a summary of data was added. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 8, 2018 Category: Consumer Health News Source Type: news

Prescribing anti-inflammatories for urine infection reduces antibiotic use but increases complication risk
This study confirmed earlier findings that NSAIDs provide reasonable symptom control, but poorer control than with initial antibiotics (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 8, 2018 Category: Consumer Health News Source Type: news

Sexually transmitted infections and screening for chlamydia in England, 2017
This report details a spike in cases of syphilis and gonorrhoea in 2017 in England. There was a 20% rise in syphilis cases, and a 22% rise in gonorrhoea cases. The overall rates of sexually transmitted infections remained stable in 2016-17. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 8, 2018 Category: Consumer Health News Source Type: news

Adjuvant Chemotherapy Guided by a 21-Gene Expression Assay in Breast Cancer
This research article is the science behind the headlines " Breast cancer: Test means fewer women will need chemotherapy " . The research concludes that the recurrence score based on the 21-gene breast cancer assay predicts chemotherapy benefit if it is high and a low risk of recurrence in the absence of chemotherapy if it is low; however, there is uncertainty about the benefit of chemotherapy for most patients, who have a midrange score. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 8, 2018 Category: Consumer Health News Source Type: news

The Improving Access to Psychological Therapies Manual
This manual is for all commissioners, providers and clinicians of services that deliver psychological therapies. It serves as an essential manual for IAPT services, describing the IAPT model in detail and how to deliver it, with a focus on the importance of providing NICE recommended care. The manual is accompanied by a resource pack containing examples of positive practice and helpful resources to support IAPT service expansion, development and delivery. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 5, 2018 Category: Consumer Health News Source Type: news

Time to deliver: report of the WHO Independent High-Level Commission on Noncommunicable Diseases
This report calls for urgent action to address chronic diseases and mental health disorders. It demands high-level political commitment and the immediate scaling up of actions to address the epidemic of NCDs (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 5, 2018 Category: Consumer Health News Source Type: news

Commission Inquiry on Health and Wellbeing Innovation
This commission seeks to review the current evidence base around innovation in health and wellbeing, generate new research and thought leadership, critically explore the opportunities and barriers to innovation and set out a blueprint for future work in this area. The commission aims to explore where innovation is happening in housing, communities and health and wellbeing and will highlight where there needs to be a renewed focus for all people to age well in the future (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 5, 2018 Category: Consumer Health News Source Type: news

Sugar reduction and wider reformulation programme: report on progress towards the first 5% reduction and next steps
This report includes a detailed assessment of progress by the food industry towards the 5 per cent reduction in the first year of the sugar reduction programme. It contains topline results showing progress in reducing sugar and calories in relevant product categories and the drinks covered by the Soft Drinks Industry Levy. It also includes a detailed assessment of progress for retailers and manufacturers. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 5, 2018 Category: Consumer Health News Source Type: news

Elective care: demand and capacity models
NHS England has published a suite of demand and capacity models to help estimate the capacity needed to run elective care services. The tools are generic and can be applied to all elective, non-overnight services. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 5, 2018 Category: Consumer Health News Source Type: news

False economy: an analysis of NHS funding pressures.
This report looks at some of the ways in which NHS trusts and commissioners improved their financial position in 2016/17. It also considers how the introduction of the sustainability and transformation fund directed funding to NHS trusts; the results of focusing funding on front-line services at NHS trusts; and the national priority for mental health services through the mental health investment standard. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 5, 2018 Category: Consumer Health News Source Type: news

A rapid evidence assessment of what works in homelessness services (2018)
Crisis commissioned the Social Care Institute for Excellence to produce a rapid evidence assessment to understand what services work to address and end homelessness, and to assess the quality of evidence that exists in published studies. A rapid evidence assessment of what works in homelessness services shows that there is potentially a wealth of evidence about what works in such services, but the evidence base is as varied in terms of quality as it is vast in scope (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - June 5, 2018 Category: Consumer Health News Source Type: news