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The examples of practice included in this database aim to share learning among NHS and partner organisations. NICE has carried out a minimal quality assurance process on each project to ensure it meets basic criteria. Inclusion in this database does not constitute NICE endorsement of the approach, product or tool.

The examples in the database do not constitute NICE guidance. NICE has not assessed the projects to confirm that they accurately reflect or implement NICE guidance. If you have queries or concerns about the relationship between NICE guidance and any examples given, please refer to the original NICE guidance, which is the only definitive statement of the guidance.

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Examples of Shared Learning
'Living with changeable moods' : a psychoeducation program for older people with bi-polar disorder.
Description: A nine week psychoeducation program was developed to support older people who live with Bipolar disorder. Running alongside this is an ongoing monthly support group for those who have attended the course to offer support and self management of changeable moods
Organisation: Sussex Partnership NHS Foundation Trust
Guidance: CG38 - Bipolar disorder
Category of submission: Clinical Date: 29 Sep 2008
'MUST do better'-our journey, to improving nutrition for everyone - a continuous cyclic, trust wide audit, of NICE Clinical Guideline 32.
Description: Our new approach to audit was going to be very different in order to effectively drive improvement. Every ward would be required to participate in repeated monthly audits with feedback shared at all levels.

The message had gone out across the entire trust: Nutrition screening using the Malnutrition Universal Screening Tool (MUST) was a 'MUST do' for everyone and we MUST do better. The findings would highlight our weakness. It was a bumpy journey. Then the findings enabled good practice to be rewarded where screening and care planning was improving month on month. Wards became eager to demonstrate their compliance.

High targets were set by our Trust board who took a vested interest every month without fail to scrutinise and challenge the results. Wards began to shine as their monthly compliance, with MUST screening for every patient, rose impressively.
Organisation: UNIVERSITY HOSPITALS SOUTHAMPTON NHS FOUNDATION TRUST
Guidance: CG32 - Nutrition Support in Adults
Category of submission: 2011-12 Shared Learning Awards Date: 31 Jan 2012
'NICE Bites User Survey': Assessing the value of a monthly bulletin for healthcare professionals in the general implementation of NICE guidance.
Description: This submission reports the results of a user survey for NICE Bites, a monthly bulletin for healthcare professionals published by the North West Medicines Information Service and relates to the general implementation of NICE guidance. The purpose of this bulletin is to provide a clear and succinct summary of key prescribing points in NICE guidance. During the second year of publication a survey was conducted to assess; if the content of this bulletin is useful, relevant to practice, and easily accessible, how people use NICE Bites and if it made any difference to their prescribing practice.
Organisation: North West Medicines Information Service
Guidance: Generic
Category of submission: 2010-11 Shared Learning examples Date: 10 Feb 2011
'NICE Bites' prescribing bulletin.
Description: This submission describes the development of a bulletin entitled 'NICE Bites' for healthcare professionals involved in prescribing.
Organisation: North West Medicines Information Centre
Guidance: Generic
Category of submission: General Date: 18 Jun 2009
'Prescribing Information to support QIPP' - an annual compendium of prescribing and healthcare data, and guidance, based around the National Prescribing Centre's 'Quality, Innovation, Productivity and Prevention' topics
Description: For the past two years, the Department of Medicines Management, Keele University, has produced this compendium as part of the Prescribing Support Service commissioned by West Midlands NHS organisations.

Produced primarily as a reference for West Midlands medicines management teams, but also of interest to commissioners and prescribers, the publication presents comparative prescribing and healthcare data related to the key medicines management topics identified by the National Prescribing Centre (NPC) as having significant potential for making a contribution to the challenge posed by QIPP (Quality, Innovation, Productivity and Prevention).

The document also contains summaries of important evidence and guidance to support the delivery of QIPP in these areas.
Organisation: Department of Medicines Management, School of Pharmacy, Keele University
Guidance: Generic
Category of submission: 2011-12 Shared Learning Awards Date: 16 Jul 2012
'Quality Standards-the heart of effective pathways'
Description: We are using NICE Quality Standards and localised Map of Medicine pathways in a novel approach to ensure that national and local guidelines are available to clinicians on demand, All relevant guidance is linked to one pathway, with information about local compliance and non-compliance. This will help to ensure that clinicians are always working in line with national and local best practice
Organisation: Worcestershire Royal Hospital
Guidance: Generic
Category of submission: - Date: 15 Dec 2011
'Realising Life Goes on' Creating a slide show of life on home dialysis to inspire and encourage new patients
Description: It is hard for pre-dialysis patients to imagine life on dialysis. We have collected home dialysis patients' photographs of their life experiences while living with this treatment for many years. We created a simple slide show in order to educate, inspire and provide hope to pre-dialysis patients and their carers, and to enable them to make a more informed choice about their future dialysis treatment. We use the slide show during patient education sessions, and also to inform new staff joining our unit.
Organisation: East Kent Hospitals University NHS Foundation Trust
Guidance: CG73 - Chronic kidney disease
Category of submission: Clinical Date: 02 Oct 2009
'Symptom-triggered' Approach to Alcohol Detoxification
Description: Implementing a 'symptom-triggered' approach to the management of alcohol withdrawal in an acute hospital.
Organisation: Pennine Acute Trust
Guidance: CG100 - Alcohol-use disorders: physical complications
Category of submission: - Date: 04 Apr 2013
'The Monday Clinic'; Implementing a maternal obesity service
Description: Obesity in pregnancy carries significant risks for both mother and baby, yet we identified limited opportunities for women to access support and advice. We initiated a midwifery-led service which encourages obese, pregnant women to make positive healthy lifestyle changes in the antenatal period, which would be sustainable after the birth.
Organisation: Doncaster and Bassetlaw Hospitals NHS Foundation Trust
Guidance: PH27 - Weight management before, during and after pregnancy
Category of submission: 2010-11 Shared Learning examples Date: 30 Jan 2011
(Update of) Care Home Support Team (CHST) - Reducing Falls
Description: The development of the Care Home Support Team (CHST) has provided a multi-disciplinary/multi-agency support and therapy service to Care Homes in Derbyshire. Access to patients in Care Homes is variable, in that the service relies on the knowledge of the care home staff to refer for appropriate services. Therefore early interventions and preventative measures are not common practice for this group of people. The CHST aims to address these discrepancies. This service offers an opportunity to improve the quality of care to residents in Care Homes and thereby reduce their risk of falls.
Organisation: Derbyshire Community Health Services
Guidance: Generic
Category of submission: 2011-12 Shared Learning Awards Date: 23 Aug 2011
(Update of) Crossing the language barrier with a dedicated Mental Health Interpreting Service
Description: Increasingly Mental Health Services have to call on the support of interpreters in order to treat patients. Clinicians and interpreters have become aware that interpreting in a mental health context differs from interpreting in other contexts. As a result, a dedicated training scheme and Mental Health Interpreting Service has been established by Mothertongue multi ethnic counselling service.
Organisation: Mothertongue Counselling and Listening Service
Guidance: CG 113 - Anxiety (partial update)
Category of submission: - Date: 13 Sep 2011
(Update of) Hospital based smoking cessation practice including pre-operative assessment
Description: To ensure hospital patients are routinely offered advice and support regarding smoking cessation.
Organisation: Bolton Primary Care NHS Trust & Bolton NHS Foundation Trust
Guidance: Generic
Category of submission: 2011-12 Shared Learning Awards Date: 13 Sep 2011
A Buddy Scheme for Pulmonary Rehabilitation
Organisation: North East Lincolnshire Care Trust Plus
Guidance: CG12 - Chronic obstructive pulmonary disease
Category of submission: General Date: 06 Feb 2007
A Collaborative Approach to Implementing Self Harm Guidance
Organisation: Sheffield Teaching Hospital, Sheffield Care Trust, Sheffield Ambulance Service
Guidance: CG016 - Self-harm: The short-term physical and psychological management and secondary prevention of self-harm in primary and secondary care
Category of submission: General Date: 21 Dec 2006
A collaborative care plan to reduce unplanned admissions to secondary care and enhance rapid access care in the community
Description: A collaborative care plan was devised between primary and secondary care in order to provide a rapid access service within the community for people with MS to prevent unplanned admissions. People with Ms had been requesting that emergency care be provided closer to home and reduce the need to be admitted to hospital. The pathway also ensures that the right treatment is provided at the right time to the patient.
Organisation: Northamptonshire Healthcare foundation Trust
Guidance: CG8 - Multiple sclerosis
Category of submission: - Date: 25 Oct 2012
A Commissioning Toolkit for use of Natriuretic Peptide assessment for suspected heart failure in Primary Care
Description: Using local experience of implementing BNP in East Sussex, this provides a summary of helpful tips, planning guidance, quality standards, how much to commission and how to monitor compliance. It is supported by a simple care pathway and education package that can be used with GPs.
Organisation: Enhancing Quality
Guidance: CG108 - Management of chronic heart failure in adults in primary and secondary care
Category of submission: 2010-11 Shared Learning examples Date: 10 Feb 2011
A cost minimization model of a national roll-out of liquid based cytology in England
Organisation: Health Economics research group
Guidance: Generic
Category of submission: Clinical Date: 09 Jul 2008
A Creative Approach to Embracing a Sizeable Piece (52 Recommendations) of NICE Guidance.
Description: This NICE guidance represents a very interesting challenge for two key reasons (1) On Wirral it is the NHS who mostly lead on baselining and action planning around NICE yet this particular guideline is largely non-clinical with many of the recommendations it makes requiring LA action. (2) The scope of the guidance (52 recommendations compared to a typical 6 -10) renders some of the normal local templates and procedures used in baselining not fit for purpose. Therefore a creative approach has been taken to baselining and action planning whereby a large number of stakeholders could feel genuinely engaged with the work on all 52 recommendations without attending an unrealistic amount of meetings.
Organisation: NHS Wirral
Guidance: PH28 - Promoting the quality of life of looked-after children and young people
Category of submission: 2011-12 Shared Learning Awards Date: 11 Nov 2011
A framework for using NICE Quality Standards to improve quality
Description: A systematic approach to using all relevant NICE Quality Standards, and examples from QS34 and QS2.
Organisation: Lancashire Care NHS Foundation Trust
Guidance: QS34 - Self-harm
Category of submission: - Date: 13 Jan 2014
A Lifestyle Matters approach with a group of older people in warden controlled accommodation
Description: A joint initiative between Gateshead Council and Gateshead PCT looking at overcoming barriers which prevent people engaging in meaningful activities. The group focuses on the well elderly in warden controlled accommodation and is held on these premises. The group looks at the link between activity and wellbeing by using goal setting graded for individual needs to enable them to overcome their barriers in order to be fit and active.
Organisation: Gateshead PCT
Guidance: PH16 - Mental wellbeing and older people
Category of submission: 2010-11 Shared Learning examples Date: 28 Jan 2011
A Local Experience: A Multi-Agency Partnership Approach to our NICE Implementation System
Description: North East Lincolnshire Care Trust Plus was formed in September 2007, a unique development, being the first in the country, to bring together health and social care under one organisation and providing an integrated Public Health function by transferring it to the Local Authority thereby facilitating influence on the wider determinants of health and well-being for our population. The challenge was to implement a systematic and robust system for the implementation of NICE guidance throughout the organisations involved in delivering primary health and social care whilst working alongside the local health economy. This paper describes our experiences in achieving this.
Organisation: North East Lincolnshire Care Trust Plus
Guidance: Generic
Category of submission: General Date: 03 Oct 2008
A new 'NICE Policy' for King's College Hospital, London
Description: We updated the King's College Hospital (KCH) NHS Foundation Trust's 'NICE Policy'. This includes process flowcharts for implementing each type of NICE guidance, including the new Medical Technologies and Diagnostics guidance, and Quality Standards, in the Trust. The policy and flowcharts also help demonstrate compliance with the NHSLA Standard on NICE (Standard 2.8 for 2012/13), and thus include steps for assessing relevance, organisational gap analysis, and ensuring recommendations are acted upon.
Organisation: c/o NICE
Guidance: Generic
Category of submission: - Date: 01 Feb 2012
A Partnership approach to improving the nutritional care of our patients
Organisation: South Tees Hospitals NHS Trust
Guidance: CG032 - Nutrition support in adults
Category of submission: Clinical Date: 01 Oct 2008
A redesigned, GP commissioned NHS service model for the early detection, referral and management of peripheral arterial disease
Description: A new NHS clinical service model for Peripheral Arterial Disease (PAD). The service was commissioned and set up in primary care settings and staffed by experienced specialist clinicians. It has resulted in planned, optimum detection and management of peripheral arterial disease along with a reduction in unnecessary referrals to secondary care vascular surgical teams.

The service specification and pathway relates to the majority of the recommendations in the NICE guidance and to the majority of people diagnosed with PAD who require non-surgical management.
Organisation: Pennine Acute Hospitals Trust
Guidance: CG147 - Lower limb peripheral arterial disease
Category of submission: 2011-12 Shared Learning Awards Date: 18 Jun 2012
A risk assessment and management training project to implement a clinical risk assessment tool - CAMORT
Description: In response to national policy including NICE guidelines and local clinical need, a standardised Clinical Assessment and Management of Risk Toolkit (CAMORT) was developed for use by multi-disciplinary teams in Manchester Mental Health and Social Care Trust. This project was designed to deliver a robust evidence based training programme for the assessment and management of risk and now been delivered to clinicians from all professional groups throughout the Trust. An evaluation of the impact of this training has been completed.
Organisation: Manchester Mental Health & Social Care Trust
Guidance: CG 16 CG 25 - Self-harm: The short-term physical and psychological management and secondary prevention of self-harm in primary and secondary care
Category of submission: Clinical Date: 30 Sep 2009
A self directed anxiety support group for older people
Description: We describe why we developed a structured anxiety management programme for over older people, how we planned and implemented it and some of the key outcomes which were apparent in the short term
Organisation: Sussex Partnership NHS Foundation Trust
Guidance: CG22 - Anxiety
Category of submission: Clinical Date: 03 Oct 2008
A self help leaflet written by a service user and member of staff to help get the two NICE guidelines on self harm into practice
Description: A self help leaflet written by a service user and member of staff to help get the two NICE guidelines on self harm into practice.
Organisation: Lancashire Care NHS Foundation Trust
Guidance: - CG16 and CG133 - Short term and long term management of self harm
Category of submission: - Date: 19 Nov 2012
Actioning NICE: a service level approach
Description: This submission relates to the formation of the NICE Action Group (NAG) within the working age adults service unit of the 2gether Foundation Trust. A need had been identified for a formal process to be determined for managing actions resulting from recommendations made within NICE guidance audit reports. In addition, communication of NICE guidance information needed to be addressed; how could communication channels be utilised more efficiently to ensure NICE guidance information was communicated to all staff and embedded into day to day working practice?
Organisation: 2gether Foundation Trust
Guidance: Generic
Category of submission: 2010-11 Shared Learning examples Date: 09 Feb 2011
Adams Portion Pot Weight Management System
Description: Practical tool to help overweight and obese people to manage recommended calorie deficit
Organisation: Adams Insight Ltd (Adams Portion Pot)
Guidance: CG43 - Obesity:Guidance on the prevention, identification, assessment and management of overweight and obesity in adults and children
Category of submission: Clinical Date: 15 Sep 2009
Addressing Unmet needs: A multidisciplinary group clinic for people with Parkinson's Disease and their carers
Description: The Parkinson's Evening Group Clinic is geared towards multidisciplinary patient centred care, developing expert patient groups and addressing key unmet needs by allowing patients and their carers to access all members of the specialist multi-disciplinary team in one meeting. By utilising underused evening clinic space the clinic has reduced delays in the patient pathway. The group also allows patients and carers the opportunity to learn from each other by providing novel suggestion around how they manage some of the difficulties they have and what has worked well for them.
Organisation: King's College Hospital
Guidance: CG35 - PARKINSON'S DISEASE National clinical guideline for diagnosis and management in primary and secondary care.
Category of submission: Clinical Date: 16 Sep 2009
ADHD 'Making Sense of NICE' campaign - putting the ADHD NICE guidelines into practice
Description: A series of practical tools to help NHS stakeholders identify development areas in local ADHD service provision with reference to NICE guidelines. The flexible framework of tools can be scaled up or down to give individuals of all roles and statuses the confidence and support to propose specific opportunities for the improved experience of service users.
Organisation: Shire Pharmaceuticals
Guidance: CG72 - Attention deficit hyperactivity disorder (ADHD)
Category of submission: 2010 Shared Learning examples Date: 08 Oct 2010
Advances in preventing injury and death during physical restraint
Description: Following the publication of the David Bennett Inquiry (December 2003), 2gether NHS Foundation Trust commenced a programme of enhancing the clinical skills of staff involved in Rapid Tranquilisation and Physical Interventions. In undertaking this programme of training recommendations from the inquiry, public evidence from national organisations and professional journals, were utilised to develop a comprehensive training programme which identified potential and possible risk factors which need to be considered during restraint. This led us to introduce Medical Emergency Response Teams (MERT).
Organisation: 2gether NHS Foundation Trust
Guidance: CG25 - Violence
Category of submission: Clinical Date: 26 Sep 2008
An audit of the implementation of NICE public health guidance on promoting physical activity for children and young people
Description: This example describes an audit of the implementation of NICE public health guidance on promoting physical activity for children and young people in Oxfordshire in the academic year 2011/12.
Organisation: NHS Oxfordshire
Guidance: PH17 - Promoting physical activity for children and young people
Category of submission: - Date: 29 Oct 2012
An audit on the investigation and management of neonatal jaundice
Description: An audit was conducted at our hospital looking at NICE jaundice guidelines and whether our trust was investigating and managing these affected babies according to the 'gold standard'.

We found the use of the transcutaneous bilirubinometer to be excellent in decreasing the number of painful blood tests needed and also in reducing our workload.

The main downfall noted and subsequently addressed was the lack of information provided to parents about the condition and management strategies.
Organisation: Barts Health NHS Trust
Guidance: CG98 - Neonatal jaundice
Category of submission: - Date: 07 Nov 2012
An E-Learning Training Programme for Recognising and Responding to the Acutely ill Patient in Hospital
Description: As a region we created and implemented a web-based e-learning programme that educates, validates, interrogates and accredits the learner's knowledge in the application of educational recommendations laid out in NICE CG50. It is accredited by the Royal College of Nursing and local universities and is designed to increase the skills of staff dealing with acutely ill patients, without taking them away from their work.
Organisation: Norfolk, Suffolk and Cambridgeshire Critical Care Network
Guidance: CG50 - Acutely ill patients in hospital
Category of submission: 2010-11 Shared Learning examples Date: 10 Feb 2011
An electronic tool to help prevent potentially fatal blood clots associated with hospitalisation
Description: We have developed an electronic venous thrombo-embolism risk assessment tool which has resulted in a dramatic improvement in the numbers of patients being routinely assessed on admission to hospital and offered appropriate preventative thromboprophylaxis measures according to national guidance. The tool provides timely reminders to clinical staff, documents the risk assessment in the electronic patient record, provides guidance according to NICE recommendations and then requires confirmation that guidance has been followed (or reasons why if deviated from) for audit purposes.
Organisation: University Hospitals Coventry and Warwickshire
Guidance: CG92 - Venous thromboembolism - reducing the risk
Category of submission: 2010-11 Shared Learning examples Date: 11 Feb 2011
An innovative approach to implementing NICE guidance via a needs-lead framework for mental health care.
Organisation: Rotherham Doncaster and South Humber NHS Foundation Trust
Guidance: Generic
Category of submission: General Date: 14 Feb 2008
An innovative approach to providing lifestyle education and behaviour change to prevent type 2 diabetes
Description: Working together the NIHR Collaboration for Leadership in Applied Health Research and Care (CLAHRC) for Greater Manchester and NHS Salford developed a six month, telephone based, quality assured intensive lifestyle change intervention programme for people at high risk of developing type 2 diabetes (high risk: those with oral glucose tolerance test result between 7.8-11mmol/l and a fasting plasma glucose result 6.1-6.9 mmol/l and diagnosed as having 'impaired glucose tolerance [IGT]'). Delivered by a team of trained health advisors, the programme provided motivation, support and evidence based education via a series of electronic scripts developed and maintained by the specialist diabetes team.
Organisation: Greater Manchester CLAHRC (Linda's) Salford Royal Foundation Trust Diabetes Team (Katherine)
Guidance: Generic
Category of submission: 2011-12 Shared Learning Awards Date: 26 Jun 2012
An integrated pathway for the treatment of personality disorder in health services.
Description: The submission presents three documents which outline a care pathway developed to assist primary and secondary mental health care services offer NICE compliant treatment for patients with borderline and personality disorder.
Organisation: Cambridge and Peterborough Mental Health Partnerships Trust.
Guidance: CG78 - Borderline personality disorder: treatment and management
Category of submission: Clinical Date: 21 Aug 2009
An ongoing implementation - reducing pressure ulcer prevalence in Birmingham Nursing Homes
Description: An increasing prevalence of Pressure Ulcers in Birmingham Nursing Homes was halved by the implementation of a regular Pressure Ulcer Audit
Organisation: Birmingham Community Healthcare
Guidance: CG 29 - Pressure Ulcers Management CG 29
Category of submission: - Date: 28 Jan 2013
Any Body Can Cook! - Engaging and encouraging the public to acquire healthy-eating skills and habits.
Description: ABC Cook! is a healthy eating initiative working in partnership with a wide range of local and national organisations and charities and has been awarded by both the Royal Society for Public Health and Wiltshire Council for its delivery of a variety of sessions and longer courses to local community participants of all ages and abilities. Delivered by qualified chef-educator, Catherine Maxwell, sessions provide motivation and support through the delivery of practical skills in cooking, shopping, nutrition, labelling and food safety. Courses are designed to meet the identified needs of each learner with evidence-based content and delivery.
Organisation: Any Body Can Cook!
Guidance: PH49 - Behaviour Change: individual approaches
Category of submission: - Date: 05 Dec 2013
Appropriate antibiotic usage in care homes
Description: In 2008 NHS North Lancashire Primary Care Trust (PCT) initiated a joint campaign with the Association of British Pharmaceutical Industries (ABPI) to reduce the incidence of Clostridium difficile infection (CDI) within their community. Antimicrobial stewardship, through encouraging the appropriate use of antimicrobials in care homes was identified as a priority as some cases of inappropriate prescribing had been identified in local community settings. Limited access was found to guidance on appropriate prescribing at a community level. As inappropriate prescribing of antibiotics can damage the gut flora and make the patient more susceptible to CDI, antimicrobial stewardship was identified as a priority for the campaign. This case study outlines the Trusts' efforts to audit antibiotic usage within their care home settings, detailing the steps taken in planning and undertaking the audit and it outlines their proposed actions, including the development of a new antibiotic formulary.
Organisation: NHS North Lancashire
Guidance: CG139 - Infection control
Category of submission: 2011-12 Shared Learning Awards Date: 02 Jul 2012
Are inpatients routinely assessed for venous-thrombo-embolism on admission?
Description: This is an audit cycle that took place between 2011 and 2012. The audit was aimed to investigate whether physical health assessment and VTE risk assessment were routinely completed and documented in the inpatients clinical notes.The results will be used to develop plans around the prevention and management of VTE in inpatients, in conjunction with the Medicines Safety Group committee.
Organisation: Oxford Health NHS Foundation Trust
Guidance: CG92 - Venous thromboembolism - reducing the risk
Category of submission: - Date: 12 Mar 2013
Assessing the impact of implementing a hospital discharge COPD (chronic obstructive pulmonary disease) care bundle on the respiratory ward at West Middlesex University Hospital
Description: Using improvement methodology, a COPD discharge care bundle was implemented by a multidisciplinary team (MDT) on the respiratory ward at West Middlesex hospital (WMUH), and its impact on readmission rates assessed after one year.
Organisation: West Middlesex University Hospital
Guidance: CG101 - Management of chronic obstructive pulmonary disease in adults in primary and secondary care (partial update, CG 101)
Category of submission: 2011-12 Shared Learning Awards Date: 28 Jan 2012
Assessment and treatment of depression in adults in primary care
Description: The existing local Primary Care Protocol for Depression Croydon, a local guideline for treating depression in adults, was 10 years old. This submission describes the process undertaken to review the guideline in line with the latest evidence to ensure it supported current prescribing and referral practice in Croydon.
Organisation: Croydon Borough Team, NHS South West London
Guidance: CG90 - Depression in adults (update)
Category of submission: - Date: 20 Dec 2012
Assessment of risk of VTE in a Community Setting
Description: We have introduced assessment of venous thromboembolism (VTE) into our Community Intermediate Care Unit (CICU). CICU is an in-patient ward providing short term medical treatment and rehabilitation to people aged over 60 years who do not need acute hospital care.
Organisation: NHS Leeds Community Healthcare
Guidance: CG92 - Venous thromboembolism - reducing the risk
Category of submission: 2010 Shared Learning examples Date: 19 Jan 2011
Assessment of the reliability of the Patient Observations undertaken in an acute hospital setting.
Organisation: Brighton & Sussex University Hospitals NHS Trust
Guidance: CG50 - Acutely ill patient in hospital
Category of submission: Clinical Date: 26 Sep 2008
Audiovisual Demonstration of Guidelines improves attitude, knowledge and behaviour: An implementation study in junior doctors management of the febrile child
Description: An audiovisual description of the NICE Feverish Illness in Children (CG160) Traffic Light Table was created for Junior Doctors working in Emergency Departments.

A before and after study (202 doctors registered) was performed. Levels of satisfaction were high, attitudes to managing febrile children improved (p<0.0001 across all domains), knowledge scores increased significantly (Z-3.942, p<0.001) and there was a trend to change in behaviours in the application of the guidance.

Audiovisual (i.e video and sound recordings) demonstrating the application of guidelines in practice is a valid methodology to improve guideline implementation.


