NHS Library and Information Service North Staffordshire

Clinical Effectiveness Bulletin for NHS Primary Care in North Staffordshire

Issue No: 57 October 2011

About this Bulletin: It aims to draw attention to some of the key documents and reviews on clinical effectiveness that have been published in the previous month. Where possible, links to the full text documents are included. If the article is in a journal, you can contact the Health Library for a copy. Link to request form: http://www.keele.ac.uk/healthlibrary/usingthehealthlibrary/interlibraryloans/#d.en.27437 [Please note - a charge of 2 per request is payable for most copies] If you need further assistance, please contact the Health Library or the NHS Outreach Librarians, details below. The bulletin can be e-mailed to colleagues who may also find it useful. A list of websites checked in the production of this bulletin is on the first page. Please suggest further useful sites. Feedback is always welcomed to inform future issues of the bulletin.

Contact information

Bulletin produced by NHS Outreach Librarians Tel: FeatureNet 8429 (External calls 0300 123 1535 ext 8429) E-mail: lindsay.snell@northstaffs.nhs.uk clareh.powell@northstaffs.nhs.uk

North Staffs Health Library Tel: 01782 679500 Fax: 01782 679582 E-mail: health.library@keele.ac.uk

NHS Library and Information Service North Staffordshire

Sources for Clinical Effectiveness Bulletin Please suggest further sites that should be monitored in the production of this bulletin Websites Cochrane Library http://www.thecochranelibrary.com/ CRD Centre for Reviews and Dissemination http://www.crd.york.ac.uk/crdweb/ - DARE (Database of Abstracts of Reviews of Effects) - NHS Economic Evaluation Database Health Technology Assessment (HTA) Database http://www.hta.ac.uk Daily Health Bulletin http://www.sheffield.nhs.uk/healthbulletin/ Department of Health http://www.dh.gov.uk/en/index.htm Kings Fund http://www.kingsfund.org.uk/ NeLM (National Electronic Library for Medicines) news bulletin http://www.nelm.nhs.uk/en/ NICE http://www.nice.org.uk/ SIGN http://www.sign.ac.uk/new.html

NHS Library and Information Service North Staffordshire Contents in this issue:
Alcohol ...................................................................................................................................... 4 Amputees.................................................................................................................................. 4 Arthritis...................................................................................................................................... 4 Cancer ...................................................................................................................................... 4 Cardiovascular Diseases .......................................................................................................... 5 Carers ....................................................................................................................................... 5 Children and Young People ...................................................................................................... 5 Commissioning ......................................................................................................................... 6 Dentists ..................................................................................................................................... 7 Diabetes.................................................................................................................................... 7 General Practice ....................................................................................................................... 7 Guidance .................................................................................................................................. 8 Health Reforms ....................................................................................................................... 10 Health Visitors ......................................................................................................................... 12 Infections ................................................................................................................................ 12 Information and Information Governance................................................................................ 12 Long Term Conditions............................................................................................................. 12 Maternal and Infant Health...................................................................................................... 13 Mental Health.......................................................................................................................... 13 Multiple Sclerosis .................................................................................................................... 14 Nursing ................................................................................................................................... 15 Obesity.................................................................................................................................... 15 Occupational Therapy ............................................................................................................. 15 Offender Health ...................................................................................................................... 15 Older People ........................................................................................................................... 16 Palliative and End of Life Care ................................................................................................ 16 Patient Care and Safety .......................................................................................................... 17 Pharmacy and Prescribing ...................................................................................................... 18 Physiotherapy ......................................................................................................................... 19 Public Health ........................................................................................................................... 19 Safeguarding Children and Vulnerable Adults ........................................................................ 21 Service Management .............................................................................................................. 21 Sexual Health ......................................................................................................................... 23 Smoking .................................................................................................................................. 23 Substance Misuse .................................................................................................................. 24 Vaccination and Immunisation ................................................................................................ 24 Womens Health ..................................................................................................................... 25 Workforce ............................................................................................................................... 25

NHS Library and Information Service North Staffordshire Alcohol

South East Alcohol Innovation Programme: Evaluation Report Centre for Public Innovation This evaluation concluded that five of the projects identified significant cost savings, and five reported reduced hospital admissions among their client groups. Three projects have been taken up as NHS Quality, Innovation, Productivity and Prevention (QIPP) initiatives, indicating their high potential to demonstrate innovation and increase quality and productivity. http://www.publicinnovation.org.uk/fckimage/South%20East%20Alcohol%20Innovation%20Pr ogramme%20Evaluation(1).pdf
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Amputees
A better deal for military amputees Department of Health This review of prosthetic services currently offered to veterans by the NHS follows concerns that the NHS may not be equipped to provide prosthetic services to the same standard as the Defence Medical Service at Headley Court. http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidanc e/DH_130824
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Arthritis
RA and Physiotherapy: a national survey National Rheumatoid Arthritis Society (NRAS) This survey of NRAS members explores the value of physiotherapy and its availability to people with rheumatoid arthritis. It also compares the findings with national guidelines. http://www.nras.org.uk/includes/documents/cm_docs/2011/r/ra_and_physiotherapy_report_12 _october_2011.pdf
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Cancer
Items in the Carers section may also be of interest.

