An alternative animated guide to the new NHS in England

The King's Fund have produced an animated guide to the structure of the post reform NHS. It gives a whistle-stop tour of the new organisations that have come into being as a result of the Health and Social Care Act and explains how they fit and work together, as well as looking at some of the political influences on how the reforms came into being.

June's Eyes on Evidence from NICE

Eyes on Evidence is a free monthly bulletin from NICE Evidence Services (formerly NHS Evidence) which reviews significant new evidence as it emerges and what this may mean for current practice.

In the June issue you can find:

Physical activity interventions for children

A meta-analysis reviews the effectiveness of physical activity interventions for children.

Drug interactions associated with herbal remedies and dietary supplements

A systematic review suggests that herbal remedies and dietary supplements may have interactions with many prescription drugs.

Metabolic profile and declining cognitive function

A cohort study suggests that metabolic abnormality is a risk factor for cognitive decline with increasing body mass index.

Risk of asthma exacerbation after stopping inhaled corticosteroids in people with stable asthma

A meta-analysis found that people with well-controlled asthma who stopped regular low-dose inhaled corticosteroids had an increased risk of asthma exacerbations compared with those who continued them. 

Heavy menstrual bleeding: levonorgestrel-releasing intrauterine system

The ECLIPSE randomised controlled trial found the levonorgestrel-releasing intrauterine system was more effective than usual medical treatment in reducing the effect of heavy menstrual bleeding on quality of life.

Case studies from the Quality, Improvement, Productivity and Prevention (QIPP) collection

We highlight a new example from the QIPP collection demonstrating how NHS organisations have implemented new local practices that have both cut costs and improved quality.

• Podiatry education to empower patients to self-care

NICE accreditation case study: College of Occupational Therapists

Julia Roberts and Mandy Sainty of the College of Occupational Therapists discuss the organisation's experience of the NICE accreditation process. 

Evidence Updates

NICE has recently published Evidence Updates on:

• Antenatal care

Berrywood Library phones out of action 11.45 am - 2.15 pm, Monday the 17th of June

Due to essential maintenance, the phones at Berrywood Library (and the rest of the hospital) will be out of action at lunchtime on Monday the 17th of June, for at least two and a half hours.

During this time you can either call the Richmond Library with any queries or email Berrywood Library. We apologise for any inconvenience.

Whilst our external number will remain the same, users dialling from inside the trust will be able to call us on extension 5650 once the work is completed.

Longer Lives - premature mortality data

The Longer Lives interactive atlas

The Longer Lives project from Public Health England makes mortality data available to everyone.

Currently the site focuses on the four most common causes of mortality in England – heart disease and stroke, lung disease, liver disease, and cancer.

The site enables the comparison of premature mortality data  between all local authority areas, but also between areas of a similar size and make up. The project is at an early stage and more data will follow, including data for county districts.

Longer Lives highlights inequalities in premature mortality across the country. It also aims to provide examples of interventions that have been effective at the local level in reducing premature mortality rates. Currently there is information on cancer, heart disease, liver disease, and lung disease with more to follow.

Northamptonshire currently ranks as worse than the national average (72 out of 150), but the picture is more mixed than the figures suggest, with heart and liver disease and stroke actually better than the national average, but cancer and lung disease worse.

Patient Safety Resource Centre

New, from The Health Foundation, the Patient Safety Resource Centre aims to provide practitioners at all levels with access to high quality information to support patient safety.

Resources available include key research, projects, national standards, implementation guidelines and case studies. All the information has been through the Health Foundation's quality assurance process to ensure it is of a robust standard. Where there are gaps in knowledge there are also plans to commission experts to produce new resources.

New areas of care are in development, but intially the PSRC has launched with three main areas of information:

• Safety management
  This area explores structures and systems required to implement and monitor safety related changes, as well as developing a comprehensive patient safety culture.

• Diabetes / Frail Elderly
  These sections address specific safety issues in relation to the pathways of care and provide tailored information and case studies about how to apply patient safety principles in practice.

Help us shop for books for you

Book in Library by Honou

We have a new selection of On Approval Books for June and July which are ready to view. They cover topics such as Alzheimer's, anaesthesia, gastroenterology, mental health, CBT, nursing, paediatrics, pharmacology, and many more.

These are recently published titles on loan from our supplier and we are looking for recommendations on which titles we should buy. 

This is your chance to help ensure the stock we hold reflects your needs (of course we are also happy to have any other recommendations you may have too!). You can find a  full list on our web site and the books are held at the Berrywood and Richmond libraries and are available for viewing during staffed hours.

You can also find a list of the latest titles we have added to our stock on our web site, as well as previous lists going back 6 months, or you can search our catalogue to see everything we hold.

