Evaluation of Introduction of Nursing Associates: Phase 1 report for Health Education England
An independent evaluation of the first cohort of trainee nursing associate (TNA) pilot sites, commissioned by Health Education England. The report is primarily focused on evaluating the training and development of TNAs. It provides insights into challenges and benefits of the new role, emerging impacts of the TNA training, and reflections on the approaches to academic and work-based learning settings. It also provides recommendations about how to support TNAs while in training. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - August 14, 2018 Category: Consumer Health News Source Type: news

Key questions for the future of STPs and ICSs.
This is the second in a series of briefings on sustainability and transformation partnerships (STPs). It summarises recent developments relevant to system working, sets out the state of play for STPs and integrated care systems (ICSs) and seeks to offer answers to a number of questions arising from the national policy focus on collaboration and integration. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - August 14, 2018 Category: Consumer Health News Source Type: news

Barriers to implementing the Sepsis Six guidelines in an acute hospital setting
This journal article concludes that knowledge deficits, lack of resources and practical issues were barriers identified. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - August 9, 2018 Category: Consumer Health News Source Type: news

Hospital sepsis deaths'jump by a third '
This news report states that sepsis deaths recorded in England's hospitals have risen by more than a third in two years, according to data collected by a leading safety expert. In the year ending April 2017, there were 15,722 deaths in hospital or within 30 days of discharge, where sepsis was the leading cause. Prof Sir Brian Jarman believes staff shortages and overcrowding on wards are partly to blame. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - August 9, 2018 Category: Consumer Health News Source Type: news

Trends in outpatient antibiotic use and prescribing practice among US older adults, 2011-15: observational study
This journal article concludes that among US Medicare beneficiaries, overall antibiotic use and potentially inappropriate use in 2011-15 remained steady or fell modestly, but individual drugs had divergent changes in use. Trends in drug use across indications were stronger than trends in use for individual indications, suggesting that guidelines and concerns about antibiotic resistance were not major drivers of change in antibiotic use. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - August 9, 2018 Category: Consumer Health News Source Type: news

Consultation on contracting arrangements for Integrated Care Providers (ICPs)
This consultation provides detail about how the proposed ICP Contract would underpin integration between services, how it differs from existing NHS contracts, and how ICPs fit into the broader commissioning system. Consultation closes 26 October 2018. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - August 8, 2018 Category: Consumer Health News Source Type: news

Hepatitis C: guidance, data and analysis
This Guidance Collection covering the characteristics, diagnosis, management and epidemiology of hepatitis C was updated in August 2018, with the addition of reports to the epidemiology section. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - August 8, 2018 Category: Consumer Health News Source Type: news

Hepatitis A: guidance, data and analysis
This Guidance Collection covering the symptoms, diagnosis, management and epidemiology of hepatitis A was updated in August 2018, with the addition of reports to the epidemiology section. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - August 8, 2018 Category: Consumer Health News Source Type: news

Supporting primary care services: NHS England's contract with Capita inquiry
This report finds that NHS England's outsourcing of primary care support services to Capita was a'shambles', with resultant service failures that were disruptive to thousands of primary care practitioners, putting patients at risk of harm. A number of recommendations are made. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - August 7, 2018 Category: Consumer Health News Source Type: news

Health inequalities: reducing ethnic inequalities
This report provides guidance to support local and national action on ethnic inequalities in health. It summarises the data and provides examples of practical approaches to address ethnic inequalities in health. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - August 7, 2018 Category: Consumer Health News Source Type: news

How to produce a Sustainable Development Management Plan
This document aims to help sustainability and social value leads in health care organisations, commissioners and providers, to compile their Sustainable Development Management Plans (SDMP) for their organisation. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - August 6, 2018 Category: Consumer Health News Source Type: news