NHS Library and Information Service North Staffordshire Cardiovascular Diseases

Statins and intracerebral hemorrhage: collaborative systematic review and metaanalysis Hackam, DG et al. The authors found no evidence that statins were associated with intracerebral hemorrhage; if such a risk is present, its absolute magnitude is likely to be small and outweighed by the other cardiovascular benefits of these drugs. Circulation. Published online before print October 17, 2011, doi: 10.1161/CIRCULATIONAHA.111.055269
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Carers
Improving support for older people looking after someone with advanced cancer University of Nottingham This project studied the experiences and support needs of older carers looking after someone with advanced cancer. It also facilitated carers active involvement in the research process. http://www.endoflifecareforadults.nhs.uk/publications/improving-support-for-older-peoplelooking-after-someone-with-advanced-cancer When a person dies: guidance for professionals on developing bereavement services National End of Life Care Programme The publication covers the principles of bereavement services, along with bereavement care at the time of death and in the days preceding and following death. It also includes guidance on workforce and education, commissioning, and quality outcomes. http://www.endoflifecareforadults.nhs.uk/publications/when-a-person-dies
Items in the General Practice section may also be of interest. [back to topics]

Children and Young People

Service Snapshots Child and Maternal Health Observatory Service Snapshots provide a summary of demand, provision and outcomes for services in a particular area. Snapshots are now available for disability, teenage pregnancy and obesity. http://atlas.chimat.org.uk/IAS/profiles/servicereports
Items in the Diabetes sections may also be of interest. [back to topics]

NHS Library and Information Service North Staffordshire Commissioning

Commission Impossible? Shaping places through strategic commissioning Localis This report draws upon the findings of a recent survey of over 100 council leaders and chief executives. The report offers a series of recommendations for central and local government and includes examples of commissioning health and social care services. http://www.localis.org.uk/article/887/Commission-Impossible?.htm Contract implementation guidance: Choice of named consultant-led team Department of Health This guidance covers introducing choice of named consultant-led team for a first outpatient appointment for elective care where clinically appropriate. http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidanc e/DH_130426 Making Difficult Choices: Ethical Commissioning Guidance to General Practitioners RCGP The guidance focuses on allocating resources fairly; GPs as commissioners, and potential conflicts of interest. http://www.rcgp.org.uk/news/press_releases_and_statements/commissioning_ethics_guidanc e.aspx A positive partnership: the independent sector and the NHS NHS Confederation This briefing describes the independent healthcare sector's engagement with the NHS in England in recent years. It provides essential facts including outline statistics about market share and treatments provided, NHS spend with independent sector providers and examples of key initiatives and areas of innovation involving the independent sector. http://www.nhsconfed.org/Publications/briefings/Pages/A-positive-partnership.aspx Patient and public engagement in the new commissioning system NHS Confederation This paper considers the critical issues which clinical commissioning groups (CCGs) will need to address in developing approaches to meaningful and effective PPE. http://www.nhsconfed.org/Publications/discussion-paper/Pages/PPE.aspx Towards more effective commissioning of local voluntary sector organisations: NHS Commissioning and place based Voluntary and Social Enterprise organisations Voluntary Sector North West This report is based on case studies and interviews with key leaders in 5 voluntary organisations and (where possible) their commissioning counterparts in the local NHS. http://www.vsnw.org.uk/activities/health/commissioningproject
Items in the Offender Health and Service Management sections may also be of interest. [back to topics]

NHS Library and Information Service North Staffordshire Dentists

Dental Earnings and Expenses, England and Wales, 2009/10 NHS Information Centre These statistics provide a detailed study of the earnings and expenses of full and part time self-employed primary care dentists who carried out NHS work in England or Wales. http://www.ic.nhs.uk/statistics-and-data-collections/primary-care/dentistry/dental-earningsand-expenses-england-and-wales-2009-10
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Diabetes
Diabetes Care for Emerging Adults: Recommendations for Transition From Pediatric to Adult Diabetes Care Systems: a position statement American Diabetes Association Diabetes Care November 2011 vol. 34(11) p.2477-2485. doi: 10.2337/dc11-1723 Dipeptidyl Peptidase-4 Inhibitors and Bone Fractures: A meta-analysis of randomized clinical trials Monami, M The authors concluded that this meta-analysis suggests treatment with DPP-4 inhibitors could be associated with a reduced risk of bone fractures. Diabetes Care November 2011 vol. 34(11) p.2474-2476. doi: 10.2337/dc11-1099
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General Practice
Investment in General Practice 2006/07 to 2010/11 England, Wales, Northern Ireland and Scotland NHS Information Centre The report draws on information obtained from country level financial monitoring reports. http://www.ic.nhs.uk/statistics-and-data-collections/primary-care/general-practice/investmentin-general-practice-2006-07-to-2010-11-england-wales-northern-ireland-and-scotland Guiding patients through complexity: modern medical generalism RCGP The Commission aimed to define, and describe the role of, medical generalism and explore its intrinsic values. It also aimed to define what patients and the public should be able to expect, and to clarify how the medical generalist interfaces with other health care professionals. The report also makes recommendations about the future development of medical generalism. http://www.rcgp.org.uk/policy/commissn_on_generalsm.aspx

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National survey of GP opinion 2011 BMA In addition to describing workforce demographics in detail, the survey provides a clear insight on a broad range of topical issues (including the current NHS reforms) within general practice. http://www.bma.org.uk/representation/branch_committees/general_prac/gpnationalsurveyresu lts2011.jsp Quality and Outcomes Framework 2010/11 NHS Information Centre This QOF information includes an online database with the results for individual surgeries; a bulletin with key findings; and national, SHA, PCT and practice level data tables. http://www.ic.nhs.uk/statistics-and-data-collections/audits-and-performance/the-quality-andoutcomes-framework/the-quality-and-outcomes-framework-2010-11 Supporting Carers: an action guide for general practitioners and their teams. RCGP This guide offers an overview of how practices can support carers within their practice, along with up-to-date policy and good practice. http://www.rcgp.org.uk/professional_development/continuing_professional_devt/carers.aspx
Items in the Commissioning, Palliative Care, Pharmacy and Prescribing and Safeguarding Children and Vulnerable Adults sections may be of interest. [back to topics]

