Clinical Governance e-Bulletin
This e-Bulletin is produced Ross Scrivener, Claire Constable and Deborah Fisher in the Quality
Standards and Innovation Unit at the RCN Learning and Development Institute. It uses key themes to
capture items about significant aspects of clinical governance. All links provided are correct at time of
publication. We welcome any ideas, tips and suggestions. You can contact us at
If you would like to learn more about Clinical Governance related issues visit the Clinical Governance
Online Resource at: http://www.rcn.org.uk/development/practice/clinical_governance
You can also keep up-to date with the RCN Clinical Governance e-Bulletin, via the social
bookmarking tool Delicious: http://delicious.com/clinicalgovernance
This Bulletin was sent out on 7 April 2011
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In our part-themed Bulletin on maternity care – „Promoting normal birth‟ sent
out on 24th March 2011 we apologise for not including an organisation very
relevant to the theme:
Independent Midwives UK. Independent Midwives are fully qualified midwives who have chosen to
work outside the NHS in a self employed capacity and their role encompasses the care of women and
babies during pregnancy, birth and the early weeks of motherhood. A strategic objective is "to
strengthen the partnership between women and midwives by protecting and promoting normality in
* * * * * * * * * * * *
A. Clinical Governance: general
DH: CNO Bulletin. Issue 95, March 2011.
DH: Modernisation of health care. This web channel provides health care professionals with all the
latest news on the modernisation of health and social care.
DH: New style online bulletins. The DH has launched two 'new style' bulletins in electronic format.
The purpose of the AHP and GP bulletins is to provide latest information from the Department for
professional health groups. They are designed to be more interactive, facilitating user engagement
and feedback. http://www.dh.gov.uk/en/Aboutus/Features/DH_125568
DH: Health is global: an outcomes framework for global health 2011-2015. The outcomes
framework builds on the cross Government strategy for global health, Health is Global - a UK
Government strategy 2008-2013. The strategy aimed to set out how government departments should
work together coherently to improve health in the UK and overseas.
Equality and Human Rights Commission (EHRC): How fair is Britain? The first Triennial
Review. Every three years the Commission is required to report to Parliament on the progress that
society is making towards this vision. This is the first Triennial Review. It brings together evidence
from a range of sources, including Census data, surveys and research, to paint a picture of how far
what happens in people‟s real lives matches up to the ideals of equality. As well as the report there is
a video overview, case studies and supporting evidence.
Healthcare Improvement Scotland: Healthcare Improvement Scotland came into operation on 1
April 2011. Healthcare Improvement Scotland includes a number of organisations. Building on work
previously done by NHS Quality Improvement Scotland and the Care Commission Healthcare
Improvement Scotland will help NHSScotland and independent healthcare providers to deliver high
quality, evidence-based, safe, effective and person-centred care, and to scrutinise services to provide
public assurance about the quality and safety of that care.
NHS Confederation: Where next for NHS reform? A discussion paper. The NHS Confederation
has supported the Government‟s objectives but has also expressed concerns about the significant
risks involved with these reforms. This paper seeks to identify the broad areas of concern and then to
suggest potential options in response. http://www.nhsconfed.org/Publications/Pages/Where-next-for-
Royal College of Nursing (RCN): RCN calls for more clarity over public health budget. The
RCN‟s response to the Public Health White Paper, Healthy lives healthy people: our strategy for
public health in England, raises a number of concerns. Plans to ring-fence money for public health are
well-intentioned but it is unclear which services would be covered, how the money would be
safeguarded, and how a public health „premium‟ would work in practice.
RCN: RCN launches Nurses‟ Day campaign. The RCN has launched a major new online campaign
to celebrate Nurses‟ Day which takes place on 12 May. In the run up to Nurses‟ Day, the RCN is
calling on patients, their friends and families to sign a pledge showing their support for individual
nurses and the profession as a whole. As part of the campaign, Sarah Brown, who campaigns to
reduce maternal mortality, describes, in a video available on the website, her support for nursing.
RCN: Keep up with Congress. If you cannot make it to Liverpool for RCN Congress, there are plenty
of ways to keep up with what‟s happening at the UK‟s premier nursing conference. On the RCN
website you can watch live or archived debate footage, read all the latest news and event features,
post your views on the RCN Discussion Zone and see photos and films from previous days‟ activities.
Congress 2011 is from 10-15 April.
Congress 2011: http://www.rcn.org.uk/newsevents/congress/congress_2011
RCN President welcomes you to Congress in Liverpool.
RCN: Principles of Nursing Practice – find out more. RCN members have the opportunity to
explore the benefits and implementation of the RCN‟s Principles of Nursing Practice in a forthcoming
event at RCN Congress.
Social Care and Social Work Improvement Scotland (SCSWIS): SCSWIS is the new unified
independent scrutiny and improvement body for care and children‟s services and has a significant
part to play in improving services for adults and children across Scotland. SCSWIS regulates and
inspects care services, carries out social work and child protection inspections and supports
improvement of care, social work and child protection services. SCSWIS came into operation on 1
April 2011. http://www.scswis.com/
SCSWIS: Introducing new approaches to registration, enquiries and complaints.
