Health e-news Friday 3 July

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

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


Statistics

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Health e-news Friday 19 June

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

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

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.

Click here to sign up to this bulletin via email.

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

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Health e-news Friday 5 June

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.

Click here to sign up to this bulletin via email.

COVID-19 guidance and policy

CSP publish Covid-19 palliative care standards

The Chartered Society of Physiotherapists (CSP) has launched a new set of Covid-19 rehabilitation standards, specifically for use in palliative care. The standards, available in full on the CSP website are relevant for all settings, and provide a framework for those providing rehabilitation and physiotherapy for those with Covid-19 who are approaching the end of their life.

BPS publish guidance for psychologists working in palliative care

New guidance from the British Psychological Society (BPS) offers considerations and recommendations for psychologists working in palliative care. The guidance highlights some of the impacts that Covid-19 might have upon end of life care, and the modifications or adaptations that may be necessary to manage these. The guide notes the importance of adhering to the existing relevant NICE Quality Standards, and also stresses the importance of communication and how best to enable this.

Intercollegiate general surgery guidance on Covid-19

Updated intercollegiate guidance on general surgery and Covid-19 has been published, to reflect the information on re-starting surgery available from various organisations, and the emerging data and evidence available. The guidance specifically highlights two separate streams of surgical patients: elective patients known to be free from Covid-19; and acute patients whose status is unknown, and offers considerations for these.

COVID-19 related news

Research bodies boost support for mental health research on COVID-19

The National Institute for Health Research (NIHR) and UK Research and Innovation (UKRI) are seeking research proposals on the identification and mitigation of the mental health effects of the Covid-19 pandemic. Immediate priorities for research that have been identified include the effects of the pandemic on mental health in the whole population and in vulnerable groups; brain function and cognition; and the mental health of patients with COVID-19. The aim of the appeal for proposals is to reduce the emergence of new mental health problems, and to improve outcomes for those whose mental health has already been affected by the pandemic.

Public Health England review of disparities in Covid-19 risks

Public Health England (PHE) have published a review of surveillance data on the disparities in risks and outcomes of Covid-19 infection. Disparities were identified for those of older age, living in deprived areas, and male sex, which replicate the existing inequalities present in UK mortality rates. As broadly reported and discussed, a disparity for those from BAME groups also exists, which deviates from typical data. Many healthcare organisations have responded to the publication, including the NMC, the CSP, the RCP, the RCN, and the AOMRC.  The Health Foundation commented, the  BMA called for action to tackle the issues highlighted, while a report in the HSJ suggests that a section of the report was removed by the government before its publication.

NHS Employers highlight resources to support diversity and equality in the NHS

NHS Employers have highlighted a series of resources that can offer support, recommendations and guidance on implementing positive change on diversity, inclusion and equality within healthcare workplaces. Noting the diversity of the NHS workforce, the organisation points out the need to ensure that the working environment in health and social care is one where all staff feel supported and valued in their work, and are safe.        

Other news

Evidently Cochrane on the absence of evidence

The Evidently Cochrane blog, from the Cochrane Library, considers what the absence of evidence might or might not mean when it comes to research, using examples from recent Cochrane reviews, and newspaper reports of studies to illustrate the matter. The piece highlights some reasons why evidence may not exist, or might be unreliable, including small study sizes, insufficient data, or poorly designed studies, but goes on to impress that the lack of evidence for a treatment does not equate to proof of no effect.

 
NICE guidance

Nice guideline

NG157 Joint replacement (primary): hip, knee and shoulder

Technology appraisal

TA631 Fremanezumab for preventing migraine


NIHR alerts 

Apps to help patients take medication on time need to be evaluated in a consistent way


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Health e-news Friday 29 May

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

NHS Employers update guidance on carrying out staff risk assessments

Guidance from NHS Employers on risk assessments for staff has been updated. The updates have added additional context on COVID-19 and the staff groups that are more vulnerable to serious illness and death, and offer recommendations for ongoing actions that can be taken to mitigate the level of risk to staff. The update also provides guidance on how employers can support colleagues to raise concerns, and offers good practice examples of responses from NHS trusts.

