NHS Library and Information Service North Staffordshire

Clinical Effectiveness Bulletin

for PCTs in North Staffordshire
Issue No: 43 – August 2010

About this Bulletin:

 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.

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

Contact information

Contents in this issue

Cancer Bulletin produced by NHS Outreach Librarians
Commissioning Tel: 07834 115958 [please leave a message]
End of Life E-mail: jayne.hickton@northstaffs.nhs.uk
General Practice
Guidance
Service Management
Workforce North Staffs Health Library
Tel: 01782 556565
Fax: 01782 556582
E-mail: health.library@keele.ac.uk

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Sources for Clinical Effectiveness Bulletin

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

Websites
Bandolier http://www.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

Cancer
Manual for Cancer Services 2008: Psychological Support Measures
Department of Health
Following a three month consultation, the final Psychological Support Measures are published for
inclusion in the Manual for Cancer Services. The draft measures can also be found on the
CQUINS website.
http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/D
H_118818

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Commissioning
Procurement guide for commissioners of NHS-funded services
Department of Health
The guide sets out expectations of commissioners on the use of procurement to improve services
for patients, including, investment in new service models or significant additional capacity, upon
expiry of existing contracts; or where services fail to improve through contract management.
http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/D
H_118218

PCT World Class Commissioning assurance results

NHS Confederation
The Department of Health has not published the World Class Commissioning (WCC) assurance
results this year. As a result the PCT Network at the NHS Confederation has analysed results
across the country. They have produced a report which analyses aggregate PCT scores on
governance and the WCC competencies and have also issued a press release to publicise this
report. They are still missing reports from five PCTs which have not yet published their results,
but will update the report when these are available. The analysis shows significant improvement
since year one of the WCC assurance process, and reflects well on the progress that boards and
staff in PCTs across the county have made over the past 18 months.
http://www.nhsconfed.org/Documents/PCT%20World%20Class%20Commissioning%20assuranc
e%20results%202009.pdf

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End of Life
End of Life Care Strategy: Second Annual Report
Department of Health
In July 2008 the Department of Health published the End of Life Care Strategy - promoting high
quality care for all adults at the end of life. This second annual report sets out the continuing
progress in implementing the strategy, highlights the need for further work and identifies the
action intended for this coming year.
http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/D
H_118810

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General Practice
Quality of general practice: health promotion and acute illness
King’s Fund
As part of an inquiry into the quality of care and services provided by GPs and other health
professionals working in general practice in England, the King's Fund has published two
discussion papers:
- A pro-active approach
Health promotion and ill-health prevention This report examines the appropriate contribution of
general practice to health promotion and ill-health prevention and assesses what good-quality of
care in this area might look like and how it might be measured.
http://www.kingsfund.org.uk/current_projects/gp_inquiry/dimensions_of_care/health_promotion.ht
ml
- Managing acute illness
This report provides a framework for assessing the quality of the different types of acute care in
general practice.
http://www.kingsfund.org.uk/current_projects/gp_inquiry/dimensions_of_care/the_management_o
f.html

The principles of GP commissioning: a GPC statement in the context of ‘Liberating the

NHS’
BMA
This GPC statement identifies a set of fundamental principles with regard to GP commissioning
which will define policy, inform debate and negotiations, and ensure that good medical practice is
enshrined within these enhanced responsibilities. The BMA believes that the Government should
recognise these principles as it further develops its policies relating to GP commissioning.
http://www.bma.org.uk/images/whitepapergpcguidence1aug2010_tcm41-199488.pdf

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Guidance
NICE Clinical Guidelines

Ablative therapy for the treatment of Barrett's oesophagus

Clinical guideline: (CG106)
http://guidance.nice.org.uk/CG106

The management of hypertensive disorders during pregnancy

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Clinical guideline: (CG107)

http://guidance.nice.org.uk/CG107

Chronic heart failure: management of chronic heart failure in adults in primary and
secondary care
Clinical guideline: (CG108)
http://guidance.nice.org.uk/CG108

Management of transient loss of consciousness in adults

Clinical guideline: (CG109)
http://guidance.nice.org.uk/CG109

NICE Technology Appraisals

Adalimumab, etanercept, infliximab, rituximab and abatacept for the treatment of

rheumatoid arthritis after the failure of a TNF inhibitor
Technology appraisal: (TA195)
http://guidance.nice.org.uk/TA195

Imatinib for the adjuvant treatment of gastrointestinal stromal tumours

Technology appraisal: (TA196)
http://guidance.nice.org.uk/TA196

Dronedarone for the treatment of non-permanent atrial fibrillation

Technology appraisal: (TA197)
http://guidance.nice.org.uk/TA197

Tocilizumab for rheumatoid arthritis

Technology appraisal: (TA198)
http://guidance.nice.org.uk/TA198

Etanercept, infliximab and adalimumab for the treatment of psoriatic arthritis

Technology appraisal: (TA199)
http://guidance.nice.org.uk/TA199

NICE Consultation Documents

Food allergy in children and young people: draft guideline consultation

Closing date for comments 6 September 2010
http://www.nice.org.uk/guidance/index.jsp?action=folder&o=50201

Headaches: scope consultation

Closing date for comments 9 September 2010
http://www.nice.org.uk/guidance/index.jsp?action=folder&o=50281

Multiple myeloma (first line) - bortezomib and thalidomide: final appraisal determination
Closing date for comments 10 September 2010
http://www.nice.org.uk/guidance/index.jsp?action=folder&o=50426

Public consultation on Evaluation Pathway Programme process guide and methods guide
Closing date for comments 10 September 2010
http://www.nice.org.uk/aboutnice/whatwedo/aboutmedicaltechnologies/EPPConsultationProcessA
ndMethodsGuides.jsp