Organisation: Leicester Hospitals
Guidance: CG160 - Feverish illness in children
Category of submission: - Date: 20 Jan 2014
Audit against NICE Guidance CG101 for patients with Chronic Obstructive Pulmonary Disease (COPD)
Description: The audit was undertaken to measure best practice for caring for people with COPD, as documented in the NICE (CG101) 2010 guidelines, against the care given to COPD patients on the caseload of the respiratory specialist nurse service which is part of Community Health Services. Recommendations from NICE guidance states:
- To improve quality of life, avoid unnecessary admissions and reduce length of stay in accordance with NICE guidance (CG101) and locally agreed pathways. (This was one of the criteria used in the audit to demonstrate how patients quality of life was measured and what steps were put in place (Audit report attached)
- The aim of this audit was also to measure the current practice within the Respiratory team in the diagnosis and management of COPD against the recommendations in NICE guidance.
- In addition we also demonstrated improvement against Quality statements 2 and 8 from the NICE Quality standard QS 10.
Organisation: Leicester Partnership NHS Trust
Guidance: CG101 - Chronic obstructive pulmonary disease (updated)
Category of submission: - Date: 23 Dec 2013
Audit of Specialist Perinatal Mental Health Services in Sussex
Description: Development of as specialist perinatal mental health service and ongoing service evaluation of clinical and cost effectiveness.
Organisation: Sussex Partnership NHS Foundation Trust
Guidance: CG45 - Antenatal and postnatal mental health
Category of submission: 2011-12 Shared Learning Awards Date: 30 Jan 2012
Auditing NICE Quality Standard 24 on Nutrition
Description: An audit project undertaken by the Lancashire Care NHS Foundation Trust dietetics team, that aimed to understand and improve current practice for their clients.
Organisation: Lancashire Care NHS Foundation Trust
Guidance: QS24 Nutrition - Nutrition
Category of submission: - Date: 19 Jan 2014
Auditing Venous Thromboembolism risk assessment at South London Healthcare Trust
Description: Following an initial audit in February 2011, the team at South London Healthcare Trust (SLHT) undertook a re-audit to assess if Venous Thromboembolism (VTE) risk assessment had taken place, to check if the appropriate thromboprophylaxis was prescribed and given and to establish if the patient had been provided with sufficient information about VTE. The audit was done in patients admitted Jan 2012 to April 2012.
Organisation: South London Healthcare NHS Trust
Guidance: CG92 - Venous thromboembolism - reducing the risk
Category of submission: - Date: 02 Oct 2012
Autism management in children and young people - recognising and overcoming barriers to accessing care
Description: When concerns in suspected autism are 'sub-threshold' children fall between services and are left unsupported. We have established a multi-agency autism forum including therapists, child and mental health services (CAMHS) psychologists and psychiatrists, paediatricians, and education, to improve referral and support the pathway.
Organisation: Hampshire Hospitals NHS Foundation Trust
Guidance: CG170 - Autism - management of autism in children and young people
Category of submission: - Date: 16 Jul 2013
Becoming a Pushy Corporate Parent
Description: To improve the health outcomes of looked after children through the concept of being pushy corporate parents and wanting key professionals to have the same aspirations for looked after children and the kind of loyal support a good parent would give.
Organisation: Wirral Borough Council
Guidance: PH28 - Looked-after children and young people full guidance
Category of submission: 2011-12 Shared Learning Awards Date: 13 Jul 2011
Better prescribing through an elearning approach
Description: Development of an elearning platform to deliver educational materials to improve prescribing by junior doctors.
Organisation: NHS West Midlands
Guidance: CG76 - Medicines adherence
Category of submission: 2010-11 Shared Learning examples Date: 10 Feb 2011
Beyond The Basics: Seeking assurance for a NICE process
Organisation: Royal Wolverhampton Hospitals NHS Trust
Guidance: Generic
Category of submission: General Date: 07 Oct 2008
Bringing the benefits of Home Haemodialysis Home
Description: An innovative approach to dialysis delivery to enable and empower patients to perform Haemodialysis independently at home, avoiding regular visits to hospital for treatment. The model has seen phenomenal success in uptake, achieving NICE recommendations, and has been associated with improvement in patient experience and outcomes.
Organisation: Manchester Royal Infirmary, Central Manchester Foundation Trust
Guidance: TA48 - Renal failure - home versus hospital haemodialysis
Category of submission: 2010-11 Shared Learning examples Date: 08 Feb 2011
Can we improve the implementation of the NICE Guidelines for Depression and the Anxiety Disorders in Southwark?
Description: Audit, implementation work and re-audit. How we improved implementation of the NICE Guidelines for Depression and the Anxiety Disorders (GAD, OCD & BDD, PTSD) in the London Borough of Southwark.
Organisation: Institute of Psychiatry
Guidance: CG31,CG26 - OCD & BDD, PTSD
Category of submission: Clinical Date: 30 Sep 2009
Cancer Survivors Group
Description: The group is to help patients who struggle to do the 'living' and 'surviving' with cancer. It aims to provide emotional support and practical advice once the treatment is complete and aims to help patients overcome the apprehension caused by not having on going hospital treatment.
Organisation: Walsall Community Health
Guidance: Generic
Category of submission: - Date: 05 Jul 2010
Care Home Support Team (CHST) - Reducing Falls
Description: CHST provides therapy, activity, support and education to residents and staff within care homes. It is reducing hospital admissions, facilitating discharge and improving the quality of life for residents. Please note that this example was originally submitted to demonstrate implementation of NICE clinical guideline 21 on the assessment and presention of falls in older people (CG21). The guidance has been updated and replaced by CG161. The practice in this example continues to be in line with the updated guidance.
Organisation: Derbyshire Community Health Services
Guidance: CG161 - Falls
Category of submission: 2010-11 Shared Learning examples Date: 07 Feb 2011
CCG and LA joint process for using NICE Quality Standards to drive quality improvement
Description: With the objectives to improve joint working, to achieve integrated commissioning and to share resources where possible, NHS Stockport CCG and Stockport Metropolitan Borough Council wanted to develop a systematic approach to align the quality agendas and to ensure they were supported by evidence based information.
Organisation: NHS Stockport Clinical Commissioning Group and Stockport Metropolitan Borough Council
Guidance: Generic
Category of submission: - Date: 16 Jan 2014
Central venous cannulation - transforming training and safety
Description: I campaigned for and obtained portable ultrasound equipment whilst working at Northampton general hospital. I then wrote the guidelines for use and devised a training program for the use of portable ultrasound in central venous cannulation.
Organisation: John Radcliffe Hospital
Guidance: TA49 - Central venous catheters - ultrasound locating devices
Category of submission: Clinical Date: 17 Sep 2009
Childhood Immunisation Guideline
Description: This guideline is based on the childhood immunisation policy developed by NHS Hampshire and the NICE Guidelines published in 2009. It focusses on increasing immunisation uptake among children and young people aged less than 19 years in groups and settings where immunisation coverage is low. The overall aim has been to ensure that every opportunity is used to encourage the increased uptake of childhood vaccines therefore reducing the incidence of disease and the possibility of outbreaks and epidemics.
Organisation: NHS South of England (Central)
Guidance: PH21 - Reducing Differences in the uptake of immunisations.
Category of submission: 2011-12 Shared Learning Awards Date: 17 May 2012
Clinical and Cost Effective Prescribing of Oral Nutritional Supplements for Adults in the Community
Description: The NHS QIPP agenda states that all NHS staff have a personal, professional and moral responsibility to address financial inefficiencies in order to treat more patients, more effectively (DOH 2010). Swindon PCT and GWH NHS Foundation Trust identified a need to improve prescribing practices of oral nutritional supplements (ONS) in the community in order to meet NICE guidelines and produce cost savings. The project included an initial audit to assess current prescribing practice in 4 GP practices identified as the highest prescribers of ONS. Nutritional education sessions were then devised to highlight the identification and treatment of malnutrition and provide guidelines to improve prescribing practices. So far a re-audit has been conducted on 2 of the GP practices 6 months post education to assess improvements in meeting NICE guidelines incorporating clinical and cost effective prescribing of ONS.
Organisation: GWH NHS Foundation Trust & NHS Swindon
Guidance: CG32 - Nutrition support in adults
Category of submission: 2010-11 Shared Learning examples Date: 10 Feb 2011
Closing the gap between evidence and practice in primary care: Development and testing of review criteria for the management of osteoporosis and depression in North East England
Description: Development and testing of review criteria for assessing compliance with NICE guidelines in primary care, using osteoporosis and depression as examples.
Organisation: NHS South of Tyne and Wear
Guidance: Generic
Category of submission: 2011-12 Shared Learning Awards Date: 27 Jan 2012
Cognitive behaviour therapy for psychosis can be adapted and implemented for minority ethnic groups: A randomised controlled trial
Description: Cognitive behavioural therapy (CBT) is recommended in treatment guidelines for psychotic symptoms (NICE, 2009) but clients from some minority groups have been shown to have higher dropout rates and poorer outcomes. This can present a challenge in implementation. This study assessed the effectiveness of a culturally adapted CBT for psychosis (CaCBTp) in Black British, African Caribbean/Black African and South Asian Muslim participants.

http://www.ncbi.nlm.nih.gov/pubmed/23231878

Please note that this example was originally submitted to demonstrate implementation of CG82 Schizophrenia (update). CG82 has now been replaced by CG178. The example has been reviewed and continues to align with the new guidance.
Organisation: Southern Health NHS Foundation Trust
Guidance: CG178 - Psychosis and Schizophrenia in adults
Category of submission: - Date: 19 Nov 2013
COMING SOON: A shared learning example of local practice based on the NICE guidance for MI with ST segment elevation
Description: -
Organisation: -
Guidance: CG167 - Myocardial infarction with ST-segment elevation
Category of submission: - Date: 25 Jun 2013
Commissioning for Quality in Rheumatoid Arthritis (CQRA)
Description: Commissioning for Quality in Rheumatoid Arthritis (CQRA) aims to standardise and improve the quality of rheumatoid arthritis (RA) service delivery in the UK based on current best evidence (NICE RA Guidelines) by developing and driving implementation of clinically-relevant, patient-driven and meaningful key commissioning metrics. These metrics can be used by commissioners as indicators to ensure they are commissioning a high quality RA service and to drive early development and implementation of quality metrics in RA services. The implementation of these commissioning metrics will assure consistent quality of RA patient services and improved outcomes.
Organisation: CQRA
Guidance: CG79 - Rheumatoid arthritis: the management of rheumatoid arthritis in adults
Category of submission: 2011-12 Shared Learning Awards Date: 28 Jan 2012
Community based Falls Prevention in Older People
Description: Development of a comprehensive multi-agency community based Falls Prevention Service for People aged 65+. Please note that this example was originally submitted to demonstrate implementation of CG21 Falls. CG21 has now been extended and updated by CG161. This example continues to align with guidance, particularly recommendation 1.1.2 Multifactorial falls risk assessment.
Organisation: Anglesey County Council
Guidance: CG161 - Falls
Category of submission: - Date: 26 Aug 2009
Community based pulmonary rehabilitation service
Organisation: Birmingham East and North PCT
Guidance: CG12 - Chronic obstructive pulmonary disease
Category of submission: Clinical Date: 30 Sep 2008
Community engagement to increase childhood immunisations
Description: Use of a community engagement approach to support children and their families in accessing GP practices for missing childhood immunisations.
Organisation: North East Lincolnshire Care Trust Plus
Guidance: PH21 - Reducing differences in the uptake of immunisations
Category of submission: 2011-12 Shared Learning Awards Date: 25 Jan 2012
COMMUNITY NICE - Lay people can play a role in both developing NICE guidelines and thereafter bringing NICE guidelines into a local community setting and delivering action
Organisation: Barton and Tredworth Community Trust Centre
Guidance: PH8 - Physical activity and the environment
Category of submission: Public Health Date: 02 Oct 2008
Comprehensive NICE Compliant Service Model for Obsessive-compulsive disorder (OCD) and Body Dysmorphic Disorder(BDD)
Description: This describes the service and clinical operation of a service for Obsessive Compulsive and Body Dysmorphic Disorders throughout the severity spectrum. The service covers an adult population of approximately 1 million but by using NICE guidance optimises the effectiveness of interventions at all levels. The service has fewer than 5 WTE staff employed to meet these aims.
Organisation: South West London and St George's Mental Health NHS Trust
Guidance: CG31 - Obsessive-compulsive disorder: Core interventions in the treatment of obsessive-compulsive disorder and body dysmorphic disorder
Category of submission: Clinical Date: 03 Aug 2009
Computerised CBT for mood problems after Stroke
Description: Working with the community neurorehab teams in Cambridgeshire, PhD student Sara Simblett identified a way of making computerised Cognitive Behavioural Therapy (cCBT) accessible to stroke patients. Gathering small groups of patients and using local library or community village hall facilities, or providing cheap laptops for use in the patient's home, she implemented a trial of the approach. Positive results, and learning from some adverse reactions build on the NICE guidelines for cCBT.
Organisation: Cambridgeshire Community Services NHS Trust
Guidance: TA97 - Computerised Cognitive Behavioural Therapy for Depression and Anxiety
Category of submission: - Date: 31 Jan 2013
Computerised Decision Support: Supporting hypertension management at the point-of-care
Description: Whilst many physicians support guidelines in principle it would appear that their uptake in practice is variable (Heagerty et al, 2006); the reasons for this are manifold and, as a consequence, a series of coordinated efforts is most likely required to support adherence. Computerised decision support has been shown to improve best practice (Kawamoto et al, 2005) and as such, may provide a useful tool within an overall guideline implementation programme. In order to make guidance more accessible to practitioners and more easily applicable to individual patients, Medicines Management, Keele University, developed a computerised prescribing decision support tool driven by up-to-date NICE guidance on the management of patients with hypertension. Please note that this example was originally submitted alongside CG34 on Hypertension. CG34 has now been replaced by CG127. The principle of developing decision making support to facilitate guidance implementation, remains sound.
Organisation: Medicines Management, School of Pharmacy, Keele University
Guidance: CG127 - Hypertension
Category of submission: - Date: 28 Sep 2009
Counselling in primary care a low cost educational model
Description: We set up a low cost 6 session model for problem solving counselling, within a general practice of 15000 patients, which has benefited patients, provided counsellors with training and reduced general practitioner consultations. The lead counsellors on the project are: Mrs Christine Dunkley Advanced practitioner in psychological therapy: Hampshire Partnership Mental Health Trust and Mrs Christine Smith CBT Counsellor and Counselling co-ordinator: Park Surgery Chandlers Ford Hampshire. Within the NHS there has, until now, been very limited funding for counselling for moderately severe depression and anxiety and this innovative model represents a low cost way in which NHS primary care can rapidly expand counselling provision. Please note that this example was originally submitted to demonstrate implementation of CG23 Depression. CG23 has now been updated and replaced by CG90. The example continues to align with the updated guidance.
Organisation: Park Surgery
Guidance: CG90 - Depression in adults (update)
Category of submission: - Date: 05 Sep 2009
Creating a health community-wide Prescribing Forum to put NICE guidance into practice
Description: Devon Partnership NHS Trust (DPT) provides services to the people of Devon excluding Plymouth. A health community-wide Prescribing Forum was created to manage the introduction of mental health-related NICE guidance into practice. This was done involving representatives of the two commissioning PCTs, the mental health trust, GPs, psychiatrists, pharmacists and nursing staff.
Organisation: Devon Partnership NHS Trust
Guidance: Generic
Category of submission: 2011-12 Shared Learning Awards Date: 26 Jan 2012
CT coronary angiography
Description: In patients presenting with stable chest pain with low to intermediate predicted risk of coronary artery disease, CT coronary angiography leads to more accurate detection of coronary artery disease, fewer second-line investigations and more definitive rule out of coronary artery disease with lower cost to reach diagnosis compared with exercise tolerance testing.
Organisation: University Hospital Lewisham
Guidance: CG95 - Chest pain of recent onset
Category of submission: 2011-12 Shared Learning Awards Date: 30 Jan 2012
Dancing down Memory Lane: Circle Dancing as a Psychotherapeutic Intervention in Dementia
Description: The National Dementia strategy (2009) outlines that 'by 2014 services are expected to be able to..enable everyone to live well with dementia'. There is increasing recognition that psychological interventions for people with dementia and their carers are of value (NICE-SICE, 2007). Neuropsychological considerations and exploration of the literature point towards the potential benefits of dance and movement therapies as non-verbal, body-oriented interventions that can be used to work psychotherapeutically with people as their cognitive abilities deteriorate. This group uses circle dancing with a view to enhancing the quality of life and emotional well-being of people with moderate to advanced dementia and their carers.
Organisation: East London NHS Foundation Trust
Guidance: CG42 - Dementia
Category of submission: 2010-11 Shared Learning examples Date: 31 Jan 2011
Davies's structured interview for assessing adolescents in crisis
Description: Three structured interviews providing a checklist of key questions to be asked by health professionals assessing suicide risk of children and adolescents in crisis situations. The questions allow for a quick and comprehensive assessment, reminding clinicians of the factors they should consider when deciding if a risk is significant or not, and ensuring that factors are not neglected or overlooked.
Organisation: The Association of Psychological Therapies (APT)
Guidance: Generic
Category of submission: - Date: 04 Jul 2013
De-medicalising long term sickness absence, human solutions to 'stress' and common mental health problems
Description: Data from 948 referrals to the Leicestershire The Fit for Work Team reveal that while 61% of referrals are for people with mental health problems, only 5% of people who have returned to work cite mental health therapy as the most important intervention. 71 % report that more practical and human interventions at the workplace are the most important intervention.
Organisation: Leicestershire Fit for Work Service
Guidance: PH19 - PH19 - Managing long-term sickness absence and incapacity for work
Category of submission: 2011-12 Shared Learning Awards Date: 30 Jan 2012
Delivering acute kidney injury (AKI) education for nursing staff in the medical assessment unit, to support the earlier identification of AKI and to improve its initial management.
Description: Acute kidney injury (AKI) - if not identified and treated early enough - can lead to significant patient harm, morbidity, increased length of hospital stay, and also loss of life. Many acutely ill patients are at risk of developing AKI, and after recognising that around 60% of patients at Derby hospital were presenting with AKI on admission, the renal unit team collaborated with the medical assessment unit to create and deliver an AKI awareness and education programme for the MAU nursing team; to maximise the initial management of patients who may be at risk of AKI. In addition to the training programme, a system of AKI refresher sessions and ongoing support is being established for the MAU nursing team.
Organisation: Derby Hospitals NHS Foundation Trust
Guidance: CG169 - Acute kidney injury
Category of submission: - Date: 13 Jan 2014
Delivering Family Interventions - The Meriden Family Programme
Description: The Meriden Family Programme is a training and organisational development programme which seeks train clinical staff, service users, and carers in the skills needed to work with families and to ensure that workers are able to deliver quality, evidence-based family interventions.

Please note that this example was originally submitted to demonstrate implementation of CG82 Schizophrenia (update). CG82 has now been replaced by CG178. The example has been reviewed and continues to align with the new guidance.
Organisation: The Meriden Family Programme
Guidance: CG178 - Psychosis and Schizophrenia in adults
Category of submission: 2011-12 Shared Learning Awards Date: 06 Oct 2011
Delivering Primary Prevention in Primary Care
Description: NICE Clinical and Public Health guidance make recommendations for primary prevention in primary care. This submission describes how in Knowsley we have engaged GPs to develop a practical framework for embedding primary prevention in the GP/nurse consultation.
Organisation: Knowsley PCT
Guidance: Generic
Category of submission: General Date: 30 Sep 2008
Delivering QIPP through NICE
Description: Effective implementation of a NICE interventional procedure guidance in Derriford resulted in safer practice, faster patient recovery, higher productivity and reduced procedure costs. The change in practice has contributed to the overall NHS QIPP agenda and to the local rationalisation of gynaecology services onto one site.
Organisation: Plymouth Hospitals NHS Trust
Guidance: IPG315 - Hysteroscopic sterilisation by tubal cannulation and placement of intrafallopian implants
Category of submission: 2010-11 Shared Learning examples Date: 11 Feb 2011
Departmental reinforcing of the North West Peripheral Arterial Disease Guidelines
Description: Reinforce the North West Peripheral Arterial Disease Guidelines throughout the Podiatry Department. Presentation and workshop on implementing the Guidelines to improve patient care and outcomes.
Organisation: Podiatry Department. Bridgewater Community Health NHS Trust
Guidance: CG147 - Lower limb peripheral arterial disease
Category of submission: - Date: 31 Jan 2013
Depression and Anxiety Spectrum Disorder Care Pathway
Description: This web-based "Care Pathway" has been developed as a partnership project between Surrey PCT and Surrey and Borders partnership Foundation NHS Trust. This "Pathway" provides a mechanism for improving outcomes for depression and anxiety spectrum disorders (GAD, PD, PTSD, OCD and social phobia) - especially disability - through more appropriate choices of management. Importantly it is also a tool that will be useful to patients and carers and for education and training of healthcare professionals.
Organisation: NHS Surrey
Guidance: CG90,22,133,31,26 - Depression with a Chronic Physical Heath Problem, Generalised disorder and panic disorder ; Obsessive compulsive disorder and body dismorphic disorder, Post-traumatic stress disorder (PTSD):
Category of submission: 2010-11 Shared Learning examples Date: 11 Feb 2011
Derby Dementia Support Service
Description: The Derby City Dementia Support Service is provided to people living in Derby who have a diagnosis of dementia or have concerns about memory or dementia like symptoms and for their informal Carers. The service assists people with dementia and their Carers prior to and at the point of diagnosis and throughout their dementia journey, providing emotional support and information, supporting self-management and facilitating peer support as appropriate. Co-locating with community mental health services and working closely with memory assessment clinics and social care, the service is embedded within the wider dementia pathway and has an important role in supporting integration of services. This example is relevant to the NICE Quality Standard 30 on supporting people to live well with dementia and particularly Quality Statement 5 on developing and maintaining relationships and Quality Statement 6 on physical, mental health and wellbeing.
Organisation: Derby City Council
Guidance: QS30 - Supporting people to live well with dementia
Category of submission: - Date: 12 Sep 2013
Developing a Greater Manchester Hepatitis C Service Specification
Description: A project to manage the development of a Greater Manchester hepatitis C service specification.
Organisation: Greater Manchester Public Health Network
Guidance: TA200 - Hepatitis C - peginterferon alfa and ribavirin
Category of submission: 2011-12 Shared Learning Awards Date: 28 Sep 2011
Developing a new NICE database
Organisation: Harrogate and District NHS Foundation Trust
Guidance: Generic
Category of submission: General Date: 08 Apr 2008
Developing an evidenced based Antiplatelet prescribing Algorithm, and encouraging its usage across Primary and Secondary care.
Description: A local guideline, in the form of an algorithm (Appendix 1) was developed by a group of doctors and pharmacists from primary and secondary care, with a special interest in Coronary Heart Disease (CHD). The guidance was based on available evidence including SIGN (1.) and NICE (2.) guidance, final draft NICE Technology Appraisals on Clopidogrel prescribing (3,4.) and a Welsh Medicines Resource Centre Newsletter (5.)Since its launch in October 1998, the prescribing of the antiplatelet agent Clopidogrel (Plavix) had grown exponentially across the Locality, to a level significantly higher than the rest of Wales (6.)and there had been concern that, the evidence base (7,8.) did not justify the growth in the use of the drug.
Organisation: Oak Tree Surgery
Guidance: TA80;TA90. - Acute coronary syndromes - clopidogrel;Secondary prevention of occlusive vascular events
Category of submission: Clinical Date: 30 Sep 2009
Developing an OCD & BDD Specialist Team and a new care pathway
Description: Reorganising an existing care pathway for clients with OCD & BDD to reflect NICE guidance stepped care model. This has included developing a multi-disciplinary tertiary care specialist team to coordinate the new care pathway, deliver training and clincial supervision, and provide a treatment service for clients with the most complex needs.
Organisation: Sheffield Health & Social Care NHS Foundation Trust
Guidance: CG31 - Obsessive-compulsive disorder: Core interventions in the treatment of obsessive-compulsive disorder and body dysmorphic disorder
Category of submission: Clinical Date: 07 Oct 2008
Developing an osteoporosis screening questionnaire
Organisation: Marple Cottage Surgery
Guidance: Generic
Category of submission: Clinical Date: 24 Jul 2008
Developing and implementing a parent held medicines record for children with complex conditions
Description: A child centered project, (led by the parents), to improve medicines safety for children, through the implementation of robust medicines reconciliation and a parent held medicines record. The project commenced in community paediatrics, aimed at children with complex conditions, and at the end of life. It has begun to link primary care, community care, schools, social care, secondary care and tertiary care.

The project has helped deliver recommendations of the NICE guidance on managing medicines in care homes (SC1 recommendation 1.7 & CG76) by introducing a 'medicine reconciliation' process in short break houses, and sharing this across the pathway when children transfer between care settings. The new record is kept accurate and up to date on each contact with the participating services. It has stimulated increased reporting of medicines related problems, and promoted resolution across the health community.
Organisation: Steve Turner Innovations Community Interest Company
Guidance: Generic
Category of submission: - Date: 14 Feb 2014
Developing Patient Health Promotion Pathways in Acute Settings
Description: Developing holistic patient health promotion assessment and referral pathways in hospital settings. Such settings are underused in health promotion yet represent a significant opportunity to make every contact count.
Organisation: NHS Bolton
Guidance: PH 1-40 - Public Health
Category of submission: - Date: 30 Oct 2012
Developing resources for improved CKD management in primary care
Description: Teams from the Greater Manchester (GM) Collaboration for Leadership in Applied Health Research and Care (CLAHRC) and Leicester, Northamptonshire and Rutland (LNR) CLAHRC have both been working to help improve care for patients with chronic kidney disease. The two teams have each developed various resources for the purpose of implementing NICE guidance, in conjunction with general practices undertaking improvement work. By working in partnership with the LNR CLAHRC since January 2011, the GM team have enabled practices to implement NICE guidance with much more efficiency through the spread and further development of these resources.
Organisation: NIHR CLAHRC for Greater Manchester
Guidance: CG73 - Early identification and management of chronic kidney disease in adults in primary and secondary care
Category of submission: 2011-12 Shared Learning Awards Date: 30 Jan 2012
Development and implementation - Healthier Choices - Alcohol Liver Disease Clinic
Description: The Alcohol Nurse Specialist [ANS] service is an innovative and entrepreneurial nurse-led service that operates within a virtual multi-disciplinary, multi sector context; which responds to the spontaneous and complicated needs of patient target group.

This comprehensive service is provided by using treatment / care pathways as recommended by the National Treatment Agency for Substance Misuse, [DOH, 2005, 2007,] and incorporates the National Institute of Health and Clinical Excellence guidelines CG 100 & CG115.

The aim is to achieve optimal wellbeing to those patients that are identified as having a problem with alcohol misuse or diagnosed with alcohol liver disease [ALD] and to facilitate this aim the ANS service delivers a Healthier Choices ALD Clinic.


Organisation: Doncaster & Bassetlaw Hospital NHS Foundation Trust
Guidance: Generic
Category of submission: 2011-12 Shared Learning Awards Date: 25 Jan 2012
Development and implementation of Venous Thromboembolism risk assessment pathway for patients being discharged from the Emergency Department with a lower limb plaster cast.
Description: In accordance with recently published NICE guidelines we implemented venous thromboembolism risk assessment of all patients being discharged from our Emergency Department in a lower limb cast.
Organisation: Portsmouth Hospitals NHS Trust
Guidance: CG92 - Venous thromboembolism - reducing the risk
Category of submission: 2011-12 Shared Learning Awards Date: 31 Jan 2012
Development of a care pathway for Schizophrenia
Description: Leeds and York Partnership NHS Foundation Trust (LYPFT) has developed a number of Integrated Care Pathways (ICPs) based on NICE and other clinical guidelines, existing procedures, protocols and pathways and local good practice. LYPFT agreed the ICP actions should be incorporated into the existing CPA care plan so that recommended actions can be linked directly with the service user's goals and translated into a personalised plan for their care. In addition to being offered core interventions tailored to their needs, service users will be offered interventions recommended for their specific mental health symptoms or diagnosis based on the Mental Health Clusters (the Psychosis Clusters in this example).

Please note that this example was originally submitted to demonstrate implementation of CG82 Schizophrenia (update). CG82 has now been replaced by CG178. The example has been reviewed and continues to align with the new guidance.
Organisation: Leeds and York Partnership NHS Foundation Trust
Guidance: CG178 - Psychosis and Schizophrenia in adults
Category of submission: - Date: 31 Jan 2013
Development of a pre operative supportive care clinic
Description: The team have developed a pre operative supportive care clinic for women with gynaecological cancer. The clinic allows patients the opportunity to discuss their concerns and address informational and supportive care needs. The clinic has improved communication across health care boundaries and enhanced the patient experience.
Organisation: Gateshead NHS foundation Trust
Guidance: CSGSP - Improving supportive and palliative care for adults with cancer
Category of submission: 2011-12 Shared Learning Awards Date: 19 Oct 2011
Distribution of information for employers - what you can do to encourage your employees to stop smoking
Organisation: Chartered Institute of Environmental Health
Guidance: PH005 - Workplace health promotion: how to help employees to stop smoking
Category of submission: Public health Date: 17 Jul 2008
Division of Ankyloglossia (Tongue Tie) For Breastfeeding
Description: Implementation of NICE IPG 149 - Division of Ankyloglossia (Tongue Tie) for Breastfeeding and to review cases of tongue-tie in accordance with the guidance.
Organisation: Cwm Taf Health Board
Guidance: - Division of ankyloglossia (tongue-tie) for breastfeeding
Category of submission: 2011-12 Shared Learning Awards Date: 22 Aug 2011
Documentation of Baseline Clinical Condition in Emergency Department Patients
Description: An easily accessible and portable reference resource for junior medical staff
Organisation: SUNDERLAND ROYAL HOSPITAL
Guidance: Generic
Category of submission: Clinical Date: 25 Sep 2009
Documenting the decision making process for initiation of pharmacological Venous Thromboembolism Prophylaxis (PVP) to psychiatric inpatients
Description: This audit forms part of a wider project looking at the effective identification and management of risk of thromboembolism on our psychiatric wards. This project and its accompanying audits were agreed at the Medicines Safety Management Committee meeting in August 2011.

