EC Trust in the top 40 for 3rd time

Extract from The Knutsford Guardian

EAST Cheshire NHS Trust has been named as one of the top 40 hospitals in the country by independent healthcare analysts CHKS for the third time in a row.

The trust made the 2013 40Top Hospitals list on the basis of evaluation carried out by CHKS around 22 key performance indicators, covering safety, clinical effectiveness, health outcomes, efficiency, patient experience and quality of care.

East Cheshire NHS Trust was also placed in the top 40 in 2012, 2011, 2006 and 2005, as well as being shortlisted for a much-coveted Quality of Care award in 2010.

NHS staff and a new era of education and training

Extract from DoH

Health Minister Dr Dan Poulter has today announced a wide ranging series of measures to improve the training, values and education of all NHS staff over the next two years and beyond.

The measures have been published in the government’s mandate to Health Education England, a new arms-length body set up to give NHS training and education unprecedented focus and importance. It will be backed by £5 billion and will be accountable to ministers for delivering the goals set out in today’s document.

Read the full article at


King’s Fund publish patient-centred leadership report

23 May 2013

A transformation of systems, leadership and organisational culture is needed throughout the NHS if the lessons of the Francis Inquiry are to be learned and acted on, according to a new report published today by The King’s Fund and supported by the Faculty of Medical Leadership and Management.

Founding Director Peter Lees was delighted to be asked to advise on Patient-centred leadership: Rediscovering our purpose as a member of The King’s Fund reference group, and FMLM members were also included in a group of more than 900 NHS professionals who took part in The King’s Fund’s Leadership Survey 2013.

The full report and survey results can be read on The King’s Fund website here.

Some statins linked to increased risk of type-2 Diabetes

Extract from BBC News/Health

Some drugs taken to protect the heart may increase the risk of developing type-2 diabetes, according to researchers in Canada.

Their study of 1.5 million people, in the British Medical Journal, suggested powerful statins could increase the risk by 22% compared with weaker drugs.

Atorvastatin was linked to one extra case of diabetes for every 160 patients treated.  Experts said the benefits of statins still outweighed any risks.

Bank Holiday Monday

Wishing everyone a pleasant long weekend. Please note the Staff Library will be closed on Monday 27 May but those with 24 hr access will still be able to gain entry using their ID badges.  Computers and journals are available and books may be borrowed using the self service system.  If you have any books to return please drop them off in the Book Return Box opposite the WRVS shop in MDGH.

Moult D.; Chandrasekaran S; Diabetic Medicine, March 2013,

Comparison of multiple daily injections (MDI) vs continuous subcutaneous insulin infusion (CSII) methods of insulin delivery in children with Type 1 diabetes in a small district general hospital

Citation: Diabetic Medicine, March 2013, vol./is. 30/(100-101), 0742-3071 (March 2013)

Author(s): Moult D.; Chandrasekaran S.

Language: English

Abstract: Objective: To compare the efficacies of two different methods of insulin delivery in diabetic children in a small district general hospital, with regard to their average HbA1c, their daily insulin requirements and the results on their body mass index (BMI), the average reported number of non-severe hypoglycaemic events a week, and the rate of both long-term and acute complications in these children.

Methods: Data were collected retrospectively between December 2010 and December 2011. A total of 80 patients were included in this audit (40 MDI vs 40 CSII). The patients were divided into thre e different age groups (below five, five to 12, over 12). Results: The average HbA1c was 8.8% for the MDI group compared with 8.4% for the CSII group. The average daily insulin requirement was 0.81u/kg/day for the MDI group compared with 0.74u/kg /day for the CSII group. The average BMI was  0.6kg/m<sup>2</sup> for the MDI group compared with 19.6kg/m<sup>2</sup> for the CSII group. The number of non-severe hypoglycaemic events was recorded at an average of 0.69 episodes per week for the MDI group compared with 1.84 episodes per week for the CSII group. The difference in HbA1c was most marked in under fives (8.4% vs 7.8%). There were no signs of nephropathy in either group among the over 12s. However, lipid abnormalities in the form of elevated cholesterol was more often seen in the CSII group compared with the MDI group in the over 12s (seven vs five). Conclusions: CSII was found to be the overall better treatment in younger age groups, but loses its effectiveness in over 12 year olds.

