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Chief Executive Bulletin
| 12- 18 April 2002
Issue 113 |
The documents in this bulletin are Crown copyright but may be reproduced
by NHS and Council staff without formal permission or charge for personal
or in-house use - ©2002
Contents:
Special item
NHS and Social Care interest
1. Configuring Hospitals in Health and Social Care Systems
2. An update on the Conference Taking Action - Meeting
the Milestones for Physical Activity in the National Service Frameworks,
20 May 2002, Kensington Town Hall, London
3. Custodial Healthcare Standards, NVQ & SVQ - Amendment
NHS interest
4. Commission for Health Improvement Investigation: West
of London Breast Screening Service at Hammersmith Hospitals NHS Trust
5. Advance Letter (MD)1/02 Pay and Conditions for Hospital
Medical and Dental Staff - Clarification of changes
to incremental points for Staff Grades and Senior House Officers
6. Introducing Modern Matrons
7. PL/CNO/2002/03 Ward Staffing Budgets
8. Consultation on Supplementary Prescribing by Nurses and
Pharmacists
9. Workforce Development Confederations: Functions
10. New HR Strategy - Consultation Document Available
11. Treating NHS Patients Overseas
12. A Practical Guide to Support the Development of Effective
Medicines Management Across the NHS
13. Modernising supply in the NHS
14. National Specialised Services Definitions Set - Progress
on Phase II
15. Copying Letters to Patients Policy Initiative
16. Principles for Best Practice in Clinical Audit
NHS / Social Care interest
1. Configuring Hospitals in Health and Social Care
Systems
We have set in train a programme of work to provide help and support
to NHS organisations and local authorities considering the development
and configuration of hospital services. The focus of the project is acute
hospitals within the context of overall health and social care systems.
Jeremy Hallett (formerly chief executive of Wiltshire Health Authority)
and Chris Howgrave-Graham (formerly chief executive of Coventry Health
Authority) have been appointed to the DH Policy Directorate and Modernisation
Agency to work in this field. They will begin by contacting all strategic
health authority chief executives to identify where such additional support
may be beneficial.
In the autumn, we plan to publish a framework for configuring hospitals,
setting out a proposed approach to assessing configurations and possible
options for models of care, balancing the need for sustainability with
opportunities to provide care closer to home.
The project is closely linked to other work within the Department and
the Modernisation Agency which impacts on the hospital configuration.
A website is being developed at www.doh.gov.uk/configuringhospitals
to:
- Provide introductory information about the project, and routes in
for those wanting more information or support
- Keep the NHS and others informed about the emerging shape of the framework
for configuring hospitals
- Provide access to useful documents, learning and examples of good
practice; and
- Publish the final framework and guidance.
For further information e-mail Helen.Lovell@doh.gsi.gov.uk
Top
2. An update on the Conference Taking Action
- Meeting the Milestones for Physical Activity in the National Service
Frameworks, 20 May 2002, Kensington Town Hall, London
This special DH conference is aimed primarily at chief
executives and directors. It will show how multiple NSF milestones can
be met through cost-effective and well-planned local services on exercise.
The Minister of State for Public Health, Yvette Cooper
will address the conference. Other speakers include; Professor Sir George
Alberti, the President of the Royal College of Physicians; Dr David Colin-Thome,
the National Director of Primary Care; and Dr Bernard Crump, Chief Executive
of Staffordshire and Shropshire Strategic Health Authority.
Further information about the conference, including a
full programme and online booking form, is available at www.health-links.co.uk/physicalactivity
To register for the conference contact Angela Lyons at
Health Links, Windsor House, 11A High Street, Birmingham B14 7BB, telephone
0121 248 3399, or email alyons@health-links.fsnet.co.uk
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3. Custodial Healthcare Standards, NVQ & SVQ - Amendment
For further copies of the resources people should contact the Prison
Healthcare Training Team on 01788 834292 and not the CCNTO as previously
stated in last weeks bulletin.
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4. Commission for Health Improvement Investigation:
West of London Breast Screening Service at Hammersmith Hospitals NHS Trust
CHI's report on their investigation into the West of London Breast Screening
Service was published on Monday 15 April. The report makes 37 recommendations
for change, including 6 aimed specifically at trusts managing breast screening
units and commissioning health organisations. These are:
- When adverse incidents occur in a breast screening service, NHS Breast
Screening Programme guidance on handling incidents in breast screening
units should be adhered to as soon as the incident has been identified
- In circumstances when a review of files is required, host trusts managing
breast screening services should take full responsibility for a swift
and thorough review of all relevant files
- Host trusts should regularly check that the breast screening service
has relevant written protocols and policies that are fully operational
and in line with national guidance
- The directors of breast screening units should ensure that the findings
of quality assurance reference centre reports are fully understood and
responded to by their trusts.
