Implementation Guidance

Psychological Therapies for Severe Mental Health Problems

Source: KnowledgeShare

Psychological therapies for severe mental health problems: implementation guidance 2024.
NHS England; 2024.

This guidance is for NHS-commissioned mental health provider organisations, integrated care boards (ICBs), regional NHS England offices, and chief psychological professions officers in mental health trusts. It aims to support mental health providers to deliver the NHS long term plan objective to increase access to psychological therapies for people with severe mental health problems, as part of a wider transformation of adult and older adult community mental health services.
Freely available online

Nurse Educator Toolkit

Professional Nurse Educator Toolkit for Mental Health Services

Source: KnowledgeShare

Professional nurse educator toolkit for mental health services.
NHS England; 2024.

Clinical mental health nursing leadership is essential in enabling and empowering registered mental health nurses to continuously improve their learning on quality and safety and the care they provide to patients and families. This document describes the implementation of the professional nurse educator (PNE) role within mental health services and offers advice on how providers of mental health services can effectively implement the role within their mental health services.

Allied Health Professionals

Current Updates

The Allied Health Professions (AHPs) strategy for England 2022-2027 – AHPs Deliver.
NHS England; 2022.

(This new strategy is for the whole Allied Health Profession (AHP) community: support workers, assistant practitioners, registered professionals, pre-registration apprentices and students. It is inclusive and reflects how AHPs work in multidisciplinary teams, so that those who identify as part of the AHP community working in a variety of health and care sectors can use it to continually improve and redesign services.)

Chief allied health professionals handbook.
NHS England; 2022.

(A guide for chief allied health professionals, aspiring chief allied health professionals and trust boards.)

Allied health professionals within integrated care systems: guidance for system executives and senior leaders.
NHS England; 2022.

(This document provides an overview of: the AHP system architecture required to ensure AHP operational delivery; AHP leadership of this architecture; an AHP quality framework to support AHP workforce transformation)

The Patients Association

Shared decision making from the perspective of clinicians and healthcare professionals

Source: The King’s Fund

This report finds health care professionals are positive about shared decision-making – a way of working with patients to decide treatment options. But the report also finds professionals’ ability to practice shared decision-making regularly is limited by the current crisis in the NHS. The report makes a number of recommendations and The Patients Association will now look to partner with NHS England, the Personalised Care Institute and other organisations to support professionals’ call for more support to practice shared decision-making.

Podcast

Tackling health inequalities

Source: The King’s Fund Podcast

Helen McKenna talks with Dr Bola Owolabi, Director of Health Inequalities at NHS England and NHS Improvement, about the NHS’s spheres of influence, the power of gathering around a common cause, and whether the experience of the pandemic will lead to a step change in tackling health inequalities.

Listen to the podcast here

Public Health

Current awareness updates

Prostate cancer.
National Institute for Health and Care Excellence (NICE); 2021.
[This quality standard covers managing prostate cancer in people referred to secondary care or having follow-up for prostate cancer in primary care. It describes high-quality care in priority areas for improvement. In December 2021, changes were made to align this quality standard with the updated NICE guideline on prostate cancer.]

Combined adult and paediatric respiratory clinical assessment service (RCAS) hubs for acute respiratory infection.
NHS England and NHS Improvement; 2021.
[This document supports systems to plan for a likely rise in respiratory infections (for example, Covid-19, respiratory syncytial virus (RSV), influenza and other infections) this winter.]

Our Vision for the Women’s Health Strategy for England.
Department of Health and Social Care (DHSC); 2021.
[Analysis of call for evidence consultation response has informed development of this document, which is published alongside the consultation response. This document sets out the government’s vision and the publication of the strategy will follow in 2022.]

Children and young people’s mental health:eighth Report of Session 2021–22.
House of Commons Health and Social Care Committee; 2021.
[This report calls for urgent action to prevent mental health services slipping backwards as a result of additional demand created by the pandemic and the scale of unmet need prior to it. MPs found that despite progress in numbers of young people receiving treatment, it was unacceptable that more than half with a diagnosable condition pre-pandemic do not receive the mental health support they need.]