The risk of thromboembolism for psychiatric patients has been recognised long ago, (Durrazzo 2010, Maly 2008) and more specifically in association with use of antipsychotics (Thomassen 2000,) and physical restraint (Dickson 2009).
Organisation: Oxford Health NHS Foundation trust
Guidance: CG92 - Venous thromboembolism - reducing the risk
Category of submission: - Date: 28 May 2013
Don't Just Screen - Intervene.
Description: The project is based on inter-agency collaboration, utilising public health, pharmacists, service users and carers, health and wellbeing practitioners, primary and secondary care agencies working together in an aim to develop a database with the objective of reducing the mortality rates of service users with a diagnosed severe mental illness through a structured physical health screening, monitoring and intervening process. The project offers a physical health intervention framework for service users who have been prescribed antipsychotic medication. Additional contributors: Dr Javed Latoo; Jane Neve, Amanda Derbyshire and Rachael Kane.
Organisation: 5 Boroughs Partnership
Guidance: Generic
Category of submission: - Date: 05 Jan 2014
Doncaster Family Nurse Partnership, making a real difference for young pregnant women and their baby.
Description: Family Nurse Partnership [FNP] is an intensive preventive programme through pregnancy until the child is aged 2. Specially trained nurses implement a 30 year, American evidenced based programme for first time pregnant teenagers, which benefits children and families who have the likelihood of poorer outcomes. The service engages pregnant women under the age of 20 onto a voluntary programme with the aim to build a therapeutic relationship between themselves and the family nurse to improve antenatal health, child development and parents' self-sufficiency. All supportive evidence is available on line from the National Family Nurse Partnership website, DOH.
Organisation: Bentley West End Youth Centre
Guidance: CG110 - Pregnancy and complex social factors
Category of submission: 2010-11 Shared Learning examples Date: 16 Feb 2011
E-tools enable easy auditing and review of NICE Guidance
Description: E-tools can help encourage the auditing of NICE guidance and enable the easy review of compliance levels across the Trust.
Organisation: Berkshire Healthcare NHS Foundation Trust
Guidance: Generic
Category of submission: 2010-11 Shared Learning examples Date: 11 Feb 2011
Early intervention in psychosis service
Description: The Trust developed an early intervention service as part of an overall service delivery model for people with psychosis when evidence of clinical and cost effectiveness was limited. This service has been particularly successful in engaging people in vocational activity, providing support to families and psycho-education to clients of the service. The multidisciplinary team has demonstrated excellent results in these areas and has been working closely with partners in statutory and non-statutory services to achieve this success. Engaging with hard to reach groups has been a key focus of the team. The recent update of the schizophrenia guideline found new evidence of clinically significant benefits of early intervention services. Please note that this example was originally submitted to demonstrate implementation of CG82 Schizophrenia (update). CG82 has now been replaced by CG178. The example has been reviewed and continues to align with the new guidance.
Organisation: Sussex Partnership NHS Foundation Trust
Guidance: CG178 - Psychosis and Schizophrenia in adults
Category of submission: Clinical Date: 29 Sep 2009
East Riding Health Trainer Service
Description: Health trainers work with disadvantaged communities with the aim of encouraging and supporting lifestyle behaviour change. We work with people on a 1-2-1 basis and sometimes in small groups to enable them to develop their own personal health action plan including goal setting, building self-esteem, providing motivation and connecting people to activities in their communities which will help them make and sustain the behaviour change goals they have set. In East Riding we work in a variety of innovative ways in order to reach isolated and marginalised groups. This includes using our Change4Life bus to visit the remote rural parts of the district and to workplaces and visiting mobile home parks on the east coast to make personal contact with residents and offer a service. We have just opened the health trainer one stop shop in Bridlington in order to make our service more accessible. We are town centre based and encourage individuals to walk in, collect information and access support.
Organisation: Humber NHS Foundation Trust
Guidance: PH42 - Obesity - working with local communities
Category of submission: - Date: 17 Jul 2013
ECBC - Earn Credit By Caring - a scheme for Home Opioid Detoxification supported by Carecreds - update July 2010
Description: ECBC is a developing new service for Primary Care. It uses a reward system to nudge Class A addicts into healthier social and personal behaviour. This helps clinicians who want to provide stress-reducing personal community care. It is a concept that is approved and recommended by NICE. The service awards credits called Carecreds for clinically validated beneficial behaviour e.g. testing street-clean for drugs, becoming fit, caring for others etc. It reduces this Credit when there are reports of negative behavior. Based on the records of these earned and independently validated credits, it issues Official Personal Testimonials and vouchers to help its participants develop caring counter habits to their substance abuse. A randomized comparative study, partially funded by the Strategic Partnership on Alcohol & Drugs (Kingston, Surrey) has compared giving a monthly flat-rate of £5 Boots voucher with giving vouchers of up to £14 per month varying with number of Carecreds earned.
Organisation: Dr D'Souza & Partners
Guidance: CG51 - Drug misuse: psychosocial interventions
Category of submission: 2010 Shared Learning examples Date: 12 Aug 2010
Educating Healthcare Professionals about Functional Electrical Stimulation to improve patient care
Description: Functional Electrical Stimulation can dramatically improve the quality of life for a patient with foot drop, enabling them to walk further and with confidence. Many Healthcare professionals don't have knowledge of this technology, so following the NICE guidance Jan 09 - we decided to find a way of running en Education event to address this gap in knowledge and ultimately improve patient care for those with dropped foot.
Organisation: PhysioFunction Ltd
Guidance: IPG278 - Treating drop foot using electrical stimulation
Category of submission: 2010-11 Shared Learning examples Date: 11 Feb 2011
Electronic VTE assessments using Sunquest ICE - zero to hero!
Description: An inspired innovative solution where common sense met idealism to produce a robust, user friendly and comprehensive electronic system for VTE risk assessment. This produced a positive impact on patient outcomes. An existing computer system was taken and adapted to replace a cumbersome paper-based system which was not fit for purpose. This was in no small way due to the creation of an enthusiastic, integrated, focused, cross-discipline team, with a core belief that anything was possible. Viewing the attached Video clip of the electronic VTE assessment prior to reading the submission material will give you a much greater understanding of how the system works. Please copy and paste this link into your browser: http://www.youtube.com/watch?v=zD6plH-So_A
Organisation: Whittington NHS Trust
Guidance: CG92 - Venous thromboembolism - reducing the risk
Category of submission: 2010-11 Shared Learning examples Date: 10 Feb 2011
Embedding Shared Decision Making (SDM) in 32 national clinical teams.
Description: AQuA has worked on a national collaborative funded by the QIPP Right Care DoH with 32 national teams to share and embed a culture of Shared Decision Making between health professionals and patients. This work has involved development by AQuA of training resources, patient engagement leaflets, decision grids, recording mechanisms and case studies.
Organisation: Advancing Quality Alliance (AQuA)
Guidance: CG138 - Patient experience in adult NHS services
Category of submission: - Date: 31 Jan 2013
Enabling purposeful occupation of older adults in residential settings
Description: Occupational therapy interventions and physical activity interventions to promote the wellbeing of older people in residential care
Organisation: Glyndwr University
Guidance: PH16 - Occupational therapy interventions and physical activity interventions to promote the mental wellbeing of older people in primary care and residential care
Category of submission: Health and wellbeing Date: 17 Sep 2009
Engaging GPs in the delivery of NICE audit
Description: The inclusion of a proposal for the provision of audit reports relevant to 2 areas of NICE guidance in the local Clinical Governance Development Plan, provides clarity for GPs and Commissioners in the expectations for the delivery of NICE Assurance. The audit reports reflect current practice, allowing necessary changes to take place within a mutually agreed timeframe.
Organisation: NHS Plymouth
Guidance: Generic
Category of submission: - Date: 26 Jan 2011
Enhanced access to endoscopy at the Royal Bolton
Description: The principal diagnostic test for people with acute upper GI bleeding is endoscopy. For these patients reduced endoscopy waiting times (diagnostic and therapeutic) lead to more rapid diagnosis and reductions in mortality, requirements for transfusions, risk of re-bleeding and length of hospital stay. With such benefits to patients and the NHS, the NICE clinical guideline 'Acute upper GI bleeding' (CG141 June 2012) recommends offering endoscopy to unstable patients with severe acute upper gastrointestinal bleeding immediately after resuscitation and endoscopy within 24 hours of admission to all other patients with upper gastrointestinal bleeding as key priorities for implementation (see guideline for recommendations in full). The Royal Bolton Hospital NHS foundation trust re-engineered their endoscopy service and the care pathways for patients with acute upper GI bleed in order to enhance the quality of care for patients and implement these recommendations.
Organisation: Royal Bolton NHS Foundation Trust
Guidance: Generic
Category of submission: 2011-12 Shared Learning Awards Date: 04 May 2012
Enhancing the quality of service user involved care planning in Mental Health Services (EQUIP)
Description: Involving and allowing service users choice in their own care and hence recovery is at the centre of policy initiatives aimed at improving quality of care. This principle is enshrined and prioritised in healthcare. Despite this and the literature produced by user and carer groups which advocate that involving users and carers in care planning is fundamental to improving the quality of care, there is substantial evidence that many users and carers are marginalised and removed from the care planning process.

A potential barrier to involving service users within planning services may be their limited baseline knowledge regarding mental health conditions and the terminology used to describe treatments and services. Limited understanding of research and research terminology which provides the underpinning reasons for commissioning a service may also be a barrier. Manchester University have developed and delivered a successful research methods course for service users and carers.
Organisation: The University of Manchester
Guidance: CG136 - Service user experience in adult mental health: improving the experience of care for people using adult NHS mental health services
Category of submission: - Date: 20 Apr 2012
Ensuring equitable access to cancer treatments in the East Midlands - a collaborative approach
Description: This paper describes how cancer treatments are commissioned in the East Midlands. A joint approach between the East Midlands Specialised Commissioning Group and the East Midlands Cancer Network involves timely reviews of all new cancer treatments including those due to be reviewed by NICE. Working alongside clinicians to prioritise those treatments that provide significant benefit to our population this collaborative approach ensures that funding is made available without delay and that all patients residing in the East Midlands have equal and timely access to cancer treatments.
Organisation: East Midlands Specialised Commissioning Group
Guidance: Cancer guidelines -
Category of submission: Clinical Date: 26 Sep 2009
Ensuring that mandatory guidance is being correctly implemented - experience of using the NICE technology appraisal audit tool from TA155
Description: The National Institute for Health and Clinical Excellence (NICE) Guidance TA155 for the treatment of wet age-related macular degeneration was issued in August 2008. In this work we describe our experience in the application of an audit tool provided on the NICE website for auditing the implementation of this guidance in our hospital setting and report on the specific and wider aspects of auditing guidance implementation.
Organisation: Wolverhampton Eye Infirmary
Guidance: TA155 - Ranibizumab and pegaptanib for the treatment of age-related macular degeneration
Category of submission: - Date: 09 Oct 2013
Enthusiasm for life: creative stimulation and behaviour change for older people and others
Description: Upstream trained mentors work with GPs, health and social care professionals and communities to identify older, more isolated (socially, psychologically, physically, financially) and often depressed people, and to engage them in stimulating, creative and social activities that increase self-confidence and independence. Mentors visit referrals to assess needs, overcome barriers and agree individually tailored programmes (c.12 weeks) that help people join existing community activities or encourage them to participate in small, informal Upstream activity groups close to home, where they can share experience and skills (from felt-making to circle dancing to reminiscence), engage in collaborative and intergenerational projects, be motivated to continue activities independently, and build supportive relationships within their communities. The project is continuously evaluated by the Peninsula Medical School and the service is currently being disseminated throughout Devon.
Organisation: Upstream
Guidance: PH6 - Behaviour change at population, community and individual levels
Category of submission: Public Health Date: 28 Sep 2008
Essential Knowledge Updates: How the Royal College of GPs uses NICE guidance to deliver essential education to 16000 family doctors
Description: The Essential Knowledge Updates (EKU) programme is an e-learning initiative by the Royal College of General Practitioners (RCGP) that focuses on new and changing information that relate to key clinical areas of national significance (e.g. newly published NICE guidelines that are central to everyday primary care, newly published Gold Standards and new relevant legislation) where there is a dependable consensus about best practice. Since 2008 it has published a new update every 6 months to a total of 16000 registered primary care practitioners.
Organisation: Royal College of General Practitioners
Guidance: Generic
Category of submission: 2010-11 Shared Learning examples Date: 11 Feb 2011
Establishing a children's insulin pump service in Leeds
Description: Refers to specific NICE guidance of TA 57 (now TA 151)
Organisation: Leeds Teaching Hospitals NHS Trust
Guidance: Ta151 - Diabetes - insulin pump therapy
Category of submission: Clinical Date: 10 Feb 2009
Establishing a Multi-disciplinary Diabetes Stakeholder Network: Early results.
Description: The Berkshire West Federation diabetes stakeholder network (Diabetes Sans Frontières (DSF) was formed in 2012 with the aim of driving up standards of care for people with diabetes in our community.

DSF was formed to ensure that care for people with diabetes is designed and delivered in the interest of the patients and their carers to achieve the best outcomes possible with the resources available.

The network aims to reduce the burden of diabetes on people in our community with the disorder, to improve outcomes, and to do this whilst reducing the unit cost of care.
Organisation: Royal Berkshire Foundation Trust
Guidance: CG66 - Type 2 diabetes (partially updated by CG87)
Category of submission: - Date: 17 Dec 2013
Establishing an ADHD team with specialist nurses (ADHD)
Description: NICE guidance CG72 was used as a tool to compare best practice with current service provided. The views of parents and carers were also used to help identify the gaps in current service. In addition eight families with newly diagnosed Children / Young People were involved in trialling a new care pathway for support to identify areas of good / positive support received and areas where our current service did not meet expectation or best practice as per CG 72.
Organisation: Bridgewater Community Healthcare
Guidance: Generic
Category of submission: - Date: 14 Dec 2012
Establishing an integrated and seamless system for cardiac rehabilitation following a myocardial infarction
Description: A novel, integrated, and seamless system for cardiac rehabilitation was established to increase the proportion of patients who complete a cardiac rehabilitation programme after a myocardial infarction. The aim was to increase the proportion of patients with optimal secondary prevention, as measured by smoking status, body mass index, cholesterol <5.0 mmol/l, and blood pressure <140/85 mm Hg. Follow up data of 106 patients after twelve months showed improvement in all four outcome measures.
Organisation: University of Exeter Medical School (Primary Care)
Guidance: Generic
Category of submission: - Date: 14 Oct 2013
Evaluation of an Opioid Patient Information Manual for palliative care patients
Description: In 2012, in response to NICE Guideline CG140 (Opioids in Palliative Care), our team created an Opioid Patient Information Manual, which received governance approval in two NHS Trusts and was also adopted by the Wales Medicines Strategy Group. NICE recommended that strong opioid prescribing in palliative care should be backed up with understandable written guidance. We decided to evaluate the effectiveness of our written opioid manual and conducted a NICE clinical audit (full audit cycle) at Velindre Cancer Centre in Cardiff. This example updates the previous version located here.

Authors: Dr Mark Taubert, Consultant in Palliative Medicine, Velindre Cancer Centre & James Holloway, Medical Student at Peninsula College of Medicine and Dentistry.
Organisation: Velindre Cancer Centre
Guidance: CG140 - Opioids in palliative care
Category of submission: - Date: 29 Dec 2013
Evidence-based insulin prescribing in type 2 diabetes
Description: As part of an overall re-design of diabetes services in Northamptonshire, we reviewed the use of insulin in line with NICE CG87.

The diabetes specialist nurses and a medicines management pharmacist ran (and continue to run) regular training sessions for practice nurses to provide them with the skills to initiate human isophane insulin.

The savings we have consequently made on the prescribing budget have been ring-fenced and used to fund a new community-based Diabetes Multidisciplinary Team.
Organisation: Nene and Corby Clinical Commissioning Groups
Guidance: CG 87 - Type 2 diabetes - newer agents (a partial update of CG66)
Category of submission: - Date: 02 Nov 2012
Evidence-based training for Evidence-based Psychological Therapies
Description: A joint initiative between a mental health trust, university and charity has resulted in a unique centre of excellence to train therapists to deliver the evidence-based psychological therapies recommended by NICE
Organisation: Berkshire Healthcare NHS Foundation Trust, University of Reading, Charlie Waller Memorial Trust
Guidance: Generic
Category of submission: General Date: 09 Sep 2009
Evolving a comprehensive, integrated and effective Trust wide strategy in optimising the management of deteriorating patients
Description: The Trust set up a steering group in direct response to the publication of "Acutely ill patients in hospital", (NICE CG50 2007) and "Recognising and Responding Appropriately to early signs of deterioration in hospitalised patients", (NPSA 2007). This group set up a range of comprehensive initiatives designed to improve early monitoring and management, including the use of educator teams to peripatetically introduce a range of trust wide competencies. Monitoring has shown that there has been marked improvement over the last four years and this work continues to be seamlessly integrated with other related patient safety initiatives .
Organisation: North Tees & Hartlepool NHS Trust
Guidance: CG50 - Acutely ill patients in hospital
Category of submission: 2011-12 Shared Learning Awards Date: 31 Jan 2012
Expansion of the use of anti-platelet cards for patients post percutaneous coronary intervention (PCI)
Description: Anti-platelet cards were introduced into the author's institution in 2006 to ensure that patients received optimal dual anti-platelet therapy post PCI. At this time there was only one anti-platelet agent used in addition to aspirin therapy. There are now two newer agents in use and it is important that patients receive the correct drug for the correct period of time.
Organisation: Royal Brompton and Harefield NHS Foundation Trust
Guidance: Generic
Category of submission: - Date: 17 Dec 2012
Explanatory letter to women who have had Caesarean Section
Description: A letter addressed to women who have just had a Caesarean Section with brief explanation on their CS and emphasising that there are good prospects of vaginal birth in a future pregnancy. The letter is intended to be given before discharge from hospital.
Organisation: York Teaching Hospital
Guidance: QS32 - Caesarean section
Category of submission: - Date: 30 Apr 2013
Familial Hypercholesterolaemia genetic screening clinics
Description: Implementation of the cascade testing recommendations from CG71.
Organisation: Royal Brompton and Harefield NHS Foundation Trust
Guidance: CG71 - Familial Hypercholesterolaemia
Category of submission: 2011-12 Shared Learning Awards Date: 31 Jan 2012
Fighting malnutrition: A strategic, multidisciplinary approach.
Description: The Royal Berkshire NHS Foundation Trust has developed a comprehensive, multidisciplinary strategy to improve the nutritional care of our patients. This approach functions at grass-roots level, encouraging cross-boundary working between wards and professional groups, and enabling staff to recognise the critical role that nutritional support plays in patients' recovery. Trust wide evidence based policy is implemented through the Nutrition Steering committee and the network of Nutrition Champions, a model that creates its own momentum, shares best practice and encourages improvements in care.
Organisation: The Royal Berkshire NHS Foundation Trust
Guidance: CG32 - Nutrition support in adults
Category of submission: 2010-11 Shared Learning examples Date: 08 Feb 2011
Foundation training and the acutely ill patient: Developing an Emergency Department education programme based on national guidance.
Description: We aimed to evaluate our existing Emergency Department (ED) FY2 education programme, and identify and introduce novel strategies to deliver the recommendations made in NICE CG50 "Acutely Ill Patients in Hospital".
Organisation: Bradford Royal Infirmary
Guidance: CG50 - Acutely ill patients in hospital
Category of submission: Clinical Date: 26 Oct 2009
Good Practice in Service User Involvement Training
Description: A variety of training sessions designed and delivered by people who use mental health services. The training sessions aim to inform mental health workers about service user involvement to enable staff to make positive changes to their working practice.
Organisation: Together: for mental wellbeing
Guidance: CG136 - Service user experience in adult mental health
Category of submission: 2011-12 Shared Learning Awards Date: 27 Apr 2012
Harmonising Pre-hospital Care across the South West
Description: The planned coming together of the South Western Ambulance Service NHS Foundation Trust and the Great Western Ambulance Service on the 1st February 2013 provided an opportunity to harmonise and advance clinical practice. The effective implementation of NICE guidelines was central to the process to ensure that patients receive the highest standards of pre-hospital care.
Organisation: South Western Ambulance Service NHS Foundation Trust
Guidance: Generic
Category of submission: - Date: 08 Feb 2013
HEART UK FH Toolkit
Description: HEART UK developed this toolkit to assist with implementation of the NICE Clinical Guideline on the identification and management of familial hypercholesterolaemia (FH). The toolkit is aimed at commissioners and relevant healthcare professionals.
Organisation: HEART UK
Guidance: CG71 - Familial hypercholesterolaemia
Category of submission: 2010-11 Shared Learning examples Date: 11 Feb 2011
Hearty Lives Bolsover; Improving standards of care for the primary and secondary prevention of cardiovascular disease for people with severe mental illness.
Description: Hearty Lives Bolsover is an innovative partnership project between the British Heart Foundation, NHS Derbyshire and Derbyshire Healthcare NHS Foundation Trust to promote physical health care amongst a vulnerable group in a deprived area with the aim of reducing health inequalities. The project was successful in improving pathways of care and communication between primary and secondary care according to NICE recommendations.
Organisation: NHS Derbyshire
Guidance: CG82/CG38 - Schizophrenia (update) / Bipolar Disorder
Category of submission: 2011-12 Shared Learning Awards Date: 30 Jan 2012
Hepatitis C GP Awareness Project
Description: A project to raise awareness to local GP's about the new care pathway that was rolled out across Greater Manchester
Organisation: Greater Manchester Hepatitis C Strategy
Guidance: TA106 - Hepatitis C - peginterferon alfa and ribavirin
Category of submission: 2011-12 Shared Learning Awards Date: 01 Jun 2012
Hepatitis information and testing in Sheffield: Outreach pilot for high prevalence communities
Description: This service development is aligned to NICE PH43 and more specifically Recommendation 2 'Awareness-raising for people at increased risk of hepatitis B or C infection'.

In 2009 Sheffield Teaching Hospitals offered viral hepatitis information and testing in community settings, including the Kinhon Chinese Health Project. An information leaflet was developed in English and Chinese that provided information about hepatitis B and advice about transmission, prevention, vaccination, alcohol and treatment. Dry blood spot testing was used for those who chose to be tested. A similar approach was offered to other affected populations including Pakistani, Slovak, Somali and Yemeni at local community events as part of the Healthy Communities Programme led by the Primary Care Trust (PCT).

In 2011 a complementary online educational package about hepatitis B and C was designed and tried in the groups above and in one GP surgery.
Organisation: Sheffield Teaching Hospitals NHS Foundation Trust
Guidance: Generic
Category of submission: - Date: 08 Apr 2013
Hospital based smoking cessation practice including pre-operative assessment
Organisation: Bolton Primary Care NHS Trust
Guidance: Generic
Category of submission: Public health Date: 23 Jul 2008
Hospital outpatient department screening patients for alcohol use disorders
Description: This multi-disciplinary service evaluation is built on the results of recent national research (Kaner et al 2013), reviewing the effectiveness of screening and brief alcohol intervention in primary care. It is a pragmatic service evaluation which has been designed to assess the feasibility of implementing alcohol screening and brief advice into a routine hospital outpatient department (as recommended in NICE PH Guidance 24). The endoscopy department at Newcastle Hospitals Trust has been the chosen clinical setting, including the national bowel screening element, due to the association between alcohol and gastrointestinal diseases. Drawing upon the theory of implementation science and reviewing professional behaviour change, the aim is to understand how to best roll out alcohol screening and brief advice across the hospital trust, as part of making every contact a health improving opportunity.
Organisation: Newcastle University: Institute Health and Society
Guidance: PH24 - Alcohol-use disorders - preventing harmful drinking
Category of submission: - Date: 29 Jan 2013
How cognitive behavioural therapy and a stepped care approach to mental health was adapted and implemented for use in the Occupational Health Department.
Organisation: Airedale NHS Trust
Guidance: CG113 - Anxiety
Category of submission: Clinical Date: 12 Jan 2009
Identification of FH in primary care, using clinical patient data
Description: The All Wales Familial Hypercholesterolaemia (FH) testing service was launched in September 2010. Based around the recommendations in the 'diagnosis' (1.1) and 'identifying people with FH using cascade testing' (1.2) sections of NICE clinical guideline 71, it delivers an equitable opportunity for the people of Wales to access specialist FH services, including support, counselling, genetic testing and cascade family testing.

As part of the strategy for increasing the identification and awareness of FH within primary care, several initiatives have been developed. These include: 'Finding FH in Primary Care' schemes, a web-based primary care education package and educational folders.

For clarity purposes, this shared learning example will focus on the identification aspect of the strategy and provide detail about the 'Finding FH in Primary Care' schemes.
Organisation: All Wales FH Cascade Testing Service
Guidance: Generic
Category of submission: - Date: 05 Feb 2014
Identifying and managing tuberculosis (TB) among hard-to-reach groups - The prison setting with a high incidence of TB.
Description: An intiative to improve the identification and management of TB patients in an inner city prison
Organisation: Royal Free Hospital
Guidance: PH37 - Tuberculosis - hard-to-reach groups
Category of submission: 2011-12 Shared Learning Awards Date: 05 Jul 2012
Identifying assets and gaps in local mental health services to develop the Joint Strategic Needs Assessment (JSNA).
Description: At a consultation event for the 2012 Croydon JSNA chapters on depression and schizophrenia, participants were asked to rate their experience of mental health services against the NICE Service User in Mental Health Quality Standard statements. Mental health service users, user and voluntary organisations, statutory service providers from the NHS and local authority and commissioners considered the Quality Standard statements mounted on display boards and used a rating scale of pictograms of happy and sad faces at either end to depict level of satisfaction (see attached photo). Information gathered in this way was subsequently used to develop recommendations for service improvement in the Joint Strategic Needs Assessment (JSNA) chapters.
Organisation: NHS South West London Croydon Borough Team
Guidance: CG136 - Service User Experience in Mental health
Category of submission: - Date: 31 Oct 2012
Impact of the 2007 NICE Guideline for Children's Head Injury
Description: We designed a retrospective study to assess the impact of the 2007 NICE head injury guideline on rates of CT scanning in children's head injury. We found that the guideline increased scanning rates from 6.0% of patients to 10.5%.
Organisation: Royal Devon and Exeter Hospital
Guidance: CG56 - Head Injury
Category of submission: 2010-11 Shared Learning examples Date: 10 Feb 2011
Implement shared care prescribing guideline for drugs for dementia
Description: Project to identify and overcome the barriers to implementing shared care guidelines for dementia medicines.
Organisation: Northumberland Tyne and Wear NHS Foundation Trust
Guidance: TA111 - Alzheimer's disease - donepezil, galantamine, rivastigmine (review) and memantine
Category of submission: Clinical Date: 21 Sep 2009
Implementation and audit of Cognitive Stimulation Therapy on an acute admission/ assessment unit for people with dementia
Description: This report evaluates the introduction of Cognitive Stimulation Therapy (CST) to a mixed-gender acute admission / assessment ward for people with dementia. The report reviews the literature relating to dementia care with specific reference to inpatient care, psychological interventions for dementia and the development of CST. It outlines the initiation of CST on an acute admission/ assessment ward for people with dementia and offers an evaluation based on the perspective of nursing staff running CST groups on the ward. The results offer an insight into some of the challenges of running CST but highlight the benefits of doing so for the individuals with dementia who are admitted to the ward.
Organisation: Sussex Partnership NHS Foundation Trust
Guidance: CG42 - Dementia
Category of submission: Clinical Date: 29 Sep 2009
Implementation and Monitoring of NICE Perioperative hypothermia (inadvertent) guideline
Description: To implement and monitor NICE CG65
Organisation: Royal Sussex County Hospital
Guidance: CG65 - Perioperative hypothermia (inadvertent)
Category of submission: 2010-11 Shared Learning examples Date: 11 Feb 2011
Implementation of a clinical decision-making pathway for the Feverish illness in children: assessment and initial management in children younger than 5 years old (NICE guidance)
Description: Please note that this example was submitted to demonstrate implementation of CG47. This guideline was updated and replaced in May 2013 by CG160. The practice in this example remains consistent with the updated guidance.
Organisation: Alder Hey Children's NHS Foundation Trust
Guidance: CG160 - Feverish illness in children
Category of submission: Clinical Date: 26 Sep 2008
Implementation of Department of Health Guidance relating to thromboprophylaxis and anticoagulation
Description: A trust-wide piece of work to implement the guidance published in 2007 from NICE, the NPSA and the DoH commons health select committee to improve the management of thromboprophylaxis and anticoagulation.
Organisation: Royal Surrey County Hospital NHS Trust
Guidance: CG46 - Venous thromboembolism: reducing the risk of venous thromboembolism (deep vein thrombosis and pulmonary embolism) in inpatients undergoing surgery
Category of submission: Clinical Date: 09 Sep 2008
Implementation of NICE CG 54:UTI
Description: Local implementation of NICE CG 54 : UTI
Organisation: Cwm Taf NHS Trust
Guidance: CG54 - Urinary tract infection in children
Category of submission: Clinical Date: 28 Sep 2009
Implementation of NICE Clinical Guideline 54 Urinary Tract Infection in Children using a care pathway to improve appropriate investigation, treatment, referral and follow-up.
Organisation: Alder Hey Children's NHS Foundation Trust
Guidance: CG54 - Urinary tract infection in children
Category of submission: Clinical Date: 26 Sep 2008
Implementation of NICE guidance on Assessment of Febrile Children
Description: NICE recommends all febrile children should have their temperature, heart rate, respiratory rate and capillary refill time measured and their subsequent management be based on a traffic light system to identify those with potential serious illness. This project was conducted in a large GP surgery, specifically aiming to improve the assessment using ALL four of assessment criteria. The project went beyond conventional audit and use the principles of improvement science to make it easier for clinicians to do the right thing and harder to do the wrong thing, and if they did forget to create systems spot and stop the omission.

Please note that this example was submitted to demonstrate implementation of CG47. This guideline was updated and replaced in May 2013 by CG160. The practice in this example remains consistent with the updated guidance.
Organisation: South Street Surgery
Guidance: CG160 - Feverish illness in children
Category of submission: - Date: 15 Feb 2012
Implementation of NICE guidance on Feverish Illness in Children
Description: Local Implementation of NICE CG 47 : Feverish Illness in Children

Please note that this example was submitted to demonstrate implementation of CG47. This guideline was updated and replaced in May 2013 by CG160. The practice in this example remains consistent with the updated guidance.
Organisation: Cwm Taf NHS Trust
Guidance: CG160 - Feverish illness in children
Category of submission: Clinical Date: 28 Sep 2009
Implementation of NICE Guidelines (Obstetrics & Gynaecology)
Organisation: North Tees & Hartlepool NHS Foundation Trust
Guidance: Generic
Category of submission: General Date: 20 Jun 2008
Implementing a policy for identifying and managing malnutrition in Care Homes
Description: Implementing NICE Clinical Guideline 32 Nutrition support in adults: Oral nutrition support, enteral tube feeding and parenteral nutrition. By supporting staff in care homes we achieved improvements in nutritional management of patients and the reduction in the number of Health Care Professionals consultations for these patients.
Organisation: City Healthcare Partnership CIC
Guidance: Generic
Category of submission: - Date: 13 Jun 2013
Implementing an alcohol referral pathway: the experience of an ambulance service
Description: How Yorkshire Ambulance Service established a region-wide alcohol referral pathway demonstrating a more efficient use of health and social care resources by putting the patient at the centre of the care pathway and identifying health needs at an early stage.
Organisation: Yorkshire Ambulance Service NHS Trust
Guidance: QS11 - Alcohol dependence and harmful alcohol use
Category of submission: - Date: 18 Jan 2014
Implementing an Inpatient Stop Smoking Treatment Service in the secondary care setting
Description: The implementation of a treatment service for patients offering 'bedside' advice, information and support to patients who use tobacco, putting in place the foundation blocks for achieving a long term quit. Timely stop smoking advice shortly after admission taps into a potential period of heightened motivation, encourages smokefree policy compliance and highlights any need for withdrawal management. The service refers all patients ready to stop smoking to the Community Stop Smoking Service (CSSS) at point of discharge. Please note that this guidance was orginally submitted to demonstrate implementation of recommendations in NICE PH10 but is also relevant to PH48 Smoking cessation - acute, maternity and mental health services, which partially updates PH10.
Organisation: Blackpool Teaching Hospitals
Guidance: Generic
Category of submission: - Date: 25 Jan 2013
Implementing and evaluating training for health visiting teams as part of the UNICEF UK Baby Friendly Initiative Community award.
Description: Implementing and evaluating Baby Friendly Initiative training for health visiting teams as part of work towards raising breastfeeding rates. This is in line with NICE CG37 and recommendation 1.3.3 which encourages breastfeeding using the Baby Friendly Initiative as a minimum standard.

