KNOWLEDGE ALERT th October 2016 Alert Bulletin/Oct… · Conference abstract: ... CONSULTATION: ENDURALIFE-powered CRT-D devices for treating heart failure: Draft guidance This National

KNOWLEDGE ALERT Date: 26th October 2016

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CONTENTS:

ANAESTHESIA CANCER CARDIOLOGY CHILDREN & YOUNG PEOPLE COMMISSIONING EDUCATION & TRAINING EMERGENCY MEDICINE/CRITICAL CARE GASTROENTEROLOGY GENERAL MEDICINE GENERAL PRACTICE AND PRACTICE MANAGEMENT GENERAL SURGERY HEALTH SERVICES MANAGEMENT INFECTION CONTROL AND INFECTIOUS DISEASES INFORMATICS AND INFORMATION GOVERNANCE LEARNING DISABILITIES MATERNITY & GYNAECOLOGY MEDICINES MANAGEMENT/PHARMACY MENTAL HEALTH AND WELLBEING NEUROLOGY OLDER PEOPLE

ORTHOPAEDICS PATHOLOGY PATIENT SAFETY PUBLIC HEALTH/HEALTH IMPROVEMENT RADIOLOGY RHEUMATOLOGY

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ANAESTHESIA Many back pain patients get limited relief from opioids and worry about taking them, survey shows Millions of people take opioids for chronic back pain, but many of them get limited relief while experiencing side effects and worrying about the stigma associated with taking them, suggests research presented at the ANESTHESIOLOGY® 2016 annual meeting. News: https://www.sciencedaily.com/releases/2016/10/161023154844.htm Conference abstract: http://www.asaabstracts.com/strands/asaabstracts/abstract.htm?year=2016&index=3&absnum=4614

CANCER TA414 Cobimetinib in combination with vemurafenib for treating unresectable or metastatic BRAF V600 mutation-positive melanoma The National Institute for Health and Care Excellence (NICE) is unable to recommend Cobimetinib in combination with vemurafenib within its marketing authorisation for treating unresectable or metastatic melanoma in adults with a BRAF V600 mutation. This guidance is not intended to affect the position of patients whose treatment with cobimetinib in combination with vemurafenib was started within the NHS before this guidance was published. Technology appraisal guidance: https://www.nice.org.uk/guidance/ta414 TA416 Osimertinib for treating locally advanced or metastatic EGFR T790M mutation-positive non-small-cell lung cancer The National Institute for Health and Care Excellence (NICE) has produced evidence-based recommendations on osimertinib (Tagresso) for treating locally advanced or metastatic EGFR T790M mutation-positive non-small-cell lung cancer in adults. Technology appraisal guidance: https://www.nice.org.uk/guidance/ta416 Prognostic value of prolactin in triple negative breast cancer A study conducted at the Research Institute of the McGill University Health Centre (RI-MUHC) suggests screening breast cancer patients for the prolactin receptor could improve the prognosis for patient and may help them avoid unnecessary and invasive treatments. News: http://ecancer.org/news/10351-prognostic-value-of-prolactin-in-triple-negative-breast-cancer.php Full text article: http://www.nature.com/articles/srep30934

CARDIOLOGY CONSULTATION: ENDURALIFE-powered CRT-D devices for treating heart failure: Draft guidance This National Institute for Health and Care Excellence (NICE) draft guideline has been prepared for public consultation. It summarises the evidence and views that have been considered, and sets out the draft recommendations made by the committee. Consultation: https://www.nice.org.uk/guidance/indevelopment/gid-mtg10004/consultation/html-content MIB84 Absorb Bioresorbable Vascular Scaffold (BVS) for coronary artery disease The National Institute for Health and Care Excellence (NICE) has developed a medtech innovation briefing (MIB) on the Absorb BVS for coronary artery disease. It is a drug-eluting bioresorbable stent used for widening narrowed coronary arteries and is intended for use in place of a metallic drug-eluting stent in people with coronary artery disease who are having angioplasty.

Briefing: https://www.nice.org.uk/advice/mib84

CHILDREN & YOUNG PEOPLE SHARED LEARNING: Learning Disability Transition Pathway Competency Framework This Framework has been developed by Health Education England, in partnership with Skills for Health to support the workforce development of people working in services with young people with learning disabilities as they lead up to and make the transition from children's to adults’ service provision. The Framework relates to the National Institute for Health and Care Excellence (NICE) guidance NG43 Transition from children’s to adults’ services for young people using health or social care services. Shared learning: https://www.nice.org.uk/sharedlearning/learning-disability-transition-pathway-competency-framework Brain changes seen in youth football players without concussion Researchers have found measurable brain changes in children after a single season of playing youth football, even without a concussion diagnosis, according to a new study. News: https://www.sciencedaily.com/releases/2016/10/161024095801.htm Abstract: http://pubs.rsna.org/doi/abs/10.1148/radiol.2016160564 Full text article (PDF): http://pubs.rsna.org/doi/pdf/10.1148/radiol.2016160564

