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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:

NHS and Social Care interest

1. Publication of Departmental Report - Department of Health
2. Social circumstances report by social workers for mental health review tribunals

NHS interest

3. Overseas treatment update and advice about operations abroad
4. Boosting GP numbers and improving working lives
5. Cost rent scheme - prescribed percentages
6. Investigation into organ retention at the Central Manchester and Manchester Children's University Hospitals NHS Trust
7. Bristol Inquiry report - Kennedy recommendation 47
8. Protection of children act (POCA) list checks - fast-track arrangements with the CRB
9. Multiple sclerosis drug treatments (beta-interferons & glatiramer acetate) - risk-sharing scheme
10. New planning framework
11. National health service (general medical services) regulations 1992 - schedule 10
12. The National Specialist Commissioning Advisory Group (NSCAG) annual report 2000
13. Ninth annual report of the Advisory Committee on Distinction Awards (ACDA)
14. Introducing payment by results
15. NHS numbers for babies
16. Delayed discharges - Health Select Committee inquiry

Social care interest

17. Homelessness Code of Guidance
18. Residential allowance (phasing out) grant 2002-3
19. Local government finance (England) special grant report no 102 on children's services (quality protects) special grants for 2001/2002 and 2002/2003

NHS / Social Care interest

1. Publication of Departmental Report - Department of Health

The twelfth annual Departmental Report for the Department of Health was published on 18th July. It describes the progress and achievements of the past year and sets out expenditure plans for 2002-03 to 2003-04.

The report sets out the aims and objectives of the Department, and describes the main activities which support them. It covers different business areas for which the Department is responsible for: public health, the National Health Service, social care and departmental management. It sets out the resources committed to each, the results that are being achieved and the priorities for the future.

The report has also been published on the internet at: www.doh.gov.uk/dohreport

For further information please contact: Karl Payne, Finance and Investment Directorate
Tel. 0113 254 5368 or Jonathan Hey, Finance and Investment Directorate, Tel. 0113 254 6012

This paper is to assist the authors of social circumstances reports in the preparation of those reports. The MHRT has prepared a guide, which might assist the responsible authorities, or the person designated by the responsible authorities to prepare or commission the reports supplied to mental health review tribunals.

The statutory requirements relating to the reports are contained in paragraph 2 of part B of Schedule 1 of the Mental Health Review Tribunal Rules 1983 (1983 S1 No. 942) and part F of the Mental Health Review Tribunal (Amendment) Rules 1996 (1996 SI No. 314) which are set out in annexes A and C hereof respectively. Provision is also made in the rules (rule 6 (4)) for the withholding and non-disclosure of information. This may be of particular importance in certain circumstances. Rule 6 (4) is set out in annex D. It is important to note that the reasons for the withholding or non-disclosure of a statement must be given and submitted in a separate document. This paper is intended to be a guide. Within the statutory requirements the form and content of the report rests with the author.

A copy of the guidance can be obtained from Adam Jones, business support manager, on 0207 972 1396 or by emailing adam.jones@doh.gsi.gov.uk

Guidance

3. Overseas treatment update and advice about operations abroad

Treatment for patients in the European economic area is one of the options open to NHS bodies seeking to increase the number of patients treated and reduce waiting times. Draft guidance for the NHS on referring patients overseas is on the DH website, at www.doh.gov.uk/international/overseastreatment.htm Comments are welcome and should be sent to Tim Baxter, tim.baxter@doh.gsi.gov.uk, 0207 210 5740, by 30 August.

In the meantime, the department would like to remind NHS organisations that lead commissioning arrangements have been set up to assist NHS bodies wishing to refer patients overseas. The lead commissioners are Guy's and St Thomas' Trust (contact Kevin Thorogood on 0207 922 8159, email kevin.thorogood@gstt.sthames.nhs.uk), who deal with capacity in Belgium, Germany and Northern Europe, and Kent and Medway Health Authority (contact Peter Huntley on 01304 205 706, email Peter.Huntley@ekentha.nhs.uk), who deal with France, Spain and Southern Europe in general.

