MPs to debate call to remove 1% nurse pay cap

MPs will today debate a call for the lifting of the 1% pay cap on public sector workers | OnMedica


Catherine McKinnell, MP for Newcastle North, will lead the debate, which resulted from a petition started by Royal College of Nursing member Danielle Tiplady and signed by over 100,000 people.

At 4.30pm today members will debate the motion: “That this House has considered e-petition 168127 relating to pay restraint for Agenda for Change NHS staff.”

Janet Davies, Chief Executive and General Secretary of the RCN, said: “Nursing staff are the backbone of the health service, working under immense pressure to take care of people at their most vulnerable.

Read the full news story here

Review of winter pressures on the NHS

NHS Providers call for urgent review as winter pressures remain severe


NHS Providers is calling for an urgent review of managing winter pressures to be led by NHS Improvement and NHS England with input from trusts.

The review would investigate how effectively the NHS prepared for this winter, looking at how funding for winter pressures is distributed and how services are supported by social care and GPs.

NHS Providers believes a review of how the NHS has handled winter pressures should include the following:

  • The review should be lead by NHS Improvement and NHS England
  • Frontline trusts should have the opportunity to contribute to the review
  • Expert organisations such as the Royal College of Emergency Medicine should also be consulted
  • The review should be conducted rapidly, with a target finish date of end April 2017 at the latest
  • The results of the review should be made public

Read more at NHS Providers

Delivering high value health care

The King’s Fund has published the presentations from a conference held on 10 January 2017 on ‘Delivering high value health care’.

The presentations include reducing wasteful spending on healthcare; tackling overuse and underuse of health services; Right Care; improving safety and reducing harm and error; patient safety improvement; and helping patients choose wisely.


  1. Delivering high value health care
  • Rt Hon Jeremy Hunt MP, Secretary of State for Health, Department of Health

2. International evidence and experience on reducing wasteful spending on health care

Find all the presentations here

Guideline: Management of Sepsis and Septic Shock

Howell, M.D, & Davis, A.M. JAMA. Published online: 19 January 2017

Managing infection:

  • Antibiotics: Administer broad-spectrum intravenous antimicrobials for all likely pathogens within 1 hour after sepsis recognition (strong recommendation; moderate quality of evidence [QOE]).

  • Source control: Obtain anatomic source control as rapidly as is practical (best practice statement [BPS]).

  • Antibiotic stewardship: Assess patients daily for deescalation of antimicrobials; narrow therapy based on cultures and/or clinical improvement (BPS).

Managing resuscitation:

  • Fluids: For patients with sepsis-induced hypoperfusion, provide 30 mL/kg of intravenous crystalloid within 3 hours (strong recommendation; low QOE) with additional fluid based on frequent reassessment (BPS), preferentially using dynamic variables to assess fluid responsiveness (weak recommendation; low QOE).

  • Resuscitation targets: For patients with septic shock requiring vasopressors, target a mean arterial pressure (MAP) of 65 mm Hg (strong recommendation; moderate QOE).

  • Vasopressors: Use norepinephrine as a first-choice vasopressor (strong recommendation; moderate QOE).

Mechanical ventilation in patients with sepsis-related ARDS:

  • Target a tidal volume of 6 mL/kg of predicted body weight (strong recommendation; high QOE) and a plateau pressure of ≤30 cm H2O (strong recommendation; moderate QOE).

Formal improvement programs:

  • Hospitals and health systems should implement programs to improve sepsis care that include sepsis screening (BPS).

Read the full guidelines here

Quality improvement: learning from innovations in the vanguards

The King’s Fund Blog | By Don Berwick


I have recently returned from an exciting, whirlwind tour of another set of new care models sites. This was my fourth such tour. My goal for these visits, which I make as an International Visiting Fellow for The King’s Fund, is to attempt to understand what the vanguard organisations are trying to do, how well they are faring, and how they might progress even better and faster. On this trip, the additional question was: ‘How can these lessons and models be spread more widely across the NHS?’

