Current Awareness Bulletin 11th – 31st August 2014 Welcome to the latest issue of our weekly Current Awareness Bulletin, a publication from the Library and Knowledge Services at Hinchingbrooke Hospital. This bulletin provides a digest of information focusing on primary care and public health. If you are unable to access any of the internet links, please contact us and we can forward the relevant information to you. If you would like to register for free to this on a permanent basis, or simply find out more about the service, please email Liza Alderman, Specialist Librarian, Primary Care and Public Health, at the address below. If you would like to suggest any new headings for the bulletin, or other sources of information to be reviewed and included in subsequent editions, please contact Liza Alderman. (Tel no: 01480 416114 or liza.alderman@nhs.net). For information about other library services including NHS Athens, please go to our website: http://www.hinchingbrooke.nhs.uk/page/our-services/library-services News Thursday, 11th September Introduction to searching the healthcare databases 10.00 – 12.00 Wed, 24th September Searching NHS Evidence 12.00 – 1.00 Thursday, 2nd October Searching UpToDate 12.30 – 1.30 Wednesday, 8th October Introduction to searching the healthcare databases 10.00 – 12.00 Thursday, 16th October Searching NHS Evidence 12.00 – 1.00 Wednesday, 22nd October Searching UpToDate 12.30 – 1.30 See our website http://www.hinchingbrooke.nhs.uk/page/our-services/libraryservices/library-skills-training for details of training session content. To book a place on any of our training sessions, or to simply find out more, please email hch-tr.libraryteam@nhs.net *Alternative training is available for those staff working within Peterborough and Luton. Please contact your local NHS library for details Contents Cancer Obesity Cardiovascular Disease Offender & Prison Health No items this week Child & Adolescent Health Older People Communicable Diseases Patient Safety Commissioning Physical Activity CQC Standards Primary Care Dental Services Respiratory Conditions (including COPD) Diabetes Safeguarding vulnerable adults Diet & Nutrition Sexual Health No items this week Disabilities Smoking & Tobacco Drugs & Alcohol Social Care & Social Work Evidence Updates Stroke Health Inequalities Waiting Times No items this week Long Term Conditions Women’s Services Medicines Miscellaneous Mental Health NICE Cancer Salt injections: not a cure for cancer “Salt injection ‘kills cancer cells’ by causing them to self-destruct,” reports the Mail Online. Source: Behind the Headlines Macmillan finds cancer survival 'postcode lottery' “Cancer postcode lottery ‘costs 6,000 lives a year’,” reports The Times. Source: Behind the Headlines Caution urged over CT scan radiation doses BBC News reports on a sharp rise in the number of CT scans being performed, exposing people to the potential health risks of radiation. Source: Behind the Headlines Botox may be useful in treating stomach cancers "Botox may have cancer fighting role," BBC News reports after research involving mice found using Botox to block nerve signals to the stomach may help slow the growth of stomach cancers. Botox, short for botulinum toxin, is a powerful neurotoxin that can block nerve signals. Source: Behind the Headlines See also Physical Activity section: Exercise may cut breast cancer risk, study finds See also Obesity section: Is UK obesity fuelling an increase in 10 cancers? See also Mental Health section: Depression therapy aids other cancer symptoms See also Diet & Nutrition section: Tomato-rich diet 'reduces prostate cancer risk' Cardiovascular Disease Cardiovascular disease profiles http://www.yhpho.org.uk/ncvinc These profiles aim to help the NHS and local authorities understand more about these conditions in their communities, highlighting important facts and including information on the leading risk factors such as smoking and obesity. The profiles bring together information about coronary heart disease, diabetes, kidney disease and stroke as a single family of conditions. In coming weeks, Public Health England will release an interactive version of the data which allows CCGs to compare themselves with others, including those in their strategic clinical network. Source: PHE (Please note that the link may only work by pasting the address into Google Chrome) Are good neighbours really life-savers? “Having good neighbours can help cut heart attack risk,” reports The Independent. Source: Behind the Headlines See also Diet & Nutrition section: High-salt diet linked to 1.6 million heart deaths See also Medicines section: Common antibiotic linked to 'tiny' rise in heart deaths Child & Adolescent Health Guide to Producing Health Information for Children and Young People The new edition of this guide aims to help anyone who communicates with children and young people about their health improve what they do. There is practical advice as well as examples of current best practice. Source: Patient Information Forum Growth of newborn babies' brains tracked "Scans chart how quickly babies' brains grow," reports BBC News Online. Source: Behind the Headlines Transfer of 0-5 children’s public health commissioning to local authorities