Spinal cord injury services (all ages)

Spinal cord injury services (all ages)
NHS England 29 April 2019

• This service specification covers the provision of spinal cord injury services for adults and children.

Risk factors associated with revision for prosthetic joint infection following knee replacement

Risk factors associated with revision for prosthetic joint infection following knee replacement: an observational cohort study from England and Wales.
Lancet Infect Dis 2019, 17 April 2019 http://dx.doi.org/10.1016/S1473-3099(18)30755-2
Researchers from University of Bristol have found that patients who are under 60 years of age, males, those with chronic pulmonary disease, diabetes, or liver disease, and people with a higher body mass index are at increased risk of having the joint replacement redone due to infection.

Abstract:

Robot‐assisted surgery in gynaecology

Robot‐assisted surgery in gynaecology
Cochrane Systematic Review 15 April 2019, DOI 10.1002/14651858.CD011422.pub2

• A systematic review of the literature concludes that evidence on the effectiveness and safety of robot‐assisted surgery (RAS) compared with conventional laparoscopic surgery (CLS) for non‐malignant disease (hysterectomy and sacrocolpopexy) is of low certainty but suggests that surgical complication rates might be comparable. Evidence on the effectiveness and safety of RAS compared with CLS or open surgery for malignant disease is more uncertain because survival data are lacking. 
• RAS is an operator‐dependent expensive technology; therefore evaluating the safety of this technology independently will present challenges.

NHS efficiency map updates

NHS efficiency map updated
HFMA, NHS Improvement and NHS England, updated 12 April 2019

• The map is a tool that promotes best practice in identifying, delivering and monitoring cost improvement programmes (CIPs) and quality, innovation, production and prevention (QIPP) schemes in the NHS. The map contains links to a range of tools and guidance to help NHS bodies improve their efficiency. 
• Updated case studies on Theatres reporting and utilisation  and Aligned incentive contract.

Hepatitis C in England 2019

Hepatitis C in England, 2019 report: Working to eliminate hepatitis C as a major public health threat
PHE 9 April 2019

• The report summarises the scale of the Hepatitis C virus (HCV)  problem in 2017 in England, to help support focused action to meet the commitment to reduce the incidence of chronic HCV infection by 80% and HCV mortality by 65% by 2030 at the latest.
• The Hepatitis C patient registry and treatment outcome system was developed by Arden GEM CSU.

Risk factors for early revision after total hip and knee arthroplasty:

Risk factors for early revision after total hip and knee arthroplasty: National observational study from a surgeon and population perspective.
PLoS One. 2019 Apr 9;14(4):e0214855

• Analysis of predictors of early revision (within 3 years of the index operation) for hip and knee replacement (HR, KR) from both surgeon and population perspectives.

Abstract

Comprehensive Investment Appraisal Model and guidance for the NHS

Comprehensive Investment Appraisal (CIA) Model and guidance
DHSC 9 April 2019

• The CIA Model is for use by the NHS to support economic appraisals in business cases. It replaces the Generic Economic Model (GEM).
• The user guide shows how the CIA Model can be used to support economic appraisals in business cases. It provides guidance on the key economic principles, how these are used in economic appraisals and how the outcome of these appraisals is interpreted.

Heart valve disease - HSJ Guide

Heart Valve Disease
HSJ Guide April 2019 [subscription required]

• An HSJ supplement which looks at where we are with heart valve disease today - treatments, TAVI its commissioning and how to reduce variation.
• [Lots of data cited but no references.]

Establishing a tele-clinic service for kidney transplant recipients through a patient-codesigned quality improvement project

Establishing a tele-clinic service for kidney transplant recipients through a patient-codesigned quality improvement project.
BMJ Open Qual 2019;8:e000427. 8 April 2019. doi: 10.1136/bmjoq-2018-000427

• Findings from a pilot tele-clinic (telephone consultation) service for kidney transplant patients attending North Bristol NHS Trust Renal Unit shows that they are deliverable and well received by patients with a positive environmental impact and modest financial savings. 
• "It has the potential to be rolled out to other renal centres if a national tele-clinic tariff can be negotiated, and an integrated, appropriately reimbursed community phlebotomy system can be developed to facilitate remote monitoring of patients."