COMMISSIONING Seven-day Services - England, April 2015 - March 2016, Experimental statistics The experimental statistics presented in this report are being published to provide a starting point for discussions on how we can effectively measure both improvement and variation in care provision across the week. Statistics: http://www.content.digital.nhs.uk/catalogue/PUB22253 News: https://digital.nhs.uk/article/898/Three-hospital-trust-indicators-published-to-aid-research-into-seven-day-NHS-provision Learning Disability Services Monthly Statistics - England Commissioner Census (Assuring Transformation) - September 2016, Experimental Statistics This statistical release published by NHS Digital makes available the most recent data relating to patients with learning disabilities and/or autistic spectrum disorder receiving inpatient care commissioned by the NHS in England. Statistics: http://www.content.digital.nhs.uk/catalogue/PUB22231 The Government Response to the House of Commons Health Select Committee Report on Primary Care (Fourth Report of Session 2015-16) The government’s response to the Health Select Committee primary care report explains the measures which have been put in place to support primary care and improve patients’ access to services. Response: https://www.gov.uk/government/publications/primary-care-report-government-response Breastfeeding prevalence at 6-8 weeks after birth (Experimental Statistics) 2016/17 Quarter 1 Quarterly experimental statistics on the number and proportion of infants who have been fully, partially or not at all breastfed at 6 to 8 weeks after birth. Information is presented at local authority of residence, Public Health England (PHE) Centre and England level. Statistics: https://www.gov.uk/government/statistics/breastfeeding-at-6-to-8-weeks-after-birth-2016-to-2017-quarterly-data Breastfeeding prevalence at 6-8 weeks after birth (Experimental Statistics) 2015/16 Annual experimental statistics on the number and proportion of infants who have been fully, partially or not at all breastfed at 6 to 8 weeks after birth. Information is presented at local authority of residence, Public Health England (PHE) Centre and England level. This latest annual data covers the period 1 April 2015 to 31 March 2016. Statistics: https://www.gov.uk/government/statistics/breastfeeding-at-6-to-8-weeks-after-birth-annual-data

Health and Wellbeing 2026: Delivering Together This document is the 10 year vision of Northern Ireland Health Minister, Michelle O’Neill, to transform the current health and social care system. It is the outworking of the recommendations of the Expert Panel’s report “System, Not Structures: Changing Health and Social Care”. Document: https://www.health-ni.gov.uk/sites/default/files/publications/health/health%20and%20wellbeing%202026-%20delivering%20together-october%202016%20.pdf News: https://www.health-ni.gov.uk/news/oneill-launches-10-year-vision-health-social-care Associated documents: https://www.health-ni.gov.uk/publications/systems-not-structures-changing-health-and-social-care-full-report AWARDS: Patient Experience Network (PEN) 2016 National Awards Following the success of last year’s inaugural Friends and Family Test (FFT) Awards, the NHS England’s Insight & Feedback Team and PEN are delighted to announce a partnership to include the FFT Awards as a key part of the PEN National Awards programme for 2016. There is now have a new dedicated category for FFT within the PEN National Award programme. Closing date for entries is 28th November 2016. Further information: http://patientexperiencenetwork.org/award-categories/ Winter indemnity scheme for GPs – 2016 As part of a broader General Practice Forward View commitment to address the issue of rising indemnity costs, NHS England’s 2016 winter indemnity scheme for GPs will run until Friday 31 March 2017. It is designed to meet the costs of personal professional indemnity for any additional out of hours work undertaken by GPs this winter to enable the freedom to work additional sessions without having to pay additional subscriptions to their medical defence organisation (MDO). Further information: https://www.england.nhs.uk/ourwork/gpfv/gp-indemnity/winter-indemnity/

EDUCATION & TRAINING CONSULTATION OUTCOME: Consultation on the transposition of the revised Mutual Recognition of Professional Qualifications (MRPQ) Directive 2005/36/EC: Amendments to health and care regulators’ legislation: Government response 35 responses were received to this consultation. This document sets out a summary of these responses, which have informed the final drafting of the department’s regulations. Consultation response: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/561630/MRPQ_cons_response.pdf Associated documents: https://www.gov.uk/government/consultations/mutual-recognition-of-professional-qualifications-in-healthcare

EMERGENCY MEDICINE/CRITICAL CARE MIB85 Needle-free arterial non-injectable connector (NIC) The National Institute for Health and Care Excellence (NICE) has developed a medtech innovation briefing (MIB) on the needle-free arterial NIC, which is connected to the sampling port of an arterial line and through which blood samples can be collected. It is intended for use instead of arterial connectors currently used in adults with arterial lines in critical care facilities, operating theatres, and emergency departments. It is not licensed for use in children. Briefing: https://www.nice.org.uk/advice/mib85

GASTROENTEROLOGY TA413 Elbasvir–grazoprevir for treating chronic hepatitis C The National Institute for Health and Care Excellence (NICE) has produced evidence-based recommendations on elbasvir–grazoprevir (Zepatier) for treating genotype 1 or 4 chronic hepatitis C in adults. Technology appraisal guidance: https://www.nice.org.uk/guidance/ta413