Publication Type: Journal: Conference Abstract

Source: EMBASE

This article is not available fulltext but can be ordered through our inter-library loan scheme.

Orthopaedics News

[HTML] Titanium Alloys in Orthopaedics

W Wang, CK Poh – 2013
Schematic figure of a hip implant. The femoral neck is the region at risk of compromised vascularity. Arrows indicate area of compromised vascularity where osseiointegration fails to take place. Figure 2. Schematic figure of a hip implant. The femoral neck is the region at


EVIDENCE-BASED ORTHOPAEDICS 940 Intra-Articular Infusion with Bupivacaine Decreased Pain and Opioid Consumption After Total Knee Arthroplasty

MJ Bolesta
EVIDENCE-BASED ORTHOPAEDICS 940 Intra-Articular Infusion with Bupivacaine Decreased Pain and Opioid Consumption After Total Knee Arthroplasty 941 Hemiarthroplasty Did Not Confer Any Benefit in Older Patients with Four-Part Humeral Fractures

Learning at Work Day: TODAY! 22 May 2013

LAW ladyLook out for learning and development colleagues today who will be in the Lecture Theatre, MDGH from 11:00 – 3.00pm

Following the theme, “Many Ways to Learn” – a number of L&D representatives will be on hand to discuss and demonstrate the many learning opportunities available to staff and students.

News ~ information ~ free trials and samples ~ 

Find out how the Staff Library can help YOU!

Mathioudakis, AG, and Mathioudakis GA; Journal of Aerosol Medicine and Pulmonary Drug Delivery

Tiotropium Inhaler Devices: Seeking Convenience When Mortality Is at Stake?

To cite this article:
Alexandros G. Mathioudakis and Georgios A. Mathioudakis. Journal of Aerosol Medicine and Pulmonary Drug Delivery. April 2013, 26(2): 120-120. doi:10.1089/jamp.2012.0988.

Published in Volume: 26 Issue 2: April 3, 2013
Online Ahead of Print: October 1, 2012

Moore, SR, Moore, DJ, Parikh, RJ et al: BMJ Online 2012

This article has recently had a correction:

In the online version of this Endgames case report by Seyed Ali Moeinoddini and colleagues (BMJ 2012;345: e7361, doi: 10.1136/bmj.e7361), the affiliations of the last two authors are reversed. Sarah Ruth Moore should be affiliated to East Cheshire NHS Trust, Macclesfield District General Hospital, Macclesfield, UK and David James Moore should be affiliated to Sheffield Teaching Hospitals NHS Trust, Northern General Hospital, Sheffield, UK.

Sequential bilateral femoral fractures

SA Moeinoddini, RJ Parikh, SR Moore…
BMJ (Online), January 2012, vol./is. 345/7891, 1756-1833 (19 Jan 2013)
A 78 year old woman presented to the emergency department with an
off-ended, shortened, anteriorly deviated, long oblique fracture of the right femoral diaphysis. She had been experiencing thigh pain for several weeks before this acute presentation and analgesia 

Naveed M.A.; Khan Y.; Ratnam K.R.; Fischer J; European Orthopaedics and Traumatology

European Orthopaedics and Traumatology
March 2013, Volume 4, Issue 1, pp 59-61

Keep it blunt: Aberrations in the course of the superficial peroneal nerve during lateral ankle approach

Author(s): Naveed M.A.; Khan Y.; Ratnam K.R.; Fischer J.
Language: English
Publication Type:   Journal: Article
Source:  EMBASE