B. Quality Improvement Processes & Techniques
Agency for Healthcare Research and Quality (AHRQ): Care Coordination Measures Atlas. This
American resource lists existing measures of care coordination, with a focus on ambulatory care, and
presents a framework for understanding care coordination measurement. The Atlas is useful for
evaluators of projects aimed at improving care coordination and for quality improvement practitioners
and researchers studying care coordination. http://www.ahrq.gov/qual/careatlas/
BMC Public Health: Good practice in health care for migrants: views and experiences of care
professionals in 16 European countries. Health care professionals in different services experience
similar difficulties when providing care to migrants. They also have relatively consistent views on what
constitutes good practice. The degree to which these components already are part of routine practice
BMJ Quality and Safety April 2011: Supplement on Knowledge for Improvement. This special
supplement which is on open access is the outcome of a colloquium and covers six major areas: the
structure of improvement knowledge; discovering and defining sources of evidence; the social
determinants of action; the importance of cross-disciplinary work; the challenges of professional
education; and rethinking methods of inference. http://qualitysafety.bmj.com/content/20/Suppl_1?etoc
Care Quality Commission (CQC): State of Care 2009/10. The latest report reveals that services
provided during the lead up to the Health and Social Care Act 2008 improved: more care homes and
home care services met the essential standards; the quality of care commissioned by councils;
service users had greater control over their care. Areas for improvement were also highlighted.
CQC: New registration fees from April 2011. All providers of regulated activities will pay one annual
fee. This fee will cover all of their registration and compliance requirements for all of their locations.
Centre for Mental Health: Pathways to unlocking secure mental health care. This report
examines the extent to which pathways into and through secure mental health services can be
improved through the different security levels and ensure a better flow between prison and secure
DH: Supporting partnerships to reduce alcohol harm: key findings, recommendations and
case studies from the Alcohol Harm Reduction National Support Team. This report contains
signposting, case studies and examples of good practice.
DH: NHS emergency planning guidance: planning for the management of burn-injured patients
in the event of a major incident: interim strategic national guidance. This guidance gives best
practice guidance to NHS organisations in planning, preparing and responding to incidents and
emergencies that give rise to burn injuries regardless of cause, source or nature. This includes
chemical, biological and radiological incidents. The principles apply regardless of the number of
patients being treated. The guidance covers adults and children.
DH: Stop smoking service delivery and monitoring guidance 2011/12. This document provides
best practice guidance relevant to the provision of all publically provided stop smoking interventions
and sets out fundamental quality principles for the commissioning and delivery of services which can
be used to inform the development of local commissioning and provision arrangements.
DH: NHS at home: children‟s community nursing services. This report shares the findings of a
review of the contribution community children's nursing services, as a key component of community
children's services, can make to the future outcomes of integrated children's services.
DH: Practice-based commissioning: budget guidance for 2011/12 – methodological changes
and toolkit guide. The Department of Health has updated the toolkit that can be used to determine
weighted capitation indicative budgets at sub-PCT level. The toolkit also provides information at
practice level that may be useful for emerging pathfinders and emerging consortia.
DH: Transparency in outcomes: a framework for quality in adult social care - response to
consultation. The Department of health has published the first national Adult Social Care Outcomes
Framework, which will apply to the year 2011/12. This is an important part of the Government's
commitment to rebalancing the relationship with local government, and focusing on what matters most
to people. http://www.dh.gov.uk/en/Consultations/Responsestoconsultations/DH_125464
DH: Fulfilling and rewarding lives: evaluating progress. This guidance and self-assessment
framework is to help support Local Authorities and NHS organisations and their partners to implement
the statutory guidance ‟Implementing „Fulfilling and rewarding lives‟ in their localities.
DH: Response to sexual violence needs assessments (RSVNA) toolkit: informing the
commissioning and development of co-ordinated specialist services for victims of sexual
violence. This document is guidance for local area partnerships conducting a Response to Sexual
Violence Needs Assessment.
DH: Good Practice Procedure Guide: The transfer and remission of adult prisoners under s47
and s48 of the Mental Health Act. This is a good practice procedure guide for transferring and
remitting remand, Immigration Act detainees to and from inpatient treatment under the Mental Act.
DH: Cost-effective prescribing: Better Care Better Value (BCBV) indicator on statins. Guidance
on the use of the prescribing Better Care Better Value Indicators, especially in relation to the use of
the indicator for statins. It clarifies that the indicators are not intended for use as targets.
Department of Health, Social Services and Public Safety (DHSSPS): Residential family centres:
minimum standards. These Centres are specialist units run by qualified social workers where
families are referred by Health and Social Care Trusts (HSCTs) in order to have their parenting skills
assessed, developed and improved. The standards reflect the regulations of 2007 and requirements
of other legislation relevant to the running of a Centre.
Healthcare A2Z: Communication matters: How to ensure your message lands. Bevis Moynan
NLP Master practitioner talks about how to use some simple techniques to ensure your message
Healthcare Improvement Scotland: SWHMR draft version – for consultation. Version 5 of the
Scottish Woman Held Maternity Record is out for consultation until 6 May 2011.
Healthcare Quality Improvement Partnership (HQIP): National clinical audits for inclusion in
Quality Accounts‟ portal. HQIP has created a new space on our website covering national clinical
audits for inclusion in Quality Accounts. This is to aid local Trusts in completion of their Quality
House of Commons, Health Select Committee: Health Committee - Fifth Report
Commissioning: further issues. This report follows on from the previous report on commissioning,
published in January 2011 which was a response to the proposed reforms which were set out in the
health White Paper. It further examines issues which were previously highlighted as requiring further
consideration such as maintaining high quality care while delivering efficiency gains in the NHS.
RCN: RCN welcomes commissioning recommendation. Report has agreed that nurses must be
represented and involved on local commissioning boards.
