Don’t forget your Diabetes UK – elearning

If you prescribe, prepare or administer insulin make sure you complete the Diabetes UK e-learning programme available at

When you register you will need to know your ESR staff number (see payslip) plus the Trust prefix 209. Complete the Learner tutorial and Safe use of Insulin modules and deliver safe care.

Health Matters in March: Shoulder replacement surgery

The next in the popular series of monthly public lectures – ‘Health Matters’, will take place on Tuesday 6 March 2012, ‘Shoulder replacement surgery – how does it work and who will benefit’ presented by Jochen Fischer, Consultant Upper Limb Surgeon. The session will examine what shoulder replacement surgery involves and the benefits of this surgery for arthritic patients.

For further information on ‘Health Matters’ and to book your place at the 7 March lecture, from 7.00pm, Macclesfield District General Hospital, Education and Training Centre please contact The Communications and Engagement Department on freephone 0800 195 4194 or email

6 great reasons to visit the Library

  1. Visit our great BOOK EXCHANGE – taking place all this week at lunchtimes upstairs in ‘Spirals’.  You can swap or donate 1 book or half a dozen!
  2. Receive support with literature searching whether you are based in the community or an acute setting.
  3. We can order books or journal articles for you for a very small charge
  4. Take part in the 6 book challenge – a great reason to seek out some new stories
  5. Get connected using our free Internet and WIFI.  Find a comfortable spot in ‘Spirals’ to use your laptopamabob!!
  6. Need help with using e-learning?  We can help you to get started on courses like Information Governance. 

If you have a query about our services or facilities or anything listed above, please contact us on 01625661362 or email us at  the Staff Library on

NEW Journal Watch

If you visit our Community page, you will see the latest newsfeed to be added, entitled Journal Watch, put together by Richard Leman.  Thirty years ago Richard became a general practitioner in Banbury.  “For the last ten years he has written down personal comments on the main general medical journals, first of all for his immediate colleagues, soon after for the Oxford University Department of Primary Care, and over subsequent years for an ever-growing readership throughout the world.”

Under the CEBM banner, Richard continues to regularly look at individual journals like The Lancet and BMJ, then summarises some of the most interesting articles. This should be of particular interest to GPs.

Extract from CEBM at

Eyes on Evidence: Biologic drugs for the treatment of psoriasis

Overview: Psoriasis is a skin condition in which skin cells reproduce too quickly, causing red, flaky, crusty patches with silvery scales. It affects about 2% of the UK population and is a chronic condition that often goes through cycles and can return at any time. There are several clinical variants of psoriasis, including plaque, guttate, erythrodermic and pustular. Plaque type is the most common form, accounting for 80% of cases. Psoriasis runs in families, although the exact role of genetics in the condition is unclear. The inflammatory processes of psoriasis are not fully understood but it is known that levels of tumour necrosis factor-alpha (TNF-alpha) are elevated in the skin of people with the condition.

See the NHS Evidence topic page on psoriasis for a general overview of the condition.

NICE recommends the use of biologic drugs infliximab, adalimumab and etanercept when psoriasis is severe and has failed to respond to standard systemic therapies such as methotrexate. Continue reading

Eyes on Evidence: Benefit of adjuvant radiotherapy in breast cancer

Overview: Breast cancer is the most common cancer affecting women in Englandand Wales, with about 40,500 new cases diagnosed and 10,900 deaths recorded in Englandand Waleseach year. In men breast cancer is rare, with about 260 cases diagnosed and 68 deaths in Englandand Waleseach year.

Current treatment: Treatment for breast cancer usually involves surgery to remove part, or all, of the breast. Depending on the type and stage of breast cancer, this may be followed by radiotherapy, endocrine therapy, biological therapy or chemotherapy.

The NICE Pathway: breast cancer, brings together all related NICE guidance and associated products on the condition in a set of interactive topic-based diagrams. For all patients with early breast cancer NICE advises starting adjuvant chemotherapy or radiotherapy as soon as clinically possible and within 31 days of surgery.
New evidence: A meta-analysis by The Early Breast Cancer Trialists’ Collaborative Group (EBCTCG) of individual patient data for 10,801 women in 17 randomised trials examined the effect of radiotherapy after breast-conserving surgery on 10 year recurrence and 15 year breast cancer death (Darby 2011).