The Department recommends that the NHS locally use these lead commissioning arrangements. If you do not intend to do so, you should consult the lead commissioners before entering into any contracts with overseas hospitals or intermediary organisations. In particular, until a corporate diligence process has been completed by the Department and you are notified otherwise, NHS commissioners are advised not to enter into contracts with Operations Abroad, a commercial organisation marketing services as an intermediary to arrange treatment for NHS patients in hospitals overseas.

On 12 July, health minister John Hutton announced a package of measures to boost GP numbers and make primary care a better place to work.

They include:

• The publication of the GP Delayed Retirement Scheme (formerly the Golden Goodbye Scheme) Full details can be found at www.doh.gov.uk/pricare/delayedretirement
• The extension of the Flexible Careers Scheme, which operates for hospital doctors, to primary care. The scheme will offer flexible and part-time working options and will be launched for GPs later this year
• An amendment to the GMS Statement of Fees and Allowances to allow the retainer fee to continue to be paid to practices while the retainer is on leave. The amendment to the SFA can be found at www.doh.gov.uk/pricare/sfapara39.htm
• An amendment to the GMS Statement of Fees and Allowances to remove the qualifying period that GPs returning to practice after a career break have to serve before they can claim seniority payments. The amendment to the SFA can be found at www.doh.gov.uk/pricare/sfapara16.htm

For further details see press release 2002/0313

Any queries should be directed to Katie Cusick on 0113 254 5850 or email at katie.cusick@doh.gsi.gov.uk.

Each quarter the prescribed percentages applicable to the cost rent scheme for GMS premises are reviewed. The latest figures can be found at http://www.nhsestates.gov.uk/capital_procurement/index.asp

Please ensure that the relevant personnel at all primary care organisations are informed of this update. Future updates to this and other primary care premises issues may be found at the same site.

The Retained Organs Commission has completed a report of the investigation into organ retention at the Central Manchester and Manchester Children's University Hospitals NHS Trust. The report sets out the investigation team's terms of reference, key findings and recommendations.

A key recommendation is that the report should be specifically drawn to chief executives' attention because of the important lessons it contains about the need for changing attitudes and culture within the NHS.

A copy of the report can be found on the Retained Organ Commission's website:
http://www.nhs.uk/retainedorgans/manchester_report.htm

Hard copies of the report can be obtained from the commission's helpline on 0800 092 0203 or by email: retained-organs-commission@doh.gsi.gov.uk.

The Government has published a response to this report which is available at www.doh.gov.uk/tissue/manchesterresponse.htm

Retained Organs Commission contact - Janet Lewis: Janet.Lewis@doh.gsi.gov.uk
Department of Health contact - Briony Enser: Briony.Enser@doh.gsi.gov.uk

Ref No(s) - main report 28550, Government response 28551.

Recommendation 47 of the Kennedy Report on the Bristol Inquiry states that: "Trusts should be able to deal as employers with breaches of the relevant professional code by a healthcare professional, independently of any action which the relevant professional body may take". The Department has agreed in principle with this recommendation.

NHS employers will wish to consider taking steps to include the following wording in their local codes of conduct:

Professional healthcare staff are responsible for complying with the relevant standards set by their regulatory or professional bodies (eg. for example the GMC's good medical practice, and for nurses and midwives, the NMC's code of professional conduct. A breach of such standards may lead to action by NHS bodies independent of any taken by the regulatory or professional body concerned. It will be investigated fairly and appropriate steps taken to prevent a recurrence and address any wider causes.

Enquiries to: Godfrey Perera on 0113 254 5757.

Due to the current delays at the CRB the Department has arranged for some POCA checks to be fast-tracked for the NHS. Please click here for further details

A briefing note from the Department of Health is available on www.doh.gov.uk/pricare/drugsmultiplesclerosis.htm

The note asks strategic health authorities and primary care trusts to nominate lead officials to take responsibility for overseeing implementation of the risk-sharing scheme. The scheme envisages that prescribing will be carried out by locally designated specialist centres in NHS trusts. NHS trusts should be taking steps to prepare for implementation, including agreeing appropriate funding, to ensure that prescriptions may be initiated at the earliest opportunity. NHS bodies are reminded that there is a statutory obligation to fund the cost of the drugs and infrastructure costs needed to assess and support patients.

Health authorities should have finalised their nominations before 31 July and be in a position to report on progress by 15 September.

