A National Prospective Service Evaluation of severe GI Bleeding Requiring Upper GI Endoscopy plus Emergency Endoscopy in under 16s

Size: px
Start display at page:

Download "A National Prospective Service Evaluation of severe GI Bleeding Requiring Upper GI Endoscopy plus Emergency Endoscopy in under 16s"

Transcription

1 A National Prospective Service Evaluation of severe GI Bleeding Requiring Upper GI Endoscopy plus Emergency Endoscopy in under 16s On behalf of the British Association of Paediatric Gastroenterology, Hepatology and Nutrition (BSPGHAN) and British Association of Paediatric Surgeons (BAPS) and JAG Investigators: Lead applicant names Role Organisation Prof Nick Croft PI QMUL & Barts Health NHS Trust QMUL, BSPGHAN Council Barts Health NHS trust Dr Ramiya Kirupananthan Clinical Fellow Barts Health NHS Trust Barts Health NHS trust Mr Chronis Kemos Investigator - Data manager and statistician QMUL Prof Mike Thomson Co-Investigator EWG, BSPGHAN Sheffield Dr David Devadason Co-investigator EWG, BSPGHAN EWG, BSPGHAN Nottingham Dr Priya Narula Co-Investigator Chair BSPGHAN EWG, Paed member on JAG Sheffield Mr Mike Stanton Co-Investigator British Association Paediatric Surgeons Southampton NHS Trust Dr Alastair Baker Co-I Paed-Hepatology representative BSPGHAN (Hepatology) Kings College Hospital Prof Siwan Gibson-Thomas Co-I JAG/BSG Northwick Park 1

2 1) Background BSPGHAN/RCPCH Standards 2017 have highlighted the need for appropriate availability of emergency upper GI endoscopy for children. Standard 4: Paediatric endoscopies must be undertaken in a child-friendly environment with appropriate facilities. In an emergency, timely access to an endoscopy must be available through clear and agreed pathways within the network. In an emergency, timely access to an endoscopy must be available through clear and agreed pathways within the network. However the provision of this service is patchy around the UK, in previous BSPGHAN audits in 2014/2015 of 200 trusts, there were about 25 paed gastro units plus 3 paed liver units of which only 33% had 24 hours rotas for on call. Of these 80% undertake <7 interventions per year for GI bleeds and 60% less than 3. So as well as having only very limited availability of on call rotas the level of exposure to and therefore expertise for managing severe GI bleeding by paediatric endoscopists is felt to be low. These are similar data to that reported in 2012 by the Toronto sick children s one of the largest Children s Hospitals in the world who over 7 years had 617 children present with GI bleeds, 20% of whom were admitted but there were only 4 interventions per year for GI bleeds. One of the key issues is that a severe bleed may present to any A&E with or without paed gastro services or adult bleeding rotas. In recent years there has been a major focus on adult emergency endoscopy rotas via JAG and the BSG but thus far the needs of under 16s have been excluded from this planning. The National Institute of Clinical Effectiveness (NICE) have published treatment guidelines for those above 16 years of age in this area and the guidance indicates intervention within 4 hours of the presentation of an adult with an upper GI bleed as the ideal. The absolute lack of data on the incidence of the problem in children is significant and extrapolation of practice in adults is unhelpful. In order to sensibly plan for services we need some reliable data about incidence of these most severe bleeds but also the needs for emergency endoscopy for other indications. To do this requires a collaborative study include paed surgeons, paed gastro, paed gastro SPIN and adult gastro. This will also be unique and important data in literature and worthy of publication in its own right. 2) Aims and Objectives Identify the services available for emergency endoscopy in under 16s across the UK, include expertise and training of individuals in the unit. Prospectively estimate the incidence of severe GI bleeds in under 16s requiring endoscopy Estimate the incidence (and indications for) other emergency upper GI endoscopy in under 16s. Examine the 1 month outcomes of these patients Examine variation in indications for emergency endoscopy across the UK 2

3 Establish a network for system for future online studies for paediatric endoscopy in the UK. 3) Methods Summary: Using openly available software Redcap we will design and undertake a prospective 6 month survey across the UK. At the outset a short survey will collect data on the availability and provision of services with reference to the BSPGHAN RCPCH standards. This will include collecting denominator data for each centre to allow estimates of incidence. This methodology is already being used at QMUL for a pan- European safety survey in paediatric IBD and so is easily translated to this project. CRFs for the cases will be designed and set up in Redcap. No patient identifiable information will be collected. 1. Case definitions: a. Inclusion criteria i. <16 years of age at the time of the endoscopy AND either b. Exclusion criteria 2. Collaborators 1. Upper GI bleed requiring endoscopy (ie with signficant haematemesis/melaena/other suspicion of upper GI bleed) OR 2. Urgent upper GI endoscopy performed for other reasons (eg foreign body) (defined as performed within 24 hours of the event leading to the procedure) i. Routine or semi elective endoscopy delayed but done for convenience on ii. out of hours (eg waiting list initiatives) While we aim to include all the paed gastro & hepatology units (20-25) plus most of the paed surgical units we would not expect to cover 100% of the UK. Quality and reliability of data from each centre is more important than universal coverage. We will gather a range of large tertiary units, stand-alone children s or within the adult hospitals, plus DGHs. In order to gather data on emergency endoscopies in under 16s we propose to include adult GI lead in collaboration with JAG. The following leads will be identified but may delegate to a specified person (eg trainee) in each unit. This will depend on the local arrangements and be agreed before data is collected. 1. A lead for each paed gastro/liver centre performing endoscopy will be identified and will take responsibility for ensuring all cases are reported in their centre. 3

