Clinical Effectiveness training

The Clinical Effectiveness Team is offering 4 x 1 hour, training sessions to all trust staff on Clinical Audit, NICE and Research Governance to support and develop staff in all areas of audit on the following dates:

  • Tuesday 17 April: How to suceed in clinical audit
  • Tuesday 24 April: Are you on the right pathway for NICE?
  • Tuesday 1 May: Research governance
  • Tuesday 8 May: How to suceed in clinical audit

More information

Places are limited, reserve your place on the session most relevant by emailing


Last reminder: Have you completed 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 quote your 8 digit ESR staff number (see payslip) plus the Trust prefix 209. Complete the Learner tutorial and Safe use of Insulin modules and deliver safe care.

Map of Medicine latest highlights

The latest evidence
Map of Medicine monitors over 150 guidance producers, and constantly searches over 3,000 sources for the latest meta-analyses and systematic reviews, enabling healthcare professionals to stay abreast of changes through a single resource. Over 40 care maps have been updated with the very latest evidence in our current issue, including:

Acute coronary syndrome: two new pieces of guidance from NICE incorporated. Ticagrelor added as a treatment option for selected patients. Management of hyperglycaemia, including testing, provision of information and lifestyle advice added for people with poor glycaemic control. 

Atrial fibrillation: new restrictions and monitoring requirements for the use of dronedarone in patients with atrial fibrillation, following MHRA Drug Safety Update.

Caesarean section: newly updated NICE recommendations including information on indications for caesarean section, including maternal request; and provision of evidence-based information and support for women.

Contraception: newly updated recommendations from the Faculty of Sexual and Reproductive Health (FSRH) on emergency contraception and combined hormonal contraception.

  • Athens users: visit the Map here and select ‘International’ / ‘England’ or your local view

Cochrane Library – FREE Webex Training sessions

2 more dates to add to your diary if you would like to sign up for these FREE Introductory Cochrane Library online courses.  Follow this link to register:

3 Apr 2012  9:30    The Cochrane Library – An int…  
Gavin Stewart
  40 mins Register Register
17 Apr 2012  16:00    The Cochrane Library – An int…  
Gavin Stewart
  40 mins Register Register

A New Strategy for NHS Procurement: Securing the Future of NHS Services

Manchester Conference Centre17th April 2012.

By 2015 the NHS aims to have delivered savings of £20bn

  • Following consultations with the health sector the Department of Health has been working with the NHS to draw up a new strategy for NHS procurement
  • Are you involved in procurement in the health sector?
  • Interested in hearing about the New Strategy for NHS Procurement?

Register Your Place Today  Confirmed Speakers Include

Main Sponsor: John Neilson: Chief Executive, NHS Shared Business Services

John Warrington: Deputy Director, Procurement, Department of Health

Lord Hunt of Kings Heath: President, Health Care Supply Association

Catherine Beardshaw:
Chief Executive, Aintree University Hospital NHS Foundation Trust

Aaron Cummins: Chair, Foundation Trust Network Finance Directors Forum

View Full Details of Programme and Speakers

The Department of Health is working with the NHS to draw up a new strategy for NHS procurement and this will be published by 31st March 2012. A New Strategy for NHS Procurement will help launch this initiative and engage with all parts of the NHS, both to brief delegates and promote discussion about how it can be implemented, the implications and, in particular, how the savings can be achieved.

Delegates will have the chance to challenge, discuss and debate the key issues and gain relevant insight applicable to their professional roles which they can embed within their organisations and improve services.


Ahmed SH, Wai P, Silverdale M. Posterior encephalopathy: An uncommon manifestation of calcium toxicity. Indian J Endocr Metab 2012;

Letter to Indian Journal of Endocrinology and Metabolism


Hypercalcemia is a common metabolic abnormality encountered in clinical practice, with primary hyperparathyroidism and malignancy being the commonest causes. [1] We present a case of iatrogenic hypercalcemia, which presented with features of posterior encephalopathy. illustrates an uncommon neurotoxic manifestation of hypercalcemia.