Please ensure that the contents of the briefing note are cascaded to all relevant staff.

DH contact - Colin Pearson at colin.pearson@doh.gsi.gov.uk

Delivering the NHS Plan described the programme of system reform required to deliver core NHS Plan priorities. A key element of the programme is the introduction of a new planning framework for the NHS, to be delivered through the following actions:

• all planning at a national and local level will be moved to a three-year basis from 2003-2004
• national planning requirements, and the setting and reporting of targets at a national level, will be reduced and streamlined
• time-scales for planning will change to reflect the need for planning to be a process that ensures delivery rather than an end in itself
• the new timetable will allow more time at a local level to involve front line staff, key delivery partners, patients and the public in the development of plans.

Programmes and Planning unit in DECA will implement this programme and will be in touch with branches to discuss the implications of the programme.

A brief on the framework can be found on the website at http://www.doh.gov.uk/planning or contact kathy.beynon-tullett@doh.gsi.gov.uk for further information.

From 1 August 2002 the following products may not be prescribed by GPs on the NHS or dispensed in the community:

• Healthaid glucosamine sulphate tablets
• Lamberts glucosamine sulphate tablets
• Boots glucosamine sulphate capsules
• Vega glucosamine sulphate capsules
• Solgar glucosamine sulfate tablets

With effect from the same date the current prohibition on GP prescribing and community dispensing of two infant formulae for premature babies is lifted. The two products are:

• Cow & Gate Nutriprem 2
• Farley's Premcare

Amendments have been made to schedule 10 to the National Health Service (General Medical Services) Regulations 1992 to give effect to these changes. In addition the Advisory Committee on Borderline Substances (ACBS) has reinstated its earlier recommendation of the two infant formulae as "suitable for catch-up growth in pre-term infants (ie less than 35 weeks at birth) and small for gestational age infants, until 6 months post-natal age.

These changes are recorded in Part XVIIIA of the drug tariffs for August 2002 and subsequent months (changes to schedule 10) and Part XV of the same tariffs (amendments to the ACBS recommended list).

NSCAG's annual report 2000-2001 is now available on the website.

NSCAG's aim is to ensure that the highest possible standard of care that can be delivered within available resources is provided to all NHS patients requiring treatment or investigation of a very specialised nature or for a very uncommon condition.

The annual report describes the 23 highly specialised services centrally commissioned by the Department of Health with the support of NSCAG and progress achieved during 2000-2001. It also includes a chapter highlighting some of the successes and key lessons of the work of the 8 regional specialised commissioning groups during 2000-2001.

The annual report can be accessed at http://www.doh.gov.uk/nscag/reports.htm. Alternatively, copies can be ordered from the NHS Responseline on 08701 555 455. For further information email helen.forgacs@doh.gsi.gov.uk

Ref. 28170.

Lady Elizabeth Vallance, chairman of the ACDA announced the publication of the ninth annual report for the committee. The report includes a list of all consultants who received awards in 2001 and a complete list of all distinction award holders.

Distinction awards are granted in recognition of outstanding contributions to the NHS - often of national and international significance - which involves consultants devoting a substantial part of their time to activities of wider benefit to patient care in the NHS as a whole. This ranges from awards to those developing services in the local setting through to those taking a lead role in national or international health policy development or planning. ACDA looks for performance over and above that which is expected in respect of a consultant's contractual obligations.

As the report makes clear this is the penultimate round of distinction awards before they are succeeded by the clinical excellence award scheme which was the subject of wide ranging consultation last year. The scheme is continuing to develop in ways which improve transparency so as to pave the way for the introduction of clinical excellence awards in 2004.

Contact details: ACDA, Area 531B Skipton House, 80 London Road, London SE1 6LH. Tel: 020 7972 5049 Fax: 020 7972 5793

Annual Report

Delivering the NHS Plan announced major changes to the way money will flow through the NHS, including the introduction of payment linked to results. These changes have significant implications for all PCTs and NHS trusts.

Delivering the NHS Plan (4.9) made a commitment that in 2003/4 changes would be introduced under which:

• providers would be contracted for a minimum volume of cases to achieve waiting time reductions
• providers will lose money on a cost per case basis for failure to deliver
• providers will earn extra resources on a cost per case for additional patients that move to them

These changes will help to support the movement of patients between providers and reward good performers.

