Guidelines – St George's Library blog

Health E-News Friday 25 September

September 25 2020February 23 2022stglibrary

Health E-News is a weekly update on policy and guidelines from organisations including NICE and individual Royal Medical Colleges, and news and views on health related subjects and research from trusted sources such as The King’s Fund, Cochrane, The Health Foundation, the NHS and the Department of Health and Social Care.

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COVID-19 guidance and policy

New guidance on preparing anaesthesia and critical care for a second COVID-19 surge

New joint guidance produced by the Faculty of Intensive Care Medicine, the Intensive Care Society, the Association of Anaesthetists and the Royal College of Anaesthetists, outlines key principles for clinical directors to consider when planning service changes. The guidance aims to enable services to increase the availability of critical care facilities for COVID-19, while also protecting planned surgery, preserving training, and protecting the health and wellbeing of healthcare staff.

COVID-19 related news

New discovery in structure of Coronavirus could offer way of stopping virus

A new discovery in the structure of the SARS-CoV-2 Spike protein could offer a potentially significant means of eliminating the COVID-19 virus. An international team led by the University of Bristol, who have been examining the molecular composition of the virus, have made a finding that suggests that it might be possible to develop anti-viral drugs to target a particular part of the virus spike, thereby stopping its infectivity. The full findings are available in an article published in Science.

Cochrane blog offers summary of existing evidence on COVID-19

A piece on the Cochrane blog offers a summary of the existing Cochrane Reviews and Special Collections on various aspects of the virus. These include reviews on detecting COVID-19, testing and screening options, measures for controlling the spread – which include PPE, quarantine and travel-based measures – and treatment options for patients with COVID-19. The piece also considers the impact of the pandemic on other areas of health and wellbeing, and links to relevant reviews. Keep up to date with Cochrane news and reviews on COVID-19 at their page dedicated to Coronavirus resources.

Other news

Healthcare regulators publish annual joint report on whistleblowing disclosures

The GMC, NMC and the six other UK healthcare regulators have published their joint ‘Whistleblowing disclosures report 2020’. The report covers any disclosures made between 1 April 2019 and 31 March 2020, and outlines the number of disclosures received by each of the regulating bodies, as well as summarising the actions taken as a result of these disclosures.

Latest evidence from Cochrane on psychological therapies for chronic pain

A recently published Cochrane review investigates the use of three common psychological therapies for chronic pain in adults: cognitive behavioural therapy (CBT), behavioural therapy (BT) and acceptance and commitment therapy (ACT). The review is based upon studies of face to face treatment delivered by trained psychological therapists, and found that CBT offers small benefits on pain, disability and distress, while the evidence for ACT and BT was uncertain.

King’s Fund report examines the workplace needs of nurses and midwives

A report from the King’s Fund, ‘The courage of compassion: Supporting nurses and midwives to deliver high-quality care’, examines the pressures faced by nursing and midwifery staff, and investigates the workplace transformations that could contribute to improved health and wellbeing, decreased stress, and increased motivation. The report suggests that three core needs of autonomy, belonging and contribution must be met, and provides recommendations for how these can be achieved.

Flu vaccination programme aiming to reach 30 million people

This year’s flu vaccination programme will be expanded in an attempt to provide the vaccine to 30 million people, as findings from Public Health England (PHE) research earlier this year suggests that the risk of death more than doubled for people who tested positive for both flu and COVID-19, compared to those with COVID-19 alone. The vaccine will first be offered to all primary school children, two and three year olds, and the most at-risk groups, including adults over 65 and those with long term health conditions, before being rolled out to others later in the season. All staff at St George’s can, of course get their flu jab from the daily flu clinic.

Evidence review on the influences of improvement processes in healthcare

An evidence review commissioned by The Healthcare Improvement Studies (THIS) Institute at the University of Cambridge, and carried out by the RAND Corporation, explores the key influences affecting the implementation of improvement processes in healthcare. Based upon a review of publications covering a range of improvement approaches, six factors were found to be key influences on the successful implementation of improvement. These include leadership, patient and public involvement, and the use of data. The review is intended to highlight the issues that need to be considered when designing improvement initiatives.

NICE guidance

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Health E-news Friday 4 September

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COVID-19 related news

Further evidence for benefits of corticosteroids in COVID-19 treatment

Findings in papers published this week in Journal of the American Medical Association (JAMA), have reinforced evidence that outcomes for patients severely affected by COVID-19 can be significantly improved by corticosteroids. The first of the papers examines the effect of hydrocortisone on mortality and organ support, finding more rapid recovery and better survival rates in treatment with the steroid. The second paper looked at mortality over a 28-day period after the start of treatment with corticosteroids, estimating a 20 percent reduction in risk of death.

Government announce funding of increased testing capacity

The government has announced funding for increasing the current capacity for existing polymerase chain reaction (PCR) COVID-19 testing, with the aim of enabling large-scale repeat population testing. In addition, funds will go to expanding pilot trials of new testing techniques and technology, including a rapid test that could provide results in as little as 20 minutes.

New findings add to picture of COVID-19 risks in pregnancy

A systematic review published in the BMJ offers further detail to the known risk factors, clinical manifestations, and outcomes in pregnant and recently pregnant women with COVID-19. The key findings of the review are: that increasing maternal age, existing co-morbidities or high BMI are risk factors for severe COVID-19 in pregnancy; that women with the virus are more likely to experience preterm birth; and pregnant women are less likely to manifest symptoms of fever and myalgia than non-pregnant women with COVID-19.

Nuffield Trust briefing on impact of COVID-19 on use of technology in NHS

A briefing from the Nuffield Trust explores how the pandemic has pushed the adoption of technology in the delivery of NHS services and notes the increased usage of digital health services by patients. The report examines what has enabled these changes, considers possible risks of the move to remote service delivery alongside the positive outcomes, and calls for the balancing of change with evidence of its benefit. Finally, the funding, infrastructure and workforce requirements of sustaining any lasting technological adoptions is highlighted.

Other news

RCPCH statement on paediatrician role in supporting mental health

The Royal College of Paediatrics and Child Health (RCPCH) has published a statement on the role of paediatricians in supporting the mental health of children and young people. Noting the increasing incidence of mental health issues among children and young people, the heightened risks for those in vulnerable groups, and the anticipated increase in support needs resulting from COVID-19, the statement makes a series of recommendations relating to training for paediatricians, and also for service developments.

