The guidance includes: supporting the attachment of looked-after children; managing intravenous fluid therapy in children; managing and diagnosing tuberculosis (TB) and measures for its prevention and control; and the social care needs of older people with long-term health conditions. The full list of draft guidance is set out below:   

Children’s attachment

As the number of children in England’s care system is rising, NICE has opened consultation on a new draft guideline to help ensure that vulnerable children and young people are able to develop stable, secure relationships with those that look after them.

The bond children develop with their main care giver (known as attachment) has a huge impact on how they interact with their surroundings. Children who are moving through the care system are more prone to having difficulty developing a secure bond which can lead to problems with their mental health, emotional wellbeing and education.

The draft guideline includes recommendations on how to assess when children are having attachment difficulties, appropriate interventions and the support which should be provided in schools, as well as health and social care settings. The public consultation will be open until Monday 13 July 2015. 

Social care of older people with long-term conditions

NICE is developing a guideline to address the social care needs of older people with multiple long-term health conditions following reports that health and social care services for this group can often be disjointed and hard to access.

As the population ages and more of us live longer, the number of people developing more than one long-term medical condition is increasing.  Nearly 3 million people in England are expected to be living with multiple chronic health problems by 2018, one million more than in 2008. The NICE guideline will highlight ways to best address the growing needs of this group and promote better, integrated care.

NICE has published a draft version of the guideline for consultation aimed at supporting healthcare professionals and social care commissioners, providers - including care homes – and social care workers. Its provisional recommendations address issues including:

• how health and social care services should work together to ensure better integrated care;
• the need for care to be personalised to each individual;
• how social care services can work with others, such as community groups, to tackle loneliness.

Transfusion

Blood transfusions are commonly used as a treatment, from managing the symptoms of cancer and arthritis, to helping people recover after a severe accident or major surgery. In recent years, great efforts made in educating and training healthcare professionals has led to improvements in the use of transfusions in the UK. However it is not yet completely risk-free and there are still instances where patients are suffering from serious avoidable harm. In some instances patients may also be receiving transfusions unnecessarily: official figures have shown inappropriate use over several years.

NICE has opened a consultation on a new draft guideline which sets out best practice advice on the care of adults, children and young people who may need a transfusion. The recommendations cover appropriate use of transfusions, when to consider alternatives and what information should be provided to patients. The public consultation will be open until Monday 13 July 2015.

Tuberculosis (TB)

TB is a growing problem in the UK: over the past 20 years cases have gradually increased, particularly in ethnic minority communities and urban areas where many people originally born in countries with high rates of TB now live. Areas with a high level of homelessness or drug use, poor housing, or general poverty are also at risk. The disease is spread by bacteria in coughs and sneezes which are then inhaled by other people.

The draft updated guideline from NICE, which has been published for consultation, combines clinical advice and public health guidance for the first time. Most people with TB - more than 4 in 5 - can be cured if treated properly. However, taking the wrong dose or combination of medicines, or taking medication irregularly or for too short a time can lead to drug resistance. If left untreated, 1 person with pulmonary TB could potentially infect as many as 15 people every year.

The draft guideline makes recommendations on the prevention, diagnosis and management of TB, including drug resistant forms of the disease.

NICE is calling for comments on the draft guideline. The consultation will remain open until Monday 13 July 2015.

Intravenous fluid therapy in children

Intravenous (IV) fluids – which are given to children, young people and adults through a drip to rebalance their bodies’ fluid and electrolyte levels - are some of the most common treatments in hospital. Despite this, there has historically been little formal training and education for hospital staff responsible for prescribing, administering and monitoring IV fluids.

NICE has published a draft guideline for consultation setting out how nurses, doctors and other healthcare professionals can best manage IV fluid care for children and young people under the age of 16.

Caring for children who are receiving IV fluids can be challenging as they may not fully understand why they need a drip. They may find the blood tests to monitor their progress distressing and it can be difficult for hospital staff to effectively monitor the child’s urine output. There is also some debate about whether or not hypotonic fluids - a type of IV solution - are completely safe, and how best to calculate IV requirements for each patient.

The development of this NICE guideline follows the publication of NICE guidance in 2013 focusing on the best standard of care for adults in hospital requiring IV fluids.

Ends

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