4 2. A Paed Surgical lead will be identified for each paed surgical centre 3. Adult endoscopy leads for adult GI unit (identified via JAG) will be asked to report any emergency endoscopies performed in under 16 year olds in their units during this period. It is expected that these numbers will be very small and should be easy for endoscopy leads to be aware of. 3. Ethics a. This will be a service evaluation as defined by NRES and no patient identifiable information will be collected so it is expected ethical approval is not required, this will be clarified before the start of the project. 4. Data Online forms will be developed using REDCap hosted at QMUL. a. Initial online survey (takes about 15 minutes to complete) will be performed to get basic data on the centre, networking arrangements and facilities (facilities, staffing, rota s). This will be designed to examine the relevant BSPGHAN and JAG/GRS standards. This will include denominator (referral population of the unit) data using a web based system already set up in Queen Mary, University of London. i. The denominator data will collect details of the population that the endoscopy unit covers, The forms will be designed in accordance to the denominator forms used already in another project *. This system has been used successfully already, several responders are likely expected to be familiar with it. In addition, this approach will allow direct comparisons (and/or combinations of) data between the different areas and the Eurostat datasets. b. Once the collaborators have been identified and confirmed they are willing to participate a fortnightly will be sent asking if there have been any endoscopies fitting the defined criteria, initially all that is required is a yes/no answer. If they answer is yes then they will be asked to complete a short on line CRF for each patient. If no no other response action is required but the negative response is important. For the adult units it is expected no will be the vast majority. This is the system used by the BPSU across all paediatricians which gets a roughly 90% response rate to the s. c. The electronic case record form will be finalised over the first 2 months of the project if the recipient of the reports yes then this will be completed To include a. Venue of the initial bleed and where first seen by medic b. Initial Clinical Data and management including o age, sex, medication 4

5 o Presenting symptoms o Sheffield score o HR/BP o Need for boluses / transfusion (Y/N then ml/kg); o Presenting and follow up Hb levels; clotting screens if done, platelets o Need for other medications to combat blood loss before endoscopy (Y/N and details of meds); o Previous personal history of liver disease or GI bleeding. o Family history of GI bleeding diseases or coagulation problems; c. Details of any transfers (including timing of initial communications and transfers) d. Details of the endoscopy o Timing o source of referral o Location o Macroscopic findings o Endoscopic intervention where this was required. o Grade/ background of endoscopist(s) involved i. Case outcome at 28 days will be recorded. Including any consequent morbidity or mortality, and any need for repeat endoscopy or surgical intervention. 4) Plan of project Before starting confirm via NRES / Trust Audit office this is a Service Evaluation, if IRAS application required will add at least 4 months to the study a. Months 1-3 b. Months 3-10 c. Months 9-12 ii. Design initial survey form (against BSPGHAN/JAG standards) for current facilities and denominator data iii. Identify all collaborators, gain their agreement to participate iv. Design CRF for data collection v. Test sending fortnightly vi. Send fortnightly to all investigators over a 7 month period, if endoscopy reported then connect the collaborators to the e-crf for completion. Reminders if no response will be automatically sent out vii. Data cleansing throughout viii. Data cleansing and lock down 5

6 ix. Statistical analysis and estimations of incidence and prevalence The incidence will be calculated and analysed using the Poisson distribution. The collected data will meet the Poisson postulates ** and therefore justify formal application of the Poisson distribution. The Poisson parameter will be calculated and subsequently interpreted as the incidence rate multiplied by the person-time. Depending on the sample size, we will also calculate, 'exact' confidence limits, and where the size of the cohort allows it, approximate confidence limits based on the Gaussian approximation to the Poisson distribution. x. Drafting of abstracts and papers * Classification of Territorial Units for Statistics established by Eurostat **Since we can assume that the severe GI bleeding occurs independently in different patients and in the same patient at different time points as well as that the likelihood that a new case will occur in a short period is proportional to the number of people, and that disease risks are homogeneous across people and time for patient with similar characteristics. 5) Finances required and roles 12,000 (6000 BSPGHAN and 6000 BAPS) This pays for one day a week of data manager and statistical support for one year who will: Support the overall project, assist with any ethics/other approvals Assist in the development design of the Web based case report form (within Redcap), Set up Redcap (based in QMUL), test and ensure data entry is reliable Set up sites (individuals) to access the web entry site and trouble shoot if problems Develop some simple training materials Set up and run the survey with reminders to ensure completion of data Cleanse and finalise data throughout (with queries etc) Report on the data quality and completeness monthly to feed back to each site With Dr Croft statistical analysis of the data once cleansed Unfunded time at Barts/QMUL/collaborating sites Clinical fellow With Prof Croft and the collaborators the clinical fellow will help coordinate and identify the centres and the leads in each centre Ensure approvals as required in place Support the design of the CRF in collaboration with the database manager and the above collaborators 6

7 Data entry at Barts Health With database manger design the Help draft abstracts/papers 6) Final Comments This proposal has been extensively reviewed and has provisional support from many people and will generate new prospective data of a kind not published before but of great importance in planning our endoscopy services for the future. This project will not be eligible for the NIHR portfolio (and therefore support from the CRN), so each site/collaborator will have to commit to ensuring completeness of data from their unit, how they do this will be up to them, we envisage most sites would have 2 people leading but larger ones may have more. For this reason the study has been made only over 6 months as we hope the amount of patients will not be unmanageable and we will ensure in the design the data collection is as quick and easy as is possible. This will also set a template with the potential for taking other similar projects nationally as once the systems and contacts are set up then it would seem advisable to use them for other studies of importance 7

Paediatric Gastroenterology, Hepatology and Nutrition (PGHAN) Taster Day

Paediatric Gastroenterology, Hepatology and Nutrition (PGHAN) Taster Day Page1 Paediatric Gastroenterology, Hepatology and Nutrition (PGHAN) Taster Day Friday, June 15th 2018, Postgraduate Centre, Queen s Medical Centre, Nottingham This Taster Day in June 2018 will provide

More information

Paper for the Health Board Quality and Safety Committee. Out of Hours Upper GI Haemorrhage