Public Health

Current awareness updates

Drug users urged to be extra careful following a high number of likely heroin overdoses.
Public Health England (PHE); 2021.
[Public Health England (PHE) has issued a warning of a sharp rise in the number of overdoses linked to people using drugs in several areas across England. To date, there have been at least 46 poisonings resulting in 16 deaths but investigations are still ongoing. The areas affected include South London, the South East, South West and East of England.]

Mental Health Crisis Care Profile.
PHE Fingertips; 2021.
[The Crisis Care Profile collates and analyses a wide range of publicly available data on associated prevalence of mental health crisis. Risk factors include access to care, treatment, and outcomes. Includes risk factors around age, deprivation, illness and disabilities, crime and social isolation. Other topics – urgent and emergency care, quality of treatment, access to support. Data available by local authorities.]

Dental health: migrant health guide.
Public Health England (PHE); 2021.
[Advice and guidance on the health needs of migrant patients for healthcare practitioners. 17 August 2021: New model of care to support refugees and asylum seekers to access NHS dental services.]

Cervical screening: support for people who find it hard to attend.
Public Health England (PHE); 2021.
[Guidance on support for people who find it hard to attend cervical screening due to having a mental health condition, or having experienced trauma or abuse. 16 August 2021: Clarification that this guidance is based on research conducted with users of mental health services and addition of signposting to guidance to support other underserved groups.]

Oral healthcare: model for asylum seekers and refugees.
Public Health England (PHE); 2021.
[This model of care provides professionals with guidance to support access to NHS dentists. Asylum seekers and refugees can face barriers when accessing NHS dentists. This model of care details the processes, rights and entitlements to care and includes supporting information and links to forms and guidance. It is designed for local authorities, support services and health professionals who work with asylum seekers and refugees.]

Antenatal care.
National Institute for Health and Care Excellence (NICE); 2021.
[This quality standard covers care for healthy women and their babies during pregnancy (up to 42 weeks). It covers routine antenatal care in primary, community and hospital settings. It describes high-quality care in priority areas for improvement. In August 2021, changes were made to align this quality standard with the updated NICE guideline on antenatal care.]


Service specification: Cystinosis diagnosis and co-ordination of management (all ages).
NHS England; 2021.
[This service specification covers the provision of services for patients with Cystinosis, all ages.]

Continuous positive airway pressure for the treatment of obstructive sleep apnoea/hypopnoea syndrome.
National Institute for Health and Care Excellence (NICE); 2021.
[Evidence-based recommendations on continuous positive airway pressure for treating obstructive sleep apnoea/hypopnoea syndrome in adults. August 2021: The recommendation on continuous positive airway pressure (CPAP) for mild obstructive sleep apnoea/hypopnoea syndrome (OSAHS) has been updated and replaced by recommendation 1.5.2 on CPAP for mild OSAHS in the NICE guideline on obstructive sleep apnoea/hypopnoea syndrome and obesity hypoventilation syndrome in over 16s.]

Obstructive sleep apnoea/hypopnoea syndrome and obesity hypoventilation syndrome in over 16s.
National Institute for Health and Care Excellence (NICE); 2021.
[This guideline covers the diagnosis and management of obstructive sleep apnoea/hypopnoea syndrome (OSAHS), obesity hypoventilation syndrome (OHS) and chronic obstructive pulmonary disease with OSAHS (COPD–OSAHS overlap syndrome) in people over 16. It aims to improve recognition, investigation and treatment of these related conditions.]

Ethnic differences in SARS-CoV-2 vaccine hesitancy in United Kingdom healthcare workers: Results from the UK-REACH prospective nationwide cohort study.
Woolf K. The Lancet Regional Health – Europe 2021;8(-):100180.
[Using a nationwide prospective cohort study and qualitative study in a multi-ethnic cohort of clinical and non-clinical UK healthcare workers (HCWs) researchers analysed ethnic differences in SARS-CoV-2 vaccine hesitancy. Of the 11,584 HCWs included in the cohort analysis, 23% (2704) reported vaccine hesitancy. Ethnicity was a significant predictor of hesitancy.]