Planning and paying for public health services for 0 to 5 year olds will transfer from the NHS to local authorities in October 2015. Source: DoH Motivational interviewing for alcohol misuse in young adults Source: The Cochrane Library Antibiotics for early onset neonatal infection Source: Evidence Update See also CQC section: Getting inspections right for children and young people See also Mental Health section: Antidepressant use in pregnancy linked to ADHD Commissioning Bulletin for CCGs: Issue 62, 03 July 2014 Source: NHS England Maternity pathway payment system: guidance for NHS providers and commissioners Source: Monitor/NHS England The Engagement Cycle This model was developed by InHealth Associates to support commissioners aiming to engage with patients and the public throughout the commissioning cycle. It has been updated to align with current statutory guidance, new commissioning arrangements and current healthcare challenges. Source: Centre for Leadership/King’s Fund NICE support for commissioning for varicose veins in the legs NICE support for commissioning [SFCQS67] NICE support for commissioning for intravenous fluid therapy in adults in hospital NICE support for commissioning [SFCQS66] Bulletin for CCGs: Issue 65, 14 August 2014 Source: NHS England Specialised commissioning stakeholder newsletter: Issue 3 Source: NHS England Bulletin for CCGs: Issue 66, 28 August 2014 Source: NHS England Population level commissioning for the future This paper presents analysis of a Kent 'whole population' dataset, linking whole population demographics with activity and cost data for the population from acute, community, mental health and social care providers. The data helps commissioners to understand the impact of different selections methods for people with 'very complex' health and social care needs, particularly in relation to the development of a LTC year of care currency. Source: NHS Improving Quality Learning, developing and improving working practices Clarity of purpose, timescale and communication are crucial to establishing a practice federation. The latest issue of Commissioning Excellence draws together an arsenal of top tips that will help make federating (relatively) easy. The issue also looks at how Central Manchester CCG is piloting new ways to manage a local rise in emergency department attendances and how Integrated Community Teams in Gloucestershire are transforming the way health and care services are provided within the county. Source: PCC Lessons learned: implementing an electronic palliative care co-ordination system (EPaCCS) An NHS England funded taskforce focused on overcoming barriers to implementation of EPaCCS (Electronic Palliative Care Co-ordination Systems) is working with CCGs to provide technical and clinical expertise supported by NHS Improving Quality (NHS IQ). EPaCCS enable the recording and sharing of people’s care preferences and key details about their care at the end of life. This factsheet details key learning and implementation advice. See also Cardiovascular Disease section: Cardiovascular disease profiles See also Diabetes section: London’s Diabetes Care Pathway: Commissioning Recommendations For Psychological Support See also Disabilities section: Joint health and social care learning disability self-assessment framework Communicable Diseases Communicable disease outbreak management operational guidance Source: Public Health England Vaccine update for immunisation practitioners Source: Public Health England Who to screen for MRSA Outlines a more focused, cost-effective approach to MRSA screening whilst concentrating on reducing infections and improving patient health. Source: DoH CQC Standards Getting inspections right for children and young people This report has resulted in 73 recommendations; a number of which formed the basis of two successful pilot inspections of specialist children’s hospitals (Sheffield and Alder Hey) that took place in May-June 2014. All the recommendations have now been considered and CQC accepts in whole or in part 70 of these recommendations. CQC has deferred making a decision on the remaining three. The CQC has also published its inspection report into Sheffield Children's NHS Foundation Trust. Dental Services Toothbrushing advice 'conflicting' "Teeth-brushing advice unacceptably inconsistent," reports The Guardian, while the Mail Online states that a "simple, gentle scrub is best" Source: Behind the Headlines Number of people seen by an NHS dentist nearing 30 million Source: HSCIC NHS Dental Statistics for England - 2013-14 This annual report includes information on all patients that received NHS dental care in England for the 12-month period to 31 March 2014. Subjects covered include: dental activity, clinical treatment and dental workforce. Information on the number of patients seen by an NHS dentist for the 24-month period to 30 June 2014 is also included. This information is used by the Department of Health to inform government policy on NHS dentistry and by local NHS managers in the planning and delivery of local dental services. Source: HSCIC Diabetes 2.2 million pounds spent every day on diabetes drugs in primary care Source: HSCIC London’s Diabetes Care Pathway: Commissioning