Paper for the Health Board Quality and Safety Committee. Out of Hours Upper GI Haemorrhage Paper for the Health Board Quality and Safety Committee Out of Hours Upper GI Haemorrhage This short paper describes the current pathways within the Health Board for the management of out of hours emergency

More information

Data, analysis and evidence

Data, analysis and evidence 1 New Congenital Heart Disease Review Data, analysis and evidence Joanna Glenwright 2 New Congenital Heart Disease Review Evidence for standards Joanna Glenwright Evidence to inform the service standards

More information

Specialised Services Service Specification: Inherited Bleeding Disorders

Specialised Services Service Specification: Inherited Bleeding Disorders Specialised Services Service Specification: Inherited Bleeding Disorders Document Author: Assistant Specialised Services Planner Cardiac and Cancer Specialised Services Planner Cancer and Blood Executive

More information

Retrospective Chart Review Studies

Retrospective Chart Review Studies Retrospective Chart Review Studies Designed to fulfill requirements for real-world evidence Retrospective chart review studies are often needed in the absence of suitable healthcare databases and/or other

More information

ENDOSCOPY NURSE LED CONSENT PROCESS

ENDOSCOPY NURSE LED CONSENT PROCESS ENDOSCOPY NURSE LED CONSENT PROCESS Date issued January 2011 Reviewed By Next Review August 2012 Responsible H Chisholm C/N G Greenhill, C/N Halcrow, C/N Chisholm Contents Guideline Content 1.0 Introduction

More information

British Society of Gastroenterology. St. Elsewhere's Hospital. National Comparative Audit of Blood Transfusion

British Society of Gastroenterology. St. Elsewhere's Hospital. National Comparative Audit of Blood Transfusion British Society of Gastroenterology UK Com parat ive Audit of Upper Gast roint est inal Bleeding and t he Use of Blood December 2007 St. Elsewhere's National Comparative Audit of Blood Transfusion Acknowledgements

More information

Potential challenges when assessing organisational processes for assurance of clinical competence in labs with limited clinical staff resource

Potential challenges when assessing organisational processes for assurance of clinical competence in labs with limited clinical staff resource Contents 1. Introduction... 1 2. Examples of Clinical Activity... 2 3. Automatic selection and reporting... 3 Appendix 1... 8 Appendix 2... 9 1. Introduction ISO 15189 is necessarily written such that

More information

Teaching and Training for Hepatitis C Consultants (2009)

Teaching and Training for Hepatitis C Consultants (2009) Teaching and Training for Hepatitis C Consultants (2009) Authors Dr Katy Harrison Research Fellow, University of Manchester Angela Pilkington Project Assistant, University of Manchester. Date: 4 November

More information

05/04/2016. Joint Advisory Group on GI Endoscopy 2015 GRS Census Analysis of Responses

05/04/2016. Joint Advisory Group on GI Endoscopy 2015 GRS Census Analysis of Responses 05/04/2016 Joint Advisory Group on GI Endoscopy 2015 GRS Census Analysis of Responses Background Annual Census of Endoscopy Units Conducted during April and May 2015 477 units invited to participate. Note

More information

British Society for Surgery of the Hand. (BSSH) Evidence for Surgical

British Society for Surgery of the Hand. (BSSH) Evidence for Surgical British Society for Surgery of the Hand (BSSH) Evidence for Surgical Treatment (B.E.S.T.) Process Manual 1 st Edition (12 th version, November 2016) Review Date: November 2019 BSSH Evidence for Surgical

More information

HEE CLINICAL ENDOSCOPIST TRAINING PROGRAMME

HEE CLINICAL ENDOSCOPIST TRAINING PROGRAMME HEE CLINICAL ENDOSCOPIST TRAINING PROGRAMME PLANNING FOR A SUCCESSFUL APPLICATION AND PROGRAMME COMPLETION FOR TRAINING OCTOBER 2017-APRIL 2018. Organisational support The pilot programme and cohorts to

More information

NHS Pathways and Directory of Services

NHS Pathways and Directory of Services NHS Pathways and Directory of Services Core Narrative Purpose The NHS Pathways and the Directory of Services core narrative has been designed to support NHS communications leads and/or project managers

More information

Organisational factors that influence waiting times in emergency departments

Organisational factors that influence waiting times in emergency departments ACCESS TO HEALTH CARE NOVEMBER 2007 ResearchSummary Organisational factors that influence waiting times in emergency departments Waiting times in emergency departments are important to patients and also

More information

Executive Summary 10 th September Dr. Richard Wagland. Dr. Mike Bracher. Dr. Ana Ibanez Esqueda. Professor Penny Schofield

Executive Summary 10 th September Dr. Richard Wagland. Dr. Mike Bracher. Dr. Ana Ibanez Esqueda. Professor Penny Schofield Experiences of Care of Patients with Cancer of Unknown Primary (CUP): Analysis of the 2010, 2011-12 & 2013 Cancer Patient Experience Survey (CPES) England. Executive Summary 10 th September 2015 Dr. Richard

More information

How NICE clinical guidelines are developed

How NICE clinical guidelines are developed Issue date: January 2009 How NICE clinical guidelines are developed: an overview for stakeholders, the public and the NHS Fourth edition : an overview for stakeholders, the public and the NHS Fourth edition

More information

UK Inflammatory Bowel Disease Audit 3rd Round

UK Inflammatory Bowel Disease Audit 3rd Round UK Inflammatory Bowel Disease Audit 3rd Round Report of the results for the national organisational audit of paediatric inflammatory bowel disease services in the UK Prepared by the The UK IBD Audit Steering

More information

UK Cystic Fibrosis Registry. Data sharing policy

UK Cystic Fibrosis Registry. Data sharing policy UK Cystic Fibrosis Registry Data sharing policy 1 Contents Introduction... 3 The UK Cystic Fibrosis Registry... 3 Governance... 3 Purpose... 3 Scope... 4 Policy... 4 Submitting a request... 4 Quality control...