Guidance
NICE Clinical Guidelines Management of hyperglycaemia in people with acute coronary syndromes CG130 http://guidance.nice.org.uk/CG130 NICE Technology Appraisals Mifamurtide for the treatment of osteosarcoma TA235 http://guidance.nice.org.uk/TA235 Ticagrelor for the treatment of acute coronary syndromes (ACS) TA236 http://guidance.nice.org.uk/TA236 NICE Diagnostics Guidance EOS ultra low dose 2D3D system: biplanar X-ray system for postural assessment (EOS low dose) DTG1 http://guidance.nice.org.uk/DTG1

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NICE Consultation Documents Borderline personality disorder (BPD): review proposal consultation To comment, contact the registered stakeholder organisation that most closely represents your interests. Closing date for comments: 14 November 2011 http://www.nice.org.uk/guidance/index.jsp?action=folder&o=56891 Chronic kidney disease: review proposal consultation To comment, contact the registered stakeholder organisation that most closely represents your interests. Closing date for comments: 14 November 2011 http://www.nice.org.uk/guidance/index.jsp?action=folder&o=56895 Hip fracture quality standard consultation Closing date for comments: 30 November 2011 http://www.nice.org.uk/guidance/qualitystandards/indevelopment/HipFracture.jsp Lung cancer quality standard consultation Closing date for comments: 25 November 2011 http://www.nice.org.uk/guidance/qualitystandards/indevelopment/LungCancer.jsp Pressure ulcers: scope consultation To comment, contact the registered stakeholder organisation that most closely represents your interests. Closing date for comments: 30 November 2011 http://www.nice.org.uk/guidance/index.jsp?action=folder&o=56928 Preventing and reducing domestic violence between intimate partners: consultation on the draft scope To comment, contact the registered stakeholder organisation that most closely represents your interests. Closing date for comments: 22 November 2011 http://guidance.nice.org.uk/PHG/Wave20/60/ScopeConsultation Public health guidance process and method guides: consultation NICE is proposing a number of changes to the processes and methods for developing public health guidance. To comment, contact the registered stakeholder organisation that most closely represents your interests. Closing date for comments: 9 January 2012 http://www.nice.org.uk/aboutnice/howwework/developingnicepublichealthguidance/publichealt hguidanceprocessandmethodguides/public_health_guidance_process_and_method_guides.js p Spasticity in children and young people: guideline consultation Closing date for comments: 14 December 2011 http://www.nice.org.uk/guidance/index.jsp?action=folder&o=56735

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Venous thromboembolic diseases: guideline consultation To comment, contact the registered stakeholder organisation that most closely represents your interests. Closing date for comments: 21 December 2011 http://www.nice.org.uk/guidance/index.jsp?action=folder&o=56836
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Other Guidance Evidence-based guideline update: Treatment of essential tremor Quality Standards Subcommittee of the American Academy of Neurology Neurology. Published online before print October 19, 2011, doi: 10.1212/WNL.0b013e318236f0fd Guidance on the management of the public health risks from fish pedicures Health Protection Agency http://www.hpa.org.uk/webw/HPAweb&Page&HPAwebAutoListName/Page/1317130999316
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Other Health Technology Assessments Adaptive e-learning to improve dietary behaviour: a systematic review and costeffectiveness analysis Harris, J et al. This study found that e-learning devices designed to promote dietary behaviour change will not produce clinically significant changes in dietary behaviour and are at least as expensive as other individual behaviour change interventions. Health Technol Assess 2011:15(37)
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Health Reforms
Building a successful NHS Commissioning Board: a perspective from the NHS NHS Confederation This paper includes an analysis of the main issues facing the Board and makes 20 recommendations for improving chances of success. http://www.nhsconfed.org/Documents/NHS%20Commissioning%20Board%20briefing%20FIN AL.pdf Developing the NHS Commissioning Board: update Department of Health In July, 'Developing the NHS Commissioning Board' set out initial thinking for the role of the NHS Commissioning Board, subject to the passage of the Health and Social Care Bill. This short update provides further information on the Boards development. http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidanc e/DH_130725

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The Health and Social Care Bill: Monitor's evolving role Department of Health This information sheet covers Monitors role in regulating prices; enabling integration and protecting against anti-competitive behaviour; and supporting service continuity. http://www.monitor-nhsft.gov.uk/home/our-publications/browse-category/about-monitor/whatwe-do/the-health-and-social-care-bill-monit New partnerships, new opportunities: a resource to assist setting up and running health and wellbeing boards Local Government Improvement and Development This website provides discussion about the main opportunities, challenges and solutions involved in setting up boards; questions to consider when preparing for HWBs; case studies showing the journeys of nine boards; and a summary of national and regional resources available to support implementation. http://www.idea.gov.uk/idk/core/page.do?pageId=31196365 Operating principles for health and wellbeing boards NHS Confederation These operating principles, developed by a number of national organisations, are designed to be a realistic and practical response to supporting health and wellbeing boards. They are intended to help board members consider how to create really effective partnerships across local government and the NHS. http://www.nhsconfed.org/Publications/reports/Pages/Operating-principles.aspx Sixth cohort of CCG pathfinders Department of Health The sixth cohort of pathfinder clinical commissioning groups includes the North Staffordshire Clinical Commissioning Group. http://healthandcare.dh.gov.uk/sixth-cohort-list/ Social enterprise in action: Right to request projects Department of Health A list of First Wave Right to Request projects is available. The projects range from primary care for the homeless and for those in custodial/ offender care environments, to mental health services, dental services and services for children and young people. http://www.dh.gov.uk/health/2011/10/right-to-request-projects/ Summary list of the HealthWatch pathfinders Department of Health This document sets out the focus of the HealthWatch pathfinders work, who to contact about it, and which English region they are located in. http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidanc e/DH_130528
Items in the Commissioning and General Practice sections may also be of interest. [back to topics]