A 63-year-old woman, with Grave’s disease, complicated active thyroid eye disease,underwent a total thyroidectomy 5 months after diagnosis. This operation was complicated by severe hypocalcemia (calcium 0.9 mmol/l) and hypoparathyroidism (parathyroid hormone or PTH < 0.3 pmol/l). It was thought to be secondary to ischemic injury to parathyroid glands as they had been visualized and left intact intraoperatively. Stability was attained on oral calcium and high dose of alfacalcidol.

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New risk prediction tool for venous thromboembolism

Venous thromboembolism (VTE) is a condition in which a blood clot (a thrombus) forms in a vein. Embolism occurs when the thrombus dislodges from its site of origin and travels in the blood.

VTE is an important and preventable cause of morbitity and mortality, with almost a third of survivors experiencing long term effects. To improve survival and prevent complications, the occurence of VTE needs to be reduced.

Current advice: NICE guidance on reducing the risk of VTE in patients admitted to hospital, highlights the need for new research to develop and validate risk prediction models for use by primary care research databases.

Although there are currently no validated algorithms to predict risk for VTE designed for use in primary care, computerised clinical decision support could improve appropriate use of thromboprophylaxis in a hospital setting.

Extended VTE prophylaxis is a research recommendation in the current NICE guidance and features in the VTE NICE Quality Standard.

NICE has guidance in development on the management of venous thromboembolic diseases and the role of thrombophilia testing.

See New Evidence

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C Skouras, Thomas Skouras, M Pai, E Zacharakis and D Spalding: Updates in Surgery 2012

Case Report published in Updates in Surgery, 2012

Inguinoscrotal extension of a pancreatic collection: a rare complication of pancreatitis—case report and review of the literature by Christos Skouras, Thomas Skouras, Madhava Pai, Emmanouil Zacharakis and Duncan Spalding

Pancreatitis associated with the extension of a pancreatic collection, pseudocyst or abscess into the groin is a rare phenomenon with few reports in the English literature. Nevertheless, it remains a clinically important differential diagnosis as it may be mistaken for more common pathologies in the groin and with a subsequent unnecessary surgical intervention. A case of this rare complication of pancreatitis is reported, together with a review of the literature.

Medicines and Healthcare products Regulatory Agency: Orthopaedics

The following section/document has been added/updated

Title: Orthpaedics

Summary: The MHRA is issuing updated information and advice about the management and monitoring of patients implanted with metal-on-metal (MoM) hip replacements.

You can find the section/document here:

Latest updates from NHS Evidence

The following new style Evidence Updates were published recently:

 Pregnancy and complex social factors: Evidence Update January 2012: focuses on a summary of selected new evidence relevant to NICE clinical guideline 110, ‘A model for service provision for pregnant women with complex social factors’ (2010).

Bacterial meningitis and meningococcal septicaemia: Evidence Update January 2012: focuses on a summary of selected new evidence relevant to NICE clinical guideline 102, ‘Management of bacterial meningitis and meningococcal septicaemia in children and young people younger than 16 years in primary and secondary care’ (2010).

Chronic obstructive pulmonary disease: Evidence Update February 2012: focuses on a summary of selected new evidence relevant to NICE clinical guideline 101, ‘Management of chronic obstructive pulmonary disease in adults in primary and secondary care’ (2010).

Venous thromboembolism: reducing the risk, Evidence Update February 2012: focuses on a summary of selected new evidence relevant to NICE clinical guideline 92, ‘Reducing the risk of venous thromboembolism (deep vein thrombosis and pulmonary embolism) in patients admitted to hospital’ (2010).

News from HTA: Heart defects screening for the newborn


Screening test for heart defects in newborn babies


Research published in Health Technol. Assess. has found a quick and painless test that is able to detect more cases of life threatening heart defects in newborn babies.


Congenital heart defects are the most common group of congenital malformations and one of the leading causes of infant death in the developed world. Currently in the UK, all newborn babies undergo a routine screening examination, usually in the first 24 hours after birth, during which, among other things, a careful assessment of the cardiovascular system is undertaken. However, it is estimated that over 50 per cent of babies with undiagnosed congenital heart defects fail to be picked up by routine neonatal examination

.  [more…]

NHS National End of Life Care Programme

Critical success factors that enable individuals to die in their preferred place of death

Highlighting good practice from seven PCTs across the country, this report identifies the critical success factors associated with improving end of life care and enabling a person to die in the place of their choice. The report is intended as a starting point to help those commissioning and planning services to see what has worked well in other areas although it does not suggest that one size fits all.