News selection from the BMJ

BMJ 2013;346:f3129 (Published 16 May 2013)

BMJ 2013;346:f3114 (Published 14 May 2013)


BMJ 2013;346:f2716 (Published 14 May 2013)

New CPD offer from Radcliffe Health

Radcliffe Health and Continuing Professional Development are making a number of their books available FREE online to achieve CPD (Continuing Professional Development) points through directed reading. The only stipulation is that you register with them and complete an online form to document your learning by adding notes. Upon submission of the form they will send you a copy via email and provide a CPD certificate for you to print out and add to your professional record. The form contains 8 questions and is best done whilst the knowledge you have gained is still fresh.

Examples of CPD questions are:

  • What is the most important action you need to undertake as a result of your learning activity?
  • How will your learning influence (or change) your current way of working/thinking?
  • How has this learning enhanced your understanding and way of working?

Sample titles include:

radcliffe titles

Focus on Equality Diversity and Human Rights

Now in it’s second year, last week saw the first day of NHS Equality, Diversity and Human Rights week 2013, which ran from 13-17 May.
Equality and Diversity week balloons
Whilst this post may not have been published in time, we feel this subject  deserves a mention not just for a week but for all year, every year.  Now in its second year, the NHS-wide Equality, Diversity and Human Rights week is an opportunity for NHS organisations to raise awareness of equality and diversity.

Getting the most from information and sharing knowledge openly

NHS organisations around the country will highlight their work and raise awareness of equality and diversity locally. Raising awareness of equality and diversity issues and taking action ensures the NHS continues to meet the diverse needs of local populations and is a place where staff from all backgrounds want to work.

This year the theme has been knowledge and data – with an emphasis on collecting high quality information, getting the most from information and sharing knowledge openly.

Join in: #eqw2013

More information is available from NHS Employers where you can tap into E&D literature all year round and at these other websites.

BMJ Learning modules available

Extract from BMJ Learning


BMJ Learning modules – have you done this one yet on Prostate Cancer?

One of your patients is an 85 year old man who has recently been diagnosed with intermediate risk, localised prostate cancer. The hospital has suggested a watchful waiting strategy for his management. He understands that the main advantage of watchful waiting is that there will be no physical side effects of treatment. However he wonders if there are any disadvantages of this strategy. What would you say to him? What if he didn’t want to follow the advice given? If you would like to learn more about this topic, then click on the link to complete this module today.

Prostate cancer: understanding the patient pathway and treatment options – in association with Prostate Cancer UK

And here are their most popular modules in respiratory medicine for you to complete. 

