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Implementation of echocardiographic contrast agents into clinical practice: a United Kingdom National Health Service Survey on behalf of the British Society of Echocardiography
Conclusion The use of echocardiographic contrast agents within routine echocardiographic practice in the UK is limited to <4% of all transthoracic echocardiographic studies. Major barriers to the implementation of contrast use are the absence of cardiac imaging specialists directly supervising echocardiography departments and the training of sonographers to independently administer contrast. (Source: European Journal of Echocardiography)
Source: European Journal of Echocardiography - May 13, 2013 Category: Cardiology Authors: Bhattacharyya, S., Khattar, R., Lloyd, G., Senior, R., on behalf of the British Society of Echocardiography Tags: CLINICAL/ORIGINAL PAPERS Source Type: research

BJSM social media contributes to health policy rethink: a physical activity success story in Hertfordshire
Strategies to modernise the National Health Service (NHS) in England have brought about the development of local organisations called Health and Wellbeing (H&WB) boards through the Health and Social Care Act 2012. These boards were intended to become a forum where key leaders and stakeholders from health and care systems work together to improve the health and well-being of their local population and reduce health inequalities. Throughout England these boards have been drafting their strategies, largely ignoring the importance of physical activity in health and well-being. In the county of Hertfordshire, the initial dr...
Source: British Journal of Sports Medicine - May 10, 2013 Category: Sports Medicine Authors: Weiler, R., Neyndorff, C. Tags: Case report Source Type: research

Tilt testing is more cost-effective than implantable loop recorder monitoring as a means of directing pacing therapy in people with recurrent episodes of suspected vasovagal syncope that affect their quality of life or present a high risk of injury
Conclusions TT alone is likely to be the most cost-effective strategy in this population. (Source: Heart)
Source: Heart - May 1, 2013 Category: Cardiology Authors: Davis, S., Westby, M., Petkar, S., Pitcher, D. Tags: Drugs: cardiovascular system, Clinical diagnostic tests Heart rhythm disorders Source Type: research

‘It ain't what you do it's the way that you do it’: lessons for health care from decommissioning of older people's services
Abstract Public sector organisations are facing one of the most difficult financial periods in history and local decision‐makers are tasked with making tough rationing decisions. Withdrawing or limiting services is an emotive and complex task and something the National Health Service has always found difficult. Over time, local authorities have gained significant experience in the closure of care homes – an equally complex and controversial issue. Drawing on local knowledge and best practice examples, this article highlights lessons and themes identified by those decommissioning care home services. We believe that such...
Source: Health and Social Care in the Community - May 1, 2013 Category: Health Management Authors: Suzanne Robinson, Jon Glasby, Kerry Allen Tags: Original Article Source Type: research

Clinicians in leadership and management in the National Health Service
In the UK, the National Health Service (NHS) underwent its most significant reform in 2008 during its 60th anniversary when Lord Darzi led the NHS Next Stage Review. This reform was clinically led, emphasising the importance of clinical leadership in developing a vision for the future of the NHS for the benefit of the patient. As a result, the national leadership council was established by the NHS chief executive in 2009. After the elections of 2010, the Secretary of State for Health of the Coalition Government introduced the White Paper ‘Liberating the NHS’ which set out radical plans for further reforming the NHS. (S...
Source: Obstetrics, Gynaecology and Reproductive Medicine - May 1, 2013 Category: OBGYN Authors: Boon H. Lim, Tahir Mahmood Tags: Ethics/Education Source Type: research

[Perspectives] The Doctor in early Cold War America
To commemorate the semi-centennial of the UK's national health service (NHS) in 1998, The Lancet published a full-page reproduction of Sir Luke Fildes' painting The Doctor under the heading “NHS at 50”. It seemed to capture a message that for more than a century has been attached to the image: here was a visual embodiment of the physician's devotion to patients, and, in this instance, the state's commitment to guarding the health of the people. (Source: LANCET)
Source: LANCET - April 27, 2013 Category: Journals (General) Authors: John Harley Warner Tags: Perspectives Source Type: research