Read the full blog post here

UK child health near bottom in Europe

An alarming gap between rich and poor is jeopardising UK children’s health. | Royal College of Paediatrics and Child Health (RCPCH) | OnMedica 

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A report by  report by the RCPCH has revealed that despite some improvements in the health of UK children over past decades, the UK has one of the highest rates of child mortality in western Europe. The BMA said the UK is failing many of its children, who should not be paying with their health for the economic downturn.

The RCPCH reported in The State of Child Health that almost one in five children in the UK is living in poverty, and that inequality is blighting their lives – deprivation is strongly associated with higher levels of child mortality, child obesity and smoking during pregnancy, and with lower rates of breastfeeding. The College report showed that:

  • The UK ranks 15 out of 19 western European countries on infant mortality; infant mortality is more than twice as high in the lowest socio-economic groups as in the highest.
  • The prevalence of smoking during pregnancy in the UK is much higher than in many European countries and strongly associated with deprivation. In Scotland, 25.9% of women in the most deprived areas acknowledged smoking following the birth of their baby, against 3.3% in the least deprived areas. Child smoking is also much more prevalent among children from the most deprived areas.
  • Breastfeeding rates in England and Scotland have barely improved since records began in 1975, and not at all in the past five years; they are lower than in many other comparable high-income countries. Across the UK, 46% of mothers in the most deprived areas breastfed compared with 65% in the most affluent areas.
  • Across England, Scotland and Wales more than one in five children in the first year of primary school are overweight or obese. In 2015-16, 40% of children in England’s most deprived areas were overweight or obese, compared with 27% in the most affluent areas.


Mental health in general hospitals: Treat as One

Treat as One: Bridging the gap between mental and physical healthcare in general hospitals National Confidential Enquiry into Patient Outcome and Death (NCEOPD)

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This report examines the quality of mental health and physical health care for patients aged 18 years or older with a significant mental disorder who are admitted to a general hospital.  It takes a critical look at areas where the care of patients might have been improved.

NHS ambulance services

The National Audit Office (NAO) has published NHS ambulance services.

This report provides an update to the NAO 2011 report and examines:

  • the challenges facing the ambulance service in England
  • the performance of the service
  • the extent to which the service is maximising its impact and supporting the challenges facing the wider health system.

It highlights that NHS ambulance services are finding it increasingly difficult to cope with rising demand for urgent and emergency services.

Full report: NHS Ambulance Services

NAO Podcast on Ambulance Service:


Additional links: BBC news report

Cancer diagnosis in GP surgeries

Better GP access to cancer diagnostic tools would benefit doctors and patients, says RCGP |via OnMedica


The Royal College of GPs has welcomed a £5 million grant aimed at giving GPs better access to cancer diagnostic tools. Cancer Research UK (CRUK), which is funding the research project, said having more effective ways to diagnose cancer in GP surgeries would save both doctors’ and patients’ time, and reduce anxiety for patients.

The charity announced its £5 million funding for the “revolutionary” CanTest project as part of its Catalyst Award, which it said “aims to help researchers from around the world deliver trailblazing progress in their field with long-lasting results”. CanTest will investigate and develop new ways for GPs, physician’s assistants and nurse practitioners to diagnose cancer in GP surgeries. It will assess the accuracy, cost effectiveness and suitability of a range of diagnostic methods and tools, with the aim of cutting both the wait for diagnosis and the number of referrals.

Read more:





Promoting better hygiene with children and young people

NICE and Public Health England recommend children and young people are taught the importance of hand washing to tackle antimicrobial resistance.


The guidance recommends children in nurseries and young people at university be taught when and how to wash and dry their hands, for example after going to the toilet and before preparing food, in order to prevent the spread of infections. Public Health England’s (PHE) educational resources, e-Bug and Germ Defence, are listed as two ways to promote better hygiene.

The guidance by NICE and PHE, is aimed at NHS organisations, local authorities and health and social care professionals so they can provide information to people in their care.