More information

European network of paediatric research (EnprEMA)

European network of paediatric research (EnprEMA) 17 February 2012 EMA/77450/2012 Human Medicines Development and Evaluation Recognition criteria for self assessment The European Medicines Agency is tasked with developing a European paediatric network

More information

National clinical audit of inpatient care for adults with ulcerative colitis

National clinical audit of inpatient care for adults with ulcerative colitis National clinical audit of inpatient care for adults with ulcerative colitis UK inflammatory bowel disease (IBD) audit Executive summary report June 2014 Prepared by the Clinical Effectiveness and Evaluation

More information

The Northern Ireland Clinical Research Network. Guidance Document

The Northern Ireland Clinical Research Network. Guidance Document The Northern Ireland Clinical Research Network Guidance Document Document Page NICRN Steering Committee Terms of Reference 2 NICRN Clinical Management Group Terms of Reference 4 NICRN Clinical Lead Role

More information

POPULATING SERVICE DELIVERY MODELS USING OBSERVATIONAL REPORT FOR THE GUIDELINES TECHNICAL SUPPORT UNIT

POPULATING SERVICE DELIVERY MODELS USING OBSERVATIONAL REPORT FOR THE GUIDELINES TECHNICAL SUPPORT UNIT POPULATING SERVICE DELIVERY MODELS USING OBSERVATIONAL DATA: CASE STUDY ON ENDOSCOPY PROVISION FOR ACUTE UPPER GASTROINTESTINAL BLEEDING REPORT FOR THE GUIDELINES TECHNICAL SUPPORT UNIT 23rd July 2013

More information

Neurosurgery. Themes. Referral

Neurosurgery. Themes. Referral 06 04 Neurosurgery The following recommendations were produced by the British Society of Neurological Surgeons to highlight where resources could be released in NHS neurological services, while maintaining

More information

Public Health Skills and Career Framework Multidisciplinary/multi-agency/multi-professional. April 2008 (updated March 2009)

Public Health Skills and Career Framework Multidisciplinary/multi-agency/multi-professional. April 2008 (updated March 2009) Public Health Skills and Multidisciplinary/multi-agency/multi-professional April 2008 (updated March 2009) Welcome to the Public Health Skills and I am delighted to launch the UK-wide Public Health Skills

More information

Safe Staffing in Community Services

Safe Staffing in Community Services Safe Staffing in Community Services Dr Louise Thomson Laura Dunk Laurie Hare Duke Report presented to Lincolnshire Partnership NHS Foundation Trust October 2014 1. Introduction This report describes a

More information

STANDARD OPERATING PROCEDURE

STANDARD OPERATING PROCEDURE STANDARD OPERATING PROCEDURE Title Reference Number Sponsorship SOP-RES-001 Version Number 3 Issue Date 29 th Sep 2016 Effective Date 10 th Nov 2016 Review Date 10 th Nov 2018 Author(s) Reviewer(s) Teresa

More information

Department of Health. Managing NHS hospital consultants. Findings from the NAO survey of NHS consultants

Department of Health. Managing NHS hospital consultants. Findings from the NAO survey of NHS consultants Department of Health Managing NHS hospital consultants Findings from the NAO survey of NHS consultants FEBRUARY 2013 Contents Introduction 4 Part One 5 Survey methodology 5 Part Two 9 Consultant survey

More information

Frequently Asked Questions (FAQ) Updated September 2007

Frequently Asked Questions (FAQ) Updated September 2007 Frequently Asked Questions (FAQ) Updated September 2007 This document answers the most frequently asked questions posed by participating organizations since the first HSMR reports were sent. The questions

More information

NHS SERVICE DELIVERY AND ORGANISATION R&D PROGRAMME

NHS SERVICE DELIVERY AND ORGANISATION R&D PROGRAMME NHS SERVICE DELIVERY AND ORGANISATION R&D PROGRAMME PROGRAMME OF RESEARCH ON ACCESS TO HEALTH CARE A Empirical studies to evaluate innovations to improve access repeat call B Empirical study of priority

More information

Advanced Professional Module Clinical Research (2016) Approved by GMC on 14 July 2016 and launched September 2016

Advanced Professional Module Clinical Research (2016) Approved by GMC on 14 July 2016 and launched September 2016 Advanced Professional Module Clinical Research (2016) Approved by GMC on 14 July 2016 and launched September 2016 Anchor Statement To define the skills that a Consultant Obstetrician/ Gynaecologist requires,

More information

Experience of inpatients with ulcerative colitis throughout

Experience of inpatients with ulcerative colitis throughout Experience of inpatients with ulcerative colitis throughout the UK UK inflammatory bowel disease (IBD) audit Executive summary report June 2014 Prepared by the Clinical Effectiveness and Evaluation Unit

More information

Clinical Practice Guideline Development Manual

Clinical Practice Guideline Development Manual Clinical Practice Guideline Development Manual Publication Date: September 2016 Review Date: September 2021 Table of Contents 1. Background... 3 2. NICE accreditation... 3 3. Patient Involvement... 3 4.

More information

NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE. Interim Process and Methods of the Highly Specialised Technologies Programme

NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE. Interim Process and Methods of the Highly Specialised Technologies Programme NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE Principles Interim Process and Methods of the Highly Specialised Technologies Programme 1. Our guidance production processes are based on key principles,

More information

Best Practice Tariff: Early Inflammatory Arthritis

Best Practice Tariff: Early Inflammatory Arthritis Best Practice Tariff: Early Inflammatory Arthritis Dear colleague, The Payment by Results team at the Department of Health has recently issued the 2013-14 road test package for comment. The purpose of

More information

2017/18 and 2018/19 National Tariff Payment System Annex E: Guidance on currencies without national prices. NHS England and NHS Improvement

2017/18 and 2018/19 National Tariff Payment System Annex E: Guidance on currencies without national prices. NHS England and NHS Improvement 2017/18 and 2018/19 National Tariff Payment System Annex E: Guidance on currencies without national prices NHS England and NHS Improvement December 2016 Contents 1. Introduction... 3 2. Critical care adult

More information

Process and methods Published: 23 January 2017 nice.org.uk/process/pmg31

Process and methods Published: 23 January 2017 nice.org.uk/process/pmg31 Evidence summaries: process guide Process and methods Published: 23 January 2017 nice.org.uk/process/pmg31 NICE 2018. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and-conditions#notice-ofrights).