News update from NHS Networks

A survey commissioned by the all-party parliamentary group for continence care has vividly demonstrated a decline in the level of provision for continence care services in England.
Dementia is a major and growing challenge for both health and social care.
The Children and Young People’s Health Forum was asked by the secretary of state to help develop a new strategy for improving care for children and young people.
The NHS Confederation has published a briefing for non-executive directors (NEDs) interested in improving their understanding of their organisations’ data.
The Stroke Association is the UK’s leading charity for people affected by stroke and has recently taken over running a fortnightly email bulletin from the now defunct Stroke Improvement Programme.
This narrative was developed with service users, by National Voices and partners and shows what coordinated care would look like from the perspective of patients, service users, families and carers.
NHS England has published its latest bulletin for CCGs.
This letter invites local areas to express an interest in becoming ‘pioneers’, demonstrating the use of ambitious and innovative approaches to delivering integrated care.
New recommendations, published by the Royal College of General Practitioners, the Royal College of Radiologists and the Society and College of Radiographers, have outlined improvements for patients by ensuring that timely and appropriate medical imaging services such as scans are provided to them and their referring doctors.
This report looks at the nature of employee voice and the impact of social media.
This case study is part of a series designed to share good practice and lessons learned by local NHS organisations involved in major reviews of local health services.
The Dementia Challenge report describes achievements in the three main areas of the challenge: driving improvements in health and care, creating dementia friendly communities and better research.
Bob Ricketts, director of commissioning support, strategy and market development for NHS England, will outline the vision for service transformation.
Health sector regulator Monitor and NHS England are working together to reform the way NHS services are paid for.
The government has announced plans for a more joined up health and social care system by 2018.
A new guide by the BMA will help doctors tackle some of the dilemmas that they face on a daily basis.
The direct specialised commissioning function of NHS England is supported by a devolved clinical leadership model.
This report was commissioned as part of a review of HIV services in London and the aim was to gather data from patients to better understand patterns of service use and what they value in HIV services.
This update has been released in response to the government’s consultation on safeguarding power of entry between 11 July 2012 and 12 October 2012.
New chair-elect for the Royal College of General Practitioners (RCGP).
This briefing examines what the NHS mandate means for mental health services and the people who use them.
NHS England has published detailed data about the first four of the 14 hospitals involved in the review of mortality data.
Figures published by Public Health England (PHE) show that confirmed cases of whooping cough in England have continued to decrease in 2013 with 434 cases reported in March.
Report from NHS Change Day.
The Local Government Association and PHE have produced a guide for local councillors about the national child measurement programme (NCMP).
The National Institute for Health and Care Excellence (NICE) is seeking to recruit the following professional members to the NICE accreditation advisory committee.
Plans to strengthen performance in urgent and emergency care are being put in place across the country to help hospital A&E departments meet demand and tackle waiting time pressures.
NHS England has written to NHS Trust medical directors and area team medical directors setting out interim arrangements for issuing healthcare professional alert notices.
This publication supports local authority health and wellbeing boards to develop and update pharmaceutical needs assessments (PNAs).
The Care Bill will modernise the law to put people’s wellbeing at the heart of the care and support system.

The King’s Fund

Learning from the LINks: resources for Healthwatch
These resources aim to preserve examples of good practice from the work of Local Involvement Networks (LINKs) and are also intended to help volunteers and staff feel supported in the transition to local Healthwatch. Resources are grouped around four themes: leadership and governance; representation; engagement; and influencing.

Asthma Data Tool

Asthma data tool
This tool has been launched by PHE’s INHALE, a website set up to provide data on lung conditions in England. It aims to provide clinicians and commissioners with a one-stop portal for accessing reliable data on asthma outcomes in England as well as helping clinical commissioning groups to understand the outcomes of asthma care in their area.

Eyes on Evidence

Latest news roundup from Eyes on Evidence

A cohort study reports that rates of death from both natural and external causes are higher in people who self-harm than would be expected in the general population.
Probiotics in antibiotic-associated diarrhoea
A systematic review suggests that probiotics can reduce antibiotic-associated diarrhoea.

‘Anti-fat’ bias among doctors
Results of a web-based survey, designed to assess attitudes towards weight, reveal implicit and explicit ‘anti-fat’ bias among doctors.

Domestic violence presenting in primary care
A survey examines knowledge, attitudes and clinical skills related to domestic violence in selected UK general practices.
Small benefits of Z drugs over placebo for insomnia
A meta-analysis has found that Z drugs reduce the time taken to fall asleep by 22 minutes compared with placebo. However, this result may not be clinically significant and any benefit of Z drugs must be balanced against their well-documented risks.
Hormone replacement therapy (HRT): cardiovascular outcomes after recent menopause
Data from long-term follow-up of an open-label randomised controlled trial suggest that HRT reduces cardiovascular endpoints in women if started early after menopause. However, limitations of the analysis make interpretation of the results difficult.
Case studies from the Quality, Improvement, Productivity, and Prevention (QIPP) collection
We highlight 2 new examples from the QIPP collection, demonstrating how NHS organisations have implemented new local practices that have both cut costs and improved quality.

Evidence Updates
NICE has recently published Evidence Updates on:

  • Self-harm: longer term management
  • Autism diagnosis in children and young people