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Bulletin for allied
health professionals
Patient choice: the next steps The next steps towards an NHS where every patient has a choice of when, where and how they are treated have been set out by the Department of Health. Following a national consultation that reached 110,000 people, a strategy paper – Building on the Best; Choice Responsiveness and Equity in the NHS – has been published. The key measures outlined in the paper include:
Building on the Best will expand the choices already being extended to patients for hospital treatment. Patients waiting more than six months for heart surgery are being offered the chance to have operations in other hospitals within the NHS, in the private sector or abroad. This choice is being extended to other specialties. More at www.doh.gov.uk/choiceconsultation/index.htm AHPs encouraged to expand roles New guidance encouraging AHPs to develop primary and community care services by focusing on areas of special interest has been published by the Department of Health. Implementing a scheme for Allied Health Professionals with Special Interests recognises the importance of multi-professional teamwork by outlining how AHPs and their respective trusts can improve patient care through service redesign. It also highlights a number of pilot schemes involving AHPs with special interests (AHPwSI) through which key lessons can be learned. This complements guidance already made available to GPs and nurses with a special interest. Chief health professions officer Kay East said: "The professions which make up the allied health professions have always understood the broader context of service provision across health and social care, whilst understanding and appreciating the needs and values of service users. "Their aim has always been to provide high-quality, effective and integrated patient care which meets the health needs of their local communities. In doing this they have worked hard to develop the clinical, intellectual and personal skills of both professionally qualified staff and the support workers who are an essential part of the team." The guide highlights the issues which must be addressed when developing an AHPwSI service, including identifying who will use the service and the factors governing a patient’s care pathway. Any planned AHPwSI service should be located somewhere convenient for patients but also make effective use of resources. Possible sites include GP surgeries and health centres. Expanded AHP roles highlighted include a dedicated SLT-led service for ear, nose and throat patients at York Hospital NHS Trust and a community OT at Cambridge City Primary Care Trust. Patient involvement in each step of the service design process is also crucial, with feedback encouraged through patient forums and their satisfaction measured as part of the evaluation process. Kay East said: "This document demonstrates the innovation of these service providers who have moved things forward by developing excellent clinical services. "They are driving forward a new network of health and social care services not dependent on professional or organisational boundaries." Implementing a scheme for Allied Health Professionals with Special Interests is at www.doh.gov.uk/chpo The redesign of physiotherapy services in Huntingdonshire PCT is paying dividends for both clients and staff. Physio Direct allows patients needing physiotherapy to telephone a dedicated helpline for advice and, if necessary, an appointment, without being referred by a GP. Specialist AHPs in the form of a consultant physiotherapist and an extended scope practitioner lead the service. It was introduced after physiotherapists noted that people were being referred for treatment later than necessary by GPs, which limited access to services. Huntingdonshire PCT provided £15,000 to get the project, based at Hinchingbrooke Hospital, up and running. Already the service has improved access rates and cut the ‘did not attend’ rate to less than one per cent. A review of the trust by the Commission for Health Improvement has also highlighted the scheme as an area of notable practice. Consultant physiotherapist Jill Gamlin said: "Once patients are in the physiotherapy system they can be managed by us to the point of handover to secondary care if required. The GP is informed that this is happening rather than wasting valuable time sending the patient back to the GP for onward referral." By March next year all PCT patients will have access to Physio Direct. The next stage of the pathway redesign will be to set up an orthopaedic screening panel in primary care to ensure that GP referrals direct to secondary care are appropriate. Jill added: "Our current experience in physiotherapy extended scope practitioner clinics is that up to 70 per cent of referrals to orthopaedic surgeons can be redirected and managed by physiotherapists. "This is a complete redesign of the way patients access physiotherapy services and are managed through to secondary care. The impact of the scheme will be great and far-reaching." For more information e-mail Jill.Gamlin@hinchingbrooke.nhs.uk Improvement partnership for ambulance services The modernisation of ambulance services and leadership development in the service will be supported by a new partnership. The Improvement Partnership for Ambulance Services (IPAS), backed by £1 million of government funding, will help trusts improve performance and spread good practice. The Department of Health, the NHS Modernisation Agency, ambulance trust chief executives and other key stakeholders are all involved in the project, which will support improvement in emergency response times, clinical effectiveness and non-urgent patient journeys. It will also contribute significantly to other NHS targets including the four-hour A&E target, emergency care reforms, national service frameworks, access to thrombolytic drugs and out-of-hours services.