NICE guidance

Diagnostics guidance

DG41 Implantable cardiac monitors to detect atrial fibrillation after cryptogenic stroke

Medtech innovation briefing

MIB225 Helge for detecting haemolysis

Medical technologies guidance

MTG50 Axonics sacral neuromodulation system for treating refractory overactive bladder

NICE guideline

NG159 COVID-19 rapid guideline: critical care in adults Updated

Technology appraisal

TA645 Avelumab with axitinib for untreated advanced renal cell carcinoma

TA646 Glasdegib with chemotherapy for untreated acute myeloid leukaemia (terminated appraisal)

TA647 Eculizumab for treating relapsing neuromyelitis optica (terminated appraisal)

NIHR alerts

Male prisoners develop unhealthy hearts at younger ages than people on the outside

Teams of healthcare professionals from a wide range of disciplines and pay grades are most effective at delivering improvements in patients’ experiences

Psychiatric drugs given to children and adolescents have been ranked in order of safety

Anti-inflammatory drugs do not lift depression in bipolar disorder

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Health e-news Friday 28 August

August 28 2020February 23 2022stglibrary

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COVID-19 guidance and policy

Joint vision for eye care services during and beyond COVID-19

The College of Optometrists and The Royal College of Ophthalmologists (RCOphth) have developed a joint vision for the two professions to continue to work together to support the delivery of safe and sustainable eye care services in England. The vision sets out three key principles and recommendations for the development and governance of high quality eye care service. The three principles are: balancing visual loss due to delays against the risk of acquiring COVID-19; decisions about the most effective patient care being made by the appropriate clinician, and; all pathways to be underpinned by the highest standards of joint optometry and ophthalmology clinical governance.

COVID-19 related news

Study offers more detailed picture of COVID-19 risk factors and outcomes in children

Findings, published in the BMJ, of an observational study of 651 children and young people (aged less than 19 years) with COVID-19 admitted to hospitals across England, Wales and Scotland between 17 January and 3 July 2020, offer further details of the symptoms, risks and outcomes of the virus in children. The nationwide study highlights that a very small number of children (six) died, and that those children most at risk of requiring intensive care are babies under one month old, and children aged 10 to 14 years. In common with adults, the study found that obesity, and black ethnicity were factors that increased the risk of requiring intensive care.

New measures to support development and rollout of COVID-19 vaccines announced

The government has outlined a number of measures that will allow the safe future mass rollout of a COVID-19 vaccine. These include an expansion of the trained workforce that can administer vaccines, in order to increase access; and giving the Medicines and Healthcare products Regulatory Agency (MHRA) powers to consider approving use of a vaccine ahead of a full product licence; providing that robust clinical trials demonstrate its safety and effectiveness. Linked with these proposals, a consultation is seeking views on the safe distribution of potential COVID-19 vaccines and treatments.

Other news

RCN launches fresh campaign for nursing pay rise

The Royal College of Nursing (RCN) has launched a new ‘Fair pay for nursing’ campaign, seeking an immediate pay rise of 12.5% for all NHS nursing staff. The RCN highlight that the pay rise is needed to: provide safe and effective patient care for all people of the UK by addressing the staffing crisis within nursing; recognise the skill, accountability and expertise of a safety critical profession; and recognise that the salaries of nursing staff have not kept pace with increases in the cost of living. The campaign page also notes the political nature of health care funding in its call for action to address the years of inadequate support for nurses.

RCPCH on declining vaccination rates in the UK

The Royal College of Paediatrics and Child Health (RCPCH) considers some of the factors that are contributing to the ongoing trend of declining vaccination rates in the UK. The piece highlights some of the potential barriers that prevent access to vaccines; considers the significant role of misconceptions, misinformation and belief; and in light of the pandemic, also discusses the impact of disruption to routines and the development and distribution of new vaccines.

NHS Confederation calls for inspections to be paused until after winter

The NHS Confederation has written to the Secretary of State for Health and Social Care, calling for the routine inspections of hospitals and other health care providers to be put on hold until after winter. Pausing inspections, the organisation says, will enable hospitals and other providers to focus on the backlog of treatment that has built up, as well as address issues like staff exhaustion, while also managing the ongoing threat from coronavirus. A recent report by the NHS Confederation makes the case for learning from the present moment, and asks questions of what governance and regulation of healthcare could look like if bureaucracy were reduced.

NHS Providers report on meeting the needs of everyone

A report from NHS Providers, ‘Getting it right for everyone: Meeting the needs of people with a learning disability and autistic people in NHS services’ looks at the longstanding structural inequities faced by people with a learning disability and autistic people, and the further impact of the pandemic upon these inequalities. Drawing upon interviews with leaders in trusts providing good and outstanding learning disabilities and autism services, the report sets out in detail the common themes behind high quality care, offering detailed case studies of how they have succeeded.

NICE guidance

Clinical guideline

CG134 Anaphylaxis: assessment and referral after emergency treatment Updated

Diagnostics guidance

DG40 High-sensitivity troponin tests for the early rule out of NSTEMI

Medtech innovation briefing

MIB224 FebriDx for C-reactive protein and myxovirus resistance protein A testing

Quality standard

QS196 Community pharmacies: promoting health and wellbeing

QS197 Faltering growth

NIHR alerts

Screening for lymphoedema after breast cancer surgery could identify women likely to benefit from compression sleeves

The weekly break from dialysis is harmful to patients with kidney failure

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Health E-news Friday 14 August

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COVID-19 guidance and policy

NHS publishes guidance for phase three response to COVID-19

The NHS has published a guidance document offering recommended actions across several key areas, including: addressing inequalities in provision and outcomes; mental health planning; and the restoration of community health services. Responding to the publication of the guidance, the NHS Confederation welcomed the emphasis on tackling the health equalities exposed by the pandemic.

COVID-19 related news

Briefing from NHS Providers explores trusts’ experiences of COVID testing regime

A new report from NHS Providers, drawing on the responses from 112 trusts to a survey conducted during June and July, explores the experiences that trusts have had with the national testing strategy so far. The report examines levels of confidence in the government’s approach and strategy, and trust leaders’ confidence in being able to meet testing requirements; considers issues relating to variable turnaround time for test results, and the implications of these; and calls for greater local involvement and control in testing in order to manage routine testing of staff and patients as services resume.

REACT study publishes first findings

The REACT (REal Time Assessment of Community Transmission) study, which has been using antibody finger-prick tests to track past infections and monitor the progress of the pandemic, has published pre-print findings on antibody prevalence based on 100,000 study participants. The findings indicate that 3.4 million people – 6% of the population – had been infected by COVID-19 by 13 July 2020. People living in London were most likely to have been infected, as were those working in care homes and health care, and people from Black, Asian and other minority ethnic groups and people living in larger households. All findings from the study can be found on the group’s page on the Imperial website.

COVID-19 pay protection FAQs

The NHS Staff Council Executive has published FAQs on pay protection relating to workforce issues arising from COVID-19. The document is an addition to existing guidance from the Department of Health and Social Care, and answers questions relating to staff who are redeployed to help service and patient needs, or in cases of redeployment following a risk assessment.

