Evidence Base Clause Samples

Evidence Base. The Department of Health proposed the NHS Health Check programme, based on the evidence and cost benefit presented in the Impact Assessment2 document. Modelling work3 undertaken by the Department of Health (DH) found that offering an NHS Health Check to people between the ages of 40 and 74 and recalling them every five years was both clinically and cost effective. Cardiovascular Disease, which includes heart disease, stroke, diabetes and kidney disease are the biggest causes of death in the UK. The national Health Checks programme could on average: • Prevent 1,600 heart attacks and strokes • Prevent at least 650 premature deaths • Identify over 4,000 new cases of diabetes each year. • Detect at least 20,000 cases of diabetes or kidney disease earlier, allowing individuals to be better managed to improve their quality of life. NICE guidance is available for some of the components of the health check and on interventions in associated referral pathways following the health check e.g. physical activity and smoking cessation. Public Health England has produced a briefing outlining the evidence base supporting the mandated NHS Health Check programme4.

Evidence Base. The service will apply and/or support evidence-based practice and will be informed by national and local drivers for change for example: • Current DoH policy and guidelines, delivery of national key targets & NSF & NICE guidelines • CQC registration requirements • Gold Standards Framework and Liverpool Care Pathway for people at the end of life • Essence of Care • Infection Control Standards e.g. hand hygiene audits • Locality commissioning plans and locally agreed care pathways • The Devon Joint Strategic Plan and subsidiary action and operational plans • The integration of health and social care delivery in Devon through the continuing development of localities and clusters The commissioning specification is supported by the joint Health and Wellbeing Strategy 2013–16.

Evidence Base. 1.7.1. With the production of a Revised LDP, there will be a corresponding need to update or renew a number of studies/documents contained within the current LDP evidence base, which underpins the plan. In line with previous AMRs, all contextual, policy and legislative changes that have occurred since the adoption of the LDP will also need to be given due consideration, as part of the evidence base updates. The list below illustrates those evidence base documents that are likely to be required, as part of the LDP full revisions process: • Population Data and Housing Forecasts • Local Housing Market Assessment (LHMA) • Gypsy and Traveller Accommodation Needs Assessment • Urban Capacity Study • Settlement Boundary Review • Sustainable Settlement Hierarchy • Employment Land Review • Retail Study Update • Green Infrastructure Assessment • Assessment of Environmental Constraints • Public Open Space Assessment • Renewable Energy Assessment • Transport Assessment • Landscape 1.7.2. The list is not definitive nor exhaustive, as the need for additional evidence may present itself throughout the plan-making process. 1.7.3. Given that a number of local authorities within South East Wales are currently progressing Revised plans, the Council will endeavour to explore possibilities for the joint commissioning of evidence base documents.

Evidence Base. The National Stroke Strategy; • The Cochrane Review of ESD; • Royal College of Physicians Clinical Guidelines for Stroke 2008; • The National Sentinel Stroke Audits; • The National Service Framework for Older People Standard 5; • The Accelerated Stroke Programme; • Revised ESD Consensus Statement prepared by Prof. ▇▇▇▇▇▇ ▇▇▇▇▇▇ and Dr ▇▇▇▇▇▇▇ ▇▇▇▇▇▇ of the Collaborative Leadership and Research in Health Care (CLAHRC), for NDL; • Evaluation tool to assess the implementation and effectiveness of ESD in practice in rural and mixed settings developed by Collaborative Leadership and Research in Health Care (CLAHRC), for NDL; • The East Midlands Public Health Observatory (EMPHO) previous and future demand modelling; 2. Scope 2.1 Aims and objectives of service • Eligible patients will have access to ESD to give the best possible outcomes for the patients and allow local NHS providers and commissioners to use resources effectively within the health economy. • To ensure a whole system approach that raises standards across the whole stroke pathway by establishing a recommended model and limit point. • To establish a recommended model for ESD services across the East Midlands to include specialist stroke multidisciplinary teams, who will support stroke patients on discharge from acute care to their place of residence in order to fulfil identified achievable measureable and agreed rehabilitation goals, and offer support and guidance to their carers and families. In most instances this will occur in a time limited framework. The team will signpost, or transfer to relevant NHS, Social Service and voluntary sector services for ongoing support. • To show a reduction in length of hospital stay, thereby increase the proportion of patients spending at least 90% of their time on a stroke unit. • To ensure timely discharge of all eligible stroke patients. • To ensure equity of access to an ESD. • To reduce hospital re-admission rates. • To reduce premature admission into long term care.