Improvements in leadership skills and better integration with the NHS are also aims of the recently launched IPAS Leadership Development Portfolio which is focused mainly on zero and one-star ambulance trusts. Part of the Raising Standards improvement programme designed to see all NHS organisations achieve three-star status, the development portfolio will give ambulance trusts easier access to leadership training for frontline staff and board members. Future NHS Leadership Centre middle management development programmes will also reserve places for ambulance staff and there will be other middle management leadership development opportunities for ambulance managers. More at www.modern.nhs.uk/ambulance Emergency care practitioners – a new way forward The new role of emergency care practitioner (ECP) is helping to drive forward patient care reform within the NHS. The number of emergency 999 calls continues to increase each year, with ambulance services currently responding to around five million 999 calls. The introduction of new roles like ECPs means the number of patients who are treated at the scene of an incident and don’t need to be treated in A&E continues to rise. To build on these developments and help reduce the workload in A&E and primary care out-of-hours services, the NHS Modernisation Agency is working with 14 sites to develop the ECP role. The role of ECP involves training paramedics and other allied health professionals to work in A&E and GP practices to diagnose and treat a wide range of conditions. ECPs also refer patients to other health care services where necessary. Andrew Newton, a paramedic adviser for the Department of Health, said: "There is a pressing need to modernise the training and education of paramedics to enable NHS emergency services to respond to patient needs more appropriately. The ECP initiative is a very important and welcome development that reflects the best aspects of the modernisation agenda. "A recent survey by London Ambulance Service on best practice for ECPs has revealed the pilots are making good progress. Patients are receiving a more appropriate level of care far more rapidly. Once further evaluation has taken place within the existing sites, it is hoped training for ECPs will be rolled out nationally in the next 18 months. We will now concentrate on developing national education guidelines." A good example of the ECP initiative can be seen in South Yorkshire Ambulance Trust. Working across South Yorkshire’s health and social care services, the scheme enables older patients to be treated at home by paramedics who have undergone four months training with Sheffield Teaching Hospitals and Sheffield Hallam University. This has enabled paramedics to assess and treat patients who fall or suffer a minor injury in their home and also identify the need for x-ray, suture wounds, administer certain drugs and assess head injuries. South Yorkshire Ambulance Trust chief executive Ray Shannon said: "The project has already resulted in more than half of older patients with minor injuries being treated at home so they don’t have to present at A&E." Staff praised for part in NHS progress AHPs are making a strong contribution to the NHS’s continued improvement in performance. Patients are being seen faster than before and getting more treatment in their communities and in their homes. Health secretary John Reid thanked NHS staff for their hard work and commitment which has seen waiting times fall over the past year. The number of patients waiting longer than one year for their operation fell from 16,689 in September 2002 to 114 in this September and the number of people waiting longer than 21 weeks for an outpatient appointment fell by 99 per cent to 198. More than 93 per cent of patients were also able to see an AHP in primary care within one working day. Therapists are also helping to provide more care for people at home and in the community. About 4,000 more people were receiving intensive home care than the year before and the number of delayed hospital transfers for patients over 75 dropped to 2,998 in September, compared to 4,147 the year before. The AHP workforce is also increasing. At the last count there were 53,460 qualified AHPs working in the NHS compared to 51,320 the year before. And the number of training places has risen by almost 2,000. The figures are revealed in a report by NHS chief executive Sir Nigel Crisp on the progress being made against NHS Plan targets. Sir Nigel said: "Too often people try to judge value for money in the NHS by looking only at acute hospital admissions - in fact, the vast majority of patient care is provided outside hospital settings. "This report shows that we’re beginning to see operations, which used to need a stay in hospital, move to take place outside hospitals, in the community, by different groups of staff. "This year we expect to see more excellent progress – the capacity to treat more patients is growing as more staff are appointed and new services and facilities come on line." More at www.doh.gov.uk/nhsreport/index.htm Celebrating the work of radiographers The work of radiographers has been celebrated both across the NHS and internationally as part of World Radiography Day which took place on 8 November. Departmental open days were organised to introduce the profession to local schoolchildren and the public, and many were delighted with the response. Superintendent radiographer Barbara Turner at the Kent and Canterbury Hospital, part of East Kent Hospitals NHS Trust, said: "We were absolutely inundated with visitors from the moment we opened the doors. "We had a wide range of people interested in finding out more about radiography, from A-Level students and those wanting a career change to people who had previously worked in radiography but thought they were past their sell-by date." At a national level, the Society of Radiographers selected Margaret Waltier of Halton Hospital in Runcorn, part