Study reveals extent of symptoms or infection of healthcare staff resulting from intubation

A new study published in Anaesthesia, explores the extent to which healthcare staff involved in procedures such as intubation might be exposed to elevated risk of acquiring COVID-19. The study of 1,718 healthcare workers from 503 hospitals in 17 countries shows that overall, 1 in 10 healthcare workers involved in intubating seriously ill patients with COVID-19 later reported symptoms, or had lab-confirmed COVID-19 themselves. The study authors recommend use of the findings to inform service planning, and suggest future work should aim at identifying interventions to reduce risks to healthcare professionals.

Other news

Research finds breast screening women aged 40-49 reduces cancer mortality

Research published in The Lancet Oncology, from a trial involving 23 breast screening units across Great Britain, suggests that yearly mammography commencing at age 40 or 41 years could lead to reductions in breast cancer mortality. The trial involved over 160 thousand women, recruited between October 1990 and September 1997, and the publication offers analysis of the data at 23 years of follow-up.

BMA report on disability in the medical profession

A new report from the BMA examines the experiences of disabled people studying, training and working in medicine, and offers recommendations for improving the support on offer. The report, based upon responses to a BMA survey, shows that just over half of respondents receive adjustments that they need, and which are a legal duty to provide. Over three quarters of respondents also expressed concerns over being treated unfavourably if disclosing a disability or long-term health condition.

NICE guidance

Interventional procedures guidance

IPG678 Deep brain stimulation for refractory epilepsy in adults

IPG679 Implanted vagus nerve stimulation for treatment-resistant depression

Medtech innovation briefing

MIB221 Healthy.io test for home testing of urine albumin to creatinine ratio

MIB222 pCONUS2 Bifurcation Aneurysm Implant for complex intracranial aneurysms

MIB223 Spartan RX point-of-care CYP2C19 test to guide treatment in acute coronary syndrome

Quality standard

QS194 Decision making and mental capacity

NICE Guideline

NG160 COVID-19 rapid guideline: dialysis service delivery Updated

NG174 COVID-19 rapid guideline: children and young people who are immunocompromised Updated

Technology appraisal

TA641 Brentuximab vedotin in combination for untreated systemic anaplastic large cell lymphoma

TA642 Gilteritinib for treating relapsed or refractory acute myeloid leukaemia

TA643 Entrectinib for treating ROS1-positive advanced non-small-cell lung cancer

TA644 Entrectinib for treating NTRK fusion-positive solid tumours

NIHR alerts

Early warning scores used in hospitals must be based on sound science

High rates of delirium, persistent fatigue and post-traumatic stress disorder were common after severe infection in previous coronavirus outbreaks

Fluoxetine does not improve outcomes after stroke

Statistics

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Health E-news, 31 July

July 31 2020July 31 2020stglibrary

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COVID-19 guidance and policy

Latest guidance updates from NHS Employers

NHS Employers have information on the latest COVID-19 guidance updates. Updates include: details on the government announcement confirming that registered health and care professionals travelling to the UK from high-risk countries will be required to self-isolate for 14 days; revised guidance on quarantine, including leave and pay options for staff required to quarantine; and guidance relating to the pausing of shielding, which is effective 1 August.

COVID-19 related news

NHS Confederation on ONS excess mortality statistics and test and trace figures

In a response to the publication of Office for National Statistics (ONS) comparison of all-cause mortality between European countries, and the latest figures for the test and trace programme, Dr Layla McCay, a director at NHS Confederation, expressed concerns over the week-on-week decreases in the percentage of close contacts being reached by tracing system, and stressed the importance of this system to the ability to identify and manage any surges in infections.

Chief executives of NHS trusts voice concerns over staff wellbeing

In a report published by the NHS Confederation this week, chief executives from NHS trusts across England revealed concerns about the impacts of COVID-19 on their staff. Executives voiced serious concerns over: the increasing levels of anxiety and fatigue reported by staff during the pandemic; the safety of BME staff, in light of the disparities of COVID-19 impacts; and protecting the safety of patients and staff as routine services are resumed.

NIHR announce funding of projects to investigate higher COVID-19 risk among certain ethnic groups

The National Institute for Health Research (NIHR) has announced joint funding with UK Research and Innovation (UKRI) of six new research projects to eek to explain and mitigate the disproportionate death rate from COVID-19 among people from Black, Asian and minority ethnic (BAME) backgrounds. One of the studies, UK-REACH, led by the University of Leicester, will establish a unique partnership between national healthcare organisations to specifically address the prevalence of COVID-19 amongst BAME healthcare workers.

NHS England launch online portal to support COVID-19 rehabilitation

A new website from NHS England has been launched, offering an ‘online portal’ to help the rehabilitation of patients discharged from hospital post COVID-19 and those managing their illness at home. The site has been developed with the support and input of several royal colleges, professional bodies and charities. The site offers support for managing a variety of common physical effects those recovering from the virus may experience, as well as for supporting mental health and wellbeing.

PHE report confirms increased COVID-19 risks of being obese or excessively overweight

A report from Public Health England (PHE), which summaries findings from recent publications examining he effects of excess weight and obesity on COVID-19, confirms that the data show that obese people are significantly more likely to become seriously ill and be admitted to intensive care with COVID-19 compared to those with a healthy BMI. The report also summarises evidence regarding the nation’s eating and exercise habits during the COVID-19 pandemic. While some data suggests that more people have exercised during lockdown, evidence indicates that the nation’s exercise levels have not increased overall since before the pandemic.

Other news

NHS England sets out plan to roll out new A&E standards before winter

NHS England is planning to roll out new emergency care standards, designed to replace the four-hour A&E target, before this winter. The new standards have not been published or consulted on and do not have official sign-off from ministers, though the plans have the backing of the Royal College of Emergency Medicine and other royal colleges. Details of the proposed changes are outlined in a paper discussed at an NHSE and NHS Improvement board meeting.

Induction of labour: if, and when, to induce

Evidently Cochrane discusses a recently updated Cochrane review, ‘Induction of labour at or beyond 37 weeks’ gestation’, looking at the effects for women and their babies of inducing labour towards the end of pregnancy. The review found evidence that induction later in pregnancy, when compared to waiting for birth to happen, reduced the number of perinatal deaths, led to fewer babies requiring intensive care, and a probable reduction in the number of caesareans required. The review does highlight the variation in values and preferences, and reiterates the need for collaborative discussion and shared decision-making.

New e-learning resource for those working with people with dysphagia

A new Dysphagia Guide, developed in conjunction between Health Education England (HEE), Sheffield Teaching Hospitals NHS Foundation Trust, and the Royal College of Speech and Language Therapists has been made available to access without registration on the HEE e-Learning for Healthcare website. The guide is intended as a resource for health and care professionals working with people with dysphagia, as well as carers and those living with dysphagia themselves.