The findings show a reduction in cancer recurrence within the first year after radiotherapy which lasts throughout the first decade. By 10 years after breast cancer diagnosis, 35% of the women who did not have radiotherapy had a recurrence, compared with only 19% of the women who had radiotherapy. The effect of radiotherapy on breast cancer mortality was evident 15 years after breast cancer diagnosis, by which time 25% of the women who did not have radiotherapy had died from breast cancer compared with 21% of the women who had radiotherapy. These results suggest that killing microscopic tumour foci in the conserved breast with radiotherapy reduces the potential for both local recurrence and distant metastatis.

The researchers note that there was no substantial adverse effect of radiotherapy on the 15-year risk of death from the aggregate of all causes other than breast cancer so that, among the women who did have radiotherapy, the 15-year risk of death from any cause was reduced by almost as much as the reduction in breast cancer mortality. They add that screening, surgery, pathology, radiotherapy, and systemic therapy have all changed substantially since most of these women were randomly assigned, so the absolute recurrence reduction with radiotherapy in future patients might differ greatly from that recorded in these trials.

However, because radiotherapy roughly halved the recurrence rate after breast-conserving surgery in a wide range of patients with very different absolute risks suggests that it might also roughly halve the recurrence rate in future patients given breast-conserving surgery.

Commentary: “This report updates an earlier 2005 systematic overview of radiotherapy effects in women undergoing adjuvant radiotherapy for early breast cancer. It represents the most authoritative statement available on treatment outcomes, based as it is on level I evidence. The updated evidence confirms that the beneficial effects persist for at least 15 years, and that there is no evidence of adverse effects on survival even after this long interval. The subgroup analyses suggest that identifiable populations of women have more to gain than others, particularly younger age groups and those of any age with higher grade tumours. Older age groups with small, oestrogen receptor rich, low grade tumours appear to have low risks of local relapse after complete microscopic resection and adjuvant endocrine therapy, even without radiotherapy, raising the opportunity for prospective cohort studies evaluating selective avoidance of radiotherapy in future”. –

John Yarnold, Professor of Clinical Oncology,InstituteofCancerResearch andRoyal MarsdenHospital, Sutton.

The great BOOK Exchange!

Come along to the Staff Library any lunchtime next week Feb 13- 17 and take part in our first Book Exchange. It’s an opportunity to meet other readers and swap paperbacks you have read for something new.  No money needed. Bring 1 book or 6 and take a few minutes to browse the shelves over a cup of tea or coffee.

You don’t have to swap. If anyone simply wants to donate some of their books, we will be happy to take them.

Are you up for a challenge?

The Staff Library is inviting all staff to discover or rediscover a love of reading via the Six Book Challenge. Starting this month and running through until the end of June 2012, staff are encouraged to sign up to the challenge, which involves reading six books of their choice and writing a brief summary of their response to each book. There will be prizes along the way and entry into the final prize draw, as well as a completion certificate for each reader. We are kicking this event off  with a Book Exchange during the week beginning February 13, where staff can bring any used fiction books to the library to swap for other titles or simply donate, and perhaps meet other interested readers. This will take place each day in the Library’s ‘Spirals’ meeting room between 12:30-1:30pm, although staff can come over any time that week as suits their schedules.

Diabetes UK e-learning programme

Calling all Healthcare Staff

It is a requirement of the NPSA report that all healthcare staff who are expected to prescribe, prepare or administer insulin complete the Diabetes UK e-learning programme

Can you please cascade to all staff in your areas who this may apply to and ensure that they complete the e-learning programme before 31st March 2012

To register for the programme at staff will need their 8 digit ESR staff number found their payslip and will need to prefix this with the Trust number 209

Please follow the 10 steps below to register and access the training:

See with you ESR number and Trust code to hand

  • Select Safe Use of Insulin Module
  • Click on e-learning courses  link
  • Click on “The 111 e-learning module is now available click here to access” button
  • On Welcome Page selectEngland
  • Register for the programme (Login if already registered)
  • Accept terms and conditions box if registering for the first time
  • Input ESR staff number with  209 prefix
  • Complete Learner Tutorial
  • Complete Safe Use of Insulin Modules and deliver safe care

Staff will need 2 hours time to register for and complete the e-learning programme which can be completed using computers available within the Trust’s Staff Library. Further support in accessing the module will also be available if required.