Guidance from WHO/Europe on long-term care and COVID-19

In light of the high numbers of COVID-19 related infections and deaths in care facilities and other long-term care, the World Health Organization (WHO) Europe has produced guidance on how to prevent and manage infections in these settings going forward. The guidance also calls for integrated, person-centred long-term care systems, working in collaboration with health services in order to improve outcomes for residents and staff in care settings, while also minimising pressure on health care systems.

Latest updates to COVID-19 guidance from NHS Employers

The most recent set of updates to COVID-19 related guidance from NHS Employers includes information on: deploying nursing, midwifery and allied health professional students; visa extensions and application process; support resources available for NHS staff; and tips on carrying out interviews via video conferencing.

Guidance on NHS test and trace service

Various guidance on the government’s test and trace programme has been published. This includes an overview of the system, including what happens if you test positive, or have had close contact with someone who has tested positive. Separate guidance has been published for workplaces, offering advice for employers, workplaces and employees, and also for individuals who have had contact with possible or confirmed cases.

Discussion paper from IZA considers design of safe COVID-19 exit strategy

Non-profit research institute, the Institute of Labor Economics, (IZA) has published a paper on the design of strategy for exiting COVID-19 lockdown. The paper argues against a general release strategy, suggesting that this ignores the fatality risks this may pose for citizens in midlife and older. Presenting data from China, Italy and the UK which highlights the strong age pattern in the risk of death from COVID-19, the authors recommend a rolling age-release strategy, combined with continued social distancing measures. The paper also discusses the benefits of releasing lockdown according to the age gradient of risk, including the decreased likelihood of having to introduce further rounds of lockdown.

COVID-19 related news

MHRA offers support for use of remdesivir in COVID-19 treatment

The Medicines and Healthcare products Regulatory Agency (MHRA) has given support for use of remdesivir through the UK’s Early Access to Medicines Scheme (EAMS). This step will enable the drug, which was originally developed as an ebola treatment, to be used in the treatment of adults and adolescents hospitalised with severe coronavirus (COVID-19) infection who meet additional clinical criteria.

Results of RCN survey suggests BAME staff more likely to be left without PPE

A recent RCN member-wide survey suggests disparities in access to personal protective equipment (PPE), and the offer of PPE training, between respondents from BAME backgrounds and those from white British backgrounds. In light of the results, both the RCN and the NMC have reiterated the need for all health and care professionals to have access to the necessary PPE and training to protect themselves and those they care for.

Research highlights value of lung ultrasound in COVID-19 management

A paper in the journal, Anaesthesia, reviews the early evidence and guidance on the use of lung ultrasound in COVID-19 patients. The research considers the diagnostic advantages of ultrasound over alternatives such as CT scans, stethoscopes and chest X-rays, including the high diagnostic accuracy, the portability of ultrasound machines, and the low infection control implications. The article also explores the practical issues around implementing lung ultrasound into routine clinical practice.

Other news

Government research maps current provision of occupational health and work-related MSK services

Research commissioned by the government’s Work and Health Unit to inform the ongoing development of policy relating to occupational health has published its findings. The research aimed to examine the available models of private and NHS service provision; how these are commissioned, resourced and accessed; examine the workforce of private and NHS providers; and investigate the commissioning of MSK and work-related NHS services.

 
NICE guidance

Technology appraisal

TA630 Larotrectinib for treating NTRK fusion-positive solid tumours


NIHR alerts 

Loneliness, but not social isolation, predicts development of dementia in older people

Largest ever trial into a rare cancer of the urinary system shows clear benefits of chemotherapy after surgery


Statistics

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Health e-news Friday 22 May

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.

Click here to sign up to this bulletin via email.

COVID-19 guidance and policy

Guidance on government antibody testing programme

In support of the announcement of an antibody testing programme intended to begin from next week, the government has published guidance explaining the aims of the programme. The guidance details who will currently be eligible for testing, what antibody testing is, and what the test will tell you. In conjunction with the guidance, there is also an infographic to explain the different coronavirus tests; the swab test to identify whether an individual has the virus, and the new antibody test to identify if someone has had it.