NHS People Plan published

The NHS People Plan has today (30 July) been published, outlining actions that organisations, employers and staff will need to take in the coming months.
We are the NHS: People Plan 2020/21 sets out guidelines for employers and systems within the NHS, as well as actions for NHS England and NHS Improvement and Health Education England throughout the coming months and year. While welcomed by royal colleges and professional bodies representing health professionals, there was widespread comment on the need for action on staff shortages and a commitment to funding. This was echoed by the Health Foundation in it’s response.

NICE guidance

Medtech innovation briefing

MIB220 Prontosan for acute and chronic wounds

NICE Guideline

NG164 COVID-19 rapid guideline: haematopoietic stem cell transplantation Updated

NG179 COVID-19 rapid guideline: arranging planned care in hospitals and diagnostic services

Quality standard

QS195 Renal and ureteric stones

NIHR alerts

Statistics

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Health e-news Friday 17 July

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COVID-19 guidance and policy

AOMRC recommendations for COVID-19 winter surges

The Academy of Medical Royal Colleges (AOMRC) have published a statement, further to a report by the Academy of Medical Sciences warning of the potential for a higher winter peak of coronavirus infections. Acknowledging the risks highlighted, the AOMRC make a series of recommendations for preparatory action across key areas, including: system capacity; workforce requirements; infection control and PPE; and testing, amongst others. In each area, they outline actions that need to be taken at a national level, together with necessary local and regional actions.

Joint statement on improving medical pathways for acute care

The Royal College of Emergency Medicine (RCEM), Royal College of General Practitioners (RCGP), Royal College of Physicians (RCP) and the Society for Acute Medicine (SAM) have published joint recommendations for transformation of the urgent and emergency care pathway, in light of the continuing COVID-19 pandemic. The statement includes a number of recommendations which they hope can enable organisations to provide care in such a way that appropriately manages risks of crowding of emergency services, and infection prevention and control.

FSRH update guidance to patients of sexual and reproductive health services

The Faculty of Sexual & Reproductive Health (FSRH) have published an update to their advice for patients who need to access contraception, abortion care and other sexual and reproductive health services. The update contains information on which services are likely to be available, along with contact information for relevant services in all countries of the United Kingdom. The guidance is designed for use and distribution by any healthcare workers supporting women with their sexual and reproductive health needs.

Government publishes guidance on managing local COVID-19 outbreaks

New guidance from the government has been published, setting out how national and local organisations should work together in order to contain and manage local COVID-19 outbreaks. The guidance outlines local authority plans and powers, and the roles and responsibilities of both local authorities and national organisations including NHS Test and Trace and the Joint Biosecurity Centre (JBC), and Public Health England (PHE).

COVID-19 related news

Research questions the effectiveness of aerosol boxes

A recently published study in Anaesthesia, suggests that aerosol boxes that have been manufactured in order to protect healthcare workers from COVID-19 might actually be increasing the risks of exposure to airborne particles carrying the virus. The devices are intended for use during tracheal intubation in patients requiring ventilation, but the paper builds on concerns from the medical community that the devices may either not work, or could be causing unforeseen harm to medical staff. The paper notes the untested nature of such devices and their absence from recommendations or endorsement in any existing guidelines, and calls for appropriate testing and regulation.

Transparent face masks for health and care professionals

The Royal College of Speech and Language Therapists (RCSLT) have been lobbying for the introduction of transparent face masks for use in health and social care settings over the past few months, in light of the communication barriers caused by opaque face coverings. In an update to these efforts, the government has accepted the importance of transparent face masks, and have placed an order with the one supplier whose offerings meet the necessary standards. The masks on order are single use, will not require FIT testing, and will not be suitable for use in high-risk environments.

Other news

PHSO report paints stark picture of NHS complaint handling

A report from the Parliamentary and Health Service Ombudsman (PHSO), paints a stark picture of the state of NHS complaint handling, drawn from evidence taken from interviews with a wide range of individuals and organisations who have first-hand experience of how the NHS and UK Government departments approach complaints. The report highlights three areas of particular concern: a lack of consistency in how staff are expected to handle and resolve complaints; inconsistent training on handling complaints; and a negative view of complaints at the organisational level. The report recommends establishment of a complaints standards framework, similar to that pioneered by the Scottish Public Services Ombudsman, which would provide better consistency in the handling of complaints across public services.

RCN survey results reveal increase in numbers considering leaving profession

Initial results of a survey of Royal College of Nursing (RCN) members have been revealed in the first published report. The survey received 42,000 responses, and offers a view of how nursing staff feel about their professional lives. Across both NHS and independent sectors, the percentage of those considering leaving the profession has risen to 36%, up from 27% last year. A high percentage of those considering leaving cited pay as a factor (61%), along with the way nursing staff have been treated during the pandemic (44%), low staffing levels (43%) and lack of management support (42%). The report also notes that while 74% of those responding felt more valued by the public throughout the recent months of COVID-19, only 18% felt more valued by the government.

SOM report on mental health and wellbeing of nurses and midwives

A report from the Society of Occupational Medicine (SOM) offers a summary of the research evidence on the mental health and wellbeing of UK nurses and midwives. The report considers a variety of questions relating to the topic, highlights key findings from the relevant studies found, and makes a series of recommendations for improving current working conditions. The report identifies considerable risk of stress, burnout and mental health problems related to work amongst nurses and midwives; low satisfaction with job demands, control and support; a high risk of bullying and harassment; and a variety of other working conditions that not only threaten the health of nurses and midwives, but also impact on their ability to deliver high quality care to patients.

NHS Employers guidance on supporting staff with childcare responsibilities

NHS Employers have published updated guidance on how NHS organisations can support staff with childcare responsibilities. The guidance covers issues relating to childcare through the summer, the beginning of the new school term in September, and on providing flexibility as an employer.

King’s Fund on obesity and the need for significant government action

The King’s Fund here consider the potential forms of government action to tackle rising rates of obesity in the UK, and the evidence for their likely success or failure. Obesity is a well-established risk factor for diabetes and a range of other diseases and chronic health conditions, to which list can now be added COVID-19, and the piece argues for a strategy that goes beyond public information campaigns, and which makes use of existing evidence demonstrating the need for fiscal and structural actions.