of the North Cheshire NHS Trust, as the UK Radiographer of the Year for her work both in the UK and also in Ghana. Margaret regularly travels to Ghana to teach in hospitals and universities, as well as lobbying hard for better conditions for patients in the UK. "It makes me feel very humble to have won," she said. "I want to help people and if, at the end of the day, I can make someone a little happier then that is good enough for me." A special award was also made to Jane Tomlinson, a radiographer from Leeds General Infirmary, who was voted a BBC Sports Personality of the Year in 2002 for her courage in the face of adversity. Jane has raised hundreds of thousands of pounds for charity by running in the London marathon, Great North Run and various triathlons and long-distance cycle races since being diagnosed with incurable cancer in 2000. Earlier this year she received an MBE. More on radiography skills mix projects at www.doh.gov.uk/radiography/index.htm Therapists across England are being encouraged to create a more soothing and convivial atmosphere for patients, families and NHS staff. Hospitals in London have already been using colour, light and design to help ditch the dreary image of hospital corridors and brighten their surroundings. Now the Enhancing the Healing Environment programme, run by the King’s Fund and funded by NHS Estates, is being extended to 23 trusts nationwide. Nurse-led multi-disciplinary teams, including physiotherapists, occupational and art therapists, will each have a £35,000 budget with which to bring their creative projects to life. New pieces of art and sculpture have already transformed patient waiting rooms and wards, improving staff recruitment and retention, enhancing the well-being of patients and even cutting cases of aggressive behaviour. Staff at the Mayday University Hospital brought a touch of the Mediterranean to Croydon by turning a bland courtyard into a Roman-style garden. At Great Ormond Street Children's Hospital, artwork has been placed at the operating theatre entrance to reduce patient stress and fear. Enhancing the Healing Environment programme director Sarah Waller said: "We hope to raise awareness among NHS staff about how to bring about practical, value-for-money environmental improvements in hospitals. "The projects already carried out in London have been universally welcomed by patients and staff. They clearly demonstrate the capacity and capability of front line staff to be stunningly creative in improving the environment in which they deliver care." Each acute, primary care or mental health trust taking part was nominated by its respective strategic health authority. The schemes should be completed by early 2005. More details, including a list of the trusts, are at www.kingsfund.org.uk and www.enhancingthehealingenvironment.org.uk AHPs help pioneer improvements at trust Inspectors have praised the high-level involvement of AHPs at a Nottinghamshire primary care trust. The latest Commission for Health Improvement review for Rushcliffe PCT in Nottingham singled out the positive role of AHPs within the trust as a major advantage in pioneering health care improvements. Senior physiotherapist Loraine Wojciechowicz and senior occupational therapist Jo Williams are both members of the PCT’s professional executive committee, giving AHPs a significant voice at a strategic level.
The PCT director of clinical services Angela Bright – herself an occupational therapist by background – is also the board lead for AHPs. "We have a very supportive management team within the trust," said Loraine. "We also have some very dedicated and talented staff. Consequently, AHPs are both well represented and closely involved in the trust’s strategic processes." The CHI report highlighted the trust’s development of care pathways and integrated multi-disciplinary team working. The report said: "Clinicians are driving the clinical audit agenda through strong professional leadership within each service. This is particularly evident with AHPs." Loraine said the example laid down by her own trust was a model she would like to see adopted across all trusts for the benefit of AHPs. "It can sometimes be hard for AHPs because they tend to be fewer in number, more fragmented and they find it difficult to shift people’s views away from the traditional role of doctors and nurses," she added. "AHPs have a lot to offer and while some of the ideas we’ve implemented here are not unique, but the way we have discussed them and put them into practice demonstrates the important part AHPs can play in the strategic process." For more information e-mail loraine.wojciechowicz@gp-c84025.nhs.uk Eliminating therapy waiting lists An integrated service delivery system that has virtually eliminated therapy waiting lists in parts of Australia is being offered in the UK. The Maroondah Approach to Clinical Services (MACS) was created at Maroondah Hospital in Victoria, Australia as a way of tackling a 12-month waiting list for therapy. Since its implementation the wait for treatments has been virtually eliminated and patient research shows satisfaction levels of at least 95 per cent. In one case, Robert, aged three years, nine months was initially assessed in July 2002 and diagnosed with a severe phonological impairment and language delay. His first cycle of treatment finished early due to a worsening of his condition. The family successfully attended a parent-focused fluency group and developed an excellent therapy routine. Robert, now aged four years 11 months has intelligible speech, excellent language skills and mild phonological delay. In the course of his treatment, Robert has received therapy from six different clinicians, with his primary clinician (the assessing clinician) monitoring his progress through cycle reviews. The MACS model combines different service delivery models and used simple mathematical formulae to find the best way of timetabling services for Robert.