More information

Clinical NURSE. Specialist SURVEY

Clinical NURSE. Specialist SURVEY Clinical NURSE Specialist SURVEY RESULTS SUMMARY MAY 2 rk? o w ou y o ed r ew e i h v e W r ou y do nts? e r e e Wh r pati tle? i t you job u o is y t ase a e h s i W of d th? s a re k wi a t r a Wh ou

More information

R. Fay, Research Governance & GCP Manager K. Mahiouz, Clinical Trials Facilitator E. Clough, R&D Governance Operations Manager

R. Fay, Research Governance & GCP Manager K. Mahiouz, Clinical Trials Facilitator E. Clough, R&D Governance Operations Manager Standard Operating Procedures (SOP) for: BH/QMUL Sponsorship of CTIMPs, ATMPs and Clinical Trials of non- CE marked Medicinal Devices Process for Researchers SOP Number: 11a Version Number: V1.0 Effective

More information

The UK Rehabilitation Outcome Collaborative (UKROC) Database

The UK Rehabilitation Outcome Collaborative (UKROC) Database The UK Rehabilitation Outcome Collaborative (UKROC) Database September 2016 Further information and advice may be obtained from: Professor Lynne Turner-Stokes DM FRCP Regional Hyper acute Rehabilitation

More information

NHS. The guideline development process: an overview for stakeholders, the public and the NHS. National Institute for Health and Clinical Excellence

NHS. The guideline development process: an overview for stakeholders, the public and the NHS. National Institute for Health and Clinical Excellence NHS National Institute for Health and Clinical Excellence Issue date: April 2007 The guideline development process: an overview for stakeholders, the public and the NHS Third edition The guideline development

More information

#NeuroDis

#NeuroDis Each and Every Need A review of the quality of care provided to patients aged 0-25 years old with chronic neurodisability, using the cerebral palsies as examples of chronic neurodisabling conditions Recommendations

More information

Job Planning Driving Improvement Ensuring success for consultants, the service and for improved patient care

Job Planning Driving Improvement Ensuring success for consultants, the service and for improved patient care Job Planning Driving Improvement Ensuring success for consultants, the service and for improved patient care Dr Jeremy Cashman Associate Medical Director Delivering successful job planning The 2003 contract

More information

Scottish Hospital Standardised Mortality Ratio (HSMR)

Scottish Hospital Standardised Mortality Ratio (HSMR) ` 2016 Scottish Hospital Standardised Mortality Ratio (HSMR) Methodology & Specification Document Page 1 of 14 Document Control Version 0.1 Date Issued July 2016 Author(s) Quality Indicators Team Comments

More information

Acutely ill patients in hospital

Acutely ill patients in hospital Issue date: July 2007 Acutely ill patients in hospital Recognition of and response to acute illness in adults in hospital Developed by the Centre for Clinical Practice at NICE Contents Key priorities for

More information

Review of Local Enhanced Services

Review of Local Enhanced Services Review of Local Enhanced Services 1. Background and context 1.1 CCGs are required to prepare for the phasing out of LESs by April 2014 by reviewing the existing LES portfolio and developing commissioning

More information

Final Accreditation Report

Final Accreditation Report Guidance producer: Healthcare Infection Society Guidance product: Clinical Guidelines Date: 23 March 2015 Version: 1.6 Final Accreditation Report Page 1 of 19 Contents Introduction... 3 Accreditation recommendation...

More information

The British Society of Haematology and NIHR Clinical Research Network Award scheme to recognise NHS consultants and trainees active in research

The British Society of Haematology and NIHR Clinical Research Network Award scheme to recognise NHS consultants and trainees active in research The British Society of Haematology and NIHR Clinical Research Network Award scheme to recognise NHS consultants and trainees active in research Please send completed applications to ian.nickson@nihr.ac.uk

More information

Evaluation of the Threshold Assessment Grid as a means of improving access from primary care to mental health services

Evaluation of the Threshold Assessment Grid as a means of improving access from primary care to mental health services Evaluation of the Threshold Assessment Grid as a means of improving access from primary care to mental health services Report for the National Co-ordinating Centre for NHS Service Delivery and Organisation

More information

NHS. Challenges and improvements in diagnostic services across seven days. Improving Quality

NHS. Challenges and improvements in diagnostic services across seven days. Improving Quality NHS Improving Quality NHS Improving Quality working in partnership with NHS England Challenges and improvements in diagnostic services across seven days 2 Foreword Across the country, hospitals and primary

More information

ROLE OF OUT-OF-HOURS NURSE CO-ORDINATORS IN A CHILDREN S HOSPITAL

ROLE OF OUT-OF-HOURS NURSE CO-ORDINATORS IN A CHILDREN S HOSPITAL Art & science The synthesis of art and science is lived by the nurse in the nursing act JOSEPHINE G PATERSON ROLE OF OUT-OF-HOURS NURSE CO-ORDINATORS IN A CHILDREN S HOSPITAL Amy Hensman and colleagues

More information

Schedule C1. Community Pharmacy Anti-Coagulation Management Services

Schedule C1. Community Pharmacy Anti-Coagulation Management Services Schedule C1 Community Pharmacy Anti-Coagulation Management Services 1. Definition This service specification relates to the anticoagulation management of Service Users on warfarin by an accredited community

More information

European network of paediatric research (EnprEMA)

European network of paediatric research (EnprEMA) 20 December 2010 EMA/770017/2010 Human Medicines Development and Evaluation Recognition criteria for self assessment The European Medicines Agency is tasked with developing a European paediatric network

More information

National clinical audit of inpatient care for adults with ulcerative colitis

National clinical audit of inpatient care for adults with ulcerative colitis National clinical audit of inpatient care for adults with ulcerative colitis UK inflammatory bowel disease (IBD) audit IBD165 University Hospital of North Durham June 2014 Prepared by the Clinical Effectiveness

More information

Nurse Led Follow Up: Is It The Best Way Forward for Post- Operative Endometriosis Patients?

