A career in health visiting

A health visiting career
This guidance aims to promote understanding of the current picture, identifies areas of good practice, and suggests ways that these can be shared and enhanced. It gives an overview of the novice to expert journey and the pathway for newly qualified health visitors in their first two years. It was published for commissioners, practice educators, line managers, service leads and newly qualified health visitors, including all those who have responsibility for the skills, support and experiences of newly qualified health visitors.

Guidance from GMC and RCN

General Medical Council (GMC)

Continuing professional development: guidance for all doctors
This guidance was published to help doctors across the UK keep their knowledge and skills up to date throughout their working life. It is aimed at helping doctors as they reflect on their practice, prepare for their annual appraisal, and ultimately for their revalidation. It was developed in co-operation with doctors, medical Royal Colleges, employers, patients and the public, following widespread public consultation earlier this year and emphasises that doctors must take account of the needs of their patients and their healthcare teams when considering the learning they may need to undertake.

Royal College of Nursing (RCN)

Advice for RCN members during British Medical Association (BMA) industrial action
This guidance is for nursing staff who may be affected when members of the BMA take industrial action on Thursday 21st June. The RCN is not involved in the dispute and members will be working as normal on that day.

Victoria Infirmary News

A NEW voice has joined the campaign to maintain services at Northwich’s infirmary.

A doctor spoke to Northwich Town Council at its latest meeting about proposals to cut the GP out of hours service at Victoria Infirmary Northwich (VIN).  Dr Adrian Heald stressed that he was speaking as a private citizen when he addressed town councilors about the service, which has been under consultation because it is under-used.

A decision about reducing the service at VIN and moving the resources to Leighton Hospital was expected to be made in April but health bosses from East Cheshire NHS Trust decided to look into it further after public outcry in the initial consultation.

Speaking to town councillors, Dr Heald emphasised the difficulties for mid Cheshire patients travelling to Crewe if they did not own a car and said the current service should be advertised.

He said: “What I would propose is that the public of Vale Royal are made fully aware of the GP out of hours provision at VIN in evenings and weekends.

“There should be advertising on relevant websites – Cheshire West and Chester Council, Cheshire East Council and the hospital website – so the public are fully aware such provision exists.

“Following a public awareness campaign we could see if there’s increased uptake at VIN.”

He added: “VIN itself makes a very important contribution to the health of people in this area and it should be built on.

East Cheshire NHS Trust is expected to update Cheshire West and Chester councillors on its plans in July.

Extracts from BMJ: June 14 2012

Srividya Seshadri, Pippa Oakeshott, Catherine Nelson-Piercy, and Lucy C Chappell

New leadership and management development programme

Skills for Health

The need for effective leadership and management skills has never been more crucial within the healthcare sector. However, organisations have traditionally focused on strategic and senior leadership development. Given the current challenges facing healthcare organisations at an operational level, it is essential that leadership skills are developed in service level staff, both to help resolve the current challenges, but also to provide a continuity of leadership development for staff who may progress to more senior roles.

Skills for Health are supporting healthcare sector employers by providing a leadership and management development programme primarily aimed at staff equivalent to Agenda for Change Bands 5-7. The programme focuses on an introduction to leadership and the associated skills. It aims to develop a cohort of enthusiastic and motivated staff who are relatively new to leadership responsibilities or are highly likely to move into a more formal leadership role.

The programme, which is mapped to the NHS Leadership Framework and the Leadership and Management National Occupational Standards, is delivered via three intensive workshop days. It explores key elements of leadership and management including leadership styles, change management and communication skills through a combination of presentation, facilitated discussion, practical exercises, reflective learning, and group work. A key element is the application of the learning from the programme to current service challenges faced by the individuals.

Investing in leadership is recognised as essential by all good organisations. If you are interested in exploring how Skills for Health’s Leadership and Management programme could help your organisation please contact your regional / country representative at www.skillsforhealth.org.uk/contact-us for further information.

NHS Evidence Updates – Cancer

The following updates are available from NHS Evidence



via Evidence Updates – NHS Evidence – Search Engine for Evidence in Health and Social Care.

End of life care qualifications

Skills for Care has developed end of life care qualifications in conjunction with a wide range of employers including Marie Curie Cancer Care, the UK Home Care Association and Barchester Care, in addition to a number of hospices.