New advice for cancer patients undergoing radiotherapy

The Royal College of Radiologists (RCR) have worked with other professional bodies, and leading cancer care charities to created tailored coronavirus guidance for radiotherapy patients. The advice stresses the importance of continuing with treatment, and aims to reassure patients of the precautions being taken by cancer centres to prevent the transmission of the virus, and to keep patients and staff as safe as possible.

FICM guidance addresses delivery of critical care during transition

New guidance from the Faculty of Intensive Care Medicine (FICM) reflects upon the changes in provision that were made to accommodate COVID-19 patients, and addresses the considerations that will have to be faced in the transition back to restoring more routine services. These include issues relating to capacity, staffing levels and the availability of drugs, consumables and PPE, as well as the need to manage infection control, potentially by adapting the site of service delivery.

CPOC advice for patients going for surgery

The Centre for Perioperative Care (CPOC) has published FAQs to address some of the concerns that patients may have about going to hospital during the ongoing pandemic, and to offer advice on how best to prepare for an operation. The series of FAQs take patients through measures being taken to protect patients and staff, and questions to ask the hospital, as well as providing an idea of the surgery journey.

COVID-19 related news

NHS Confederation stress importance of testing, tracking and tracing strategy

In an open letter to the Secretary of State for Health and Social Care, Chief Executive of the NHS Confederation, Niall Dickson, highlighted the crucial nature of implementing a coherent test, track and trace strategy, involving local agencies and public health professionals, in order to limit the risk of unleashing another wave of infections when lockdown measures are further eased.

Government announces antibody testing programme

A new antibody testing programme, intended to start from next week, will offer tests to NHS and care staff and eligible patients and care residents. The test will aim to identify whether someone has already had the virus, and to provide data on the antibodies they have developed. While there is no current evidence that the presence of antibodies means a person is immune to COVID-19, or that they cannot be re-infected or pass the virus along to others, data from the testing will help to answer questions relating to immunity that are currently under examination, and will offer additional information on the prevalence of the virus.

New trial to look at whether dogs can help with detection of COVID-19

Trials to explore whether specially trained ‘detection dogs’ may be able to detect coronavirus in humans are set to begin. The research will bring together researchers from the London School of Hygiene and Tropical Medicine (LSHTM) and Durham University, with the charity Medical Detection Dogs. Dogs have already been successfully trained to detect the odour of diseases such as cancer, malaria and Parkinson’s in humans, and the new research will see if dogs could detect COVID-19 even before symptoms appear.

Research to examine re-purposing of existing immune response drugs

A new trial, led by Cambridge and King’s College London, will set out to test whether existing drugs which target the body’s immune response, can be re-purposed for use in the treatment of COVID-19. For those patients who develop a severe case of the virus, the most serious symptoms appear to be caused by the immune system response, which results in the destruction of healthy cells as well as those infected by the virus. The two drugs to be trialled are Ravulizumab and Baricitinib, and have been chosen by doctors and scientists with expertise in immune-response diseases.

Other news

Mental Health Awareness week centres upon theme of kindness

Hosted by charity the Mental Health Foundation, Mental Health Awareness week this year is centred upon the theme of kindness. On the website supporting the week, there are resources discussing why kindness matters, and the links between kindness and good mental health, a look at some of the research on kindness, and some thoughts on the importance of kindness in public policy.

FICM guidance on enhanced care in the acute setting

The Faculty of Intensive Care Medicine (FICM), in collaboration with the Royal College of Physicians (RCP) have produced guidance for the development of enhanced care in the acute hospital setting. The guidance addresses those patients whose needs fall into the gap between critical care and the provision available on a normal ward, and outlines a framework to be considered in developing a service to meet these needs.

Royal College of Surgeons offer five tips for Mental Health Awareness Week

The Royal College of Surgeons have highlighted five things that can be done to support good mental health. While some of the advice is more specifically aimed at surgeons, the list includes advice on taking time for self-care, making use of support networks or trusted colleagues, and being kind to others.