GENERAL MEDICINE Expanding the role of hospitalist physician assistants achieves similar clinical outcomes, costs less More and more medical centers are relying on hospitalists - hospital-based internal medicine specialists who coordinate the complex care of inpatients. Now, an 18-month study comparing two hospitalist groups - one with a high physician assistant (PA)-to-physician ratio ("expanded PA") and one with a low PA-to-physician ratio ("conventional") - has found no significant differences in key clinical outcomes achieved by both groups. News: https://www.sciencedaily.com/releases/2016/10/161024090620.htm Full text article: http://www.jcomjournal.com/reports-from-the-field-a-comparison-of-conventional-and-expanded-physician-assistant-hospitalist-staffing-models-at-a-community-hospital/

GENERAL PRACTICE AND PRACTICE MANAGEMENT Seven-day Services - England, April 2015 - March 2016, Experimental statistics The experimental statistics presented in this report are being published to provide a starting point for discussions on how we can effectively measure both improvement and variation in care provision across the week. Statistics: http://www.content.digital.nhs.uk/catalogue/PUB22253 News: https://digital.nhs.uk/article/898/Three-hospital-trust-indicators-published-to-aid-research-into-seven-day-NHS-provision The Government Response to the House of Commons Health Select Committee Report on Primary Care (Fourth Report of Session 2015-16) The government’s response to the Health Select Committee primary care report explains the measures which have been put in place to support primary care and improve patients’ access to services. Response: https://www.gov.uk/government/publications/primary-care-report-government-response Attitudes to dementia: Findings from the 2015 British Social Attitudes survey This paper presents findings on attitudes to dementia in Britain. While the majority of people have known someone with dementia and knowledge of the symptoms of dementia is high, there are clear gaps in public knowledge of the risk factors. There is also evidence of stigmatising attitudes towards people living with dementia. Paper: http://www.bsa.natcen.ac.uk/media/39130/bsa-33-attitudes-to-dementia.pdf Further information: http://www.bsa.natcen.ac.uk/latest-report/british-social-attitudes-33/dementia.aspx Press release: https://www.gov.uk/government/news/public-unaware-of-the-factors-that-increase-the-risk-of-dementia Health and Wellbeing 2026: Delivering Together This document is the 10 year vision of Northern Ireland Health Minister, Michelle O’Neill, to transform the current health and social care system. It is the outworking of the recommendations of the Expert Panel’s report “System, Not Structures: Changing Health and Social Care”. Document: https://www.health-ni.gov.uk/sites/default/files/publications/health/health%20and%20wellbeing%202026-%20delivering%20together-october%202016%20.pdf News: https://www.health-ni.gov.uk/news/oneill-launches-10-year-vision-health-social-care Associated documents: https://www.health-ni.gov.uk/publications/systems-not-structures-changing-health-and-social-care-full-report AWARDS: Patient Experience Network (PEN) 2016 National Awards Following the success of last year’s inaugural Friends and Family Test (FFT) Awards, the NHS England’s Insight & Feedback Team and PEN are delighted to announce a partnership to include the FFT Awards as a key part of the PEN National Awards programme for 2016. There is now have a new dedicated category for FFT within the PEN National Award programme. Closing date for entries is 28th November 2016. Further information: http://patientexperiencenetwork.org/award-categories/ Winter indemnity scheme for GPs – 2016 As part of a broader General Practice Forward View commitment to address the issue of rising indemnity costs, NHS England’s 2016 winter indemnity scheme for GPs will run until Friday 31 March

2017. It is designed to meet the costs of personal professional indemnity for any additional out of hours work undertaken by GPs this winter to enable the freedom to work additional sessions without having to pay additional subscriptions to their medical defence organisation (MDO). Further information: https://www.england.nhs.uk/ourwork/gpfv/gp-indemnity/winter-indemnity/ E-cigarettes could be used to help combat obesity in smokers trying to quit: study Researchers in Britain and New Zealand have found a potential new use for electronic cigarettes in smokers who want to give up - controlling appetite and limiting the weight gain that often comes with quitting. In a review, scientists found that it's the nicotine in cigarettes that makes smokers less likely to overeat, and suggested e-cigarettes, which contain nicotine but no tobacco, may help prevent them from eating too much when they quit. News: http://uk.reuters.com/article/us-health-obesity-ecigarettes-idUKKCN12P1DB Abstract: http://ntr.oxfordjournals.org/content/early/2016/10/23/ntr.ntw278.abstract Expert reaction: http://www.sciencemediacentre.org/expert-reaction-to-research-into-the-potential-of-e-cigarettes-to-combat-obesity/ Many back pain patients get limited relief from opioids and worry about taking them, survey shows Millions of people take opioids for chronic back pain, but many of them get limited relief while experiencing side effects and worrying about the stigma associated with taking them, suggests research presented at the ANESTHESIOLOGY® 2016 annual meeting. News: https://www.sciencedaily.com/releases/2016/10/161023154844.htm Conference abstract: http://www.asaabstracts.com/strands/asaabstracts/abstract.htm?year=2016&index=3&absnum=4614