Association of the COVID-19 lockdown with smoking, drinking and attempts to quit in England: an analysis of 2019–20 data.
Addiction; 2021.
[Following the March 2020 COVID-19 lockdown, smokers and high-risk drinkers in England were more likely than before lockdown to report trying to quit smoking or reduce alcohol consumption and rates of smoking cessation and use of remote cessation support were higher. However, high-risk drinking prevalence increased post-lockdown and use of evidence-based support for alcohol reduction by high-risk drinkers decreased with no compensatory increase in use of remote support.

Everybody active, every day: 5 years on.
Public Health England (PHE); 2021.
[Summary of the 5 year review to the national physical activity framework, ‘Everybody active, every day’ and the PHE response.]

Quality in Qual: a proposed framework to commission, judge and generate good qualitative evaluation in wellbeing impacts.
whatworkswellbeing; 2021.
[Based on interviews with ten leading organisations and individuals who have in-depth evaluation and methodological expertise this report sets out why work on qualitative evaluation is valuable and important, what resources already exist. The report identifies six prompts for potential uses of qualitative research in evaluations.]

Genomics nation: A benchmark of the size and strengths of the UK genomics sector.
UK Bioindustry Association; 2021.
[The NHS Long Term Plan promised greater focus on prevention to help people stay healthy and ease the burden on the health service. The early detection of disease, rather than merely the diagnosis and treatment of illness, will be critical to achieve this objective. The NHS Genomic Medicine Service (GMS), launched in 2018, provides a single, national coordinated approach to genomic testing and genomic research in the NHS.]

A joint thematic inspection of community-based drug treatment and recovery work with people on probation.
HM Inspectorate of Probation (HMIP); 2021.
[Probation services across England and Wales supervise nearly 156,000 people in the community. HM Inspectorate of Probation estimates that almost 75,000 of these individuals have a drugs problem, yet fewer than 3,000 people were referred by probation services to specialist drug misuse treatment in 2019/2020. HMIP partnered with the Care Quality Commission to examine how probation services supervise this cohort and found probation services are responding poorly to drugs misuse and addiction cases.]

Public Health

Current awareness updates

Statistics on alcohol: England.
House of Commons Library; 2021.
[Research briefing. This note provides a summary of statistics on alcohol consumption among adults and children in England. Data on alcohol-related hospital admissions in England and alcohol-related deaths in
England, the UK and worldwide is also shown.]

Towards a dementia-inclusive society: WHO toolkit for dementia-friendly initiatives.
World Health Organization (WHO); 2021.
[This toolkit supports individuals, communities and countries in raising awareness of, and empowering people living with, dementia to remain in, and be a significant part of, their community. The toolkit provides practical guidance and tools that can support efforts, including planning and implementation activities, to create dementia-inclusive societies.]

Social isolation and loneliness among older people: advocacy brief.
World Health Organization (WHO); 2021.
[This brief highlights the growing public health and policy concern on these issues, made more salient by the COVID-19 pandemic. The brief summarises the scale, impact, and harms of social isolation and loneliness among older people and outlines what can be done to reduce them. It also describes several policy windows that offer opportunities for addressing social isolation and loneliness among older people and proposes a three-point global strategy for tackling these issues.]

WHO guideline on school health services.
World Health Organization (WHO); 2021.
[School health services are services provided by a health worker to students aged 5–19 in primary or secondary education, either within school premises or in a health service situated outside the school. Schools offer a unique opportunity to implement effective health services at scale for children and adolescents. Web Annexes found at the end of this summary link to intervention and implementation tools.]