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NHS Library and Information Service North Staffordshire Health Visitors

Retaining your health visitor workforce NHS Confederation This document brings together suggestions and tips to help HR, line managers and staff side representatives work together to develop a retention strategy for the health visiting workforce. These approaches will often mirror the staff pledges in the NHS Constitution. http://www.nhsemployers.org/Aboutus/Publications/Pages/Retaining-workforce.aspx
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Infections
Safe Supplies: Focusing on Epidemiology NHS Blood and Transplant This report looks at levels of infection in blood donors, risks of transmitting infections through transfusions, and reasons why donors do not report risk information. http://www.hpa.org.uk/Publications/InfectiousDiseases/BloodBorneInfections/1109Safesupplie sfocusonepidemiology2010/
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Information and Information Governance

NHS Information Governance: Effective Management of Records During a Period of Transition or Organisational Change Department of Health This document supplements the 'Records Management: NHS Code of Practice.' http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidanc e/dh_130505 Preparing for information being mission-critical to the NHS: report on the Information Revolution BCS: The Chartered Institute for IT This report includes surveys and interviews with healthcare workers and informaticians. It aims to help guide local health organisations in preparing for information being mission critical to their services and to help inform the forthcoming NHS information strategy. http://www.bcs.org/upload/pdf/prepare-for-mission-critical.pdf
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Long Term Conditions

Long term health conditions 2011: research study Department of Health This document includes results of a study exploring attitudes towards 'self-care' and the public's perceptions and behaviour with regard to their own health and the NHS generally. It 12

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captures the attitudes and behaviour of those people with an LTC regarding self management of their condition and their use of healthcare services http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidanc e/DH_130785
Items in the Commissioning, General Practice and Mental Health sections may also be of interest. [back to topics]

Maternal and Infant Health

Preparation for birth and beyond: a resource pack for leaders of community groups and activities Department of Health This pack aims to improve outcomes for babies and parents through a refreshed approach to antenatal education. http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidanc e/DH_130565 Suffering in silence: 70,000 reasons why help with postnatal depression has to be better 4Children This report looks at the impact of postnatal depression on families. It makes recommendations for increasing awareness, and improving prevention, diagnosis and treatment, of postnatal depression. http://www.4children.org.uk/information/show/ref/2701
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Mental Health
2010/11 working age adult and older adult National Survey of investment in Mental Health Services Department of Health http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidanc e/DH_117488 Enhancing Recovery Rates: IAPT Year One Report NHS Improving Access to Psychological Therapies This report looks into the reasons for the variability in performance between sites and presents lessons learnt' that IAPT service managers can draw on to further improve prospects for patient recovery. http://www.iapt.nhs.uk/services/measuring-outcomes/enhancing-recovery-rates--iapt-yearone-report/

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Inpatients formally detained in hospitals under the Mental Health Act 1983 and patients subject to supervised community treatment, Annual figures, England 2010/11 NHS Information Centre This summary includes information from high security psychiatric hospitals as well as from other NHS service providers and independent hospitals. http://www.ic.nhs.uk/statistics-and-data-collections/mental-health/mental-health-act/inpatientsformally-detained-in-hospitals-under-the-mental-health-act-1983-and-patients-subject-tosupervised-community-treatment-annual-figures-england-2010-11 Mental health, employment and the social care workforce Social Care Institute for Excellence This report summarises evidence on what prevents people with mental health problems from working or retaining work in social care and what can be done to enable them to work. It summarises a range of policy and programmes designed to enable people with mental health problems to gain, retain and regain work, with specific focus on employment in social care. Report: http://www.scie.org.uk/publications/reports/report48 Briefing: http://www.scie.org.uk/publications/briefings/briefing38 At a glance: http://www.scie.org.uk/publications/ataglance/ataglance48.asp Mental Health of Students in Higher Education Royal College of Psychiatrists The report makes 14 key recommendations and provides practical help to those who wish to improve the care and treatment of mentally troubled students. http://www.rcpsych.ac.uk/publications/collegereports/cr/cr166.aspx Payment by Results: Draft 2012-13 Mental Health Guidance Department of Health http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidanc e/DH_130196
Items in the Carers and Offender Health sections may also be of interest. [back to topics]

Multiple Sclerosis
The national audit of services for people with multiple sclerosis 2011 Royal College of Physicians The audit measures the NHS against the standards embedded in the NICE clinical guideline Management of multiple sclerosis in primary and secondary care (2003) and the National Service Framework for Long-term Conditions (2005). Data were collected from acute and community service providers, PCTs, SHAs, GPs and people with multiple sclerosis. http://www.rcplondon.ac.uk/resources/audits/MS
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NHS Library and Information Service North Staffordshire Nursing

When someone asks for your assistance to die: RCN guidance on responding to a request to hasten death RCN This guidance looks at practical and legal issues around responding appropriately to requests to hasten death. http://www.rcn.org.uk/__data/assets/pdf_file/0004/410638/004167.pdf
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Obesity
Does skipping breakfast help with weight loss? National Obesity Observatory This one page evidence summary looks at the evidence on skipping breakfast. http://www.noo.org.uk/uploads/doc/vid_12928_Eating-breakfast.PDF Healthy lives, healthy people: a call to action on obesity in England Department of Health This document sets out how the new approach to public health will enable effective action on obesity and encourages a wide range of partners to play their part. http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidanc e/DH_130401
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Occupational Therapy
Reablement: a key role for occupational therapists Social Care Institute for Excellence This briefing summarises research and practice evidence about reablement and explains the contribution that occupational therapists make to reablement services. It provides four case studies. http://www.scie.org.uk/publications/ataglance/ataglance46.asp
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Offender Health
Early years of Dangerous and severe personality disorder programme Ministry of Justice This summary is based on two studies. The first focused on treatment delivered to dangerous and severe personality disorder (DSPD) prisoners/patients. The second was concerned with management and staffing of the four high-secure DSPD units for men. http://www.justice.gov.uk/publications/research-and-analysis/moj/dangerous-severepersonality-disorder.htm