The qualifications will help adult social care employers support the national end of life strategy. They also build on the work of common core competences and principles for end of life care.



The Mental Health Act 2007: a review of its implementation

This report examines key issues in the operation of the Mental Health Act five years on. It finds that while there have been some improvements in the treatment of people detained under the Act there remain major concerns about the use of compulsory powers and the availability of advocacy and support for the most vulnerable people. It argues that CCGs and local authorities must ensure that they uphold the rights of people detained under the Mental Health Act as they take up their new responsibilities.


Healthcare Associated Infection (HCAI) Surveillance computer system


A new web based Healthcare Associated Infection (HCAI) Surveillance computer system is being developed which will replace the existing MESS system used to collect the patient level mandatory surveillance data on MRSA, MSSA and E. coli bloodstream infections, and C.difficile infections. Expected to go live in April 2013, the new computer system will be faster and have new features which will give users improved facilities to input and manipulate the data more easily. It will also allow users to produce customised tabulated and graphical reports of local, regional and national HCAI data.

Read more of this letter at dh_134577.pdf (application/pdf).

Evaluating palliative care ward staffing using bed occupancy, patient dependency, staff activity, service quality and cost data

Evaluating palliative care ward staffing using bed occupancy, patient dependency, staff activity, service quality and cost data

Dai Roberts droberts@sah.org.uk

St. Ann’s Hospice, UK, Keith Hurst, Independent Researcher and Analyst, Nottinghamshire, UK


Background: Palliative care staffing has remained unchallenged for decades while service provision has changed markedly, bringing new workforce demands. There is little evidence to inform hospice workforce structures, which strive to deliver the highest-quality holistic care.

Aim: The study had three main aims, to: (i) adapt the acuity-quality workforce planning method used extensively in the UK National Health Service (NHS) for use in hospices; (ii) compare hospice and NHS palliative care staffing establishments and their implications; and (iii) create ward staffing benchmarks and formulae for hospice managers.

via Evaluating palliative care ward staffing using bed occupancy, patient dependency, staff activity, service quality and cost data.

Don’t forget Barnaby

The Barnaby Festival 2012 is almost upon us!

Carole Keeling from the Staff Library has been very busy this week cataloging all the fantastic art pieces due for display at Waters Green Medical Centre.  She has been inundated with canvasses large and small, covering all sorts of themes from flowers to modern abstracts.  At the last count there were over 60 pieces created by our obviously very talented East Cheshire Trust staff.

To see what’s on during the festival please visit http://www.barnabyfestival.org.uk/about-us  – you’re sure to be impressed.



Health and Social Care Act explained | Department of Health

Health and Social Care Act explained via Health and Social Care Act explained | Department of Health.

15 June, 2012

A series of factsheets on the Health and Social Care Act 2012 explain particular topics contained in the Act, including its key themes. They include case studies of the policy in action, or answer frequently asked questions about the topic.

The factsheets were first published in October 2011 and have since been updated to reflect the changes made during the Act’s Parliamentary passage.

  • Overview
  • Case for change
  • Overview of health and care structures
  • Scrutiny and improvements
  • Key policy areas in the Act
  • Clinically-led commissioning
  • Provider regulation to support innovative and efficient services
  • Greater voice for patients
  • New focus for public health
  • Greater accountabilty locally and nationally
  • Streamlined arm’s length bodies
  • Factsheet on support worker regulation
  • Cross-cutting themes of the Bill
  • Improving quality of care
  • Tackling inequalities in healthcare
  • Promoting better integration of health and care services
  • Choice and competition
  • The role of the Secretary of State
  • Reconfiguration of services
  • Establishing new national bodies
  • Embedding research as a core function of the health service
  • Education and training

30 day trial to Health Information and Libraries Journal

Wiley-Blackwell are offering a free 30 day trial to the Health Information and Libraries Journal.

To access please follow the instructions below.

1. Log into Wiley Online Library  If you have not registered, please do so

2. Once logged in, go to the trial access page within your profile (in the left-hand menu bar)

3. Now enter the access code HILJTRIAL30 and click ‘Submit code’

4.When you have successfully submitted the code, you should see a confirmation message on-screen

Eyes on Evidence: Issue 38, June 2012

 People who are admitted to hospital with a psychotic disorder may have their illness misclassified. Diagnosis should be reassessed periodically to ensure that the most appropriate interventions are being used.