GENERAL SURGERY MIB85 Needle-free arterial non-injectable connector (NIC) The National Institute for Health and Care Excellence (NICE) has developed a medtech innovation briefing (MIB) on the needle-free arterial NIC, which is connected to the sampling port of an arterial line and through which blood samples can be collected. It is intended for use instead of arterial connectors currently used in adults with arterial lines in critical care facilities, operating theatres, and emergency departments. It is not licensed for use in children. Briefing: https://www.nice.org.uk/advice/mib85 University of Michigan (U-M) launches effort to prevent surgery-related opioid addiction across Michigan $1.4M/year state grant creates network to link doctors & hospitals around the state for safer prescribing and drug take-back events. America’s opioid drug epidemic has struck hard in Michigan. But now, a team from the University of Michigan is striking back at a key factor: opioid prescriptions for patients before and after surgery. News: http://www.uofmhealth.org/news/archive/201610/u-m-launches-effort-prevent-surgery-related-opioid-addiction

HEALTH SERVICES MANAGEMENT CONSULTATION: ENDURALIFE-powered CRT-D devices for treating heart failure: Draft guidance This National Institute for Health and Care Excellence (NICE) draft guideline has been prepared for public consultation. It summarises the evidence and views that have been considered, and sets out the draft recommendations made by the committee. Consultation: https://www.nice.org.uk/guidance/indevelopment/gid-mtg10004/consultation/html-content SHARED LEARNING: Learning Disability Transition Pathway Competency Framework This Framework has been developed by Health Education England, in partnership with Skills for Health to support the workforce development of people working in services with young people with learning disabilities as they lead up to and make the transition from children's to adults’ service provision. The Framework relates to the National Institute for Health and Care Excellence (NICE)

guidance NG43 Transition from children’s to adults’ services for young people using health or social care services. Shared learning: https://www.nice.org.uk/sharedlearning/learning-disability-transition-pathway-competency-framework SHARED LEARNING: Audit of the Use of Platelets in Three UK Transfusion Committee Regions This example describes a multi-regional audit of the use of platelets in UK hospitals. These three audits used identical data collection forms to allow benchmarking against British Committee for Standards in Haematology (BCSH) guidelines and the National Institute for Health and Care Excellence (NICE) guideline relating to transfusion (NG24). Shared learning: https://www.nice.org.uk/sharedlearning/audit-of-the-use-of-platelets-in-three-uk-transfusion-committee-regions MIB84 Absorb Bioresorbable Vascular Scaffold (BVS) for coronary artery disease The National Institute for Health and Care Excellence (NICE) has developed a medtech innovation briefing (MIB) on the Absorb BVS for coronary artery disease. It is a drug-eluting bioresorbable stent used for widening narrowed coronary arteries and is intended for use in place of a metallic drug-eluting stent in people with coronary artery disease who are having angioplasty. Briefing: https://www.nice.org.uk/advice/mib84 MIB85 Needle-free arterial non-injectable connector (NIC) The National Institute for Health and Care Excellence (NICE) has developed a medtech innovation briefing (MIB) on the needle-free arterial NIC, which is connected to the sampling port of an arterial line and through which blood samples can be collected. It is intended for use instead of arterial connectors currently used in adults with arterial lines in critical care facilities, operating theatres, and emergency departments. It is not licensed for use in children. Briefing: https://www.nice.org.uk/advice/mib85 Seven-day Services - England, April 2015 - March 2016, Experimental statistics The experimental statistics presented in this report are being published to provide a starting point for discussions on how we can effectively measure both improvement and variation in care provision across the week. Statistics: http://www.content.digital.nhs.uk/catalogue/PUB22253 News: https://digital.nhs.uk/article/898/Three-hospital-trust-indicators-published-to-aid-research-into-seven-day-NHS-provision Learning Disability Services Monthly Statistics - England Commissioner Census (Assuring Transformation) - September 2016, Experimental Statistics This statistical release published by NHS Digital makes available the most recent data relating to patients with learning disabilities and/or autistic spectrum disorder receiving inpatient care commissioned by the NHS in England. Statistics: http://www.content.digital.nhs.uk/catalogue/PUB22231 CONSULTATION OUTCOME: Consultation on the transposition of the revised Mutual Recognition of Professional Qualifications (MRPQ) Directive 2005/36/EC: Amendments to health and care regulators’ legislation: Government response 35 responses were received to this consultation. This document sets out a summary of these responses, which have informed the final drafting of the department’s regulations. Consultation response: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/561630/MRPQ_cons_response.pdf Associated documents: https://www.gov.uk/government/consultations/mutual-recognition-of-professional-qualifications-in-healthcare The Government Response to the House of Commons Health Select Committee Report on Primary Care (Fourth Report of Session 2015-16) The government’s response to the Health Select Committee primary care report explains the measures which have been put in place to support primary care and improve patients’ access to services. Response: https://www.gov.uk/government/publications/primary-care-report-government-response