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National guidance on commissioning sexual health and blood borne virus services in prisons 2011 British Association for Sexual Health and HIV http://www.bashh.org/news/620_national-guidance-on-commissioning-sexual-health-andblood-borne-virus-services-in-prisons Safe and Secure Administration of Medication in Police Custody Faculty of Forensic and Legal Medicine These guidelines are provided for healthcare professionals involved in the care of detainees in police custody; and as a reference for police personnel and civilian staff. http://fflm.ac.uk/upload/documents/1317312087.pdf
Items in the Womens Health sections may also be of interest. [back to topics]

Older People
Dignity and nutrition inspection programme: National overview Care Quality Commission This report summarises the findings from individual reports from the programme of unannounced inspections between March and June 2011. http://www.cqc.org.uk/publications.cfm?fde_id=18815 International Comparisons in Health Economics: Evidence from Aging Studies Rand Corporation The authors provide an overview of the growing literature that uses micro-level data from multiple countries to investigate health outcomes, and their link to socioeconomic factors, at older ages. Analysis for the US and England is the most common. http://www.rand.org/pubs/working_papers/WR880.html Regulatory activity in hospital settings: A critical analysis of the Care Quality Commissions Dignity and Nutrition Inspection of 100 English hospitals Action on Elder Abuse This report makes extensive recommendations: to the Department of Health, to the Care Quality Commission, to NHS Trusts, and to the Public. http://www.elderabuse.org.uk/Mainpages/CQC%20DANI.htm
Items in the Carers section may be of interest. [back to topics]

Palliative and End of Life Care

Hospice Care: A Framework for the Future Bow Group This paper reflects on the UKs ageing population and the concurrent increase in chronic long-term conditions and sets out how the hospice movement should look in the future. http://www.bowgroup.org/content/bow-group-calls-new-vision-hospices 16

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Quick guide to identifying patients for supportive and palliative care Macmillan Cancer Support, NHS Camden and NHS Islington Following requests from GPs, a quick guide to identifying patients for supportive and palliative care has been developed. http://www.endoflifecareforadults.nhs.uk/publications/quick-guide-to-identifying-patients-forsupportive-and-palliative-care
Items in the Carers and Nursing section may be of interest. [back to topics]

Patient Care and Safety

Equality and human rights guidance for our inspectors Care Quality Commission The guidance for inspectors also states how equality and human rights applies to CQC and health and social care providers. http://www.cqc.org.uk/guidanceforprofessionals/adultsocialcare/registration/latestupdates.cfm ?widCall1=customWidgets.content_view_1&cit_id=37651 Listening and Learning: the Ombudsmans review of complaint handling by the NHS in England 2010-11 This report shows how, at a local level, the NHS is still not dealing adequately with the most straightforward matters. Two particular themes stand out: poor communication, which can have a serious, direct impact on patients care; and in a small but increasing number of cases, removal of patients from the GPs list, often without warning or opportunity for both sides to talk about what happened. As GPs prepare to take on greater responsibility for commissioning patient services, this report provides an early warning that some are failing to handle even the most basic complaints appropriately. http://www.ombudsman.org.uk/listening-and-learning-2011/home Local Involvement Networks (LINks) annual reports 2010-11 Department of Health This report brings together information on resources, activity and outcomes from the Local Involvement Networks (LINks) annual reports of 2010/11. It includes case studies and a quantification of the value of LINks. http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidanc e/DH_130567 Making the case for public engagement Involve This toolkit demonstrates how to make the case for engagement using monetary terms. http://www.involve.org.uk/making-the-case-for-public-engagement/

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Mortality Monitoring Bulletin: update to include data for 2010 Department of Health This update includes data on life expectancy, mortality from all causes, and mortality from selected causes (cancer, all circulatory diseases, intentional self-harm (suicide) and injuries of undetermined intent and accidents). http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsStatistics/DH_130 282 Patient consent for blood transfusion Advisory Committee on the Safety of Blood Tissues and Organs (SaBTO) This report is based on a public consultation and includes recommendations for governance, the education of patients and health professionals, and other issues. http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidanc e/DH_130716 Principles for Integrated Care National Voices These 12 principles aim to ensure services work in the interests of patients, carers, service users and their families. http://www.nationalvoices.org.uk/sites/www.nationalvoices.org.uk/files/principles_for_integrate d_care_final_20111021.pdf Summary Hospital-level Mortality Indicator (SHMI): Deaths associated with hospitalisation, England, April 2010 - March 2011. Experimental Statistics. NHS Information Centre The SHMI is a ratio of the observed deaths in a trust over a period of time divided by the expected number given the characteristics of patients treated by that trust. http://www.ic.nhs.uk/statistics-and-data-collections/hospital-care/summary-hospital--levelmortality-indicator-shmi/summary-hospital-level-mortality-indicator-shmi--deaths-associatedwith-hospitalisation-england-april-2010--march-2011-experimental-statistics
Items in the Older People, Service Management and Workforce section may be of interest. [back to topics]