Recommendations For Psychological Support This document provides guidance on emotional and psychological support on the London diabetes care pathway. It uses information gathered from discussions with professionals and patients, and from surveys about local provision. Source: NHS Networks/King’s Fund Diet & Nutrition Preoperative carbohydrate treatment for enhancing recovery after elective surgery Source: The Cochrane Library High-salt diet linked to 1.6 million heart deaths "Salty diet 'causes 1.6 million deaths worldwide each year'," reports The Daily Telegraph. It goes on to quote a researcher saying this is "nearly 1 in 10 of all deaths from cardiovascular causes worldwide". Source: Behind the Headlines Breakfast 'not the most important meal of the day' "Breakfast might not be the most important meal of the day after all,” the Mail Online reports. Source: Behind the Headlines Common bacteria could help prevent food allergies "Bacteria which naturally live inside our digestive system can help prevent allergies and may become a source of treatment," BBC News reports after new research found evidence that Clostridia bacteria helps prevent peanut allergies in mice. Source: Behind the Headlines Tomato-rich diet 'reduces prostate cancer risk' “Tomatoes ‘cut risk of prostate cancer by 20%’,” the Daily Mail reports, citing a study that found men who ate 10 or more portions a week had a reduced risk of the disease. Source: Behind the Headlines Establishing food standards for NHS hospitals Source: DoH Disabilities Autistic brain 'overloaded with connections' "Scientists discover people with autism have too many brain 'connections'," the Mail Online reports. US research suggests that people with an autistic spectrum disorder have an excessive amount of neural connections inside their brain Source: Behind the Headlines Joint health and social care learning disability self-assessment framework CCGs should be aware that the results of the 2013/14 joint health and social care selfassessment have been published on the Public Health England website. The details of the 2014/15 self-assessment are currently being developed by the Winterbourne View working group. Local authorities should complete the self-assessment with local partners, including CCGs. Local discussions should occur between CCGs, area teams, learning disability partnership boards and regional ADASS to agree an approach to undertaking and quality assuring the self-assessment. Source: PHE Drugs and Alcohol Ambitious For Recovery: Tackling Drug And Alcohol Addiction In The UK This report outlines and forecasts addiction problems in the UK and warns that deaths linked to ‘legal highs’ could overtake those linked to heroin by 2016. Amongst some of the recommendations suggested is a 'treatment tax' which should be added to the cost of alcohol in shops to fund a new generation of rehabilitation centres and stem the tide of Britain's addiction problem. Source: Centre for Social Justice/King’s Fund Motivational interviewing for alcohol misuse in young adults Source: The Cochrane Library Alcohol dependence and harmful alcohol use quality standard NICE quality standards [QS11] Health inequalities See also Medicines section: Research shows potential of community pharmacies to cut health inequalities Long Term Conditions Integrated disease management programmes for chronic obstructive pulmonary disease Source: Eyes on Evidence See also Medicines section: Depression 'common' in early Parkinson's Medicines Bone marrow drug could treat alopecia “Alopecia sufferers given new treatment hope with repurposed drug,” The Guardian reports. Source: Behind the Headlines Common antibiotic linked to 'tiny' rise in heart deaths An antibiotic given to millions of people in the UK to treat chest infections has been linked to an increased risk of heart death, report The Daily Telegraph and The Independent. Source: Behind the Headlines Dual vaccine approach could help eradicate polio Double vaccines "could hasten the end of polio", BBC News reports. Researchers in India found that using a combination of the oral and injected vaccines provided enhanced protection against the disease. Source: Behind the Headlines Research shows potential of community pharmacies to cut health inequalities Research has confirmed the unique position that community pharmacies have at the heart of even the most deprived communities and highlighted the potential for the sector to be better used to help tackle health inequalities and public health issues. The study, which was carried out at the University of Durham, looked at the phenomenon known as the “inverse care law” which states that those who are the most able to access healthcare are the least likely to be in need of it. Researchers found that in the world of community pharmacy the opposite is true. Source: BMJOpen The New Medicine Service Evaluation The New Medicine Service (NMS) can significantly increase patients’ adherence to their new medicines and will save the NHS money through better patient outcomes at overall reduced costs, an evaluation of the service has concluded. The evaluation, which was led by researchers at Nottingham University, recommended that the service could be improved by expanding the range of