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News - June 2011

Contents

NICE publishes guideline on mental health disorders

Common mental health disorders affect up to 15% of the population at any one time. They include depression, generalised anxiety disorder, panic disorder, obsessive-compulsive disorder, post-traumatic stress disorder, and social anxiety disorder. The new NICE guideline aims to help GPs provide quick and cost-effective treatment to improve the lives of people experiencing these common disorders.

The guideline focuses on identification and pathways to care in primary care and will advise managers and commissioners on how to develop referral and care pathways in their local area.

The guideline covers:

  • improving access to services
  • identification and assessment, including:
    • antenatal and postnatal mental health
    • risk assessment and monitoring
  • treatment and referral, including:
    • identifying treatment options
    • treatment and referral advice to help prevent relapse
  • developing local care pathways.

Recommendations on the identification and assessment of common mental health disorders will also help GPs tackle the under-recognition of depressive and anxiety disorders; this is important as only a small number of people who experience anxiety disorders ever receive treatment.

At the launch of the guideline, Dr Clare Gerada, Chair of the RCGP, said: 'We are really pleased that NICE is listening to GPs and producing practical guidance that can be easily adopted for the benefit of patients.'

www.nice.org.uk

Guidance for preventing type 2 diabetes released

NICE has published a guideline on preventing type 2 diabetes. The guideline focuses on providing population and community level interventions for people in high-risk groups and in the general population. People from high-risk groups include those of South-Asian, African-Caribbean, black African, and Chinese descent.

This guideline will be followed by a second piece of guidance, which will consider the effectiveness and cost-effectiveness of interventions to prevent type 2 diabetes among individuals at high risk. Both guidelines will be useful for those working in national and local public health services.

www.nice.org.uk

Guide on achieving QOF points is available

Supplementary guidance has been released to assist PCTs and practices in England to understand and work through the new quality and productivity (QP) indicators featured in the 2011/12 QOF guidance. The supplementary guidance was produced jointly by NHS Employers and the BMA.

It offers a step-by-step guide on how best to achieve the maximum number of QOF points available for each indicator. It will also cover frequently asked questions, discuss how to calculate QOF points achieved, and provide a working example for QP prescribing indicators.

www.networks.nhs.uk

BTS and SIGN publish annual update of asthma guideline

The British Thoracic Society (BTS) and the Scottish Intercollegiate Guidelines Network (SIGN) have revised the British guideline on the management of asthma. The guidance includes updates to pharmacological management and monitoring asthma, and a new section on asthma in adolescents.

New and updated recommendations include:

  • the use of closed rather than open questions during assessment of asthma (e.g. do you use your blue inhaler every day?) to provide more information
  • using current control of asthma as the best predictor of future exacerbations
  • monitoring of children with asthma in primary care by routine clinical review at least annually.This should cover recording factors, such as:
    • symptom score
    • exacerbations, oral corticosteroid use, and time off school/nursery as a result of asthma
    • inhaler technique
    • adherence
    • growth
    • exposure of tobacco smoke
    • possession and use of self-management plan/personalised action plan
  • the prescribing of all beclometasone hydrofluoroalkane products by name
  • the prescribing of combination inhalers to ensure that long-acting β2 agonists are not taken without inhaled steroid.

The new section on asthma in adolescents covers:

  • underdiagnosis in this patient group
  • taking into account patient preference for inhaler device to improve treatment adherence
  • identifying individuals with anxiety and/or depression
  • using school as a setting for delivery of healthcare and asthma education
  • the importance of the transition from paediatric to adult services
  • provision of career advice.

It is hoped that the BTS/SIGN guideline on asthma continues to serve as a foundation for high-quality management of both acute and chronic asthma and a stimulus for research into areas for which there is little evidence.

www.sign.ac.uk

Commissioning report for continence care released

The All Party Parliamentary Group For Continence Care has produced the report Cost-effective commissioning for continence care. It provides a framework for implementing and monitoring an integrated continence service, and outlines the essential components for each phase of the commissioning cycle.

Evidence-based clinical pathways can achieve cost savings by reducing issues and conditions, such as:

  • pressure ulcers linked to poor continence care
  • acute hospitalisations for urinary retention, renal failure, and faecal impaction.

www.appgcontinence.org.uk

Advice on peripheral arterial disease issued by NICE

The most common symptom of peripheral arterial disease is intermittent claudication. In Technology Appraisal 223, NICE recommends naftidrofuryl oxalate as a treatment option for this indication in individuals with peripheral arterial disease for whom vasodilator therapy is considered appropriate after consideration of other treatment options. Therapy should be initiated with the least costly licensed preparation. Cilostazol, pentoxifylline, and inositol nicotinate have not been recommended for treatment of intermittent claudication in people with peripheral arterial disease.

www.nice.org.uk

The NICE Shared Learning Award has been awarded to the home haemodialysis team based at Manchester Royal Infirmary

The team developed a programme that improved patient experience, resulted in superior outcomes for home haemodialysis, and delivered financial savings.

www.nice.org.uk

A guide on capacity, care planning, and advance care planning in life-limiting illness has been published

It has been developed to help healthcare and social care staff who are involved in care planning and decision making for people with life-limiting illness.

www.networks.nhs.uk

A self-review tool for quality criteria for young people friendly health services has been published by the Department of Health

The quality criteria will provide guidance based on local practice and aim to improve patient experience and health outcomes for young people.

www.dh.gov.uk

Skills for Health launches competence framework for patient-centred respiratory care

The framework supports the delivery of the upcoming National Outcomes Strategy for COPD as well as helping commission, manage, and improve patient care.

tinyurl.com/3t5nn47

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