Implementation Science: Achieving continuity of care: facilitators and barriers in community
mental health. The study concluded that substantive challenges exist in harnessing the benefits of
integrated CMH Team working to deliver continuity of care. Team support should be prioritised in
terms of IT provision linked to a review of current models of administrative support, along with
investment in education and training for role development, leadership, workforce retention and skills
to meet service users' complex. http://www.implementationscience.com/content/6/1/23/abstract
Implementation Science: The effectiveness of strategies to change organisational culture to
improve healthcare performance: a systematic review. „Current available evidence does not
identify any effective, generalisable strategies to change organisational culture. Healthcare
organisations considering implementing interventions aimed at changing culture should seriously
consider conducting an evaluation (using a robust design, e.g. ITS) to strengthen the evidence about
this topic.‟ http://www.implementationscience.com/content/6/1/33/abstract
Joint Commissioning Panel for Mental Health (JCP-MH): This is a new collaboration between
leading organisations with an interest in mental health and learning disabilities.
King‟s Fund: Integrating health and social care: Where next? "The coalition government has
made clear its commitment to the integration of health and social care in its proposals for reform. In
the context of the intense financial and demographic challenges facing both health and social care,
this paper offers a fresh assessment of the prospects for integrating health and social care and the
opportunities and challenges arising from the government‟s proposals".
Integrating health and social care in Torbay: improving care for Mrs Smith. This paper sets out
how one particular area – Torbay – created an integrated care system that aimed to improve care for
„Mrs Smith‟, a fictitious user of health and social care services.
National Cancer Action Team: Holistic needs assessment for people with cancer: a practical
guide for healthcare professionals. Complements the earlier guidance published in 2007. It
provides further practical advice and case studies.
National Clinical Audit Patient Outcomes Programme (NCAPOP): National Kidney care Audit
(Vascular Access) 2010 report. The audit report summary makes a series of recommendations
around data collection; access provision and morbidity and mortality.
NHS Confederation: Facing up to the challenge of personal health budgets. This report
examines attitudes and motivations to personal health budgets amongst frontline professionals
working with mental health service users.
NHS Diabetes: National Diabetes Inpatient Audit (NaDIA) 2010 (England). The audit which was
conducted in acute hospitals in England on a single weekday in the first two weeks of November 2010
found that people with diabetes account for 15 percent of inpatients in England.
Policy Exchange: Implementing GP commissioning. This report suggests that the Health and
Social Care Bill‟s proposals to abolish every PCT by 2013 could lead to the new structure replicating
the existing system in all but name. It notes that by slowing down the proposed reforms, the potential
to deliver real and lasting transformation in the NHS is enormous.
Primary Care Commissioning (PCC): New@PCC. 30 March 2011, Issue 256.
RCN: Support for people with mental health needs in justice system welcomed. Dr Peter Carter
has welcomed a government commitment to divert people with mental health needs from the justice
system and to improve treatment and support in the community. The RCN‟s Chief Executive &
General Secretary co-signed a letter, written by the Care not custody campaign, which was published
in The Guardian.
RCN: Principles of Nursing Practice: How the Principles are being used. A new case study from
the Nurse Leadership Group at Eastern and Coastal Kent Community NHS Trust describes how the
Principles have been formally endorsed by the Trust to support safe quality patient care and
continuous improvement. They are to be embedded in the recruitment process for newly qualified
nurses, used to facilitate the preceptorship programme, and will be integrated into clinical
competences to provide “a living aspirational framework for the standard of everyday nursing
RCN: NHS missing out on £5.5m a year in potential savings. The RCN has revealed that the NHS
could potentially save up to £5.5 million a year if health organisations improve the way they dispose of
waste. Using the RCN‟s Frontline First campaign, nursing staff have contacted the RCN to raise
concerns that some health care organisations were treating waste as infectious rather than offensive.
The RCN submitted a Freedom of Information to investigate and the subsequent report confirmed this
was the case.
RCN: Freedom of information report on waste management.
RCN: Spread the word about school toilet award. RCN members who are school nurses are being
encouraged to spread the word about a new award for school toilets. The Bog Standard School Toilet
award aims to encourage schools to improve their toilets.
BOG Standard website. http://www.bog-standard.org/
RCN Crohn‟s and Colitis Special Interest Group: Inflammatory Bowel Disease Audit. A three
part web-based audit targeted at specialist nurses, who carry out an IBD role commenced at the end
of March. The audit is in three parts: nurse profile (part 1); service profile (part 2), and a two week
prospective audit of IBD practice (part 3).
RCN Policy and International Department: Influencing commissioning – Procurement. This
powerpoint presentation developed by the RCN provides an overview of the framework surrounding
the current procurement processes in the NHS (England) including: an overview of various rules and
guidance; weblinks on slides for further resources. Please note that this is a dynamic area and
guidance will change over time. This is a resource for members to adapt and to use as appropriate.
RCN Policy and International Department policy briefing 02/2011: Price and competition in
health care in England. Price competition in the NHS in England is controversial and this briefing
provides an overview of some of the evidence from the English NHS and discusses price competition
as part of the broader framework of funding and financing.
Royal College of Paediatrics and Child Health, Royal College of General Practitioners &
College of Emergency Medicine: Urgent and emergency care clinical audit toolkit. This learning
tool aims to support and improve the quality of urgent and emergency care services for patients.
Social Care Institute for Excellence (SCIE): Windows of opportunity: prevention and early
intervention in dementia. A tool for commissioners and providers. Early intervention is often
seen as anticipatory information and support delivered at the earliest stage of dementia, following
diagnosis. Prevention encompasses the range of interventions that prevent an increase in need that
may tip an individual into a higher or more intensive level of service. This SCIE resource explains this
further and offers a greater understanding of the journey through dementia.
SCIE Social Care TV: Looked after children. Two new films relevant to this area.
Welsh Assembly Government (WAG): National cancer standards for children published. The
Standards provide a foundation for NHS Wales to plan and deliver effective high quality services for
children with cancer from birth up to and including the age of 15. http://www.wales.nhs.uk/news/18754
C. Patient Safety
AHRQ: Surveys on patient safety culture: New resource on patient safety dimensions. The
web-based resource is organized by the dimensions assessed in the HSOPS, such as teamwork
within units, overall perceptions of safety, and feedback and communication about errors. It contains
links to useful tools and examples that organisations can use to help improve their safety culture.
