[NICE Meditech innovation briefing] CADScor system for ruling out coronary artery disease in people with symptoms of stable coronary artery disease

NICE | March 2019 | CADScor system for ruling out coronary artery disease in people with symptoms of stable coronary artery disease

NICE has developed a medtech innovation briefing (MIB) on CADScor system for ruling out coronary artery disease in people with symptoms of stable coronary artery disease.

Full details from NICE 

Social prescribing: applying All Our Health

Public Health England | March 2019 | Social prescribing: applying All Our Health

Social prescribing: applying All Our Health is a guide designed to help front-line health and care staff use their trusted relationships with patients, families and communities to promote the benefits of social prescribing.


Image source: gov.uk

Public Health England also recommend important actions that managers and staff holding strategic roles can take.

Social prescribing: applying All Our Health

Paying to breathe: why unfair asthma prescription charges must be stopped

Asthma UK | February 2019 | Paying to breathe: why unfair asthma prescription charges must be stopped

A new report from Asthma UK- Paying to breathe: why unfair asthma prescription charges must be stopped outlines how people with asthma in England pay prescription charges Asthma medication is prescribed by the NHS, but, unlike
many other long-term conditions that rely on daily medication, asthma is not included on the prescription charges exemptions list. Asthma UK says it is unfair that people with asthma have to pay for their prescriptions to stay alive, especially as people with other long-term conditions such as diabetes and epilepsy, and those in Scotland, Wales and Northern Ireland get free prescriptions. 6000 people with asthma were involved in Asthma UK’s research. 

asthma UK
Image source: asthma.org.uk

The report’s key findings:

  • 3 in 4 people with asthma who have to pay for their prescriptions struggle to afford them
  • More than half (57 per cent) of people who pay for their prescriptions have at some point cut back on their medication due to cost
  • Cutting back on asthma medication is having a dramatic impact on people’s health
  • Regional variations in the impact of prescription charges are potentially driving health inequalities
  • Payment prescription Certificates are still an unfair burden on people with asthma and not everyone can afford them
  • People with asthma think prescription charges are unfair and should be stopped

Asthma UK [press release] ‘Unfair’ prescription charges putting more than a million people at risk of a life-threatening asthma attack

Paying to breathe: Why unfair asthma prescription charges must be stopped 

Implementing the NHS Long Term Plan

The NHS Long Term Plan included suggested legislative changes to help implement the Plan easier and faster.  NHS England Strategy & Innovation Directorate and NHS Improvement Strategy Directorate are now setting these out in further detail and invite views on the proposals.

The proposals outline eight groups of suggested legislative changes in the NHS Long-Term Plan, with feedback invited by April 25 2019. These include proposed changes to both the Competition and Markets Authority (CMA) and NHS Improvement’s roles in respect of competition. These proposals are based on feedback from patients, clinicians, NHS leaders and partner organisations, as well as national professional and representative bodies.

Full document: Implementing the NHS Long Term Plan: Proposals for possible changes to legislation

See also:

Race equality in the NHS workforce

This podcast explores big ideas in health and care, and features experts from The King’s Fund and beyond discussing the NHS, social care, and all things health policy and leadership.

What can be done about race inequality in the NHS workforce? How can we ensure representative leadership happens? Helen McKenna talks with Yvonne Coghill, Director at NHS England Workforce Race Equality Standard (WRES); Dionne Daniel, Project Lead, Nursing Workforce Remodelling Research Project; and Ben Morrin, Director of Workforce at University College London Hospitals.

KF pod.PNG


Air pollution: outdoor air quality and health

This updated NICE quality standard covers road-traffic-related air pollution and its impact on health. It describes high-quality actions in priority areas for improvement | National Institute for Health & Social Care


In a new Quality Standard, Nice has suggested councils should use their planning permission powers to make sure developers take steps to reduce pollution where people live. The publication recommends houses, flats, schools, nurseries and care homes be protected from pollution. Nice also add that councils should actively try to reduce the number of people on the roads, encouraging them to take public transport, cycle or walk, suggesting councils should plant trees and plants outside and on roofs, and create areas for people to walk and cycle in clean air.

Air pollution causes an estimated 40,000 premature deaths a year in the UK and is linked to health problems from childhood illnesses to heart disease and dementia.

Full document: Air pollution: outdoor air quality and health | Quality standard [QS181] NICE | February 2019

See also: Air pollution: outdoor air quality and health | NICE guideline [NG70] Published  June 2017

Changes in millennial adolescent mental health and health-related behaviours over 10 years: a population cohort comparison study

Patalay, P. & Gage, S. H.| 2019|  Changes in millennial adolescent mental health and health-related behaviours over 10 years: a population cohort comparison study| International Journal of Epidemiology|  dyz006|  https://doi.org/10.1093/ije/dyz006

Research that used data from the Millennium Cohort study to explore two cohorts of adolescents aged 14  from 2005 and 2015 has found that young people in the second cohort  are sleeping less and have more depressive symptoms than previous adolescents. The research team draw comparisons between the two cohorts, and include their finding  that adolescents in the  2015 group reported higher levels of depressive symptoms, self-harm and hyperactivity and peer problems compared to the earlier group. When compared to the 2005 cohort,  levels of substance use such as smoking cigarettes, drinking alcohol and cannabis were the same or lower in the 2015 cohort. Young people in the 2015 group were getting less sleep and had higher levels of obesity than those ten years previously. 