Each clinician sets their own working timetable within the requirements of their department and MACS then produces workable timetables for all team members. It has been used in a variety of outpatient settings covering disciplines such as speech pathology, physiotherapy, occupational therapy and psychology. A series of workshops on MACS are being held in the UK in summer 2004. More on MACS and the UK workshops at www.easternhealth.org.au/maroondah/macsMar.html Helping disabled children into mainstream schools Children with disabilities are getting faster access to mainstream education after the appointment of an occupational therapist funded through the Children’s Fund. London borough Tower Hamlets created the new post as a response to the closure of a local special school and the requirements of the Special Educational Needs and Disabilties Act 2001 (SENDA) for schools. OTs had previously been working closely with education staff to identify environmental access difficulties for disabled children transferring into mainstream schools. Unfortunately, this contributed to longer waiting times for OT. Frances Badenhorst was recruited to fulfil a new role of building stronger links between health and education services for children integrating into mainstream schools. She has also been able to provide help to children who would normally have been excluded from mainstream OT services. Frances has undertaken audits of school buildings, working alongside school staff and architects when planning accessible facilities. Collaborative working has helped secure funding for the needed improvements. Her role works in partnership with the physical impairment advisory service in education, allowing for a faster response to requests for advice and new services. "We have been able to draw on each other’s knowledge and skills to identify and address educational concerns quickly," she said. For further information e-mail frances.badenhorst@thpct.nhs.uk SENDA information www.hmso.gov.uk/acts/acts2001/20010010.htm This month chief health professions officer Kay East stresses the importance of research in professional practice, the development of the evidence base and proving that AHPs really do provide quality care for patients This month we invited the Improving the Patient Experience programme manager to our team meeting to discuss implications for allied health professions. Many of you will have read the key messages which introduced the document Fair For All Personal to You and seen that it is through research studies that patients, users and careers have told service providers that they want to participate in decisions about their treatment and care. It is research that has shown us that patients want more choice. We know that in health care, research can be concerned with addressing what works for patients and carers and this has helped to improve the quality of care that is provided. Developing the evidence base to underpin practice is an important factor in delivering services; I know we have many active researchers within the NHS and social care, people who are studying for research degrees and others who enjoy being involved in developing and extending the knowledge base underpinning health care. Sir Nigel Crisp's report to the NHS demonstrates the positive changes that are taking place in health care (see Staff praised for part in NHS progress in Top News). The NHS is committed to delivering clinical services in an environment informed by research, scholarship and excellence, but there is also a responsibility to develop professionals and their practice. It can enhance job satisfaction and provide the baseline for developing services. We know that all AHPs need to be able to use information proactively and time is always limited so skills of critical analysis are essential. Addressing the evidence for and against a proposition and the ability to see connections between apparently disparate areas of knowledge are vital. These are the skills that enable the clinician to critically evaluate developments in health care and critically review their contribution in whatever dimension of care they are working. I fully appreciate that not every AHP can be an active researcher but all of us need to be critical users of research findings. If you have been involved in a project which demonstrates the effectiveness of clinical practice, we would be pleased to put a short piece in the bulletin to raise your profile. If you want to know more visit the Department of Health's research site at www.info.doh.gov.uk/doh/rd2policy.nsf/pages/home?open Special message from Kay East Many of you will be sorry to hear of the death of Jill Simpson, rehabilitation services manager in Salford. Jill was a member of the National Workforce Development Board, the Workforce Taskforce and the Modernisation Action Team. Jill was a great person to work with. Her commitment to integrated working brought together people from many professions who enjoyed working with her and appreciated her sound common sense approach. Discussions have begun between senior AHP officials and workforce development confederations (WDCs) to boost numbers and training for therapists and other health professionals. The first meeting was held with chief health professions officer Kay East, Guy Cross from the Department of Health’s human resources directorate and WDC AHP leads. The main objective of the meeting was to initiate dialogue between the Department of Health and the WDC leads for AHPs, and to introduce the objectives behind initiatives such as the Changing Workforce Programme and the Workforce Review Team. WDCs have responsibility for modernising the NHS workforce. Their remit includes planning the increase of NHS staff and ensuring adequate training for future roles and requirements. One of the main topics considered at the first meeting was how to increase the number of training places available, particularly in relation to radiographers. More on WDCs at www.doh.gov.uk/workdevcon/ NHS electronic recruitment services goes live AHPs will be among those who will be able to benefit from an NHS electronic recruitment project launched on 1 December. The three-month pilot will initially cover London, Hampshire, the Isle of Wight, County Durham and Teeside, and the south west Midlands. National roll-out is expected to begin in March. The service is based on a user-friendly, searchable jobs database and an online application