NICE guidance

Quality standard

QS193 Specialist neonatal respiratory care for babies born preterm

NIHR alerts

Some antidepressants can help people quit smoking, but other medications may offer greater benefits

Most patients undergoing planned surgery do not need compression stockings

Asthma patients with a history of opioid use have worse outcomes

Statistics

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Health e-news Friday 10 July

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COVID-19 guidance and policy

BSG issue two further guidance updates

The British Society of Gastroenterology (BSG), with input from organisations including the British Liver Trust and NHS Blood & Transplant, have provided guidance on patient groups who should be considered highly vulnerable, or advised to shield. In addition to this, guidelines for triage of patients referred for upper gastrointestinal (UGI) physiology investigations have also been made available. These latter guidelines apply to new referrals and referrals from prior to the pandemic.

Government adopts RCPCH guidance on children and shielding

Recent guidance from the Royal College of Paediatrics and Child Health (RCPCH), on COVID-19 shielding in children and young people, has now been adopted by the government. The guidance gives recommendations on which patients should continue to shield, and notes that patients should only be removed from the shielding patient list by their GP or specialist doctor, following consultation. The recommendations have been incorporated into Public Health England guidance on shielding.

COVID-19 related news

Cochrane Review on signs and symptoms of COVID-19

A new Cochrane Review explores the available evidence on the signs and symptoms of COVID-19, in an effort to inform timely and accurate diagnosis of the virus. The review considered studies published between January and April 2020, addressing the accuracy of any signs and symptoms, either alone or in combination, for the diagnosis of COVID-19. The 16 studies included, covering 27 signs and symptoms, so far provide little in the way of reliable evidence for diagnosis, and the authors conclude that “neither absence nor presence of signs or symptoms are accurate enough to rule in or rule out disease.” As with all COVID-19 related Cochrane Reviews, this one will be updated as new evidence becomes available.

Independent SAGE report on COVID-19 and ethnicity

Independent SAGE have released a report examining the question of why more people from black and ethnic minority (BME) backgrounds appear to be at greater risk of hospitalisation and deaths with COVID-19. As with previous reports on the topic, the evidence considered appears to point to a complicated picture involving interplay between socio-economic disadvantage in BME populations, high prevalence of chronic diseases and the impact of long-standing racial inequalities being key explanations.

Oxford CEBM examine ONS figures on COVID-19 mortality

Here, the Oxford based Centre for Evidence Based Medicine (CEBM) examine the latest Office for National Statistics (ONS) data on deaths. Looking at figures for the week ending 26 June (Week 26), as well as comparing data for this year so far against five year averages, they consider what the numbers of ‘excess deaths’ can tell us about the impact of COVID-19.

UKRI and NIHR announce funding for study of long-term impacts of COVID-19

UK Research and Innovation (UKRI) and the National Institute for Health Research (NIHR) have announced funding of a study into the long term health impacts of COVID-19. The PHOSP-COVID study will aim to recruit patients who have been discharged from hospital after having COVID-19, and will set out to determine the short to long terms health issues experienced and to explore the effectiveness of medicines, treatments and care pathways for particular disease characteristics.

Report on divergent mental health experiences during pandemic

The Mental Health Foundation have shared further findings from their ongoing Coronavirus: Mental Health in the Pandemic study. Exploring the divergent mental health experiences of different population groups, the report highlights those groups identified as being at high-risk from mental health problems, and the impact that the pandemic and the measures to manage it has had on these groups.

Other news

IMMDR publishes ‘First Do No Harm’ report

The Independent Medicines and Medical Devices Safety Review (IMMDR) has published its report, ‘First Do No Harm’, following a two year long examination of how the English healthcare system responds to reports from patients on the harmful side effects of medical devices and medicines. The report focuses on three interventions: Primodos, sodium valproate and pelvic mesh, setting out a series of recommendations for the support of those who suffered as a result of these, and to reduce the future risk of avoidable harms from medical interventions. The report also highlights some of the themes to come from patient evidence, relating to a lack of information enabling informed choices, and a struggle to be properly listened to by healthcare professionals, amongst others.

FSRH amongst signatories of letter calling for reversal of cuts to PrEP funding

Charities and health organisations including the Faculty of Sexual & Reproductive Healthcare (FSRH), have written to the Secretary of State for Health and Social Care, Matt Hancock, to express concerns over the announcement that the budget for local authority implementation of HIV Pre-Exposure Prophylaxis (PrEP) is to be cut by £5 million this year, and to request that the decision be reconsidered. The cut represents a reduction of almost a third of the promised budget of £16 million. PrEP has proven to be highly effective in preventing HIV transmission, and signatories of the letter fear that the budget cut will hamper the delivery of equitable access of PrEP to all communities that might benefit.

King’s Fund on interventions to improve inclusion in NHS providers

The King’s Fund have published research, carried out before the pandemic, on three NHS case studies seeking to address workforce race inequalities and develop positive and inclusive working environments. The three trusts included in the research were selected on the basis of showing promising signs of positive change on inclusion and addressing race inequalities. Work in each of the three organisations included interventions such as establishing staff networks, ensuring safe routes for staff to raise concerns, and enabling staff development and career progression.

NICE guidance

Medtech innovation briefing

MIB219 CFHealthHub for managing cystic fibrosis during the COVID-19 pandemic

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Health e-news Friday 3 July

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COVID-19 guidance and policy

RCR and SCoR produce guidance for radiology patients

The Royal College of Radiologists (RCR) and the Society and College of Radiographers (SCoR) have produced guidance for patients who are attending hospital for imaging and interventional radiology procedures. The guidance details arrangements that hospitals are putting into place to protect visiting patients from coronavirus. It also reminds patients of the guidance around wearing a face covering or mask while on hospital sites.

CSP video offers easy to follow advice for COVID-19 recovery

A short video recently produced by the Chartered Society of Physiotherapists (CSP), offers practical and easy to follow advice for those recovering from COVID-19. The video shows people what to expect, offering reassurance that it may take time for a return to normal energy and fitness levels, while highlighting the need for a gradual approach. The video is supported by a series of resources to support recovery, including specific advice on breathlessness, and useful strengthening exercises.

BSG publish guidance on reconfiguring services

The British Society of Gastroenterology (BSG) has published guidance on reconfiguring outpatient gastroenterology and hepatology services in the wake of the first peak of COVID-19. The guide is a first step towards restarting services, which will be updated as the situation evolves. It makes a series of recommendations at this stage, including the importance of signposting patients to the correct pathway; the necessity of face to face consultations in some circumstances; and the need for appropriate IT and support to enable successful remote consultations.

COVID-19 related news

Preliminary results suggest no mortality benefits to lopinavir/ritonavir in COVID-19 patients

Further preliminary results from the RECOVERY trial, which is investigating several potential treatments fro COVID-19, have been made available. The new findings suggest that the antiviral drug lopinavir/ritonavir has no significant mortality benefit in hospitalised COVID-19 patients. Noting the need to provide information quickly as effective treatments for the virus are sought, UKRI stressed in its announcement that these results, as with previous findings have not been subjected to peer review.