Health Protection Agency (HPA): UK-acquired HIV nearly doubles in ten years. New diagnoses
for people infected with HIV in the UK almost doubled over the past decade, (from 1,950 in 2001 to
3,780 in 2010). Men who have sex with men remain the group most at risk of becoming infected with
HIV in the UK. New diagnoses in this group alone have increased by 70 per cent in the past 10 years.
HPA: HPA Guidelines for the Public Health Management of Pertussis. Published by the HPA‟s
Pertussis Guidelines Group, these guidelines update and consolidate the guidance published in 2002
for use of erythromycin chemoprophylaxis in persons exposed to pertussis.
HPA: Health protection in prisons report 2009-2010. Outlines the progress made in meeting the
objectives of the work programme for 2009-2010 which covered improving infectious disease
surveillance, the hepatitis B vaccination monitoring programme, and information and communication.
Health Protection Scotland (HPS): Publication of National Hand Hygiene NHS Campaign
Compliance with Hand Hygiene - Audit Report. This is the twelfth bi-monthly report to present hand
hygiene compliance data at a country level which continues to aid understanding of compliance
throughout NHSScotland. http://www.hps.scot.nhs.uk/news/spdetail.aspx?id=395
HPS: Publication of the ICU Associated Infection National Surveillance Programme Pilot
Report. This first report provides data for the period May 2009 to January 2010 from 19 Intensive
Care Units in Scotland. http://www.hps.scot.nhs.uk/news/spdetail.aspx?id=396
HPS: Publication of Surveillance of Surgical Site Infection: Annual Report. The Scottish
Surveillance of HAI Programme (SSHAIP) within HPS co-ordinates the SSI surveillance programme
that is mandatory in all NHS boards in Scotland. This is the seventh national annual report from this
programme of surveillance and presents the results of the analysis of both the cumulative data from
01/01/2003 to 31/12/2009 and also focuses on data from 01/01/2009 to 31/12/2009.
HPS: Publication of quarterly reports on Clostridium difficile infection and S. aureus
Health Protection Surveillance Centre: Strategy for the Control of Antimicrobial Resistance in
Ireland (SARI): Guidelines for the prevention of ventilator-assisted pneumonia in adults in
Ireland. The SARI Working Group reviewed a number of existing guidelines and updated as
necessary to produce this single guideline for Ireland. http://www.hpsc.ie/hpsc/A-
Healthcare Inspectorate Wales (HIW): Safeguarding People Affected by the Mental Health Act:
HIW Produces First Annual Report. Healthcare Inspectorate Wales (HIW) has published its first
annual report summarising the result of its monitoring of how the Mental Health Act was used in
Wales in 2009 - 10. http://www.hiw.org.uk/news.cfm?orgid=477&contentid=18761
Medically Induced Trauma Support Services (MITSS): Engaging Minority Communities
in Safer Healthcare. An American report from a conference looking at how medical errors/adverse
medical events impacting the minority communities – people of different races, ethnicities, cultures,
and those for whom English is a second language? http://www.mitss.org/EMCISHfinal.pdf
National Patient Safety Agency (NPSA): The adult patient‟s passport to safer use of insulin.
The aim of this Alert is to improve patient safety by empowering patients as they take an active role in
their treatment with insulin. This will be achieved with a patient information booklet and a patient-held
record (the Insulin Passport) which documents the patient‟s current insulin products and enables a
safety check for prescribing, dispensing and administration. The Insulin Passport will complement
existing systems for ensuring key information is accessed across healthcare sectors.
New England Journal of Medicine: Videos in clinical medicine: Hand hygiene. This video
compiled in the USA, divided into ten sections, is freely available as part of a series in the NEJM.
Scottish Government: A pathway of care for vulnerable families (0-3). Guidance to support the
implementation of Getting it right for every child through continuous assessment and a continuum of
World Health Organization (WHO): World Health Day – 7 April 2011: Antimicrobial resistance:
no action today, no cure tomorrow. On World Health Day 2011, WHO has introduced a six-point
policy package to combat the spread of antimicrobial resistance. http://www.who.int/world-health-
BBC Health: Europe „losing‟ superbugs battle. http://www.bbc.co.uk/news/health-12975693
D. Patient Focus
AHRQ: Health literacy interventions and outcomes: an update of the Literacy and Health
Outcomes Systematic Review of the Literature. The report, an update of a 2004 literature review,
found an association between low health literacy in all adults, regardless of age, and more frequent
use of hospital emergency rooms and inpatient care, compared with other adults as well as
demonstrating links to poorer health status and a higher risk of death.
BMC Public Health: The views of young children in the UK about obesity, body size, shape and
weight: a systematic review. This systematic review of qualitative and quantitative research aimed
to explore the views of UK children about the meanings of obesity and body size, shape or weight and
their own experiences of these issues. http://www.biomedcentral.com/1471-2458/11/188/abstract
BMC Public Health: The effectiveness of peer health coaching in improving glycemic control
among low-income patients with diabetes: protocol for a randomized controlled trial. This
protocol for a study undertaken in America proposes a multicenter, randomized control trial to
evaluate the effectiveness of utilizing peer coaches to improve clinical outcomes and self-
management skills in low-income patients with poorly controlled diabetes.
DH: Working together for a stronger NHS. Describes why the way the Department provides health
and care needs to change and the plan to modernise the NHS, and invites the reader to get involved
in the process.
DH: Introducing Solid Foods: Giving your baby a better start in life. This leaflet provides mothers
with important information about introducing solid foods.