process. NHS employers interested in taking the service, which is centrally funded by the Department of Health, should contact Sarah Clark, project co-ordinator, at sarah.clark@doh.gsi.gov.uk or call 0113 254 5316. The new recruitment website is at www.nhs.uk/jobs More at www.doh.gov.uk/hrinthenhs/electronicrecruitment New Roles for Allied Health Professionals conference The 10 key roles structure will provide a tool for AHPs to actively promote change and improve care for patients, an AHP-led conference heard. Department of Health adviser Shelagh Morris told delegates at Addressing the New Roles for Allied Health Professionals – Promoting Education, Training and Workforce Development that formalising the key roles would also help influence service development locally and nationally and will affect how AHPs work in the future as well as the present. The conference's key aims included highlighting national policy developments concerning AHPs, exploring how acute and primary care trusts can ensure AHPs have access to training and personal development opportunities, and examining the growing influence of workforce development confederations. AHPs can play an important part in the modernisation of services as they develop new roles, which contribute to improve the patient experience. Shelagh Morris said the key roles were established to demonstrate AHP flexibility in working across organisational and professional boundaries. They would also encourage AHPs to take a more active role in strategic planning and developing local organisations' policies and services. Other speakers at the conference included Chartered Society of Physiotherapists' chief executive Phil Gray and the Health Professions Council's education and training committee chairman Professor Diane Waller. More about the conference at www.neilstewartassociates.com/sh142/ Bringing the NHS and local government together An Integrated Care Network has been set up by the Department of Health and is sponsored by a range of Government departments and representative bodies including the Local Government Association, Association of Directors of Social Services, NHS Confederation and the Improvement and Development Agency. The network works with frontline NHS and local government organisations to make sure service planning and delivery is joined up to improve the experience of users, patients and carers. Using the experience of frontline organisations and practitioners, material from research and policy documents, the network has developed a number of ways to support the integration of services. These include an interactive website, national meetings to share information, action learning networks, discussion and briefing papers. Over the next few months the network will be expanding its work to support efforts by AHPs to integrate services. The development of this work will be reported in the AHP Bulletin. Watch this space! The network’s website gives access to its events and publications. By registering with the site, users receive a regular update as to the work of the network specifically and integration generally. It is at www.integratedcarenetwork.gov.uk Court intermediary training for SLTs Speech and language therapists and other communication specialists are being specially trained to act as intermediaries for vulnerable witnesses in court. The Intermediary Pilot Project, run by the Home Office, will provide witnesses with communication difficulties with a trained intermediary who will act as a ‘conduit’ for communication, ensuring that the witness is both understood and understands questions put to them in court. An intermediary’s role includes assessing the person’s communication difficulties, facilitating investigative interviews and court testimony and ensuring that other people are aware of the difficulties being faced by the person, such as sensory impairment. The Speaking Up for Justice report (1998) made 78 recommendations covering reporting crime, identifying vulnerable or intimidated witnesses (VIWs) and measures to assist VIWs before, during and after trials. More than 250 people applied to join the scheme and, of the 47 candidates selected for training, the majority are speech and language therapists. Other suitably qualified professionals are also involved and will be encouraged to apply in the future. Legal issues, note-taking and report writing are among the areas covered. An intermediary standards committee, including representatives from the Department of Health’s AHP branch and the Royal College of Speech and Language Therapists, is also being set up. The scheme will eventually be available to courts across England and Wales. More information from Matthew Capper of the Home Office’s Justice and Witnesses Unit on 0207 273 2088. Art therapists working in palliative care Palliative care patients and carers are benefiting from the work of a dedicated group of art therapists. The Creative Response organisation was formed to provide support for all art therapists working in this field and promotes awareness of its relevance to allied health professions and the general public. Its members work with people who have, or know someone with, a life-threatening illness such as cancer or AIDS, or who have been bereaved. Art therapists are trained to provide the help and encouragement necessary to facilitate what can often be a difficult process, allowing release and resolution in a safe, supportive environment. It can be offered in a variety of settings including a hospice, drop-in centre or in the patient’s own home. Members hold regular study days where they can pool their knowledge, learn from each other’s experience and stay up to date with the latest publications and developments. They also give presentations on all aspects of art therapy, as well as holding training workshops and giving general advice on setting up new services. Joining the Creative Response is free to all state-registered art therapists working in palliative care. To register send your details (name, address, telephone, fax, e-mail, where and in what year you qualified) to The Secretary, Creative Response, The Old Coal House, Station Road, Ardleigh, Colchester, Essex, CO7 7RR or e-mail mandy@pratt35.freeserve.co.uk More information at www.creativeresponse.org.uk New guidance aimed at ensuring NHS chaplaincy services reflect the religious diversity of the communities the NHS serves has been unveiled. Patients are set to benefit