Specialised services: transforming delivery for patients

Specialised services: transforming delivery for patients
NHS Providers February 2020

• This report shows how NHS specialised services are adapting to a changing environment to deliver world-class and innovative care for patients and service users. It presents the opinions of leaders from trusts and the wider health and care sector on key issues and looks at the key role specialised services play in delivering the ambitions of the long-term plan.

Clinical standards - Faster Dignosis Standard

Clinical Review of Standards: Progress Update
NHS England / Improvement Board meeting 30 January 2020

• The paper notes the progress to date and the latest learning from the Clinically-led Review of NHS Access Standards, including cancer proposals.
• Initial testing during phase one focused on demonstrating that there is no detriment either to patients or overall operational performance in moving to the Faster Diagnosis Standard, with phase two focussing more specifically on the impact of interventions to improve 28-day performance. This review will make its final recommendations in respect of cancer in the spring of 2020.

Rapid cancer diagnosis for patients with vague symptoms: a cost-effectiveness studyRapid cancer diagnosis for patients with vague symptoms: a cost-effectiveness study

Rapid cancer diagnosis for patients with vague symptoms: a cost-effectiveness study
British Journal of General Practice 2020; 70 (692): e186-e192. DOI: https://doi.org/10.3399/bjgp20X708077
Data from a pilot study at Neath Port Talbot Hospital indicates that a Rapid Diagnosis Centre for patients presenting with vague or non-specific symptoms suspicious of cancer in primary care reduces time to diagnosis and provides excellent value for money if run at ≥80% capacity.

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UK strategy for rare diseases: 2020 update to the implementation plan for England

UK strategy for rare diseases: 2020 update to the implementation plan for England
NHS England 26 February 2020

• This year’s update on the strategy’s progress over the last year covers 5 main areas: empowering those affected by rare diseases, identifying and preventing rare diseases, diagnosis and early intervention, coordination of care and the role of research.
• It also sets out the actions that DHSC and partner organisations will take in 2020 to implement the commitments of the strategy.

Genomics Clinical Reference Group

Genomics Clinical Reference Group
NHS England February 2020

• NHS England has convened a Genomics Clinical Reference Group (CRG) to support the implementation of the NHS Genomic Medicine Service. The CRG will be chaired by Professor Bill Newman Professor of Translational Genomic Medicine in The Manchester Centre for Genomic Medicine at the University of Manchester and Honorary Consultant at Manchester University NHS Foundation Trust.

Hip replacements: do public or private providers do better?

Hip replacements: do public or private providers do better?
BMJ 2020;368:m362, 19 February 2020 doi: https://doi.org/10.1136/bmj.m362

• Analysis of health outcomes using EQ-5D after hip replacement or revision in  NHS and non-NHS hospitals.

Patient Reported Outcome Measures (PROMs) Finalised Hip & Knee Replacements, April 2018 – March 2019

Finalised Patient Reported Outcome Measures (PROMs) in England for Hip & Knee Replacements, April 2018 – March 2019
NHS Digital 13 February 2020

• The data includes improvement for revision surgery.
• Data by provider or CCG Click here to access the report.

Early prediction of ICU readmissions using classification algorithms

Early prediction of ICU readmissions using classification algorithms
Computers in Biology and Medicine; Mar 2020; v118, March 2020, 103636 https://doi.org/10.1016/j.compbiomed.2020.103636

• Existing work on predicting ICU readmissions relies on information available at the time of discharge, however, in order to be more useful and to prevent complications, predictions need to be made earlier. This work investigates the hypothesis that the basal characteristics and information collected at the time of the patient's admission can enable accurate predictions of ICU readmission.

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Medicines and Medical Devices Bill

Medicines and Medical Devices Bill 
DHSC 13 February 2020

• The Medicines and Medical Devices Bill will allow:
• NHS hospitals to use innovative, personalised medicines for unique cancers and diseases,
• increase the range of professions able to prescribe medicines in low-risk circumstances, reducing unnecessary GP appointments
• introduce new regulations on medical devices, such as pacemakers, breast implants and ultrasound imagers, to ensure patient safety

November 2019 prioritisation decisions

November 2019 Specialised Services prioritisation decisions
NHS England 11 February 2020