Health and Wellbeing 2026: Delivering Together This document is the 10 year vision of Northern Ireland Health Minister, Michelle O’Neill, to transform the current health and social care system. It is the outworking of the recommendations of the Expert Panel’s report “System, Not Structures: Changing Health and Social Care”. Document: https://www.health-ni.gov.uk/sites/default/files/publications/health/health%20and%20wellbeing%202026-%20delivering%20together-october%202016%20.pdf News: https://www.health-ni.gov.uk/news/oneill-launches-10-year-vision-health-social-care Associated documents: https://www.health-ni.gov.uk/publications/systems-not-structures-changing-health-and-social-care-full-report AWARDS: Patient Experience Network (PEN) 2016 National Awards Following the success of last year’s inaugural Friends and Family Test (FFT) Awards, the NHS England’s Insight & Feedback Team and PEN are delighted to announce a partnership to include the FFT Awards as a key part of the PEN National Awards programme for 2016. There is now have a new dedicated category for FFT within the PEN National Award programme. Closing date for entries is 28th November 2016. Further information: http://patientexperiencenetwork.org/award-categories/ Expanding the role of hospitalist physician assistants achieves similar clinical outcomes, costs less More and more medical centers are relying on hospitalists - hospital-based internal medicine specialists who coordinate the complex care of inpatients. Now, an 18-month study comparing two hospitalist groups - one with a high physician assistant (PA)-to-physician ratio ("expanded PA") and one with a low PA-to-physician ratio ("conventional") - has found no significant differences in key clinical outcomes achieved by both groups. News: https://www.sciencedaily.com/releases/2016/10/161024090620.htm Full text article: http://www.jcomjournal.com/reports-from-the-field-a-comparison-of-conventional-and-expanded-physician-assistant-hospitalist-staffing-models-at-a-community-hospital/ New evaluation model delivers improved care for patients with cognitive disorders First year data on the effectiveness of a new care model has been published. The work, which follows a three-step evaluation and management plan from clinicians in Geriatrics, Neuropsychology and Neurology, examines patients referred for evaluation of cognitive complaints based on activities of daily living, demographic information, co-morbid conditions, and medication review. News: https://www.sciencedaily.com/releases/2016/10/161024095952.htm Abstract: http://onlinelibrary.wiley.com/doi/10.1111/jgs.14473/abstract 'Middle England' faces lowest psychosis risk The risk of developing a psychotic disorder such as schizophrenia is highest for young people, men, ethnic minorities and people living in urban areas and poorer neighborhoods, an English study concludes. News: https://www.sciencedaily.com/releases/2016/10/161024100001.htm Abstract: http://ajp.psychiatryonline.org/doi/abs/10.1176/appi.ajp.2016.16010103

INFECTION CONTROL AND INFECTIOUS DISEASES TA413 Elbasvir–grazoprevir for treating chronic hepatitis C The National Institute for Health and Care Excellence (NICE) has produced evidence-based recommendations on elbasvir–grazoprevir (Zepatier) for treating genotype 1 or 4 chronic hepatitis C in adults. Technology appraisal guidance: https://www.nice.org.uk/guidance/ta413 Legionnaires’ disease in England and Wales – 2015 This report presents and discusses the epidemiological data on cases of Legionnaires’ disease reported in residents of England and Wales where symptoms started during 2015. Comparative data from previous years are included where appropriate. Report: https://www.gov.uk/government/publications/legionnaires-disease-in-england-and-wales-report-2015

INFORMATICS AND INFORMATION GOVERNANCE SURVEY: Core Data Items to Support Anonymisation R01267 The Burden Advice and Assessment Service (BAAS) team - formerly ROCR - are evaluating an application to collect data for Core Data Items to Support Anonymisation standard. They would like you to let them know your views on this collection through spending a few minutes completing a simple feedback form. This information will help to provide accurate information as to the overall burden that will be imposed as a result of this data collection. Survey: https://nhs-digital.citizenspace.com/rocr/r01267/consult_view/

LEARNING DISABILITIES SHARED LEARNING: Learning Disability Transition Pathway Competency Framework This Framework has been developed by Health Education England, in partnership with Skills for Health to support the workforce development of people working in services with young people with learning disabilities as they lead up to and make the transition from children's to adults’ service provision. The Framework relates to the National Institute for Health and Care Excellence (NICE) guidance NG43 Transition from children’s to adults’ services for young people using health or social care services. Shared learning: https://www.nice.org.uk/sharedlearning/learning-disability-transition-pathway-competency-framework Learning Disability Services Monthly Statistics - England Commissioner Census (Assuring Transformation) - September 2016, Experimental Statistics This statistical release published by NHS Digital makes available the most recent data relating to patients with learning disabilities and/or autistic spectrum disorder receiving inpatient care commissioned by the NHS in England. Statistics: http://www.content.digital.nhs.uk/catalogue/PUB22231

MATERNITY & GYNAECOLOGY Breastfeeding prevalence at 6-8 weeks after birth (Experimental Statistics) 2016/17 Quarter 1 Quarterly experimental statistics on the number and proportion of infants who have been fully, partially or not at all breastfed at 6 to 8 weeks after birth. Information is presented at local authority of residence, Public Health England (PHE) Centre and England level. Statistics: https://www.gov.uk/government/statistics/breastfeeding-at-6-to-8-weeks-after-birth-2016-to-2017-quarterly-data Breastfeeding prevalence at 6-8 weeks after birth (Experimental Statistics) 2015/16 Annual experimental statistics on the number and proportion of infants who have been fully, partially or not at all breastfed at 6 to 8 weeks after birth. Information is presented at local authority of residence, Public Health England (PHE) Centre and England level. This latest annual data covers the period 1 April 2015 to 31 March 2016. Statistics: https://www.gov.uk/government/statistics/breastfeeding-at-6-to-8-weeks-after-birth-annual-data CG98 Jaundice in newborn babies under 28 days (Updated) This National Institute of Health and Care Excellence (NICE) clinical guideline, which covers diagnosing and treating jaundice in neonates, has been reviewed. Recommendation 1.4.9 was amended to clarify when intensified phototherapy should be used in relation to time since birth. Clinical guideline: https://www.nice.org.uk/guidance/cg98