The link below gives further information on the changes beginning next year and on the medium term direction, as well as project team contact details.

For general project queries contact programme manager Loraine Hawkin at Lorraine.Hawkins@doh.gsi.gov.uk or programme co-ordinator Frances Smethurst at Frances.Smethurst@doh.gsi.gov.uk

Details

15. NHS numbers for babies

Responsibility for issuing NHS numbers for babies will transfer from the Registrar of Births and Deaths to NHS trusts from 29 October 2002.

In January chief executives of trusts providing maternity or child health services were requested to ensure their organisations would be in a position to confirm readiness for this initiative by 31 July 2002.

A 'statement of readiness' form has been developed which must be completed and returned to the NHS Information Authority by 9 August at the latest.

The form together with guidance material on its completion can be found at:
http://nww.nhsia.nhs.uk/nn4b/pages/confirm_ready.asp

Jacqui Smith appeared before the Health Select Committee as part of its inquiry into delayed discharges. This is the final public session of the inquiry before the committee prepares its report, probably before the July recess, and follows on from an earlier session with officials which took place on 13 February.

If you are interested in seeing an uncorrected transcript of the session, e-mail Emma Preece at emma.preece@doh.gov.gsi.uk
[Please note that in accordance with the committee's wishes, no public use of the text should be made, nor should it be quoted.]

Cross-charging bill
In Delivering the NHS Plan the Government announced its intention to introduce a system of cross-charging similar to that used in Scandinavian countries. When these reforms were introduced in Scandinavia they had a major impact on reducing the extent of delayed discharge for older people and expanding the volume and range of care available in the community.

The intention is that, once a patient is ready to be discharged from hospital and their onward care is the responsibility of social services, social services should take on responsibility from that point. Where things are working well, the person will then be discharged with the minimum of delay. However where social services are unable to provide the onward care in the community, they will be charged for the care which the person is receiving in hospital. These costs will be higher than the equivalent cost of providing community care and so will act as an incentive for social services to invest in an extended range of services outside hospital.

Ministers are still considering the detail of how such a system will work and will be consulting on these fully over the summer.

For more information on the cross-charging system contact Emma Preece on emma.preece@doh.gov.gsi.uk

The consultation paper will soon be available at http://www.doh.gov.uk/jointunit/delayeddischarge/index.htm

17. Homelessness Code of Guidance

This notice alerts Social Services Departments that the Homelessness Code of Guidance has been published jointly by the Office of the Deputy Prime Minister and the Department of Health. It is available on the at www.housing.odpm.gov.uk/local/guide/index.htm. Directors will have already received hard copies.

Comments on the code should be sent to Graham Barker at the Office of the Deputy Prime Minister, Zone 1/J4, Eland House, Bressenden Place, London SW1E 5DU by 31 October 2002.

In LASSL(2001)13, published on 4 December, each local authority was notified of its share for 2002-2003 of the residential allowance (phasing out) grant, which totals £93 million for the year. Payment of the grant for the period April - July 2002 inclusive has been made to each authority. Subsequent payments will be made on a monthly basis.

Authorities are required to use their allocations to provide community care services. Full details of the grant conditions are set out in annex B of the residential allowance (phasing out) grant 2002-3, a copy of which is available at www.doh.gov.uk/scg/resgrant.htm

DH contact - Roger Pettit on 0207 972 4723, Roger.Pettit@doh.gsi.gov.uk or at
Room 211, 133-155 Waterloo Road, London, SE1 8UG.

Parliament approved the Quality Protects (QP) Special Grant Report for 2002/2003 on July 10 2002. Councils will therefore receive the first of the four instalments of the QP grant including the ring fenced element of the grant for implementing the Children (Leaving Care) Act 2000, during July or August.

Local councils were notified of their allocations in December 2001 in LASSL(2001)13.

A LASSL will shortly be issued to chief executives and directors of social services setting out arrangements for payment of the grant and the auditing process. A copy of the special grant report will be sent to all directors of social services and, together with the LASSL, will be available from the QP website at http://www.doh.gov.uk/qualityprotects

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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copyright: © | Last updated: 18 July, 2002