There is evidence that mental health problems are increasing and substance use behaviours are decreasing. This paper aimed to investigate recent trends in mental ill health and health-related behaviours in two cohorts of UK adolescents in 2005 and 2015.


Prevalences in mental health (depressive symptoms, self-harm, anti-social behaviours, parent-reported difficulties) and health-related behaviours (substance use, weight, weight perception, sleep, sexual intercourse) were examined at age 14 in two UK birth cohorts; Avon Longitudinal Study of Parents and Children (ALSPAC, N equal to 5627, born 1991–92) and Millennium Cohort Study (MCS, N equal to 11 318, born 2000–02). Prevalences and trend estimates are presented unadjusted and using propensity score matching and entropy balancing to account for differences between samples.


Depressive symptoms (9% to 14.8%) and self-harm (11.8% to 14.4%) were higher in 2015 compared with 2005. Parent-reported emotional difficulties, conduct problems, hyperactivity and peer problems were higher in 2015 compared with 2005 (5.7–8.9% to 9.7–17.7%). Conversely, substance use (tried smoking, 9.2% to 2.9%; tried alcohol, 52.1% to 43.5%, cannabis, 4.6% to 3.9%), sexual activity (2% to 0.9%) and anti-social behaviours (6.2–40.1% to 1.6–27.7%) were less common or no different. Adolescents in 2015 were spending less time sleeping (less than 8 h 5.7% to 11.5%), had higher body mass index (BMI) (obese, 3.8% to 7.3%) and a greater proportion perceived themselves as overweight (26.5% to 32.9%). The findings should be interpreted bearing in mind limitations in ability to adequately harmonize certain variables and account for differences in attrition rates and generalizability of the two cohorts.


Given health-related behaviours are often cited as risk factors for poor mental health, our findings suggest relationships between these factors might be more complex and dynamic in nature than currently understood. Substantial increases in mental health difficulties, BMI and poor sleep-related behaviours highlight an increasing public health challenge.

Rotherham NHS staff can request this journal article from the Library & Knowledge Service 

In the news:

BBC News Adolescent health: Teens ‘more depressed and sleeping less’

The Independent Generation Z teenagers have more mental health problems despite drops in smoking, drugs and antisocial behaviour 


Centre for Ageing Better: Raising the bar on strength and balance

Centre for Ageing Better | February 2019 | Raising the bar on strength and balance: The importance of community- based provision

A new report from the Centre for Ageing Better argues that NHS falls rehabilitation services often don’t have the funding or ability to themselves provide strength and balance programmes for more than a few hours over just 6-8 weeks, much less than the 50+ hours over six months needed to make a difference to a person’s ability to do everyday activities.  

The report-Raising the bar on strength and balance: The importance of community- based provision– shows that, for adults with declining mobility and those experiencing a loss of muscle and bone strength or balance, there can be a corresponding decline in their ability to manage everyday activities like eating, bathing and getting dressed on their own.


The report presents the models of delivery, issues, barriers and innovative solutions that the Centre for Better Ageing found. It focuses on community-based strength and balance programmes targeting all older adults and includes evidence-based programmes to reduce falls.

The findings have been organised into five themes:

  • Raising awareness
  • Encouraging take-up
  • Exercise referral pathways that work
  • Sticking to the evidence
  • Monitoring for outcomes and improvement

Raising the bar on strength and balance recommends that NHS and local authorities support evidence-based programmes, making sure that the most effective approaches to improving strength and balance are accessible and affordable for everyone. Making people aware of the benefit of strength and balance exercises should be a priority, and commissioners must work together to reinforce the information given to patients. There also needs to be improved collaboration between those referring people to programmes and those delivering them (Source: Centre for Ageing Better).

Raising the bar on strength and balance: The importance of community- based provision

Report resources including videos, projects and documents

Centre for Ageing Better Report highlights postcode lottery in strength and balance programmes which help people at risk of falls [press release]

New research for CQC shows people regret not raising concerns about their care – but those who do raise concerns see improvements

Care Quality Commission | February 2019 | New research for CQC shows people regret not raising concerns about their care – but those who do raise concerns see improvements

The Care Quality Commission (CQC) is encouraging people who have concerns about their care to raise concerns. According to their research 7 million people in England who have accessed health and social care during the last five years have concerns about their care but have not raised them.  More than half (58 per cent) expressed regret about no raising concerns (Source: CQC).

Declare your care
Image source: cqc.org.uk

The main explanations given for raising a concern were:

  • delays to a service or appointment
  • lack of information
  • poor patient care

Reasons cited for not raising a concern were:

  • Not knowing how (20 per cent)
  • Not knowing who to raise it with (33 per cent)
  • Not wanting to be seen as a trouble maker
  • Worried about not being taken seriously
  • More than a third (37 per cent) felt that nothing would change as a result of raising a concern

Although when concerns were raised two-thirds found their issue was resolved quickly.

The findings have been published to coincide  with the CQC campaign ‘Declare Your Care’- which is encouraging people to share their experiences of care with CQC to support its work to improve standards of care in England.

Read the full press release from CQC

Survey data can be downloaded from CQC 

Related:  CQC ‘Declare Your Care’