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Chief Executive Bulletin 7 - 13 September 2001
Issue 83

 
Home Publications Chief Executive Bulletin

Hard copy versions of these publications can be ordered from the NHS Responseline 08701 555 455.

Contents:

NHS interest

  1. New Powers for HAs and PCTs to Discipline FHS Practitioners
  2. Training: Annual Appraisal for General Practitioners
  3. New Legislation to Facilitate Electronic Transmission of Prescription Pilot Schemes
  4. Out of Area Treatment Adjustment and Specialised Services
  5. Language Testing for General Dental Practitioners Seeking Admission to Health Authority Dental Lists

NHS and Social Care interest

  1. Children and Adolescents Who Try to Harm, Hurt or Kill Themselves
  2. SAFETY NOTICE - MDA SN2001(25) Oesophageal Stent (EsophaCoil®): Increased Potential for Fracture

NHS interest

1. New Powers for HAs and PCTs to Discipline FHS Practitioners

The Department of Health has provided a new and better framework for dealing with the very small minority of people whose fitness to provide family health services is in question, in line with the NHS Plan. They are part of the overall effort to improve the quality and management of NHS services and most come into force on 1 December. These measures concern the four FHS contractor professions and can be summarised as:

  • the abolition of the NHS Tribunal;


  • changes to the regulation of the medical, pharmaceutical, optical and dental lists which introduce new HA powers of suspension, removal from and refusal to admit to these lists;


  • the introduction of HA Supplementary Lists of non-principals working in GMS (from 1 December) , PhS, GOS and GDS (all during the first half of 2002);


  • the introduction of a HA Services List (during the first half of 2002) for those practitioners performing Personal Medical Services and Personal Dental Services.

In line with Shifting the Balance of Power, these decisions will move to PCTs (subject to Parliamentary approval) within approximately 12 - 15 months. HAs, old and new, will need to agree their arrangements with their PCTs and in doing so look to creating procedures that will readily transfer from HA to PCT in due course.

A letter from Rob Webster, Head of General and Personal Medical Services, to HA and PCT Chief Executives, describing this new framework can be found on the DH website at www.doh.gov.uk/gpdiscipline

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2. Training: Annual Appraisal for General Practitioners

As part of a comprehensive range of measures to assure the quality of care that patients receive, all NHS doctors - GPs as well as trust employed doctors - are to be required to participate in annual appraisal. Part of the requirement for successful appraisal is the input from trained appraisers. Chief Executives are asked to complete the attached form, suggesting at least three suitable GP candidates from within their PCG/T to undergo training to become a GP appraiser.

Letter and form

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3. New Legislation to Facilitate Electronic Transmission of Prescription Pilot Schemes

Orders made under the Electronic Communications Act 2000 and amending the Prescription Only Medicines (Human Use) Order and the NHS Regulations which govern GPs' and pharmacists' terms of service and NHS charges for prescriptions came into force on 11 September 2001.

The Order amending pharmacists' terms of service also includes an amendment to the Misuse of Drugs Regulations 1985 to enable prescriptions for temazepam (but not other Schedule 2 or 3 controlled drugs) to be included in these arrangements. Equivalent amending Directions for GPs under Personal Medical Services came into force on the same day.

These amendments allow for the creation and transmission of NHS prescriptions by electronic means (ETP). They will only apply to sites approved by the Secretary of State.

Further details of the three consortia selected to test ETP were announced in press release 2001/0159 of 29 March 2001. The consortia are expected to begin live tests later this year. More information is available at www.doh.gov.uk/pharmacy

The Orders and Directions are:

The Prescription Only Medicines (Human Use) (Electronic Communications) Order S.I. 2001/2889

The National Health Service (Charges for Drugs and Appliances) (Electronic Communications) Order S.I. 2001/2887

The National Health Service (General Medical Services) (Electronic Communications) Order S.I. 2001/2890

The National Health Service (Pharmaceutical Services) and (Misuse of Drugs) (Electronic Communications) Order S.I. 2001/2889

These priced publications are available from the Stationery Office www.the-stationery-office.co.uk

The Health Authorities and Primary Care Trusts Implementation of Pilot Schemes (Personal Medical Services) (Amendment) Directions 2001 available at www.doh.gov.uk/pricare/pmsdirections.htm

For more information about the legislation, contact Peter Dunlevy (tel: 0207 210 5822) or e-mail peter.dunlevy@doh.gsi.gov.uk

For more information about the ETP project, contact Richard Barker (tel: 0113 254 6070) or e-mail richard.barker@doh.gsi.gov.uk

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4. Out of Area Treatment Adjustment and Specialised Services

A letter from Sheila Adam, Director of Policy, to Chief Executives and Finance Directors of NHS Trusts, copied to Chief Executives of Health Authorities, Primary Care Groups and Trusts and to Regional Specialised Commissioning Group Chairs is attached.

In October 2000 each region in England was asked to ensure that specialised services were incorporated into service agreements for 2001/2002, with a view to establishing a risk-sharing approach across health authorities and regions where appropriate.

Discretion was given to regions on how best to implement the guidance. This led to regions employing differing approaches, depending on local circumstances. It became apparent that a common approach would need to be adopted across all regions, both during 2001 and in the longer term, in order to minimise the scope for potential disputes between commissioners and provider trusts throughout the country.

The key issues were discussed at a meeting that was attended by Department of Health policy leads for OATS and specialised services, finance representatives from each Regional Office and representatives of each Regional Specialised Commissioning Group (RSCG). This meeting made recommendations for 2002/03 and suggested a handling strategy for 2001/02.

The approach, which is set out in more detail in the letter is as follows:

  • For 2002/03All specialised services (elective and emergency services) should be removed from the OATs matrix, with no de minimus/materiality threshold, and should be incorporated in service agreements. The National Specialised Services Definitions Set should form the basis for all discussions regarding which services should be treated as specialised.


  • For 2001/02 the handling strategy should be to manage any financial risk locally unless the problem is sufficiently serious to involve the RSCG in a brokerage role between the NHS Trust, Health Authority(ies), RSCG(s) and Regional Office(s) involved.

Letter

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5. Language Testing for General Dental Practitioners Seeking Admission to Health Authority Dental Lists

A letter to Chief Executives of Health Authorities, Regional Dental Officers and Consultants in Dental Public Health with advice on a standard procedure on English language testing has been placed on www.doh.gov.uk/dental/language.htm

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NHS / Social Care interest

6. Children and Adolescents Who Try to Harm, Hurt or Kill Themselves

This ONS report was published on 17 August 2001 and details further analysis from the national survey of the mental health of children and adolescents in Great Britain in 1999. It presents prevalence rates of self-harm among children and adolescents aged 5-15.

Office for National Statistics web site
http://www.statistics.gov.uk

Ref. 25213

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7. SAFETY NOTICE - MDA SN2001(25) Oesophageal Stent (EsophaCoil®): Increased Potential for Fracture

This Safety Notice was issued on the 10th of September to NHS Trusts and Health Authorities Chief Executives . As usual it was also issued to Liaison Officers of Trusts and Health Authorities for action and for onward distribution as specified in the Notice.

Electronic version of SN 2001 (25) can be found at: www.medical-devices.gov.uk/sn2001(25).htm

For further information on the role and nomination of Liaison Officers e-mail us at:

bs@medical-devices.gov.uk http://www.medical-devices.gov.uk

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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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This page last updated 13 September 2001