Cold Weather Alert!

There is a 90% probability of severe cold weather/icy conditions/heavy snow between 1200 on Wednesday 28 Jan and 1200 on Tuesday 3 Feb in parts of England. This weather could increase the health risks to vulnerable patients and disrupt the delivery of services.

More details about the weather alert is available on the MET Office website.

NICE updates: June 2013

More treatments for women at risk of breast cancer                            

Updated guidance from NICE gives more options to women to reduce their risk of breast cancer. NICE recommends tamoxifen or raloxifene as preventative treatments for certain women at high risk of breast cancer due to a family history.

Nicotine products can help people to cut down before quitting smoking         

Licensed nicotine products, such as patches and gum, should be offered to people who smoke and are struggling to quit to help them cut down on cigarettes, NICE says. NICE recommends that stop smoking advisers and health professionals advise people to stop smoking in one go, but for those who aren’t ready or are unable to stop in one step, they should suggest considering a harm-reduction approach.

Offer range of effective treatments for people with hep B

More people with hepatitis B should be assessed, referred and offered the range of clinical and cost effective treatments available for the disease, according to NICE. In its first clinical guideline on hepatitis B, NICE recommends a range of measures to help raise awareness of the condition and reduce the current variation in treatments offered.

Older patients at high risk of hospital falls

Updated guidelines from NICE recommend that healthcare professionals should consider patients aged 65 or older, and those aged over 50 with underlying conditions such as stroke, at high risk of falling while in hospital care.

Podcasts available on falls and antisocial behaviour and conduct disorders

We’ve produced implementation podcasts on our updated falls guidance and our guideline on antisocial behaviour and conduct disorders to help you get the most out of these products.

Two shared learning examples from London and Portsmouth on hepatitis B are also now available, which highlight innovative uses of NICE guidance.

Let us know what you think of our draft guidance on behaviour change. The behaviours covered are alcohol, diet, physical activity, sexual behaviour and smoking, and the consultation closes on 31 July 2013.

We’d also like to hear your thoughts on our draft update of our guideline on neuropathic pain. Neuropathic pain is pain caused by a lesion or disease of the central somatosensory nervous system. The consultation closes on 18 July 2013.


Prevention of Falls Network (ProFouND)

The Prevention of Falls Network for Dissemination (ProFouND) is a new EC funded initiative dedicated to bring about the dissemination and implementation of best practice in falls prevention across Europe.

ProFouND comprises 21 partners from 12 countries, associate members from a further 10 countries. ProFouND aims to influence policy to increase awareness of falls and innovative prevention programmes amongst health and social care authorities, the commercial sector, NGOs and the general public so as to facilitate communities of interest and disseminate the work of the network to target groups across EU.

More specifically ProFouND’s objective is to embed evidence based fall prevention programmes for elderly people at risk of falls by using novel ICT and effective training programmes in at least 10 countries/15 regions by 2015 so as to facilitate widespread implementation. ProFouND will achieve this in three main ways.

Read the full article online…

Latest from BMJ Learning

Case Study:
An 84 year old woman is having trouble sleeping at night. This has been a recurring problem for some months. You know she has had a fall earlier this year. She wants some medication to help her sleep as she feels that this is affecting her ability to do things during the day. What would you advise? What if she didn’t want to follow your advice? If you would like to learn more about this topic, then click on the link to complete this module today.

Falls in older people: prevention and management

And here are our most popular modules in urology for you to complete.

Idiopathic constipation and nocturnal enuresis in childhood: a guide to management – in association with NICE

Lower urinary tract symptoms in men: a guide to management – in association with NICE

Erectile dysfunction: diagnosis and treatment

Managing patients at risk of prostate cancer: in association with the NHS prostate cancer management programme

Urinary tract infection in children: diagnosis, treatment, and long term management – in association with NICE

Health Matters: 5 February 2013

The next Health Matters public lecture will be held on Tuesday 5 February 2013, from 7-8pm, in the Lecture Theatre, Education & Training. The talk will be presented by Dr Rubina Japanwala, Consultant Orthogeriatrician, and is entitled “Bone Health Matters, or does it?”

The aim of the talk is to increase awareness to improve bone health and to prevent falls and fractures, and will give information about osteoporosis, falls, vitamin D, and fractures.
Dr Japanwala is also the Falls Lead for the Trust.

Members of staff are very welcome to attend this interesting talk.  If you would like to attend please contact the Communications & Engagement Team on ext 1560 (01625 661560) or email us at

This article “Discrepancies in predicted fracture risk in elderly people” is published in the BMJ (Jan 2013) looks at calculators used to estimate fracture risk in elderly people which give widely different results. Mark Bolland and colleagues argue that treatment decisions should be based on calculators using 3-5 year estimates of risk.  Click for full article

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 



New approaches to integrated falls prevention services

This Briefing shares the learning and recommendations from a workshop for members held by the NHS Confederation and the Ambulance Service Network on falls prevention strategies for the older population.

It is intended to help the NHS and local government think about new approaches to the commissioning and provision of comprehensive, integrated falls prevention services. It shows that a focus on prevention and early intervention through joint working has benefits for the whole health and social care system, and that not taking action may soon become unaffordable.

via Falls prevention: new approaches to integrated falls prevention services..

King’s Fund: Toolkit for care of frail older people

Royal College of Physicians

Toolkit for improving care for frail older people
This is the third in a series of acute care toolkits which aims to improve the care of the frail older patient. The toolkit, produced in collaboration with the British Geriatrics Society, recommends procedures for both initial assessment on admission and later Comprehensive Geriatric Assessment.

Older people make up 60–70% of hospital inpatients, and most are admitted through an Acute Medical Unit (AMU), making this a key area in which care for older people can be influenced. It can be difficult for doctors to assess frail older patients as they can often arrive at hospital with multiple symptoms or conditions which can make it difficult to deduce the true cause of the admission.

The new six-page toolkit, produced in collaboration with the British Geriatrics Society, recommends procedures for both initial assessment on admission and later Comprehensive Geriatric Assessment (CGA). 

Developing and Evaluating Clinical Practice Guidelines: A Systematic Approach

Levin, RF. 
Evidence based Geriatric Nursing Protocols for Best Practice – 4th edn 

Clinical decision making that is grounded in the best available evidence is essential to promote patient safety and quality health eg: guidelines for falls prevention recommend developing a protocol for toileting elderly, sedated, or confused patients …

Falls prevention articles

Reducing Falls and Fall-Related Injuries in Acutely and Critically Ill Patients

MA Halm… – American Journal of Critical Care, 2011
Nurses manage competing priorities for these patients, dealing with medically acute conditions and unexpected acute/emergent situations and complications while ensuring the patient’s safety.  These safety needs include protecting patients from falls and fall-related injuries

Not available via Athens but can be ordered if required through inter-library loan request

The National Falls and Bone Health Audit: implications for UK emergency care

J Banerjee, J Benger, J Treml, FC Martin, R Grant… – Emergency Medicine …, 2011

Introduction The National Clinical Audit of Falls and Bone Health, coordinated by the Royal College of Physicians, assesses progress in implementing integrated falls services across the UK against national standards and enables benchmarking between service providers. Nationally, falls are a leading contributor towards mortality and morbidity in older people and account for 700 000 visits to emergency departments and 4 million annual bed days in England alone.

Not available via Athens – see above

News from NHS Networks: 23 Sept

The September edition of the National End of Life Care Programme newsletter is now available.    Read more »
Carrying out NICE recommended risk assessments among the elderly could limit the numbers who have falls, a review in the British Medical Journal (BMJ) suggests.              Read more »