Mental health support: an overview of our future work
This briefing sets out a plan of action on mental health and how the Healthwatch network and stakeholders can get involved. It outlines a multi-year programme to find out what support people want with their mental health. It also sets out how this insight will be shared to influence policy, commissioning and practice at a national and local level. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - August 6, 2018 Category: Consumer Health News Source Type: news

The lives we want to lead
This green paper from the Local Government Association sets out how the adult social care system could be improved and the radical measures that it believes need to be considered given the scale of the funding crisis. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - August 2, 2018 Category: Consumer Health News Source Type: news

Assessing the Causal Role of Body Mass Index on Cardiovascular Health in Young Adults
Study found that both Mendelian randomization (n=1420 –3108 for different outcomes) and Recall-by-Genotype (n=386–418) methodologies suggest higher BMI causes worse cardiovascular health, specifically high blood pressure and left ventricular mass index, even in youth (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - August 2, 2018 Category: Consumer Health News Source Type: news

Clinical relevance of bacterial resistance in lower respiratory tract infection in primary care: secondary analysis of a multicentre European trial
This research article found no statistically significant difference in duration of symptoms, mean symptom severity and worsening of illness between antibiotic resistant and antibiotic sensitive infections (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - August 2, 2018 Category: Consumer Health News Source Type: news

Can antibiotic resistance be reduced by vaccinating against respiratory disease?
This journal article details that vaccines can reduce acquisition and transmission of resistant disease and also decrease antibiotic use. To predict the impact of vaccines on resistance, authors propose evaluating resistance endpoints for existing and new vaccines (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - August 2, 2018 Category: Consumer Health News Source Type: news

Implementation of a whole of hospital sepsis clinical pathway in a cancer hospital: impact on sepsis management, outcomes and costs
This journals article looks at the development and implementation of a hospital clinical pathway for the management of sepsis (SP) in a specialised cancer hospital and measures the impact on patient outcomes and healthcare utilisation. It concludes that the SP was associated with significant improvement in patient outcomes and reduced costs. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - August 1, 2018 Category: Consumer Health News Source Type: news

Ultrasound shows potential for confirming the diagnosis of pneumonia in children
This NIHR Signal concludes that lung ultrasound may be a viable and accurate alternative to chest X-ray for confirming a clinical diagnosis of community-acquired pneumonia in children. The authors states that if ultrasound could replace at least some of the X-ray investigations in emergency departments, it would spare children a dose of radiation. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - August 1, 2018 Category: Consumer Health News Source Type: news

Antimicrobial Resistance and Immunisation
This report describes the role for immunisation in tackling AMR, both globally and in the UK, the use of existing vaccines and how vaccine development aligns with public health priorities.   (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - August 1, 2018 Category: Consumer Health News Source Type: news

Listeria: guidance, data and analysis
This Guidance Collection covers the symptoms, diagnosis, management and epidemiology of listeriosis, the infection caused by listeria bacteria. It was updated in July 2018 with the edition of'Listeria contamination of frozen vegetables: professional guidance'. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - August 1, 2018 Category: Consumer Health News Source Type: news

Antibiotic Discretion in the Treatment of Acute Uncomplicated Diverticulitis
This journal article highlights discretionary rather than routine use of antibiotics is reasonable given absence of immunosuppression and sepsis in patient, and treatment with NSAIDs and oral hydration would have been reasonable and may have avoided inpatient admission and C diff infection. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - August 1, 2018 Category: Consumer Health News Source Type: news

National Cancer Patient Experience Survey 2017
This National Results Summary indicates that overall ratings continue to improve, with year on year increases in reported positive experience. Patients also reported more positively on areas including involvement in decisions about care and treatment, and being treated with dignity and respect. The survey also points to areas for further improvement including follow up community and social care after treatment. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - August 1, 2018 Category: Consumer Health News Source Type: news

Living With and Beyond Cancer Baseline Activity (Jan-Mar 2017)
This report sets out baseline activity data from January to March 2017 for Stratified Follow Up and Recovery Package interventions. This is the first time national data of this type has been reported. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - August 1, 2018 Category: Consumer Health News Source Type: news

