Winner: Central and Eastern Cheshire PCT and Mid Cheshire PCT

NICE guidelines were the starting point for a project that set out to reduce incidences of pressure ulcers across primary and secondary care

Compliance with NICE guidelines on pressure ulcer prevention and treatment was low and a project was developed to push this to 100 per cent over a two-year period.

The ultimate objective was to reduce the number of pressure ulcers across primary and secondary care.

The judges described this entry as: "An excellent project with lessons that could be usefully applied to other parts of the NHS and the care sector."

To standardise and implement the guidelines across two primary care trust areas and one hospital trust (which in the past have had different resources, levels of training and availability of pressure-relieving equipment), the tissue viability service took the lead on the project on behalf of Mid Cheshire Hospital trust and Central and Eastern Cheshire PCT.

The project led to improved patient documentation, better educated and more aware staff, refined local guidelines and pathways, a new central equipment and decontamination store within the hospital, and management of pressure-relieving equipment by the tissue viability department in the community.

The project has improved adherence to the guidelines; ensured delivery of evidence-based care; created a robustly monitored service measured against NICE guidelines; and meant no admissions into hospital or delayed discharges as a result of pressure-relieving equipment being unavailable.

It has reduced costs on dressings through a formulary across hospital and community, which ensures only modern dressings are used.

All pressure-relieving equipment is available within four hours of assessment and the community service meets infection control guidance for decontamination of pressure-relieving equipment.

Pressure ulcer prevention and treatment, contact

Finalist: Greater Manchester and Cheshire Cancer Network

Clinical nurse specialists in the Greater Manchester and Cheshire Cancer Network identified a deficit in the routine referral of female patients with cancer to a fertility specialist, which is recommended by NICE fertility guidance. The judges said this was: "An important and innovative project with significant learning opportunities for other cancer networks."

Fertility consultation and preservation services were implemented for these patients, in liaison with the reproductive medicine unit at St Mary's Hospital in Manchester.

Patients are contacted with an appointment to see a fertility expert within seven working days.

Cancer network's fertility project, contact

Finalist: Islington PCT

This introduced a pulmonary rehabilitation programme to primary care, in accordance with the 2004 NICE guidelines on chronic obstructive pulmonary disease.

Patients with COPD are referred through GP practices to an eight-week programme of exercise and education run by a respiratory physiotherapist and a respiratory nurse.

Quality of life has improved, with reduced breathlessness on exertion, increased exercise capacity, improved self-management and symptom control and greater independence. The programme is part of a long-term conditions team and operates across social services, primary and secondary care and the voluntary sector.

Embedding pulmonary rehabilitation into primary care, contact

Finalist: Oak Tree Surgery

Since its launch in October 1998, the prescribing of the anti-platelet agent clopidogrel (Plavix) had grown exponentially across Brigend, to a level significantly higher than the rest of Wales.

A local guideline was developed by doctors and pharmacists from primary and secondary care with a special interest in coronary heart disease, based on evidence from SIGN and NICE.

Practices now invite patients for review, which helps ensure those who require anti-platelet therapy receive appropriate, safe treatment, thus reducing the risk of interactions and side effects. Bridgend local health board's levels of clopidogrel prescribing are now consistently below the national position.

Review of anti-platelet prescribing, contact

Finalist: West Midlands Ambulance Service trust

The trust felt that the NICE guidance on the management of febrile children was a significant change in managing this group of patients and was highly relevant. It devised an implementation plan to inform and educate clinical staff on how to use it.

The trust produced a summary of the guidelines, a laminated quick reference guide and a training package for the new guidelines; it also purchased new thermometers.

Recognition of febrile illness in children has improved, resulting in better management of these patients.

The judges said: "Good, effective piece of work, delivering benefits and improving care for young children."

Implementation plan to inform and educate staff, contact