DH: Off to the best start: Important information about feeding your baby. This leaflet provides
mothers with important information about feeding their baby.
DH: The cancer drugs fund. The establishment of a Cancer Drugs Fund will enable patients to
access the cancer drugs their doctors think will help them.
DH: The Cancer Drugs Fund: Government response to consultation.
DH: NHS dental services in England – leaflet. Provides information about how NHS dental services
in England work, including how to find an NHS dentist, what treatment you can expect and how much
it will cost.
DH: HealthWatch Transition Plan. This document highlights key issues for Local Involvement
Networks (LINks), their host organisations and local authorities during 2011/12, prior to the
establishment of HealthWatch.
Healthcare Improvement Scotland: My View - Putting my views at the heart of my mental health
services and support. This tool was disseminated to the service in March 2011 and is also available
from the ICP toolkit. It comes with staff guidance notes. These provide extra information for
professionals using My View with service users.
Health in Wales: Developing and Improving Services for Dementia Sufferers in Wales. „This
Statement highlights the Welsh Assembly Government‟s commitment to develop services for people
with dementia, ensuring that in Wales, people with dementia are supported and receive the help,
dignity and respect that they deserve.‟ http://www.wales.nhs.uk/news/18719
Health in Wales: New regulations streamline the handling of concerns about the Welsh NHS.
New regulations aimed at streamlining the handling of concerns about the Welsh NHS come into
force on 1 April 2011. Under the new Putting Things Right arrangements, the NHS in Wales will aim
to “investigate once, investigate well”, ensuring that concerns are dealt with in the right way, the first
time round. People raising concerns will also be given the chance to be involved in the process.
NHS Wales: NHS Wales Shared Services Partnership. The NHS Wales Shared Services
Partnership provides common services to support NHS Wales in delivering front line healthcare.
Scottish Government: Update Scottish Inpatient Patient Experience Survey 2010 Volume 1:
National Results with Healthcare Experience Indicator. The Healthcare Experience Indicator has
been developed to measure the reported experience of people using the NHS. It is one of the 45
National Indicators on Scotland Performs, which measures and reports on progress of government in
Scotland in creating a more successful country.
Scottish Government: GP access survey results 2011. Summarises feedback from patients about
whether they were able to see or speak to someone at their GP practice fairly quickly (within 2
working days / 48 hours) and about whether they were able to book appointments in
Scottish Government: Guides on health costs. Information about health costs (dental and optical)
and help that may be available.
Are you entitled to help with health costs.
A quick guide to help with health costs.
Society for Cardiothoracic Surgery in Great Britain & Ireland (SCTS): Maintaining patients‟
trust: modern medical professionalism. This report describes the SCTS' commitment to collecting
and benchmarking clinical outcome data; examines the impact of publishing information about
outcomes by hospital and by individual surgeon; and explores the implications for our understandings
of medical professionalism and patient-centred care.
BMC Medical Informatics and Decision Making: Medical record: systematic centralization
versus secure on demand aggregation. This study undertaken in France concludes that "a system
that gathers all of the currently available information regarding a patient on the request of health-care
professionals could be of great interest. This low-cost pragmatic alternative to centralized medical
records could be developed quickly and easily".
BMC Medical Informatics and Decision Making: Phase 1 pilot study of email support for people
with long term conditions using the Internet. Pilot undertaken in south-west England for a
definitive randomised controlled trial. http://www.biomedcentral.com/1472-6947/11/20/abstract
DH: DH Digital. Learn about the latest developments in digital communications at the Department of
Health from Stephen Hale, DH's Head of Digital Communications. http://hale.dh.gov.uk/
DH: A simpler and better digital presence. http://hale.dh.gov.uk/2011/04/01/a-simpler-and-better-
Health in Wales: Your information, your rights. A new leaflet has been published which explains
why NHS Wales collects individual health information and how the information is used. It is a revised
edition of the Welsh assembly‟s 2002 version. It now includes a section on „information held on a
computer‟ and has been produced to reflect modern guidance on public privacy notices.
Health Foundation: DAWN - Diabetes Appointments via Webcam in Newham. This Shine 2011
project explores replacing routine follow-up outpatient appointments that don‟t require physical
examination with web-based consultations.
Health Rights Information Scotland: eHealth – using computers to improve your healthcare.
The Scottish Government has commissioned Health Rights Information Scotland (HRIS) to produce a
public information leaflet and an animated film clip which looks at eHealth in simple images and plain
language from a patient‟s perspective. http://www.hris.org.uk/patient-information/information-about-
Journal of Medical Internet Research (JMIR): Social cognitive determinants of nutrition and
physical activity among web-health users enrolling in online intervention: the influence of
social support, self-efficacy, outcome expectations, and self-regulation. This study examines the
demographic, behavioural, and psychosocial characteristics of Web-health users recruited for an
online social cognitive theory (SCT)-based nutrition, physical activity, and weight gain prevention
intervention, the Web-based Guide to Health (WB-GTH). http://www.jmir.org/2011/1/e28/
New England Journal of Medicine: Tapping the unmet potential of health information
technology. "Health information technology (HIT) holds promise for facilitating vast improvements in
care and, ultimately, in the health of Americans but achieving that potential remains a daunting task".
Article outlines potential and the challenges in achieving them.
NHS Connecting for Health (NHS CFH): NHS Number guidance for GP practices V1. The
guidance aims to assist GP practices in maximising their use of the NHS number and increase patient
awareness of why the number is important.
F. Evidence Based Practice Tools and Techniques
BMC Medicine: Interpreting systematic reviews: are we ready to make our own conclusions?:
A cross-sectional study. This study assessed how well a group of Malaysian hospital practitioners
and medical students derived their own conclusions from systematic reviews (SRs) and to what extent
these were influenced by their prior beliefs and the direction of the study results.
