Update for Primary Care

Our vision over the next 5 years is reflected in 4 key pillars that underpin where we'll focus our transformation efforts:

1. Rapid, robust and responsive technology evaluation
2. Dynamic, living guideline recommendations
3. Effective guidance uptake to maximise our impact
4. Leadership in data, research and science.

New guideline on the assessment and management of chronic primary pain

We recommend that people with chronic primary pain should be offered a range of treatments to help them manage their condition. The guideline emphasises the need to put patients at the centre of their care and highlights the importance of healthcare professionals gaining an understanding of how a person's life affects their pain, and how pain affects their life.

New clinical knowledge summary (CKS) topics and updates on the site from the start of April include:

• Platelets – abnormal counts and cancer is a new CKS topic.
• Itch – widespread. Recommendations have been updated in line with current evidence. The sections on management and causes have been merged. The recommendations on prescribing oral antihistamines have been amended to consider the use of non-sedating oral antihistamines as a first line treatment, unless there is a history of troublesome nocturnal itch. New sections on Cetirizine, Loratadine, and Fexofenadine have been added to the section on prescribing information.
• Contraception – progestogen-only. The topic structure has been changed and updated in line with Faculty of Sexual and Reproductive Healthcare guidance. Drug interaction of the levonorgestrel intrauterine system (LNG-IUS) with Esmya® (ulipristal acetate 5 mg) has been removed.
• HIV infection and AIDs. Recommendations on post-exposure prophylaxis have been updated in line with the British Association for Sexual Health and HIV UK guideline for the use of HIV post-exposure prophylaxis 2021.

Delegating clinical tasks to informal carers and relatives during the COVID-19 pandemic

Livewell Southwest used our guidance on end of life care for adults and our COVID-19 rapid guideline on managing symptoms (including at the end of life) in the community, to develop their end of life care for adults policy.

At the peak of the COVID-19 pandemic, the team avoided unnecessary visits by delegating care tasks to families and carers where appropriate. The policy gives clarity on the roles and responsibilities of staff when care is delegated. Staff also completed training covering:

• what third party delegation entails
• exclusion criteria
• what is required of them
• what they are permitted to delegate.

The greatest benefits were seen in supporting relatives and informal carers to administer wound care and change dressings. This reduced home and care home visits by staff, which may have helped to prevent the spread of COVID-19. This method also helped to reduce caseloads, particularly when staff were off sick or isolating due to COVID-19 and it enabled more patients to be seen when needed.

Changes to health technology evaluation methods and process review timelines

Because of the COVID-19 pandemic, we extended our process review for health technology evaluation consultation by 4 weeks. This was to make sure our stakeholders had enough time to respond. This timeline change means the final publication date of our methods and processes programme manual will be later than anticipated.
 
Our new key dates are:

• August/September 2021: 6-week public consultation on the draft programme manual
• December 2021: final programme manual publishes
• January 2022: implementation of new methods and processes.

Help shape how we present our guidance

We’d like your help with improving how we present our guideline content on diagnosing and managing type 2 diabetes, with a focus on supporting shared decision-making. We’re aiming to make it easier to access and use.

Comment on a consultation

Our current consultations include:

• Brain tumours (primary) and brain metastases in adults
  Submit your comments by Tuesday 4 May 2021.
• Weight management
  Submit your comments by Friday 7 May 2021.
• Fenfluramine for treating seizures associated with Dravet syndrome
  Submit your comments by Monday 10 May 2021.
• Type 1 diabetes in adults: diagnosis and management (update)
  Submit your comments by Wednesday 19 May 2021.
• Radiofrequency ablation for palliation of painful spinal metastases
  Submit your comments by Monday 24 May 2021.
• Lateral elbow resurfacing for arthritis
  Submit your comments by Monday 24 May 2021.

Join a committee

We’re looking for GPs, nurses, consultants, specialists and managers to join 6 committees:

• Weight management (update) committee
  Apply by Friday 7 May 2021.
• Interventional procedures advisory committee
  Apply by Sunday 9 May 2021.
• Indicator advisory committee
  Apply by Wednesday 12 May 2021.
• Medical technologies advisory committee
  Apply by Sunday 16 May 2021.
• Prostate cancer (update) committee
  Apply by Monday 17 May 2021.
• Technology appraisal committee
  Apply by Sunday 23 May 2021.

Observe a meeting

Due to the coronavirus pandemic, we're currently holding all our public meetings virtually. You'll need to register in advance to join. 

Upcoming public meeting:

• Friday 11 May 2021 – Quality standards advisory committee
  • Fetal alcohol spectrum disorder
  Registration closes Tuesday 4 May 2021.
  Agenda and register

• Friday 21 May 2021 – Medical technologies advisory committee
  • Evaluation of GID-MT553 Synergo for non-muscle-invasive bladder cancer
  • Evaluation of MT507 Plus Sutures for preventing surgical site infection
  Registration closes Thursday 6 May 2021.
  Agenda and register