 
NICE guidance

Evidence summary

ES24 COVID-19 rapid evidence summary: angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) in people with or at risk of COVID-19

ES25 COVID-19 rapid evidence summary: Long-term use of non-steroidal anti-inflammatory drugs (NSAIDs) for people with or at risk of COVID-19

ES26 COVID 19 rapid evidence summary: Anakinra for COVID-19 associated secondary haemophagocytic lymphohistiocytosis

Medtech innovation briefing

MIB217 Cytokine adsorption devices for treating respiratory failure in people with COVID-19

Nice guideline

NG160 COVID-19 rapid guideline: dialysis service delivery Updated

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

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


NIHR alerts


Statistics

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Health E-news Friday 15 May

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.

Click here to sign up to this bulletin via email.

COVID-19 guidance and policy

NHS Employers highlight recent guidance updates

NHS Employers highlight the most recent updates to COVID-19 guidance for NHS workforce leaders. The updates include new information on registering staff for COVID-19 testing, FAQs on the extension to visas for international healthcare professionals, and details of the professions covered by the extension scheme.

Risk reduction framework for healthcare staff published

A new framework produced by the Faculty of Occupational Medicine, and backed by NHS England, offers recommendations on how to reduce the risks of COVID-19 to healthcare staff. Based upon the current evidence available on the heightened risks linked with characteristics including age, gender, ethnicity and long term health conditions, the framework offers recommendations on how to approach risk assessments incorporating the workplace, workforce and the individual. One potential consideration is for the redeployment of staff to lower risk environments.

Guidance supporting compassionate visiting arrangements

NHS England have produced guidance on supporting compassionate visiting arrangements for those receiving end of life care. The guidance highlights general practical considerations, and provides advice on how to facilitate visiting in inpatient, hospice, care home settings, as well as at home. All recommendations are consistent with the existing advice on suspension of visiting and palliative care in hospitals, and general advice from the government.

Resources to support staff in difficult conversations

Health Education England (HEE) have produced a set of resources aimed at supporting staff to manage difficult conversations with patients and families during the Covid-19 outbreak. A series of films have been produced, alongside some print resources aimed to guide the process of communicating unwelcome news.

RCN course supporting delivery of end of life care

The Royal College of Nursing (RCN) has developed a learning resource to support the delivery of dignified end of life care. The programme is intended to equip staff with some of the resources necessary to support dying people and their family and carers, and to ensure the provision of dignified end of life care, and also offers support for the wellbeing and self-care of nursing and midwifery staff. The online programme has been designed to be flexible, allowing staff to access and revisit individual resources as necessary.

Multidisciplinary guidance for safe tracheostomy during Covid-19

Multidisciplinary guidance published in the journal Anaesthesia, brings together the work of surgeons, anaesthetists, intensive care staff, nurses, physiotherapists, speech & language therapists and importantly, from patient groups, offering consensus on how to improve safety in tracheostomy of patients with Covid-19. Topics covered by the guidance include: the infectivity of patients with respect to tracheostomy indications and timing; aerosol‐generating procedures and risks to staff; insertion procedures; and management following tracheostomy.

Rehabilitation of Covid-19 patients

Two new sets of guidance provide recommendations for the rehabilitation needs of patients surviving COVID-19 related critical illness. The Faculty of Intensive Care Medicine (FICM) have produced provisional guidance on the recovery and rehabilitation of patients, considering the necessarily multidisciplinary nature of the services and professionals involved, and providing an example hospital care pathway.

Meanwhile, the Chartered Society of Physiotherapists (CSP) have launched a set of standards aimed at physiotherapists and service leads, and outlining the need for continuation of rehabilitation from critical and acute care  through to hospital or community-based rehabilitation services.

Reintroducing healthcare services

A series of resources have been produced, outlining key principles for reintroducing routine aspects of the healthcare services in the UK that have taken a backseat during the first peak of COVID-19:

NHS England have produced a road map, noting the requirement for patients to isloate for 14 days prior to attending planned procedures, and to be symptom free in order to be admitted. It also mentions testing and social distancing requirements relating to both elective and emergency treatment.