Nurse Led Follow Up: Is It The Best Way Forward for Post- Operative Endometriosis Patients? Research Article Nurse Led Follow Up: Is It The Best Way Forward for Post- Operative Endometriosis Patients? R Mallick *, Z Magama, C Neophytou, R Oliver, F Odejinmi Barts Health NHS Trust, Whipps Cross

More information

Portsmouth Hospitals NHS Trust Individual Placement (Job) Descriptions for Foundation Year 1

Portsmouth Hospitals NHS Trust Individual Placement (Job) Descriptions for Foundation Year 1 Portsmouth Hospitals NHS Trust Individual Placement (Job) Descriptions for Foundation Year 1 Placement The department Where the is for the in this F1 Acute Placement Acute Medicine Unit/Surgical Assessment

More information

National Institute for Health Research Coordinated System for gaining NHS Permission (NIHR CSP)

National Institute for Health Research Coordinated System for gaining NHS Permission (NIHR CSP) National Institute for Health Research Coordinated System for gaining NHS Permission (NIHR CSP) Operating Manual Please check the CCRN Portal for the latest version. Version: 5.2 Status: Consultation in

More information

Nutritional Care Tool Report 2017

Nutritional Care Tool Report 2017 Nutritional Care Tool Report 2017 A Report by the BAPEN Quality and Safety Committee Dr Ailsa Brotherton, Kate Cheema, Anne Holdoway, Vera Todorovic and Professor Mike Stroud On behalf of the Quality and

More information

The Royal Infirmary of Edinburgh. Endoscopy Operational Policy

The Royal Infirmary of Edinburgh. Endoscopy Operational Policy The Royal Infirmary of Edinburgh Endoscopy Operational Policy Date issued 1 st November 2009 Reviewed Next Review August 2012 Responsible H Chisholm K Trimble/N Church/H Chisholm 9/2011 1 INTRODUCTION

More information

Paediatric Cardiac and Adult Congenital Heart Disease Compliance Assessment. University Hospitals of Leicester NHS Trust. 7 th November 2016

Paediatric Cardiac and Adult Congenital Heart Disease Compliance Assessment. University Hospitals of Leicester NHS Trust. 7 th November 2016 Paediatric Cardiac and Adult Congenital Heart Disease Compliance Assessment University Hospitals of Leicester NHS Trust 7 th November 2016 University Hospitals of Leicester NHS Trust welcomes the opportunity

More information

The non-executive director s guide to NHS data Part one: Hospital activity, data sets and performance

The non-executive director s guide to NHS data Part one: Hospital activity, data sets and performance Briefing October 2017 The non-executive director s guide to NHS data Part one: Hospital activity, data sets and performance Key points As a non-executive director, it is important to understand how data

More information

Version 2 15/12/2013

Version 2 15/12/2013 The METHOD study 1 15/12/2013 The Medical Emergency Team: Hospital Outcomes after a Day (METHOD) study Version 2 15/12/2013 The METHOD Study Investigators: Principal Investigator Christian P Subbe, Consultant

More information

Physiotherapy outpatient services survey 2012

Physiotherapy outpatient services survey 2012 14 Bedford Row, London WC1R 4ED Tel +44 (0)20 7306 6666 Web www.csp.org.uk Physiotherapy outpatient services survey 2012 reference PD103 issuing function Practice and Development date of issue March 2013

More information

Appendix 6 1 Emergency Radiological Interventions 6

Appendix 6 1 Emergency Radiological Interventions 6 Non vascular Standard Operating Procedure to Request Out of Hours Classification: SOP Lead Author: Dr. J Carlin, Consultant Radiologist Additional author(s): Jonathon Priestley, Radiology Business Manager

More information

PARTICULARS, SCHEDULE 2 THE SERVICES, A Service Specification. 12 months

PARTICULARS, SCHEDULE 2 THE SERVICES, A Service Specification. 12 months E09/S(HSS)/b 2013/14 NHS STANDARD CONTRACT FOR VEIN OF GALEN MALFORMATION SERVICE (ALL AGES) PARTICULARS, SCHEDULE 2 THE SERVICES, A Service Specification Service Specification No. Service Commissioner

More information

Document Title: GCP Training for Research Staff. Document Number: SOP 005

Document Title: GCP Training for Research Staff. Document Number: SOP 005 Document Title: GCP Training for Research Staff Document Number: SOP 005 Version: 2 Ratified by: Version 2, 04/10/2017 Page 1 of 13 Committee Date ratified: 26/10/2017 Name of originator/author: Directorate:

More information

Post-operative and Discharge Pathways for PBM Claire L J Atterbury CNS Transfusion and Haematology

Post-operative and Discharge Pathways for PBM Claire L J Atterbury CNS Transfusion and Haematology Post-operative and Discharge Pathways for PBM Claire L J Atterbury CNS Transfusion and Haematology 1 Plan for the worst and hope for the best claire.atterbury@qehkl.nhs.uk 2 Where were we? What year? The

More information

Methods: National Clinical Policies

Methods: National Clinical Policies Methods: National Clinical Policies Choose an item. NHS England INFORMATION READER BOX Directorate Medical Operations and Information Specialised Commissioning Nursing Trans. & Corp. Ops. Commissioning

More information

Review of Children And Young People s Private Hospital Facilities in England

Review of Children And Young People s Private Hospital Facilities in England March 2016 Independent Report on Paediatric Facilities in the Private Sector Review of Children And Young People s Private Hospital Facilities in England Sponsored by 1. INTRODUCTION This report sets out