There may be differences in mortality risk between individual antipsychotic agents used to treat people with dementia. Patients should be monitored for adverse events in the acute treatment period, and periodic attempts to discontinue medication should be made.

Caution is urged over the long-term use of antiplatelets in people with chronic kidney disease. Treating 1000 patients with oral antiplatelet therapy for a year may prevent nine heart attacks, but this needs to be balanced against an increased risk of bleeding.
Pregnant women may experience some benefit from using relaxation techniques during labour, in relation to reduced pain, increased satisfaction and improved clinical outcomes. However, the available evidence is insufficient to make clinical recommendations.

Antimuscarinic drugs for urinary incontinence in women 

There is no strong evidence of a clinically important difference in efficacy between antimuscarinic drugs. The choice of antimuscarinic drug for an individual woman is likely to depend on tolerability, patient preference, and cost.

Details of a new resource available via NHS Evidence search.

Cochrane quality and productivity topics

Potential disinvestment opportunities highlighted this month are:
  • Aminosalicylates for induction of remission or response in Crohn’s disease.
  • Oral budesonide for induction of remission in ulcerative colitis.

Evidence Updates

This month NHS Evidence has published three Evidence Updates.
  • Improving outcomes in head and neck cancers.
  • Familial breast cancer.
  • Sedation in children and young people.

FREE Cochrane Library online training session

Wiley are offering instructor-led online training on how to use The Cochrane Library thecochranelibrary.com

All that you will need is a good internet connection and access to a telephone.  This training is completely free of charge and will be conducted over the telephone and via the internet using a product called webex that allows you to view live presentations from your desktop.  Once registered, the trainer will supply you with a Toll-Free number to dial, so that attendees can speak to the presenter, listen to the presentation and take part in the online meeting at the same time without incurring any costs.  A set of headphones is useful to avoid distracting others.   A pc and headphones can be booked in the Staff Library if that helps.

The session will last approximately 1 hour.  Places are strictly limited and to sign up just follow the link below and paste it and then select “Registration”:

Session date: Wednesday, 20 June 2012


Once you are approved by the host, you will receive a confirmation email with instructions for joining the session.


Falls Awareness | Services and practice | Professional resources | Age UK

Falls Awareness Week 18 – 22 June 2012

Falls represent a serious problem for older people; they occur in around 30% of over 65s and 50% of those aged over 80 every year, often resulting in serious consequences, both physically and psychologically. In addition to bruising, fractures, and in some cases, death, a fall can destroy confidence, increase isolation and reduce independence.

via Falls Awareness | Services and practice | Professional resources | Age UK.

Don’t forget you can subscribe to the regular monthly bulletin by following this link at Falls Prevention Horizon Scanning 



An offer from BMJ – too good to refuse?

BMJ Learning is fast approaching two million module completions!

To celebrate, from 2-9 July, everyone will be able to access all of our modules for free – including journal related modules.

Plus, if you complete the two millionth module, you will win an iPad. We expect this module completion to happen this week.

Here are our latest and most popular modules which you could complete:

AQuA news

AQuA News Bulletin – June 2012  a regular newsletter which keeps you up to date with all the latest developments in AQuA. In this issue you’ll find:

How to apply the Shingo principles of operational excellence

The Manufacturing Institute has an excellent two-day workshop on offer.

Healthcare Foundation Shine Awards : Applications now open
The Health Foundation’s Shine programme open for funding applications – over £1 million available for support innovative healthcare teams.
Link to full details…

Recruiting for the next free “Nurse First” cohort in Manchester in September 2012
Nurse First is the most intensive innovation and leadership programme in the UK for clinical staff. It is a free 21 – day residential programme that runs over a year and includes masterclasses, learning sets and coaching support, developed in partnership with the Queens Nursing Institute, Bucks New University, the Shaftesbury Partnership and Johnson & Johnson. It will support you to: create innovative ideas to clinical challenges, raise the funding needed to make these ideas happen and help you implement them in your organisation.  For more information visit: www.nursefirst.org.uk

Get to grips with PDSA testing
Are you ready to start PDSA testing around the ‘Safe & Timely Discharge’ interventions? As we start work on PDSA testing of our 4 ‘safe & timely discharge interventions’ I invite you to join me for a practical ‘PDSA – Hands on, Getting to grips with PDSA’ afternoon on 23rd May at the Frank Rifkin Lecture Theatre, at the Mayo Centre, Salford Royal Hospital Trust, 2-4pm.