NHS Providers have produced a briefing on balancing the needs of managing the ongoing demands and risks of COVID-19 treatment, alongside restarting care for other healthcare needs.

 A joint piece from the Health Foundation, The King’s Fund and Nuffield Trust identifies five immediate challenges they believe the NHS face, including reassuring the public about using the services they need, looking after the workforce, and using the changes that have been made to services as the basis for future innovation and improvement.

The Academy of Medical Royal Colleges (AOMRC) have published principles for reintroducing healthcare services, again addressing the use of remote or virtual care where appropriate, the need for the public to seek necessary medical help, and staff support. Their guidance also provides further links to key specialty specific and individual College guidance.

Intercollegiate guidance on the pre-operative COVID-19 testing for elective cancer surgery has been updated. The guidance, from organisations including the Royal College of Surgeons of Edinburgh (RCSED), the Royal College of Surgeons of England (RCS) and the Royal College of Radiologists (RCR), clearly outlines the necessary process for screening before surgery.

The British Orthopaedic Association (BAO) have issued new guidance on restarting non-urgent trauma and orthopaedic care. The guidance comprises three sections: capacity issues for resuming surgery; infection prevention and control measures for planned surgery and prioritising patients for surgery.

A number of NHS unions have jointly produced a blueprint for return, focussed on keeping staff and patients safe.

COVID-19 related news

New study will attempt to identify genetics that may influence COVID-19 reaction

A new study will attempt to explore how genetics might influence individual reactions to COVID-19, offering explanations as to why some patients experience a mild infection, while others’ response of the virus is much more severe. In setting out to identify which genes cause particular people to be susceptible to specific infections, the study aims to determine which existing treatments may be effective, and to support the development of new treatments.

Cochrane Rapid Review on convalescent plasma for COVID-19 treatment

A Cochrane Rapid Review published yesterday, examines the evidence for convalescent plasma in the treatment of patients with COVID-19. While the existing evidence consists of 8 very small studies, meaning the effectiveness and safety of this treatment is uncertain, the authors identified 48 ongoing studies into the use of convalescent plasms in COVID-19 patients. The review will be updated based on monthly searches.

RCN urges better tracking of data on COVID-19 infection in healthcare workers

The Royal College of Nursing (RCN) has called for the collection of accurate data on health and care staff who contract COVID-19 in an open letter sent to the UK’s health secretaries and ministers. The letter states that a failure to properly collect data on workers testing positive, those admitted to hospital or having died as a result of the virus, means that decisions are being made without sufficient information.

HEE announce medical rotations will take place in August

Trainee rotations in August will take place as planned, Health Education England (HEE) have announced, following the cancellation of all planned rotations in May, June and July. Trainees in Foundation and Core posts will rotate at the beginning of August, though these will take account of local requirements and COVID-19 pressures. A webinar for trainees will take place at 7pm on Tuesday 26 May, and further information and up to date guidance for trainees can be found on the HEE website.

RCP urges ‘new deal’ for international health and social care staff

The Royal College of Physicians (RCP) has called on the government to make changes for international health and social care staff, in recognition of their vital frontline role, which has been highlighted during the management of the current pandemic. Changes proposed by the RCP would see staff exempted from the International Health Surcharge, extension of the proposed NHS Visa to social care staff, and indefinite leave to remain offered to all NHS and social care staff who have worked during the pandemic, along with their spouses and dependents.

RCOG and RCM respond to study on pregnant women and COVID-19

The Royal College of Obstetricians and Gynaecologists (RCOG) and the Royal College of Midwives (RCM) have published a joint statement in response to a study on the outcomes of pregnant women and their babies during the pandemic. Findings from the UK study support the existing clinical guidance that pregnant women are at no greater risk of severe illness, but did show that older pregnant women, or those who were obese or overweight, had pre-existing conditions including diabetes, or were of BAME background were more likely to be hospitalised if infected. In addition, the majority of women hospitalised were in the third trimester of their pregnancy.