Innovation in health economic modelling of service improvements for longer-term depression: demonstration in a local health community
Conclusions: Cost-effective service improvements for longer-term depression have been identified. Also identified were limitations of the current evidence for the long term impact of services. (Source: BMC Health Services Research)
Source: BMC Health Services Research - April 26, 2013 Category: Journals (General) Authors: Jonathan ToshBen KearnsAlan BrennanGlenys ParryThomas RickettsDavid SaxonAlexis Kilgarriff-FosterAnna ThakeEleni ChambersRebecca Hutten Source Type: research

The United Kingdom National Health Service Perspective on the Power of Information in Healthcare [News & Views]
(Source: Clinical Chemistry)
Source: Clinical Chemistry - April 26, 2013 Category: Chemistry Authors: Kellogg, M. D. Tags: Current Issues in Laboratory Medicine News & amp; Views Source Type: research

The Complexities of 'Consumerism': Choice, Collectivism and Participation within Britain's National Health Service, c.1961-c.1979
This article explores the overlapping and conflicting points of contact between ‘consumerism’, collectivism and participation in Britain's National Health Service during a period of relatively well-funded expansion during the economic ‘golden age’ of the 1960s and 1970s. Despite recent neo-liberal attempts to define ‘consumerism’ around the wishes and choices of the individual, and to conceptualise areas such as individual hospital referrals as particularly ‘consumerist’, this article demonstrates that collective provision, the protection of disadvantaged groups and the conce...
Source: Social History of Medicine - April 25, 2013 Category: History of Medicine Authors: O'Hara, G. Tags: Original Articles Source Type: research

Never events: the cultural and systems issues that cannot be addressed by individual action plans
Despite the term ‘never events’ these events continue to happen in the NHS. This paper considers the findings from a review of the causes of nine surgical ‘never events’; looking at the learning from the investigations to provide ‘a window on the system’ and considering the multiple issues that need to be addressed to reduce future risk. The paper discusses why many of the causes described in investigation reports cannot be adequately addressed by the action plans that target each individual cause — things are never that simple — instead the causes should be seen as a reflect...
Source: Clinical Risk - April 25, 2013 Category: UK Health Authors: Burnett, S., Norris, B., Flin, R. Tags: Safety Culture Source Type: research

An analysis of the culture in Ireland on open disclosure following adverse events in healthcare
This study was directed at the multidisciplinary healthcare team and senior management within the Health Service Executive (HSE) and Voluntary sectors. The oldest hospitals in Ireland are voluntary public hospitals some of them originating from the 18th century, having been established by charities and religious orders. Voluntary hospitals are partly funded by the HSE, specifically having their own governance structure. There was a response rate of 67% (n = 192). A total 56.5% of respondents stated their organization did not have an open disclosure policy, procedure or guideline in place however, 16% of the attendees state...
Source: Clinical Risk - April 25, 2013 Category: UK Health Authors: Duffy, A. Tags: Safety Culture Source Type: research

Ultrasound-guided regional anaesthesia: a safer option than general anaesthesia?
There is increasing evidence to support the safety and reliability of ultrasound-guided regional anaesthesia (regional nerve ‘blocks’ using local anaesthetic drugs) in the setting of elective orthopaedic surgery. In response to a patient safety incident that occurred while under general anaesthesia (GA), we set out to offer awake regional nerve blocks to high-risk patients as a safe alternative to GA. Between September 2010 and July 2011, 43 patients scheduled for elective upper limb surgery on ‘high-risk lists’ were given a regional anaesthetic for their operation. Patients were followed up by tele...
Source: Clinical Risk - April 25, 2013 Category: UK Health Authors: Goddard, N., Batistich, S., Smith, Z., Turner, J., Tomlinson, P. Tags: Clinical Safety Source Type: research

Editorial: AvMA 30 years on
(Source: Clinical Risk)
Source: Clinical Risk - April 25, 2013 Category: UK Health Authors: Walsh, P. Tags: AvMA Medical & amp; Legal Journal Source Type: research