Pharmacy and Prescribing

Draft regulations under the Health Act 2009: Market entry by means of pharmaceutical needs assessments (PNAs) and quality and performance. Department of Health The government is seeking feedback on draft Regulations regarding market entry based on PNAs and new remedial actions, including the ability, for a PCT to remove a pharmacy or dispensing appliance contractor from its pharmaceutical list where the contractor commits a serious breach or fails to remedy past poor performance. Closing date for comments: 25 January 2012 http://www.dh.gov.uk/en/Consultations/DH_130510

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The new medicine service: a guide for GPs and other healthcare professionals Centre for Pharmacy Postgraduate Education This ca rd outlines the New Medicine Service and its main benefits. http://www.cppe.ac.uk/wizard/file/DETAILING%20CARDS/CPPE%20NMS%20Detailing%20C ard%20Sept%202011.pdf Public consultation (MLX375): Consolidation and review of UK medicines legislation Medicines and Healthcare Products Regulatory Agency The MHRA is seeking feedback on the draft consolidated medicines regulations and proposed policy changes. Consultation closing date: 17 January 2012 http://www.mhra.gov.uk/Publications/Consultations/Medicinesconsultations/MLXs/CON13205 4
Items in the Offender Health sections may also be of interest. [back to topics]

Physiotherapy
Stretched to the limit: An audit of physiotherapy services in England Chartered Society of Physiotherapy This audit argues that early access to physiotherapy services is highly cost effective and clinically effective for a wide range of patients including stroke survivors, those with musculoskeletal disorders and patients with long term conditions. http://www.csp.org.uk/documents/stretched-limit
Items in the Arthritis sections may also be of interest. [back to topics]

Public Health
Change4Life three year social marketing strategy Department of Health This companion document to Healthy Lives, Healthy People: A call to action on obesity in England describes how the social marketing programme will support the achievement of the new national obesity ambitions, as well as promoting other lifestyle changes. http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidanc e/DH_130475 Joint statement on the future of public health in England Local Government Association, British Medical Association, Faculty of Public Health, Association of Directors of Public Health, NHS Confederation and Royal College of Midwives This joint statement sets out the conclusions of these organisations joint work to date to prepare for the reform of public health in England and areas of agreement. It is intended to shape future national discussion on legislation, guidance and implementation of the reforms. http://www.local.gov.uk/c/document_library/get_file?uuid=fea12f9d-bf8f-4e84-8cf3dbd754ad9677&groupId=10161 19

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Measuring change in health care equity using small area administrative data: evidence from the English NHS 2001-8 This study developed a method for measuring change in socio-economic equity in health care utilisation using small area level administrative data. It provides more detailed information on utilisation than survey data but only examines socio-economic differences between neighbourhoods rather than individuals. The authors conclude that there was no substantial deterioration in socio-economic equity in health care utilisation in the English NHS from 2001 to 2008, and if anything, there may have been a slight improvement. http://www.york.ac.uk/media/che/documents/papers/researchpapers/CHERP67_measuring_c hange_in_health_care_equity.pdf National Diet and Nutrition Survey: headline results from years 1 and 2 (combined) of the rolling programme, 2008/09 - 2009/10; Supplementary report: Blood Analytes Department of Health The results in the main NDNS report were based on assessment of food consumption over four days. The supplementary report provides an analysis of blood samples which gives an indication of the nutritional status of the population over a longer period. The report presents descriptive statistics on a number of blood analytes including iron and vitamin D. http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsStatistics/DH_130 728 Radioactivity in Food and the Environment (RIFE) 2010 Food Standards Agency This report looks at the potential dose to consumers eating locally grown food around the UK's nuclear sites. Other dose assessments are included for consumers in areas well away from nuclear sites, where sources of naturally occurring radiation are known to contribute to the radioactivity in the general diet. The report also contains sections on radiological dose assessment methods, recently published surveys and research, current legislation and updates on national and international commitments pertinent to radiological protection. http://www.food.gov.uk/science/surveillance/radiosurv/rife/rife2010/ Social action health and well-being: building co-operatives communities: Department of Health strategic vision for volunteering Department of Health This document sets out to enhance the profile of volunteering; highlight its potential in terms of health, well-being and addressing health inequalities; and promote good practice across the health and social care system. http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidanc e/DH_130503
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NHS Library and Information Service North Staffordshire Safeguarding Children and Vulnerable Adults
The protection of children online: a brief scoping review to identify vulnerable groups Department for Education This review explores levels of intended and unintended exposure to specific risks, the impact of harm suffered by children, and the characteristics of children who may be at highest risk. https://www.education.gov.uk/publications/RSG/AllPublications/Page1/CWRC-00085-2011 Safeguarding Children Across Services: Messages from Research Department for Education The Safeguarding Children Research Initiative is an important element in the government response to the Inquiry following the death of Victoria Climbi. Its purpose is to provide a stronger evidence base for the development of policy and practice to improve the protection of children in England. This Overview focuses on the findings from this initiative, but also refers extensively to a further four important research studies that also reported during the same time period. https://www.education.gov.uk/publications/RSG/AllPublications/Page1/DFE-RR164 Briefs, including one for Health Professionals, are available at https://www.education.gov.uk/publications/RSG/AllPublications/Page1/DFE-RB164 Safeguarding children who may have been trafficked: Practice guidance Department for Education This guidance has been updated to reflect developments such as the introduction in April 2009 of the National Referral Mechanism and the duty on the UK Border Agency to safeguard and promote the welfare of children, which came into force in November 2009. https://www.education.gov.uk/publications/standard/publicationDetail/Page1/DFE-00084-2011 Safeguarding vulnerable adults: a toolkit for general practitioners BMA The toolkit highlights the obligation doctors have to protect vulnerable adults, including identifying abusers, identifying systemic healthcare failures and reporting poor performance by health professionals. It includes examples of good practice and signposts key guidance, relevant legislation and useful names and addresses. http://www.bma.org.uk/ethics/doctor_relationships/safeguardvulnerableadults.jsp
[back to topics]