POST briefings examine expert concerns over COVID-19

The Parliamentary Office of Science and Technology (POST) have produced a series of briefings based on the concerns that experts have relating to COVID-19 and various aspects of short, medium and long-term management and treatment. The briefings address concerns about the health and social care system, future preparedness for public health crises, research into testing, treatment and therapies, and the virology, immunology and epidemiology of COVID-19.

Centre for Mental Health forecast increased mental ill health

The Centre for Mental Health has used international evidence from previous epidemics and the aftermath of the 2008 banking crisis, to estimate the potential effects of COVID-19 on the mental health of the UK population. The briefing highlights groups who are at especially high risk of mental health difficulties, and offers recommendations for action that the government and the NHS can take in order to protect and support the mental health of the population.

Other news

Nurses Day celebrated amidst changed circumstances

International Nurses Day took place on the 12 May, and while planned celebrations had to be put on hold, or much adapted in light of the current pandemic, the always vital contribution of nursing staff to the healthcare system was still marked, locally, nationally and internationally. The RCN created a video to mark the day, and also urged nursing staff to ensure their own self-care and wellbeing.

 
NICE guidance

Medtech innovation briefing

MIB215 Space from Depression for treating adults with depression

Nice guideline

NG176 COVID-19 rapid guideline: chronic kidney disease

NG177 COVID-19 rapid guideline: interstitial lung disease

Technology appraisal

TA628 Lorlatinib for previously treated ALK-positive advanced non-small-cell lung cancer

TA629 Obinutuzumab with bendamustine for treating follicular lymphoma after rituximab


NIHR alerts 

Functional braces are effective alternatives to plaster casts for ruptured Achilles tendons

Eplerenone does not improve vision in people with central serous chorioretinopathy


Statistics

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Health E-News Friday 8 May

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.

Click here to sign up to this bulletin via email.

COVID-19 guidance and policy

Joint statement addresses death certification during COVID-19 pandemic

A joint statement from the Care Quality Commission, the General Medical Council and Healthcare Improvement Scotland addresses questions raised by changes to the legislation relating to completion of the medical certificate cause of death (MCCD). The statement provides clarity over certification of death in cases where a positive swab diagnosis of COVID-19 is not available, advising practitioners to apply clinical judgement in stating the cause of death. The statement also makes it clear that the inclusion of COVID-19 in any part of the MCCD should be a matter solely for the doctor completing the form.

Government guidance on verifying deaths outside of hospitals

The government has published guidance clarifying practice for verifying deaths outside of hospitals and providing a framework for safe verification of death during the coronavirus emergency. The guidance applies to all cases outside of hospital, and supports verification of death by registered professionals, including paramedics, medical practitioners and registered nurses.

AOMRC statement on CPR and personal protective equipment (PPE)

The Academy of Medical Royal Colleges (AOMRC) have released a statement on the use of PPE when carrying out chest compressions and defibrillation as part of resuscitation, addressing divergent recommendations. Revised guidance from Public Health England does not include CPR on the list of aerosol generating procedures, and advises that first responders can begin CPR and defibrillation without the need for PPE. In contrast, guidance from the Resuscitation Council (UK) considers chest compressions to be an aerosol generating procedure and that PPE should be used where available, while they advise use of a cloth or towel in community settings if there is a perceived risk of infection. The statement also includes links to College specific guidance on CPR and PPE.

COVID-19 related news

IFS report examines evidence of disproportionate effect of COVID-19 on BAME groups

The Institute for Fiscal Studies (IFS) have published a report examining the evidence that the impact of COVID-19 is not uniform across ethnic groups, including the stark reality that in the UK, per-capita deaths amongst the black Caribbean population have occurred at three times those of the white British population. The report also explores the broader socio-economic impacts on BAME groups of the pandemic more generally. Meanwhile, a study from Imperial College looking at the characteristics and outcomes of hospitalised COVID-19 patients, also found an increased risk of mortality amongst people in BAME groups, and figures from the Office of National Statistics (ONS) suggest that black males are 4.2 times more likely to die from COVID-19 than white males. A recent piece from the King’s Fund considers what can be done to tackle these issues from the perspective of those working in health care.