Complementary Medicine, Refusal of Conventional Cancer Therapy, and Survival Among Patients With Curable Cancers
This research article found patients who received CM were more likely to refuse additional conventional cancer treatment (surgery/chemo or radio or hormone therapy) and had higher risk of death. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - August 1, 2018 Category: Consumer Health News Source Type: news

IDPS: Checks and audits to improve quality and reduce risks
This Guidance covers the NHS Infectious Diseases in Pregnancy Screening (IDPS) Programme processes for ensuring a seamless and safe screening pathway. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - August 1, 2018 Category: Consumer Health News Source Type: news

Making the case for preconception care: planning and preparation for pregnancy to improve maternal and child health outcomes
These resources aim to help health professionals in planning and preparation for pregnancy care, to improve outcomes for mothers and babies. It covers the impact of preconception health, ways to improve birth outcomes, and ways to reduce inequalities through embedding preconception care (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - July 31, 2018 Category: Consumer Health News Source Type: news

The toolkit for a sustainable health workforce in the WHO European Region (2018).
The toolkit is aimed at policy-makers, human resources for health (HRH) planners and professionals, and other stakeholders, such as education institutions and those implementing policy. It is framed around four strategic domains mirroring the themes of the global strategy – education and performance, planning and investment, capacity-building, and analysis and monitoring – and proposes policy options and implementation modalities (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - July 31, 2018 Category: Consumer Health News Source Type: news

Promising practices for health and wellbeing at work
This research, commissioned by Public Health England, examines the landscape of workplace wellbeing interventions and the extent and quality of evidence being collected. It is intended to support organisations in developing their workplace wellbeing offer and aid understanding of whether interventions are having a positive health outcome and how to capture and gauge the evidence. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - July 31, 2018 Category: Consumer Health News Source Type: news

Hospital vending machines: helping people make healthier choices
Obesity-related illness costs the NHS around £ 6.1 billion per year and vending machines in hospitals can support healthy consumption habits among NHS staff, patients and visitors. This trial at Leeds Teaching Hospitals NHS Trust used 17 cold drink and mixed-snack vending machines to test whether changing the availability or positioning of products within the vending machines could encourage healthier choices and whether this approach was economically viable. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - July 31, 2018 Category: Consumer Health News Source Type: news

The Montefiore Health System in New York: a case study
The report describes how the Montefiore Health System in the Bronx, New York, has found ways of helping even the most deprived by stepping beyond the bounds of conventional health services. This commissioned report builds on the 2 External 0 0 0overview of the Montefiore Health System false https://www.kingsfund.org.uk/publications/montefiore-health-system-summary true false%> published by the King's Fund in April 2018 and explores building primary and community care, managing patients with complex needs, supporting infrastructure, and elements of a high-performing system. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - July 31, 2018 Category: Consumer Health News Source Type: news

Joint statement on emerging concerns protocol
Eight health and social care regulators and other bodies have signed the new agreement to help them share concerns with each other more effectively. The Emerging Concerns Protocol seeks to provide a clearly defined mechanism to share information and intelligence that may indicate risks to users of services, their carers, families or professionals. Sharing concerns at the right time can make it easier to notice that a problem is emerging. Working together more effectively can reduce duplication and encourage organisations to come up with joint plans when they share similar concerns. The protocol will help ensure regulators ...
Source: Current Awareness Service for Health (CASH) - July 31, 2018 Category: Consumer Health News Source Type: news

Delivering integrated care: the role of the multidisciplinary team
This report gives a snapshot of the practice of multi-disciplinary teams in delivering integrated care. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - July 31, 2018 Category: Consumer Health News Source Type: news

Government Response to the Consultation on Transforming Children and Young People's Mental Health Provision: a Green Paper and Next Steps
The government has published its response to a public consultation on the green paper on children and young people's mental health. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - July 27, 2018 Category: Consumer Health News Source Type: news