Evidence Base. There is strong evidence to support the use of EHCs to support women with pregnancy choices. Pharmacists must have the appropriate competency and have completed the self-declaration in order to deliver the EHC under the PGD. The must be familiar with and follow NICE, BASH and FSRH guidance relating to contraception and Sexual Health. BASH Home Page NICE Guidance on EHCs FSRH home page The service will be underpinned by the following A quality Standard for contraceptive services (FSRH, 2014) PH51 Contraceptive services with a focus on young people up to the age of 25 (NICE, 2014) A Framework for sexual Health Improvement in England (DH, 2013) Clinical governance in Sexual Health (DH, 2013) Service Standards for Sexual and Reproductive Healthcare (FSRH 2013) British HIV Association Standards of Care for People Living with HIV (BHIVA 2013) Clinical Guidance – Emergency Contraception (FSRH 2011) UK National Guideline on Safer Sex Advice (BASHH & BHIVA 2012) National Chlamydia Screening Programme Standards (6th Edition 2012) Recommended Standards for Sexual Health Services (MEDFASH 2005) NICE guidelines on prescribing. UKMEC Clinical Guidance for delivery of EHC by the FSRH MHRA Guidance 1.3 General Overview Spectrum Community Health CIC has been awarded the contract to deliver an Integrated Sexual Health Service for Barnsley until April 2019. Spectrum is integrating the GUM and CASH elements of the service and is putting greater focus on prevention of STIs and unintended conceptions. To bring this into practice we are managing and leading a service transformation which requires a change in the model for sexual health provision in Barnsley. Spectrum is delivering an integrated sexual health service with an increase in both the capacity for, and the impact of, the prevention element of the service. Spectrum is investing in dual training of clinical staff to deliver integrated holistic sexual health services in multiple locations .Spectrum uses various methods to increase access to sexual health services for targeted high risk groups. Spectrum is investing in a programme of education and support in schools and other non-school settings, incorporating innovative delivery methods. The service model will promote pro-active outreach work and deliver a one-stop-shop model offering choice to reach all target groups. Spectrums 3 criteria for delivering the Pharmacies EHC element of the service; The service offer will be high quality, integrating contraception needs with...

Evidence Base. This specification draws its evidence and rationale from a range of documents and reviews as listed below: • Improving Outcomes; a Strategy for Cancer – Department of Health (2011) • Cancer Commissioning Guidance - Department of Health (2011) • Five year forward view - Department of Health (2014) • Report of the Independent Cancer Taskforce - ‘Achieving World-Class Cancer Outcomes: A Strategy for the NHS 2015-2020’

Evidence Base. Vide supra 4. THE REQUIREMENTS

Evidence Base. Promoting the health and wellbeing of pupils not only has the potential to improve their health and wellbeing outcomes, but also their educational outcomes. For example, children and young people who are aerobically fit have been found to have higher academic scores, with the intensity and duration of exercise both linked to improved academic performance, including GCSE results at age 15 and notably girls results in science8. Robust evidence shows that interventions taking a ‘whole school’ approach have a positive impact in relation to a range of health improvement outcomes, to include body mass index, physical activity, physical fitness, fruit and vegetable intake, tobacco use, and being bullied9. A whole school approach is one that goes beyond the learning and teaching in the classroom to pervade all aspects of the life of a school including: Leadership, management and managing change Policy development Curriculum planning and resources, including working with outside agencies Learning and teaching School culture and environment Giving children and young people a voice Provision of support services for children and young people Staff professional development needs, health and welfare Partnerships with parents, carers and local communities Assessing, recording and reporting children and young people’s achievement With specific reference is addressing obesity, evidence highlights the effectiveness of multi-component interventions in schools focused on improving both diet and physical activity, including: specialised educational curricula, trained teachers, supportive school policies, a formal PE program, healthy food and beverage options, and a parental/family component. Evidence highlights the effectiveness of multi-component interventions in schools focused on improving both diet and physical activity, including: specialised educational curricula, trained teachers, supportive school policies, a formal PE program, healthy food and beverage options, and a parental/family component 101112. For example, Waters et al13 found strong evidence to support the beneficial effects of child obesity prevention programmes on BMI, particularly for programmes targeting children aged six to 12 years. Whilst it is not easy to determine those programme components which are most effective, this review highlighted the following as promising policies and strategies: school curriculum that includes healthy eating, physical activity and body image increased sessions for physical...

Evidence Base. The National Carers Strategy 2008: Carers at the heart of 21st-century families and communities • Recognised, valued and supported: next steps for the Carers Strategy: Nov 2010 • The Operating Framework for the NHS in England 2011/12 • The NHS Outcomes Framework 2011/12