Details of practical implementation of community staff training for BFI from Nicki Symes, breastfeeding co-ordinator, Bristol City Council : nicki.symes@bristol.gov.uk
Organisation: University of Bristol
Guidance: CG37 - Postnatal care
Category of submission: - Date: 04 Sep 2013
Implementing best practice in the management of elderly fallers in the emergency department based on national guidelines
Description: 1) TO ENSURE ELDERLY FALLERS ADMITTED INTO THE EMERGENCY DEPARTMENT ARE ADEQUATELY ASSESSED. 2) TO IMPLEMENT CHANGES IN THE MANAGEMENT OF ELDERLY FALLERS BASED ON THE NICE GUIDELINES
Organisation: UNIVERSITY HOSPITALS OF LEICESTER NHS TRUST
Guidance: CG21 - Falls
Category of submission: Clinical Date: 29 Sep 2009
Implementing Best Practice taken from NICE and incorporated into the 2009 influenza clinic to aid diagnosis of Atrial Fibrillation
Description: A comprehensive flow chart for rapid and safe reference to ensure 'Best Practice' as per NICE guidance during a fast paced annual influenza clinic incorporating a Direct Enhanced Service to diagnose Atrial Fibrillation in asymptomatic individuals aged 65 and over. (In preference to the very basic protocol supplied by the PCT which in my opinion did not reference NICE guidance fully)
Organisation: Sheringham medical practice
Guidance: CG36 - CG36 Atrial fibrillation: full guideline
Category of submission: Clinical Date: 09 Sep 2009
Implementing early rectal cancer multidisciplinary teams in secondary care
Description: This case study describes the Merseyside and Cheshire Cancer Network model for establishing early rectal cancer multidisciplinary teams. Although cited in 'Improving outcomes in colorectal cancers' (NICE cancer service guidance 2004) very few early rectal cancer multidisciplinary teams have been established. This case study has been compiled to demonstrate how early rectal cancer multidisciplinary teams can be established, so that the following recommendation from NICE Clinical Guideline 131 on early rectal cancer MDTs can be implemented in practice. An early rectal cancer MDT should decide which treatment to offer to patients with stage I rectal cancer, taking into account previous treatments, such as radiotherapy [Recommendation 1.2.3.4]
Organisation: Merseyside and Cheshire Cancer Network
Guidance: CG131 - Colorectal cancer
Category of submission: 2011-12 Shared Learning Awards Date: 10 Jan 2012
Implementing evidence-based practice into local authority setting
Description: Active and Healthy Gateshead Directors Group, within Gateshead Borough Council, agreed to use NICE guidance to support the prioritisation of interventions designed to improve the health of the local population, and maximise effectiveness. One objective of this work was to embed evidence-based practice into the culture and planning of work within the local authority setting. Initial work consisted of audits using diverse elements of guidance which identified a number of gaps in understanding and so it was agreed to host a multi-disciplinary workshop facilitated by representatives from NICE. The Behaviour Change guidance (PH 6) was chosen to assess the degree to which a draft Council Health Strategy 'The Big Shift', was evidenced based. The findings resulted in amending the strategy, to improve its links with the evidence.
Organisation: Gateshead PCT
Guidance: Generic
Category of submission: 2010-11 Shared Learning examples Date: 09 Feb 2011
Implementing guidelines on lipid modification & hypertension to our primary care team
Description: Power point presentation to all clinicians (prompted by learning need on what to do with all those cholesterol results) Simple guidelines on management of new and ongoing hypertensives.
Organisation: Honley Surgery
Guidance: CG 34, CG 67, CG 71 - Hypertension, Lipid modification, Familial hypertension
Category of submission: Clinical Date: 26 Aug 2009
Implementing NICE Guidance across the Peninsula: sharing experience
Description: Initiation of the Peninsula NICE Collaborative Group (PNCG). Other group members: Sharon Strang: NICE Implementation Faciliator, Torbay Care Trust sharon.strang@nhs.net Ruth Aidrie: Head of Clinical Effectiveness, NHS Devon ruth.airdrie@nhs.net Caroline Court: Consultant in Public Health Medicine Caroline.Court@CIOSPCT.cornwall.nhs.uk
Organisation: NHS Plymouth
Guidance: Generic
Category of submission: 2010 Shared Learning examples Date: 01 Sep 2010
Implementing NICE TA 77: Guidance on the use of Zaleplon, Zolpidem and Zopiclone for the Short-term Management of Insomnia
Description: The main objective of this piece of improvement work is to implement NICE Technology Appraisal No.77
Organisation: Cwm Taf NHS Trust
Guidance: TA77 - Insomnia - newer hypnotic drugs
Category of submission: Clinical Date: 29 Sep 2009
Implementing nutritional screening in care homes
Description: Peterborough PCT in collaboration with Nutricia have devised and implemented a new training programme, with the aim of implementing the NICE guidelines on nutritional screening in care homes. The programme is designed to teach care homes how to recognise and monitor residents for signs of under-nutrition using the Malnutrition Universal Screening Tool (MUST), and to take appropriate action and treat at risk residents.
Organisation: Peterborough Community Services
Guidance: CG32 - Nutrition support in adults
Category of submission: Clinical Date: 29 Sep 2008
Implementing Physical Health Policy in Islington Residential and Rehabilitation Services
Description: A well-being Advisor was appointed to implement the Physical health policy in Islington Residential and Rehabilitation Services (within Camden and Islington Foundation Trust). This submission relates to the challenges faced and the work that was achieved whilst implementing the policy.
Organisation: Camden and Islington Foundation Trust
Guidance: CG1 - Schizophrenia (replaced by CG82)
Category of submission: Clinical Date: 28 Sep 2009
Implementing the 'Acutely Ill Patient in Hospital' NICE Guidance (CG50) [July 2007]
Description: The implementation of the Acutely Ill Patient in Hospital NICE guidance (CG50) across 5 Acute Trusts, the universities and medical school in West Yorkshire. This involved a pre and post audit using national guidance. Engaging all key stakeholders, the Acutely Ill Competency Framework was piloted in all 5 Acute Trusts in West Yorkshire and as a result recommendations were made.
Organisation: West Yorkshire Critical Care Network
Guidance: CG50 - Acutely Ill Patients in Hospital: Recognition of and response to acute illness in adults in hospital
Category of submission: Clinical Date: 20 Apr 2009
Implementing the NICE bipolar guideline with respect to lithium monitoring, in Oxleas NHS Foundation Trust.
Description: The NICE guidelines for depression and bipolar disorder both recommend lithium as an effective treatment; patients who take lithium should have regular blood tests to monitor the amount of lithium in their blood (every 3 months), and to make sure the lithium has not caused any problems with their kidneys or thyroid (every 6 months). Lithium monitoring is known to be sub-optimal and has been the subject of a National Patient Safety Agency (NPSA) alert. This submission describes how taking a systematic approach to overcoming barriers to best practice has had a positive effect.
Organisation: Oxleas NHS Foundation Trust
Guidance: CG38 - Bipolar disorder
Category of submission: - Date: 17 Jan 2014
Improved access to breastfeeding peer support
Description: The Plymouth volunteer breastfeeding peer support service has grown in size, quality, accessibility and effectiveness since its inception in 2003. The volunteer service has adapted to meet the needs of mothers and families from different socio-economic and cultural backgrounds. Delivered in partnership with midwifery, health visitors, children's centres and volunteers, the peer support service can engage with women during both the antenatal and postnatal period.
Organisation: NHS Plymouth
Guidance: PH11 - Maternal and child nutrition
Category of submission: - Date: 25 Oct 2012
Improvement in the detection of depression and anxiety in long term sickness absence cases and the development of a care pathway
Description: Depression and anxiety are common barriers to return to work of staff absent on long term sickness absence (LTSA) i.e four consecutive weeks or longer. Motivated by participation in the National Audit of depression detection and management of staff on long term sickness absence (Health & Work Development Unit, RCP) we have overcome barriers to improve our Occupational Health Service performance. Our service assessment of depression improved from 55% (58% National Audit round one average) to 90% (67% National Audit round two average). We have also created a clear clinical pathway to guide clinicians on client self help information, advice on treatment options, onward referral for physician assessment and guidance on review.
Organisation: NHS Camden Provider Services Occupational Health Service
Guidance: CG91 ,PH19 ,CG90 - Depression with a chronic physical health problem
Category of submission: 2010-11 Shared Learning examples Date: 09 Feb 2011
Improving access to psychological care after stroke
Description: This national project encompasses both the NICE quality standard for depression in adults with a chronic physical health problem and the NICE stroke quality standard 9 to routinely screen people for mood and cognitive disorders. Assessment and management of psychological disorders after stroke is poorly organised with patients receiving sub optimal services and support (National Audit Office report, 2010 and Care Quality Commission stroke review, 2011). These national projects demonstrate effective improvement in organisation and delivery of psychological care after stroke.
Organisation: NHS Improvement- Stroke
Guidance: CG91 - Depression with a chronic physical health problem
Category of submission: 2011-12 Shared Learning Awards Date: 19 Jan 2012
Improving Care and Management of the Acutely ill Oncology Patient
Description: Implementing the NICE Acutely ill Patients in hospital guidelines (CG50) using a care bundle based approach has improved the care and management of the acutely ill patients within a regional oncology hospital.
Organisation: Velindre NHS Trust
Guidance: CG50 - Acutely ill Patients in hospital
Category of submission: 2010-11 Shared Learning examples Date: 04 Feb 2011
Improving care for men with lower Urinary Tract Symptoms (LUTS)
Description: Referral letters are an underutilised source of unique data and information that reflect the quality of care provided by primary care clinicians. We demonstrate a focused approach to analysing these data, using the results to develop information in partnership with consultant colleagues, applying quality markers based on NICE guidance, then feeding back on individual performance to each clinician. This provides the basis for developing focused educational support for clinicians and patients. We have shown a significant reduction in inappropriate referrals, a 39% increase in appropriate referrals, up-to 43% improvement against the top seven quality markers and the potential annual savings of £28,000 across our 16 practices.
Organisation: South Norfolk Healthcare CIC
Guidance: CG97 - Lower urinary tract symptoms
Category of submission: 2011-12 Shared Learning Awards Date: 12 Jun 2012
Improving care for patients with chronic kidney disease
Description: A collaborative involving 19 general practices from four PCTs across Greater Manchester working to improve care for patients with chronic kidney disease. Practices aimed to identify undiagnosed patients and ensure that at least 75% of patients on registers were treated to the NICE recommended blood pressure targets. In 12 months 1,324 patients were identified and 74% of the patients on registers were treated to BP targets.
Organisation: CLAHRC for Greater Manchester
Guidance: CG73 - Chronic kidney disease
Category of submission: 2010-11 Shared Learning examples Date: 11 Feb 2011
Improving Choice for Kidney Patients and Carers - Increasing access to home dialysis.
Description: NHS Kidney has held a series of events in each SHA throughout England bringing together Department of Health leads, providers of kidney services, clinicians, patients and carers with the aim of increasing the availability of home haemodialysis and maximising patient choice of dialysis modality and setting. This activity supports the implementation of NICE Guidance which states that all suitable patients should be offered the informed choice between home haemodialysis and hospital haemodialysis.
Organisation: NHS Kidney Care
Guidance: TA48 - Renal failure - home versus hospital haemodialysis
Category of submission: 2010-11 Shared Learning examples Date: 14 Feb 2011
Improving COPD patient care in line with NICE recommendations
Description: An educational programme to improve the quality and productivity of COPD management by ensuring that all of its practices provide a consistent standard of care in line with NICE COPD guidelines. The programme was then monitored and measured by the use of an audit tool to ensure successful outcomes could be implemented across all practices.
Organisation: Wearside Commissioning Group
Guidance: CG101 - Chronic obstructive pulmonary disease (update)
Category of submission: 2010-11 Shared Learning examples Date: 04 Feb 2011
Improving management of Patient Group Directions (PGDs) during organisation change
Description: The formation of PCT clusters in 2011, and subsequent CCGs in 2013 covering the whole of Devon, gave opportunity for the medicines optimisation teams to collaborate, produce, review and authorise PGDs for primary care covering a population of approximately 1.1million across an area of 2,500 square miles in Devon. The use of the NICE PGD Medicines Practice Guidelines (MPG) and the Medicines Practice Guidelines PGD Baseline Assessment Tool, has allowed us to benchmark the work that we do.
Organisation: New Devon and Torbay Clinical Commissioning Group (CCG)
Guidance: Generic
Category of submission: - Date: 20 Jan 2014
Improving managing violence training - combining managing violence and life support
Description: Combining Managing Violence and Life Support training has created a safer response to violence by highlighting the importance of life support during restraint. Including the service user's views into the training has increased the staff understanding of the impact of restraint on the individual. We emphasise the importance of early intervention to prevent violence.
Organisation: Rotherham Doncaster and South Humber Mental Health NHS Foundation Trust
Guidance: CG25 - Violence: The short-term management of disturbed/violent behaviour in in-patient psychiatric settings and emergency departments
Category of submission: Clinical Date: 29 Sep 2008
Improving Outcomes through On-line Collaboration: The Teenager and Young Adults Cancer Services
Description: The Teenage and Young Adults Cancer Services (TYA) is a new and innovative service funded by the Teenage Cancer Trust. The IOG for Children and Young People with Cancer set out recommendations on how healthcare services for children and young people with cancer should be organised. Based on these guidelines a novel approach to multidisciplinary working with Teenagers and Young Adults (TYA) with cancer was developed in the South West region: a virtual Multi-Disciplinary advisory Team (MDaT). Using a new online collaboration tool the team members are able to contribute remotely, making geographical patient treatment and support easier.
Organisation: Ideal
Guidance: CSGCYP - Improving outcomes in children and young people with cancer: Improving Outcomes Guidance (IOG) 2005
Category of submission: 2010-11 Shared Learning examples Date: 05 Feb 2011
Improving Pressure ulceration documentation pathways
Description: The introduction of a primary care trust wide documentation system for the district nursing service to promote standardised assessment and management using best practice indicators for the management of pressure ulceration in community settings.
Organisation: Trafford Provider Services
Guidance: CG29 Pressure ulcers - The prevention and treatment of pressure ulcers
Category of submission: 2010-11 Shared Learning examples Date: 03 Feb 2011
Improving safety through a Therapeutic Chlordiazepoxide prescribing Detoxification Regime
Description: Tameside Hospital serves a population of 250.000 across Tameside. Figures show that about 22% of the population are binge drinkers (37,000 people). Admissions almost tripled over the last 10 years. In April 2013 the HALS (Hospital Alcohol Liaison Service) was established. The team consists of a Team Leader Specialist nurse, 2 Alcohol Specialist nurses, Data Administrator and Consultant Hepatologist. The team run a 7 day 8am-8pm service, offering a duty response to all inpatient and outpatient departments within the hospital, in addition to the response work the service also runs a 7/7 Ambulatory Detoxification clinic, based at the hospital which is flexible to patient's needs. The team are predominantly based in A&E as a frontline service. Almost immediately it proved a positive impact on the support offered to patients admitted for alcohol misuse, the team have been pivotal in launching and applying the principles of the NICE Alcohol withdrawal pathway.
Organisation: Tameside Foundation Trust
Guidance: Generic
Category of submission: - Date: 29 Jan 2014
Improving services by focussing on what works: developing NICE learning in a Local Authority
Description: A ninety minute lunchtime learning seminar was organised to raise awareness about the use of NICE guidance and resources within a local authority setting. Through an interactive format of presentations and small discussion groups we aimed to engage with local authority colleagues and provide a wider understanding of NICE's role in supporting the local government agenda. The seminar included small discussion groups to encourage participants to think about and discuss how NICE guidance can be used in the local planning and commissioning processes, focussing on three specific pieces of relevant Public Health guidance.
Organisation: London Borough of Bromley
Guidance: -
Category of submission: - Date: 23 Dec 2013
Improving the detection and response to patient deterioration
Description: NICE CG50 requires that all adult patients in hospital have (i) a clear written monitoring plan specifying which vital signs should be recorded (and at what frequency), (ii) their severity of illness measured using a physiological early warning score (EWS) and (iii) a graded response strategy. VitalPAC, a wireless, handheld computer-based system, provides a structured mechanism for clinical staff to record patient vital signs electronically at the bedside on general hospital wards, calculates patients' early warning scores and provides instruction to bedside staff (e.g., 'increase the observation frequency', 'obtain assistance'). Importantly, all the data collected by VitalPAC is integrated with the hospital's other clinical systems and provides staff elsewhere in the hospital with instantaneous, reliable access to the charts and data via the intranet.
Organisation: Portsmouth Hospitals NHS Trust
Guidance: CG50 - Acutely ill patients in hospital
Category of submission: 2010-11 Shared Learning examples Date: 07 Feb 2011
Improving the quality of care for children with epilepsy
Description: We targeted two major priorities in our care for children and young people with epilepsy.
(i) Referral time by primary care to a specialist in Paediatric Epilepsy.
(ii) Information shared and, in particular the very difficult subject of SUDEP.
Organisation: Musgrove Park Hospital
Guidance: NICECG137 - The epilepsies: the diagnosis & managemnet of epilepsies in adults & children in primary & secondary care
Category of submission: - Date: 23 Nov 2012
Improving the quality of care through implementing the NICE 'alcohol use disorders' guidelines
Description: To implement NICE guidance and develop an evidence-based streamlined pathway for service users with alcohol use disorders both within the organisation and with partner organisations.

To maximise all opportunities to deliver interventions relating to alcohol use disorders and to ensure high quality care across all services in particular during in-patient admission.

To design and deliver training solutions to support the above using a range of methods to ensure staff have the knowledge and practical competence to deliver the improvements detailed by NICE.


Organisation: Manchester Mental Health and Social Care Trust
Guidance: CG 115, 100, PH24 - Alcohol dependence and harmful alcohol use
Category of submission: 2011-12 Shared Learning Awards Date: 30 Jan 2012
Improving the standard of service provision for people with epilepsy and learning disability in Nottinghamshire.
Description: This example was originally submitted to demonstrate implementation of CG20 on Epilepsy. CG20 was replaced by CG137. The practice in this example remains consistent with the updated guidance.
Organisation: Nottinghamshire Healthcare NHS Trust
Guidance: CG137 - Epilepsy
Category of submission: Clinical Date: 03 Oct 2008
In the balance : Development of a model Occupational Health system based on the NICE Obesity Guidance (Clinical Guidance CG 43 ) for detecting , assessing and managing overweight and obesity in NHS staff in an Acute Hospital Trust.
Description: Pennine Acute Hospital NHS Trust, continuing the momentum set by Dame Carol Black and Dr Stephen Boorman in their recent reports, aims to reduce sickness absence from 18 to 8 days/employee/year and expects Occupational Health(OH) to play a key role by targeting obesity in staff thereby reducing disability, premature retirement, work stress and injury whilst improving work attendance and productivity. Current obesity management in OH is inconsistent with no set protocol and muddled care pathways, yet NICE has produced in CG43 a systematically developed framework to promote high quality evidence-based assessment and management of obesity. An audit was performed to identify deviations in OH practice from recommendations in CG43, design an action plan to correct deficiencies bringing clinical staff up-to-date with best practice, to ensure a consistent standard in diagnosis and management of obesity and also to dispel the current apathy in OH which surrounds the subject of obesity.
Organisation: Pennine Acute hospitals NHS Trust
Guidance: CG43 - Obesity
Category of submission: 2011-12 Shared Learning Awards Date: 05 Dec 2011
Increasing Healthy Start vitamin uptake
Description: We wanted to ensure that the Healthy Start vitamins (containing Folic Acid, Vitamins C and D) were available to everyone who needed them.

We set up a local scheme so that Healthy Start vitamins were available to buy or on voucher exchange (for those on the Healthy Start welfare programme) in all children centres across North East Lincolnshire (NEL).

In addition we offer a free 'starter' pack (2 months supply) of women's vitamins for all pregnant women through maternity services. We also are offering a free 'starter' bottle of children vitamin drops through health visiting teams.
Organisation: North East Lincolnshire Care Trust Plus
Guidance: PH11 - Maternal and child nutrition
Category of submission: - Date: 26 Oct 2012
Increasing NICE compliance through improved database monitoring and reporting
Description: We have developed, in-house, a bespoke Access database to enable monitoring and assurance of the Trust's status against NICE guidance. The database allows comprehensive and accurate reporting in numerous permutations at the touch of a button. The facilities for improved monitoring of progress and flagging when deadlines and next actions are due have enabled us to demonstrate an increase in compliance of more than 50% since the database was introduced in November 2011.
Organisation: University Hospitals Coventry & Warwickshire
Guidance: Generic
Category of submission: - Date: 13 Jan 2014
Integrated care documents - a means of implementing NICE guidance
Organisation: Taunton & Somerset NHS Foundation Trust
Guidance: CG063 - Diabetes in Pregnancy
Category of submission: Clinical Date: 22 Aug 2008
Integrating men being treated for prostate cancer into exercise referral schemes
Description: We identified a low level of exercise and high level of obesity in men with Prostate Cancer, both risk factors for extra toxicity following ADT, particularly fatigue. Working with patients, health care commissioners and the government body- Skills Active, and a training provider we developed a national level 4 qualification in exercise rehabilitation which empowered local (and national) gym instructors to accept referrals for patients with cancer within the national exercise referral scheme. All men, with prostate cancer now receive exercise counselling, supported by a written information pack and are offered referral to a 12 week exercise programme which when later audited had a high uptake rate and satisfaction. This project is in line with recommendation 1.4.19 in CG175 which states: Offer men who are starting or having androgen deprivation therapy supervised resistance and aerobic exercise at least twice a week for 12 weeks to reduce fatigue and improve quality of life (new 2014).
Organisation: Bedford and Addenbrooke's Cambridge University Hospitals
Guidance: CG175 - Prostate cancer: diagnosis and treatment
Category of submission: - Date: 19 Dec 2013
Interactive simple telehealth for the management of blood pressure
Description: This innovative simple interactive telehealth system has demonstrated rapid improvement in historically difficult to treat hypertension using just a home blood pressure monitor and interactive SMS texting between clinician and patient with a mobile telephone. Patient satisfaction with the system was high. Pragmatic use of the system during has demonstrated that there may be a place for this technology in diagnosing, refuting a diagnosis of or managing a pre-existing diagnosis of hypertension.
Organisation: Stoke-on-Trent Clinical Commissioning Group
Guidance: CG127 - Hypertension
Category of submission: - Date: 29 Nov 2012
Introducing a Governance framework for New Interventions and Intervention Procedures Guidelines
Description: In response to the Healthcare Circular - HSC 2003/011, the University Hospitals of Leicester (UHL-NHS trust) and the Medical Director established an advisory body; the New Interventional Procedures Advisory Group (NIPAG) to oversee the process and to oversee the application of NICE issued IPGs. Since it was established, NIPAG has received 47 new applications and distributed 146 IPGs. This submission describes the challenges and key learning points.
Organisation: University Hospitals of Leicester
Guidance: Generic
Category of submission: General Date: 29 Sep 2009
Introducing techniques and medical devices
Description: It is vital that the inauguration of any new technique or medical device takes into consideration not only costs, implication and benefits but also ensures any risks to patients, staff and the Trust are minimised.

The Royal Liverpool and Broadgreen University Hospital Trust (RLBUHT) established the Techniques and Medical Devices group (T&MDg) to formally assess any new technique/medical device and ensure governance arrangements are in place for its introduction.
Organisation: Royal Liverpool and Broadgreen University Hospital Trust
Guidance: Generic
Category of submission: - Date: 30 Jan 2013
IPG404: Transoral incisionless fundoplication (TIF) in children
Description: Prospective audited cohort of 20 children showing efficacy (pH objective, QOL subjective, and drugs stopped) and safety of TIF, with a median follow up of 30 months.
Organisation: Sheffield Children's Hospital NHS Foundation Trust
Guidance: IPG404 - Endoscopic threatment for gastro-oesophageal reflux
Category of submission: 2011-12 Shared Learning Awards Date: 16 Dec 2011
Is Lithium Therapy Safe? A local Audit of Lithium Monitoring in Primary and Secondary Care of Patients in Regular Contact with Secondary Care
Description: Renal failure, hypothyroidism and fatal toxicity can all result from lithium therapy, a drug commonly used as a mood stabilizer for bipolar patients. As a result of the above regular monitoring is required as set out by the NICE guidelines for bipolar disorder (CG38). A retrospective audit was carried out in Osborn House CMHT (Community Mental Health Trust) in Birmingham in order to asses the concordance with these guidelines.
Organisation: University of Birmingham
Guidance: CG38 - Bipolar disorder; The management of bipolar disorder in adults, children and adolescents, in primary and secondary care
Category of submission: - Date: 28 Jan 2013
Isle of Wight Respiratory Inhaler Project
Description: Poor inhaler technique was an issue for the Isle of Wight PCT, as across the NHS. Through a simple, patient-led intervention, significant reductions in hospital admissions and the cost of medication have been achieved. So much so that The Isle of Wight now has the lowest standardised admission rate for asthma in the UK.
Organisation: Isle of Wight PCT
Guidance: TA138 - Asthma (in adults) corticosteroid - plus other TAGs and CGs
Category of submission: 2010-11 Shared Learning examples Date: 11 Feb 2011
Joint Agreement & Implementation
Description: We have 1 30 minute clinical meeting each week to give clinicians opportunity to discuss cases and keep each other updated. When ever we receive a new NICE guideline we discuss the guideline, compare to our current procedures and then agree, if required, a change to our current procedures which is documented on a Joint Agreement & Implementation form which I created which details the guideline, changes to be made, date of implementation and clinicians involved in the agreement. This then acts as a working protocol and copies are stored in clinicians PDP's. I find this stops NICE guidelines being dumped in a draw/folder never to be seen again. It invokes discussion and thought which I am sure is the ultimate aim.
Organisation: Family Medical Practice
Guidance: Generic
Category of submission: General Date: 27 Aug 2009
Keeping patients warm (NICE guideline CG65)
Description: How are we as a hospital performing in terms of avoiding inadvertent hypothermia? Several audits have been performed examining this question and this is a summary of the findings and our experience.
Organisation: Prince Charles Hospital
Guidance: CG65 - Perioperative hypothermia (inadvertent)
Category of submission: - Date: 30 Nov 2012
Knowledge of 5 Key NICE clinical guidelines relevant to Health Visiting and School Nursing Practice
Description: - Health visiting and School nursing practice is influenced by several NICE guidelines.
- An audit was carried to determine the current working knowledge of 5 key NICE guidelines that have been published between 2007 and 2010.
The audit focused on knowledge of:
1) Key signs and symptoms
2) When further action is needed
3) The correct management and advice to give.
Organisation: Leicester Partnership NHS Trust
Guidance: - CG47, CG57, CG84, CG98, CG99
Category of submission: - Date: 14 Jan 2014
Labour analgesia clinical audit
Description: A clinical audit of the provision analgesia in labour and women's satisfaction with the analgesia they received. Authors: Dr.Indrani Wijesurendra, Dr. Surendhren Moodliar, Dr.Imran Sharieff, Dr.Sudath Kumarasinghe, Dr.Sara Ameen.
Organisation: South London Healthcare NHS Trust
Guidance: CG55 - Intrapartum care
Category of submission: 2011-12 Shared Learning Awards Date: 24 Jul 2012
Leicester Square to Covent Garden Walking Corridor
Description: The aim of the scheme was to create an improved, step free, more comfortable and legible walking route between Leicester Square and Covent Garden in order to encourage more people to walk between these two close destinations (400m apart) instead of taking the tube. The route involves crossing two major junctions so improving safety was a key element of the project, and despite their close proximity, legibility was also a barrier to walking this route. The project was delivered in four phases between 2007 and 2012 and involved footway widening (50% more footway space provided in Long Acre, at St Martin's Lane and on Cranbourn Street) and resurfacing, improved pedestrian crossing facilities, decluttering, a new contraflow cycle lane and a review of parking and loading arrangements.
Organisation: Westminster City Council
Guidance: PH41 - Walking & Cycling as forms of travel or education (PH41) and Physical activity and the environment (PH8)
Category of submission: - Date: 31 Jan 2013
Lessons from implementation of Nice Guidelines on Familial Hypercholestrolaemia
Description: The guidelines published by NICE in 2008 prompted us to audit our practice in secondary care and implement changes. Involvement of regional networks proved crucial to the implementation of specific action plans.
Organisation: University Hospitals Bristol NHS trust
Guidance: Generic
Category of submission: Clinical Date: 30 Sep 2009
Lincus Trial: YMCA Liverpool pilot study for individuals with multiple and complex needs
Description: Lincus, a tool designed to capture the impact of interventions on individuals and their communities, has been developed by Rescon, a UK technology company, in collaboration with the: Liverpool City Council (LCC), 3rd sector providers, NHS and industry. Following on from work with the Technology Strategy Board funded Dallas Mi project Lincus was developed for the Liverpool based Big Lottery project that is focused on utilising a variety of interventions to address the needs of those with any three of the following: poor physical health, homelessness history, substance misuse issues, mental ill-health and offending risk (multiple and complex needs). Due to the multifaceted needs of the users, a new evaluation approach was required to capture the impact of interventions on the target population and city ecosystem. A bespoke Lincus tool was co-developed with LCC and Liverpool YMCA. A pilot study was then undertaken to test its usefulness and usability by service users and providers.
Organisation: Rescon
Guidance: Generic
Category of submission: - Date: 21 Nov 2013
Linking the NICE Database to NICE Management (A Step By Step Guide)
Organisation: Harrogate and District NHS Foundation Trust
Guidance: Generic
Category of submission: General Date: 05 Aug 2008
Liverpool Women's Foundation Trust's Multiple Pregnancy Service
Description: The Multiple Pregnancy Service (MPC) at Liverpool Women's Foundation Trust provides the additional care that women with multiple pregnancies should receive. It also provides tertiary level care for women with higher risk or complicated multiple pregnancies. Women are cared for by the clinical team within the service as per Statement 3 in the NICE Quality Standard. This team is made up of a Consultant in Fetal and Maternal Medicine, a Professor of Obstetrics and Gynaecology, Specialist Midwives and a Midwife Sonographer.