Web site of the month: NICE Clinical Knowledge Summaries

The relaunched Clinical Knowledge Summaries service aims to provide primary care clinicians (and others) with a readily accessible summary of the latest evidence, as well as practical guidance on current best practice in relation to the 300 most commonly seen disease presentations in primary care.

You can browse the CKS by clinical topic on a simple A-Z list, as well as searching.

There is also the option to browse by Clinical Speciality, where you can look at wider clinical topics, for example mental health, cancer or musculoskeletal.

CKS for Depression

Once you have found the topic you are interested in, the information is broken down into a number of sections that include a summary and background information, as well as diagnosis.

There are further sections with management scenarios (for example with a new diagnosis or ongoing cases) as well as practical prescribing information including dosage recommendations, adverse effects and contraindications. You can even link to the evidence used to formulate the summary.

The CKS are reviewed and updated when significant new evidence emerges and NICE aim to add up to 10 new topics every year. CKS is a simple, practical, evidence based resource for front line staff in primary care and beyond.

The new NHS in 2013 infographic poster

NHS Employers have produced a simple poster that clearly illustrates the new structure of the NHS post April 2013.

The poster is aimed at both NHS staff and the public and shows the new structure on both national and local levels including some of the new organisations that have been created.

 The poster is available as a .PDF in both A4 and A3 sizes.

FindZebra - the search engine for difficult medical cases

FindZebra is a specialist search engine aimed at medical professionals for support in the diagnosis of difficult cases.  

FindZebra has a very simple search interface, is intuitive and very easy to use. The service allows you to enter a number of symptoms and then search. The results are ranked based on the number of hits for each diagnostic symptom with the most likely coming first.

Designed by staff at the Technical University of Denmark, the search engine contains links to over 31,000 medical articles focused on rare and genetic diseases from a variety of sources.

Incidentally, the name "FindZebra" comes from a University of Maryland professor who, when describing an unexpected diagnosis said  “When you hear hoof beats behind you, don’t expect a zebra.”

Or to put it another way, the famous (and fictional) Dr House said "I look for zebras because other doctors have ruled out all the horses." 

Spring bank holiday closure

All the libraries will be unstaffed on Monday the 27th of May for the spring bank holiday.

24 hour access is available as usual to our registered members by swiping in using your library card at the Berrywood and Richmond libraries.

We reopen as normal on Tuesday the 28th at all of our sites.

Eyes on Evidence from NICE

Eyes on Evidence is a free monthly bulletin from NICE Evidence Services (formerly NHS Evidence) which reviews significant new evidence as it emerges and what this may mean for current practice.

In the May issue you can find:

Premature death after self-harm
A cohort study reports that rates of death from both natural and external causes are higher in people who self-harm than would be expected in the general population.

Probiotics in antibiotic-associated diarrhoea
A systematic review suggests that probiotics can reduce antibiotic-associated diarrhoea.

'Anti-fat' bias amongdoctors
Results of a web-based survey, designed to assess attitudes towards weight, reveal implicit and explicit 'anti-fat' bias among doctors.

Domestic violence presenting in primary care
A survey examines knowledge, attitudes and clinical skills related to domestic violence in selected UK general practices.

Small benefits of Z drugs over placebo for insomnia
A meta-analysis has found that Z drugs reduce the time taken to fall asleep by 22 minutes compared with placebo. However, this result may not be clinically significant and any benefit of Z drugs must be balanced against their well-documented risks.

Hormone replacement therapy (HRT): cardiovascularoutcomes after recent menopause
Data from long-term follow-up of an open-label randomised controlled trial suggest that HRT reduces cardiovascular endpoints in women if started early after menopause. However, limitations of the analysis make interpretation of the results difficult.

Case studies from the Quality, Improvement, Productivity,and Prevention (QIPP) collection
We highlight 2 new examples from the QIPP collection, demonstrating how NHS organisations have implemented new local practices that have both cut costs and improved quality.

• Simple behavioural interventions that can reduce non-attendance 
• Reducing hospital admission rates for people with type 2 diabetes

Web site of the month: The NHS in Numbers

It is not always easy to find the statistical data you may want about the NHS. Often it is produced in a wide variety of formats and on a number of different sites.

Produced by the Nuffield Trust, the NHS in Numbers project  brings together  key performance and funding data from different sources and presents it using simple interactive charts. 

The information available includes:

• Expenditure
• Hospital activity
• Prescribing (including cost information)
• Performance (including waiting times, length of stay and mortality)
• Staffing and hospital beds

The data for the charts is drawn from official sources and they will be updated on an annual basis when new data becomes available. New charts may also be developed when different data sets become available.

Individual charts are available to download as .PDF or as an image in various formats. The NHS in Numbers is a really useful source of national NHS statistical data.