from improved support from NHS hospital chaplains following the launch of NHS Chaplaincy: Meeting the Religious and Spiritual needs of Patients and Staff. The Department of Health guidance for NHS trusts sets a framework for the provision of chaplaincy services and will be used as a good practice guide. It has been cited as truly multi-faith, having been written and developed by multi-faith organisations. Chief nursing officer Sarah Mullally said: "The modern NHS should be capable of responding sensitively to the diverse nature of the communities it serves. One way of doing this is for multi-faith support and guidance to be available to today's multi-cultural and spiritually diverse patients and staff." She added: "Chaplains make a valuable contribution to bereavement care, support and guidance for both patients and staff, and have a commitment to high standards in recruitment practice, both for chaplains and volunteers." More at www.doh.gov.uk/chaplain International multi-professional education Delegates at an international conference found that the UK experience of multi-professional education and regulation in health and social care had many interesting lessons for the rest of the world. Some 300 people from 35 countries representing around one dozen health professions attended an international conference in Australia where the UK experience was admired. Two representatives from the Health Professions Council (HPC), chief executive and registrar Marc Seale and education director Peter Burley, found that the current UK structure, whereby no one profession was dominant and where standards were universally applicable, was widely admired. Many countries are now finding that multi-professional approaches are the only viable means of developing their services. What they learnt from the UK was a particular way of achieving multi-professional outcomes which had not been tried before. Considerable interest was shown in the way the HPC has set standards for all professions simultaneously and identified a common thread of shared expectations about maintaining competence, performance and ethics. The conference was organised by The Network: Towards Unity for Health, a non-governmental organisation related to the World Health Organisation. More at www.the-network.org Food industry challenged over salt levels Food retailers, manufacturers and caterers have been told to cut salt levels in processed foods to improve people's health or face having to carry warning labels. These options were debated at a national Salt Summit set up to promote healthy eating, tackle obesity and reduce high blood pressure, stroke and heart disease. Excessive salt intake can lead to high blood pressure and over a third of adults suffer from the condition, which contributes to around 100,000 deaths from heart disease and 50,000 deaths from stroke each year. The British Dietetic Association, which represents dietitians, is supporting the Government’s call. Registered dietitian and the association’s spokesperson Amanda Wynne said: "It would be useful for consumers if the salt content was included on the food label so they would have a better understanding of how much salt is in a food." Currently an average ready meal contains half the total daily recommended amount of salt for adults. To meet the recommended daily intake, an average reduction of 40 per cent would be required in beefburgers, between 20 and 40 per cent in breakfast foods and bread, and one third in baked beans. Amanda added: "About three quarters of the salt we eat comes from processed foods, so any measures by the food industry to reduce the salt content of processed foods would be welcome. "In terms of what we can do ourselves to cut down on salt, we can limit our intake of high salt foods and snacks and avoid adding salt during cooking or at the table." More at www.foodstandards.gov.uk Personality disorders guidance New guidance on treating people with personality disorders has been published by the National Institute for Mental Health in England (NIMHE). Many people with personality disorder have been considered untreatable in the past. Agencies and practitioners have been confused and uncertain about how to respond to the complex needs of people with this diagnosis. Breaking the Cycle of Rejection: The Personality Disorder Capabilities Framework aims to help create a workforce with a better understanding of personality disorder and its impact on individuals, families, agencies and society. It follows discussions with service users, staff, trainers, workforce development confederations and professional bodies. Agencies wanting to develop training programmes can use the framework to identify which staff require training to support the user pathway at identified points including initial access and referral, sustained episodes of treatment and care, and supporting recovery. The Department of Health is to allocate £2 million for training programmes through the eight regional NIMHE development centres during 2004-2005. Enquiries should be directed to the regional personality disorder leads at the NIMHE development centres at www.nimhe.org.uk The framework is at www.nimhe.org.uk/downloads/personalitydisorders.pdf Examining psychological services Expanding the psychological services provided by Mersey Health Care NHS Trust was the focus of its latest ‘open space’ event for service providers and users. The open space concept allows all participants to join in a series of discussion workshops, with the topics decided by the delegates. Breaking Down Walls and Building Bridges examined how psychological services in the Merseyside area should operate and develop as a new and larger service. More than 200 delegates, comprising service users and carers, and representatives of other key local partners, attended the event at Aintree Racecourse. Around forty topics were suggested for workshop sessions and all the ideas put forward have been circulated to staff. Mersey Health Care NHS Trust’s psychological services clinical director Dr Mary Jackson said it had been a ‘great success’. More at www.merseycare.nhs.uk National occupational standards consultation AHPs are invited to respond to a consultation on the review of the national occupational standards and care awards. Supporting the allied health professions is just one of the functions related to this area, with others including blood and renal services and perioperative care. The outcome