When twin pregnancy is already known before booking, women are allocated to book as per normal booking routine and attend the Multiple Pregnancy Clinic (MPC) within 3 weeks of booking.

When twin pregnancy is diagnosed at booking or later at the dating scan, care is transferred to the MPC. The woman is seen in the clinic within 3 weeks of diagnosis.
Organisation: Liverpool Women's Foundation Trust
Guidance: QS46 - Multiple pregnancy
Category of submission: - Date: 16 Sep 2013
Lung Cancer Psychosocial pilot support group 2010
Description: The Lung cancer psychosocial group aimed to provide a space for cancer patients and their carers to gain support on a wide variety of lung cancer issues in an informal setting. It also aimed to educate patients and carers about a range of professionals who provide information and advice within Walsall cancer services.
Organisation: Walsall community Health NHS Trust
Guidance: CSGP - NICE Guidance Improving Supportive and Palliative Care for Adults with Cancer (2004)
Category of submission: 2010-11 Shared Learning examples Date: 21 Feb 2011
Maggie Young, Amy Wicksteed & Brian Hockley: Community Mental Health Teams Approach to Clients with Eating Disorders: assessing needs in relation to NICE Guidance
Description: Recent policy changes has meant Community Mental Health Teams are now referred clients with eating disorders in our Trust. It was unclear how these clients were managed in this setting and what knowledge CMHT's had in relation to specialist and voluntary sector services. This audit used a vignette approach to identify gaps in knowledge and quantify the scale of the problem in terms of treatment and referral pattern.
Organisation: Sheffield Health and Social Care FT (SHSCFT)
Guidance: CG9 - Eating Disorders: core interventions in the treatment and management of anorexia nervosa, bulimia nervosa and related eating disorders
Category of submission: Clinical Date: 21 May 2009
Making Every Contact Count: implementing NICE behaviour change guidance
Description: The Prevention and Lifestyle Behaviour Change: a competence framework is the essence of the regional 'Making Every Contact Count' strategy and will deliver on improving health and wellbeing, prevention and health inequalities. This framework is an innovative whole system response to enable a sustainable commissioner led approach to promoting healthy lives. The framework is split into generic and specialist level competences and is being used by service and education commissioners; service providers, including human resources and organisational development; education providers and individual workers to bring together the required processes and systems to realise whole workforce change. Collaboration across the SHA region facilitated agreement of the required workforce transformation to achieve this and with the NICE (2007) challenge to 'equip practitioners to support behaviour change' serving as a critical evidence base, the framework was developed.
Organisation: NHS North
Guidance: PH6 - The most appropriate means of generic and specific interventions to support attitude and behaviour change at population and community levels
Category of submission: 2011-12 Shared Learning Awards Date: 14 Dec 2011
Making NICE Happen in Primary Care - Make it Easy
Description: Producing QOF style business rulesets for NICE guidelines allows the systematic deployment and monitoring of NICE guidelines in primary care. Adding QOF style prompts to support adherence to the guidelines produces further benefits to patient care. Being able to run this across a PCT/CCG.
Organisation: NHS Kent and Medway
Guidance: Generic
Category of submission: 2011-12 Shared Learning Awards Date: 07 Jan 2012
Management of NICE guidance under the Guidelines & Alerts Steering Process (GASP)
Description: This submission outlines the development of a robust central process within an Acute Trust to identify and manage all national guidance and alerts received in the Trust. A central working group, the Guidelines & Alerts Steering Process (GASP) group, was set up to review all types of guidance and alerts received. The GASP working group meets monthly (shortly after the publication of NICE guidance) and its role is to: identify clinical and managerial leads; review responses received on level of compliance; and escalate any major issues identified (exception reporting) through the appropriate channels. The group's membership includes representatives from Clinical Effectiveness, Pharmacy, Medical Devices and primary care and is chaired by the Acting Medical Director (Quality & Safety).
Organisation: Royal Cornwall Hospitals NHS Trust
Guidance: Generic
Category of submission: General Date: 25 Sep 2009
Management of the child with fever: an audit
Description: The aim of this audit was to look at all children under the age of six months presenting to A&E in the MidYorkshire Hospital Trust to find out whether the standards set out in the 2007 NICE guidance for managing febrile children were being met. We hoped to highlight areas where these NICE guidelines could be followed to provide a better standard of care of febrile children.

Please note that this example was submitted to demonstrate implementation of CG47. This guideline was updated and replaced in May 2013 by CG160. The practice in this example remains consistent with the updated guidance.
Organisation: MidYorkshire NHS Trust
Guidance: CG160 - Feverish illness in children
Category of submission: Clinical Date: 11 Nov 2008
Maximising access to a cardiac rehabilitation service through service redesign and an innovative web-based approach, 'Activateyourheart'.
Description: We have developed a sophisticated, interactive, password-protected secure cardiac rehabilitation (CR) website,'Activateyourheart', to increase capacity and choice associated with the delivery of CR. In addition we have taken a different approach to delivering our educational component of phase three CR to ensure our patients have much more timely access to information about heart disease, treatments, symptom management, medications, diet and exercise with a much greater emphasis on behaviour change using principals of motivational interviewing. This has increased choice for patients; proved accessible for people who otherwise would not have participated; reduced waiting times for education sessions and released capacity.
Organisation: University Hospitals of Leicester NHS Trust.
Guidance: CG172 - Myocardial infarction: secondary prevention
Category of submission: - Date: 10 Dec 2013
Measuring Success: An audit process for guideline No.8; The management of multiple sclerosis in primary and secondary care. (Updated 2008)
Description: The MS Society developed, piloted and then rolled out an audit tool and process for measuring the success of service providers in implementing the NICE Guideline No8 that put the voice of service users in the centre of the process. Service user's views from focus groups were combined with the results of the audit and synthesized into prioritised action plans for service improvement/developments for people with MS. The MS Society works in partnership with the service provider through the whole process and can reward or 'pump prime' developments.
Organisation: Multiple Sclerosis Society
Guidance: CG8 - Multiple sclerosis
Category of submission: Clinical Date: 11 Sep 2008
Medicines Reconciliation
Description: This project will reduce medication errors and in the extreme prevent deaths - safety. This project will allow service users to be prescribed correct medication at the point of admission or to have their medication reviewed at that time and ensure they are prescribed effective treatment in a timely manner to aid recovery and thus shorten their length of stay - effectiveness. In line with above, to have effective treatment and consequently alleviate symptoms in a timely fashion will increase the service user experience. Being in hospital for a shorter time as possible will add to an increase in quality of experience for the service user - patient experience.
Organisation: Rotherham Doncaster and South Humber Mental Health NHS Foundation Trust
Guidance: Pt safety Guidance 1 - Technical patient safety solutions for medicines reconciliation on admission of adults to hospital
Category of submission: Clinical Date: 30 Sep 2009
Medicines Reconciliation at South London Healthcare Trust
Description: The aim of medicines reconciliation on hospital admission is to ensure that medicines prescribed on admission correspond to those that the patient was taking before admission. Details to be recorded include the name of the medicine (s), dosage, frequency, and route of administration. A retrospective audit was carried out to ensure that medicines reconciliation was carried out correctly, and to determine if unintentional discrepancies identified during the MR process were successfully resolved.
Organisation: South London Healthcare NHS Trust
Guidance: PSG001 - Technical patient safety solutions for medicines reconciliation on admission of adults to hospital
Category of submission: 2011-12 Shared Learning Awards Date: 09 Jul 2012
Medway NICE Guidelines Implementation Strategy
Description: A strategy for implementation of NICE Guidelines was developed. It focuses on training and awareness, barriers to implementation, formation of subgroups for implementation, development of checklists, audits and facilitation of practice of NICE Guidelines
Organisation: Kent and Medway NHS and Social Care Partnership Trust
Guidance: Generic
Category of submission: 2010-11 Shared Learning examples Date: 11 Feb 2011
Meeting spiritual needs on an acute mental health admission ward
Description: Adapting the environment of an inpatient mental health admissions ward to meet the spiritual and religious needs of patients and reduce levels of anxiety and disturbance.
Organisation: Sussex Partnership NHS Foundation Trust
Guidance: cg38 - Bipolar disorder
Category of submission: Clinical Date: 03 Oct 2008
Mental Health Champions Development Programme
Description: The Mental Health Champions Development Programme was a structured education programme The primary aims behind this programme were to improve the provision of care for individuals with mental health problems using Portsmouth Hospitals Trust (PHT) services and to support staff through a structured education programme in managing people with mental health problems. The programme has been devised and delivered by collaborative working between Portsmouth Hospitals Trust and Portsmouth City teaching Primary Care Trust.
Organisation: Portsmouth City PCT
Guidance: CG16 - Self-harm: The short-term physical and psychological management and secondary prevention of self-harm in primary and secondary care
Category of submission: Clinical Date: 17 Sep 2008
Mind the Gap
Description: Intervention to reduce the drop-off between those patients newly diagnosed with Hepatitis C in Northern Ireland and those referred for assessment.
Organisation: NI Regional Hepatitis B&C Managed Clinical Network
Guidance: Generic
Category of submission: - Date: 20 Nov 2012
Mind the Gap: Analysis of clinical practice and service provision compared to NICE Quality Standards
Description: Mersey Care NHS Trust focused on the use of NICE quality standards in its Strategic Framework, objectives and SMART targets during 2013/14; this includes conducting an initial gap analysis followed by a move towards full compliance against the standards. The language used surrounding the work initially included "implementation" and "compliance", It became clear that NICE would intend quality standards to be "aspirational" and to drive "quality improvement" and this led to the initial aims and objectives to be modified.

The trust reviewed all current NICE quality standards between April and June 2013 in order to identify gaps and areas for future development; as well as designing a trust specific approach to describe the required metrics for quality and effective mental health service provision, with a particular focus on physical health care.
Organisation: Mersey Care NHS Trust
Guidance: Generic
Category of submission: - Date: 17 Jan 2014
Monitoring of stroke care within the North West England
Description: The Advancing Quality Programme aims to improve the clinical outcomes for patients diagnosed with stroke. In improving the clinical outcomes the programme aims to reduce hospital stay, reduce readmission rates and improve overall patient experience. Twenty four Trusts within the North West of England participate in data collection and analysis for seven aspects of patients care within the first 72 hours of diagnosis of stroke.
Organisation: Advancing Quality Alliance (AQuA)
Guidance: Generic
Category of submission: 2011-12 Shared Learning Awards Date: 26 Jan 2012
Moving on, The Lunch Club experience
Description: Making a choice about when to move into a dementia care home can be a challenging, frustrating and frightening prospect for many older people. Opening our care home up to the community for lunch club assisting with dispelling myths of care homes, helping with a smooth dignified transition into care.

The NICE Quality Standard QS30 Dementia includes the following quality statements:
QS 2 - choice and control in decision making
QS 3 - Reviewing needs and preferences
QS 4 - Activities of interest and choice
QS 5 - Maintaining and developing relationships
Lunch club enables all above quality standards to flow, supporting a resident before one decides to move into a care home. Making sure that a quality pre-assessment of ones holistic needs can be met on admission. Lunch club supports one with developing new relationships prior to moving in, so a less anxious time for the resident plus their family/friends.
Organisation: The Abbeyfield Society
Guidance: QS30 - Supporting people to live well with dementia
Category of submission: - Date: 19 Jan 2014
Moving vocational rehabilitation closer to primary care to prevent long term sickness absence
Description: One of 10 national Fit for Work service pilots across the UK aimed at providing early interventions to people at risk of long term sickness absence. The Leicestershire pilot is the only one led by a GP and has focussed entirely on receiving referrals from primary care and is unique in taking on responsibility for signing fit notes for the duration of service. The service is provided by a multi-disciplinary team that identifies barriers to work as soon as possible and provides or co-ordinates interventions towards a return to work in keeping with the guidelines in PH19 - Managing long-term sickness absence and incapacity for work
Organisation: Leicestershire Fit for Work service (LFFWS)
Guidance: PH19 - Managing long-term sickness absence and incapacity for work
Category of submission: 2010-11 Shared Learning examples Date: 10 Feb 2011
Multi-agency MST project
Description: This is a multi-agency project that uses MST to help young people 11- 17 who display ant-social behaviour. Young people have complex needs that place them at the risk of custody, social exclusion, school exclusion or reception into care. The project is also part of a national multi-centre research project.
Organisation: Children and Young People's Service
Guidance: CG77 - Antisocial personality disorder
Category of submission: 2010-11 Shared Learning examples Date: 31 Jan 2011
Multi-disciplinary pathway development for individual with dementia and a learning disability.
Description: A multi-disciplinary working group was set up to look at how the NICE guidance for dementia should be applied to adults with a learning disability. This led to the development of a coherent pathway which clinicians can refer to in order to help them chart the steps from pre-diagnosis to end of life care.
Organisation: Sussex Partnership NHS Foundation Trust
Guidance: CG42 - Dementia
Category of submission: Clinical Date: 03 Oct 2008
Multi-treatment Foster Care (MTFC)
Description: Multi-treatment Foster Care (MTFC), also known as Intensive Fostering (IF), is based on social learning theory. Intensive support is given to the young person in a solo foster placement, supported by a multi-disciplinary team, each with a clearly defined role and set of responsibilities. The intention is to change behaviour through promoting positive role models.

Placements, which last between 9 and 12 months, are intense and tailored to the young person's specific needs, with 24-hour support from the programme supervisor. During the placement, the young person's behaviour is closely monitored and good behaviour is rewarded by a points-based system.

Young people are placed with a specially trained foster family, who positively reinforce appropriate behaviour. Family therapy is provided for birth parents, and they are taught the same MTFC strategies in preparation for reuniting them with their child. This initiative aligns with quality statements 2, 5 and 7 in QS31.
Organisation: Action for Children - Multi-treatment Foster Care (MTFC), also known as Intensive Fostering
Guidance: Generic
Category of submission: - Date: 12 Mar 2014
Multifactorial interventions can reduce harm from falls in Acute Hospital settings
Description: The Trust has implemented an evidenced based multifactorial and multidisciplinary falls care bundle; the interventions are individualised for each patient and account for complexities in regards to the reason for their admission and prior co morbidities. The falls care bundle enables staff to choose from various falls interventions and apply these interventions to their patients care requirements at different stages of their recovery. The interventions include medical causes, medication reviews, mobility and footwear, environmental factors/hazards, cognitive assessment, consideration of delirium, continence assessment and appropriate use of equipment. The communication of a patient's risk of falls to the Multidisciplinary team is enabled by an electronic communication system; this is then linked by a number of alerts to the medical and pharmacy teams.
Organisation: University Hospitals Birmingham NHS Foundation Trust
Guidance: CG161 - Falls
Category of submission: - Date: 16 May 2013
Multiple pregnancy service, St George's Hospital: influencing stakeholders to implement NICE guidance
Description: The multiple pregnancy antenatal care service at St George's Hospital, London provides an example of a multidisciplinary integrated antenatal clinic where women with multiple pregnancy have all aspects of their care, including ultrasound scans and antenatal appointments at the same visit. These women are looked after by the core team and supported by the enhanced team. The core team consists of two specialist midwives, two senior sonographers and a fetal medicine consultant who provide continuity of care following the antenatal pathway recommended by NICE. The enhanced team includes specialists in perinatal mental health and safeguarding, a dietician, physiotherapist, bereavement midwife and breastfeeding specialist. Our recent survey has revealed that the level of awareness of the NICE guidance is poor. To address this, we have organised an educational meeting that specifically targets multiple pregnancy, supported by the Royal College of Obstetricians and Gyaecologists (RCOG).
Organisation: St George's Healthcare NHS Trust
Guidance: Generic
Category of submission: - Date: 15 Aug 2013
Multisystemic therapy for young people with antisocial behaviour
Description: In partnership with Haringey and Camden Youth Offending Teams, Research Department of Clinical, Educational and Health Psychology University College London and the Centre for the Economics of Mental Health Kings College London, the Brandon Centre initiated and ran the first UK randomised controlled trial of Multisystemic therapy (MST) in order to test whether MST plus management as usual is more effective than management as usual in preventing re-offending by young people aged 13 to 17. The trial was run from 2004 to 2010, 108 families participated in the study, preliminary findings two years post treatment show a significant decline in the probability of re-offending and in the number of offending behaviours in favour of MST. The trial and NICE clinical guideline 77 supported the development of MST as a commissioned service.
Organisation: The Brandon Centre
Guidance: CG77 - Antisocial personality disorder Treatment, management and prevention
Category of submission: 2010-11 Shared Learning examples Date: 05 Feb 2011
My Best Move - GP training for physical activity for patients with Long Term Conditions
Description: My Best Move is a project initiated and sponsored by NHS London and delivered by Intelligent Health, to increase physical activity in patients with long term conditions. It is one of the key 2012 Games health legacies of NHS London. The focus of the project was on training GPs and other health professionals to deliver physical activity interventions that were appropriate and relevant for these patient groups, with a focus on walking and 'everyday' physical activity.
Organisation: NHS London
Guidance: PH41 - Walking and cycling
Category of submission: - Date: 31 Jan 2013
National database to evaluate the effectiveness of outdoor physical activity initiatives
Description: Development of a unique, robust, longtitudinal evaluation instrument to demonstrate that Health Walks and broader green exercise are an effective intervention for health professionals to recommend to inactive patients. This is a 'world first'- between 1 - 5 million data entries per year are expected at current levels.
Organisation: Natural England
Guidance: PH002 - Four commonly used methods to increase physical activity
Category of submission: Public health Date: 30 Sep 2008
Newsletter - Clinical Effectiveness Update: Alerting Clinicians to New Guidance Relating to Mental Health and Learning Disabilities (update date July 2008)
Organisation: Cumbria Partnership NHS Foundation Trust
Guidance: Generic
Category of submission: General Date: 24 Jul 2008
NHS Sheffield Webtool for monitoring and reporting on the NICE Quality Standards
Description: An innovative web based resource has been developed by NHS Sheffield that will enable users across a health community to record progress and collate evidence to support the implementation and monitoring of the NICE Quality Standards Programme.
Organisation: NHS Sheffield
Guidance: Generic
Category of submission: 2010-11 Shared Learning examples Date: 14 Feb 2011
NICE & Knowledge: Developing an initiative to enable a robust cascade of NICE Guidance backed by documentary evidence of clinician's knowledge at appraisal. (update 2009)
Description: NICE and Knowledge identifies Technology Appraisals and Clinical Guidelines relevant to the Children's Directorate caseload (and more recently Mental Health and Learning Disabilities) and has developed e-learning modules linking the NICE quick reference guide, clinical standards and a test assessing knowledge of these standards, to provide evidence of knowledge to be presented at appraisal. Disciplines within the directorate have checklists identifying all appropriate NICE guidance and indicating whether they need to undertake the test or simply provide evidence that they have accessed the information. In both instances a certificate is generated to evidence compliance, which is required for annual appraisal and cross linked with the KSF requirements to simultaneously support staff and organisational needs.
Organisation: South Staffordshire & Shropshire Healthcare NHS Foundation Trust
Guidance: Generic
Category of submission: General Date: 01 Oct 2009
NICE care - preventing venous thromboembolism
Description: The RCN's online learning resource on VTE is intended for a nursing audience ranging from health care assistants with little or no prior medical training, to registered nursing staff who have completed a degree. The resource was developed in response to the recommendation from the National VTE Leadership Summit (hosted by the All Party Parliamentary VTE Group and the Department of Health) for focussed learning content for nursing staff to further embed VTE prevention and the NICE guideline CG92, into mainstream clinical practice. The resource utilises engaging and accessible e-learning to deliver the content throughout the NHS and independent health care sectors to support the achievement of the required learning outcomes for this 'time challenged' audience.
Organisation: Royal College of Nursing (UK)
Guidance: CG92 - Venous thromboembolism - reducing the risk
Category of submission: 2011-12 Shared Learning Awards Date: 11 Jan 2012
NICE CG38 medication for bipolar disorders (audit)
Description: This is a report of the change of practice in mental health learning difficulties as a result of a NICE audit - Is the physical health of patients with co-morbidity: learning disabililty and bipolar disorder being monitored according to the recomendations of NICE guidance CG38 Bipolar Disorder?
Organisation: Birmingham Community Healthcare
Guidance: CG38 - Bipolar Disorder
Category of submission: - Date: 17 Jan 2014
NICE Compliance Database
Description: We have designed a database to record all aspects of NICE from publication to Trust compliance levels. We record published NICE guidance and implementation tools available. We record who within the Trust these have been sent to and when. We use the database to track compliance responses and collate evidence supplied to support compliance statements. The database then records compliance levels, gap analysis and action plans. We can then produce compliance reports to NICE guidance for our Divisional Structures, Trust Board and local commissioners. A NICE Guidance Process Flowchart forms part of our Trust NICE Implementation Procedure(attached)
Organisation: Barking, Havering & Redbridge University Hospitals NHS Trust
Guidance: Generic
Category of submission: General Date: 04 Sep 2009
NICE Do not Do prompts
Description: Nottinghamshire Healthcare NHS Trust has developed a booklet containing 'do not do' prompts for clinical practices that NICE recommend should be discontinued or not used routinely. These pocket sized booklets (6" x 4") cover twenty-one conditions that are core to our services and have been rolled out to clinicians for every-day use.
Organisation: Nottinghamshire Healthcare NHS Trust
Guidance: CG115, CG100, CG45 - CG77, CG72, CG142, CG128, CG78, CG123, CG90, CG28, CG91, CG51, CG52, CG113, CG133, CG28, CG120, CG82, TA136
Category of submission: - Date: 03 Dec 2013
NICE Guidance CG10 (2003) - Type 2 diabetes the prevention and management of foot problems: How top down implementation removed waiting times (up to 18 months waits)
Description: Podiatry senior managers implemented NICE guidance CG10 to transform and improve the foot protection service of people with diabetes in Birmingham. Report includes cost savings as a result of NICE guidance.
Organisation: Birmingham Community Healthcare
Guidance: CG 10 - Type 2 diabetes the prevention and management of foot problems
Category of submission: - Date: 30 Jan 2013
NICE Guidelines for Depression and Anxiety: Audit and Implementation in Southwark
Description: This project was designed to identify whether patients with Anxiety and Depression in Southwark were being treated in accordance with the NICE Guideline recommendations; specifically with regards to stepped-care and the provision of evidence-based psychological treatments. In addition to this barriers to implementation were identified and recommendations to increase implementation were made. The follow-up project involves implementing the recommendations from the project to increase compliance with the NICE Guidelines.
Organisation: Institute of Psychiatry, Kings College London
Guidance: CG22 & CG23 - Anxiety & Depression
Category of submission: Clinical Date: 23 Sep 2008
NICE implementation database
Organisation: South Essex Partnership NHS Foundation Trust
Guidance: Generic
Category of submission: General Date: 12 Jan 2009
NICE Quality Standards for service reviews
Description: NICE Quality Standards for End of Life Care and Dementia were used as frameworks to conduct service reviews as part of our CQUIN. For both reviews, we triangulated information from patient stories, stakeholder events and hard data sources to form a picture of current services and to make recommendations for change. The Quality Standards (QS) provided an independent, evidence based definition of high quality services against which we could evaluate our service provision.
Organisation: Cumbria Partnership NHS FT
Guidance: - Quality Standard for Dementia/Quality Standard for End of Life Care
Category of submission: - Date: 24 Jan 2013
NICE Scholars Programme: An experience of implementing NICE with clinical and research practice within a trauma and orthopaedic department.
Description: As the first physiotherapist on the new NICE Scholars programme I have outlined my Scholarship aims and objectives and how these have developed throughout the twelve month programme to improve the quality of patient care within trauma and orthopaedics.
Organisation: University of Warwick/ University Hospitals of Coventry and Warwickshire
Guidance: Generic
Category of submission: 2010-11 Shared Learning examples Date: 19 Nov 2010
NICE training improves outcomes: making the right way the easiest way
Description: A strategy to implement NICE guidance, assess and monitor outcomes: from safe design to safe practice and beyond, through interprofessional training. D Siassakos, Clinical Lecturer (Hon) in Medical Education and Research Specialist Registrar Obstetrics; T Sibanda, Research SpR Obstetrics; C Winter, Practice Development Midwife; T Draycott, Consultant Obstetrician
Organisation: North Bristol NHS Trust
Guidance: CG55 - Intrapartum care: management and delivery of care to women in labour
Category of submission: Clinical Date: 25 Sep 2008
NICE with No Barriers: How to make NICE & Information Literacy part of your clinical practice
Description: Training, resources and current awareness were provided by the Trust Outreach Librarian to support the effective implementation of NICE guidelines and evidence-based practice. Barriers to access were reduced by having a flexible approach to delivery i.e. on site, and at times to suit individual teams and wards. As a result, staff feel more informed, valued and able to access a range of resources to support their clinical practice.
Organisation: Lancashire Care NHS Foundation Trust
Guidance: Generic
Category of submission: 2010-11 Shared Learning examples Date: 14 Feb 2011
NICE, Foresight and the National Support Team- a Winning Combination for Partnership Engagement in Cornwall & Scilly.
Organisation: Cornwall & Isles of Scilly PCT
Guidance: CG43 - Obesity
Category of submission: Public Health Date: 26 Sep 2008
NICEr management of urinary tract infection in children!
Description: Implementing the NICE UTI in Children guideline in a UK Paediatric Emergency Department by devising a new Standard Operating Procedure (SOP). Using prospective audit to monitor change in practice and evolve better care pathways for our patients.
Organisation: Leicester Royal Infirmary
Guidance: CG54 - Urinary Tract Infection in Children
Category of submission: Clinical Date: 29 Sep 2009
North Bristol NICE Junior Doctor Electronic Toolbox
Description: The initiative is about addressing perceived and real barriers to junior doctor engagement with Clinical audit and NICE related audit in particular. It is also about addressing the notions that clinical audit is a symbolic exercise with little meaningful prospect of effecting change and improvement in quality and safety. Following a small scale barrier analysis and utilising quality Improvement methodology. The Quality Improvement and Clinical Audit Service conducted a series of small scale tests of change to find solutions to these barriers and to tackle perceptions about the value and merit of clinical audit activity. It is manifested at a simple level in the development of an electronic tool box for audit tools but has required a strategic change in how clinical audit activity is supported, the tempo of that work and the innovative solutions that are needed to truly impact on quality and safety within North Bristol.
Organisation: North Bristol NHS Trust
Guidance: Generic
Category of submission: General Date: 30 Sep 2009
North West Patient Leaders Programme and NW COPD Patient Passport
Description: Demonstrating meaningful involvement and shared decision making with patients and the public is a real challenge for commissioners in the NHS. Meaningful involvement is however a key enabler to efficiency improvements in quality, innovation, productivity and prevention.
We have implemented two initiatives:
(1) NW Patient leaders programme -One or two patient leaders from each CCG area are provided training and support to help them meaningfully engage with their local commissioners and providers and support them in service improvement or engaging other patients and communities.
(2) NW COPD Patient Passport - 7 steps to best COPD care-We developed a patient-held kite mark based on NICE Guidance (CG101) and Quality Standards (QS10) which is being used by patients to understand care received by them and engage with their clinicians
Organisation: NHS North West
Guidance: QS10 - Chronic obstructive pulmonary disease (COPD)
Category of submission: - Date: 29 Jan 2013
Nurse-led care for patients after a TIA
Description: Specialist Transient Ischaemic Attack (TIA) clinics were set up following the publication of the National Stroke Strategy and NICE CG68 to provide specialist assessment of patients with a suspected TIA. This has led to much earlier diagnosis and initial management of TIAs. However, patients can be overwhelmed following the initial diagnosis with its significant implications on lifestyle. The National Stroke Strategy and national guidance (DH 2007; Intercollegiate Stroke Working Party 2008) recommend patients are followed up within 1 month of diagnosis either in primary or secondary care. Specialist Nurse-led TIA follow-up clinics are an effective way of delivering specialist advice, helping patients cope with their diagnosis and empowering them to manage their cerebrovascular risk factors.
Organisation: Nottingham University Hospitals NHS Trust
Guidance: Generic
Category of submission: 2011-12 Shared Learning Awards Date: 31 Jan 2012
Occupational therapy and the promotion of mental wellbeing.
Description: Using the NICE public health guidelines 16 as a framework, occupational therapy staff have used specific knowledge and experience to deliver creative solutions to complex occupational problems arising through mental illness. This has been delivered through individual and groupwork interventions, to promote mental wellbeing.
Organisation: Cornwall Partnership Trust
Guidance: PH16 - Occupational therapy intervention and physical activity interventions to promote the mental well being of older people in primary care and residential care.
Category of submission: Health and wellbeing Date: 29 Sep 2009
One Stop Shop for Multiple Sclerosis relapse management
Description: The submission presents documentation detailing results of a multiple sclerosis audit utilising the MS Society Measuring Success Audit tool to identify gaps in relapse management. It includes draft relapse care pathways and an action plan for service development to embed an integrated care pathway for relapse management between services. Also a power point presentation delivered at stakeholders day highlighting the requirement for a 'One Stop Shop'
Organisation: NHS Walsall Community Health
Guidance: CG8 - Multiple sclerosis
Category of submission: Clinical Date: 28 Sep 2009
Open wide project: raising awareness of the risks of smokeless tobacco and shisha pipe smoking and the signs and symptoms of mouth cancer.
Description: The Open Wide project is delivered within community settings and aims to raise awareness within Asian communities of the risks of using chewed tobacco and other forms of tobacco such as shisha pipes. The project's group work sessions also highlight the signs and symptoms of oral cancer.
Organisation: Bolton Council, Public Health Team/Bolton CVS Engagement Team
Guidance: PH39 - Smokeless tobacco cessation - South Asian communities
Category of submission: - Date: 18 Apr 2013
OPERA (Online Personal Education and Risk Assessment) Updated November 2009
Description: Update on the risk assessment tool and personalised information resource
Organisation: Macmillan Cancer Support
Guidance: CG41 - Familial breast cancer
Category of submission: - Date: 21 Jan 2010
Opioids in Palliative Care-A Patient Manual and Diary
Description: Opioids are offered frequently in palliative care to help reduce pain and breathlessness. The initiation and titration happens in clinics and outpatient settings, can sometimes be part of a much wider consultation on disease status and information between prescriber and patient tends to be verbal and not always backed up by written guidance. Yet these are complicated medicines to take, with varying regimens and they carry a lot of stigma, with patients (and carers) left frightened about possible side-effects and addiction potential.