MEDICINES MANAGEMENT/PHARMACY TA413 Elbasvir–grazoprevir for treating chronic hepatitis C The National Institute for Health and Care Excellence (NICE) has produced evidence-based recommendations on elbasvir–grazoprevir (Zepatier) for treating genotype 1 or 4 chronic hepatitis C in adults. Technology appraisal guidance: https://www.nice.org.uk/guidance/ta413 TA414 Cobimetinib in combination with vemurafenib for treating unresectable or metastatic BRAF V600 mutation-positive melanoma

The National Institute for Health and Care Excellence (NICE) is unable to recommend Cobimetinib in combination with vemurafenib within its marketing authorisation for treating unresectable or metastatic melanoma in adults with a BRAF V600 mutation. This guidance is not intended to affect the position of patients whose treatment with cobimetinib in combination with vemurafenib was started within the NHS before this guidance was published. Technology appraisal guidance: https://www.nice.org.uk/guidance/ta414 TA415 Certolizumab pegol for treating rheumatoid arthritis after inadequate response to a TNF-alpha inhibitor The National Institute for Health and Care Excellence (NICE) has produced evidence-based recommendations on certolizumab pegol (Cimzia) for treating severe active rheumatoid arthritis in adults who have had a tumour necrosis factor-alpha inhibitor. Technology appraisal guidance: https://www.nice.org.uk/guidance/ta415 TA416 Osimertinib for treating locally advanced or metastatic EGFR T790M mutation-positive non-small-cell lung cancer The National Institute for Health and Care Excellence (NICE) has produced evidence-based recommendations on osimertinib (Tagresso) for treating locally advanced or metastatic EGFR T790M mutation-positive non-small-cell lung cancer in adults. Technology appraisal guidance: https://www.nice.org.uk/guidance/ta416 Many back pain patients get limited relief from opioids and worry about taking them, survey shows Millions of people take opioids for chronic back pain, but many of them get limited relief while experiencing side effects and worrying about the stigma associated with taking them, suggests research presented at the ANESTHESIOLOGY® 2016 annual meeting. News: https://www.sciencedaily.com/releases/2016/10/161023154844.htm Conference abstract: http://www.asaabstracts.com/strands/asaabstracts/abstract.htm?year=2016&index=3&absnum=4614 University of Michigan (U-M) launches effort to prevent surgery-related opioid addiction across Michigan $1.4M/year state grant creates network to link doctors & hospitals around the state for safer prescribing and drug take-back events. America’s opioid drug epidemic has struck hard in Michigan. But now, a team from the University of Michigan is striking back at a key factor: opioid prescriptions for patients before and after surgery. News: http://www.uofmhealth.org/news/archive/201610/u-m-launches-effort-prevent-surgery-related-opioid-addiction

MENTAL HEALTH AND WELLBEING Attitudes to dementia: Findings from the 2015 British Social Attitudes survey This paper presents findings on attitudes to dementia in Britain. While the majority of people have known someone with dementia and knowledge of the symptoms of dementia is high, there are clear gaps in public knowledge of the risk factors. There is also evidence of stigmatising attitudes towards people living with dementia. Paper: http://www.bsa.natcen.ac.uk/media/39130/bsa-33-attitudes-to-dementia.pdf Further information: http://www.bsa.natcen.ac.uk/latest-report/british-social-attitudes-33/dementia.aspx Press release: https://www.gov.uk/government/news/public-unaware-of-the-factors-that-increase-the-risk-of-dementia New evaluation model delivers improved care for patients with cognitive disorders First year data on the effectiveness of a new care model has been published. The work, which follows a three-step evaluation and management plan from clinicians in Geriatrics, Neuropsychology and Neurology, examines patients referred for evaluation of cognitive complaints based on activities of daily living, demographic information, co-morbid conditions, and medication review. News: https://www.sciencedaily.com/releases/2016/10/161024095952.htm Abstract: http://onlinelibrary.wiley.com/doi/10.1111/jgs.14473/abstract

'Middle England' faces lowest psychosis risk The risk of developing a psychotic disorder such as schizophrenia is highest for young people, men, ethnic minorities and people living in urban areas and poorer neighborhoods, an English study concludes. News: https://www.sciencedaily.com/releases/2016/10/161024100001.htm Abstract: http://ajp.psychiatryonline.org/doi/abs/10.1176/appi.ajp.2016.16010103