of the consultation, which runs until 31 December, will have significant implications for the structure of awards in the health care field. It is also running alongside a sister project to develop the national occupational standards and awards relating to health and social care jointly and which is subject to separate consultation. You can take part by visiting www.skillsforhealth.org.uk Alternatively, you can register for one of five events being held across the UK. There have also been a number of focus groups held with individual AHP staff groups including chiropody, speech and language therapy and occupational therapy. More information from Dawn Allen on 01782 710158 or Niki Marshall on 0117 922 1155. Did you see the news about…? If you missed an announcement or new development of interest to you, the chances are that it could be listed in The Digest. Each month in The Digest we feature subjects of note including where to obtain more information. A message board is being trialled on the AHP project web pages of the Greater Manchester Workforce Development Confederation. Users going to http://gmconfed.org.uk/core_developments/ahp can share their views, best practice, advice, contacts and other key information. For more information e-mail project manager Tárávandaná at taravandana@gmconfed.org.uk or telephone 0161 234 6692. The Government is to introduce new legislation in health and child care. The Human Tissue Bill will tighten up the rules on the circumstances under which doctors are allowed to retain organs and tissue from dead patients. A new independent ‘champion’ for children is promised in the Children’s Bill, following recommendations proposed by Lord Lamming in the Victoria Climbié report. The bill aims to improve the tracking and sharing of information between child care services after every child has been allocated an identity number. The full Queen’s Speech is at www.number-10.gov.uk/output/Page4897.asp The number of Government health agencies is expected to be reduced as part of the drive to reduce bureaucracy in the NHS. NHS chief executive Sir Nigel Crisp will explore the scope for combining some functions of 31 health agencies currently in operation, employing more than 19,000 staff. A further eight bodies are due to start operation in 2004. More on tackling bureaucracy at www.doh.gov.uk/bureaucracy/ Next wave of NHS foundation trusts The next wave of NHS trusts eligible to pursue foundation status has been unveiled. To date 32 trusts have submitted preliminary applications, with a view to adopting foundation status from October next year. Having passed the preliminary application stage, they must now submit a more formal application to the Department of Health demonstrating they have put in place the systems and structures needed to operate as a foundation trust. More at www.doh.gov.uk/nhsfoundationtrusts/ Primary care trusts (PCTs) will be commissioning NHS Direct services from next year as a result of funding changes. From next April NHS Direct will become a special health authority with legal responsibility for delivering all existing NHS Direct services. PCTs will be given the money to purchase the nurse-led health advice services through arrangements agreed by strategic health authorities. Further information is available by e-mailing admin.nhsdirect@doh.gsi.gov.uk Out-of-hours care for patients in deprived inner city and remote rural areas will be backed by an extra £28 million from the Government. The funding is aimed at helping local areas deliver health care from December 2004 when GPs can opt out of providing out-of-hours (OOH) services. This choice is available under the new GP contract. Earlier this year, the Department of Health set aside £110m for OOH care. From next April, it will be the responsibility of all primary care trusts (PCTs) to ensure adequate, high-quality OOH services are available for the communities they serve. Details of each PCT’s share have now been released. More at www.doh.gov.uk/pricare/oohreview.htm A new drive to reduce health inequalities across England has been launched. NHS trusts, local authorities and other organisations will be able to use a new set of indicators to track progress against targets. This will help to identify areas that need further support and investment. The new indicators relate to areas including poverty, homelessness and lifestyle. Next year the first ever annual report on health inequalities will be published, providing a national stocktake of progress as well as recognising local achievements. More at www.doh.gov.uk/healthinequalities/ A further £100 million has been allocated for local councils to provide further support for older people. The additional funds are on top of the £220 million councils have already been allocated for older people’s services for the forthcoming year. In total, councils will receive an extra £775m for adult social services next year – an 8.2 per cent increase on the current year. This also includes services for disabled adults. The Department of Health will give councils freedom to use resources in the best way to meet local needs. But councils will be expected to meet tough targets, which include speeding up assessments of older people’s individual needs and reducing delayed discharges. More at www.doh.gov.uk/ssi/socialcareolderpple.htm Social service performance improves Star ratings for councils show there have been significant improvements in the performance of social services. Ratings published by the Social Services Inspectorate (SSI), show that 60 per cent of councils now have either two or three stars. The SSI found that 97 per cent of child protection reviews are being carried out at the correct time. Five per cent more households are getting intensive home care and 57 per cent of older people receiving home care services say they are very or extremely satisfied. The SSI report is at www.doh.gov.uk/pssratings Antony Sheehan, joint head of mental health at the Department of Health, has been appointed as its director of care services. Accountable to the chief medical officer Sir Liam Donaldson, his portfolio includes mental health, children’s services, older people’s care, disabilities and prison health. The role will allow Mr Sheehan, former chief executive of the National Institute for Mental Health in England (NIMHE), to continue to shape the future of mental health provision, while influencing other key policy areas within the