Here, we present a written Patient Manual to taking opioids in palliative care settings, which includes a diary, and represents a useful take-home supplement to consultations where opioids have been discussed and considered.
Organisation: Velindre NHS Trust
Guidance: CG140 - Opioids in palliative care
Category of submission: - Date: 03 Jan 2013
Options for provision of MRI surveillance in Wales to women with a family history of breast cancer as recommended in NICE guidance 41
Description: Women under 50 years with a family history of breast cancer which suggests they have an increased risk of developing the disease compared with the population as a whole are offered annual mammography by Breast Test Wales, although this is not funded. NICE clinical guidance 41 published in July 2006 recommended these women should receive annual MRI surveillance in addition to mammography, at present there is no system in Wales to provide this level of surveillance. This project explores the options for implementing the NICE guidance across Wales.
Organisation: National Public Health Service for Wales
Guidance: CG41 - Familial breast cancer
Category of submission: Clinical Date: 30 Sep 2008
Our pledge - empowering staff to deliver a high quality patient experience
Description: Utilising the Patient Experience in Adult NHS Services Quality Standard (QS15) in an innovative way to reinforce our commitment to providing high quality care.

Our pledge is developed by each of our services to increase the focus on the quality of the patient experience in an increasingly demanding environment.

This enables services to focus service provision and resources into providing care that really matters to their patients.
Organisation: Medway Community Healthcare CIC
Guidance: QS15 - Patient experience in adult NHS services
Category of submission: - Date: 29 Jan 2013
Out of the Blues
Description: A 6 week course designed to support women with PND
Organisation: Tameside and Glossop NHS
Guidance: CG45 - Antenatal and postnatal mental health
Category of submission: Clinical Date: 26 Aug 2009
Oxygen therapy for cluster headaches
Description: There is substantial evidence to show that initiation of oxygen therapy is effective in the treatment of cluster headaches, however baseline assessment work against CG150 Headaches: Diagnosis and management of headaches in young people and adults identified this was not always accessible, therefore a project was undertaken to develop a shared care pathway to ensure that patients across the North West region could access oxygen therapy when clinically indicated.
Organisation: Lancashire Care NHS Foundation Trust
Guidance: CG150 - Headaches: Diagnosis and management of headaches in young people and adults
Category of submission: - Date: 09 Jan 2014
PADex, Manchester's disease specific supervised exercise programme for patients with intermittent claudication
Description: The NICE clinical guideline on Lower Limb peripheral arterial disease recommends offering a supervised exercise programme to all people with intermittent claudication. This report and supporting appendices, documents the development of a new community supervised exercise programme (PADex) for patients with intermittent claudication in Manchester.
Organisation: Physical activity and Referral Service. Manchester Health and Social Care Trust
Guidance: CG147 - Lower limb peripheral arterial disease
Category of submission: 2011-12 Shared Learning Awards Date: 18 Jun 2012
Pathway to recovery: Development and recovery of a person centered pathway of care for psychosis
Description: Tees, Esk & Wear Valleys NHS Trust have developed a Psychosis pathway to support the implementation of NICE CG82 Schizophrenia; the evidence based pathway covers all clients with a diagnosis of psychosis within the communities of Tees, Esk and the Wear Valley. The concept of the Pathway is to understand and articulate the client journey, and the effective and efficient management of the systems, people and environment supporting that journey. It ensures there is a robust governance structure in place which facilitates the effective application and monitoring of the NICE guidance.

Please note that this example was originally submitted to demonstrate implementation of CG82 Schizophrenia (update). CG82 has now been replaced by CG178. The example has been reviewed and continues to align with the new guidance.
Organisation: Tees, Esk & Wear Valleys NHS Trust
Guidance: CG178 - Psychosis and Schizophrenia in adults
Category of submission: Clinical Date: 30 Sep 2009
Patient Group influences commissioning to improve patient care in Rheumatoid Arthritis in East of England
Description: Our submission describes the process we went through to bring about change in commissioning evidence based best care for people with rheumatoid arthritis in the East of England region. It describes the stakeholders we collaborated with to effect such change and to develop and introduce standards based on NICE RA Guidelines and how this work has subsequently led to the introduction of a QIPP report demonstrating substantial savings to be made.
Organisation: National Rheumatoid Arthritis Society
Guidance: CG79 - Rheumatoid arthritis
Category of submission: 2010-11 Shared Learning examples Date: 02 Feb 2011
Patient information leaflets about preventing falls in hospital and the use of bedrails
Description: To produce easy read patient information leaflets that explained how patients and carers might help to recognise and reduce their own falls risks while in hospital and the potential risks and benefits associated with bedrail usage.
Organisation: Portsmouth Hospitals NHS Trust
Guidance: Generic
Category of submission: - Date: 16 May 2013
Patients and carers experience of living with a complex neurological and palliative diagnosis.
Description: The development of a service in which the patient is an active partipant in their health care which is coordinated and mediated to afford a bespoke health package that meets the individual needs of patients and their carers.
Organisation: Hertfordshire Community NHS Trust
Guidance: Generic
Category of submission: - Date: 20 Aug 2013
PBNX (pharmacy-based Needle exchange) Programme for Community Introduction
Description: Learning package designed to highlight best practice and excellence of service delivery, amongst pharmacy staff, during implementation of a community based needle exchange programme.

Please note that this example was originally submitted to demonstrate implementation of PH18 but remains consistent with the updated guidance PH52.
Organisation: The Can Partnership
Guidance: Generic
Category of submission: - Date: 04 Aug 2013
Physical Health & VTE Risk Assessment Audit - Mental Health Division (Re-audit)
Description: A re-audit looking whether physical health assessments are being carried out and whether they are being documented in the correct place. The audit was carried out across all adult and older adult wards. Authors: Dr Hasanen Al-Taiar MBChB, MRCPsych (Specialist Registrar in Forensic Psychiatry) Dr Adil Nathoo (foundation doctor) Dr Sidra Shaheed (CT1 Psychiatry)
Organisation: Oxford Health NHS Foundation Trust
Guidance: CG92 - Venous thromboembolism - reducing the risk
Category of submission: - Date: 06 Sep 2013
Physiotherapy Low Back Pain Drop-in Services
Description: The Physiotherapy Low Back Pain Drop-in Service project was introduced in East Lancashire to improve access and quality of service for patients with low back pain, through a re-designed and enhanced physiotherapy service. Staff, patients and referrers were involved in developing new 'Drop-in' clinics. These are run by experienced physiotherapists who offer early assessment ,advice and reassurance. Waiting times are now minimal (as the service is not appointment based but patients are invited to 'Drop-in'), duplicate referrals and unnecessary diagnostics have been vastly reduced; and patient outcomes are good.
Organisation: East Lancashire Hospitals NHS Trust
Guidance: Generic
Category of submission: 2010-11 Shared Learning examples Date: 08 Feb 2011
Pilot to improve the appropriate prescription of oral nutritional supplements within the Walsall area
Description: Growth in expenditure of oral nutritional supplements (ONS), which are commonly used to treat malnutrition, has risen substantially in recent years. A high proportion of supplements (57-75%) are prescribed inappropriately, resulting in significant waste and unnecessary healthcare costs. Despite this significant cost, evidence suggests that recognition of malnutrition and monitoring of patients in the community is poor and ONS are often used inappropriately. Assessing the appropriateness of ONS expenditure in the community falls into the NHS QIPP (Quality, Innovation, Productivity and Prevention) agenda. 1) London Procurement Programme Clinical Oral Nutrition Support Project (January 2009) 2) Loane D, Flanagan G, Siun A, McNamara E, Kenny S (2004) J Hum Nutr Diet 17 257-266 3) Kennelly S, Kennedy NP, Flanagan Rughoobur G, Glennon Slattery C, Sugrue S (2009) J Hum Nutr Diet 22(6) 511-520
Organisation: Walsall Healthcare NHS Trust
Guidance: CG32 - CG32-Nutrition support in adults
Category of submission: 2011-12 Shared Learning Awards Date: 19 Jul 2011
Plymouth Great Expectations Antenatal education programme
Description: Great Expectations antenatal education programme is a multidisciplinary parenting course for pregnant women, their partner (or chosen supporter). The development and delivery of this programme has brought together a range of practitioners, who have reviewed the evidence base, looked at NICE guidance, quality standards and examples of best practice. These have been considered alongside service user feedback and evaluations, to design an interactive, practical, and engaging parent education package.

The development of Great Expectations has been overseen by a quality assurance group, with representatives from a range of partners, who have maintained a focus on quality, equity, accessibility and managing capacity.

The implementation of this programme has enhanced the antenatal care pathway offering pregnant women (and partners) greater choice, and increased accessibility across a range of venues, times and days of the week.
Organisation: Plymouth Community Healthcare (CiC)
Guidance: CG62 - Antenatal care
Category of submission: - Date: 17 Jan 2014
Positive Ageing Group
Description: The Positive Ageing group is facilitated by occupational therapy staff from older adult community mental health teams based in the Glenkirk Centre, Drumchapel, Glasgow. It is aimed primarily at service users aged 65 and over with a functional diagnosis, usually but not exclusively anxiety and/or depression who may be referred by G.P.s, or medical and nursing staff in the community mental health teams. Referrals may also be accepted from service users with mild cognitive impairment if they are able to take on board new information.
Organisation: Older Adult CMHT
Guidance: PH16 - Occupational therapy interventions and physical activity interventions to promote the mental wellbeing of older people in primary care and residential care
Category of submission: Health and wellbeing Date: 30 Sep 2009
Pre Registration Pharmacists - Community Investment Project with the Third Sector
Description: Boots pre registration pharmacists across the country investing time to engage with local community organisations to provide a fun, challenging team day that will benefit the overall health of local people in some way.
Organisation: Healthy Living Alliance
Guidance: PH009 - Community Engagement
Category of submission: Public health Date: 23 Sep 2008
Pregnancy Plus
Description: A 10 week community based health intervention programme, aimed at obese pregnant women with a body mass index of 30kg/m2. This programme offers advice in accordance with the National Institute of Health and Clinical Excellence guidance (PH27, 2010).
Organisation: Dartford & Gravesham NHS Trust
Guidance: PH27 - Weight management before, during and after pregnancy
Category of submission: - Date: 23 Dec 2012
Prescribing antipsychotic medications for the treatment of behavioural symptoms in people with Dementia, Milton Keynes 2012.
Description: This audit was aimed at finding out if the Old Age psychiatry Services were following the good practice guidlines in relation to the prescription of antipsychotics in dementia patients.
Organisation: Oxford Health NHS Foundation Trust
Guidance: CG42 - Dementia
Category of submission: - Date: 18 Apr 2013
Prescription of oral nutritional supplements
Description: A clinical audit of the use of nutritional supplements and monitoring of people having nutritional support on inpatient wards.
Organisation: South London Healthcare NHS Trust
Guidance: CG32 - Nutrition support in adults
Category of submission: 2011-12 Shared Learning Awards Date: 20 Jul 2012
Prevalence of malnutrition in nursing, care and residential homes in Walsall
Description: Malnutrition is common across nursing, care and residential home settings. Without continued staff training and resident screening using Malnutrition Universal Screening Tool (MUST), malnutrition would have been unrecognised and untreated. The audit also showed that identifying and appropriately treating malnutrition could potentially reduce health care costs, as well as inappropriate prescribing of ONS.
Organisation: Walsall Healthcare NHS Trust
Guidance: CG32 - CG32-Nutrition support in adults
Category of submission: 2011-12 Shared Learning Awards Date: 19 Jul 2011
Prevention and management of violence and aggression - promoting safe and therapeutic services in older people's mental health
Description: How a practice development nurse managed the introduction of a new programme of training in the prevention and management of violence and aggression for older people's mental health inpatient staff. We describe the process of implementation from pilot to rollout of an organisation/ county wide initiative and we describe the outcomes of clear patient and staff benefits.
Organisation: Sussex Partnership NHS Foundation Trust
Guidance: CG42 - Dementia
Category of submission: Clinical Date: 28 Sep 2009
Prevention of Accidental Scalds at Bath Time - Implementing NICE Public Health Guidance 30. Preventing unintentional injuries among the under-15s in the home
Description: Sefton families with a child aged 5 years and under are being offered free thermostatic mixing valves (TMVs). The valves regulate the temperature of water from the bath hot tap and can help prevent scalds at bath time.

Sefton's hospital admissions data showed us that burns and scalds were one of the more frequent causes of childhood injuries in the Sefton area, however our child injury prevention scheme didn't include any specific interventions for burns and scalds.

A literature review on the efficacy and cost-effectiveness of TMVs in reducing bath water scalds supported NICE Public Health Guidance 30, 'Preventing unintentional injuries among the under-15s in the home', which called for local authorities to develop local agreements with housing associations and landlords to ensure that permanent home safety equipment is installed and maintained in all social and rental dwellings.
Organisation: Sefton Council
Guidance: PH30 - Preventing unintentional injuries among under-15s in the home
Category of submission: - Date: 16 Jan 2014
Primary Care Dyspepsia Management Programme
Description: A dyspepsia management programme developed to implement the standards set by NICE clinical guideline 17: Dyspepsia: Managing Dyspepsia in Adults in Primary Care 2004 (updated 2005). A primary care based clinical service, developed with support of local Gastroenterologists to improve the care of patients suffering with dyspepsia and empower patients to improve self-care through enhanced patient knowledge and education. The project has so far reviewed over 15,000 patient records and seen over 3000 patients with a face-to-face review.
Organisation: IntraHealth
Guidance: CG17 - Dyspepsia: Managing dyspepsia in adults in primary care
Category of submission: Clinical Date: 04 Aug 2009
Process for dissemination of NICE guidance (and other national guidance) and assurance mechanism
Description: This submission describes SRFTs process for dissemination of NICE guidance. The process and assurance mechanism ensures that the Trust has comprehensive documentation of the applicability of NICE guidance to the services it delivers. It explains the processes used to ensure clinical audit evidence of compliance is forthcoming.
Organisation: Salford Royal NHS Foundation Trust
Guidance: Generic
Category of submission: General Date: 30 Sep 2009
Prosiect Sir Gar - Workplace cardiovascular (Diabetes and CHD) health assessment and management programme
Description: Prosiect Sir Gâr is one of the first programmes of its kind to engage with occupational health services to use the workplace as the setting for identifying and managing increased cardiovascular risk. Launched in March 2009, Prosiect Sir Gâr is considered a pioneer project with a strong partnership between Hywel Dda Health Board (HDHB), Public Health Wales, Carmarthenshire County Council, Tata Steel Works (Trostre), Swansea University (School of Medicine) and the Pharmaceutical Industry. As government policy focuses increasingly on prevention and management, members from the project board identified the need to develop a co-ordinated approach towards tackling the unacceptable levels of CVD within Carmarthenshire.
Organisation: Hywel Dda Health Board
Guidance: Generic
Category of submission: 2011-12 Shared Learning Awards Date: 26 Jun 2012
Psychotherapy Service Provision for Carers of People with Dementia
Description: Carers of people with dementia often experience their own feelings loss and emotional pain (McCurry, 2008; Meisen 2006, Woods, Wills, Higginson, Hobbins, & Whitby, 2003) while providing full-time care to the person with dementia who has complex and changing needs, which can result in major depression and anxiety, increasing the possibility of referral to mental health services. Treating carers distress is vital not only for their mental health but to enable them to continue in their caring role, without which the current care system would collapse. Our service is meeting this need by providing psychological therapy services to carers of people with dementia of all ages where needed within the Mental Health Care of Older People's service in Newham. We have found that Cognitive Analytic Therapy (CAT) is an effective and flexible therapy for this purpose.
Organisation: East London NHS Foundation Trust
Guidance: CG42 - Dementia
Category of submission: 2010-11 Shared Learning examples Date: 31 Jan 2011
Putting NICE guidelines into practice managing a Pharmacy Needle and Syringe Programme
Description: When taking over the operational management of the Pharmacy Needle and Syringe programme (PNSP) scheme within South Staffordshire, there was a need to address a number of challenges and make the scheme compliant with NICE guidance. The challenges included - Ensuring the membership to the scheme met local needs and was sufficient - Reviewing the costs and efficiency of supply, distribution and waste collection - Introducing an effective support system for the pharmacies on the scheme - Eliminating some of the practices that contradicted NICE guidance such as limiting distribution and insisting on returns - Ensuring pharmacies submitted monthly statistics, recording the equipment given out and returned as required by the NTA.

Please note that this example was originally submitted to demonstrate implementation of PH18 but remains consistent with the updated guidance PH52.
Organisation: Addaction
Guidance: PH52 - Needle and syringe programmes
Category of submission: - Date: 28 Sep 2009
Putting service users at the heart of training and development for enabling practitioners - Self Injury
Description: The Self Injury and Suicide committee at Alpha Hospitals Bury Is a dedicated committee that works on improving and implementing evidence based practice across the hospital. The committee consists of a variety of experienced practitioners who work with individuals who self injure and service users who have personal experience of self injury. The committee meet once a month to plan initiatives that are carried out throughout the month. The committee works to a partnership/collaborative model and the service users are valued members of the committee whose input is greatly valued alongside that of the experienced practitioners.
Organisation: Alpha Hospital
Guidance: Generic
Category of submission: 2011-12 Shared Learning Awards Date: 18 Mar 2011
Quality Standards: How I tackled these 'Sentinel Markers'
Description: The issue I intended to tackle can be defined as:

To develop a process, including the use of clinical audit methodologies and the use of technological innovations, to allow me to understand, implement and measure against the NICE Quality Standards as soon as possible following publication, so that I can provide the Trust Board and Commissioners with assurance that Mersey Care are delivering best practice.
Organisation: Mersey Care NHS Trust
Guidance: Generic
Category of submission: - Date: 24 Dec 2012
Raising the profile of LARC in North Lincolnshire
Organisation: North Lincolnshire PCT
Guidance: Generic
Category of submission: Clinical Date: 20 May 2008
Raising the Standard of Care and Treatment for People who Self Harm
Description: County Durham and Darlington Foundation Trust consists of 3 acute hospitals, it is estimated there are approximately 2,500 attendances at accident and emergency for self harm annually, care treatment and interventions following self harm is important as patients are statistically at higher risk of suicide (Hawton 2003). Service user's describe contact with services as often being difficult characterised by ignorance and negative attitudes and it is no longer acceptable for healthcare professionals to fail to address this experience of care by service users and their carers. With such statistics and issues the Mental Health Liaison Team from Tees, Esk & Wear Valleys NHS Trust in collaboration with the Acute hospital were awarded a place on a national quality improvement program with the aim of optimising and improving services for self harm and increasing compliance with NICE self harm guidelines.
Organisation: Tees Esk and Wear valley NHS Trust
Guidance: CG16 - Self Harm: The Short Term Physical and Psychological Management and Secondary prevention of self harm in primary and secondary care.
Category of submission: Clinical Date: 30 Sep 2009
Re-development of a Community Continence Service
Description: NHS Kensington and Chelsea Practice Based Commissioning Group led the re-development of the Community Continence Service based on the implementation of NICE guidance on conservative therapy. *Please note that this example was previously submitted for CG40 but the practice it details remains current against the updated guidance CG171.
Organisation: NHS Kensington and Chelsea
Guidance: CG171 - Urinary incontinence: The management of urinary incontinence in women
Category of submission: Clinical Date: 07 Aug 2009
Reducing Alcohol Consumption in Young People
Organisation: Staffordshire County Council
Guidance: PH7 - Interventions in schools to prevent and reduce alcohol use among children and young people
Category of submission: Public health Date: 29 Aug 2008
Reducing antibiotic prescribing by 15% using NICE respiratory tract illness prescribing guidelines
Description: We developed and implemented a practice-wide programme based on management of common respiratory tract infections based on the NICE CG69: Antibiotic prescribing for self-limiting respiratory tract infections in adults and children. Consistent messages were prepared for clinicians and patients and implemented via a range of media. We were able to document a 15% reduction in antibiotic prescribing for respiratory tract infections within three months.
Organisation: Churchill Medical Centre
Guidance: CG69 - Antibiotic Prescribing for self-limiting respiratory tract infections in adults and children.
Category of submission: - Date: 16 Nov 2013
Reducing avoidable sight loss from glaucoma through a reduction in delays to glaucoma patient follow-up appointments and patients lost to follow up.
Description: This document covers the learning accrued by RNIB from three eye hospital trusts on their experience of reducing unnecessary sight loss in glaucoma patients through decreasing the number of delayed follow up appointments for glaucoma patients and patients lost to follow up. This work is in relation to the 2009 NICE Guidance: Glaucoma: diagnosis and management of chronic open angle glaucoma and ocular hypertension.

The issue of delayed follow-up appointments is picked out in the 2011 NICE Quality Standard on glaucoma number eight 'People diagnosed with chronic open angle glaucoma (COAG), suspected COAG or with Ocular Hypertension have access to timely follow-up appointments and specialist investigations at intervals in accordance with NICE guidance. Sufficient capacity is put in place to provide this service, and systems are developed to identify people needing clinical priority if appointments are cancelled, delayed or missed'.
Organisation: Royal National Institute of Blind People
Guidance: CG85 - Glaucoma
Category of submission: - Date: 10 Jan 2014
Reducing common barriers in implementing mental health guidelines
Description: A thematic review of the guidelines relevant to mental health services identified some common themes running through each guideline. Organisational barriers were preventing some of these recommendations from being implemented. Targeted work has been undertaken to remove or reduce these barriers, resulting in increased level of implementation across all guidelines.
Organisation: Lancashirecare NHS Trust
Guidance: Generic
Category of submission: 2010 Shared Learning examples Date: 23 Dec 2010
Reducing mortality through improving care for 'acutely ill patients in hospital'
Description: A program, which started in 2007 (launch of NICE CG 50), improved the Trust's mortality, reduced cardiac arrest rates and reduced proportionally level 3 and increased level 2 admission to ITU. This means deteriorating patients are picked up earlier, treated earlier and have better outcomes. Between 2007 and 2012 the Trust's crude mortality for all admissions and for non-elective admission fell by 39% and its cardiac arrest rate fell by 73%.
Organisation: Dartford & Gravesham NHS Trust
Guidance: CG50 - Acutely ill patients in hospital
Category of submission: - Date: 31 Jan 2013
Reducing the variability of management of kidney disease in primary care using a care bundle approach
Description: The aim of the project was to improve quality and reduce the variability in care of people with kidney disease (CKD) in primary care. The approach used a group of simple, well-defined, evidence-based quality improvement interventions (based on NICE guidance CG73), called a care bundle. We have implemented the care bundle for CKD in 26 GP Practices in England and Wales.
Organisation: Kidney Research UK
Guidance: CG73 - Chronic kidney disease
Category of submission: 2011-12 Shared Learning Awards Date: 27 Jan 2012
Refining and standardising head injury care in Salisbury
Organisation: Salisbury NHS Foundation Trust
Guidance: CG56 - Head injury
Category of submission: Clinical Date: 31 Jul 2008
Respiratory Nurse Led Cognitive Behavioural Therapy Service for patients with Respiratory Disease
Description: A Respiratory Nurse led CBT service for patients with long term respiratory conditions. The service is provided within the hospital or community setting.
Organisation: Newcastle upon Tyne Hospitals NHS Foundation Trust
Guidance: CG113 - Anxiety
Category of submission: 2011-12 Shared Learning Awards Date: 26 Oct 2011
Review and redesign of adult weight management services in Kirklees
Description: NHS Kirklees initiated a review and redesign of weight management provision aiming to implement a person centred, evidence based, tailored service for obese people living within Kirklees. The review and redesign process involved a wide range of stakeholders including health practitioners, service users (attending weight management activity) and target groups (not attending weight management support). The outcome was the implementation of a single point access service, based on a tiered approach, for people aged 16 years or over, with a body mass index (BMI) of 30kg/m2 or above.
Organisation: NHS Kirklees
Guidance: CG43 - Obesity
Category of submission: 2010-11 Shared Learning examples Date: 11 Feb 2011
Risk Assessment Tool for Venous Thromboembolism in Pregnancy & the Puerperium
Description: Venous thromboembolism is the most frequent direct cause of maternal death. We have created two multi-professional guidance and documentation tools for the implementation of thromboprophylaxis in pregnancy and the puerperium. These cover NICE & RCOG guidance jointly.
Organisation: TAUNTON & SOMERSET NHS TRUST
Guidance: CG092 - Reducing the risk of venous thromboembolism in patients admitted to hospital
Category of submission: 2010-11 Shared Learning examples Date: 02 Feb 2011
Royal Free Hospital FH service and family support centre
Description: The Royal Free London NHS Foundation Trust is a secondary and tertiary centre for the treatment of lipoprotein abnormalities. Within this lipid service the Royal Free Hospital provides cascade screening, including genetic testing for FH, through the FH service and associated family support centre.
Organisation: Royal Free London NHS Foundation Trust
Guidance: CG71 - Familial hypercholesterolaemia
Category of submission: 2011-12 Shared Learning Awards Date: 27 Apr 2012
SADIE - a local education programme for people with Type 1 diabetes
Description: Over recent years, a number of diabetes centres across theUK have developed their own local structured education programmes. In 2004, the Eastbourne District Diabetes Centre developed SADIE (Skill for Adjusting Diet and Insulin in East Sussex). Five years later an audit was undertaken, examining glycaemic control, quality of life and body weight changes.
Organisation: Eastbourne District General Hospital
Guidance: TA60 - Diabetes (types 1 and 2) - patient education models
Category of submission: 2011-12 Shared Learning Awards Date: 28 Dec 2011
SAINT - Specific Approaches and INTerventions in day and community services for older people with mental health needs
Description: An education and practice development program for staff in secondary mental health care to develop and help staff implement best practice in day services
Organisation: Sussex Partnership NHS Foundation Trust
Guidance: - Mental Health
Category of submission: Clinical Date: 30 Sep 2008
Saving sight the N.I.C.E way
Description: The UHBFT Ophthalmology Team in collaboration with the divisional management and with support from the Trust Board, developed a robust service plan in anticipation of the NICE guidance and the first Lucentis® treatments commenced in April 2008 (subject to case by case funding approval from the relevant PCT) well in advance of the actual publication of the NICE guidance. Systemic, structured and responsive approach to the service development has enabled UHBFT to expand the service from one to four clinics a week and to accommodate the rapidly growing demand. During 2008/09 the UHBFT Ophthalmology team performed 439 Lucentis® treatments, over 3.5 times more than the originally anticipated 120 cases.
Organisation: University Hospitals Birmingham NHS Foundation Trust
Guidance: TA155 - Macular degeneration (age-related) - ranibizumab and pegaptanib
Category of submission: Clinical Date: 30 Sep 2009
Screening for Depression in Older Adults with Chronic Physical Health Problems
Description: This submission relates to the implementation of depression screening for adults with Chronic Health Problems through the application of rapid cycle audit, supported by the local development of a depression pathway within a Community Rehabilitation Team.
Organisation: central North West London NHS Foundation Trust- Camden Provider Services
Guidance: CG91 - Depression with a chronic physical health problem
Category of submission: 2011-12 Shared Learning Awards Date: 31 Jan 2012
Secondary prevention of osteoporosis in fracture clinic
Description: Auditing Referral rates for treatment and investigation of osteoporosis in fracture clinic following introduction of new proforma
Organisation: Department of trauma and orthopaedics
Guidance: TA161 - Osteoporosis - secondary prevention including strontium ranelate
Category of submission: Clinical Date: 28 Sep 2009
Sefton maternal mental health
Description: From undertaking a Health Equity Audit of the HV service, maternal mental health was identified by HV's across Sefton as being a key concern both in terms of the frequency of occurrence and their perceived lack of skills in prediction, detection, assessment and management of mental health difficulties. Furthermore, an audit was undertaken using the NICE Audit criteria to monitor local practice in respect of antenatal and postnatal mental health. This audit revealed a real disparity in terms of assessment across the PCT and an action plan was put in place to address this. Alongside this was the introduction of the Healthy Child Programme and it was decided to use this as a vehicle for implementation of the guidance in relation to antenatal and postnatal mental health. This piece of work only looked at the guidance in relation to prevention, prediction, detection and initial management as HV's are part of the public health workforce and focused on primary and secondary prevention.
Organisation: Sefton NHS
Guidance: CG45 - Antenatal and postnatal mental health
Category of submission: 2010-11 Shared Learning examples Date: 14 Feb 2011
Service User & Carer involvement in the delivery of Collaborative Learning Imitative (CLI) at the University of Birmingham
Description: The CLI is a joint learning program involving students from different professional backgrounds, specialising in mental health. The focus of the CLI is on interdisciplinary working and applying different theoretical perspectives, including service user and carer perspectives. Service users and carers work as integral members of the teaching team meaning they were involved in the design, delivery, evaluation and dissemination of the fully interdisciplinary teaching.
Organisation: University of Birmingham
Guidance: CG136 - Service user experience in adult mental health
Category of submission: 2011-12 Shared Learning Awards Date: 30 Apr 2012
Service user-led training in self-injury
Description: No Secrets, a voluntary organisation, provides self-injury specific training sessions around self-injury to local professionals who may come into contact with people who self-injure.
Organisation: No Secrets
Guidance: CG16 - Self-harm
Category of submission: 2011-12 Shared Learning Awards Date: 04 Jul 2011
Setting up a home dialysis programme for patients with stage 5 chronic kidney disease (CKD).
Description: This shared learning example can be used by organisations caring for patients with stage 5 CKD, to help them to develop a home dialysis programme. It demonstrates the pathway followed and the multi-disciplinary team approach (MDT) required enabling patients to make an informed decision about their choice of dialysis, in line with the current peritoneal dialysis NICE guideline.