- All NHS organisations involved with breast screening services need
to take into account not only population size but also associated demographic
and socio-economic factors to ensure that the service is sensitive to
the needs of the local population.
- Service level agreements between host trusts and NHS organisations
commissioning breast screening services should specify that compliance
with the principles of NHS Breast Screening Programme guidance is compulsory.
The report can be accessed on the CHI website at: http://www.chi.nhs.uk/eng/organisations/london/hammersmith/index.shtml
An action plan, giving details of the Department of Health's response
to CHI's recommendations and the action that will be taken to implement
them, will be placed on CHI's website. The trust will also be producing
an action plan.
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5. Advance Letter (MD)1/02 Pay and
Conditions for Hospital Medical and Dental Staff - Clarification of changes
to incremental points for Staff Grades and Senior House Officers
There has been some confusion over the implementation
of the additional pay points on the staff grade and senior house officer
pay scales. These additional points have been inserted at the top of the
basic scales, before the discretionary points, and because of the different
nature of the discretionary points (SHO increments are awarded automatically
except in cases of poor performance, while Staff Grade increments are
subject to review) some clarification was felt to be helpful.
Staff Grade
Practitioners who at 31 March 2002 had been paid on the
top non-discretionary point of the staff grade scale for more than twelve
months should move on 1 April 2002 to the new non-discretionary maximum
of MH03. Those on the top non-discretionary point with less than twelve
months service on that point should move to the new non-discretionary
maximum on their normal incremental date.
There remain four discretionary points at the top of
the staff grade scale. Practitioners with one, two, three or four discretionary
points will move on 1 April 2002 to the first, second, third or fourth
discretionary scale point respectively on the new scale.
Example 1: Staff grade doctors who have been on the maximum
of the non discretionary payscale for 12 months or more i.e. were on £36,070
would move up to the new incremental point of £39,675 on 1 April 2002
and could be considered for optional points without waiting for another
year. Those staff grades who have been on the maximum for less than 12
months would have their salary uplifted to £37,370 until their increment
date when they would go up to £39,675.
Example 2: Staff grade doctors who had 1 optional point last year will
automatically get the uplift from £38,295 to £41,980.
Senior House Officers
Practitioners who at 31 March 2002 had been paid on the
top discretionary point of the SHO scale for more than twelve months should
move on 1 April 2002 to the new maximum discretionary point. Those on
the top discretionary point with less than twelve months service on that
point should move to the new discretionary maximum on their normal incremental
date.
There have been some minor amendments to the Advance
Letter (MD) 1/02 since it was first published on the internet.
Updated
Advance Letter
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6. Introducing Modern Matrons
Health Service Circular 2001/010 (at http://www.doh.gov.uk/cno/hsc.htm)
required trusts and PCTs with wards to introduce modern matrons, each
accountable for a group of wards. On Monday 15 April the Secretary of
State for Health launched a brief report on progress implementing the
policy and setting out next steps.
The report is available at: www.doh.gov.uk/modernmatrons
Ref. 23691.
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7. PL/CNO/2002/03 Ward Staffing Budgets
Following publication of an Audit Commission report, Ward Staffing,
in a speech to the Chief Nursing Officer's annual conference in November
2001, the Secretary of State for Health said that "over the next 12 months
the Modernisation Agency would lead a management programme to support
devolution of staffing budgets to those ward sisters and charge nurses
in England's hospitals who do not yet have that control." To coincide
with the launch of a learning support booklet produced by the Modernisation
Agency Leadership Centre, further guidance about this initiative is provided
in a chief nursing officer professional letter
Professional
Letter
Top
8. Consultation on Supplementary Prescribing by Nurses
and Pharmacists
The Department's press release of 16 April 2002 set out the Government's
proposals for supplementary prescribing by pharmacists and nurses, following
diagnosis by a doctor.
The purpose of this note is to draw your attention to the consultation
paper, Proposals for supplementary prescribing by nurses and pharmacists
and proposed amendments to the Prescription Only Medicines (Human Use)
Order 1997. This is being distributed to chief executives, directors
of nursing and chief pharmacists in health authorities, NHS trusts and
primary care trusts, as well as GP practices, community pharmacies and
NHS Walk-in Centres. Would you please ensure that all relevant staff within
your organisation are aware of the consultation. Comments have been requested
by 9 July 2002. Additional copies can be obtained from the DH supplementary
prescribing website: www.doh.gov.uk/supplementaryprescribing
Ref. 27667. Will be mailed NHS Chief Executives, Medical and Nursing
Directors, GP Practices and Community Pharmacists w/c 22/4/02.