"Rabone, Misinterpreted"
This article provides a response to "A Bad Decision for Patients", an article by Bertie Leigh, Partner at defence firm Hempsons, which appeared in Clinical Risk 2012;18 157 commenting upon the landmark judgment of the Supreme Court in Rabone v Pennine Care NHS Foundation Trust (2012); a decision which Mr Leigh deemed to be "profoundly wrong" and "bad for patients". This article seeks to explain that his conclusions are based on a misinterpretation of the Supreme Court's decision. (Source: Clinical Risk)
Source: Clinical Risk - April 25, 2013 Category: UK Health Authors: Edwards, G. Tags: AvMA Medical & amp; Legal Journal Source Type: research

Cuts, claims and cautionary tales - an overview of circumcision
This article explains the various types of circumcision, including those done for religious purposes, and attempts to provide an understanding of the issues relating to claims. The writer is a medicolegal expert (Accident & Emergency Consultant) who trained in surgery and for over 25 years has performed neonatal circumcision for religious purposes (usually in the home), child circumcision and adult circumcision. He has provided reports for both claimant and defendants, in negligence claims, civil claims and GMC proceedings. (Source: Clinical Risk)
Source: Clinical Risk - April 25, 2013 Category: UK Health Authors: Zoltie, N. Tags: AvMA Medical & amp; Legal Journal Source Type: research

Professional Discipline and Health Regulators - A Legal Handbook
(Source: Clinical Risk)
Source: Clinical Risk - April 25, 2013 Category: UK Health Authors: Hopkins, C. Tags: Book Review Source Type: research

Editorial
(Source: Clinical Risk)
Source: Clinical Risk - April 25, 2013 Category: UK Health Authors: Mead, J. Tags: Healthcare and Law Digest Source Type: research

Cauda Equina -- Trust not liable: Bryce v Newcastle upon Tyne Hospitals NHS FT (Newcastle County Court, 22/08/2012 -- Judge Walton)
(Source: Clinical Risk)
Source: Clinical Risk - April 25, 2013 Category: UK Health Tags: Healthcare and Law Digest Source Type: research

Orthopaedic Claim Fails: Ruth Tootell v Lancashire Teaching Hospitals NHS Foundation Trust (Manchester County Court, 12/10/12 -- Mr Recorder Hinchliffe QC)
(Source: Clinical Risk)
Source: Clinical Risk - April 25, 2013 Category: UK Health Authors: Chapman, J. Tags: Healthcare and Law Digest Source Type: research

Operating theatre staff cleared of causing shoulder injury: Hussain v King Edward VII Hospital (High Court, 30/11/2012 -- Eady J)
(Source: Clinical Risk)
Source: Clinical Risk - April 25, 2013 Category: UK Health Tags: Healthcare and Law Digest Source Type: research

Purpose and effectiveness of psychoeducation in patients with bipolar disorder in a bipolar clinic setting.
CONCLUSION: Psychoeducation enables patients to understand bipolar disorder, get actively involved in therapy planning, and be aware of methods for episode prevention, therefore effectively contributing to improved treatment outcomes and patient quality of life. PMID: 23581788 [PubMed - in process] (Source: Acta Psychiatrica Scandinavica Supplementum)
Source: Acta Psychiatrica Scandinavica Supplementum - April 23, 2013 Category: Psychiatry Tags: Acta Psychiatr Scand Suppl Source Type: research

Physical health of patients with bipolar disorder.
CONCLUSION: Early pharmacotherapeutic and psychoeducational interventions are required to improve treatment outcomes, as well as improving patient understanding of ways to minimise comorbidity development. PMID: 23581787 [PubMed - in process] (Source: Acta Psychiatrica Scandinavica Supplementum)
Source: Acta Psychiatrica Scandinavica Supplementum - April 23, 2013 Category: Psychiatry Tags: Acta Psychiatr Scand Suppl Source Type: research