NEUROLOGY Brain changes seen in youth football players without concussion Researchers have found measurable brain changes in children after a single season of playing youth football, even without a concussion diagnosis, according to a new study. News: https://www.sciencedaily.com/releases/2016/10/161024095801.htm Abstract: http://pubs.rsna.org/doi/abs/10.1148/radiol.2016160564 Full text article (PDF): http://pubs.rsna.org/doi/pdf/10.1148/radiol.2016160564 New evaluation model delivers improved care for patients with cognitive disorders First year data on the effectiveness of a new care model has been published. The work, which follows a three-step evaluation and management plan from clinicians in Geriatrics, Neuropsychology and Neurology, examines patients referred for evaluation of cognitive complaints based on activities of daily living, demographic information, co-morbid conditions, and medication review. News: https://www.sciencedaily.com/releases/2016/10/161024095952.htm Abstract: http://onlinelibrary.wiley.com/doi/10.1111/jgs.14473/abstract

OLDER PEOPLE New evaluation model delivers improved care for patients with cognitive disorders First year data on the effectiveness of a new care model has been published. The work, which follows a three-step evaluation and management plan from clinicians in Geriatrics, Neuropsychology and Neurology, examines patients referred for evaluation of cognitive complaints based on activities of daily living, demographic information, co-morbid conditions, and medication review. News: https://www.sciencedaily.com/releases/2016/10/161024095952.htm Abstract: http://onlinelibrary.wiley.com/doi/10.1111/jgs.14473/abstract

ORTHOPAEDICS Many back pain patients get limited relief from opioids and worry about taking them, survey shows Millions of people take opioids for chronic back pain, but many of them get limited relief while experiencing side effects and worrying about the stigma associated with taking them, suggests research presented at the ANESTHESIOLOGY® 2016 annual meeting. News: https://www.sciencedaily.com/releases/2016/10/161023154844.htm Conference abstract: http://www.asaabstracts.com/strands/asaabstracts/abstract.htm?year=2016&index=3&absnum=4614

PATHOLOGY SHARED LEARNING: Audit of the Use of Platelets in Three UK Transfusion Committee Regions This example describes a multi-regional audit of the use of platelets in UK hospitals. These three audits used identical data collection forms to allow benchmarking against British Committee for Standards in Haematology (BCSH) guidelines and the National Institute for Health and Care Excellence (NICE) guideline relating to transfusion (NG24). Shared learning: https://www.nice.org.uk/sharedlearning/audit-of-the-use-of-platelets-in-three-uk-transfusion-committee-regions

Prognostic value of prolactin in triple negative breast cancer A study conducted at the Research Institute of the McGill University Health Centre (RI-MUHC) suggests screening breast cancer patients for the prolactin receptor could improve the prognosis for patient and may help them avoid unnecessary and invasive treatments. News: http://ecancer.org/news/10351-prognostic-value-of-prolactin-in-triple-negative-breast-cancer.php Full text article: http://www.nature.com/articles/srep30934 Old blood is as good as new, international study shows It’s been long thought that when blood transfusions are needed, it may be best to use the freshest blood, but researchers have led a large international study proving that it is not so. The study of almost 31,500 patients at six hospitals in four countries showed that having a transfusion with the freshest blood did not reduce the proportion of patients who died in hospital. News: https://www.sciencedaily.com/releases/2016/10/161024090616.htm Abstract: http://www.nejm.org/doi/abstract/10.1056/NEJMoa1609014 Full text article (PDF): http://www.nejm.org/doi/pdf/10.1056/NEJMoa1609014 CG98 Jaundice in newborn babies under 28 days (Updated) This National Institute of Health and Care Excellence (NICE) clinical guideline, which covers diagnosing and treating jaundice in neonates, has been reviewed. Recommendation 1.4.9 was amended to clarify when intensified phototherapy should be used in relation to time since birth. Clinical guideline: https://www.nice.org.uk/guidance/cg98

PATIENT SAFETY MIB85 Needle-free arterial non-injectable connector (NIC) The National Institute for Health and Care Excellence (NICE) has developed a medtech innovation briefing (MIB) on the needle-free arterial NIC, which is connected to the sampling port of an arterial line and through which blood samples can be collected. It is intended for use instead of arterial connectors currently used in adults with arterial lines in critical care facilities, operating theatres, and emergency departments. It is not licensed for use in children. Briefing: https://www.nice.org.uk/advice/mib85

PUBLIC HEALTH/HEALTH IMPROVEMENT Personal Social Services: Expenditure and Unit Costs, England - 2015-16 [NS] This report contains information on the annual expenditure and unit costs of Councils with Adult Social Services Responsibilities (CASSRs) with Adult Social Services Responsibilities in England during the reporting period 1 April 2015 to 31 March 2016. This year the publication also contains experimental data regarding Deferred Payment Agreements (DPAs). Statistics: http://www.content.digital.nhs.uk/catalogue/PUB22240 News: https://digital.nhs.uk/article/902/Latest-figures-released-on-local-councils-adult-social-care-spending- Breastfeeding prevalence at 6-8 weeks after birth (Experimental Statistics) 2016/17 Quarter 1 Quarterly experimental statistics on the number and proportion of infants who have been fully, partially or not at all breastfed at 6 to 8 weeks after birth. Information is presented at local authority of residence, Public Health England (PHE) Centre and England level. Statistics: https://www.gov.uk/government/statistics/breastfeeding-at-6-to-8-weeks-after-birth-2016-to-2017-quarterly-data Breastfeeding prevalence at 6-8 weeks after birth (Experimental Statistics) 2015/16 Annual experimental statistics on the number and proportion of infants who have been fully, partially or not at all breastfed at 6 to 8 weeks after birth. Information is presented at local authority of residence, Public Health England (PHE) Centre and England level. This latest annual data covers the period 1 April 2015 to 31 March 2016. Statistics: https://www.gov.uk/government/statistics/breastfeeding-at-6-to-8-weeks-after-birth-annual-data