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9. Workforce Development Confederations: Functions
Shifting the Balance of Power: The Next Steps
sets out in broad terms the relationship and accountability arrangements
between Workforce Development Confederations, Strategic Health Authorities
and Postgraduate Deaneries. The document (see link below) sets the arrangements
out in more detail, updating the functions of Workforce Development Confederations
to show how they will relate to Postgraduate Deaneries and Strategic Health
Authorities.
Workforce Development Confederations have a central role
in enabling the delivery of Strategic Health Authority franchise plans
through planning and development of the healthcare workforce, working
with Postgraduate Deaneries to commission education and training, and
managing the DH annual investment in training of almost £3 billion.
Document available at www.doh.gov.uk/workdevcon/guidance.htm
Further information can be obtained from keith.baggs@doh.gsi.gov.uk
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10. New HR Strategy - Consultation Document Available
Andrew Foster will announce this week that the consultation document
outlining the new HR strategy is available for comment and discussion.
The document has been developed by the National Workforce Taskforce and
the Human Resources Directorate in the Department of Health, and the final
document will be launched at the HR in the NHS conference in July. The
NHS Plan contains nearly 50 targets that are workforce led and the successful
implementation of many of the other Plan targets are dependent on the
workforce. HR in the NHS Plan proposes how the vision outlined
in the NHS Plan can be turned into reality and suggests how the NHS should
look once the workforce targets have been met. It sets out the relationships
between the necessary strands of modernisation and important concepts
such as the Skills Escalator. HR in the NHS Plan calls upon the
NHS to become both a model employer and offer a model career and outlines
the benefits for staff, patients and employers.
The HR in the NHS Plan will be available by 19
April at www.doh.gov.uk/hrinthenhsplan
together with details of how you can comment. There are a range of specific
questions in the document on which we would particularly welcome your
responses.
It would help us enormously if you could let us have
your comments on the proforma on the web-site and if all comments and
questions could be e-mailed to hrinthenhsplan@doh.gsi.gov.uk
by 17 May 2002. If you require any further information, please contact
Maggie Evans at Maggie.Evans@doh.gsi.gov.uk
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11. Treating NHS Patients Overseas
Since rulings of the European Court of Justice last year it has been
clear that NHS bodies may commission care in Europe. Ministers have made
clear their preference that, when considering the use of spare capacity
in other health systems, the NHS should seek where possible to attract
overseas providers to the UK, for example in the form of surgical teams.
But sending patients overseas for treatment is now one of the options
available to trusts for expanding capacity outside the NHS.
The pilot scheme to treat NHS patients overseas draws to a close this
month, although we expect that patients will continue to travel abroad
over the coming months to help trusts at risk of breaching waiting times
guarantees.
The extent of overseas commissioning in the medium term will be subject
to evaluation of the pilot and Ministerial decisions. However, given that
patients are likely to travel overseas for treatment at least for the
short term the Department has decided to set up lead commissioning arrangements
to facilitate high quality and good value commissioning overseas. These
lead commissioners will be based in the London and South DHSCs, as these
are the areas of greatest pressure on waiting times. That said, NHS trusts
elsewhere are strongly recommended to approach them if they wish to use
overseas capacity.
In London, Guy's and St Thomas' Trust (GST) will be the responsible commissioner.
In the south a team based in Kent and Medway Strategic Health Authority
will take on this role. The two lead commissioners have agreed a geographical
split: GST will be responsible for finding capacity in Germany, Belgium
and northern Europe in general, Kent for France, Spain and more southerly
countries. The contact for London is Kevin Thorogood at GST (020 7922
8159, email kevin.thorogood@gstt.sthames.nhs.uk)
and for the South Peter Huntley (01304 205 706, email Peter.Huntley@ekentha.nhs.uk).
NHS trusts in London and the South will be expected to approach their
regional lead commissioner if and when considering using capacity overseas.
The lead commissioner will then organize treatment using their contracts.
As stated above, NHS trusts elsewhere are strongly recommended to use
either GST or Kent and Medway StHA.
Further guidance on overseas treatment will be circulated in due course.
The Departmental policy contact remains Tim Baxter on 0207 210 5740, email
tbaxter@doh.gsi.gov.uk.
The lead commissioners will also take the lead on managing arrangements
for clinical teams being brought to the UK. The Departmental contact is
Jonathan Mogford on 020 7210 5682, jonathan.mogford@doh.gsi.gov.uk.
