QUALITY IMPROVEMENT: Supporting a hospital in difficulty: -experience of a '-buddying' agreement to implement a new medical pathway.

Increased NHS regulation has identified many healthcare organisations with operational and/or financial difficulties. Although the causes are often complex, most cases are effectively managed internally with limited input from external agencies. How best to support the few organisations needing additional support has not been established.

The power of digital communications: improving outpatient attendances in south London.

Missed appointments represent a significant burden to healthcare budgets. The average 'did not attend' (DNA) rate across the NHS is 6.7%; however, significant variation can be observed.

Association of thrombotic microangiopathy and intimal hyperplasia with bleeding post-renal biopsy in antiphospholipid antibody-positive patients.

Objective: Renal biopsy remains the gold standard investigation for both diagnostic and prognostic purposes in the clinical management of lupus nephritis. However, it is not without potentially significant complications. The objectives of this study were to determine the rate of significant bleeding post-renal biopsy in patients with lupus nephritis and to identify risk factors associated with hemorrhagic complications.

Implementing the National Institute of Clinical Excellence improving outcome guidelines for head and neck cancer: developing a business plan with reorganisation of head and neck cancer services.

The implementation of the National Institute of Clinical Excellence improving outcome guidelines (NICE-IOG) manual for head and neck cancer may have a huge potential cost implication. Head and neck cancer is a rare disease which utilises large quantities of resources which can only be provided in a tertiary centre. Head and neck cancer services should be centralised into a single site for each cancer network.

Late low-dose steroid withdrawal in renal transplant recipients increases bone formation and bone mineral density.

Corticosteroids have been the most widely used immunosuppressive agents since the first clinical transplantation in the 1950s. There are few studies of late steroid withdrawal in renal transplantation and none have prospectively assessed bone mineral density (BMD). The study aim was to assess the impact of corticosteroid withdrawal, in stable renal transplant recipients, on BMD and bone turnover.