Legionnaires’ disease in England and Wales – 2015 This report presents and discusses the epidemiological data on cases of Legionnaires’ disease reported in residents of England and Wales where symptoms started during 2015. Comparative data from previous years are included where appropriate. Report: https://www.gov.uk/government/publications/legionnaires-disease-in-england-and-wales-report-2015 Attitudes to dementia: Findings from the 2015 British Social Attitudes survey This paper presents findings on attitudes to dementia in Britain. While the majority of people have known someone with dementia and knowledge of the symptoms of dementia is high, there are clear gaps in public knowledge of the risk factors. There is also evidence of stigmatising attitudes towards people living with dementia. Paper: http://www.bsa.natcen.ac.uk/media/39130/bsa-33-attitudes-to-dementia.pdf Further information: http://www.bsa.natcen.ac.uk/latest-report/british-social-attitudes-33/dementia.aspx Press release: https://www.gov.uk/government/news/public-unaware-of-the-factors-that-increase-the-risk-of-dementia Health and Wellbeing 2026: Delivering Together This document is the 10 year vision of Northern Ireland Health Minister, Michelle O’Neill, to transform the current health and social care system. It is the outworking of the recommendations of the Expert Panel’s report “System, Not Structures: Changing Health and Social Care”. Document: https://www.health-ni.gov.uk/sites/default/files/publications/health/health%20and%20wellbeing%202026-%20delivering%20together-october%202016%20.pdf News: https://www.health-ni.gov.uk/news/oneill-launches-10-year-vision-health-social-care Associated documents: https://www.health-ni.gov.uk/publications/systems-not-structures-changing-health-and-social-care-full-report E-cigarettes could be used to help combat obesity in smokers trying to quit: study Researchers in Britain and New Zealand have found a potential new use for electronic cigarettes in smokers who want to give up - controlling appetite and limiting the weight gain that often comes with quitting. In a review, scientists found that it's the nicotine in cigarettes that makes smokers less likely to overeat, and suggested e-cigarettes, which contain nicotine but no tobacco, may help prevent them from eating too much when they quit. News: http://uk.reuters.com/article/us-health-obesity-ecigarettes-idUKKCN12P1DB Abstract: http://ntr.oxfordjournals.org/content/early/2016/10/23/ntr.ntw278.abstract Expert reaction: http://www.sciencemediacentre.org/expert-reaction-to-research-into-the-potential-of-e-cigarettes-to-combat-obesity/ Social Inequalities in Health and their Determinants: Topline Results from Round 7 of the European Social Survey (ESS) – Issue 6 This report analyses attitudes towards physical and mental health in 21 European countries. It concludes that a substantial number of Europeans suffer from a wide range of physical and mental health conditions, in part due to their economic and social conditions. Report: http://www.europeansocialsurvey.org/docs/about/ESS_-Topline6_Health_FINAL.pdf News: http://www.europeansocialsurvey.org/about/news.html Fragranced products: Risks for people and profits? Over one-third of Americans report health problems - from asthma attacks to migraine headaches - when exposed to common fragranced consumer products such as air fresheners, cleaning supplies, laundry products, scented candles, cologne, and personal care products. The same study also found that fragranced products may affect profits, with more than 20% of respondents entering a business, but leaving as quickly as possible if they smell air fresheners or some fragranced product. News: https://www.sciencedaily.com/releases/2016/10/161024095420.htm Full text article: http://link.springer.com/article/10.1007/s11869-016-0442-z Brain changes seen in youth football players without concussion Researchers have found measurable brain changes in children after a single season of playing youth football, even without a concussion diagnosis, according to a new study. News: https://www.sciencedaily.com/releases/2016/10/161024095801.htm Abstract: http://pubs.rsna.org/doi/abs/10.1148/radiol.2016160564 Full text article (PDF): http://pubs.rsna.org/doi/pdf/10.1148/radiol.2016160564

RADIOLOGY Brain changes seen in youth football players without concussion Researchers have found measurable brain changes in children after a single season of playing youth football, even without a concussion diagnosis, according to a new study. News: https://www.sciencedaily.com/releases/2016/10/161024095801.htm Abstract: http://pubs.rsna.org/doi/abs/10.1148/radiol.2016160564 Full text article (PDF): http://pubs.rsna.org/doi/pdf/10.1148/radiol.2016160564

RHEUMATOLOGY TA415 Certolizumab pegol for treating rheumatoid arthritis after inadequate response to a TNF-alpha inhibitor The National Institute for Health and Care Excellence (NICE) has produced evidence-based recommendations on certolizumab pegol (Cimzia) for treating severe active rheumatoid arthritis in adults who have had a tumour necrosis factor-alpha inhibitor. Technology appraisal guidance: https://www.nice.org.uk/guidance/ta415