Chief Medical Officers urge recruitment of more COVID-19 patients

The UK’s four Chief Medical Officers and NHS England and Improvement’s’ National Medical Director have written a joint letter to every NHS Trust, emphasising the importance of enrolling more patients into nationally prioritised COVID-19 clinical trials. In the absence of any proven existing treatment, the need for evidence from trials is especially important in guiding future treatment options.

RCEM set out recommendations for ‘resetting’ emergency department care

In a position statement published this week, the Royal College of Emergency Medicine (RCEM) have set out five fundamental aims that they believe to be necessary for emergency department care in the aftermath of the peak of the COVID-19 pandemic. The aims and associated recommendations in the statement call for emergency department care to be reset, and urge wholesale change to improve patient safety and the wellbeing of staff in emergency departments.

RCOT call on members to join the ‘Big Rehab Conversation’

The Royal College of Occupational Therapists (RCOT) are calling on members to join the ‘Big Rehab Conversation’ – a series of one hour virtual sessions held over Zoom every other Thursday evening. The first meeting will take place on Thursday 14 May. The discussions are intended to help set best practice for rehabilitation, and to identify challenges that might arise in the rehabilitation of people recovering from COVID-19. Interested members can sign up here.

Other news

RCN make preparations to mark Nurses’ Day on May 12

Next Tuesday, the 12 May marks Nurses’ Day, on the 200th anniversary of the birth of Florence Nightingale. In light of the COVID-19 pandemic, many plans to recognise and celebrate this day will have to be adapted, but the Royal College of Nursing (RCN) highlight the added importance of shining a light on the remarkable work done by nurses, and ask the public and patients to use the day to thank nurses around the world. The RCN website will be updated to note the day.

 
NICE guidance

Nice guideline

NG175 COVID-19 rapid guideline: acute kidney injury in hospital


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Presenting: (new) Pubmed interface

PubMed users will have noticed a new version of Pubmed, which will become the default after 18 May 2020.

How to access the new Pubmed

Customised versions of PubMed make it easier to access the full-text of articles where they are available.

NHS users should use the following link, to access content available through OpenAthens: https://www.ncbi.nlm.nih.gov/pubmed/?otool=igbsgnhslib

Staff and students of St George’s, University of London should use the following link to access content available through your university login: https://www.ncbi.nlm.nih.gov/pubmed?otool=igbsgulllib

What’s new?

Changes to the site have primarily been made in order to offer an updated and more responsive PubMed, that provides the same experience and tools for users across all types of devices, from laptops to tablets and phones. Find out more about the transition from old to new here.

Some of the key changes to how results are presented include:

  • A new and improved best match, which is now the default sorting
  • A new summary view for results, which includes snippets from the abstract of each article

A new user guide and FAQs are available on the PubMed home page, or can be accessed directly here, and any questions, comments or other feedback can be shared using the Feedback button at the bottom of the new site. For those wishing to keep up to date with enhancements and changes to PubMed as they happen, follow the New and Noteworthy page.

There is lots of online training available for Pubmed. Their tutorials and on-demand course for the new interface are particularly useful.

How to find articles in Pubmed

Best search practices in the new PubMed remain the same as the legacy system:

  • To find articles by topic, enter your keywords or phrases into the search box and let PubMed’s term mapping do the work for you. Remember to be specific, don’t use quotation marks, search tags, or boolean operators, and avoid truncation (*)
  • To find articles by citation, enter the citation elements you have (author, title words, journal, volume, year, etc.) and let the citation sensor find the article for you
  • To find articles by author, search the author’s last name and initial(s)
  • To find articles by journal, use the complete journal title, ISSN or title abbreviation

During these uncertain times, we continue to provide support to all at St George’s. Whether you are NHS staff, a student or a researcher, don’t hesitate to get in touch and we will be able to advise. Email us at liaison@sgul.ac.uk.

Health E-News, Friday 1 May

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.

Click here to sign up to this bulletin via email.