WHO Guideline on the prevention of drowning through provision of day-care and basic swimming and water safety skills.
World Health Organization (WHO); 2021.
[This guideline addresses: provision of day-care for children under the age of 6 years and provision of basic swimming skills and water safety training to children aged 6 years and older. Developed following GRADE methodology, approved by the WHO Guideline Review Committee and intended for use by policy-makers and practitioners, the guideline issues strong recommendations in favour of both interventions for drowning prevention.]

Alcohol and drug misuse prevention and treatment guidance.
Public Health England (PHE); 2021.
[Information and other resources to support commissioners, service providers and others providing alcohol and drug interventions. 11 August 2021: Added new group: Opioid substitution treatment good practice resources.]

Supporting mental healthcare in a maternity and neonatal setting: good practice guide and case studies.
NHS England; 2021.
[This guide is for commissioners and staff involved in maternity and neonatal care. It describes the underpinning principles of and good practice for supporting good mental health and psychological wellbeing in maternity and neonatal settings. It also considers the role of specialist maternal mental health services (MMHS) in supporting this function.]

Improving non-emergency patient transport services.
NHS England; 2021.
[This report sets out a new national framework for non-emergency patient transport services to support them in becoming consistently more responsive, fair and sustainable.]

PCN winter planning tool.
Primary Care Commissioning (PCC); 2021.
[PCC has published a winter planning tool to support PCNs in preparing for the winter pressures that are anticipated. The tool is free to download and contains an introductory sheet with instructions for completion. We have also recorded a short video guide to using the tool.]

Responding to pandemics and other disease outbreaks in homeless populations: a review of the literature and content analysis.
Babando J. Health & Social Care in the Community 2021;-(6 April):13380.
[This review illustrates that the current breadth of academic literature on homeless populations has focused on tuberculosis rather than diseases that are more recent and closely related to COVID-19. Thematic content analysis revealed six themes that offer recommendations which include (1) education and outreach, (2) adapting structure of services, (3) screening and contract tracing, (4) transmission and prevention strategies, (5) shelter protocols and (6) treatment, adherence and vaccination.]

Government response to the independent review of drugs by Dame Carol Black.
Department of Health and Social Care (DHSC); 2021.
[Part 2 of Dame Carol Black’s review set out 32 recommendations for a whole system approach to tackling drug misuse. As a result, the government is developing a long-term strategy which will present a whole-of-government response to drive down drug supply and demand to be published by the end of the year. Immediate actions include a new cross government joint combating drugs unit and development of a national outcomes framework to set out measurable goals for the combating drugs programme.]

Restrictive eating disorders in higher weight persons: A systematic review of atypical anorexia nervosa prevalence and consecutive admission literature.[Abstract]
Harrop EN. International Journal of Eating Disorders 2021;54(8):1328-1357.
[Although atypical anorexia (AAN) appears to occur more frequently than AN in communities, fewer patients with AAN are being referred and admitted to eating disorder specific care, particularly in the United States. Given the significant medical and psychosocial consequences of AAN, and the importance of early intervention, this represents a crucial treatment gap.]

Attentional bias in eating disorders: A meta-review.[Abstract]
Stott N. International Journal of Eating Disorders 2021;54(8):1377-1399.
[There is evidence for attentional avoidance and vigilance in eating disorders depending on stimulus properties (low vs. high-calorie food; high-body mass vs. low-body mass index photos of others) and attentional avoidance of food stimuli in those with anorexia nervosa. Sad mood induction may generate attentional bias for food in those with binge-eating disorder. There may also be attentional bias to general threat in eating disorder samples.]

Podcast

‘If you’re not counted, you don’t count’: what can be done to tackle LGBTQ+ health inequalities?

Source: The King’s Fund

People who identify as LGBTQ+ experience disproportionately worse health outcomes and have poorer experiences when accessing health services. Three years on from the Government’s LGBT action plan, Helen McKenna sat down with Dr Michael Brady, National Advisor for LGBT Health at NHS England, and Michelle Ross, Co-Founder and Director of Holistic Wellbeing services at cliniQ to explore the health inequalities LGBTQ+ people face and what needs to happen to make sure health services are inclusive.