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12. A Practical Guide to Support the Development of
Effective Medicines Management Across the NHS
The National Prescribing Centre (NPC), in collaboration with the National
Primary Care Research and Development Centre (NPCRDC), has produced a
practical resource aimed at supporting the NHS locally in the development
of effective medicines management services to improve patient care. It
is entitled Modernising Medicines Management: A guide to achieving
benefits for patients, professionals and the NHS.
This resource consists of two books and will be of value to professionals
and managers from primary care trusts, GP practices and also hospitals.
Book 1 gives a concise overview of the 'why, what and how' of medicines
management, and is aimed primarily at senior NHS managers and professionals.
Book 2 is a more detailed reference source and will be of most value to
those individuals who have direct responsibilities for developing and
delivering effective medicines management services for patients in practice.
The guide will help with the implementation of NHS Plan targets involving
medicines and, in particular, those set out in Pharmacy in the Future
(DH, September 2000 at www.doh.gov.uk/pharmacyfuture/index.htm).
The guide is being launched, and widely distributed across the NHS, during
the week commencing 15 April. In addition, it will be accessible
from both the NPC and NPCRDC websites: www.npc.co.uk
or http://nww.npc.ppa.nhs.uk
and www.npcrdc.man.ac.uk
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13. Modernising supply in the NHS
Over the past year the Audit Commission has, in conjunction with the
NHS Purchasing and Supply Agency, been conducting a study of NHS procurement
as a follow-up to its 1996 report, Goods for your health. The report,
to be published in May, will highlight significant differences in purchasing
performance across the NHS.
To address this situation, NHS PASA is leading a fundamental re-organisation
of purchasing and supply throughout the NHS. This centres on the creation
of a 'middle tier' of purchasing to bridge the gap between national (NHS
PASA) and local (individual trust) level purchasing. For the executive
summary: http://nww.pasa.nhs.uk/corporate/publications/modernising_supply_april_2002_exec.doc
For the full report: http://nww.pasa.nhs.uk/corporate/publications/modernising_supply_april_2002.doc
Top
14. National Specialised Services Definitions Set -
Progress on Phase II
The National Specialised Services Definition Set (NSSDS) is a set of
definitions created to facilitate commissioning of specialised services.
The NSSDS identifies those services that cover planning populations similar
to or greater than that of a strategic health authority population (i.e.
1-2 million) which consequently require some form of collective commissioning.
In Phase 1, 23 specialised services were defined in detail and were published
on the DH website in December 2001 (www.doh.gov.uk/specialisedservicesdefinitions).
A further 13 definitions are currently in draft form with publication
planned for the early autumn (Phase 2). Each of these draft definitions
has been drawn up by a Working Group which includes clinicians and managers
from providers of specialised services; representatives from district
general hospitals and primary care and commissioners from across the country.
Comments are invited on these drafts, which should be received no later
than 7 May. Further information including the text of the 13 draft definitions
can be obtained by clicking on www.doh.gov.uk/specialisedservicesdefinitions/consultation.htm
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15. Copying Letters to Patients Policy Initiative
This is the third update on the copying letters to patients policy initiative.
The report of the working group on copying letters to patients was sent
by Barbara Meredith, chair of the Working Group to Dr Nick Hicks, manager
of the Quality Task Force on 14 February, and presented to the Quality
Task Force on 14 March.The report contains advice and recommendations
from the working group to officials at the Department of Health. The report
can be found on the Department of Health's web-site at the following address:
www.doh.gov.uk/patientletters/issues.htm
and may be useful to those in the NHS who wish to continue developing
existing schemes, or to those who wish to make progress on copying letters
to patients in anticipation of formal guidance from the Department of
Health.
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16. Principles for Best Practice in Clinical Audit
NICE has launched a NICE and CHI-endorsed publication, Principles
for Best Practice in Clinical Audit, to support NHS staff implementing
clinical audit projects. The importance of clinical audit is clear following
the Kennedy Report which stated that clinical audit should be compulsory
for all healthcare professionals providing clinical care. The book details
the methods, tools, techniques and activities related to each stage of
clinical audit. It includes a systematic review of literature relating
to audit, and electronic links to a wide range of online audit resources.
NHS organisations received four free copies of the book in early May,
which were mailed to chief executive officers, clinical governance leads
and libraries as appropriate. An electronic version of the book can be
downloaded from the NICE website at www.nice.org.uk.
To purchase additional hard copies of the book, please contact Radcliffe
Medical Press Ltd by calling on 01235 528 820.
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 - ©2002
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