Update on Urgent and Emergency Care Review

NHS England has published Transforming urgent and emergency care services in England Update on the Urgent and Emergency Care Review. This update sets out what the review has been doing since the last reported in November 2013. It reports on progress with NHS England’s work with local commissioners and the development of their five year strategic and two year operational plans as well as updates on planning to develop demonstrator sites to trial new models, including the new NHS 111 service specification.

Evidence update: Acute upper gastrointestinal bleeding

NICE has published a new evidence update Acute upper gastrointestinal bleeding (Evidence Update 63). This update provides a summary of selected new evidence relevant to NICE clinical guideline 141 ‘Acute upper gastrointestinal bleeding: management’ (2012). Evidence updates are intended to increase awareness of new evidence they do not replace current NICE guidance and do not provide formal practice recommendations.

Freedom to speak up: whistleblowing review

An independent review into whistleblowing has been launched by Sir Robert Francis, QC.  The review, Freedom to speak up, is to look at creating an open and honest reporting culture in the NHS.  Staff are asked to contribute their experiences, both good and bad, of raising concerns in the NHS. In particular the review would like to hear from: NHS workers who have successfully raised concerns at work as well as those who have felt deterred from doing so; people who have supported colleagues who have raised concerns; those who say they have suffered detriment as a result of raising legitimate concerns, or supporting others who have raised concerns; employers, trade unions, professional and system regulators and professional representative bodies; and organisations who support those who raise concerns.  Views should be submitted by 16 September 2014 and the final report will be published by the end of November.

The General Medical Council has also launched a review of how it deals with doctors who raise concerns in the public interest.  It will look will look at how doctors who raise concerns are currently treated by the GMC and how best they might be supported in future.

Additional link: Information from NHS Employers

Urgent and emergency care workforce briefing

The NHS Confederation has published a briefing which brings together the learning from two workshops which explored how to develop a more flexible, integrated workforce to deliver urgent and emergency care.  A workforce fit for the future: working together to improve the delivery of urgent and emergency care is intended as a reference document, providing an overview of existing programmes designed to deliver workforce changes at system level and practical examples of their implementation. It also offers some useful recommendations to national bodies involved in workforce design, planning and training on how to accelerate and better align their initiatives.

Learning module on oral anticoagulants

The Medicines and Healthcare products Regulatory Agency (MHRA) has launched an online learning module for healthcare professionals on reducing the side effects of oral anticoagulants. Anticoagulants are vital medicines for treating and preventing blood clots. However, if the patient is not managed correctly their side effects can lead to a small number of people needing hospital treatment.  The interactive programme, aimed at doctors, nurses and pharmacists covers key points about these medicines, how to manage risks and how to make sure patients get the most benefit from the medicines.

Additional link: MHRA press release

National Institute for Health Research (NIHR)

Meeting the support needs of patients with complex regional pain syndrome through innovative use of wiki technology: a mixed-methods study

 Using online discussion forums can have a positive impact on psychological well-being through development of shared group identity and validation of thoughts, feelings and experiences. This may be particularly beneficial to people with complex regional pain syndrome (CRPS), who often become socially isolated, lack mobility and face threats to their sense of identity. This study set up a peer-support online forum to identify the nature of support provided and to explore its development over time.


WHO declare Ebola “a public health emergency of international concern”

On August 8, the World Health Organization (WHO) Director-General Margaret Chan declared the West Africa Ebola crisis a “public health emergency of international concern,”1 triggering powers under the 2005 International Health Regulations (IHR). 

JAMA have published The Ebola Epidemic:  A Global Health Emergency



Reducing emergency department attendance

The University of Bristol has published Primary care factors and unscheduled secondary care: a series of systematic reviews. The report has been compiled by researchers from the university’s Centre for Academic Primary Care who looked at evidence from studies around the world. It highlights that attendances at emergency departments could be reduced by enabling patients to see the same GP every time they visit their doctor’s surgery. The report also focuses other factors that affected admission and attendances at emergency departments these include: how easy it is for patients to access GP surgeries and primary care providers; the distance the patients live away from the emergency department; and the number of confusing options patients had for accessing emergency care. The research, published in the open access journal BMJ Open, was carried out in collaboration with the Universities of Manchester, Oxford and UCL.

NICE guidance: Lipid modification

NICE has issued new clinical guidance Lipid modification: cardiovascular risk assessment and the modification of blood lipids for the primary and secondary prevention of cardiovascular disease (CG181). This clinical guideline updates and replaces NICE clinical guideline 67 (published May 2008) and NICE technology appraisal guidance 94 (published January 2006). It offers evidence-based advice on the care and treatment of people at risk of cardiovascular disease and people who have had previous cardiovascular disease. It includes new and updated recommendations on risk assessment, lifestyle modifications and the use of lipid-lowering drugs.

Additional links: NICE press release    BBC news report

The future for acute and emergency care

Acute and emergency care: prescribing the remedy is a new report co-authored jointly by the College of Emergency Medicine, Royal College of Paediatrics and Child Health, Royal College of Physicians and Royal College of Surgeons. The report sets out a way forward for improving the delivery and funding of urgent and emergency care. iT sets out 13 recommendations for Government, national bodies, commissioners, providers, professional bodies and clinicians, to take forward at local and national levels. The Colleges believe implementing these measures will help build an urgent and emergency care system that is sustainable and resilient to cope with future service demands.

Additional link: Foundation Trust Network 


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