Abstract

NHSX

NHSX

4 April 2019

Highlights from Matt Hancock's speech at The Royal Society of Medicine event 'Medical apps: mainstreaming innovation'. We must drive tech innovation and improvement across the NHS  and DHSC News item NHSX: digital experts will be part of cancer and mental health teams

• NHSX is a new specialist unit that brings together tech leadership from the DHSC, NHS England and NHSI into one place. Setting national policy for NHS tech, digital and data and standards that work across the whole of health and care.
• NHSX will be led by the government’s digital policy chief, Matthew Gould, and become operational in July. In the interim it will be led by a senior team from NHS England and the Department of Health and Social Care.
• NHSX will have 3 early priorities:
• ensuring tech saves time for staff so they can focus on patients.
• giving patients the tools to access information and services directly.
• creating a system that means patient information can be accessed, safely and reliably, wherever it is needed.
• From July, NHSX will mandate the use of internationally recognised technology and data standards across the NHS to ensure all systems can talk to each other.
• To test a new way of working, tech experts from NHSX will be embedded in national cancer, mental health and urgent care teams to bring the benefits of modern technology to every patient, clinician, and carer.
• The digital experts will support NHS England's cancer and mental health national policy teams in:
  
  • making it easier for patients to access services through smartphones
  • giving clinicians access to the relevant diagnostic information about a patient
  • making it easier to collect and use health data which can benefit research and patient

Clinical radiology UK workforce census report 2018

Clinical radiology UK workforce census report 2018
Royal College of Radiologists April 2019

• This report provides an overview of the radiology workforce in September 2018 (size, trends, specialisms, working activities and less than full time working), workforce forecasts and documents changes in demand for radiology services.

Quality of Life and Rare Disease: Lessons from Spinal Muscular Atrophy

How Should We Measure Quality of Life Impact in Rare Disease? Recent Learnings in Spinal Muscular Atrophy
Office of Health Economics Briefing, 2 April 2019

• Based on discussion of current approaches to the measurement of quality of life in Spinal Muscular Atrophy, the report highlights four possible strategies for improving the quantity and quality of data available to inform decision makers in the context of rare diseases:
• Bespoke data collection which is relevant to health technology assessment decision makers;
• Simple economic modelling methods, which reflect the evidence available at the time of the assessment;
• Collaboration among the different parties involved; and
• Identifying what is ‘good enough’ to inform decision making on use at the time of launch or of the health technology assessment process.
• New approaches to research could facilitate health technology assessment processes and improve patients’ access to cost-effective treatments for rare diseases.

Improving Complex Pediatric and Adult Spine Care While Embracing the Value Equation.

Improving Complex Pediatric and Adult Spine Care While Embracing the Value Equation.
Spine Deform. 2019 Mar;7(2):228-235. doi: 10.1016/j.jspd.2018.08.006.

• This manuscript reviews the expert opinion of leading spine specialists on the improvement of safety, quality and improvement of value of pediatric and adult spinal surgery.

Abstract

Rapid access to pulmonary investigation days: the RAPID programme

Rapid access to pulmonary investigation days: the RAPID programme in suspected lung cancer
Health Foundation August 2017

• The RAPID programme is a patient-focused approach to early diagnosis of lung cancer, developed at the University of Manchester NHS FT, aiming to ensure all patients have a clear diagnosis within seven days of referral. 
• The programme has evaluated over 1,000 referrals since March 2016 and has embedded:
• next day access to CT scanning for GP two-week wait referrals
• daily triage of referrals with a CT scan and same day confirmation of no cancer
• integrated nursing and navigation support for patients requiring investigation
• a clear investigation plan on first clinic attendance with all appointments pre-booked
• a RAPID hub, with dedicated patient and physician contact details.
• The key successes of the programme include:
• elimination of two-week waits and 31-day breaches
• increased number of CT scans performed by day seven (92% of GP referrals)
• reduced time from GP referral to outpatient clinic, with a fully reported CT scan, from an average of ten days to four days
• increased MDT discussions by day 14 from GP referral by 42%, and by day 21 by 77%
• absence of cancer confirmed on the day of CT scan (previously an average six-day wait)
• improved patient experience and satisfaction, despite the pathway’s increased speed.
• The RAPID programme is now an established service within UHSM.