Service Management
Does Hospital Competition Harm Equity? Evidence from the English National Health Service University of York. Centre for Health Economics This report looks at whether competition undermines socio-economic equity in the utilisation of care, in the context of the pro-competition reforms introduced from 2004 to 2006. http://www.york.ac.uk/media/che/documents/papers/researchpapers/CHERP66_does_hospita l_competition_harm_equity.pdf

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Focus on sustainability NHS Supply Chain This report highlights the commitment invested in sustainability and places a strong emphasis on minimising the business impact on the environment. It recognises how NHS Supply Chain works closely with customers, suppliers and employees to develop environmental best practice and improve the supply chain across the NHS. http://www.supplychain.nhs.uk/news/press-releases/2011/sustainability-report/ Hospital Estates and Facilities Statistics 2010/11 Department of Health These statistics cover a broad spectrum of information, including the size of the estate, quality of buildings, single bedroom provision, hospital cleaning and hospital food. http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsStatistics/DH_130 355 How is the NHS performing? October 2011 quarterly monitoring report Kings Fund This report aims to provide a regular update on how the NHS is coping as it grapples with the evolving reform agenda as well as the more significant challenge of making radical improvements in productivity. http://www.kingsfund.org.uk/publications/nhs_performance_oct.html Implementing a 'Duty of Candour': a new contractual requirement on providers. Proposals for consultation Department of Health The contractual Duty of Candour will be an enforceable duty on providers to ensure they are open and honest with patients or their families and provide them with information on any investigations and lessons learned. Closing date for comments: 2 January 2012 http://www.dh.gov.uk/en/Consultations/Liveconsultations/DH_130400 The NHS Constitution and Whistleblowing: consultation report Department of Health This report outlines proposed changes to the NHS Constitution following the consultation on whistleblowing. http://www.dh.gov.uk/en/Consultations/Responsestoconsultations/DH_130551 NHS Improvement: providing practical support to primary care NHS Improvement This publication demonstrates how NHS Improvement, working with GPs, practice managers, practice nurses and commissioners can help to deliver free practical service improvements across a range of different clinical areas. http://www.improvement.nhs.uk/documents/Primary_Care.pdf Personal health budgets: countdown to roll-out NHS Confederation This Briefing sets out learning from the views of local leaders, clinicians and service users and carers, and what this means for the timetable to prepare for the roll-out of personal health 22

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budgets across the country. It includes five tests to guide and inform future debate on personal health budgets, and invites contributions to finding the solutions. http://www.nhsconfed.org/Publications/briefings/Pages/Personal-health-budgets.aspx Personal health budgets: early experiences of budget holders. Fourth interim report Department of Health This report is based on interviews with 58 budget holders in the pilot about their experiences of personal health budgets after three months. http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidanc e/DH_130576 Product Pricing Project: Summary Report Department of Health This pilot benchmarking exercise examined prices paid by individual trusts for the same goods, and aims to promote greater transparency between trusts to deliver greater efficiency, as well as demonstrate the benefits of trusts sharing their pricing information. http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidanc e/DH_130375 Right to provide: your questions answered Department of Health http://healthandcare.dh.gov.uk/r2p-faqs Tailor made Demos Through interviews and focus groups with care users and staff, this pamphlet explores how person-centred services can be achieved for those who need it most those with multiple and complex needs, and in settings where personalisation is most challenging such as residential care homes and palliative care centres. http://www.demos.co.uk/publications/tailormade Use of non-geographic telephone numbers (e.g. 0845) by the NHS and GPs practices House of Commons Library This briefing looks at relevant guidance and ongoing concerns. http://www.parliament.uk/briefing-papers/SN06094
Items in the Commissioning, Mental Health and Patient Care and Safety sections may also be of interest. [back to topics]

Sexual Health
Items in the Offender Health section may also be of interest.

Smoking
Smoking statistics: Illness and death Action on Smoking and Health http://ash.org.uk/files/documents/ASH_107.pdf 23

NHS Library and Information Service North Staffordshire Substance Misuse

Drug treatment and recovery in 2010-11 National Treatment Agency for Substance Misuse This report looks at trends in treatment for substance misuse, including a significant rise in the number of illegal drug users recovering from addiction in the last year. NTA can source local and regional breakdowns of the number of people recovering from addiction on request. http://www.nta.nhs.uk/uploads/drugtreatmentandrecovery2010-11.pdf National Poisons Information Service: Annual Report 2010/2011 Health Protection Agency This report looks at common causes of poisoning and trends in requests for information about different poisons. It also looks at the availability of antidotes in different NHS Trusts. http://www.hpa.org.uk/Publications/ChemicalsPoisons/NationalPoisonsInformationServiceAnn ualReports/1110NPISAnnualreport20102011/ Novel psychoactive substances report (2011) Home Office This report is concerned with advice on the issue of novel psychoactive substances (NPS), sometimes known as 'legal highs'. NPS are drugs which mimic, or are claimed to mimic, the effects of illegal drugs. There is a common, but mistaken, perception that because such drugs are not legally controlled or banned they are safe. http://www.homeoffice.gov.uk/publications/agencies-public-bodies/acmd1/acmdnps2011
[back to topics]