BMC Public Health: 'Pedometers cost buttons': the feasibility of implementing a pedometer
based walking programme within the community. The results of the study suggest that pedometer
based walking interventions may be considered cost-effective and suitable for implementation within
the wider community. Study also highlights the gaps in research.
BMC Public Health: The effect of two different health messages on physical activity levels and
health in sedentary, overweight middle aged women. This study found that “low active, overweight
women undertook significantly more physical activity when they had a daily 10,000 step goal using a
pedometer, than when they were asked to achieve 30 minutes of walking/day”.
BMJ: Randomised prostate cancer screening trial: 20 year follow-up. This study undertaken in
Sweden concludes that "after 20 years of follow-up the rate of death from prostate cancer did not
differ significantly between men in the screening group and those in the control group".
DH: Bereavement care services: a synthesis of the literature Final Report of review
commissioned by DH to support implementation of the End of Life Care Strategy. This report
sets out the findings of a literature review on bereavement services conducted by the University of
Nottingham. The review was commissioned to inform future work on bereavement care, as part of the
implementation of the End of Life Care Strategy.
Guidelines and Audit Implementation Network (GAIN): General palliative care guidelines for
the management of pain at the end of life in adult patients. This updates the 2003 guideline on
general palliative care for control of pain in patients with cancer in Northern Ireland, but has been
modified to provide guidance on relieving pain at the end of life regardless of the underlying diagnosis
and reflects consultation with a wider group of professionals.
Healthcare Improvement Services: Depression measures research report. Findings from this
study show that across the UK, the commonly used scales for measuring the severity of depressive
symptoms are invalid for selecting treatments which have been determined by depression severity.
National Collaborating Centre for Mental Health (NCCMH): Psychosis with coexisting
substance misuse. This guideline offers best practice advice on the assessment and management
of people with psychosis and coexisting substance misuse. Psychosis is a condition that affects a
person‟s mental state, including their thoughts, mood and behaviour.
National Prescribing Centre (NPC): MeReC Bulletin Volume 21 Number 4 - Common questions
around medicines used for inflammatory bowel disease.
National Prescribing Centre (NPC): MeReC Monthly Number 36, March 2011.
NHS Clinical Knowledge Summaries (NHS CKS): New and updated CKS topics. Bruising (new),
Chest pain (new), Contraception – emergency, Meningitis (bacterial)/meningococcal septicaemia
(new), and Osteoporosis - prevention of fragility fractures (new).
NHS Evidence – neurological conditions: Annual Evidence Update on Multiple Sclerosis, 28
March - 1 April 2011. http://www.library.nhs.uk/neurological/viewResource.aspx?resid=407609
NHS Evidence: Eyes on Evidence. Issue 23, March 2011.
NICE: New quality standards. The quality standards are intended to be markers of excellence in
patient care and are applicable nationwide, across the NHS in England.
Depression in adults:
Diabetes in adults:
NICE: Early identification and management of chronic kidney disease in adults. This provides
support for the local implementation of NICE guidance through commissioning. It draws on the NICE
clinical guideline on the early identification and management of chronic kidney disease in adults in
primary and secondary care and the NICE quality standard on chronic kidney disease in adults.
NICE: Weight management before, during and after pregnancy. This guide provides support for
the local implementation of NICE guidance through commissioning. This is one in a series of good
practice guides intended to support commissioners in designing services to improve outcomes for
patients and to help the NHS make better use of its resources. The guide draws on NICE guidance on
dietary and physical interventions for weight management before, during and after pregnancy.
Scottish Intercollegiate Guidelines Network (SIGN): Clinical Guideline 125 - Management of
atopic eczema in primary care. The guideline summarises the evidence and, where appropriate, provides
evidence based recommendations around diagnosis and referral and a range of treatments and interventions.
SIGN: SIGN Apps. SIGN guideline recommendations are now available on the move within the new,
free SIGN App. http://www.sign.ac.uk/guidelines/apps/index.html
G. Staff focus
DH: Government Response to the House of Commons Health Select Committee: fourth report
of session 2010-11: the revalidation of doctors. Patients and the public have the right to expect
that the doctors who care for them are up to date and fit to practise and the Government welcomes
the report of the Health Select Committee.
DH: Health visiting return to practice and recruitment drive. The documents outline the
recruitment offer, and provide answers to frequently asked questions for NHS employers.
DH: Making quality your business: A guide to the right to provide. This guide tries to answer
some of the questions healthcare staff may have about setting up a staff-led enterprise. It will help
identify the next steps they need to take and where to find further information.
DH: Review of the Mary Seacole scholarship awards: steering group governance processes.
This review analyses the governance processes, systems and structures used by the Mary Seacole
Scholarship Awards Steering Group members.
DH: National allied health professional (AHP) leadership challenge toolkit. The national AHP
Leadership challenge programme provided clinical leadership development to nearly 1000 AHPs in
bands 5-9. This toolkit provides the information and tools needed to develop leadership challenges to
fit any organisation‟s needs.
Health in Wales: Back to school for school nurses. The One Wales commitment to ensure that
every secondary school in Wales has a school nurse is expected to be achieved by the end of the
current Assembly. http://www.wales.nhs.uk/news/18559
International Centre for Human Resources in Nursing (ICHRN): Nursing in Mauritius. A case
study. „Much has been achieved in the field of health in Mauritius but there is still a long way to go to
reach international standards in the fields of health and well-being comparable to some industrialised
NHS Education for Scotland (NES): The new Nursing and Midwifery Council (NMC) standards
for pre-registration nursing education - Advice on implementation for health services in
Scotland. Underlines the changes for service organisations in Scotland.