Listen to the podcast here.

Covid 19

Current awareness updates

Characterisation of in-hospital complications associated with COVID-19 using the ISARIC WHO Clinical Characterisation Protocol UK: a prospective, multicentre cohort study.
Drake TM. The Lancet 2021;:https://doi.org/10.1016/S0140-6736(21)00799-6.
[Complications and worse functional outcomes in patients admitted to hospital with COVID-19 are high, even in young, previously healthy individuals. Acute complications are associated with reduced ability to self-care at discharge, with neurological complications being associated with the worst functional outcomes. COVID-19 complications are likely to cause a substantial strain on health and social care in the coming years.]

COVID-19 and the digital divide: Supporting digital inclusion and skills during the pandemic and beyond.
Centre for Ageing Better; 2021.
[This report offers examples of good practice and recommendations for organisations that deliver services to users and help digitally excluded people with skills training. The report finds that the key to building digital inclusion isn’t only about getting more people online, but also building skills and confidence.]

Alcohol consumption and harm during the COVID-19 pandemic.
Public Health England (PHE); 2021.
[A report collating data on alcohol consumption and alcohol-related harm in England during the COVID-19 pandemic and comparing it to data from previous years. The report improves our understanding of how alcohol consumption and harm changed in England while physical and social restrictions to prevent and control coronavirus were in place. The findings help to understand whether pandemic-related changes have affected rates of alcohol hospital admissions and deaths as well as health inequalities.]

COVID-19 vaccination of children and young people aged 12 to 17 years: JCVI statement.
Department of Health and Social Care (DHSC); 2021.
[Statement from the Joint Committee on Vaccination and Immunisation (JCVI) on COVID-19 vaccination of children and young people aged 12 to 17 years.]

NHS COVID Pass Verifier app.
NHS England; 2021.
[A fast, secure and easy way of allowing people to demonstrate their COVID pass is valid, giving staff confidence in the legitimacy of what is being presented to them. It is a fast, secure way to scan the 2D barcode on an individual’s NHS COVID Pass and verify whether or not they have been fully vaccinated against COVID-19, had a negative test, or have recovered from the virus – allowing staff to check the legitimacy of what is being presented to them.]

JCVI issues advice on COVID-19 vaccination of children and young people.
Public Health England (PHE); 2021.
[The Joint Committee on Vaccination and Immunisation (JCVI) is today advising that children at increased risk of serious coronavirus (COVID-19) disease are offered a vaccine.]

The impact of Brexit and COVID-19 on nursing in the UK. [Comment]
Carvalho F. British Journal of Nursing 2021;30(13):822-823.
[Over the years, many experts have stated that nursing in the UK is in crisis and nurses are struggling owing to the increasing number of older and sicker patients, staff shortages and budget cuts that have affected working conditions (Beech et al, 2019). With the rise of the COVID-19 pandemic, unprecedented levels of pressure were placed on an already strained nursing workforce.]

A healthy recovery – Acting on findings from the COVID-19 impact inquiry
The Health Foundation; 2021.
[Launched in October 2020, the COVID-19 impact inquiry has been carefully exploring the pandemic’s broad impact on health and what this means for improving health and reducing health inequalities in the UK – now and in the future. The inquiry launched its final report on 6 July 2021. This webinar, held on the same day, discussed key issues raised in the report – the impact of the pandemic and what needs to be done in recovery to create a healthier, fairer society.]

Unequal pandemic, fairer recovery: The COVID-19 impact inquiry report.
The Health Foundation; 2021.
[By mid-March 2021 the pandemic had led to 119,000 excess deaths in the UK and in 2020 caused a 9.9% drop in GDP. Behind these overall figures lie the unequal burdens carried by different population groups and regions. Although the pandemic is still ongoing, this report explores these impacts and the range of different, intersecting factors influencing them. It provides an initial assessment of the effects of the pandemic using evidence available up to May 2021.]