NICE: Hypertension in adults: diagnosis and management

NICE | August 2019 | Hypertension in adults: diagnosis and management | NICE guideline [NG136]

NICE has published Hypertension in adults: diagnosis and management, the guideline covers identifying and treating primary hypertension (high blood pressure) in people aged 18 and over, including people with type 2 diabetes. It aims to reduce the risk of cardiovascular problems such as heart attacks and strokes by helping healthcare professionals to diagnose hypertension accurately and treat it effectively.

Full details from NICE 

What should be done to fix the crisis in social care?

This ‘long read’ sets out five messages for government about priorities and options for social care reform in England, based on an assessment of the evidence and analysis of the costs of reform.  It focuses primarily on changes to the funding system rather than other policy questions such as the relationship between the NHS and social care | The Health Foundation

This analysis from the Health Foundation sets out five priorities for the new government for social care:

  • To stabilise the current social care system, which is at risk of collapse. The Health Foundation estimates this would cost £4.4bn by 2023/24. In 2020/21, this would cost £1bn.
  • To protect individuals against unfair and catastrophic care costs. A range of approaches could be used here. The Health Foundation recommends a Dilnot-style model where the government can set the maximum amount individuals would be required to pay over their life time. An approach whereby the maximum cost was capped at £46,000 would cost government an additional £3.1bn per annum by 2023/24.
  • To increase eligibility and access to social care. To reinstate levels of access to 2010 levels would cost an additional £8.1bn, according to Health Foundation analysis.
  • To see the capped cost model as a flexible approach to reform. The principle of a cap on care costs was included in the 2014 Care Act and could be put in place without new legislation.
  • To explore a range of options for raising revenue. After a decade of austerity in public finances, cutting other services to pay for social care is not feasible or desirable. Increases in tax revenue is likely to be needed, although borrowing could also play a part.

Full detail: What should be done to fix the crisis in social care? Five priorities for government

See also: Press release: New government must act to end the shameful policy failure at the heart of adult social care

NICE: Alcohol interventions in secondary and further education

NICE | August 2019| Alcohol interventions in secondary and further education NICE guideline [NG135]

NICE have issued a new guideline which covers interventions in secondary and further education to prevent and reduce alcohol use among children and young people aged 11 up to and including 18. It also covers people aged 11 to 25 with special educational needs or disabilities in full-time education. It will also be relevant to children aged 11 in year 6 of primary school.

Read the guidance in full from NICE

[NICE updated guidance] Venous thromboembolism in over 16s: reducing the risk of hospital-acquired deep vein thrombosis or pulmonary embolism

NICE |  August 2019 | Venous thromboembolism in over 16s: reducing the risk of hospital-acquired deep vein thrombosis or pulmonary embolism| NICE guideline [NG89]

This guideline covers assessing and reducing the risk of venous thromboembolism (VTE or blood clots) and deep vein thrombosis (DVT) in people aged 16 and over in hospital. It aims to help healthcare professionals identify people most at risk and describes interventions that can be used to reduce the risk of VTE.

Full details available from NICE 

Cochrane: Simple changes to food environments may reduce overconsumption

Cochrane Library | August 2019 | Simple changes to food environments may reduce overconsumption

A piece of research that explored the impact of convenience and proximity altered individual’s decisions to consume food, alcoholic beverages and tobacco products; the researchers behind this study wanted to see if  this altered people’s decision to purchase and consume these food products.


The team used 24 studies from high-income countries, all of the studies included had at two different levels of availability of a product (6 studies) or its proximity (18 studies), and included a measure of selection or consumption of the manipulated product.

See also: Cochrane Simple changes to food environments may reduce overconsumption

Full reference: Hollands,  G.J. | 2019| Altering the availability or proximity of food, alcohol, and tobacco products to change their selection and consumption| Cochrane Database of Systematic Reviews|Issue 8| Art. No.: CD012573. DOI: 10.1002/14651858.CD012573.pub2.

Plain language summary

Altering the availability or proximity of food, alcohol, and tobacco products to change their selection and consumption

Unhealthy patterns of consumption of food, alcohol, and tobacco products are important causes of ill health. Changing the availability (the range or amount of options, or both) of these products or their proximity (the distance at which they are positioned) to potential consumers could help people make healthier choices.

What is the aim of this review?

This review investigated whether altering the availability or proximity of food (including non‐alcoholic beverages), alcohol, and tobacco products changed people’s selection (such as purchasing) or consumption of those products. We searched for all available evidence from randomised controlled trials (a type of study in which participants are assigned to one of two or more treatment groups using a random method) to answer this question, and found 24 studies, all of which were conducted in high‐income countries.

What are the main results of the review?

Six studies involved availability interventions, of which four changed the relative proportion of less‐healthy to healthier options, and two changed the absolute number of different options available. In statistical analyses that combined results from multiple studies, it was found that reducing the number of available options for a particular range or category of food(s) reduced selection of those food products (from analysing 154 participants) and possibly reduced consumption of those products (from 150 participants). However, the certainty of the evidence for these effects was low.

Eighteen studies involved proximity interventions. Most (14/18) changed the distance at which a snack food or drink was placed from the participants, whilst four studies changed the order of meal components encountered along a line. One study found that this reduced selection of food (from analysing 41 participants), whilst in a statistical analysis combining results from multiple studies, it was found that placing food farther away reduced consumption of those food products (from analysing 1098 participants). However, the certainty of the evidence for these effects was very low and low, respectively.

