Acute Respiratory Infection Hubs: A Service Model with Potential to Optimise Infection Management.

Patients with acute respiratory infections (ARI)-including those with upper and lower respiratory infections from both bacterial and viral pathogens-are one of the most common reasons for acute deterioration, with large numbers of potentially avoidable hospital admissions. The acute respiratory infection hubs model was developed to improve healthcare access and quality of care for these patients. This article outlines the implementation of this model and its potential impacts in a number of areas.

Evaluation of the NHS England evidence-based interventions programme: a difference-in-difference analysis.

Background: The NHS England evidence-based interventions programme (EBI), launched in April 2019, is a novel nationally led initiative to encourage disinvestment in low value care.

Method: We sought to evaluate the effectiveness of this policy by using a difference-in-difference approach to compare changes in volume between January 2016 and February 2020 in a treatment group of low value procedures against a control group unaffected by the EBI programme during our period of analysis but subsequently identified as candidates for disinvestment.

Results: We found only small differences between the treatment and control group after implementation, with reductions in volumes in the treatment group 0.

Shoulder Pain Diagnosis, Treatment and Referral Guidelines for Primary, Community and Intermediate Care.

These care pathway guidelines for the shoulder have been written in collaboration with the NHS Evidence Based Interventions (EBI) programme. The EBI programme is a partnership between the Academy of Medical Royal Colleges, NHS Clinical Commissioners, the National Institute for Health and Care Excellence, as well as NHS England and Improvement.

The implications of high bed occupancy rates on readmission rates in England: A longitudinal study.

Hospital bed occupancy rates in the English National Health Service have risen to levels considered clinically unsafe. This study assesses the association of increased bed occupancy with changes in the percentage of overnight patients discharged from hospital on a given day, and their subsequent 30-day readmission rate. Longitudinal panel data methods are used to analyse secondary care records (n = 4,193,590) for 136 non-specialist Trusts between April 2014 and February 2016.

Strategy to improve the quality of care in England.

The Five Year Forward View describes 'closing the care and quality gap' as one of three strategic challenges facing the English NHS by 2020. The need for a coherent national strategy for achieving high-quality, affordable care has rarely been more pressing, but how effectively do existing national decisions and interventions support clinicians delivering care on the front line? And, in a complex and dynamic environment with multiple players, how should the health service move forward to develop a balanced strategy for quality that accommodates longer term goals as well as more immediate political priorities? Research by a team at the Health Foundation has assessed how the array of organisations, initiatives and approaches to quality stack up as an emergent strategy. Four concepts were used to provide a yardstick for quality-related policies and activities to help identify potential imbalances, gaps and duplication.

Infections in patients taking Rituximab for hematologic malignancies: two-year cohort study.

Background: Rituximab (R) is a chimeric human-murine anti-CD20 monoclonal antibody used to treat B-cell lymphomas. Despite R remarkable activity against malignant cells, there are concerns that R may facilitate the occurrence of infections. This study is aimed to define risk factors for infections, and the potential interaction with time since therapy, in patients undergoing R containing regimens.

Risk of infection in patients with lymphoma receiving rituximab: systematic review and meta-analysis.

Background: The addition of Rituximab (R) to standard chemotherapy (C) has been reported to improve the end of treatment outcome in patients affected by CD-20 positive malignant lymphomas (CD20+ ML). Nevertheless, given the profound and prolonged immunosuppression produced by R there are concerns that severe infections may arise. A systematic review and meta-analysis were performed to determine whether or not the addition of R to C may increase the risk of severe infections in adults undergoing induction therapy for CD20+ ML.

First report of Salmonella enterica serotype paratyphi A azithromycin resistance leading to treatment failure.

The prevalence of Salmonella enterica serotype Paratyphi A infection is increasing, and multidrug resistance is a well-recognized problem. Resistance to fluoroquinolones is common and leads to more frequent use of newer agents like azithromycin. We report the first case of azithromycin resistance and treatment failure in a patient with S.