More information

Familial Hypercholesterolaemia Quality Improvement Tool Instruction Guide

Familial Hypercholesterolaemia Quality Improvement Tool Instruction Guide Familial Hypercholesterolaemia Quality Improvement Tool Instruction Guide PRIMIS development of this tool was part supported by independent funding from Amgen. Prepared by PRIMIS January 2017 The University

More information

*** Q1: What is NIHR Research Capability Funding?

*** Q1: What is NIHR Research Capability Funding? RCF FAQs (revised March 2017) Q1: What is NIHR Research Capability Funding? Q2: Which organisations will receive NIHR RCF? Q3: How can an organisation qualify for and receive NIHR RCF? Q4: How much NIHR

More information

Facing the Future: Standards for Paediatric Services. April 2011

Facing the Future: Standards for Paediatric Services. April 2011 Facing the Future: Standards for Paediatric Services April 2011 Facing the Future: Standards for Paediatric Services April 2011 (First Published December 2010 and amended by RCPCH Council March 2011) 2011

More information

Executive Summary. This Project

Executive Summary. This Project Executive Summary The Health Care Financing Administration (HCFA) has had a long-term commitment to work towards implementation of a per-episode prospective payment approach for Medicare home health services,

More information

NIHR Funding Opportunities

NIHR Funding Opportunities NIHR Funding Opportunities David King Newcastle 12 th May, 2008 Consultation 2005 New Government Strategy 2006 Best for Best Health Vision To create a health research system in which the NHS: supports

More information

General practitioner workload with 2,000

General practitioner workload with 2,000 The Ulster Medical Journal, Volume 55, No. 1, pp. 33-40, April 1986. General practitioner workload with 2,000 patients K A Mills, P M Reilly Accepted 11 February 1986. SUMMARY This study was designed to

More information

Colorectal Straight To Test Pathway for 2 week wait referrals. Harriet Watson, Colorectal Consultant Nurse

Colorectal Straight To Test Pathway for 2 week wait referrals. Harriet Watson, Colorectal Consultant Nurse Colorectal Straight To Test Pathway for 2 week wait referrals Harriet Watson, Colorectal Consultant Nurse 1 Background Traditional 2WW model Outpatient clinic within day 14 20 minute appointment but usually

More information

GUIDANCE ON SUPPORTING INFORMATION FOR REVALIDATION FOR SURGERY

GUIDANCE ON SUPPORTING INFORMATION FOR REVALIDATION FOR SURGERY ON SUPPORTING INFORMATION FOR REVALIDATION FOR SURGERY Based on the Academy of Medical Royal Colleges and Faculties Core Guidance for all doctors GENERAL INTRODUCTION JUNE 2012 The purpose of revalidation

More information

NAME SPECIALTY PLEASE NOTE THAT THE CONSULTANT SURGEONS RUN A 4 WEEK ROLLING ROTA OF ACTIVITY. (HENCE THE 'BUSY' JOB PLAN)

NAME SPECIALTY PLEASE NOTE THAT THE CONSULTANT SURGEONS RUN A 4 WEEK ROLLING ROTA OF ACTIVITY. (HENCE THE 'BUSY' JOB PLAN) CONSULTANT CONTRACT JOB PLAN NAME SPECIALTY PLEASE NOTE THIS IS INTENDED AS A GUIDE ONLY. AN FORMAL JOB PLAN WILL BE DEVISED WITH THE SUCCESFUL CANDIDATE TO TAKE ACCOUNT OF PERSONAL INTERESTS AND SPECIALTY

More information

Hospital Generated Inter-Speciality Referral Policy Supporting people in Dorset to lead healthier lives

Hospital Generated Inter-Speciality Referral Policy Supporting people in Dorset to lead healthier lives NHS Dorset Clinical Commissioning Group Hospital Generated Inter-Speciality Referral Policy Supporting people in Dorset to lead healthier lives PREFACE This Document outlines the CCG s policy in respect

More information

Policy Summary. Policy Title: Policy and Procedure for Clinical Coding

Policy Summary. Policy Title: Policy and Procedure for Clinical Coding Policy Title: Policy and Procedure for Clinical Coding Reference and Version No: IG7 Version 6 Author and Job Title: Caroline Griffin Clinical Coding Manager Executive Lead - Chief Information and Technology

More information

Patient Reported Outcome Measures Frequently Asked Questions (PROMs FAQ)

Patient Reported Outcome Measures Frequently Asked Questions (PROMs FAQ) Patient Reported Outcome Measures Frequently Asked Questions (PROMs FAQ) Author: Secondary Care Analysis (PROMs), NHS Digital Responsible Statistician: Jane Winter 1 Copyright 2016 Health and Social Care

More information

Quality Surveillance Team. Neonatal Critical Care (NCC) Quality Indicators

Quality Surveillance Team. Neonatal Critical Care (NCC) Quality Indicators Quality Surveillance Team Neonatal Critical Care (NCC) Quality Indicators Neonatal Critical Care Quality Indicators Introduction These neonatal critical care quality indicators have been developed using

More information

The costs and benefits of managing some low-priority 999 ambulance calls by NHS Direct nurse advisers

The costs and benefits of managing some low-priority 999 ambulance calls by NHS Direct nurse advisers The costs and benefits of managing some low-priority 999 ambulance calls by NHS Direct nurse advisers Report for the National Co-ordinating Centre for NHS Service Delivery and Organisation R & D (NCCSDO)

More information

A Career in Haematology in the West Midlands

A Career in Haematology in the West Midlands A Career in Haematology in the West Midlands Speciality training in Haematology Contents Haematology Overview Advantages / Disadvantages Career Pathway Examinations - FRCPath Recruitment Commitment to

More information

A Day in the LIFE of the AMU Society for Acute Medicine s Benchmarking Audit (SAMBA)

A Day in the LIFE of the AMU Society for Acute Medicine s Benchmarking Audit (SAMBA) A Day in the LIFE of the AMU Society for Acute Medicine s Benchmarking Audit (SAMBA) 2015 - Summary There is great variation in the experience of patients presenting to Hospital as Medical Emergencies.