Key messages

Mindful of its limitations, the current evidence suggests that changing the number of available food options or changing where foods are positioned could contribute to meaningful changes in behaviour, justifying policy actions to promote such changes to food environments. However, more high‐quality studies in real‐world settings are needed to make this finding more certain.


Cochrane Altering the availability or proximity of food, alcohol, and tobacco products to change their selection and consumption


See also:

Public Health England Health Matters: Addressing the food environment as part of a local whole systems approach to obesity


UK National eye health and hearing study

UK National Eye Health and Hearing Study | August 2019 | UK National eye health and hearing study

The  UK’s first vision and hearing survey aims to capture vital data on UK issues. The UK National Eye Health and Hearing Study( UKNEHS) report has been produced to request UK Government funding for vital research , which can enable a step change in the way eye health and hearing services are delivered in the UK.
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A lack of accurate data is contributing to a £58billion bill for vision and hearing loss in the UK, according to a report published today that calls on the Government to support the first ever national survey of the UK population’s sensory needs.

It is estimated that around 2 million people in the UK are affected by partial sight loss, and this is expected to rise to 2.4 million by 2024. The number affected by hearing loss is estimated at 11 million, and this is also rising (Source:

Full report UK National eye health and hearing study case for investment

See also Vision UK [press release] Poor eyesight and hearing loss costs billions


How Does UK Healthcare Spending Compare With Other Countries?

This briefing provides an analysis of UK health care spending relative to comparable countries, such as the G7 group of large developed economies or member nations of the Organisation for Economic Co-operation and Development (OECD) | Office for National Statistics


It finds that the UK spent an average of £2,989 per person on health care in 2017 which is the median for OECD countries. However, of the G7 group of large, developed economies, UK healthcare spending per person was the second-lowest, with the highest spenders being France (£3,737), Germany (£4,432) and the United States (£7,736).

Other key findings:

  • As a percentage of GDP, UK healthcare spending fell from 9.8% in 2013 to 9.6% in 2017, while healthcare spending as a percentage of GDP rose for four of the remaining six G7 countries.
  • The UK’s publicly funded NHS-based health system contributes to the UK having one of the highest shares of publicly funded healthcare (79%) in the OECD.
  • In 2017, the UK spent the equivalent of £560 per person on health-related long-term care, which was less than most other northern or western European countries, but a similar amount to France (£569) and Canada (£556).

Full document: How does UK healthcare spending compare with other countries?
An analysis of UK healthcare spending relative to comparable countries, using data produced to the international definitions of the System of Health Accounts.

Professionalism and Cultural Transformation (PACT) toolkit

NHS Employers | August 2019 | Professionalism and Cultural Transformation (PACT) toolkit

NHS Employers has created a Professionalism and Cultural Transformation (PACT) toolkit which aims to educate and empower staff to improve professionalism within their workplace, helping organisations move towards making the NHS the best place to work.
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The toolkit is based on tried and tested work undertaken by Hull University Teaching Hospitals NHS Trust and is designed to help managers embed the PACT programme in their organisation.


GPs diagnosing cancers earlier

New study concludes that GPs appear to be diagnosing cancers earlier, helping to reduce the numbers of cancer patients receiving their diagnosis in accident and emergency (A&E) departments, thereby improving their chance of survival British Journal of General Practice | via OnMedica

In this large study, the researchers studied Routes to Diagnosis data on 554,621 patients with cancer in England who presented as emergencies between 2006 to 2015. They found there was a decline in the annual rate of emergency presentations, with emergency referrals from GPs falling by about a half.

The authors suggested this was likely to reflect increasing use by GPs of the two week wait referral pathways, as well as reductions in emergency presentations following a GP referral, likely indicating a trend towards earlier diagnosis in general practice.

Full story at OnMedica

Full article: Herbert A, Abel GA, Winters S, et al. | Cancer diagnoses after emergency GP referral or A&E attendance in England: determinants and time trends in Routes to Diagnosis data, 2006–2015 | British Journal of General Practice 2019

Closer links between police and health services can improve experiences for people in mental health crisis

Tighter working partnerships between health professionals and police services are likely to improve the care of people who come into contact with police during mental health crises | National Institute for Health research


People experiencing severe mental health episodes can present with extreme and unpredictable behaviour posing a danger to themselves and members of the public. Police are often the first to respond in these challenging situations.

New models are emerging of mental health staff working with police. This NIHR-funded review found limited UK-relevant evidence of mixed quality. Studies showed different models in use, from police and mental health staff responding to incidents together to health staff in police control rooms providing support and advice. There was little evidence on which approaches work best, but some research suggested a reduction in formal detentions although there were few outcome data reported.

Research shows potential for improving health outcomes for individuals in crisis by ensuring they are diverted to appropriate services, and in helping direct the appropriate use of police and NHS resources.

Further detail at National Institute for Health Research

Full reference: Rodgers M, Thomas S, Dalton J, Harden M and Eastwood A. Police-related triage interventions for mental health-related incidents: a rapid evidence synthesis. Health Services and Delivery Research. 2019;7(20).