Inequalities in the use of dental services among adults in inner South East London
This study explored inequalities in dental services use among adults in a socially deprived, ethnically diverse metropolitan area of London; satisfaction with services; and public views for improvement of services. Data from 695 adults were analysed for this study (56% of the eligible sample). Inequalities in dental services use and satisfaction with care according to sociodemographic factors were assessed in unadjusted and fully adjusted models. The proportion of participants who reported attending the dentist in the last 24 months was 69%, with inequalities according to social grade, ethnicity, sex and age but not accor...
Source: European Journal of Oral Sciences - April 19, 2013 Category: Dentistry Authors: Mustafa Al‐Haboubi, Charlotte Klass, Kate Jones, Eduardo Bernabé, Jennifer E. Gallagher Tags: Original Article Source Type: research

Deep vein thrombosis in shoulder arthroplasty - A prospective study
We present the risk of DVT associated with shoulder arthroplasties to establish a good quality evidence for thromboprophylaxis. The study is underway and we would further be able to define whether the general risk factors for DVT are relevant to shoulder replacements. (Source: BMC Musculoskeletal Disorders)
Source: BMC Musculoskeletal Disorders - April 18, 2013 Category: Orthopaedics Authors: Thayur MadhusudhanAmit SinhaDavid Widdowson Source Type: research

Better value eye care for the 21st century: the population approach
Health services globally and in the UK face challenges from increasing need and rising expectations to inequalities and financial constraints. The UK government has recently published a Public Health Framework for the first time. This has included preventable sight loss as an outcome measure for the nation's public health reflecting increasing recognition of eye health issues in the broader public health agenda. This presents a real opportunity to improve eye care services at a population level. However, the chief executive of the National Health Service (NHS) has set his own challenge to the NHS to find £20 billion ...
Source: British Journal of Ophthalmology - April 16, 2013 Category: Opthalmology Authors: Malik, A. N. J., Cassels-Brown, A., Wormald, R., Gray, J. A. M. Tags: Global issues Source Type: research

Anticoagulation Prophylaxis in Orthopedic Surgery:
Conclusion: Traditional cost-effectiveness analysis systematically excludes information related to the safety profiles of these anticoagulants. The efficiency frontier approach presented in this study provides critical information, without substantial effort, to permit a fully informed decision by taking into account all relevant outcomes as they relate to the costs associated with treatment choice. Keywords: orthopedic surgery; efficiency frontier; venous thromboembolism; total knee arthroplasty; total hip arthroplasty read more (Source: Postgraduate Medicine Online)
Source: Postgraduate Medicine Online - April 15, 2013 Category: Internal Medicine Authors: admin Source Type: research

Physical health of patients with bipolar disorder
ConclusionEarly pharmacotherapeutic and psychoeducational interventions are required to improve treatment outcomes, as well as improving patient understanding of ways to minimise comorbidity development. (Source: Acta Psychiatrica Scandinavica)
Source: Acta Psychiatrica Scandinavica - April 15, 2013 Category: Psychiatry Authors: A. H. Young, H. Grunze Tags: Clinical overview Source Type: research

Purpose and effectiveness of psychoeducation in patients with bipolar disorder in a bipolar clinic setting
ConclusionPsychoeducation enables patients to understand bipolar disorder, get actively involved in therapy planning, and be aware of methods for episode prevention, therefore effectively contributing to improved treatment outcomes and patient quality of life. (Source: Acta Psychiatrica Scandinavica)
Source: Acta Psychiatrica Scandinavica - April 15, 2013 Category: Psychiatry Authors: N. Stafford, F. Colom Tags: Clinical overview Source Type: research

Development of a Standard Evaluation Framework for Weight Management Interventions
There have been major increases in the levels of overweight and obesity in recent years. In England, it is estimated that excess weight costs the National Health Service more than £5bn each year, and reversing the upward trend in obesity has become a stated government commitment. Despite a growing body of research into the problem, knowledge of effective approaches for tackling the problem remains sparse. Recent reviews have found limited evidence of effective interventions. (Source: Public Health)
Source: Public Health - April 15, 2013 Category: Global & Universal Authors: L.J. Ells, N. Cavill, K. Roberts, H. Rutter Tags: Short Communication Source Type: research