The renal unit at (Central Manchester Foundation Trust CMFT) Manchester Royal Infirmary (MRI) has a strong tradition of enabling home dialysis, and currently places 30% of incident patients on a home dialysis therapy (which is above the current UK average). The unit offers home haemodialysis (HHD), continuous ambulatory peritoneal dialysis (CAPD), automated peritoneal dialysis (APD) and assisted automated peritoneal dialysis (APD) as home therapy options. By using an expert-led, team approach the service is maintaining and growing a home dialysis programme.
Organisation: Central Manchester Foundation Trust CMFT
Guidance: CG125 - Peritoneal dialysis
Category of submission: 2011-12 Shared Learning Awards Date: 03 Feb 2012
Setting up Nottingham city's Asperger's syndrome service
Description: Nottingham City Asperger Service is a multidisciplinary diagnostic assessment and support service for adults with Asperger syndrome living in Nottingham city.
Organisation: Nottinghamshire Healthcare NHS Trust
Guidance: CG142 - Autism: recognition, referral, diagnosis and management of adults on the autism spectrum
Category of submission: 2011-12 Shared Learning Awards Date: 07 Jun 2012
Sheffield Community Health Champions programme; addressing obesity through community engagement
Description: Health Champions are volunteers based in trusted local community organisations and trained to support healthy eating, physical activity and mental wellbeing in communities with worse than average health outcomes. Champions provide appropriate peer support, helping build confidence and self-esteem and offering free activities people can join in their community. Without this support, many disadvantaged clients are unlikely to act on their own to make sustainable changes based solely on health information.

This submission reflects recommendation 3 of PH42 in that Community Health Champions should be identified and contribute to preventing obesity. It also supports recommendation 6 which is about involving the community.
Organisation: Sheffield Cubed
Guidance: PH42 - Obesity - working with local communities
Category of submission: - Date: 17 Jul 2013
Singing as a form of voice therapy for people with Parkinson's (update 2008)
Organisation: Hereford PCT
Guidance: CG35 - Parkinson's Disease:Diagnosis and Management in Primary and Secondary Care
Category of submission: Clinical Date: 08 Sep 2008
Smoking cessation in routine antenatal care
Description: Smoking in pregnancy is a particular problem in Rotherham. This example outlines how we reshaped the existing service to bring the smoking cessation advice into routine antenatal care and improve outcomes without additional investment.
Organisation: NHS Rotherham
Guidance: PH26 - Quitting smoking in pregnancy and following childbirth
Category of submission: 2010-11 Shared Learning examples Date: 10 Feb 2011
Solihull Approach Parenting Group
Description: Solihull Approach is a 10 week parenting group for parents with children from universal to complex needs and aged 0-18 years. It is based on the Solihull Approach model of containment, reciprocity and behaviour management and uses social learning theory in the design of the parenting programme. It is delivered by two trained professionals from a wide range of professions and agencies through joint working and following a resource manual for parents with children.

Please note that this example was originally submitted to demonstrate implementation of recommendations in NICE TA102 'Parent-Training/ Education programme in the management of children with conduct disorders'. TA102 has now been replaced by CG158. The example continues to align with guidance, particularly recommendation 1.5.1 in CG158 on Parent training programmes.
Organisation: Solihull Approach
Guidance: CG158 - Conduct disorders in children and young people
Category of submission: - Date: 28 Sep 2009
Specialist Reporting of Paediatric Neuroimaging.
Description: Alder Hey Children's NHS Foundation Trust has developed a service level agreement (SLA) to ensure the effective reporting of neuroimaging as part of the investigation for epilepsy. This agreement has established a network between Alder Hey Children's NHS FT and the Blackpool Victoria Hospital, the Shrewsbury and Telford Hospitals Trust, and other hospitals in the North West of England and North Wales to provide second opinions on paediatric neuroimaging.
Organisation: Alderhey Children's Hospital
Guidance: QS27 - Epilepsy
Category of submission: - Date: 25 Feb 2013
Statins for ischaemic heart disease: Excellence and equity
Description: Three east London PCTs Hackney, Newham and Tower Hamlets, have 15,000 people on GP Ischaemic Heart Disease Registers. In 2004 65% were on statins and in 2010 93% were on statins. Serum cholesterol less than 5mmol/l increased from 67% to 83%. The Clinical Effectiveness Group used local summaries of NICE guidance, in-practice facilitation and practice audit reports to support improvement, contributing to some of the best levels of statin prescription in E&W at low cost. Identifying equity of provision by age, sex and ethnic group, has also been an important feature in an ethnically diverse area with some of the highest deprivation and CVD mortality. We estimate we prevent 37 people a year from recurrent CVD through this low cost improvement.
Organisation: East London Clinical Effectiveness Group
Guidance: CG67 - Lipid modification
Category of submission: 2010-11 Shared Learning examples Date: 06 Feb 2011
Stay on your feet! Implementing the Falls clinical guideline
Description: This example was originally submitted to demonstrate implementation of CG21. This guideline has now been replaced by CG161. The practice within this example remains consistent with the updated guidance.
Organisation: Kingston Hospital NHS Trust
Guidance: CG161 - Falls: the assessment and prevention of falls in older people
Category of submission: - Date: 26 Sep 2008
Stop the Clot: Implementation of extended thromboprophylaxis in patients undergoing major abdominal and pelvic cancer surgery
Description: Development, implementation and audit of a prompt and safe response to NICE guidance Venous Thromboembolism- Reducing the Risk (January 2010), recommending 28 days extended pharmacological prophylaxis for all patients undergoing major cancer surgery in the abdomen and pelvis. Despite no changes to existing infrastructure or additional funding, a multi-departmental team coordinated provision, monitoring and audit of extended thromboprophylaxis in both inpatient and outpatient settings within 9 months of publication. Dr N Quaife, FY1; Dr H Hardisty, FY1; Dr R Maclean, Consultant Haematologist; Dr R Oliver, General Practitioner; Miss L Hunt, Consultant Colorectal Surgeon at Sheffield Teaching Hospitals (STH).
Organisation: Sheffield Teaching Hospitals NHS Trust
Guidance: CG92 - Venous thromboembolism - reducing the risk
Category of submission: 2010-11 Shared Learning examples Date: 11 Feb 2011
Stop the clots: Patient information on prevention of hospital acquired VTE using electronic and media tools
Description: We have used a variety of electronic and media tools to promote patient awareness of hospital acquired VTE. This includes designing a patient video (available on youtube) electronic patient information on hospital bedside TV's, information on TV's in patient waiting areas and by publishing articles in trust magazines which are circulated to local patients. Traditional paper based information leaflets are also used and given to patients as part of the nursing discharge process and in pre-admission clinics.
Organisation: University Hospital Birmingham Queen Elizabeth
Guidance: CG92 - Venous thromboembolism - reducing the risk
Category of submission: 2010 Shared Learning examples Date: 09 Jan 2011
Sublingual Glyceryl Trinitrate (GTN) Advice Card Project
Description: The 2011 NICE guidance emphasises the importance of providing CHD patients with advice about how to use sublingual GTN (Recommendation 1.3.3). Our 5 phases project ran over 18 months. We assessed patients' knowledge of GTN use & their opinion of current advice & written info provided. Based on the feedback, we worked with patients to develop a suitable credit card sized GTN card containing readily accessible & practical instruction on how & when to use GTN during a chest pain episode. We piloted & user tested the card. 230+ patients found it very useful for managing their angina and knowing when to call 999. Our national survey of 135 Trusts across the country revealed that advice about GTN wasn't consistent, GTN use was not routinely assessed by healthcare professionals, and all participants wanted a national GTN advice card. We have now developed a national GTN card (version 2) that will be made available to all healthcare professionals who have patients with stable angina.
Organisation: Leeds Teaching Hospitals NHS Trust
Guidance: CG126 - Stable angina
Category of submission: - Date: 28 Nov 2013
Successful Implementation & evaluation & development of Adult Obesity care Pathway
Description: To develop an evidence-based adult obesity care pathway collaboratively across NHS Bassetlaw Primary Care General Practices and to ensure successful implementation and evaluation of the pathway within primary care. The evaluation of the effectiveness of implementing the care pathway using qualitative and quantitative methods should lead to identifying ways to improve & implement improved care pathways further.
Organisation: Retford Health
Guidance: CG43 - Obesity
Category of submission: - Date: 31 Jan 2013
Successful Implementation & evaluation of Adult Obesity care Pathway
Description: To develop an evidence-based adult obesity care pathway collaboratively across NHS Bassetlaw Primary Care General Practices and to ensure successful implementation and evaluation of the pathway within primary care. The evaluation of the effectiveness of implementing the care pathway using qualitative and quantitative methods should lead to identifying ways to improve the care pathway further.
Organisation: Retford Health
Guidance: CG43 - Obesity
Category of submission: 2011-12 Shared Learning Awards Date: 31 Jan 2012
Successful Implementation of Adult Obesity Care Pathway
Description: To develop an evidence-based adult obesity care pathway collaboratively across Bassetlaw Primary Care General Practices and to ensure successful implementation of the pathway within primary care. Consequently, to evaluate the effectiveness of implementing an adult obesity care pathway in primary care, using qualitative and quantitative methods.
Organisation: Retford Health
Guidance: CG43 - Obesity
Category of submission: 2010-11 Shared Learning examples Date: 11 Feb 2011
Summarising and updating NICE costing templates at a regional level
Description: NICE costing templates estimate the financial cost and the health benefits of implementing guidance. This work investigated the possibility of producing a summary of the findings generated by public health NICE costing templates at a regional level and whether it is possible to update templates which use old population data and costs. Region wide summaries were produced for 5 NICE public health guidelines and a guide to updating the costing templates was produced.
Organisation: East Midlands Public Health Observatory
Guidance: Generic
Category of submission: 2010 Shared Learning examples Date: 16 Nov 2010
Summary of NICE guideline on social anxiety disorder for use by healthcare professionals
Description: This submission describes the development of a summary of the NICE guideline on social anxiety disorder. When reading a newly published NICE guideline, Paul Blenkiron goes through the key recommendations and summarises them as a one page table so the relevant parts can easily be accessed and implemented by his clinical service and those he teaches.
Organisation: Leeds and York Partnership NHS Foundation Trust
Guidance: CG159 - Social anxiety disorder
Category of submission: - Date: 11 Sep 2013
Supporting a 36 hour Neonatal Blood Culture status check by developing the availability of blood culture status in real time.
Description: This example describes how Liverpool Women's Hospital in collaboration with Royal Liverpool University Hospital have:
- Developed real time availability of blood culture status for clinicians on the neonatal unit.
- Introduced a policy of discontinuing antibiotics in babies with negative blood cultures and no lab evidence of infection at 36 hours.
- Introduced measures to embed these into clinical practice.
Organisation: Liverpool Womens NHS Foundation Trust/ Royal Liverpool and Broadgreen University Hospitals NHS Trust
Guidance: CG149 - Antibiotics for early onset neonatal infection
Category of submission: 2011-12 Shared Learning Awards Date: 16 Jul 2012
Supporting local healthcare providers to embed quality, clinically effective and cost effective structured education in the care pathway for people with Type 2 diabetes
Description: The DESMOND Central Team identified a gap in the knowledge of local healthcare providers commissioning DESMOND structured education for people with Type 2 diabetes, preventing them from successfully embedding group education into the local care pathway for diabetes. The team developed a process for supporting local healthcare providers to identify gaps in their systems, develop flexible and sustainable infrastructures for integrating structured education in the care pathway, and explore meaningful local evaluation of performance. In organisations where this process has been adopted, structured education operates to a greater level of clinical and cost effectiveness, reaches greater numbers of people with diabetes, and provides an exemplar for the future adoption of group education in other long term conditions.
Organisation: University Hospitals of Leicester NHS Trust
Guidance: CG66 - Type 2 diabetes (partially updated by CG87)
Category of submission: 2010-11 Shared Learning examples Date: 11 Feb 2011
Supporting NICE hypertension guidance
Description: Development of a blood pressure education programme with supporting assessment and clinical guidance.
Organisation: Pennine Care NHS Foundation trust
Guidance: CG127 - Hypertension
Category of submission: 2011-12 Shared Learning Awards Date: 16 Jan 2012
Supporting nurses and allied health care professionals' involvement in NICE guideline development
Description: A learning resource developed to support nurses and allied health professionals involved in NICE guideline development.
Organisation: Royal College of Nursing
Guidance: Generic
Category of submission: 2010-11 Shared Learning examples Date: 15 Feb 2011
Surgical Site Infection in Orthopaedic Services
Description: This is a quality improvement program performed across two hospitals in the same trust, one elective and one acute hospital. The program uses Surgical Site Infection guidelines set out in the recent NICE literature (2008). This work describes the process and results of our improvement program for surgical site infection in Trauma and Orthopaedic Surgery.
Organisation: Royal Liverpool and Broadgreen University Hospital
Guidance: CG74 - Surgical site infection
Category of submission: - Date: 16 Jan 2014
Systematic and integrated peer support service for breastfeeding mothers in Blackpool
Description: The Breastfeeding Network is commissioned to deliver a systematic and integrated peer support service for breastfeeding mothers in Blackpool to tackle low breastfeeding rates. This service demonstrates how parts of statement 5 (of QS37 Postnatal Care) could be implemented. It is a locally developed service that has contributed to the gaining of Community Baby Friendly accreditation across primary, community and children centre settings in 2011. Peer supporter's (PS) skills and knowledge, as well as those of the health visiting team, are assessed by external Baby Friendly assessors as part of the accreditation process as is the care that women receive. It has also been evaluated by researchers at the University of Central Lancashire. Outcomes are monitored by breastfeeding rates at 6-8 weeks for women who engage with the service, and for Blackpool as a whole, as well as women's experiences of the service.
Organisation: Breastfeeding Network, commissioned by Public Health in Blackpool and Lancashire
Guidance: QS37 - Postnatal care
Category of submission: - Date: 06 Aug 2013
Systematically identifying and managing Familial Hypercholesterolaemia in Primary Care across a PCT/CCG
Description: Deploying audits centrally across all GP practices across a PCT/CCG to identify patients with Familial Hyperchelesterolaemia and add clinical prompts to support better management and contact tracing.
Organisation: NHS Kent and Medway
Guidance: CG71 - Familial Hypercholesterolaemia
Category of submission: 2011-12 Shared Learning Awards Date: 15 Jan 2012
Systematically implementing CG36 Atrial Fibrillation across a PCT/CCG
Description: Using automated prompts in GPs clinical systems to prompt clinicians to screen for AF annually in patients 65 and over, across a PCT/CCG. Using a CHADS2 algorithm to automatically calculate the CHADS2 score for all patients in AF not on warfarin and to prompt clinicians to consider starting those patients with a CHADS2 score of 2 or above on warfarin.
Organisation: NHS Kent and Medway
Guidance: CG36 - Atrial Fibrillation
Category of submission: 2011-12 Shared Learning Awards Date: 14 Jan 2012
Taking Health Care to the Young People - HPV vaccination clinic
Description: TAKING THE SERVICE TO THE YOUNG PEOPLE. A Study and Analysis of a Clinic specifically set up for the provision of HPV vaccination in Darlington College. IDENTIFYING THE NEED. A weekly Sexual Health Clinic was set up within Darlington College of technology in September 2007. A need for the provision of a Cervical Cancer Vaccination was observed there from January 2009. (The whole article of the success of the HPV vaccine 8 week programme is being published in the International Journal of Family Planning and Reproductive Health Care in October 2009, promoting the possibility of increasing the uptake of Immunisations as per recent NICE guidelines, especially in Young People).
Organisation: Denmark Street Surgery
Guidance: Generic
Category of submission: Health and wellbeing Date: 12 Oct 2009
Targeted Paid Breastfeeding Peer Support Service, Bristol
Description: Implementation of a Breastfeeding Peer Support service as part of the work supporting and enhancing breastfeeding in Bristol which became the first 'Baby Friendly City' in England and Wales.

Information about practical implementation of the peer support service from Nicki Symes, breastfeeding co-ordinator at Bristol City Council: nicki.symes@bristol.gov.uk
Organisation: University of Bristol
Guidance: CG37 - Postnatal care
Category of submission: - Date: 04 Sep 2013
Targeting Heart Health Inequality through a Collaborative Community Assets Approach to Promoting Behaviour Change in West Belfast
Description: We developed the Healthy Hearts in the West Initiative in response to heart health inequality in West Belfast - where life expectancy for men and women is significantly lower than the regional average - using a community assets approach, building on existing infrastructure, and developing and sustaining cross-sectoral partnerships to address the social determinants of heart health inequality.

Evaluation was built in from the outset, with reference to NICE guidance on interventions to support attitude and behaviour changes at population and community levels.

The Initiative has led to increased cross-sectoral collaboration, better use of resources, and interventions initiated by Healthy hearts being sustained by other agencies.
Organisation: West Belfast Partnership Board
Guidance: PH6 - Behaviour change: the principles for effective interventions
Category of submission: - Date: 20 Jan 2014
The Acute Medical Challenge Facing Mental Health Care: an audit of resuscitation training in a psychiatric setting
Description: Traditionally mental health units have relied on the acute medical team to provide resuscitation but increasingly psychiatric wards are geographically separated from general hospitals. Cardiac arrests remain comparatively rare on mental health wards and attrition of resuscitation skills through disuse seems to have led to a low sense of urgency amongst some psychiatrists to address the issue. We have conducted a repeat audit highlighting these issues that has led to a re-invigoration with regard to resuscitation training in mental health service provision in relation to CG25.
Organisation: Sheffield Health and Social Care NHS Foundation Trust
Guidance: CG25 - Violence: the short term management of disturbed/violent behaviour in psychiatric in-patient settings and emergency departments
Category of submission: 2010 Shared Learning examples Date: 07 Jan 2011
The Acutely Ill Competency Study Day
Description: The aim of this educational project is to effectively implement the NICE acutely ill Guidelines (2007) into our Emergency Department, providing staff with a standardised learning "in practice" document that will allow us to assess skills in clinical scenarios. The document also aims to improve patient care by equipping our emergency nurses with effective assessment and monitoring skills that are knowledge based. The course consists of a training manual that all staff are expected to read prior to commencement of the course, the day itself consists of two initial lectures followed by scenario based teaching. The day ends with an MCQ paper and course evaluation. See attached lesson plans. The training package ideology is based around an Andragogical model of learning, it hopes to assist learner's to enhance their capability to function as self directed learner's.
Organisation: Bradford Teaching Hospitals
Guidance: CG50 - Acutely Ill Patients in hospital
Category of submission: Clinical Date: 03 Jun 2009
The Aintree Medical Emergency Team
Description: If a deteriorating patient has a cardiac arrest then survival to discharge from hospital is less than 5%. The Medical Emergency Team (MET) was created following several clinical incidents to improve safety and quality of care for acutely ill/deteriorating patients and has resulted in a sharp and sustained reduction in cardiac arrests within the Trust.
Organisation: Aintree University Hospitals NHS Foundation Trust
Guidance: CG50 - Acutely ill patients in hospital
Category of submission: - Date: 25 Jan 2011
The Alphabet Strategy for Diabetes Care: Delivering NICE Guidance and the POETIC Vision
Description: There have been several NICE Clinical Guidelines in relation to managing the patients with diabetes mellitus. We have created a healthcare professional and patient strategy for diabetes care and education which delivers high standards of care with a focus on reducing complications of diabetes and prevention of diabetes in those at high risk. This is based around the mnemonic: Advice, Blood Pressure, Cholesterol, Diabetes Control, Eye-care, Foot-care and Guardian drugs.
Organisation: Diabetes and Endocrinology Centre
Guidance: CG15 - Type 1 Diabetes
Category of submission: - Date: 10 Feb 2011
The Behaviour and Family Support Team - A specialist Child and Adolescent Mental Health Service for children with disabilities and their families
Description: The BFST is a specialist CAMHS service that focuses on the emotional, behavioural and mental health needs of children with moderate to severe learning disabilities and/or autistic spectrum disorders and Aspergers Syndrome. The BFST is a multidisciplinary service consisting of a full time Consultant Clinical Psychologist/Manager, two full time Clinical Psychologists, an Assistant Clinical Psychologist, a part time Speech and Language Therapist, Occupational Therapist, Psychiatrist and office administrator. We see children aged 5- 18 years who live in Kensington and Chelsea. The BFST has an intervention focus, as opposed to a focus on diagnostic assessment. The team provides intervention work across different settings, consultation, family support and counselling, practical advice strategies, direct CBT/emotional literacy work, social skills training and joint work with/referral to other services where appropriate.
Organisation: Behaviour and Family Support Team
Guidance: CG170 - Autism - management of autism in children and young people
Category of submission: - Date: 16 Sep 2013
The Changing Minds Training as Trainers Programme
Description: Changing Minds is a therapeutic intervention that involves social learning and building leadership skills of long term mental health service users in order to challenge the status quo about mental ill health. People undertake a nine-month part time training course (consisting of 14-19 sessions) that equips them with the skills to co-design and co-deliver training from their own mental health perspective and to be paid for this.

All participants had been secondary mental health patients on the ward or been in contact with secondary mental health services at some point.
Organisation: Created at South London and Maudsley NHS Foundation Trust (SLaM). Current contact details below
Guidance: CG136 - Service user experience in adult mental health
Category of submission: - Date: 22 Aug 2012
The development of a NICE Guidance Policy & Procedure for Commissioners and establishment of a NICE Commissioning Assurance Group
Description: Wolverhampton Clinical Commissioning Group (WCCG) is committed to ensuring that there is a systematic process in place for planning, implementing, auditing and evaluating NICE guidance in the services it commissions. It accepts that NICE guidance is evidence based and represents good practice and effective use of resources, hence the requirement of a WCCG Policy. WCCG will ensure through the contracts and service level agreements with providers that, where relevant, providers will demonstrate compliance with current NICE recommendations, as outlined in our policy and monitored via our assurance group.
Organisation: Wolverhampton Clinical Commissioning Group
Guidance: Generic
Category of submission: - Date: 03 Mar 2014
The development of an integrated, coordinated and family centred Neonatal Neuroprotection Service across the East of England.
Description: The East of England Neonatal Neuroprotection Project, funded by a grant from the Health Foundation, was launched to improve the quality of care for infants born with hypoxic-ischaemic encephalopathy (HIE) and their families by developing a coordinated, integrated and family centred pathway of care throughout the region. HIE, resulting from a lack of oxygen around birth, is a devastating condition for which until recently there was no specific treatment. Several large randomised controlled trials demonstrated that therapeutic hypothermia significantly improved neurodevelopmental outcome in these infants and in line with the NICE recommendation the East of England Neuroprotection Team strove to translate this research into standard clinical practice.
Organisation: Cambridge University Hospitals NHS Foundation Trust
Guidance: IPG347 - Therapeutic hypothermia with intracorporeal temperature monitoring for hypoxic perinatal brain injury
Category of submission: 2011-12 Shared Learning Awards Date: 24 Jan 2012
The HEALTH Passport: Helping Everyone Achieve Long Term Health
Description: There are currently 32 Public Health Guidance Guidelines which include most of the main risks to future health such as smoking, sub-optimal physical activity, mental wellbeing, prevention of cardiovascular disease, immunisations and weight management. The HEALTH Passport offers a cost-effective handheld record on individualised risk assessment for future health according to identification of the 10 most important factors for maintaining health or preventing ill heath. A personal responsibility for one's own health is fostered with a drive towards improving the health of the whole family and community.
Organisation: George Eliot Hospital NHS Trust
Guidance: Most PH 1-32 - Most PH Guidance is included: most of the 32 Published
Category of submission: 2010-11 Shared Learning examples Date: 09 Feb 2011
The Imperial cardiovascular prevention and rehabilitation programme
Description: Imperial College Healthcare's cardiovascular prevention and rehabilitation programme (CPRP) comprises a hospital-based programme at Charing Cross Hospital and a community-based programme (MyAction) in Westminster.

The dedicated full-time multidisciplinary team offers a comprehensive menu-based rehabilitation programme that meets the needs of its local community as well as that of a leading tertiary referral centre for coronary revascularisation, heart failure and implantable devices.

It serves 400,000 people living in Hammersmith, Fulham and Westminster, where over a quarter of people are from black and minority ethnic groups and receives referrals for over 1,300 people annually.
Organisation: Imperial College Healthcare NHS Trust
Guidance: Generic
Category of submission: - Date: 08 Nov 2013
The Implementation of NICE Guidelines Relating to Psychological Interventions for People with Schizophrenia
Description: As part of the development of a comprehensive Early Intervention Service, to increase access to evidence-based psychological therapy for people with psychosis and thereby improve outcomes.

Please note that this example was originally submitted to demonstrate implementation of CG82 Schizophrenia (update). CG82 has now been replaced by CG178. The example has been reviewed and continues to align with the new guidance.
Organisation: Greater Manchester West Mental Health NHS Foundation Trust
Guidance: CG178 - Psychosis and Schizophrenia in adults
Category of submission: Clinical Date: 27 Mar 2009
The insertion of temporary sacral nerve stimulator can be carried out under local anaesthetic without compromising outcome and with positive effect on cost
Description: In order to allow greater access to trial of sacral nerve stimulation, we now routinely insert all temporary SNS electrodes under local anaesthetic and have found that this has no effect on results of the trial of SNS, nor on the long term outcome from permanent implantation. We therefore conclude that temporary SNS electrodes can be inserted under local anaesthetic without adversely affecting patient outcomes and with the advantage of minimising anaesthetic risks and costs.
Organisation: University Hospital of South Manchester
Guidance: IPG 99, CG 49 - Sacral nerve stimulation for faecal incontinence, Faecal incontinence
Category of submission: Clinical Date: 24 Aug 2009
The integration of a Trauma and Self Injury (TASI) systemic Programme for Women who use forensic services: developed, delivered and evaluated in collaboration with those who use it
Description: The Trauma and Self Injury (TASI) programme is systemic and multi modal in its delivery. It has been co-developed with the women who use forensic services. This population has experienced trauma, has complex post traumatic stress disorder (PTSD) related symptoms, uses self injury as a way of coping and is at risk of hurting others. Whilst it was developed within the National High Secure Service for Women (NHSHSW) it has been integrated across a pathway of women's medium and low secure forensic services. The programme is delivered at 3 levels; Level 1 includes proactive health and wellbeing initiatives along with co developed and delivered education; Level 2 focuses on the enhancement of a trauma informed therapeutic milieu, which promotes a safe collaborative environment enhancing the women's capacity to deal differently with their distress; Level 3 provides NICE recommended individual and group therapies. Evaluation is integral to the programme.
Organisation: Nottinghamshire Healthcare NHS Trust
Guidance: CG16, CG26, CG133 - Self Harm and PTSD
Category of submission: - Date: 31 Jan 2013
The Newcastle upon Tyne Hospitals NHS Foundation Trust Multiple Pregnancy Service
Description: The Multiple Pregnancy Service at Newcastle upon Tyne Hospitals Foundation Trust provides the additional care that women with multiple pregnancies should receive. This care is based on best practice and best available evidence in keeping with the National Institute for Health and Care Excellence (NICE) Multiple Pregnancy Clinical Guideline and Quality Standard and the Northern Survey of Twins and Multiple Pregnancy (NorSTAMP) Standards of Care (Public Health England).
Organisation: The Newcastle upon Tyne Hospitals NHS Foundation Trust
Guidance: Generic
Category of submission: - Date: 03 Sep 2013
The NICE Way (update 2008)
Description: To standardise the implementation and audit of NICE guidance. To give assurance to the Trust on the implementation and audit of NICE guidance. To manage NICE guidance in a robust and centralised way
Organisation: Cambridge University Hospitals (Addenbrooke's)
Guidance: Generic
Category of submission: General Date: 26 Sep 2008
The Positive Impact of a Pregnancy and Childbirth Implementation Group
Description: Through the development of a joint working group across all the acute specialties concerned with pregnancy, childbirth and newborn care, we have maximized the effectiveness of the resources used in implementing maternity related NICE guidance. This has ensured that patients experience the benefits of the implemented guidance throughout their entire journey, from antenatal care through delivery to neonatal services (where necessary) and minimized the chance of service disconnect both in relation to NICE guidance initiatives and other aspects of the services. It has also enabled the staff of these services to identify problems with NICE implementation earlier than would otherwise have been the case and pool resources to address these issues.
Organisation: Brighton and Sussex University Hospitals NHS Trust
Guidance: CG55 - Intrapartum Care
Category of submission: Clinical Date: 30 Sep 2008
The provision of safety net advice to parents of feverish children: Interventions at Induction can improve adherence
Description: This initiative improved the documentation of safety net advice given by junior doctors in an Emergency Department via a very simple presentation given at their induction. Although a busy period for staff; orientation programmes provide a valuable opportunity to promote awareness of clinical guidelines.