Evidence from Cochrane on antibody tests for COVID-19

Evidently Cochrane discusses the existing evidence relating to antibody testing and COVID-19, in the light of publication of a rapid review on the topic. The review set out to examine the accuracy of antibody testing, which appears to be heavily reliant upon the timing of when a test is administered. Tests done at 1 to 7 days from onset of symptoms correctly identified only 30% of people known to have COVID-19, rising to 70% between 8 and 14 days and 90% at 15 to 35 days. Other questions remain regarding the usefulness of antibody testing, including the uncertainty as to whether the presence of antibodies provides protection against further infection. The review is a living review, and will be updated on the basis of frequent searches for new relevant studies.

Insufficient evidence to support role for vitamin D in reducing COVID-19 risk

Two new rapid reviews, from the Scientific Advisory Commission on Nutrition (SACN) and the National Institute for Health and Care Excellence (NICE), have found there to be insufficient evidence on the role of vitamin D in reducing the risks of acute respiratory tract infections (ARTIs) or COVID-19. The SACN review did not specifically assess the effect of vitamin D supplementation on COVID-19 risk, but did conclude that the available evidence does not support a role in the prevention of ARTIs. The evidence summary from NICE evaluating vitamin D and COVID-19, meanwhile, pointed to low quality evidence. Both organisations noted that trials on vitamin D and COVID-19 are ongoing, and will assess new evidence as it becomes available.

RCS survey on elective surgery and recommendations

The Royal College of Surgeons of England (RCS) have published results of their survey of elective surgery which was carried out between 8 June and 15 June, along with a series of recommendations aimed at mitigating the challenges currently being faced by surgical teams. Of the 1,741 respondents, 33% reported being unable to undertake elective procedures in the last four weeks; 62% reported being able to access COVID-light facilities for their patients; and 91% of those who had resumed planned procedures reported that patients were receiving pre-operative COVID-19 tests. Recommendations include twice weekly testing for surgical staff; and work to speed up access to patient test results.

Research describes range of complications with potential link to COVID-19

Research published in The Lancet Psychiatry investigates the breadth of COVID-19 complications which affect the brain, including findings of stroke, encephalitis, and altered mental states such as psychosis and catatonia. The study of 153 patients during three weeks at the peak of the virus found that the majority of cerebrovascular events occurred in those over 60 years of age, while half of the cases with altered mental states were under 60. These complications may not be a direct result of the virus itself, but the findings offer a first view of some of the mental health support that may be required following illness with the virus.

NHS Providers report on recovery of NHS services

NHS Providers have published a report based upon a survey of all NHS trust leaders, which explores the challenges to be faced as the NHS recovers from the initial peak of COVID-19. Drawing on the responses provided by nearly 60% of providers (representing 126 trusts), the report highlights four key findings, including the significantly increased demand for urgent or crisis care; the constraints and uncertainties around restarting services; and the particularly large challenges faced by acute hospitals. The report concludes that ‘sustained realism’ is required from government and national bodies on the return to full services. The report comes in the same week that the Royal College of Physicians (RCP) reported on a survey indicating that almost half of medical specialties expect to be working at less than pre-COVID levels for at least 12 months.

Open letter from medical Royal Colleges call for urgent rapid review on COVID-19

An open letter recently published in the BMJ, signed by the presidents of the UK’s medical Royal Colleges, and others, calls for the government to carry out a rapid review of the current situation with regards to the COVID-19 pandemic, and the actions that are required to prevent, and/or prevent a second wave of infections. The letter calls for specific attention to be paid to the overall governance of the situation, and scrutiny of this; procurement of supplies; the disproportionate burden on black, Asian and minority ethnic communities; and the need for international collaboration.

Other news

King’s Fund discuss forthcoming report on race inequalities and inclusion in the NHS

The King’s Fund discusses the forthcoming publication of its report on workforce race inequalities and inclusion in NHS providers. The report draws upon research carried out with three NHS organisations, and the experiences of ethnic minority staff, and is expected to be published in full later this month. Here, some initial thoughts on the scale of the problem, and the extent of the efforts required to bring about significant change are shared.

NHS Confederation launches Health and Care LGBTQ+ Leaders Network

NHS Confederation recently launched the Health and Care LGBTQ+ Leaders Network, with the aim of promoting and ensuring the equal treatment of members of the LGBTQ+ community, both as patients and members of the health care workforce. The network will also work collaboratively to engage with the LGBTQ+ community, allies, wider NHS leadership and other organisations, with a view to increasing the LGBTQ+ membership of boards and the representation of the community amongst senior leadership.

RCN joins 13 other health unions in calling for NHS pay rise

The Royal College of Nursing (RCN) has joined unions including the CSP, UNISON, and the Royal College of Midwives (RCM), in writing to the Prime Minister and Chancellor to call for a start to NHS pay discussions. Alongside calls for a fair pay rise, the unions have asked the government to act upon the significant staffing shortages across the NHS, and to work towards a long-term pay deal that will help to attract people to join the NHS.

Londoners set out expectations for appropriate use of health data

In a London-wide Citizen’s Summit, representatives have set out expectations on the appropriate use of individual and aggregated health and social care data. The summit involved 100 individuals, with representation from each London borough, a range of attitudes towards data sharing, and a diversity intended to reflect the broader population. The summit offered almost unanimous support of the joined up use of identifiable data for the provision of health care, and also discussed the benefits – with conditions and appropriate governance and oversight – of using de-personalised data to inform service planning, and for research and development. A report of the findings can be found here.

NICE guidance

Evidence summary

ES28 COVID-19 rapid evidence summary: vitamin D for COVID-19

Interventional procedures guidance

IPG673 Intravascular lithotripsy for calcified coronary arteries during percutaneous coronary intervention

Medical technologies guidance

MTG49 Rezum for treating lower urinary tract symptoms secondary to benign prostatic hyperplasia

Nice guideline

NG167 COVID-19 rapid guideline: rheumatological autoimmune, inflammatory and metabolic bone disorders Updated

Technology appraisal

TA626 Avatrombopag for treating thrombocytopenia in people with chronic liver disease needing a planned invasive procedure

TA634 Daratumumab with lenalidomide and dexamethasone for untreated multiple myeloma (terminated appraisal)

TA635 Ramucirumab with erlotinib for untreated EGFR-positive metastatic non-small-cell lung cancer (terminated appraisal)

TA636 Eculizumab for treating refractory myasthenia gravis (terminated appraisal)

TA637 Ranibizumab for treating diabetic retinopathy (terminated appraisal)

TA638 Atezolizumab with carboplatin and etoposide for untreated extensive-stage small-cell lung cancer

TA639 Atezolizumab with nab-paclitaxel for untreated PD-L1-positive, locally advanced or metastatic, triple-negative breast cancer

NIHR alerts

Ambulance staff who respond to suicides need more support

Interactive dashboard identifies patients at risk of unsafe prescribing in a flexible and sustainable way

Public health messages on alcohol need to consider how and why people drink, not just how much

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Health e-news Friday 19 June

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COVID-19 guidance and policy

Updated guidance on AGPs and the need for PPE

The government has updated its guidance on the use of personal protective equipment in relation to COVID-19, clarifying the list of aerosol generating procedures (AGPs) considered to be potentially infectious. The update comes following review by the committee of an evidence summary by Health Protection Scotland which set out to establish an evidence base for which AGPs should be considered to pose a high risk of infection transmission.