NES: Protecting Vulnerable Groups Scheme (PVG). On 28th February 2011, the Scottish
Government introduced a new membership scheme to replace and improve upon the current
disclosure arrangements for people who work with vulnerable groups. It will introduce a new system
that will continually update people's membership records, should any new vetting information become
NHS London: Healthy boards for a healthy London. This publication is tasked with delivering
practical leadership development solutions for health services across the capital. In light of the current
emphasis on effectiveness and efficiency, this practical guide aims to deliver targeted support for
board members within London.
NICE: NICE launches training pack for maternity settings. NICE has launched a training package
to support and reinforce the skills and competencies of midwives, health visitors and social workers
when raising sensitive issues with pregnant women who face difficult social circumstances.
NICE: NICE unveils latest Fellows and Scholars.
Nursing and Midwifery Council (NMC): New advice for Botox® nurses and midwives. The
advice makes clear the NMC‟s position that remote prescriptions or directions to administer should
not be used to administer injectable cosmetic medicinal products such as botulinum toxin (Botox®).
NMC: Remote prescribing and injectable cosmetic medicinal products.
RCN: RCN contributes to new Botox advice.
NMC: Complaints against nurses and midwives rise by 57 per cent. The NMC has experienced a
record year on year increase in the number of complaints against nurses and midwives. 833 new
referrals were received in January and February of this year compared to 530 for the same period in
2010 - an increase of 57 per cent. http://www.nmc-uk.org/Press-and-media/Latest-news/Complaints-
NMC: NMC wins gold at the 2011 International Visual Communications Association (IVCA)
awards. The NMC safeguarding film: 'If you don't do something, who will?' took the top prize in the
Motivational Training category at this year's IVCA awards.
Queen‟s Nursing Institute (QNI): QNI News newsletter, Spring 2011.
Royal College of Midwives (RCM): The right to raise concerns. Midwives magazine reviews NMC
guidance on raising and escalating concerns.
RCN: New midwifery and women‟s health adviser joins the RCN. The RCN has appointed Carmel
Bagness to the position of RCN Adviser for Midwifery and Women‟s Health.
RCN: RCN seeks comments on Fair Deal proposals. The RCN is seeking member comments to
use in its response to the HM Treasury consultation on the current Fair Deal arrangements. The
consultation follows Lord Hutton‟s interim report on public service pensions. The consultation closes
on 15 June 2011.
RCN: RCN memorial campaign attracts media attention. The RCN‟s call for a permanent
memorial to honour nurses who have served in conflict has featured on BBC Radio 4‟s Today
RCN: Pay tribute to nursing war heroes.
RCN UK Library: Webinar Training Programme for RCN members. The RCN UK Library has
developed web-based training sessions available free of charge to all RCN members. These take the
form of "webinars", an exciting new technology that enables participants to view and actively take part
in presentations by the simple means of an Internet connection and a phone line. These sessions are
ideal for busy members who would welcome the help of an information professional to improve their
information literacy skills. One hour sessions are being held on a number of different dates on two
topics: British Nursing Index and on resources available in the RCN e-library. Details and registration
form at http://tinyurl.com/348dweg
DHSSPS: Northern Ireland Care Leavers aged 19 Statistical Bulletin (March 2011). Key findings
indicate care leavers at 19 continue to have higher proportions of young people coping with disability
(19%) compared with the general population (6%); a third (33%) of females became mothers on or
before their 19th birthday, seven percentage points higher than the previous year.
House of Commons Public Accounts Committee: Accountability for public money (April 2011).
This report addresses concerns with accountability for public spending and examines the implications
for accountability in relation to governance reforms and localism proposals.
Human Genetics Commission: Increasing options, informing choice (April 2011). The report
recommends that preconception genetic testing should be made available to all those who may
benefit from it and individuals should be supported in making informed choices about the reproductive
options available to them. http://www.hgc.gov.uk/Client/news_item.asp?NewsId=156
ISD Scotland: Cancer statistics (April 2011).Childhood cancers in Scotland (1983-2007).
Cancer in teenagers and young adults in Scotland (1979-2008).
Joseph Rowntree Foundation (JRF): Loneliness compendium: Examples from research and
practice (April 2011). An exploration of the research, rhetoric and issues surrounding loneliness.
Loneliness can affect people at any time, and for some it can become an overwhelming problem. This
paper defines loneliness, explores how lonely people can be identified and engaged, and outlines
research and projects that could inform the Neighbourhood Approaches to Loneliness programme.
National Audit Office (NAO): Managing high value capital equipment in the NHS in England
(April 2011). Value for money is not being achieved across all trusts in the planning, procurement and
use of high value equipment. There are significant variations across England in levels of activity and a
lack of comparable information about performance and cost of machine use.
NES: NES strategic framework 2011-2014: consultation report (April 2011). Provides a summary
of feedback received from our stakeholders, and how the exercise influenced the final version of the
NES Strategic Framework for 2011-2014: Quality Education for a Healthier Scotland.
Office for National Statistics (ONS): Public service output, inputs and productivity: healthcare
(April 2011). This report examines public expenditure on healthcare between 1995 and 2009 and
finds that spending and generated output rose in this period.
I. NICE consultation gateway
Call for experts: The Department of Health has asked NICE to consult on the following proposed
health technology appraisal. The RCN is seeking for nurses with expertise and knowledge of these
technologies to participate in this work.