conditions covered, improving training and engagement with GPs, and giving pharmacies access to GP records. Source: University of Nottingham Aglomelatide for depression Source: Eyes on Evidence Adverse effects after quadrivalent human papillomavirus vaccination Source: Eyes on Evidence Pharmacological interventions for sleepiness and sleep disturbances caused by shift work Source: The Cochrane Library Antibiotics for early onset neonatal infection Source: Evidence Update Dimethyl fumarate for treating relapsing‑remitting multiple sclerosis NICE technology appraisals [TA320] See also Obesity section: Anti-obesity drugs 'may still work in middle-age' See also Mental Health section: Antidepressant use in pregnancy linked to ADHD Mental Health Depression 'common' in early Parkinson's “Depression more common in early Parkinson’s,” BBC News reports, as a new study investigates the impact this degenerative condition can have on mental health. Source: Behind the Headlines Is breastfeeding inability causing depression? Mothers who plan, but are unable, to breastfeed their babies are more likely to suffer from postnatal depression, report BBC News and The Independent. Source: Behind the Headlines A manifesto for better mental health This manifesto produced by 6 mental health organisations sets out straightforward, practical changes that a future Government could make in order to ensure mental and physical health are valued equally. The five key priorities for action are: fair funding for mental health; give children a good start in life' improve physical health care for people with mental health problems; improve the lives of people with mental health problems; and better access to mental health services. Source: Centre for Mental Health Antidepressant use in pregnancy linked to ADHD “Pregnant women who take anti-depressants 'could raise their child's risk of ADHD',” reports the Mail Online, saying that this could explain “the rise in children with short attention spans”. Source: Behind the Headlines Depression therapy aids other cancer symptoms "Depression therapy could help cancer patients fight illness," reports The Daily Telegraph. Source: Behind the Headlines No Assumptions: A Narrative For Personalised, Coordinated Care And Support In Mental Health This resource describes the critical outcomes and success factors in the care, support and treatment of people who use mental health services, from their perspective. It is aimed at NHS and council commissioners and providers of services to organise person-centred care and recovery-oriented support for mental and physical health and to know when they are achieving it. Source: National Voices/King’s Fund Aglomelatide for depression Source: Eyes on Evidence Psychotherapy for depression Source: Eyes on Evidence Psychotherapy for anorexia nervosa Source: Eyes on Evidence See also Diabetes section: London’s Diabetes Care Pathway: Commissioning Recommendations For Psychological Support Obesity Anti-obesity drugs 'may still work in middle-age' “Drug to halt the dreaded spread of middle age,” reports The Daily Telegraph, with similar headlines on the Daily Express and Daily Mail websites Source: Behind the Headlines Surgery for weight loss in adults Source: The Cochrane Library Is UK obesity fuelling an increase in 10 cancers? “Being overweight and obese puts people at greater risk of developing 10 of the most common cancers,” reports BBC News. Source: Behind the Headlines 'Fat and 30' link to dementia is inconclusive “People as young as 30 who are obese may be at greater risk [of dementia],” The Independent reports. Source: Behind the Headlines Does weight loss surgery affect dementia risk? "Weight loss surgery 'reduces chance of Alzheimer's disease'," reports The Daily Telegraph. This misleading headline reports on a small Brazilian study of severely obese women before and after weight loss surgery. None of the women had any signs or symptoms of Alzheimer's. Source: Behind the Headlines Data Factsheets On Weight, Obesity And Physical Activity These factsheets compile up-to-date key information and data about obesity and its determinants in an easily readable format. The data factsheets will be a useful resource for policy makers, practitioners and anyone with an interest in obesity. Source: PHE/King’s Fund Offender and Prison Health No items this week Older People Claims magnetic brain stimulation helps memory “Magnetic brain stimulation treatment shown to boost memory,” The Guardian reports. A new study found that magnetic pulses improved recall skills in healthy individuals. It is hoped that the findings of this study could lead to therapies for people with memory deficits such as dementia. Source: Behind the Headlines See also Obesity section: 'Fat and 30' link to dementia is inconclusive See also Smoking & Tobacco section: Tobacco use knowledge summaries: tobacco use and dementia See also Obesity section: Does weight loss surgery affect dementia risk? Patient Safety Patient safety alert on risks arising from breakdown and failure to act on communication during handover at the time of discharge from secondary care Source: NHS England Physical activity Exercise may cut breast cancer risk, study finds "Exercise lowers risk of breast