Prostate cancer

Prostate cancer is the most common cancer in men, with 35,567 diagnosed in England in 2011. The disease is more common in men over the age of 65 and, with an increasingly ageing population, cases are expected to rise even further.

NICE has published a quality standard to help the NHS provide high quality care to men with prostate cancer. It highlights key areas of care that if addressed, should contribute to:

• improvements in a patient’s quality of life;
• a reduction in premature deaths from the disease;
• a better experience of hospital care for each patient;

• improvements in the need for care and support.

Osteoarthritis

Osteoarthritis is a common condition that affects the joints, most commonly the knees, hips and small joints of the hand. It is one of the leading causes of pain and disability worldwide and in the UK around 2 million people see their GP about it every year and the large majority of hip and knee replacements result from osteoarthritis.

The NICE quality standard for osteoarthritis is made up of 8 statements covering the diagnosis, assessment, management, ongoing review and referral for joint surgery of adults who have osteoarthritis. It highlights the need to reduce unnecessary diagnostic investigations as well as providing advice and support to exercise and (if appropriate) lose weight.

Personality disorders: borderline and antisocial

Borderline and antisocial personality disorders are 2 distinctive conditions that affect people differently and have different care pathways. The diagnosis affects how the condition is managed and the interventions and services that are appropriate.

Symptoms of BPD include having emotions that are up and down, unstable sense of identity, self-image and mood with fear of abandonment, rejection, and a strong tendency towards suicidal thinking and self-harm. As a result, people with BPD may have difficulties in making and maintaining relationships.

Traits of ASPD include impulsivity, anger and associated behaviours including recklessness and deceitfulness. As a result, people with ASPD may experience unstable interpersonal relationships and may disregard the consequences of their behaviour and the feelings of others.

The NICE quality standard on personality disorders: borderline and antisocial consists of 7 statements that highlight different aspects of high quality care that should be available to people with these disorders. These include ensuring that people with possible borderline or antisocial personality disorder have a structured assessment by a specialist in mental health before they are given a diagnosis. The quality standard also states that people with borderline or antisocial personality disorder are only prescribed antipsychotic or sedative medication for a short time if they have a crisis or if they have another condition that needs that medication.

Pressure ulcers

A pressure ulcer, also known as a pressure sore or bed sore, occurs when pressure is placed on the skin for a considerable amount of time, restricting blood supply. Typically, they occur in a person confined to a bed or chair most of the time by an illness. They affect people of all ages, but people over 70 are particularly at risk because they are more likely to have mobility problems, and because of their skin being more fragile. 

The new NICE quality standard on pressure ulcers covers the prevention, assessment and management of pressure ulcers in all settings, including hospitals, care homes with and without nursing, and people’s own homes. It covers people of all ages, from neonates to older people. 

Urinary tract infections in adults

Urinary tract infection (UTIs) in adults is common - around 10–20% of women will experience a symptomatic UTI – and is the second most common reason for treatment with antibiotics. However, there is considerable evidence of variation in the use of diagnostic tests, interpretation of signs or symptoms and initiation of antibiotic treatment.

Drawing on the Scottish Intercollegiate Guidelines Network 2012 guideline on Management of suspected bacterial urinary tract infection in adults, the new NICE quality standard on UTI in adults consists of 7 statements focusing on the assessment, diagnosis and treatment of UTI in adults. These include highlighting that      men with symptoms of an upper urinary tract infection are referred to a specialist for urological tests, and that adults with catheters and non-pregnant women who have bacteria in their urine but no symptoms of urinary tract infection should not be prescribed antibiotics.

If you would like more information on any of these standards, please contact the NICE press office.

Ends

For more information call the NICE press office on 0300 323 0142 or out of hours on 07775 583 813.