Readmission to the Intensive Care Unit Following Cardiac Surgery: A Derived and Validated Risk Prediction Model in 4,869 Patients

Readmission to the Intensive Care UnitFollowing Cardiac Surgery: A Derived and Validated Risk Prediction Model in4,869 Patients (in press)
Journal of Cardiothoracic and Vascular Anesthesia, 2018 DOI: https://doi.org/10.1053/j.jvca

• From a comprehensive perioperative dataset, the authors derived and internally validated a risk index incorporating 9 easily identifiable and routinely collected variables to predict readmission following cardiac surgery.
• Study: Retrospective nonrandomized study, analysis of 4,869 consecutive adult patients. 156 patients (3.2%) readmitted. St George's Hospital, London

Abstract:

Specialised Services Commissioning Committee Report, NHS England Board meeting

Specialised Services Commissioning Committee Report
NHS England board meeting 24 May 2018

Extract from report of meeting 23 April 2018

Decommissioning in specialised services
4. The Committee received an update on a proposal to undertake work on decommissioning within specialised commissioning, which is designed to ensure that NHS resources are more effectively focused on clinical interventions of proven value, by reducing ineffective care and unwarranted variations in care. Published evidence suggests that success will rely on a multi-agency approach which, in the context of specialised interventions, will include amongst others: clinical leaders, NICE and the National Institute for Health Research.

5. The Committee noted the framework for developing this work and asked for it to be aligned to the wider Value Interventions Programme within NHS England.

Cystic Fibrosis Quality Standard

Cycstic Fibrosis [QS168]
NICE Quality Standard May 2018

• This quality standard covers diagnosing and managing cystic fibrosis in infants, children, young people and adults

Carer support and involvement in secure mental health services

Carer support and involvement in secure mental health services
NHS England 18 May 2018

• This toolkit aims to provide clear information for carers, service users, service providers and commissioners about how carers of people who use secure mental health services should be engaged with, supported, involved and empowered.

Barriers to the secondary use of data in critical care

Barriers to the secondary use of data in critical care
Journal of the Intensive Care Society v19(2) p127-131, 1 May 2018

• A survey of ICUs across England demonstrates key challenges affect the secondary use of data in critical care: a lack of integration of information systems within critical care and across departments; barriers to accessing data; mismatched data tools and user requests. Data are predominantly used for reporting and research with less emphasis on using data to inform clinical practice.

Improving delivery of the 62-day cancer waiting-time standard

Improving delivery of the 62-day cancer waiting-time standard
NHS Improvement, May 2018

• Tools to address the three key elements that contribute to improved waiting times for patients and better performance against the 62-day standard - reduced number of pathway steps, reduced time to first appointment and reduced overall size of patient tracking list.

Supporting Research in the NHS: response to consultation on ETCs and commercial research

NHS England’s response to the public consultation: “Supporting Research in the NHS: A consultation covering changes to simplify arrangements for research in the NHS and associated changes to the terms of the NHS Standard Contract”
NHS England 4 May 2018

• A summary of responses received to the consultation on simplifying arrangements relating to Excess Treatment Costs (ETCs) in non-commercial research and commercial contract research. accompanied by details of 12 agreed actions to support and apply research in the NHS. 
• Specialised Commissioning will be developing a new process to be unified with the new ETC management process. The intention is to publish a planned specialised commissioning process by end of June 2018 which will be tested with stakeholders. 

North London Forensic consortium

North London Forensic consortium

• Part of the New Care models programme for specialised mental health services, the North London Forensic consortium went live in April. It comprises of five trusts - Barnet, Enfield and Haringey Mental Health Trust (lead commissioner), Central and North West London FT, North East London FT, East London FT and West London Mental Health Trust. 
• According to Mark Landy talking to HSJ (3 May 2018) the consortium aims to bring back half of the 110 forensic patients currently out of area over the next two years and stop patients being sent out of area when a provider does not have a bed available.

Providing intensive care medicine in a district general hospital

Specialist not tertiary: Providing intensive care medicine in a district general hospital
Journal of the Intensive Care Society v19(2) p 92-93, May 1, 2018

• Discussion of the pros and cons of having an intensive care unit in every hospital.

