Involving children and young people in health services

Extract from The King’s Fund:  NHS Confederation

Involving children and young people in health services 
This report highlights the key findings and recommendations from an event held in September 2011 to discuss the key priorities for child health.

All-Party Parliamentary Group on Dementia (APPG)

Inquiry into how to improve dementia diagnosis rates in the UK
The APPG has launched its next inquiry which will focus on improving dementia diagnosis rates across the UK. An inquiry into this area will bring together more evidence and understanding about the current problems there are to improving diagnosis of dementia. It will also find good practice examples where services have been helpful to people with dementia getting an early diagnosis, and ensuring they have proper information and support afterwards, so that these examples can be shared. The APPG is seeking evidence from people with dementia and their carers, health and social care providers and practitioners, and key stakeholder organisations and professional bodies. The deadline for submission of evidence is 2nd March 2012.

MIND matters

  Extract from The King’s Fund

Managing and supporting mental health at work: disclosure tool for managers
The Chartered Institute of Personnel and Development carried out a survey of 2,000 people in employment in the UK which revealed that despite more than a quarter (26%) of employees having experienced a mental health problem while in employment, too few employers are taking positive steps to manage this increasingly business critical issue. This guidance, produced by Mind, will help employers ensure that how they manage people supports their mental wellbeing and resilience, and also encourage more employees to talk about any mental health issues they may be facing at an early stage.

eLearning alternative to ECDL

The ICT Department informs us that the ECDL course is no longer offered through the NHS and there is no replacement.

Alternatively, staff at work may access the website at: at to view recorded ‘virtual classroom’ sessions and How Do I Guides.

There is also the Microsoft Office Specialist course in Office 2003, 2007 or 2010.  Staff can register for their chosen course and receive access to all the workbooks, study materials and details on how to register for Microsoft E-learning.

Keys, GW et al: Bone Joint Surgery Br, Dec 2011

 Bone Joint Surg Br.2011 Dec;93(12):1610-6.

Examination of ten fractured Oxford unicompartmental knee bearings.


Botnar Research Centre, Nuffield Orthopaedic Centre, University of Oxford, Windmill Road, Oxford OX3 7LD, UK.


Since the Oxford knee was first used unicompartmentally in 1982, a small number of bearings have fractured. Of 14 retrieved bearings, we examined ten samples with known durations in situ (four Phase 1, four Phase 2 and two Phase 3). Evidence of impingement and associated abnormally high wear (> 0.05 mm per year) as well as oxidation was observed in all bearings. In four samples the fracture was associated with the posterior radio-opaque wire. Fracture surfaces indicated fatigue failure, and scanning electron microscopy suggested that the crack initiated in the thinnest region. The estimated incidence of fracture was 3.20% for Phase 1, 0.74% for Phase 2, 0.35% for Phase 3, and 0% for Phase 3 without the posterior marker wire. The important aetiological factors for bearing fracture are impingement leading to high wear, oxidation, and the posterior marker wire. With improved surgical technique, impingement and high wear should be prevented and modern polyethylene may reduce the oxidation risk. A posterior marker wire is no longer used in the polyethylene meniscus. Therefore, the rate of fracture, which is now very low, should be reduced to a negligible level.

Crotch-Harvey MA: Breast Cancer Research, November 2011: Conference abstract

Title: Occult breast carcinoma presenting with axillary lymphadenopathy
Citation: Breast Cancer Research, November 2011, vol./is. 13/(S11-S12), 1465-5411 (04 Nov 2011)  Author(s): Crotch-Harvey M.A.
Abstract: Introduction Occult breast carcinoma presenting with axillary lymphadenopathy is an uncommon but difficult clinical problem. The most appropriate diagnostic pathway, the prognosis and the best form of treatment may be uncertain. To answer these questions, we have examined the outcomes of women presenting in this way over a number of years. Methods Thirteen women were identified prospectively over a 12- year period, presenting with suspicious lymphadenopathy but no identifiable breast tumour on initial mammography or ultrasound. Biopsy of the abnormal nodes was consistent with a breast primary in all cases. All women had further imaging with breast MRI (11 cases), breast scintigraphy (one case) and CT scanning of the chest and abdomen. Second-look ultrasound was targeted to suspicious areas identified on second-line imaging. The type of treatment, presence of distant metastases and survival were recorded. Results Further imaging revealed a primary breast lesion in seven cases, six remained truly occult. Follow-up ranged from 3 to 144 months (mean 38 months). Three patients died, one is alive with distant metastases and nine remain disease free. Those with no identifiable primary were treated with chemotherapy usually in combination with radiotherapy. Conclusion The use of MRI and targeted ultrasound-guided biopsy revealed primary tumours in approximately half our cases presenting with lymphadenopathy and negative conventional imaging. Chemotherapy with radiotherapy appears to be an effective treatment for occult breast cancer. The initial staging tests are crucial and if clear the prognosis appears similar to patients with breast cancer and positive axillary nodes.
Publication Type: Journal: Conference Abstract
Source: EMBASE
Full Text:
Available in selected fulltext at BioMedCentral
Available in fulltext at National Library of Medicine

A timely look at staff appraisal

Extract from the second issue of Mastering Management in Healthcare: a practical resource

In this issue:


This article is all about developing you and your staff. The advice is kept as  practical as possible and include things that you can apply immediately. The intention is to try and provoke you to think differently about how you manage and encourage you to innovate and experiment.

Staff Appraisal – chore or golden opportunity?

A common challenge facing clinicians entering management roles is how to conduct appraisals for the staff now reporting to them. Quite apart from practical issues such as finding the time and an appropriate environment, the employer may also have a particular format to follow, and the whole process can end up looking like one big distraction from the main objective – providing care.

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HTA: New study into fluid in the middle ear

Health Technology Assessments

New study into fluid in the middle ear funded

A new study looking at the best treatment for children with fluid in the middle ear has been funded by the NIHR HTA programme.

Cleft lip and palate are among the most common inherited abnormalities effecting around one in 700 individuals and approximately 1000 children being born with cleft lip and palate each year. Historically, care for this group of children was delivered in a fragmented way across 57 centres in the UK.  [more…]