Avoiding unnecessary Hospital Admissions and inappropriate A&E attendances of Children & Young People with Long Term Conditions

Advancing Quality Pneumonia collaborative on 29th June
We are inviting you and your AQ pneumonia team to this Advancing Quality pneumonia collaborative learning session seven on Friday 29th June 2012. The meeting will include a number of presentations and networking opportunities where we hope to share best practice across the North West in pneumonia care.

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Health Protection Report | Infection Reports | Healthcare Associated Infections

Last updated 15 June 2012 Volume 6, No 24 (PDF file, xxx kB) 

Trends in mandatory Staphylococcus aureus (MRSA and MSSA) and E. coli bacteraemia, andClostridium difficile infection data for England up to January-March 2012

The eleventh publication of the quarterly epidemiological commentary describes recent trends for mandatory surveillance of  (MRSA) and Clostridium difficile infections (CDI) reported by NHS acute Trust hospitals in England up to March 2012 [1,2]. The publication also contains analyses of the first 15 months of meticillin-sensitive Staphylococcus aureus (MSSA) bacteraemia data and a summary of the first 10 months of Escherichia coli bacteraemia surveillance (June 2011 to March 2012). This is the second quarterly epidemiological commentary to include mandatory surveillance data on E. coli bacteraemia.

The complete epidemiological commentary with additional information on the rates of MRSA, MSSA and E. coli bacteraemia, and CDI, is available on the HPA website [3].


MRSA bacteraemia

The total count of MRSA bacteraemia during the previous 10 years is shown in figure 1, and is divided into Trust apportioned episodes (this category includes patients presumed to have been infected while admitted to the Trust*) and non-Trust apportioned episodes (‘all other episodes’).

  • in 2011 there were 1,185 MRSA bacteraemia reports made. This is an 83.7% reduction compared to the number of reports in 2002 (7,274) (figure 1);
  • there were 504 Trust apportioned reports in 2011; representing an 83.7% reduction compared to 2006 (6,776 reports);
  • there were 681 non-Trust apportioned reports (all other reports) in 2011 compared to 2,244 in 2006 representing a 69.7% reduction in non-Trust apportioned reports compared to 2006 (figure 1).
  • there were 262 MRSA bacteraemia reports in the quarter January-March 2012 of which 118 and 144 were Trust apportioned and non-Trust apportioned, respectively. This represents an 86.4% decrease in reports relative to the baseline of 1,925 quarterly reports in financial year 2003/04.

Figure 1. Overview of MRSA bacteraemia reports, 2002 to 2011

MSSA bacteraemia

  • there were a total of 10,903 reports between January 2011 and March 2012. 3,569 of these reports were Trust apportioned ¥ and 7,334 were non-Trust apportioned (all other reports). An overview of reports by month is presented in figure 2.
  • there were 2,157 MSSA bacteraemia reports in the quarter January-March 2012 of which 33.3% and 66.7% were Trust apportioned and non-Trust apportioned, respectively.
  • Figure 2. Monthly counts of Trust apportioned and all other reports of MSSA bacteraemia, January 2011 to March 2012

E. coli bacteraemia

  • of all bacteraemia covered by mandatory surveillance, E. coli is currently the most common bacteraemia with monthly reports being about 28-fold and 4-fold higher than those for MRSA and MSSA bacteraemia, respectively.
  • there were a total of 26,619 E. coli bacteraemia reports between June 2011 and March 2012 (table 1). E. coli bacteraemia data is not currently being apportioned.

Clostridium difficile infection

in 2011 there were 19,130 CDI reports made. This is a 53.0% reduction compared to the number of reports in 2008 (40,705 [figure 3]);

  • there were 8,418 Trust apportioned † reports in 2011 representing a 64.0% reduction in Trust apportioned reports compared to 2008 (23,085 reports [figure 3]).
  • in 2011 there were 10,712 non-Trust apportioned (all other reports) CDI reports made, representing a 39.2% reduction from the number reported in 2008 (17,620). In 2010 the ratio of non-Trust apportioned reports to Trust apportioned reports was approximately 1:1 whilst in 2011 the ratio had increased to 1.3.
  • data for the most recent quarter (January-March 2012) showed a total of 3,708 reports, which corresponds to a 73.3% reduction on the baseline year’s quarterly average (13,875 reports for financial year 2007/08). Of the 3,708 reports, 1,610 (43.4%) were Trust apportioned while 2,098 (56.6%) were non-Trust apportioned.

