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Contents:

1. Shifting the balance of power

2. Leadership development

3. NSF for older people

4. Local Modernisation Reviews

5. Hospital food

6. Improving patient communication

7. National survey of NHS patients - coronary heart disease

8. Improving practice in seeking patient consent

9. Prescription charging arrangements

10. Other items

11. Safety notice

12. Leaderships Regional Allied Health Professions (AHPs)

Shifting the balance of power

An intensive programme has been launched to hand more power to frontline NHS staff.

The last few years have seen a new framework of standards set for the service, through such initiatives as National Service Frameworks and the clinical governance system. Within that framework, the government is now keen to see local services and staff freed up to innovate — recognising that where staff have been in control, they have come up with the goods. Some of the key messages made by Alan Milburn in his speech to the British Association of Medical Managers were:

• Local Health Communities will have more power.
• By 2004, the number of health authorities will reduce by two-thirds to around 30.
• In turn, many of the old health authority functions, including commissioning, will be devolved to PCTs, who will control 75% of the NHS budget by 2004.
• More freedom for local organisations - the new grading system for NHS trusts and PCTs will bring increased autonomy for the best performers.
• AHPs will be supported in cross-service team working. Those who are part of teams working across service boundaries — from primary, secondary and social care — have been proven to make a vital contribution to improving the patient experience.
• Local health services will carry out modernisation reviews over the summer and every member of NHS staff will have the opportunity to contribute.

Leadership development

A joint leadership event was held at the Marriott Hotel in London on March 28-29 involving the Leadership Centres Core Team and Representatives of the Allied Health Professionals Forum. From this, a business plan for 2001-3 is being developed as a key component of the AHP strategy.

Eight allied health professions around the country have been asked to take the lead on leadership in their regions. For details and contacts, see the attachment at the end of this bulletin.

The new head of the Leadership Centre, Barbara Harris, took up her post on June 18. She was previously chief executive of the Royal Bath Hospitals NHS Trust.

NSF for older people

The National Service Framework (NSF) for Older People was published on March 27. It sets new national standards and service models of care across health and social services for all older people whether they live at home, in residential care or are being cared for in hospital. The needs of older people and their carers are a central thread. The NSF leads with plans to:

• make age discrimination a thing of the past by identifying, reviewing and monitoring age-based policies to ensure that health and social care services are provided on the basis of need alone

• ensure older people and their carers receive person-centred care and services which respect them as individuals and which are arranged around their needs, regardless of health and social services boundaries. This is achieved through the single assessment process, integrated commissioning arrangements and integrated provision of services, including community equipment and continence services

• ensure that planning for an older person's discharge from hospital is developed from the time of admission. Where appropriate, an individual care plan must be drawn up to identify the support the patient and their carer requires, if they are to be discharged to home

• achieve milestones for the provision of intermediate care services.

For more information on the NSF for older people, see www.doh.gov.uk/nsf/olderpeople.htm

Local Modernisation Reviews

Feedback from the pilot sites for the forthcoming Local Modernisation Reviews (LMRs) have helped provide a clear framework for the reviews.

It has been agreed that the outcomes from the process should be:

• confidence at national, regional and local level that robust plans are in place to underpin delivery of the NHS Plan
• a clear understanding of the challenges and strategies to manage them
• a diagnosis of the development needs in the service from which Regional Offices can agree support programmes with the Modernisation Agency
• a sound basis locally from which to move into the 2002/03 SaFF round.

There will be a two stage approach to the LMRs. From June to the end of July the NHS, working with its social services and other partners, will be expected to:

• conduct baseline assessments and risk analyses of all PSA targets, NHS Plan deliverables and, if necessary NSF standards and milestones. The risk analysis will need to identify those targets and enabling strategies (capacity, capability and infrastructure) that pose the greatest risk locally
• draw up plans for engaging staff and service users in the development of local measures of success for a user-responsive service that addresses inequalities and provides access to consistently high standards of care.

From August to November the service will be expected to develop actions plans that set out local solutions to delivering high risk targets and implement supporting strategies through investment and reform.

Further information: www.doh.gsi.gov.uk/cebulletin3may.htm#8

Hospital food

The Better Hospital Food initiative launched the new NHS menu in May, designed by leading chefs. Dietitians were heavily involved in this project, which forms the basis of providing better nutritional care for patients in hospital. Trust chief executives will be required to ensure dietitians are involved in planning and monitoring food services in hospitals.

Hospital nutrition policy will be formulated to improve the outcome of care for patients. This covers all aspects of nutritional care for patients, staff and visitors. For patients, this entails identifying their need, appropriate food and artificial nutrition.

Improving patient communication

Direct patient communication is a key part of the patient experience of the NHS, and should be addressed as a component part of the patient's journey alongside clinical and other considerations. However, the quality of written communication to patients is variable, with poor standards needlessly letting the NHS down.

