Recognising and responding to critically unwell patients
Problems in recognising and responding to deteriorating patients continues to be a major source of severe harm and preventable death in hospitals. Previous research has shown that up to a quarter of preventable deaths are related to failures in clinical monitoring.

NICE guidance

• NICE guideline

• Medtech innovation briefing

• Diagnostics guidance

•  Technology appraisal guidance

NIHR Signals
The following research summaries have been added to the National Institute for Health Research website:

• Boosting omega-3 fatty acid intake is unlikely to prevent type 2 diabetes
• Herpes zoster vaccine reduces chances of shingles after stem cell transplants
• Keyhole hysterectomy is effective for women with heavy menstrual bleeding
• Significant risk of another thrombosis remains if anticoagulation is stopped
• Long-term macrolide antibiotics reduce risk of exacerbations of bronchiectasis 
• Clinicians prescribe antibiotics for childhood respiratory tract infection based on assessment, rather than parental expectation

Health and wellbeing boards and integrated care systems
The King’s Fund has published Health and wellbeing boards and integrated care systems.  This long read examines the part Health and Wellbeing Boards, and local government more broadly, have played in the emergence of ICSs so far and options for their future.

Physical activity: economic benefits
Rand Europe has published The economic benefits of a more physically active population: an international analysis.  This study explores the main economic costs of physical inactivity and identifies the key benefits to improving activity rates.

Doing good does you good
The Mental Health Foundation has published Doing good does you good.  This guide illustrates the positive impact that helping others can have on your own mental health.  It includes tips and suggestions for how you can get started with helping others.

The role of the arts in improving health and well-being
The World Health Organisation has published What is the evidence on the role of the arts in improving health and well-being? A scoping review.  The report reviews arts activities that seek to promote health and prevent ill health, as well as manage and treat physical and mental ill health and support end-of-life care.

Good practice in remote consultations and prescribing
Healthcare organisations have issued High level principles for good practice in remote consultations and prescribing.  This information for all healthcare professionals with prescribing responsibilities sets out the shared high level principles of good practice expected of everyone when consulting and or prescribing remotely from the patient.

Pre-exposure Prophylaxis (PrEP) provision
The House of Lords Library has published Pre-exposure Prophylaxis (PrEP) Provision in England: Recent Developments.  This briefing provides information on recent developments in connection with the availability of Pre-exposure Prophylaxis (PrEP) in England. The Department of Health and Social Care has stated that it will work with local authorities in England to plan for a “seamless transition” from the current trial to routine commissioning in 2020/21.

Personalised care
NHS England has produced a series of factsheets relating to personalised care.  These provide an introduction to what personalised care is and the work that NHS England is doing.  They cover areas such as personal health budgets, supported self-management, social prescribing and professional development

Primary Care Networks
The Nuffield Trust has published Primary care networks: A pre-mortem to identify potential risks.  A recent event drew together 45 GPs, local commissioners and representatives from NHS England/Improvement and the British Medical Association to undertake a ‘pre-mortem’ exercise to consider the threats and weaknesses of the introduction of Primary Care Networks by imagining their hypothetical failure. This paper presents six risks that could lead to the failure of primary care networks and suggests a set of recommendations and possible solutions for avoiding each of these pitfalls.

Disability in the workplace
NHS Employers has introduced reasonable adjustments in the workplace web pages which provide information regarding reasonable adjustments to help NHS organisations support disabled staff in the workplace.  They cover legal responsibilities links to examples of reasonable adjustments, policies and other useful resources to support good practice.

Multiple site single services
Public Health England has published Establishing the evidence base for ‘multiple site single service’ (MSSS) models of care: systematic review. This systematic review describes the evidence base for MSSS models of care which deliver care across more than one clinical site or location through a single clinical service or team.

Paediatric Critical Care and Surgery in Children Review
NHS England and NHS Improvement have published Paediatric critical care and surgery in children review: summary report.  This is the summary report of the national review into paediatric critical care and specialised surgery in children, which took place in October 2016. The aims of the review were to ensure that services are sustainable and fit for the future, and to reduce any variation in the care being provided.

NICE consultations

• Human and animal bites: antimicrobial prescribing: draft guidance consultation.  Closing date for comments: 3 December 2019.
• Decision-making and mental capacity: quality standard consultation.  Closing date for comments: 4 December 2019.
• Renal and ureteric stones: quality standard consultation.  Closing date for comments: 4 December 2019.
• PneuX for preventing ventilator-associated pneumonia in intensive care: draft guidance.  Closing date for comments: 6 December 2019.

NHS Property Services
The Public Accounts Committee has published NHS Property Services.  This report indicates that NHS Property Services Limited has made progress in tackling some of the issues that it inherited when it was set up, however it lacks the powers of a commercial landlord and inherited a range of long-standing issues.  The report concludes that urgent action is needed to overhaul “this broken system”.

General election guidance
NHS England and NHS Improvement have issued a letter setting out guidance to NHS organisations about the pre-election period. This guidance takes effect from Wednesday 6th November 2019 until Friday 13th December 2019 or the date at which a new government is formed.

Statistics

• MRSA bacteraemia: monthly data by location of onset and NHS organisation – September 2018 to September 2019
• MSSA bacteraemia: monthly data by location of onset and NHS organisation – September 2018 to September 2019
• C. difficile infection: monthly data by prior trust exposure and NHS organisation – September 2018 to September 2019
• E. coli bacteraemia: monthly data by location of onset and NHS organisation – September 2018 to September 2019
• P. aeruginosa bacteraemia: monthly data by location of onset and NHS organisation – September 2018 to September 2019
• Klebsiella spp bacteraemia: monthly data by location of onset and NHS organisation – September 2018 to September 2019

Bulletins

• NHS Workforce Bulletin – 4 November 2019
• New Medicines Newsletter – October 2019
• New Product Evaluations – October 2019
• Vaccine update – issue 300, October 2019, bug special edition
• Learning Disability Newsletter – Issue 10
• Medicines Use and Safety Update – November 2019