JCVI issue advice on priority groups for COVID-19 vaccination

The Joint Committee on Vaccination and Immunisation (JCVI) has published interim advice on the priority groups for COVID-19 vaccination, as part of the planning for deployment of any safe and effective vaccine. The committee considered health and social care workers to be the highest priority group, based on their increased exposure and the risks of their transmitting the virus to patients. The next priority for vaccination would be those at increased risk of serious disease and death from COVID-19 infection. The advice will be updated as more information becomes available.

COVID-19 related news

PHE publish stakeholder insights on COVID-19 impact on BAME communities

Following claims of its being withheld from publication in a recent report, Public Health England (PHE) have released a summary of stakeholder insights into the factors potentially influencing the disproportionate impact of COVID-19 on BAME communities. The publication summarises the views elicited from over 4,000 people, during a total of 17 hosted sessions, and make a series of requests for action and recommendations to tackle the issue. The Health Foundation response to the publication questions the absence of any recommendation on tackling entrenched discrimination, while the Chartered Society of Physiotherapists and the Royal College of Paediatrics and Child Health are amongst the professional bodies to have called for real change, noting the failure of previous reports and inquiries on racism to deliver it.

Human trials of coronavirus candidate vaccine set to begin

Researchers are set to being human trials of the COVAC1 coronavirus candidate vaccine, following the completion of pre-clinical safety tests and animal studies. The trial is seeking approximately 120 healthy volunteers for phase I, with results expected around the end of August. The first phase will evaluate three different doses of the vaccine for safety and the ability to induce an immune response.

Trial identifies positive results of dexamethasone in reducing COVID-19 mortality

The RECOVERY trial, which last week suspended investigation of hydroxychloroquine as a treatment for COVID-19, has reported positive findings from the arm examining use of the steroid dexamethasone. Amongst ventilated patients the steroid reduced the risk of dying by one-third, in patients receiving oxygen only the risk was reduced by one-fifth, while no benefit was found for patients not requiring respiratory intervention. Following announcement of the results, the government has approved this use of dexamethasone across the NHS, and is taking steps to ensure and protect UK supply of the steroid which is typically used to reduce inflammation.

Research findings suggests complex relationship between COVID-19 and ethnicity

Research published today suggests that socioeconomic or behavioural factors, cardiovascular disease risk, or vitamin D status do not wholly explain the higher rates of severe COVID-19 infections amongst BAME populations. The results confirm that BAME ethnicity, male sex, higher body mass index, greater material deprivation, and household overcrowding are independent risk factors for COVID-19, but suggest that more research is required to understand the complex relationship between COVID-19 and ethnicity.

RCN set out priorities for resumption of NHS services

The Royal College of Nursing (RCN) has set out eight priorities which they consider to be vital for the safety of health care staff and the public, as the resumption of services is planned for. The priorities include providing counselling and psychological support, ensuring full and proper risk assessments for staff, and tackling the underlying causes which have contributed to increased risks for BAME staff.

RCP priorities for resetting NHS services

The Royal College of Physicians (RCP) has set out its key priorities for the resetting and rebuilding of NHS services. To ensure effective services, the priorities include introducing improved ways of integrated working, encouraging protected time for quality improvement and research, and supporting education and development for all staff.

Online psychological first aid course available to NHS staff and volunteers

A psychological first aid course developed by Public Health England with support from NHS England and Health Education England, is available to all NHS staff and volunteers. The course is accessible through Future Learn, and is intended to support staff and volunteers in providing psychological support to people affected by COVID-19. The course takes approximately 90 minutes to complete, and is offered in three sections.

King’s Fund on resilience in the health and care system

The King’s Fund offers thoughts on what a resilient health and care system would look like, as part of the consideration of restarting and recovering services. Acknowledging the relevance of stockpiles, supply chains and hospital beds as factors contributing to a resilient system, the author argues for additional issues such as flexibility in the workforce, better integrated care, and capacity in community organisations to be accounted for when thinking about a resilient system.

Nuffield Trust examines use of emergency care during pandemic

The Nuffield Trust considers the extent of the reduction in emergency department attendances during the height of the COVID-19 pandemic, some of the factors which might have contributed to the reduced numbers, and whether some of these reductions might be sustained as lockdown measures continue to be eased. The 29% reduction of A&E visits in March and the 57% reduction in April stand in contrast to the average yearly increases of 2-5% during the last two decades, and while concerns that patients with serious health conditions may have been avoiding hospital are undoubtedly part of the cause, the complete picture is likely to be more complex.

Other news

RCN to host series of events on race inequalities

A series of online events hosted by the Royal College of Nursing will attempt to start the conversation about the nature of race, racism, structural discrimination and inequality in the nursing profession. The first event took place today, and details of future events will be available on the RCN website and Twitter account. The events will be open to non-members. The organisation has also created a new online resource drawing together information, advice and resources on diversity and inclusion in nursing.

NHS Virtual Pride to take place Friday 26 June

NHS England and NHS Improvement’s LGBTQ+ Staff Network has announced it will be holding an NHS Virtual Pride on Friday 26 June, the day before Global Pride 2020. As an alternative to the celebrations that would typically be taking place, Virtual Pride will take be hosted on Teams from 6pm. NHS organisations and individual staff are encouraged to participate; for more information, follow @VirtualNHSPride on Twitter. Use the #proudatstgeorges hashtag if you want to get involved, or to share stories or experiences more locally.

FSRH update Service Standards for Consultations

The Faculty of Sexual & Reproductive Health have published an update to their Service Standards for Consultations in Sexual and Reproductive Health. The revised guidance includes standards for online and remote consultations, additional standards supporting patients where English is a second language, and updated standards for confidentiality, amongst statements on other aspects of consultations.

NHS Confederation suggests CQC should not rush back to old inspection regime

Responding to the CQC announcement that it intends to resume some routine inspections this autumn, the Chief Executive of the NHS Confederation, Niall Dickson, has suggested that the current moment offers an opportunity for rethinking the inspection, regulation and governance of the health and care sectors. Acknowledging the important role of regulation, Dickson has called for lessons to be learnt from this period, “…before than jumping back into the old inspection regime.”