COVID-19 guidance and policy

NHS Employers highlight COVID-19 guidance updates for workforce leaders

The most recent updates to COVID-19 guidance for workforce leaders are highlighted on the NHS Employers website. Updates include guidance on deploying medical students, deploying returning doctors, overseas recruitment, and death in service benefits. The complete collection of workforce guidance can be found here.

Government guidance on supporting adults with autism or learning disabilities

The Department of Health and Social have published guidance for care workers and personal assistants supporting adults with learning disabilities and adults with autism. The guidance aims to help staff keep those they work with safe, and to protect their own wellbeing. It offers recommendations for communication of the changes that might be required under the current circumstances, and how to continue to maximise independence as far as possible. The guidance also links to further helpful resources for carers, and easy read resources that might be helpful.

COVID-19 related news

Report considers how to approach coronavirus exit strategy

The Institute for Government have published a report detailing the key issues of facing a long-term exit strategy for the current coronavirus lockdown. Acknowledging the inevitable trade-offs to be faced, the report stresses the need for the government to explain how it will balance economic concerns with the health concerns of lifting restrictions. It discusses the objectives of the government and the steps that might be taken to exit lockdown, and considers the various ways in which these two might interact. Some necessities for a successful exit, the report argues, is having adequate testing and tracing capacity in place, and transparency and a readiness to explain choices.

RCSLT report on dysphagia assessment

An expert advisory group within the Royal College of Speech and Language Therapists (RCSLT), set up in response to concerns from members on the government’s personal protective equipment (PPE) guidance, has published their report on dysphagia assessment. The report finds that dysphagia assessment should be considered an aerosol generating procedure, and should therefore be included in the list of such procedures within guidance on PPE. The report is backed by the Intensive Care Society, the National Tracheostomy Safety Project, the British Thoracic Society, ENT UK, the UK Swallow Research Group, the European Society for Swallowing Disorders, the British Association of Parenteral and Enteral Nutrition, and the British Association of Stroke Physicians, and has been sent to the government.

CSP resources to help with remote service delivery

The Chartered Society of Physiotherapists (CSP) have developed a series of resources to help physiotherapy staff support patients to remain active and to self-manage existing conditions during the COIVD-19 restrictions. The resources include support for general activity and strength and balance, alongside collections specifically for cancer and pain management, arthritis and osteoporosis, and respiratory illnesses, amongst others.

Visa extension scheme to be applied to allied health professionals

The government has announced that all regulated professions in the health and care sector will be covered by the visa extension scheme, meaning allied health professionals will now be covered. The Royal College of Occupational Therapists welcomed the announcement, who, alongside the CSP had called on the government to take this step to protect allied health professionals in addition to the medical staff originally covered by the extension.

Considering the second phase of the NHS response to COVID-19

Following correspondence on the second phase NHS response to COVID-19, a number of responses have urged a cautious approach to reintroducing normal NHS activity. A joint statement from the Faculty of Intensive Care Medicine and the British Association of Critical Care Nurses highlights the need to consider the potential impact on critical care and its capacity; while Niall Dickson, chief executive of the NHS Confederation called for local clinicians and managers to lead on the redesign of services as the situation unfolds.

Other news

Shorter course of radiotherapy could benefit early stage breast cancer treatment

Results from a pioneering study suggest that women with early stage breast cancer can be treated with fewer but larger daily doses of radiotherapy, delivered in a shorter overall duration compared with the current standard. The trial involved more than 4,000 patients and evaluated two different radiotherapy programmes, and offers findings which could reduce treatment times for early stage breast cancer patients. The full findings have been published, and are available online in The Lancet.

 
NICE guidance

Nice guideline

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

NG160 COVID-19 rapid guideline: dialysis service delivery Updated

NG161 COVID-19 rapid guideline: delivery of systemic anticancer treatments Updated

NG163 COVID-19 rapid guideline: managing symptoms (including at the end of life) in the community Updated

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

NG169 COVID-19 rapid guideline: dermatological conditions treated with drugs affecting the immune response Updated

NG173 COVID-19 rapid guideline: antibiotics for pneumonia in adults in hospital

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


Statistics

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