The Edinburgh Pain Assessment and Management Tool in cancer inpatients

Pain Management in Cancer Center Inpatients: A Cluster Randomized Trial to Evaluate a Systematic Integrated Approach—The Edinburgh Pain Assessment and Management Tool
Journal of Clinical Oncology 2018 36:13, 1284-1290

• This study compared the effect of adding a clinician-delivered bedside pain assessment and management tool (Edinburgh Pain Assessment and management Tool [EPAT]) to usual care (UC) versus UC alone on pain outcomes in inpatients in cancer centres (n=1,795). Results demonstrate that the EPAT tool demonstrated a significant improvement in worst pain without increasing opioid adverse effects.
• Study: Two-arm, parallel group, cluster randomised (1:1) trial in 19 cancer centres in the United Kingdom involving 1,795 patients. Primary outcome - change in the percentage of study participants in each centre with a clinically significant (≥ 2 point) improvement in worst pain (using the Brief Pain Inventory Short Form) from admission to 3 to 5 days after admission. Secondary outcomes included quality of analgesic prescribing and opioid-related adverse effects.

Nerve transfer to partially restore upper limb function in tetraplegia [IPG610]

Nerve transfer to partially restore upper limb function in tetraplegia [IPG610]
NICE Interventional procedures guidance, April 2018

• Evidence-based recommendations on nerve transfer to partially restore upper limb function in people with tetraplegia.

Epilepsies: diagnosis and management [CG137] - sodium valproate update

Epilepsies: diagnosis and management [CG137]
NICE Clinical guideline [CG137] updated April 2018

• All updates relate to use of sodium sodium valproate.

‘My Liver’ – liver cancer app

‘My Liver’ – Educating & Supporting Patients with Liver Cancer
26 April 2018

• ‘My Liver’ app is a dedicated information guide designed to offer information and support for those patients (and families) who are diagnosed with liver cancer, helping them through each stage in their journey. The free to download app covers initial referral to treatment, how to manage symptoms and where to find further help and support. 
• My Liver’ is the second in the series of planned apps designed by the team from Leicester Hepato-Pancreato-Biliary (HPB) Unit & digital design agency AGF Studio, the first being ‘My Pancreas’ which was launched worldwide in April 2017.

New laser enables procedures for bladder cancer to be performed without general anaesthetic

New laser enables procedures for bladder cancer to be performed without general anaesthetic at West Middlesex University Hospital
CW+ 26 April 2018

• Some bladder cancer patients at West Middlesex University Hospital are now being treated under local anaesthetic using a procedure known as Trans Urethral Laser Ablation (TULA). The TULA procedure takes just 30 minutes which is half the time of the TURBT procedure or Cystodiathermy. The procedure is also carried in the outpatient setting, in a standard clinic room within the Urology Department, and therefore patients do not need to be admitted overnight. It is estimated that 50 patients every year will benefit from the TULA procedure.

National Electronic Glaucoma Surgery and Visual Field Preservation Audit

National Electronic Glaucoma Surgery and Visual Field Preservation Audit: Feasibility report
HQIP 22 March 2018 [Report dated January 2017]

• This report includes two feasibility studies for possible national glaucoma audits based on data collected using electronic medical record systems (EMR) as part of routine care and computerised visual field tests that are linked to EMRs.
• Part 1 addresses glaucoma surgery, trabeculectomy, which is the most frequently undertaken glaucoma surgical procedure
• Part 2 addresses visual field preservation in five large glaucoma care delivery centres

Preferences for centralizing specialist cancer surgery services

Discrete‐choice experiment to analyse preferences for centralizing specialist cancer surgery services
British Journal of Surgery v105 p587-596. doi:10.1002/bjs.10761, 7 March 2018

• An evaluation of the preferences of patients, health professionals and members of the public for the characteristics associated with centralization of specialist cancer surgery services. 
• The study found that preferences were particularly influenced by risk of complications, risk of death and access to a specialist MDT. Participants were willing to travel, on average, 75 min longer in order to reduce their risk of complications by 1 per cent, and over 5 h longer to reduce risk of death by 1 per cent. Findings were similar across groups.
• Study: Discrete choice experiment, responses from 444 individuals.
• Part of the RESPECT-21 programme

Abstract

NICEimpact cancer

NICEimpact cancer
NICE January 2018

• Analysis of data which reflect the uptake of the NICE guideline on suspected cancer and guidance published by the NICE technology appraisal programme.
• Headings: Cancer referrals, Cancer medicines, Access to new medicines.