cancer after menopause," reports The Independent. This and similar headlines were sparked by a large study of postmenopausal teachers that found increased recreational activity was associated with a 10% decrease in the risk of breast cancer. Source: Behind the Headlines See also Obesity section: Data Factsheets On Weight, Obesity And Physical Activity Primary Care 2.2 million pounds spent every day on diabetes drugs in primary care Source: HSCIC Avoiding unplanned admissions enhanced service: proactive case finding and care review for vulnerable people: Guidance and audit requirements A programme of action for general practice and clinical commissioning groups Source: NHS England See also Medicines section: The New Medicine Service Evaluation Respiratory Conditions (including COPD) Asthma emergency admissions: fall in August, rise in September Source: HSCIC Integrated disease management programmes for chronic obstructive pulmonary disease Source: Eyes on Evidence Safeguarding of vulnerable adults See also Primary Care section: Avoiding unplanned admissions enhanced service: proactive case finding and care review for vulnerable people Sexual Health No items this week Smoking & Tobacco Numbers using NHS Stop Smoking Services in decline for the second year Source: HSCIC Tobacco use knowledge summaries: tobacco use and dementia This document is prepared with the objective to summarize the current evidence on this topic (tobacco use includes smoked tobacco, smokeless tobacco and exposure to second-hand smoke). This is also intended as an advocacy tool to widely include other health care professionals (such as brain health specialists, neurologists etc.) in the fight for tobacco control and prevention of tobacco related diseases. Source: WHO Study finds plain cigarette pack fears 'unfounded' "Cigarette plain packaging fear campaign unfounded," reports The Guardian Source: Behind the Headlines Social Care & Social Work See also Disabilities section: Joint health and social care learning disability self-assessment framework Stroke 'Safe' stem cell therapy may help stroke recovery BBC Online today reports that "Stem cells show promise in stroke recovery". Source: Behind the Headlines Targeted brain stimulation 'could aid stroke recovery' "Stimulating the part of the brain which controls movement may improve recovery after a stroke," BBC News reports after researchers used lasers to stimulate a particular region of the brain with promising results in mice Source: Behind the Headlines Waiting Times No items this week Women’s Services Maternity pathway payment system: guidance for NHS providers and commissioners Source: Monitor/NHS England Interventions to reduce haemorrhage during myomectomy for fibroids Source: The Cochrane Library Monitoring of stimulated cycles in assisted reproduction (IVF and ICSI) Source: The Cochrane Library Muscle training for pelvic organ prolapse Source: Eyes on Evidence See also Physical Activity section: Exercise may cut breast cancer risk, study finds See also Mental Health section: Is breastfeeding inability causing depression? Antidepressant use in pregnancy linked to ADHD Miscellaneous Testing The Bed-Blocking Hypothesis: Does Higher Supply Of Nursing And Care Homes Reduce Delayed Hospital Discharges? Hospital bed blocking occurs when hospital patients are ready to be discharged to a nursing home but no place is available, so that hospital care acts as a more costly substitute for longterm care. This paper investigates the extent to which higher supply of nursing home beds or lower prices can reduce hospital bed blocking. It uses new local authority level administrative data from England on hospital delayed discharges in 2010-13. The results suggest that delayed discharges do respond to the availability of care-home beds but the effect is modest: an increase in care-homes bed by 10% (250 additional beds per local authority) would reduce delayed discharges by about 4%-7%. It also finds strong evidence of spillover effects across local authorities: higher availability of care-homes or fewer patients aged over 65 in nearby local authorities are associated with fewer delayed discharges. Source: Centre for Health Economics/King’s Fund NHS News: Issue 70 Source: NHS England New data show rates of common NHS operations and resulting patient benefit August 14, 2014: The Health and Social Care Information Centre has published information about four common NHS operations, and patient feedback about the health outcomes of these operations. The Patient Reported Outcome Measures (PROMs) programme focuses on four procedures knee replacements; varicose vein surgery; hip replacements; and groin hernia surgery and reports on results at provider, Clinical Commissioning Group (CCG) and national level. NHS Five Year Forward View (“5YFV”) Source: NHS England Update on Urgent and Emergency Care Review Source: NHS England Informed: Issue 1 Source: NHS England Mutuals In Health: Pathfinder Programme - Supporting Health And Care Organisations Explore The Benefits Of Mutualisation Chris Ham, Chief Executive of the King’s Fund, recently published an independent review of staff engagement and empowerment in the NHS. The review recommended that government support a pathfinder