NHS England annual report: 2017/8
This report describes how the funding allocation of £ 110 billion was spent to commission healthcare services in 2017/18. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - July 26, 2018 Category: Consumer Health News Source Type: news

Multifactorial and multiple component interventions for preventing falls in older people living in the community
Analysis of 62 trials (~ 20,000 participants) concluded that multiple component interventions probably reduce the rate at which people fall and may reduce the number of people with recurrent falls. Not enough evidence to determine effects on fractures or hospital admission. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - July 26, 2018 Category: Consumer Health News Source Type: news

Each baby counts: Themed report on anaesthetic care, including lessons identified from Each Baby Counts babies born 2015 to 2017
A report from RCOG describing detailed findings of reviews into the care of mothers of 49 babies who either died or were born with brain damage, and where it was felt there were critical anaesthetic contributory factors. The report makes 12 recommendations for practice. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - July 26, 2018 Category: Consumer Health News Source Type: news

Organ Donation and Transplantation data for Black, Asian and Minority Ethnic (BAME) communities Report for 2017/2018 (1 April 2013 31 March 2018)
The new campaign aims to increase organ donation rates within black, Asian and minority ethnic (BAME) communities by raising awareness and breaking down barriers to donation. It will be delivered by NHS Blood and Transplant with support from the National BAME Transplant Alliance (NBTA). (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - July 24, 2018 Category: Consumer Health News Source Type: news

Hospital vending machines
This report presents findings from research into how changes to vending machine product availability and positioning across Leeds Teaching Hospital altered purchasing choices. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - July 24, 2018 Category: Consumer Health News Source Type: news

Palliative care as an essential component of the HIV care continuum
This review summarises the epidemiology of HIV in relation to mortality, and the symptoms and concerns of people with AIDS and those living with HIV who have either related or unrelated advanced comorbidities. The principles and practice of palliative care are described, and the evidence for its effectiveness and cost-effectiveness is appraised. The review concludes with evidence-based recommendations to improve the delivery of, and access to, high-quality HIV care until the end of life, reducing unnecessary suffering while optimising person-centred outcomes. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - July 20, 2018 Category: Consumer Health News Source Type: news

Leadership in today's NHS: delivering the impossible
This report, jointly published with NHS Providers, asks what can be done to support current leaders and encourage future ones (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - July 20, 2018 Category: Consumer Health News Source Type: news

Survival of Patients With Multiple Intracranial Metastases Treated With Stereotactic Radiosurgery: Does the Number of Tumors Matter?
This research article has led to a practice changing update on DynaMed Plus. It concludes that although the number of brain metastases has previously been accepted as an independent prognostic indicator, our multicenter analysis demonstrates that the number of intracranial metastases is highly correlated with overall disease burden and clinical status. Proper matching and controlling for these other determinants of survival demonstrates that the number of intracranial metastases alone is not an independent predictive factor, but rather a surrogate for other clinical factors. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - July 20, 2018 Category: Consumer Health News Source Type: news

Head-to-head comparison of qSOFA and SIRS criteria in predicting the mortality of infected patients in the emergency department: a meta-analysis
This meta-analysis was undertaken in order to determine the diagnostic accuracy of the qSOFA criteria in predicting mortality in ED patients with infections and compared the performance with that of the SIRS criteria. A qSOFA score  ≥ 2 and SIRS score ≥ 2 are strongly associated with mortality in ED patients with infections. However, the authors say it is also clear that qSOFA and SIRS have limitations as risk stratification tools for ED patients with infections. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - July 19, 2018 Category: Consumer Health News Source Type: news