Web pages (www.doh.gov.uk/kearbubgzone/letters.htm) have been developed to support the NHS to make improvements in written communication through:

• links to external sources of advice
• checklists of common needs and information
• standard templates for appointment, admission, test results, cancellation of appointment/admission and complaint letters.

National survey of NHS patients — coronary heart disease

The second national survey of NHS patients in England was carried out as a self-completion postal questionnaire in 1999. The purpose was to assess the quality of NHS patient care as seen by hospital in-patients and day patients who had been treated for coronary heart disease.

The report can now be viewed at www.doh.gov.uk/public/nhssurveys.htm

Improving practice in seeking patient consent

The Reference Guide to Consent for Examination or Treatment has now been published by the Department of Health. It is available from the department's website at www.doh.gov.uk/consent and also from the Department of Health Stores, PO Box 777, London SE1 6XH or on the NHS Response Line, 08701 555 455.

Prescription charging arrangements

From April 1, there are some differences in the prescription charging arrangements between Wales and the rest of the UK. In Wales the prescription charge remains at £6 and young people under 25 are entitled to free prescriptions; in England, the charge is £6.10 and the exemption arrangements are unchanged, i.e. children under 16 and under-19s in full-time education are entitled to free prescriptions.

The arrangements to apply will be those appropriate to where dispensing takes place. If dispensing takes place in England, English rules will apply even if the prescription was written in Wales or the patient has an address in Wales.

Other items

Recent bulletins to NHS chief executives and HR directors include items of potential interest to Allied Health Professions.

Chief executive's bulletin March 30-April 5 (www.doh.gov.uk/cebulletin5april.htm) includes items on:

• NHS collaboration with external funders of research and development
• Health and Social Care Planning 2001/2002
• Intermediate care: model contracts
• National Service Framework for mental health — Workforce Action Team
• Research governance framework for health and social care: baseline assessments for NHS organisations

Chief executives' bulletin April 27-May 3 (www.doh.gov.uk/cebulletin3may.htm) includes items on:

• Investing in primary care
• NHS performance indicators: a consultation
• Non-UK residents: charges for hospital treatment
• Guidance on Trust connection to NHSnet
• NHS Team Bonus pilots
• Draft guidance: Carers Grant 2001/2002

Chief executives' bulletin May 4-10 (www.doh.gov.uk/cebulletin10may.htm) includes items on:

• NHS Performance Fund 2001/02
• Coordinated service planning for vulnerable children and young people in England
• Governance arrangements for NHS Research Ethics Committees
• Representation of the People Act 2000: voting rights of detained patients
• Promoting Independence Grant 2001/02

Chief executives' bulletin May 11-17 (www.doh.gov.uk/cebulletin17may.htm) includes items on:

• Achieving the NHS Cancer Plan waiting times targets
• Local Capital Modernisation Fund
• National Clinical Assessment Authority starts work
• Inspection of Best Value reviews in Social Services
• Preserved rights: amendment to regulations governing circumstances in which councils can provide financial support

Human resources directors' bulletin May 2 (www.doh.gov.uk/hrbulletin13.htm) includes items on:

• HR in the NHS Conference, June 19
• New structure for speech and language therapists — top grade
• Pay modernisation talks
• Recruitment campaign pack — evaluation

Chief executives' bulletin April 20-26 (www.doh.gov.uk/cebulletin26april.htm) includes items on:

• Moving to mainstream — fourth wave of the National Booked Admissions programme
• £3 million a year for primary care cancer leads
• Publication of Handling Complaints: Monitoring the NHS Complaints Procedures
• Reducing GP paperwork: help with telephones and minor home adaptations under the Chronically Sick and Disabled Persons Act 1970

Chief executives' bulletin April 6-12 (www.doh.gov.uk/cebulletin12april.htm) includes items on:

• Pay for NHS senior managers 2001/2002
• Drug treatments for multiple sclerosis
• Clinical guidelines on the management of hepatitis C
• NHS Professionals — an update
• Exercise referral systems: a national quality assurance framework

Chief executives' bulletin April 13-19 (www.doh.gov.uk/cebulletin19april.htm) includes items on:

• Research governance framework for health and social care: baseline assessments for NHS organisations
• Surveillance of healthcare associated infections

Safety notice

Safety Notice MDA SN2001(09) ACCUVAC Rescue Aspirator (Portable Suction Pump): Possibility of Inadequate Suction

This safety notice was issued on March 30 to NHS Trust and health authorities. An electronic version can be found at www.medical-devices.gov.uk/sn2001(09)htm

Leaderships Regional Allied Health Professions (AHPs)

The documents in this bulletin are Crown copyright but may be reproduced by NHS and Local Authority staff without formal permission or charge for personal or in-house use - ©2001

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copyright: © | published: Mar. 24, 2002