programme to help NHS trusts and foundation trusts explore the benefits of the mutual model. In response to the review’s recommendation, Department of Health and Cabinet Office launched a joint initiative on 15 July 2014 to support health and care organisations explore the potential advantages of mutualising their services. The Pathfinder Programme is designed to support a small number of pioneering trusts, either individually or in partnership. It is open to all foundation trusts and NHS trusts. Source: DoH/King’s Fund Spend And Outcome Tool (SPOT) For Local Authorities This tool gives local authorities an overview of spend and outcome across key areas of business for public health and its sub-programmes. The tool is an interactive spreadsheet and is also accompanied by factsheets for each local authority. Source: PHE/King’s Fund NHS Health Check quarterly returns: August 2014 Public Health England has published the NHS Health Check data update for April to June 2014. This update contains data from 152 local authorities for April to June 2014 (quarter 1 for 2014 to 2015). Remote health advice bulletin This update monitors the numbers of people calling NHS 111 for health advice. It monitors patterns in phone calls to the service each day across England, tracking the spread of infectious diseases like flu and norovirus. The data provides early warning of communitybased infectious diseases. Source: PHE Evidence Updates Eyes on Evidence August 2014 Topics this month include: Integrated disease management programmes for chronic obstructive pulmonary disease, Agomelatine for depression, Psychotherapy for anorexia nervosa, Muscle training for pelvic organ prolapse, Adverse effects after quadrivalent human papillomavirus vaccination. Evidence Update Antibiotics for early onset neonatal infection NICE New Guidance Varicose veins in the legs NICE quality standards [QS67] NICE support for commissioning for varicose veins in the legs NICE support for commissioning [SFCQS67] NICE support for commissioning for intravenous fluid therapy in adults in hospital NICE support for commissioning [SFCQS66] Intravenous fluid therapy in adults in hospital NICE quality standards [QS66] Acute kidney injury: Prevention, detection and management of acute kidney injury up to the point of renal replacement therapy NICE quality standards [CG169] Patient Group Directions NICE medicines practice guidelines [MPG2] Alcohol dependence and harmful alcohol use quality standard NICE quality standards [QS11] Dimethyl fumarate for treating relapsing‑remitting multiple sclerosis NICE technology appraisals [TA320] Total prosthetic replacement of the temporomandibular joint NICE interventional procedures guidance [IPG500] Mimimally invasive video-assisted thyroidectomy NICE interventional procedures guidance [IPG499] Minimally invasive video‑assisted parathyroidectomy NICE interventional procedures guidance [IPG501] Disclaimer: Whilst we make every effort to check the content when it is first published, we cannot guarantee its correctness or completeness. The information on this website is subject to change and we cannot guarantee that it will remain up-to-date. All links from this website are provided for information only. A link does not imply endorsement of that site. We do not accept responsibility for the sites linked to, or the information displayed there. Copyright and liability You are welcome to use the information from the Current Awareness Service for Health so long as the source is acknowledged. Copyright restrictions may apply to material from other sites. Sources used: The Audit Commission, Cabinet Office, Care Quality Commission, Commission for Rural Communities, Communities and Local Government, Dept for Business, Innovation and Skills, Dept for Children, Schools and Families, Dept for Culture, Media and Sport, Dept for the Environment, Food and Rural affairs, Dept for Transport, Dept for Work & Pensions, Dept of Energy & Climate Change, Dept for Health, Directgov, Economic and Social Research Council, Electoral Commission, Environment Agency, Equality and Human Rights Commission, Food Standards Agency, Gambling Commission, General Social Care Council, Government Connect, Govt Office for London, Govt Office for the East Midlands, Govt Office for the East of England, Govt Office for the North East, Govt Office for the North West, Govt Office for the South East, Govt Office for the South West, Govt Office for the West Midlands, Govt Office for Yorkshire & The Humber, Health and safety Executive, HM Prison Service, HM Revenue and Customs, HM Treasury, Home Office, Homes and Communities Academy, Homes, and Communities Agency, Law commission, Local Better Regulation Office, Ministry of Defence, Ministry of Justice, Museums, Libraries and Archives Council, Natural England, Office for Standards in Education, Children’s Services and Skills, Office of Fair Trading, Office of Government Commerce, Office of Public Sector Information, Qualifications and Curriculum Development Authority, Sport England, Standards for England, Sustainable Development Commission, Tenant Services Authority, Training and Development Agency for Schools. Other sources: APHO, CASH, NICE, NHS Choices, King’s Fund, BBC Health News.