NICE guidance

Diagnostics guidance

DG39 Tests to help assess risk of acute kidney injury for people being considered for critical care admission (ARCHITECT and Alinity i Urine NGAL assays, BioPorto NGAL test and NephroCheck test)

Medtech innovation briefing

MIB 212 MolecuLight i:X for wound imaging

MIB216 FibroScan for assessing liver fibrosis and cirrhosis in primary care

MIB218 Actim Pancreatitis for diagnosing acute pancreatitis

NICE guideline

NG178 COVID 19 rapid guideline: renal transplantation

Quality standard

QS161 Sepsis Updated

Technology appraisal

TA633 Ustekinumab for treating moderately to severely active ulcerative colitis

NIHR alerts

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Health e-news Friday 12 June

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COVID-19 guidance and policy

Latest COVID-19 guidance updates from NHS Employers

The most recent COVID-19 updates from NHS Employers include guidance on infection control and RIDDOR reporting, the addition of a staff risk assessment proforma tool, updates on shielding, and a guide to overtime interpretation.

Updated guide to surgical prioritisation during COVID-19

Guidance on surgical prioritisation during the COVID-19 pandemic has been updated to include material on spinal surgery and paediatric cardiac surgery. The guidance outlines levels of surgical priority for patients, covering the majority of specialties. The categorisation is intended to help plan the allocation of resources, and to facilitate the development regional networks for the delivery of surgery.

RCPCH update guidance on shielded patients

The Royal College of Paediatrics and Child Health (RCPCH) updates its guidance for clinicians on the shielding of clinically vulnerable children and young people. The new guidance identifies two groups of vulnerable individuals and categorises these groups according to a recommendation for continued shielding, or consideration on a case by case basis.

FSRH guidance on restoration of services during COVID-19

The Faculty of Sexual and Reproductive Health (FSRH) have published guidance and a policy position providing recommendations on prioritisation as services are restored. The guidance includes general principles for the restoration of services, offers suggestions for essential services and recovery phases, and identifies priority and vulnerable groups. Also included in the guidance is an outline of positive changes that have been made to accommodate the lockdown, and which should remain in place. The guidance can be read here, and the policy position is available here.

COVID-19 related news

Preliminary results from RECOVERY trial of potential COVID-19 treatments

Preliminary results from the RECOVERY trial, a large randomised controlled trial of possible treatments for COVID-19, show no effect on mortality from the use of hydroxychloroquine in patients admitted to hospital with the virus. The trial, which has enrolled over 11,000 patients from 175 NHS hospitals, is testing treatments including Lopinavir-Ritonavir, Tocilizumab, convalescent plasma, and Hydroxychloroquine. Preliminary results from the arm of the trial testing Hydroxychloroquine have revealed no beneficial effect of treatment with the drug, and enrolment has been stopped.

NHS Confederation report addresses planning for next stage of COVID-19

A report from the NHS Confederation, ‘Getting the NHS back on track; planning for the next phase of COVID-19’, outlines some of the key challenges that organisations are likely to face over the coming months, and offers some practical solutions for phase three guidance and beyond. The recommendations include extending emergency funding across all NHS sectors, implementing ongoing arrangements with private sector providers, delaying CQC inspections, and a review of the impact of COVID-19 on the NHS and social care workforce. The report also make a clear call for appropriate supplies of PPE as services resume, and seeks assurances that the planned test, track and trace system will be both fully operational and robust.

BMA survey results highlight ongoing PPE issues

The results from the latest in a series of BMA surveys suggest that shortages of personal protective equipment (PPE) remains an issue in hospitals and GP surgeries. Around one in five of the respondents report either shortages, or no supply at all of FFP3 masks when working in areas where aerosol-generating procedures (AGP) are carried out, while shortages of gowns and aprons have worsened in non-AGP areas. Issues around female doctors finding masks that fit appropriately have been drawn to the attention of the DHSC.

NICE and NIHR produce advice for developers of COVID-19 medicines

NICE and NIHR have collaborated to produce advice for those developing medicinal products aimed at preventing or treating COVID-19. The guide offers support and recommendations on numerous aspects of proposed trials, including trial design, intended study population, duration, and the reporting of results.

Other news

NHS Employers highlight resources to support WDES reporting

NHS Employers have highlighted some resources on supporting staff with disabilities working within the NHS, in order to help managers and senior leaders address some of the challenges faced. The resources have been made available to help with the preparation and submission of Workforce Disability Equality Standard (WDES) reports, which organisations will be required to submit between 6 July and 31 August.

HSJ announce sponsorship of workplace race equality award

The HSJ has announced its sponsorship of a new workplace race equality award, in an effort to recognise initiatives promoting race equality and inclusion within HNS workplaces. The announcement notes that the Workforce Race Equality Standard (WRES) has helped to bring about some positive changes, and its data has helped evidence the positive outcomes of embracing workforce diversity. Nevertheless, the award entry page acknowledges the continued discrimination and disparity of experience that BME staff can face, and along with inviting submissions of initiatives that have improved workplace equality, offers suggestions to support these necessary changes.

AOMRC publish changing specialties guides for doctors in training

The Academy of Medical Royal Colleges (AOMRC) have published a series of guides offering support for flexibility in postgraduate training, and for doctors in training who wish to change specialties. The guides are accompanied by a set of FAQs which offer answers for doctors in training, as well as for Local Education and Training Boards and medical Royal Colleges.

Kings Fund on learning from staff experiences

The Kings Fund offer some thoughts on the learning that might come from staff experiences during the COVID-19 pandemic, and the potential gains that can be made. The piece argues that, “…staff must have autonomy and control, feel a greater sense of belonging and be supported in order to have a sense of competence, rather than simply being overwhelmed by excessive workload.” It also highlights the importance of reflection, reviews and learning, and calls for compassionate and collective leadership.

NICE guidance

Evidence summary

ES27 COVID 19 rapid evidence summary: Remdesivir for treating hospitalised patients with suspected or confirmed COVID-19

Medtech innovation briefing

MIB211 Archimedes for biopsy of suspected lung cancer

NICE guideline

NG29 Intravenous fluid therapy in children and young people in hospital Updated

Technology appraisal

TA632 Trastuzumab emtansine for adjuvant treatment of HER2-positive early breast cancer

NIHR alerts

Decision aids quickly and accurately rule out heart attack for almost half of all patients tested

Therapists and patients have good quality interactions during telephone sessions

A simple test may predict the risk of hospitalisation for flare-up in patients with COPD, a common lung disease

Statistics

Potential Coronavirus (COVID-19) symptoms reported through NHS Pathways and 111 online

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