• Decisions on which new specialised treatments should be routinely commissioned:
• NHS England has agreed to continue funding two stereotactic ablative radiotherapy (SABR) policies for patients with metachronous extracranial oligometastatic cancer (all ages), and for hepatocellular carcinoma (adults)
• Temozolomide as adjuvant treatment for people with newly diagnosed anaplastic astrocytoma without 1p/19q codeletion following surgery and radiotherapy (adults)
• Dexrazoxane for preventing cardiotoxicity in children and young people (under 25 years) receiving high-dose anthracyclines or related drugs for the treatment of cancer
• Human coagulation factor X for hereditary factor X deficiency (all ages)
• Canakinumab for treating periodic fever syndromes: TRAPS, HIDS/MKD and FMF (ages 2 years and older)
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Refractory Epilepsy Specialist Clinical Advisory Service

Refractory Epilepsy Specialist Clinical Advisory Service
NHS England 6 February 2020

• This Service Specification covers the provision of a specialist clinical advisory service, supporting clinicians working with patients to optimise the treatment of refractory epilepsy.

The 28 Day Faster Diagnosis Standard (FDS)

The 28 Day Faster Diagnosis Standard (FDS)
RM Partners February 2020

• A description of the Faster Diagnosis Standard for cancer.

Intensive care medicine in smaller hospitals: here to stay

Intensive care medicine in smaller hospitals: here to stay
Future Healthcare Journal February 2020 DOI: https://doi.org/10.7861/fhj.2019-0068

• This article outlines the background and work of the Faculty of Intensive Care Medicine Smaller and Specialist Units Advisory Group to support and sustain intensive care medicine in smaller hospitals and looks at critical care in the context of remote and rural healthcare.

The prevalence of frailty in patients on hemodialysis

The prevalence of frailty in patients on hemodialysis: a systematic review and meta-analysis.

Int Urol Nephrol. 2020 Jan;52(1):115-120. doi: 10.1007/s11255-019-02310-2

• A review of the evidence concludes that frailty influences almost three in ten patients on hemodialysis. 

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Making the Case for the early and Rapid Diagnosis of Lung Cancer

Early Diagnosis Matters: Making the Case for the early and Rapid Diagnosis of Lung Cancer
UK Lung Cancer Coalition (UKLCC) January 2020

• The majority of lung cancer patients are diagnosed at a late stage of the disease. This report looks at various issues which could achieve early diagnosis in a higher proportion of patients, from awareness campaigns to the aim of establishing a national screening programme and improving primary care access to diagnostic tests.

Access Matters: Achieving Universal Access To Optimal Lung Cancer Care In The UK

Access Matters: Achieving Universal Access To Optimal Lung Cancer Care In The UK
UK Lung Cancer Coalition January 2020

• This document is intended to provide some simple, practical ideas which clinicians, commissioners and policymakers could implement to help ensure that consistent and equitable treatment and care options are being offered to patients who present with similar profiles, regardless of where they live. Some of the issues raised require action and support from commissioners and national policymakers.

Update on review of children's cancer services

Update on review of children's cancer services
NHS England 30 January 2020

• NHS England and Improvement has been undertaking a review of children and young adult cancer services. Following consultation Professor Sir Mike Richards has concluded that all NHS England commissioned Principal Treatment Centres for children’s cancer must be co-located with a level 3 Paediatric Intensive Care Unit and other specialised children’s services.
• NHS England board paper including next steps
• Consultation report

Taskforce Charter: National Quality Improvement Taskforce for children and young people’s mental health inpatient services

Taskforce Charter: National Quality Improvement Taskforce for children and young people’s mental health inpatient services
NHS England 24 January 2020

• Details of the vision for mental health, learning disability, and autism inpatient services for children and young people.

Everything you need to know about the NHS genomic medicine service

Everything you need to know about the NHS genomic medicine service
Pharmaceutical Journal 2 January 2020

• An overview of the progress on NHS England genomic medicine service.

Frailty in lung transplantation: a systematic review

Frailty in lung transplantation: a systematic review
Expert Review of Respiratory Medicine, 19 December 2020, 14:2, 219-27, DOI: 10.1080/17476348.2020.1702527

• This article reviews the current literature on frailty in lung transplantation, with an emphasis on frailty measures, prevalence and impact of frailty on morbidity and mortality prior to and following lung transplantation. It concludes that frailty is identified often in lung transplant candidates and is associated with adverse pre and post-transplantation outcomes. Further research is necessary to identify potential frailty interventions.

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