Time for reflection, time for action
The publication of the ‘Report of the Mid Staffordshire NHS Foundation Trust Public Enquiry’ published in February makes for sombre reading indeed. Many of the issues reported by Robert Francis QC will have not come as a surprise to the families and others whose lives were changed forever by the series of tragic events brought about by systematic and individual failures at the Mid Staffordshire NHS Foundation Trust. The Francis Report, as it is commonly known, raises problems that will concern all health and social care services throughout the country and as such is a matter for all. The public can rightly ask why is i...
Source: Radiography - April 14, 2013 Category: Radiology Authors: Richard Price Tags: Editorials Source Type: research

Increase in emergency admissions to hospital for children aged under 15 in England, 1999-2010: national database analysis
Conclusions The continuing increase in very-short-term admission of children with common infections suggests a systematic failure, both in primary care (by general practice, out-of-hours care and National Health Service Direct) and in hospital (by emergency departments and paediatricians), in the assessment of children with acute illness that could be managed in the community. Solving the problem is likely to require restructuring of the way acute paediatric care is delivered. (Source: Archives of Disease in Childhood)
Source: Archives of Disease in Childhood - April 12, 2013 Category: Pediatrics Authors: Gill, P. J., Goldacre, M. J., Mant, D., Heneghan, C., Thomson, A., Seagroatt, V., Harnden, A. Tags: Infection (gastroenterology), Urology, Epidemiologic studies, Editor's choice, Foodborne infections, TB and other respiratory infections, Urinary tract infections, Child health, Urinary tract infections Original article Source Type: research

Postgraduate training in genitourinary medicine, HIV in-patient care and the future role of the speciality
How will doctors provide care for sexually transmitted infections (STIs) in the UK in future? Will they be hospital-based general physicians with a special interest in STIs participating in medical receiving or will they be in community settings overseeing multidisciplinary delivery of integrated sexual health? And what of HIV in-patient care? Will Genitourinary medicine (GUM) specialists continue to maintain responsibility for unwell patients? Or will GUM have disappeared having been absorbed into European Dermato-Venereology or dismantled by non-National Health Service care providers? So far, GUM has an excellent record ...
Source: Sexually Transmitted Infections - April 12, 2013 Category: Sexual Medicine Authors: Nandwani, R. Tags: Patients, Drugs: infectious diseases, HIV/AIDS, HIV / AIDS, HIV infections, Medical error/ patient safety BASHH column Source Type: research

A Survey Of Board Chairs Of English Hospitals Shows Greater Attention To Quality Of Care Than Among Their US Counterparts [Quality & Governance]
There is growing international interest in the role that hospital boards of directors play in improving the quality of health care. In England the National Health Service created a program to help boards become more effective at ensuring quality. We sought to evaluate how boards at English hospitals are engaged in quality, and we conducted the first national survey of the governance practices of the chairpersons of English hospitals. The survey was completed by 132 of 171 board chairs. We compared the results to those of a survey of the chairs of US hospital boards that we published in 2010. We found that English board cha...
Source: Health Affairs - April 8, 2013 Category: Global & Universal Authors: Jha, A. K., Epstein, A. M. Tags: Quality & amp; Governance Source Type: research

Enhancing frontline clinical leadership in an acute hospital trust
ConclusionWard managers' development is enhanced by a programme integrating theory, action learning and completion of a ward‐based project. Relevance to clinical practiceWard managers cannot be effectively developed in isolation. Leadership development is best supported where the organisation is also committed to developing. A leadership development programme that incorporates knowledge from within the organisation with external expertise can be an effective method to enhance front‐line clinical leadership. (Source: Journal of Clinical Nursing)
Source: Journal of Clinical Nursing - April 5, 2013 Category: Nursing Authors: Natasha Phillips, Geraldine Byrne Tags: Original Article Source Type: research