Other elearning modules at this website include:

Online e-learning modules

This week in the Library …… Tinnitus

Tinnitus Awareness Week 2012 runs from 6-12 February, so when you visit the Library this week be sure to check out our stand for leaflets and information.

The British Tinnitus Association are hoping to raise awareness and help GPs to have a better understanding of the services available in secondary care, so as part of Tinnitus Awareness Week 2012 the BTA are encouraging audiology departments to:

  • Put on a meeting or seminar for GPs to inform about the services available at their hospital
  • Go out to GPs meetings to promote their hospital’s tinnitus service

The second and equally important part of Awareness Week will be encouraging BTA members, and indeed anyone with tinnitus or an interest in the condition, to take a copy or copies of our Ten Top Tinnitus Tips for GPs to their local surgery.

If you would like to get involved in raising awareness of tinnitus, please contact You can download our information sheets from this website and if you would be able to hold an event to raise awareness or take copies of the Ten Top Tinnitus Tips for GPs to your local surgery we would love to hear more.

If you would like any further information please don’t hesitate to contact staff in the Staff Library.

The Ten Top Tinnitus Tips for GPs is available to download here.

New Standards for underpinning safe and effective care

Extract from Skills for Health

Healthcare support workers and adult social care workers play an important role in delivering high quality care.

We are pleased to announce that Skills for Health and Skills for Care have been invited by the Department of Health (DH, England) to develop a framework that will ensure healthcare support workers and adult social care workers in England are supported in delivering safe and effective care through the development of a Code of Conduct and minimum standards including those for induction. The outcomes of the project will be used to inform any future plans for voluntary regulation of these roles.

In discussion with DH, Skills for Health and Skills for Care are developing the project plans and identifying the outcomes to be delivered. We will present a first draft of the project plan to DH by the end of January 2012. Once these have been agreed by all parties, we will begin the project with a range of stakeholders to progress the initiative taking account of similar work that has already been undertaken especially in other UK nations.

To find out more please email

UK’s first ever Core Skills and Training Framework

Extract from Skills for Health

Skills for Health is developing a common framework for statutory and mandatory training for the UK health sector, building on work already undertaken in several NHS regions in England. In parallel, consultation is underway with Scotland, Wales and Northern Ireland. The core framework will offer the health sector common guidance and standards in this key area of learning for all health sector staff.

A consultation on the demand and support for a Core Skills Framework has just been completed with over 1000 responses. Initial analysis confirms very strong support for this initiative and overwhelming agreement on the need for standardisation. A full report of the analysis is available on our website.

The Core Skills Framework should be available to organisations from April 2012 and will:

  • provide up-to-date and authoritative guidance on minimum required standards
  • help support quality assurance of training
  • enable cost saving through reducing unnecessary duplication of training
  • encourage portability and recognition of appropriate learning.

The benefits of the Core Skills Framework will be further enhanced through use of the Skills Passport system being developed by Skills for Health.

For more information on the framework please contact


Information Prescription Service (IPS)

To IPS website

The Information Prescription Service (IPS) allows users, both professional and public, to create information prescriptions (IPs) for long-term health needs.

What is an information prescription?
Patients and carers want to know how to find information they can trust and rely on. Information prescriptions are a quick and easy way to provide information about conditions and local services.

The IPS brings together a wealth of information sources from NHS Choices and charity partners to make it easier for patients and carers to find the information they need.

How do information prescriptions help?
Information gives people the power and confidence to become partners in their care. It helps them to regain a sense of control over their lives and can reduce the fear and loneliness that the diagnosis of a life-threatening or long-term condition can bring.

User guides
The site is easy and straightforward to use but read the IPS user guides for more information.

Through the Cancer Resource Centre, our Trust is hoping to participate in this initiative during the ‘2nd wave’ of roll outs across the country. Watch out for more news and information concerning IPS.