Please note that this example was submitted to demonstrate implementation of CG47. This guideline was updated and replaced in May 2013 by CG160. The practice in this example remains consistent with the updated guidance.
Organisation: Leicester Royal Infirmary
Guidance: CG160 - Feverish Illness in Children
Category of submission: - Date: 04 Feb 2011
The Review, Implementation and Monitoring Arrangements of the Implementation of NICE Guidelines in a High Secure Setting
Organisation: Nottinghamshire Healthcare NHS Trust
Guidance: Generic
Category of submission: General Date: 03 Jul 2008
The role of Private domiciliary care for dementia care
Description: Private domiciliary care provides a wide range of non medical support to people with dementia and their carers. Such companies are often the first point of contact with social support for the public. This projects goal is to promote better integration of private companies with the public and statutory services.

Please see the attached document entitled 'How Home Instead meets NICE Quality Standard 30'.
Organisation: Home Instead Senior Care
Guidance: QS30 - Supporting people to live well with dementia
Category of submission: - Date: 19 Jan 2014
The satisfaction of service users about the work and services provided by South Cherwell CMHT (Julier Centre, 2012
Description: The aim of this re-audit was to identify the performance of the Bicester component of the North Oxfordshire Community Mental health team across a selected number of patient satisfaction questions that are related to patient awareness of CPA. The initial audit was performed in February 2011.
Organisation: Oxford Health NHS Foundation Trust
Guidance: Generic
Category of submission: - Date: 28 Apr 2013
The Sheffield Network for NICE
Organisation: Sheffield Teaching Hospitals NHS Foundation Trust
Guidance: Generic
Category of submission: - Date: 17 Oct 2006
The Sheffield Ten Stage Implementation Model
Organisation: Sheffield Teaching Hospitals NHS Foundation Trust
Guidance: Generic
Category of submission: - Date: 17 Oct 2006
The Spectrum hepatitis C support service.
Description: This service development is aligned to the NICE Public Health Guidance Hepatitis B and C: ways to promote and offer testing to people at increased risk of infection and more specifically Recommendation 2 in the document 'Awareness-raising for people at increased risk of hepatitis B or C infection'.

Following an analysis of testing and treatment uptake for hepatitis C by Spectrum Community Healthcare, it was found that the proportion of drug users in Wakefield accessing this provision was low. Patients cannot access treatment for hepatitis C locally; they are required to travel from Wakefield to Leeds. Whilst the distance between Wakefield and Leeds is only round 12 miles it was still viewed by drug users as a barrier to accessing hospital treatment. In order to address this and improve testing rates the wellbeing nursing team at Spectrum Community Health developed a hepatitis support service.
Organisation: Spectrum Community Health CIC
Guidance: Generic
Category of submission: - Date: 08 Apr 2013
The use of a liaison psychiatric nurse to promote good health, treatment and prevention of mental ill health in a general hospital setting.
Description: We describe how the liaison psychiatry service at a district general hospital has progressed and developed its remit from a focus on the A&E department to providing a service for all patients with mental health needs related to physical health problems. NICE guidance in both mental and physical health has been a catalyst to the development of this service where recommendations focus on all aspects of patients health and well being. The intervention includes education on mental health needs, changing attitudes and belief, a description of the process and some results of monitoring and audit which show an effective intervention for health care workers, patients and carers alike.
Organisation: Sussex Partnership NHS Foundation Trust
Guidance: cg48 - MI: secondary prevention
Category of submission: Clinical Date: 29 Sep 2008
The use of Clinical Audit to support the implementation of NICE guidance IPG 196 Patient Safety and reduction of risk of transmission of Creutzfeldt-Jakob disease (CJD) via interventional procedures.
Description: This submission demonstrates how Clinical Audit was used to support the implementation of, and show compliance with NICE guidance IPG 196.
Organisation: South Tees Hospitals NHS Trust
Guidance: IPG196 - Patient Safety and reduction of risk of transmission of Creutzfeldt-Jakob disease (CJD) via interventional procedures
Category of submission: Clinical Date: 29 Sep 2008
The way to medicines optimisation is through the stomach - tackling high prescribing levels using the NICE Dyspepsia guideline to review proton pump inhibitor (PPI) prescribing.
Description: PPI use is now so prevalent that a prescribing audit across three GP practices found these drugs were being prescribed for over 8% of all patients. With high levels of polypharmacy, this a prime target group for a novel approach to medicines optimisation.

Using a multi-faceted approach, including educational sessions for primary care teams, production of supporting materials for both clinicians and patients and patient centred polypharmacy reviews, medication use was successfully reduced with high levels of patient satisfaction.
Organisation: NHS Fylde & Wyre
Guidance: CG 17 - Management of dyspepsia in adults in primary care
Category of submission: - Date: 30 Jan 2013
Therapeutic Review- A NICE way to optimise prescribing
Description: Belfast Health & Social Care (HSC) Trust established a Therapeutic Review Steering Group to ensure the Trust has systems in place to record, monitor & audit use of NICE technologies as requested by Northern Ireland Health & Social Care Board (HSCB). The lead therapeutic review pharmacist audited prescribing of high cost therapies & results were presented to Service Group Managers, Directors, HSCB representatives and the multidisciplinary team to identify:

- deviations from evidence-based practice
- barriers to change
- action plans
Patient safety & quality of care was integral to the audits with the belief that focusing on quality and safety will bring improved health outcomes and thus efficiency savings.

For references please see the attached supporting material
Organisation: Belfast Health & Social Care Trust
Guidance: TA187 - TA187, TA163, TA130, TA186, TA195, TA247, TA225, TA234, TA146, TA103, TA134, TA180, TA127
Category of submission: - Date: 07 Jan 2014
Thinking Delirium in Herts and Beds Critical Care Units
Description: Delirium is a common manifestation of acute brain dysfunction in the critically ill, often not accredited with the same level of importance as other organ failures. NICE CG 103 provided the opportunity to describe current practices and consequently implement standardised, evidence based service improvement initiatives and education across the network within 6 months of commencement of the project. Positive outcomes of the project are evident in increases in preventative measures, delirium assessment and documentation practices on the critical care units as well as increasing recognition of delirium as an organ failure.
Organisation: Herts and Beds Critical Care Network
Guidance: CG103 - Delirium
Category of submission: - Date: 31 Jan 2013
To challenge the theoretical construct in COPD management through a practice-based approach
Description: To challenge the existing theoretical construct in COPD management through implementing NICE Guidance in a joint working arrangement between Walthamstow West Locality, Waltham Forest PCT and GSK to improve COPD healthcare.
Organisation: NHS Waltham Forest
Guidance: CG 101 - Chronic obtrusive pulmonary disease - Management of chronic obtructive pulmonary disease in adults primary and secondary care
Category of submission: 2010-11 Shared Learning examples Date: 11 Feb 2011
Toxic Tobacco Truths lesson resource pack (developed for the secondary school programme to reduce the uptake of smoking in young people) 2nd Edition
Description: Toxic Tobacco Truths lesson resource pack is a unit of six lessons focusing on the wider issues surrounding tobacco. Research around young people and smoking shows that successful educational programmes must address all three influences on smoking uptake: the individual, the personal environment, and the social and cultural environment - this pack seeks to address all three areas.
Organisation: Healthy Lifestyle Service, Gloucestershire Care Services NHS Trust
Guidance: PH23 - School-based interventions to prevent smoking
Category of submission: - Date: 26 Oct 2010
Trafford Tobacco Control Strategy
Description: The development of a strategy and action plan to tackle tobacco related issues in the Trafford Borough by working in partnership with a range of local and regional organisations including trading standards, youth service, children centres, fire service, housing trusts, school nurses, community groups and other allied professionals.
Organisation: NHS Trafford
Guidance: Generic
Category of submission: 2010 Shared Learning examples Date: 24 Jan 2011
Transforming acute care
Description: Within our Trust we endeavoured to ensure the safety and quality of care for the acutely ill patient . Setting standards of care from the basics of observations, to training of acute care skills for nurses and medical staff within the wards, we have ensured appropriate and timely recognition and response of the acutely ill patient. Implementing an electronic system for recording observations and automatically alerting the correct personnel, with an appropriate graded response as per the trust Early warning score policy and NICE guidance recommendation. With the review of all emergency bleeps by a core multidisciplinary team the accountability of care sits firmly with the parent teams of the patients, with support in care and processes from across the organisation. These initiatives have over the last 4 years established a safer organisation for our acutely ill patients and the consolidation of the NICE guidance CG 50 within the trust.
Organisation: Central Manchester University NHS Hospitals NHS Foundation
Guidance: CG 50 - Acutely ill patient in Hospital
Category of submission: 2010-11 Shared Learning examples Date: 10 Feb 2011
Treating and Screening for Tuberculosis in Birmingham Prison (NICE Clinical Guideline 117)
Description: Implementation of effective screen for tubeculosis at Birmingham Prison. A tool was developed that was systematic and methodical. The tool was shared by two diverse stakeholders: healthcare staff and prison security staff.
Organisation: Birmingham Community Healthcare
Guidance: CG117 - Tuberculosis
Category of submission: - Date: 30 Jan 2013
Trust-wide Implementation and Monitoring, A Multi-tiered Approach
Description: To improve awareness and compliance across the Trust for historical guidelines, and new guidelines within more strictly managed timescales, with a view to being ready for PbR tariffs being introduced into Mental Health.
Organisation: Hampshire Partnership NHS Foundation Trust
Guidance: Generic
Category of submission: General Date: 19 Aug 2009
Use of a Trustwide bulletin to disseminate NICE guidance
Description: We describe the development and implementation of bulletin designed in-house for Trust staff which regularly disseminates new NICE guidance, activity in the Trust about NICE guidance and the stakeholder programme of consultation. The publication includes all activity related to Health and Social Care Governance and is linked to all related initiatives and the Trust dissemination strategy. It is funded internally and produced at low cost but has proven to be an effective medium of information for staff.
Organisation: Sussex Partnership NHS Foundation Trust
Guidance: Generic
Category of submission: General Date: 26 Sep 2008
Use of Scenario Simulation in the introduction of Serum Natriuretic Peptide Testing
Description: More than half the primary care trusts (PCTs) in England do not provide serum natriuretic peptide (serum NP) testing as recommended by the NICE diagnostic pathway for heart failure (2010). This test helps GPs to rule out heart failure without the need for referral or further expensive diagnostic tests such as echocardiogram. NHS Improvement has been using computer generated scenarios and cost modelling for PCTs and GP consortia to assess the impact of different pathways for introducing the test, and to help them to choose the most clinical and cost effective solution.
Organisation: NHS Improvement
Guidance: CG108 - Chronic heart failure
Category of submission: - Date: 27 Jan 2011
Use of the EXOGEN ultrasound bone healing system for delayed and non-unions
Description: Implementation of the EXOGEN ultrasound bone healing system into the management of patients with delayed unions and non unions.
Organisation: Maidstone and Tunbridge Wells NHS Trust
Guidance: MTG12 - EXOGEN ultrasound bone healing system for long bone fractures with non-union or delayed healing
Category of submission: - Date: 28 Jan 2014
Use of transient elastography to assess liver disease in people with chronic hepatitis B
Description: Transient elastography is a non-invasive technique that uses both ultrasound and low-frequency elastic waves to quantify liver fibrosis. This example shows how we introduced the technology to our trust. There is a sample business case attached - this is not from our trust.
Organisation: Frimley Park Hospital NHS Foundation Trust
Guidance: CG165 - Hepatitis B (chronic): diagnosis and management of chronic hepatitis B in children, young people and adults
Category of submission: - Date: 29 May 2013
Using a NICE Implementation Steering Group to link the commissioning role of the PCT with the education and training strategy for General Practice teams
Description: This submission describes the process of how a PCT can both commission and help facilitate PHCTs to implement NICE guidelines in a timely, locally owned framework that incorporates some core quality improvement processes derived from principles of adult learning. The example of one GP team demonstrates, dissemination and adoption of guidelines done in a way that focuses on the key issues that may reinforce or change current clinical practice by all members of the practice team,within the local resources and structure, who can then be confident to relate this appropriately to patients Key steps include using a NICE Implementation Steering Group which has particular reference to the Commissioning and Education and Training strategies, local interpretation and dissemination to practice teams, protected learning time for practice teams and care pathway review system within a practice team to ensure dissemination to the point of patient self management
Organisation: NHS Bournemouth and Poole
Guidance: Generic
Category of submission: General Date: 30 Sep 2008
Using a Novel Approach to Baseline Audit the NICE OCD Guideline
Description: The aim of the project was to assess current management and treatment by teams serving both working age and older adults against guideline recommendations. A vignette approach allowed the flexibility to assess the extent to which the stepped approach is being applied. Rather than employ a yes/no compliance to standards methodology, the format asked senior team members to report upon likely service response to clients of varying complexity. This allowed implementation to be targeted in a more efficient manner particularly with regard to training and identifying areas for improvement.
Organisation: Sheffield Health & Social Care Foundation Trust
Guidance: CG31 - Obsessive-compulsive disorder - core interventions in the treatment of obsessive compulsive disorder and body dysmorphic disorder
Category of submission: Clinical Date: 15 Sep 2008
Using a Quality Improvement Framework to make local population health gains
Description: This incentivised quality improvement programme aimed to elevate population-based primary care provision to exemplary status. It provides direction to general practices through the use of specific aspirational targets, that complement and enhance national schemes, and tailored practice development plans. In addition to financial support, face-to-face advice, education and service development is utilised to improve quality of care across all participating practices.
Organisation: Stoke-on-Trent Clinical Commissioning Group
Guidance: Generic
Category of submission: - Date: 30 Nov 2012
Using national standards to develop aims, objectives and measurable outcomes for reflective practice groups on older peoples mental health wards (update September 2009)
Description: Update on Criterion-based Reflective Practice Group Courses run in 2008-9 for staff in acute wards in older people's Services, West Sussex. The groups aim to increase psychological awareness through self-reflection. The group's objectives are based on criteria derived from twelve policies and documents in current use which have made recommendations for improved care standards in mental health services. Four main areas for development were identified from a review of the policies: 1. Improved communication between staff and service users/their families 2. Improved communication between different parts of a service-user's system 3. Increased understanding of a service-user's difficulties and strengths 4. A commitment to personal development and professional practice. Following the successful pilot, the need for further groups in acute wards for older people was identified, and a set of evaluation tools were devised to be piloted in each area of West Sussex.
Organisation: Sussex Partnership NHS Foundation Trust
Guidance: CG42 - Dementia
Category of submission: Clinical Date: 29 Sep 2009
Using new NICE guidelines on child maltreatment in safeguarding children training
Description: The new guidelines on recognising child maltreatment were published in July 2009. We have used them to create a training exercise during level 2 safeguarding children courses. They will enable clinicians to assess their knowledge base around identification of cases of child abuse and enhance information sharing and subsequent referrals to social care.
Organisation: Portsmouth City teaching Primary Care Trust
Guidance: CG89 - When to suspect child maltreatment
Category of submission: Clinical Date: 01 Oct 2009
Using NICE CG16 Self-harm guidance to improve psychosocial assessment of patients following self harm
Description: The NICE CG16 self harm guide emphasises the need for comprehensive psychosocial assessment of all individuals presenting to general hospital services following self-harm. By using the clinical audit cycle we have been able to improve the quality of our psychosocial assessments and enhance practice by ensuring equity of service in a busy city psychiatric liaison service.
Organisation: Oxford Health NHS Foundation Trust
Guidance: CG16 - Self-harm
Category of submission: - Date: 17 Jan 2014
Using NICE Guidance / Quality Standards to drive Sector-Led Improvement in Greater Manchester
Description: NICE guidance / Quality Standards are pivotal to Greater Manchester's Sector-Led Improvement approach to driving improvements in public health. This programme of work aims to enable local authorities (LAs) to take responsibility for their own performance and improvement and for leading the delivery of improved outcomes using benchmarking data alongside a robust evidence base which NICE guidance / Quality Standards underpins.

The approach we have developed is based on the principles of mutual support and assistance and involves a discrete process of self-assessment and peer review using NICE guidance / Quality Standards as the driver for improving performance.

Local Action Plans are developed and reviewed regularly by LA peers to ensure that NICE guidance / Quality Standards are being implemented and that performance against PHOF (Public Health Outcomes Framework) measures improves in the long-term.
Organisation: Greater Manchester Public Health Network (Hosted by Tameside Council)
Guidance: Generic
Category of submission: - Date: 17 Jan 2014
Using organisational change to enhance the experience of women giving birth by focusing on normalising births
Description: Organisational change focusing on normalising birth at Blackpool Teaching Hospitals NHS Foundation Trust has led to enhanced quality of care and satisfaction for patients and staff.
Organisation: Blackpool Teaching Hospitals NHS Foundation Trust
Guidance: CG132 - Caesarean section
Category of submission: - Date: 19 Aug 2013
Using Public Health Intervention as an educational tool
Description: We designed and used public health intervention tools to educate our stakeholders and to assist them in identifying areas for quality and business improvement in different settings.
Organisation: North East Lincolnshire CTP
Guidance: PH14 - (Preventing the uptake of smoking by children and young people Mass-media and point-of-sales measures to prevent the uptake of smoking by children and young people)
Category of submission: Health and wellbeing Date: 26 Aug 2009
Using Quality & Productivity to Enhance Heart Failure Pathway in Primary Care
Description: Eastbourne, Hailsham and Seaford CCG Quality & Productivity (QP) indicators will be used to improve diagnosis and treatment of heart failure. The process is aligned directly with NICE guideline CG108 and the Chronic Heart Failure Quality Standard (QS9). The data from this programme will be used to assess key stages in the pathway and also aligns with the work in the Enhancing Quality Programme.
Organisation: KSS AHSN / Eastbourne Hailsham and Seaford CCG
Guidance: QS9 - Chronic heart failure
Category of submission: - Date: 10 Sep 2013
Using Quality Standards on Stroke in Quality Accounts
Description: We operate an inpatient stroke rehabilitation service and have incorporated six statements from the NICE quality standards on stroke as improvement priorities, monitored quarterly and reported in the quality account.

This project was led by Fiona Sutherland (Quality Improvement Manager) with support from Kate Jackson (Lead Physiotherapist), Mirek Skrypak (Stroke REDS co-ordinator) and Adam Backhouse (Governance Support Officer).
Organisation: Camden Provider Services
Guidance: Generic
Category of submission: - Date: 31 Jan 2012
Using Quality Standards to support improvement
Description: Salford Royal NHS Foundation Trust used the NICE Quality Standard on VTE Prevention (QS3) as a catalyst for developing an electronic assessment system to identify cases of hospital-acquired venous thromboembolism (HAT). This enabled the Trust to go above and beyond the CQUIN target for venous thromboembolism (VTE) and identify whether they were actually reducing the number of hospital-acquired blood clots.
Organisation: Salford Royal NHS Foundation Trust
Guidance: QS3 - VTE prevention
Category of submission: - Date: 08 Jan 2014
Using Sharepoint to Implement NICE Guidance in an NHS Trust
Description: This project illustrates the use of Microsoft Sharepoint for implementing NICE guidelines and Quality Standards across a large NHS Mental Health Trust. The project was developed in-house and allows feedback, discussion, project registration/presentation and information sharing via a single route.
Organisation: Sheffield Health and Social Care NHSFT
Guidance: Generic
Category of submission: 2011-12 Shared Learning Awards Date: 27 Oct 2011
Using technology to implement NICE guidance. A focus on patient centred care and supporting the wider NHS.
Description: NHS Direct uses the computer-based technology of a clinical decision support system to provide 24 hour patient centred assessment, advice and information which responds to patient's needs. By making sure the technology is updated to reflect NICE guidance, we support people, staff and the wider NHS. Remote and virtual services can improve patient experiences, relieve pressure on traditional face-to-face services, empower people to access the right services at the right time and overcome barriers to implementing NICE guidance to the benefit of both patients and staff. By ensuring the clinical content of systems are updated against NICE guidance, in this example with symptoms of diarrhoea and vomiting due to gastroenteritis, all staff have the same supported evidence and information, consistent with patients accessing this information via the web thus resulting in consistency and appropriate care and information specific to their symptoms.
Organisation: NHS Direct
Guidance: CG84 - Management of acute diarrhoea and vomiting due to gastroenteritis in children younger than 5 years
Category of submission: 2010-11 Shared Learning examples Date: 11 Feb 2011
Using the antenatal and postnatal mental health guideline to improve outcomes for mothers
Description: This submission is about how a small specialist perinatal mental health service is implementing the key priorities of the NICE Antenatal and Postnatal Mental Health (ANPNMH) guideline.
Organisation: Sheffield Health and Social Care Trust
Guidance: CG45 - Antenatal and postnatal mental health
Category of submission: 2010-11 Shared Learning examples Date: 11 Feb 2011
Using the hepatitis B surface antigen (HBsAg) quantitative assay test to evaluate patient response to treatment for chronic hepatitis B virus infection
Description: The HBsAg quantitative assay records the amount of hepatitis B surface antigen in a patient's blood. This, in combination with hepatitis B virus DNA (HBV DNA) testing, enables physicians to monitor and evaluate a patient's response to peginterferon alfa-2a therapy, and to stop treatment after 24 weeks if indicated.
Organisation: The Royal London Hospital, Barts Health NHS Trust
Guidance: CG165 - Hepatitis B (chronic): diagnosis and management of chronic hepatitis B in children, young people and adults
Category of submission: - Date: 16 May 2013
Using the Quality Standard for specialist neonatal care to inform local quality improvement work in an acute trust.
Description: How this trust is using a NICE Quality Standard to improve the quality of specialist neonatal care. Emphasis is on promoting an ethos of continuing improvement rather than introducing an additional compliance exercise. This has been achieved by aligning with existing quality improvement projects.
Organisation: Taunton and Somerset NHS Foundation Trust
Guidance: Generic
Category of submission: - Date: 31 Jan 2012
Utilising ScriptSwitch® to promote NICE guidance to prescribers in Primary Care
Description: ScriptSwitch® is a prescribing software support tool that is installed in all GP practices in Wakefield District. ScriptSwitch® enables a 'pop up' message to appear at the point of prescribing, which can be utilised to communicate cost effectiveness, formulary choices and regional/local guidelines. ScriptSwitch® is therefore an appropriate and effective medium to highlight NICE guidance to prescribers, especially in relation to the prescribing of medicines.
Organisation: NHS Wakefield District
Guidance: Generic
Category of submission: 2010-11 Shared Learning examples Date: 09 Feb 2011
Varenicline-Designing a pathway for a multi-disciplinary team
Description: NICE Guidance TA 123 - Varenicline July 2007 - Designing a pathway for a multi-disciplinary team to implement NICE guidance.
Organisation: Birmingham Community Healthcare
Guidance: TA123, PH10 - TA 123 Smoking cessation-Varenicline
Category of submission: - Date: 30 Jan 2013
Various modes used to reinforce NICE guidance for venous thrombo-embolism prophylaxis
Description: This is a learning experience of our hospital wherein adherence to NICE guidance improved exponentially following the various training modes used.
Organisation: Royal Cornwall Hospitals NHS Trust
Guidance: CG92 - Venous thromboembolism - reducing the risk
Category of submission: 2010 Shared Learning examples Date: 13 Jan 2011
VTE risk assessment for community patients
Description: Despite VTE risk assessment in the community not being a requirement of NICE, it was felt that it was best practice, patient centred and provided seamless care for patients in our primary care trust.
Organisation: Wiltshire Community Health Services
Guidance: CG92 - Venous thromboembolism - reducing the risk
Category of submission: 2011-12 Shared Learning Awards Date: 24 May 2011
VTE Risk Assessment Tool and supporting documents
Organisation: Mid Cheshire Hospitals NHS Foundation Trust
Guidance: CG46 - Reducing the risk of venous thromboembolism (deep vein thrombosis and pulmonary embolism) in inpatients undergoing surgery
Category of submission: Clinical Date: 30 May 2008
VTE. Assess. Prevent. A unique regional campaign to increase VTE risk assessment
Description: This integrated staff communications campaign asks all staff involved in the care of inpatients throughout the region, to make sure all their patients are risk assessed for VTE, and that they receive the recommended preventative treatment. Developed with focus groups of clinical and front line staff in four hospitals across the east of England, the campaign features a distinctive look to make a very clear and simple message. The campaign has a full range of integrated communications materials.
Organisation: NHS East of England
Guidance: CG92 - Venous thromboembolism - reducing the risk
Category of submission: 2010-11 Shared Learning examples Date: 10 Feb 2011
Walking Away from Type 2 Diabetes: implementation of a diabetes prevention programme
Description: The Walking Away from Type 2 Diabetes is an evidence-based person-centred diabetes prevention programme that is focused on a holistic approach to lifestyle and health. It is centred on a 3.5 hour group-based structured education programme, delivered to 8-10 participants, aimed at promoting increased physical activity and a healthy lifestyle through targeting perceptions and knowledge of diabetes and diabetes risk, self-efficacy beliefs around lifestyle change, barriers to change and self-regulation. The programme meets criteria for structured education and is specifically designed for implementation within primary care; this includes a full educator training and quality development infrastructure.
Organisation: NIHR Leicester-Loughborough Diet Lifestyle and Physical activity Biomedical Research Unit
Guidance: PH38 - Preventing type 2 diabetes: risk identification and interventions for individuals at high risk
Category of submission: - Date: 01 Jun 2012
Website to share NICE guidance and related trust information
Organisation: Derbyshire Mental Health Services NHS Trust
Guidance: Generic
Category of submission: General Date: 30 Jul 2008
Weighing Scales and Stadiometers. The need for accurate instruments in adult nutrition support.
Organisation: Southampton University Hospitals NHS Trust
Guidance: CG32 - Nutrition Support in Adults
Category of submission: Clinical Date: 14 Apr 2008
West Yorkshire Critical Care Network approach to the Rehabilitation after Critical Care Illness NICE guidance (CG83) 2009
Description: Poster submission. Large AO sized poster. Design is a pie design with each piece of the pie showing each stage of the project. Around the edge of the pie we have the areas of the project which match the QIPP agenda (Quality, Innovation, Prevention and Productivity).
Organisation: West Yorkshire Critical Care Network
Guidance: CG83 - Rehabilitation after Critical Illness
Category of submission: 2011-12 Shared Learning Awards Date: 09 Nov 2011
Wigan Breastfeeding Network peer support service
Description: Following a competitive tendering process commissioned jointly between NHS Ashton Leigh and Wigan Public Health Department and Wigan Council the Breastfeeding Network now provides a Borough-wide, evidence based, proactive peer support service providing Antenatal infant feeding choice information, and proactive postnatal breastfeeding support on the Maternity, neonatal and paediatric wards of Royal Albert Edward infirmary (RAEI) Wigan and home visiting support to all Breastfeeding families with an additional bespoke service to teenage mothers. The service is staffed by both salaried and volunteer local mothers who have breastfed their own babies and then undergone an accredited training programme supported by monthly supervision. This service is underpinned by NICE Postnatal guideline (CG37) and meets statement 5 of the new Quality Standard (QS37).
Organisation: Wigan Council
Guidance: QS37 - Postnatal care
Category of submission: - Date: 15 Aug 2013
Worcestershire Health Economy NICE Implementation Group - Moving Forward (Update 2008)
Organisation: Worcestershire Royal Hospital
Guidance: Generic
Category of submission: General Date: 17 Sep 2008
Working together to prevent premature heart disease: Finding Familial Hypercholesterolaemia
Description: We have implemented a service to diagnose individuals and families with Familial Hypercholesterolaemia (FH) across Wales designed to deliver the NICE FH clincal guideline. Day to day delivery is carried out by British Heart Foundation specialist nurses and genetic counsellors working with primary care, hospital physicians and laboratory staff, working closely with a family support group.

This is linked by a dedicated IT system and coordinated by a service management team, which reports to a multi-organisational steering group.
Organisation: University Hospital of Wales
Guidance: CG71 - Familial hypercholesterolaemia
Category of submission: - Date: 31 Jan 2013
Yorkshire and the Humber Hepatitis Project
Description: This project is aligned to the NICE Public Health Guidance Hepatitis B and C: ways to promote and offer testing to people at increased risk of infection and more specifically Recommendation 1 'Awareness-raising about hepatitis B and C among the general population' and Recommendation 2 'Awareness-raising for people at increased risk of hepatitis B or C infection'.

In 2010 the Yorkshire and Humber Hepatitis Project was formed. The project is co-ordinated by a part time project manager (employed by the Health Protection Agency [HPA]) who works with a wide range of stakeholders to raise awareness amongst professionals and the public around hepatitis B and C, improve case finding and diagnostics and improve the pathway for access to treatment and general management.
Organisation: Public Health England
Guidance: Generic
Category of submission: - Date: 08 Apr 2013

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Accessibility | Cymraeg | Freedom of information | Vision Impaired | Contact Us | Glossary | Data protection | Copyright | Disclaimer | Terms and conditions

Copyright 2014 National Institute for Health and Care Excellence. All rights reserved.