More information

Improving the prevention, early detection and management of Acute Kidney Injury (AKI) in Wessex

Improving the prevention, early detection and management of Acute Kidney Injury (AKI) in Wessex Improving the prevention, early detection and management of Acute Kidney Injury (AKI) in Wessex The case for change AKI is recognised as a major public health and patient safety concern nationally and

More information

Staffing and Scheduling

Staffing and Scheduling Staffing and Scheduling 1 One of the most critical issues confronting nurse executives today is nurse staffing. The major goal of staffing and scheduling systems is to identify the need for and provide

More information

Utilisation Management

Utilisation Management Utilisation Management The Utilisation Management team has developed a reputation over a number of years as an authentic and clinically credible support team assisting providers and commissioners in generating

More information

London, Brunei Gallery, October 3 5, Measurement of Health Output experiences from the Norwegian National Accounts

London, Brunei Gallery, October 3 5, Measurement of Health Output experiences from the Norwegian National Accounts Session Number : 2 Session Title : Health - recent experiences in measuring output growth Session Chair : Sir T. Atkinson Paper prepared for the joint OECD/ONS/Government of Norway workshop Measurement

More information

Enhanced service specification. Avoiding unplanned admissions: proactive case finding and patient review for vulnerable people

Enhanced service specification. Avoiding unplanned admissions: proactive case finding and patient review for vulnerable people Enhanced service specification Avoiding unplanned admissions: proactive case finding and patient review for vulnerable people 1 Enhanced service specification Avoiding unplanned admissions: proactive case

More information

Guidance notes to accompany VTE risk assessment data collection

Guidance notes to accompany VTE risk assessment data collection Guidance notes to accompany VTE risk assessment data collection April 2015 1 NHS England INFORMATION READER BOX Directorate Medical Nursing Finance Commissioning Operations Patients and Information Human

More information

NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE HEALTH AND SOCIAL CARE DIRECTORATE QUALITY STANDARD CONSULTATION SUMMARY REPORT

NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE HEALTH AND SOCIAL CARE DIRECTORATE QUALITY STANDARD CONSULTATION SUMMARY REPORT NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE HEALTH AND SOCIAL CARE DIRECTORATE QUALITY STANDARD CONSULTATION SUMMARY REPORT 1 standard title Nocturnal enuresis Date of Standards Advisory Committee

More information

Paediatric Observation and Assessment Unit Operational Policy

Paediatric Observation and Assessment Unit Operational Policy Paediatric Observation and Assessment Unit Operational Policy 1 Policy Title: Paediatric Observation and Assessment Unit Operational Policy Executive Summary: Supersedes: Description of Amendment(s): This

More information

London Cultural and Advice Centre Sample Referrals Policy

London Cultural and Advice Centre Sample Referrals Policy London Cultural and Advice Centre Sample Referrals Policy Date written: 10/-04-02 Date reviewed: 22-04-03 Date of next review: 25-05-04 1. Introduction and Definitions London Cultural and Advice Centre

More information

Division of Gastroenterology, Hepatology and Nutrition

Division of Gastroenterology, Hepatology and Nutrition Jewish Hospital Goals: 1. Consultative and management prevalence in hepatology, pre- and post-liver transplantation. 2. Offer diagnostic and therapeutic procedure experience. Learning Objectives: Patient

More information

Introduction of an advanced practice nurse endoscopist program to Victoria

Introduction of an advanced practice nurse endoscopist program to Victoria Introduction of an advanced practice nurse endoscopist program to Victoria Melodie Heland, Director Surgical Clinical Services Unit Sylvia Constantinou, Program Manager, State Endoscopy Training Centre

More information

EUCERD RECOMMENDATIONS on RARE DISEASE EUROPEAN REFERENCE NETWORKS (RD ERNS)

EUCERD RECOMMENDATIONS on RARE DISEASE EUROPEAN REFERENCE NETWORKS (RD ERNS) EUCERD RECOMMENDATIONS on RARE DISEASE EUROPEAN REFERENCE NETWORKS (RD ERNS) 31 January 2013 1 EUCERD RECOMMENDATIONS ON RARE DISEASE EUROPEAN REFERENCE NETWORKS (RD ERNS) INTRODUCTION 1. BACKGROUND TO

More information

Issue date: October Guide to the multiple technology appraisal process

Issue date: October Guide to the multiple technology appraisal process Issue date: October 2009 Guide to the multiple technology appraisal process Guide to the multiple technology appraisal process Issued: October 2009 This document is one of a series describing the processes

More information

JAG Global Ratings Scale Census (GRS) Report: England April 2015

JAG Global Ratings Scale Census (GRS) Report: England April 2015 JAG Global Ratings Scale Census (GRS) Report: England April 2015 Contents 1. Introduction... 3 2. Acute sector... 4 3. Community sector... 8 4. Independent sector... 11 2 1. Introduction This report provides

More information

Informed Consent SOP Number: 25 Version Number: 6.0 Effective Date: 1 st September 2017 Review Date: 1 st September 2019

Informed Consent SOP Number: 25 Version Number: 6.0 Effective Date: 1 st September 2017 Review Date: 1 st September 2019 Standard Operating Procedures (SOP) for: Informed Consent SOP Number: 25 Version Number: 6.0 Effective Date: 1 st September 2017 Review Date: 1 st September 2019 Author: Reviewer: Reviewer: Authorisation:

More information

Health Care Quality Indicators in the Irish Health System:

Health Care Quality Indicators in the Irish Health System: Health Care Quality Indicators in the Irish Health System Examining the Potential of Hospital Discharge Data using the Hospital Inpatient Enquiry System - i - Health Care Quality Indicators in the Irish

More information