care services portfolio. Anne Richardson becomes acting group head of mental health and Phil Sculthorpe becomes acting chief officer for NIMHE. More at www.nimhe.org.uk An advisory group involving patients and charities is being set up to tackle lung cancer and a framework is being developed for the local provision of Positron Emission Tomography (PET) scanners, which show great potential for assisting in the diagnosis of the disease. In particular, PET may help to better identify how far the cancer has progressed so more appropriate care can be provided. The framework will encourage and enable hospital and primary care trusts to work together to buy and fund more machines across the country and improve access to the scans for patients. More at www.doh.gov.uk/cancer A new treatment toolkit for coronary heart disease (CHD) to help NHS heart professionals assess their own performance has been published. The National Workforce Competence Framework for Coronary Heart Disease is designed to help cardiac nurses, doctors and other health care professionals build on their strengths and identify weaknesses that need further development. It specifies the standard of performance expected of staff as they carry out activities involving heart services and identifies the knowledge and skills they require. The toolkit concentrates on prevention, heart failure and rehabilitation. More at www.skillsforhealth.org.uk/ubbthreads/postlist.php?Cat=&Board=pub_coron_heart_disease A good practice guide has been launched as part of the drive to reduce accidents in the NHS. The National Patient Safety Agency (NPSA) has produced the publication to coincide with the launch of a new national network of patient safety managers. Seven Steps to Patient Safety identifies actions that NHS organisations should take to improve safety and meet clinical governance, risk management and control assurance targets. More at www.npsa.nhs.uk Faster access to NHS information A one-stop website has been launched to give patients faster access to information and advice on a wide range of NHS services. The website – www.nhs.uk – tells patients how to find their nearest NHS walk-in centre and how long they can expect to wait for treatment. The nhs.uk data on waiting times also helps patients make informed choices about their care and links them up with electronic booking systems based at GP surgeries. The site gives details of local hospital services and, in some cases, allows people to send e-mails to patients in hospital. NHS patients will benefit from the latest advances in medical science with the launch of a new £10 million bioscience strategy. A working group is being set up to develop practical proposals for improving patient benefits from research conducted within the NHS. This will build on the Government's success in doubling the number of cancer patients in clinical trials through the national cancer networks. The aim is to replicate this achievement in fighting other major diseases such as heart disease, diabetes and mental health disorders.
More at www.bioindustry.org/bigtreport NHS professionals aspiring to be leaders of the future are being invited to apply for the next intake of a leadership programme, designed to equip senior professionals with people management skills. The Leadership through Effective People Management programme is recruiting for the fourth time to this highly successful programme and the deadline for applicants is 31 January 2004. The core programme is spread over an 18-month period and includes six residential modules at Manchester Business School, followed by six two-day learning sets. Participants will also carry out local projects and have the opportunity to complete additional modules in European and US best practice. The programme also offers an option to be accredited at MSc level. Details of the programme and the application process are at www.hrmdev.com/ NHS and Primary Care magazines The magazines aim to spread good practice, stimulate debate and keep health professionals up to date with the latest developments. They can be read at www.nhs.uk/nhsmagazine/primarycare/index.asp The following are recent parliamentary questions relating to AHPs. To access the information click on the links. Chiropody Podiatry Occupational therapy Speech and language therapy 28
October Leading for improvement Leading for improvement – through partnerships and choice will take place at the Birmingham ICC on 4 March 2004. Aimed at all middle to senior managers and clinicians working in the NHS, the conference, run by the NHS Leadership Centre, will explore the key leadership issues facing the NHS today. High-profile speakers from industry, the NHS Leadership Centre and the Department of Health, including NHS chief executive Sir Nigel Crisp, will provide insight into state of the art leadership thinking and how this can be applied practically within the service. There will also be a range of innovative breakout sessions and workshops targeted at specific NHS audiences. AHPs who are currently in a leadership role or are seeking to develop their leadership capability should find the day a rewarding and stimulating experience. Further details from 020 7633 0336 or e-mail leadingforimprovement@eventsregistration.com quoting AHP Bulletin Critical care The NHS Modernisation Agency is holding a conference on critical care on 5 March 2004 at the International Convention Centre, Birmingham. Early registration is advised as numbers are limited. To register contact Classic Conferences on 01827 285800 Enabling patient confidence through rehabilitation This conference will be held on 30 March 2004 at St George’s Hospital Medical School, London. It aims to promote confidence among patients undergoing rehabilitation. It will be of interest to physiotherapists, occupational therapists and their colleagues working in acute and community settings. For further details and booking call 0208 7250220 Occupational therapists – Building the Future The Council of Occupational Therapists for the European Countries (COTEC) is holding its 7th European Congress of Occupational Therapy – Building the Future – from 22-24 September 2004 at the Hilton Hotel in Athens. Further details at www.triaenatours.gr The deadline for early registration is 31 January. Information on COTEC activities is at www.cotec-europe.org or e-mail the secretariat at beryl.steeden@cot.co.uk
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