Please contact email@example.com if you would like to be involved in any of these topics on
behalf of the RCN:
Adalimumab for children and young people aged 6-17 with moderate to severe Crohn's disease
Atrial fibrillation (stroke prevention) – Rivaroxaban
Atrial fibrillation (stroke prevention and systemic embolism) - Dabigatran etexilate
Chronic iron overload (in people with thalassaemia) - desferrioxamine, deferiprone and
Cystic fibrosis – colistemethate
Cetuximab for the treatment of head and neck cancer
Gastro-entero-pancreatic neuroendocrine tumours - Everolimus for the treatment of advanced
Leukaemia (chronic myeloid) - dasatinib, high dose imatinib and nilotinib (review)
Juvenile idiopathic arthritis - tocilizumab
Lymphoma (non-Hodgkin's, relapsed, refactory) - pixantrone (monotherapy)
Lymphoma (stage III-IV follicular) - Rituximab for the first-line treatment (Review of TA 110)
Melanoma – (previously untreated unresectable stage III or IV malignant) - Ipilimumab in
combination with Dacarbazine
Multiple myeloma - Lenalidomide for the treatment of newly diagnosed
Psoriasis - Voclosporin for the treatment of moderate to severe plaque
Organ rejection in kidney transplantation - Belatacept for the prevention of
Osteoarthritis - Naproxcinod
Schizophrenia or bipolar disorder (acute agitation) - Loxapine inhalation for the treatment of
Structural neuroimaging in first-episode psychosis
Systemic lupus erythematosus (active) – belimumab
Ulcerative colitis (moderate to severe, second line) – adalimumab
The RCN is also seeking nurses/midwives with expertise and knowledge of the following areas to
participate in the listed guideline topics:
Familial breast cancer
Hepatitis B - the diagnosis and management of hepatitis B in children, adolescents and adults
Intravenous fluid therapy
Maternal and childhood nutrition in low income households
Myocardial infarction - the management of myocardial infarction with ST-segment elevation
Opioids in palliative care
Physical activities in the work place
Preventing the uptake of smoking by children and young people
Promoting children's social and emotional wellbeing in primary education
Tobacco - harm reduction approaches to smoking cessation for PCTs and NHS Stop Smoking
Tobacco - smoking cessation services for people using smokeless tobacco
Sickle cell crisis in hospital
Smokeless tobacco: smoking cessation among South Asians
Social anxiety disorder
Ulcerative colitis: Management of ulcerative colitis
Walking and cycling: local measures to promote walking and cycling as a form of travel or
10 - 14 April 2011 RCN Congress and exhibition 2011. ACC Liverpool.
Congress 2011 Agenda.
Congress 2011 Fringe.
12 April 2011 Congress Fringe Event: RCN Principles of Nursing Practice: promoting and
implementing the Principles. 12.45 – 13.45pm.
The RCN's Principles of Nursing Practice articulate what can be expected of nursing in any setting
regardless of provider. Developed with a range of stakeholders, nurses, patients and service users,
the Principles provide the basis for quality improvement and demonstrate the contribution of nursing
to quality care. The event is an opportunity to learn about the subsequent work that is taking place to
promote the Principles, and explore how they can be used in practice. The event features
presentations giving perspectives from the Care Quality Commission (CQC are sponsoring this fringe)
and the Nursing and Midwifery Council.
13 April 2011 Congress Fringe Event: Patient Safety. 12.45 – 13.45pm.
Patient Safety is a core component of quality care across the UK with major implications for the
achievement of successful health outcomes as well as effective use of resources. The RCN‟s strategy
for patient safety and linked workstream will be shared as will a number of resources to assist
members and the profession with key issues around patient safety. The Fringe will include a
presentation on clinical human factors from Beverly Norris, NPSA Lead for Human Factors. Further
information will be available in the Congress Fringe Programme.
Other RCN Events:
14 May 2011 Dignity in health and social care: Politics, policy and practice. Royal College of
Nursing, 20 Cavendish Sq, London.
16 - 18 May 2011 Annual International Nursing Research Conference. Harrogate International
Centre, Harrogate, North Yorkshire, UK.
19 May 2011 RCN Children and Young People Acute Care Forum conference: ABC- Can you
care for me? Accountability breeds competence. University of Warwick, Coventry.
2 June 2011 RCN Management and Leadership Conference. 20 Cavendish Square, London.
15-17 June 2011 RCN Joint Education Forums‟ third international conference and exhibition –
Beyond the borders: Innovations and challenges for nursing education. Europa Hotel, Belfast,
Northern Ireland. http://www.rcn.org.uk/newsevents/event_details/rcn_eventsms/joint_education
24 June 2011 RCN Mental health conference. Thistle Marble Arch, London, W1H 7EH.
24-25 June 2011 RCN Practice Nurse Annual Conference and Exhibition. Manchester
Conference Centre, Manchester M1 3BB.
15 July 2011 RCN Annual health care associated infection conference. Manchester Conference
14-15 September 2011 RCN long-term conditions conference and exhibition. RCN HQ, London.
29 September 2011 Patient Safety Conference “Professional partnerships promote patient
safety”. RCN HQ, London.
This conference is targeted at healthcare assistants, assistant practitioners, and junior clinical nursing
staff. The keynote address will be given by Dr Peter Carter, CEO and General Secretary of the RCN.
Other plenary sessions will cover high impact actions for change and the importance of human factors
in improving the delivery of safe care to patients, and accountability issues.
Three interactive sessions will be offered on:
Recognising the deteriorating patient
Management and prevention of pressure ulcers in acute and community settings
Managing nutrition and hydration in acute and community settings
For further information please contact: firstname.lastname@example.org.
If you would like receive this Clinical Governance e-Bulletin please fill out the online form at
You can find more examples in the e-Bulletin archive at
Change of address – please notify us of any changes of email address at
email@example.com . Please state clearly your old and your new address.
If you would like to join the RCN please see the 'How to Join' webpage on the RCN website at
„Working with healthcare professionals to improve the quality of patient care