Vaccination and Immunisation

Accessing the flu vaccine strategic reserve in England Department of Health This document describes the circumstances under which the national flu vaccine strategic reserve will be made available to the NHS in England and how these vaccines can be ordered through ImmForm. http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidanc e/DH_130674 Efficacy and effectiveness of influenza vaccines: a systematic review and metaanalysis Osterholm, M et al. The authors concluded that influenza vaccines can provide moderate protection against virologically confirmed influenza, but such protection is greatly reduced or absent in some seasons. Evidence for protection in adults aged 65 years or older is lacking. LAIVs consistently show highest efficacy in young children (aged 6 months to 7 years). The Lancet Infectious Diseases, Early Online Publication, 26 October 2011. doi:10.1016/S1473-3099(11)70295-X

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Immunisation against infectious disease: 'The Green Book' Department of Health Chapters on influenza and pneumococcal have been updated. http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidanc e/DH_079917 Seasonal Influenza: Healthcare Workers Vaccine Uptake Collection 2011/12 Department of Health http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidanc e/DH_130396
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Womens Health
Life Course Approach to Womens Health Care, Why Should we Consider a Royal College of Obstetricians and Gynaecologists This paper considers the rationale for a life course approach to womens health care and the implications for health service delivery. http://www.rcog.org.uk/womens-health/clinical-guidance/life-course-approachwomen%E2%80%99s-health-care-why-should-we-consider-sacWomens health in prison: Action guidance and checklists to review current policies and practices WHO Regional Office for Europe The checklists in this document are an important tool in ensuring greater safety and better quality medical care for women in prison, and are designed to assist a review of current policies and practices. http://www.euro.who.int/en/what-we-do/health-topics/health-determinants/prisons-andhealth/publications/womens-health-in-prison-action-guidance-and-checklists-to-reviewcurrent-policies-and-practices yoUr First choicE: A Review of the provision of, and access to, Uterine Artery/Fibroid Embolisation, a less invasive treatment for Fibroids for women in England The Medical Technology Group An FOI Survey shows significant variation across some PCT areas in the number of women undergoing Uterine artery / fibroid embolisation. A set of recommendations for the Government, healthcare professionals, NHS commissioners has been developed in order to address the challenges that have been identified. http://www.mtg.org.uk/go.cfm?do=Page.Show&pid=8
[back to topics]

Workforce
Consultant physicians working with patients: the duties, responsibilities and practice of physicians in medicine - 5th edition Royal College of Physicians This publication provides comprehensive information on commissioning, service organisation and standards, workforce requirements and job plans for 28 medical specialties. It is a 25

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resource for commissioners, planners, hospital trusts, specialty leads and individual doctors. It also outlines the challenges facing physicians in the NHS today, and the role of the Royal College of Physicians in supporting them. http://www.rcplondon.ac.uk/resources/publications/consultant-physicians-working-patients Consultation on the Licence to Practise and Revalidation Regulations 2012 GMC This consultation looks at the draft regulations for licensing and revalidating doctors. Closing date for comments: 21 January 2012 https://gmc.econsultation.net/econsult/consultation_Dtl.aspx?consult_Id=217&status=2&criteria=I Equality objectives and public authorities: Tips, hints, and bright ideas BRAP This guide recounts tips and strategies to help organisations develop equality schemes and policies. http://www.brap.org.uk/content/view/416/123/ Health professional mobility and health systems: evidence from 17 European countries WHO Regional Office for Europe This publication gives evidence of the nature and extent of health professional mobility in the EU, analyses its impact on country health systems and outlines some major policy strategies to address mobility. http://www.euro.who.int/en/what-we-publish/abstracts/health-professional-mobility-and-healthsystems.-evidence-from-17-european-countries New medical professionalism: A scoping report The Health Foundation This report reviews the ways in which doctors relationships with evidence, society, patients, teams, regulators and employers have changed, are changing or may need to change. It discusses the implications of these changing relationships for medical professionalism. http://www.health.org.uk/publications/new-medical-professionalism/ NHS Pay Review Body: Review for 2012 Department of Health http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidanc e/DH_130333 Professionalism in healthcare professionals Health Professions Council The report focuses on three HPC-regulated professions: chiropodists / podiatrists, occupational therapists and paramedics, and explores their understanding of what professionalism means and how it develops. The study also looks at perceptions of unprofessional behaviour as well as the contribution of standards, context and role models. http://www.hpc-uk.org/publications/research/index.asp?id=511

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A review of integrated clinical governance in the context of medical revalidation: Organisational Readiness Self Assessment (ORSA) report for the health sector in England as at 31 March 2011 NHS Revalidation Support Team This report sets out a comprehensive snapshot of the state of clinical governance and appraisal systems in the context of revalidation. http://www.revalidationsupport.co.uk/responsible_officer/responsible_officer_orsa_report.php The Review of Continuing Professional Development Consultation GMC The GMC are asking for feedback on three main areas: a framework of principles to support doctors in planning, carrying out and evaluating their CPD. incorporation of CPD guidance into local appraisal processes. identification and dissemination of information about key trends, developments in medical practice or professionalism which may be relevant to doctors future CPD needs. Closing date for comments: 27 January 2012 https://gmc.econsultation.net/econsult/consultation_Dtl.aspx?consult_Id=213&status=2&criteria=I Safety First: Mobility of Healthcare Professionals in the EU House of Lords European Union Select Committee The report concludes that mobility of healthcare professionals can bring significant benefits to patients and professionals alike. However, the Committee considers that the Mutual Recognition of Professional Qualifications Directive as it currently stands strikes the wrong balance. Competent authorities should have the ability to satisfy themselves as to the language competence of all professionals at the point of recognition. http://www.publications.parliament.uk/pa/ld201012/ldselect/ldeucom/201/20102.htm
Items in the Dentists, Health Visitors and Mental Health sections may also be of interest. [back to topics]

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