Non-Trust apportioned reports (“all other reports”): These include all reports that are NOT apportioned to an acute Trust. The two categories are mutually exclusive.

The next commentary will be published in September 2012.

via Health Protection Report | Infection Reports | Healthcare Associated Infections.

OnMedica – Drug and Therapeutics Update

Health Protection Agency

The latest survey on radiation doses to individual patients from x-rays in hospitals and dental surgeries between 2006 and 2010, shows that doses have fallen, but that there is still room for improvement. The team, which carried out the survey, compared representative X-ray doses to patients in 320 hospitals, (about a quarter of the total number of hospitals with diagnostic x-ray facilities), and more than 4000 dental surgeries (about a third of the UK’s dental surgeries). The HPA will publish an assessment of radiation doses from CT scanning later in the year.

via OnMedica – Clinical Article – Drug and Therapeutics Update.

New guideline on the management of acute upper gastrointestinal bleeding

NICE publishes new guideline on the management of acute upper gastrointestinal bleeding

NICE, the healthcare guidance body, has today (Wednesday 13 June) published a new guideline on the management of acute upper gastrointestinal (GI) bleeding.

Bleeding in the oesophagus, stomach or duodenum is the most common emergency managed by gastroenterologists in the UK, with at least 50,000 hospital admissions per year.

Despite changes in management, mortality has not improved over the past 50 years. It is estimated that around one in ten hospital admissions for upper gastrointestinal bleeding results in the patient’s death – around 5000 deaths per year in the UK.

Upper gastrointestinal bleeding is usually caused by peptic ulcers, which can bleed as the ulcer erodes into an underlying artery, or oesophago-gastric varices (dilated veins in the oesophagus).

The guideline makes a number of key recommendations, including:

Offer endoscopy to unstable patients with severe acute upper gastrointestinal bleeding immediately after resuscitation.

Offer endoscopy within 24 hours of admission to all other patients with upper gastrointestinal bleeding.

Offer interventional radiology to unstable patients who re-bleed after endoscopic treatment. Refer urgently for surgery if interventional radiology is not promptly available.

Continue low-dose aspirin for secondary prevention of vascular events in patients with upper gastrointestinal bleeding in whom haemostasisi has been achieved.

via NICE publishes new guideline on the management of acute upper gastrointestinal bleeding.

NICE launches free British National Formulary Smartphone App for NHS England

NICE launches free British National Formulary Smartphone App for NHS England

The National Institute for Health and Clinical Excellence (NICE) has today launched a free British National Formulary (BNF) Smartphone application for download by health and social care professionals who work for or who are contracted by NHS England.

The new app is called NICE BNF and has been developed to provide easy access to the latest up-to-date prescribing information from the BNF – the most widely-used medicines information resource within the NHS.

The NICE BNF app is available to download for free to health and care professionals via the Apple App Store and Google Play Store. Users will need to enter their NHS Athens user name and password to activate the app and download the content.

via NICE launches free British National Formulary Smartphone App for NHS England.

NHS 111 service delayed

The government has announced a delay in the rollout of the NHS 111 number in England.

The free one-stop number for patients with urgent, but not life-threatening symptoms, was planned for April 2013. But now the Department of Health has said areas can have more time to introduce the service.

Doctors’ leaders – who had in the past expressed “serious concerns” about the rollout – welcomed the delay. Nursing leaders and Unison had also expressed reservations about plans for the service.

Extract from BBC News June 14

Health Education England

Health Education England is the new national leadership organisation – ensuring that education, training, and workforce development drive the highest quality public health and patient outcomes.

The purpose of the new organisation is to ensure that the health workforce has the right skills, behaviours and training, and is available in the right numbers, to support the delivery of excellent healthcare and health improvement.

A series of webinars, aimed at NHS staff, are planned in June to produce an initial range of indicators for the five domains in the Education Outcomes Framework. Webinars will take place as follows: ‘Excellent education’ – 25 June, 11.00-12.00 ‘Competent and … Read more →

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