Depression: draft quality standard

Closing date for comments 13 September 2010

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http://www.nice.org.uk/aboutnice/qualitystandards/indevelopment/depression.jsp

Colorectal cancer (metastatic) - bevacizumab: appraisal consultation

Closing date for comments 15 September 2010
http://guidance.nice.org.uk/TA/Wave19/52/Consultation/Latest

Skin cancer prevention: information, resources and environmental changes: consultation

on the draft guidance
Closing date for comments 16 September 2010
http://www.nice.org.uk/guidance/index.jsp?action=folder&o=50371

Epilepsy (update): draft guideline consultation

Closing date for comments 30 September 2010
http://www.nice.org.uk/guidance/index.jsp?action=folder&o=50162

Clinical Knowledge Summaries updated in August 2010

 Analgesia - mild-to-moderate pain (new)

 Breathlessness (new)

 Bronchiectasis (new)

 Corticosteroids - inhaled (new)

 Corticosteroids - oral (new)

 Corticosteroids - topical (skin, nose and eyes) (new)

 Epistaxis (new)

 Hepatitis A (new)

 Hepatitis B (new)

 Hypercalcaemia (new)

 LUTS in men, age-related (prostatism)

Other Guidance

Dyslexia, dyspraxia and dyscalculia

Royal College of Nursing
New guidance on dyslexia, dyspraxia and dyscalculia has been published. There are three
publications: a summary guide for managers; a guide for managers and practitioners; and a
toolkit for nursing staff. The guidance provides practical information about the conditions and sets
out to raise awareness of legal and professional responsibilities associated with them.
http://www.rcn.org.uk/newsevents/news/article/uk/rcn_publishes_guidance_on_dyslexia,_dysprax
ia_and_dyscalculia

Health Technology Assessments

Randomised controlled trial and parallel economic evaluation of conventional ventilatory

support versus extracorporeal membrane oxygenation for severe adult respiratory failure
(CESAR) (Peek)

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Health Technol Assess; 14.35

Newer agents for blood glucose control in type 2 diabetes: systematic review and
economic evaluation (Waugh)
Health Technol Assess; 14.36

A systematic review of photodynamic therapy in the treatment of pre-cancerous skin

conditions, Barrett's oesophagus and cancers of the biliary tract, brain, head and neck,
lung, oesophagus and skin (Fayter)
Health Technol Assess; 14.37

Towards single embryo transfer? Modelling clinical outcomes of potential treatment

choices using multiple data sources: predictive models and patient perspectives (Roberts)
Health Technol Assess; 14.38

Sugammadex for the reversal of muscle relaxation in general anaesthesia: a systematic

review and economic assessment (Chambers)
Health Technol Assess; 14.39

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Service Management
Principles and Rules for Cooperation and Competition
Department of Health
This document sets out revised Principles and Rule for Cooperation and Competition (PRCC) in
commissioning and provision of NHS services. The PRCC were first issued under the 2007/08
Operating Framework and are intended to support cooperation and competition in the interests of
patients and taxpayers in relation to, commissioning and procurement, cooperation and collusion,
conduct of individual organisations and mergers and vertical integration.
http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/D
H_118221

Vital Signs Monitoring

Department of Health
This report details Primary Care Trust and NHS Trust performance against plans to address
health priorities relating to the NHS Operating Framework. These health priorities are stroke,
diabetes, child and adolescent mental health services, delayed transfer of care, rapid access
chest pain clinic and maternity.
http://www.dh.gov.uk/en/Publicationsandstatistics/Statistics/Performancedataandstatistics/Vitalsig
nsmonitoring/index.htm

Best Practice Guidance for managing Appointment Slot Issues within Choose and Book
Department of Health
This document is aimed at commissioners and all providers (Acute Trusts, PCTs, the
Independent Sector) with directly bookable services on Choose and Book to inform them about
the process they have to follow when patients, referrers or The National Appointments Lines
(TAL) are unable to book an appointment on Choose and Book because there are no
appointment slots available with their chosen provider.
http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/D
H_118928

Improving data quality in the NHS: annual report on the PbR assurance programme 2010
Audit Commission

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This report summarises the outcomes of the Payment by Results data assurance programme
since it began in 2007. It finds that the accuracy of clinical coding has improved since 2007, with
the error rate dropping from 16 per cent to 11 per cent in three years. However, there remains
wide variation between the best and worst performing trusts, even if the gap is narrowing. Errors
are continuing to affect payments, and it is estimated that of the £21 billion spent on the four
specialties that have been audited for three years, £1 billion (5 per cent) was paid wrongly. To
continue to improve data quality, the report makes a series of recommendations for primary care
trusts and NHS trusts to consider.
http://www.audit-
commission.gov.uk/health/audit/paymentbyresults/reportsandstudies/Pages/default_copy.aspx

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Workforce
A framework for managing staff costs in a period of spending reduction
National Audit Office
This paper sets out a framework for effective management of staff costs in a challenging
environment of cost reduction in public services. The framework sets out how organisations
should approach the delivery of these savings in a way that minimises risk and maximises benefit
to the taxpayer. The framework also inclu
des the NAO's expectations for effective ongoing management of staff costs.
http://www.nao.org.uk/publications/1011/managing_staff_costs.aspx

Leadership needs of medical and clinical directors

King's Fund
This document reports on the outcome of a KF survey of clinical and medical directors to find out
what skills they believed they needed in order to face the current financial challenges.
http://www.kingsfund.org.uk/publications/leadership_needs.html

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