The Pope, provenance, and peer review
(Source: JRSM)
Source: JRSM - April 5, 2013 Category: UK Health Authors: Abbasi, K. Tags: From the Editor Source Type: research

The Francis report: what you permit, you promote
(Source: JRSM)
Source: JRSM - April 5, 2013 Category: UK Health Authors: Halligan, A. Tags: Editorial Source Type: research

James Lancaster's prevention of scurvy
(Source: JRSM)
Source: JRSM - April 5, 2013 Category: UK Health Authors: Griffin, J. Tags: Letters Source Type: research

Who was James Lind, and what exactly did he achieve
(Source: JRSM)
Source: JRSM - April 5, 2013 Category: UK Health Authors: Baron, J. H. Tags: Letters Source Type: research

The misapplication of medical science to literature
(Source: JRSM)
Source: JRSM - April 5, 2013 Category: UK Health Authors: Perkins, P. Tags: Letters Source Type: research

Fewer administrators
(Source: JRSM)
Source: JRSM - April 5, 2013 Category: UK Health Authors: Fenton, T. Tags: Letters Source Type: research

Cataract skills: how do we judge competency?
(Source: JRSM)
Source: JRSM - April 5, 2013 Category: UK Health Authors: Smith, R. Tags: Letters Source Type: research

Erratum
(Source: JRSM)
Source: JRSM - April 5, 2013 Category: UK Health Tags: Erratum Source Type: research

Addressing the 'postcode lottery' in local resource allocation decisions: a framework for clinical commissioning groups
(Source: JRSM)
Source: JRSM - April 5, 2013 Category: UK Health Authors: Russell, J., Greenhalgh, T., Lewis, H., MacKenzie, I., Maskrey, N., Montgomery, J., O'Donnell, C. Tags: Essays Source Type: research

Disentangling secular trends and policy impacts in health studies: use of interrupted time series analysis
(Source: JRSM)
Source: JRSM - April 5, 2013 Category: UK Health Authors: Pape, U. J., Millett, C., Lee, J. T., Car, J., Majeed, A. Tags: Essays Source Type: research

Mobile health use in low- and high-income countries: an overview of the peer-reviewed literature
This article provides an overview of the peer-reviewed literature, published between 1 August 2006 and 1 August 2011, for the application of mobile/cell phones (from basic text-messaging systems to smartphones) in healthcare in both resource-poor and high-income countries. Smartphone use is paving the way in high-income countries, while basic text-messaging systems of standard mobile phones are proving to be of value in low- and middle-income countries. Ranging from infection outbreak reporting, anti-HIV therapy adherence to gait analysis, resuscitation training and radiological imaging, the current uses and future possibi...
Source: JRSM - April 5, 2013 Category: UK Health Authors: Bastawrous, A., Armstrong, M. J. Tags: Review Source Type: research

Patients' experiences of their healthcare in relation to their expectations and satisfaction: a population survey
Conclusions It is the ability of the system to meet patients’ expectations in respect of the emotional and human features of the consultation, and the clinical outcomes, that matter most to people. This research also questions prevailing stereotypes of older age: it is not the case that older patients are more satisfied with their care because their expectations are lower. In fact, they are higher, but they believe that they are being met. (Source: JRSM)
Source: JRSM - April 5, 2013 Category: UK Health Authors: Bowling, A., Rowe, G., McKee, M. Tags: Research Source Type: research

Four early clinical studies to assess the effects of Peruvian bark
(Source: JRSM)
Source: JRSM - April 5, 2013 Category: UK Health Authors: Maehle, A.-H. Tags: From the James Lind Library Source Type: research

Reforming the past: the challenges faced by Obamacare
(Source: JRSM)
Source: JRSM - April 5, 2013 Category: UK Health Authors: Jha, S. Tags: Media Source Type: research

From JRSM Short Reports
(Source: JRSM)
Source: JRSM - April 5, 2013 Category: UK Health Tags: JRSM Short Reports Source Type: research

Death Notices
(Source: JRSM)
Source: JRSM - April 5, 2013 Category: UK Health Tags: Death Notices Source Type: research