Pediatric Sepsis: A Primer for the Pediatrician
This journal article outlines how sepsis is the body's systemic response to infection and is a serious health care concern that affects neonatal, pediatric, and adult populations worldwide. Severe sepsis and septic shock are still associated with high mortality rates despite improvements in the management of infectious processes. The cellular processes that occur as a result of the inflammatory response in sepsis, including impaired perfusion and microcirculatory coagulation, can lead to organ system dysfunction. Early recognition of sepsis can help prompt treatment to improve patient care. Current pediatric guidelines emp...
Source: Current Awareness Service for Health (CASH) - July 19, 2018 Category: Consumer Health News Source Type: news

Meningococcal Working Group report
This is a report on raising awareness of the signs and symptoms, and ensuring early diagnosis and treatment, of sepsis and meningococcal disease. It sets out 12 recommendations aimed at organisations and bodies that have a role to play in improving awareness and early diagnosis of sepsis and meningococcal disease. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - July 19, 2018 Category: Consumer Health News Source Type: news

Repeated vital sign measurements in the emergency department predict patient deterioration within 72 hours: a prospective observational study
This research article found that more than one in five patients presenting to the emergency department (ED) with (suspected) infection or sepsis deteriorate within 72 h from admission. The authors state that surprisingly little is known about vital signs in relation to deterioration, especially in the ED. The aim of the study was to determine whether repeated vital sign measurements in the ED can differentiate between patients who will deteriorate within 72 h and patients who will not deteriorate. They found that repeated vital sign measurements in the ED are better at identifying patients at risk for deterioration within ...
Source: Current Awareness Service for Health (CASH) - July 19, 2018 Category: Consumer Health News Source Type: news

Corticosteroids in Sepsis: An Updated Systematic Review and Meta-Analysis
Conclusions: In critically ill patients with sepsis, corticosteroids possibly result in a small reduction in mortality while also possibly increasing the risk of neuromuscular weakness. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - July 19, 2018 Category: Consumer Health News Source Type: news

Arguing for Adaptive Clinical Trials in Sepsis
Sepsis is life-threatening organ dysfunction due to dysregulated response to infection. Patients with sepsis exhibit wide heterogeneity stemming from genetic, molecular, and clinical factors as well as differences in pathogens, creating challenges for the development of effective treatments. In this review, we discuss challenges in the evaluation of treatments for sepsis, and explore potential benefits and weaknesses of recent advances in adaptive trial methodologies to address these challenges. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - July 19, 2018 Category: Consumer Health News Source Type: news

Gut-origin sepsis in the critically ill patient: pathophysiology and treatment
This Literature Review concludes that gut permeability is increased in critically ill patients, and is associated with the development of the systemic inflammatory response syndrome and multiple organ dysfunction syndrome (MODS). The pathogenetic link(s) and potential therapies are an area of intense research over the last decades. There is an emerging need for application of sensitive non-invasive and easily measured biomarkers of early intestinal injury (e.g., citrulline, intestinal fatty acid protein, and zonulin) in our everyday clinical practice, guiding the early pharmacological intervention in critically ill patient...
Source: Current Awareness Service for Health (CASH) - July 19, 2018 Category: Consumer Health News Source Type: news

Time-related association between fluid balance and mortality in sepsis patients: interaction between fluid balance and haemodynamics
In conclusion, the positive FB during the second but not the first 24 hours was associated with increased mortality in sepsis. Achieving more negative FB was associated with decreased mortality only in the second 24 hours. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - July 19, 2018 Category: Consumer Health News Source Type: news

CE: A Review of the Revised Sepsis Care Bundles
Sepsis is an extreme response to infection that can cause tissue damage, organ failure, and death if not treated promptly and appropriately. Each year in the United States, sepsis affects more than 1.5 million people and kills roughly 250,000. Prompt recognition and treatment of sepsis are essential to saving lives, and nurses play a critical role in the early detection of sepsis, as they are often first to recognize the signs and symptoms of infection. Here, the authors review recent revisions to the sepsis care bundles and discuss screening and assessment tools nurses can use to identify sepsis in the ICU, in the ED, on ...
Source: Current Awareness Service for Health (CASH) - July 19, 2018 Category: Consumer Health News Source Type: news