Transforming end of life care in acute hospitals: the route to success ‘how to’ guide
This guide builds upon the framework set out in ‘The route to success in end of life care – achieving quality in acute hospitals’, published in 2010. It highlighted best practice models developed by acute hospital trusts, providing a framework to enable hospitals to deliver high quality care to people at the end of life. This guide aims to help clinicians, managers and directors implement ‘The route to success’ more effectively, drawing on valuable learning from the NHS Institute for Innovation and Improvement’s Productive Ward: Releasing time to care series.

Step by step approach to Microsoft Qualification

A few years ago the Cheshire ICT Service registered as an Microsoft Office Specialist Testing Centre and in 2011, NHS Connecting for Health successfully negotiated a contract with Microsoft for NHS Staff to complete the exams for free.

In addition NHS Connecting for Health provided some funds to purchase Microsoft Office books to help staff study towards the Microsoft Office Specialist Qualification.  If you are interested in knowing more about this course you should contact Cheshire ICT’s training team at

The good news is that enough books have been purchased to distribute between the staff libraries at East Cheshire and West Cheshire. 

The books cover the popular applications of MS Word, Excel, Powerpoint and Outlook. There is a choice of versions (2003, 2007 and some 2010) and 2 different book styles.

Learners may choose from the larger spiral bound books which have a colour, easy to follow layout featuring numbered instructions, illustrations and test yourself quizzes. The other ‘Step by Step’ series, is more text based but still covers the key points clearly.  Both series include support material on CD Rom.
It is hoped that the books will help staff to learn how to use the Office packages more efficiently from work or at home.

Health checks for people with learning disabilities

Overview: People with learning disabilities have poorer health than their non-disabled peers and evidence suggests that this is partly because of barriers associated with identifying ill health and ensuring timely access to healthcare services (Michael 2008).

Current advice: The Department of Health recommends that primary care services provide comprehensive annual health checks for people with learning disabilities using local or directly enhanced schemes. Local authorities should help to identify individuals who would benefit from, and would be eligible for, enhanced services.

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NHS Mail – the No 1 choice.

This is just to remind library users who drop in to use our internet facilities to check their personal emails that  Trustwide access to Hotmail, AOL, BTInternet, Yahoo, GMAIL and many others is no longer permitted.  Please make sure you apply and register for an NHS Mail address as soon as possible.  Contact your manager or supervisor who will organise one for you.

If it’s been a while …

since you last visited the Staff Library, you’ll notice a few changes.

Apart from offering 24/7 access to books, journals and computers, you will also find:

  • leisure reading books
  • newspapers
  • complementary tea and coffee
  • wifi access available on request
  • staff art exhibition
  • and no cardigan wearing librarians , peering over their glasses who say “Schhhhhhhh”!!

Hard to believe? Come in and see for yourself. It’s your library.


Join in the SIX Book Challenge

The Six Book Challenge invites readers to read six books and record their reading in a diary in order to receive a certificate and the chance to enter a national prize draw.

The Reading Agency launched the Six Book Challenge in 2008. Since then an estimated 47,500 people have registered for the scheme and 17,000 have completed it.

Who takes part?
– Around 100 prisons and YOIs took part in 2011 at least doubling their involvement
– 90 workplaces were involved in 2011 including Boots, Wincanton Logistics, Transport for London, McVitie’s and over 20 NHS Trusts.

The Staff Library is the place to start – come along and see the range of titles and choose from either short stories or perhaps you might prefer a more substantial read. We have something for every taste – fiction, non fiction, sci-fi or biographical. Why not bring a colleague, browse the shelves and have a coffee?

NHS Evidence Jan-Feb updates (Cardio-respiratory)

An NHS Athens account may be required in some cases:

Added in February

Added in January

NHS Evidence February updates (Cancer)

Added in February