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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. Safeguarding children in whom illness is fabricated or induced
2. CI(2002)12 charges for residential accommodation guide: deferred payments
3. Hepatitis B immunisation of short-term foster carers
4. The abolition of preserved rights and the phasing out of the residential allowance: impact on entitlement to free NHS dental treatment, prescriptions etc.
5. Guidance on restrictive physical interventions for people with learning disability and autistic spectrum disorder, in health, education and social care settings

NHS interest

6. NHS Dentistry: Options for Change
7. Implementing Pharmacy in the Future - funding for clinical governance in community pharmacy
8. NHS Pensions Agency quinnquennial review
9. Patient choice: information for patients
10. NHS national shared services initiative - electronic staff record (ESR) project
11. Prescription charge prepayment - medical and maternity exemption certificates
12. Excellent results from the NHS smoking cessation service
13. NAO study: achieving change through clinical governance
14. Review of The Rehabilitation of Offenders Act 1974
15. National programme for IT in the NHS
16. Medicines control agency objects to importation of unlicensed urabe mumps vaccine

Social care interest

17. Modern social services: a commitment to reform - the 11th annual report of the chief inspector social services inspectorate 2001 - 2002
18. LASSL (2002) 7 special grant for the development of treatment foster care programmes.
19. Quality support to carers: how good is your service to carers?
20. Piloting an integrated approach to the delivery of services to children and their families
21. Promoting independence grant
22. Rules for invalid care allowance (ICA)
23. Domiciliary Care Agency and Residential Family Centre regulations and national minimum standards
24. Policy and practice guidance for adult placement schemes

NHS / social care interest

1. Safeguarding children in whom illness is fabricated or induced

Following wide consultation, the Government has issued Safeguarding Children in whom Illness is Fabricated or Induced: Supplementary Guidance to Working Together to Safeguard Children (1999). The guidance is intended to provide a national framework within which agencies and professionals at local level - individually and jointly - draw up and agree upon their own more detailed ways of working together where illness may be being fabricated or induced in a child. It is addressed to those who work in the health and education services, the police, social services, the probation service, and all others whose work brings them into contact with children and families. It is relevant to those working in the statutory, voluntary and independent sectors. It is issued under Section 7 of the Local Authority Social Services Act 1970, which requires local authorities in their social services functions to act under the general guidance of the secretary of state.

Publication of this new guidance is an important component of a wide-ranging programme of Government activity to strengthen protection for children and to improve the support provided to vulnerable children and families. It should be implemented by 31 July 2003.

The guidance can be found on The Department of Health's ACPC website at www.doh.gov.uk/acpc/safeguardchild.htm and its Quality Protects website at www.doh.gov.uk/qualityprotects. Hard copies are available from Department of Health, PO Box 777, London SE1 6XH.

Ref. 28835. Will be mailed w/c 12/8/02 to NHS and local authorities.

Directors of social services are asked to note that they should remind local councils that they have a discretionary power to offer deferred payments. The policy guidance on deferred payments was issued to all local councils in October 2002 under LAC 2001(25). Councils could be challenged if they do not consider exercising that discretion in individual cases. The policy guidance clearly indicates that the Department of Health expects councils to have a deferred payments scheme in place.

DH contact Sanjay Khatri at sanjay.khatri@doh.gsi.gov.uk

Ref. 28729. Mailed to directors of social services.

CI(2002)12

The Department of Health is distributing £750,000 to strategic health authorities in 2002-2003 by cash limit adjustment to enable primary care trusts to facilitate the hepatitis B immunisation of foster carers who look after children at short notice, as recommended in the recent consultation document Children in Need and Blood-borne Viruses: HIV and Hepatitis (www.doh.gov.uk/childrenbbvs).

It is envisaged that immunisation will probably be most easily delivered by GPs. Primary care trusts may wish to contract with GPs either through local development schemes under section 36 of the NHS (Primary Care) Act 1997 or by providing incentives for GPs in PMS pilot schemes under varied contracts. The allocations are available at www.doh.gov.uk/hepatitisb/fostercarersallocations.htm

For further information, please contact Helen Christmas at helen.christmas@doh.gsi.gov.uk Tel: 020-7972-6061.

4. The abolition of preserved rights and the phasing out of the residential allowance: impact on entitlement to free NHS dental treatment, prescriptions etc.

With the abolition of preserved rights earlier this year - see the guidance in Circular LAC(2002)7, published on 12 March - a significant number of care home residents who were in receipt of income support before 8 April are no longer entitled to it. This is because their total income, including that from other social security benefits, exceeds the reduced income support/minimum income guarantee threshold that now applies. The residents concerned are, however, entitled to local authority funding towards the cost of their care.

Similarly, with the abolition of the residential allowance for anyone who claimed income support towards the cost of their care home place from 8 April onwards, there will be a number of residents who are entitled to local authority funding but not to income support itself.

Authorities should note that a person who is not entitled to income support but who receives local authority funding towards their care home fees has an automatic entitlement to free dental treatment, free prescriptions and other similar NHS services that attract charges. A passport procedure is in place to enable this to happen. The resident concerned (or someone on his behalf) has to complete a short claim form - form HC1(SC) - to provide name, address and details of the supporting local authority. An NHS charges certificate (HC2) will then be issued confirming their entitlement to free dental treatment etc. Claim forms HC1(SC) can be obtained from: Department of Health Publications, PO Box 77, London SE1 6XH, by post; by fax, using telephone number 01623-724 524; or by e-mail, using the address doh@prolog.uk.com.

Further information on entitlement to free NHS dental care etc. in these circumstances can be obtained from Pharmacy and Prescriptions Branch at the Department of Health (telephone: 020-7210 5925; e-mail: veena.kavia@doh.gsi.gov.uk ). Advice on the preserved rights and the residential allowance changes can be obtained from Roger Pettit at the Department of Health (telephone: 020-7972 4723;
e-mail: Roger.Pettit@doh.gsi.gov.uk ).

Issued under section 7 of the LASSL Act 1970. This document is issued jointly by Department of Health and Department for Education and Skills.

It focuses on the need for provider agencies to have effective policies, procedures and training for staff who work with people who may have behavioural episodes where restrictive physical intervention is necessary for their safety and the safety of others.

The British Institute of Learning Disability are in the process of accrediting training organisations who offer training in restrictive physical interventions for those working with people with learning disabilities and autistic spectrum disorder.

A limited number of printed copies are available from: Department of Health Publications, PO Box 777, London SE1 6XH. Fax: 01623 724524. Email: doh@prolog.uk.com

David Ellis, Social Services Inspector, Department of Health, Disability Policy Branch
Tel - 0207 972 4278

Guidance

On 6 August health minister David Lammy published the NHS Dentistry: Options for Change Report. This report sets out opportunities to test and develop new ways of working within NHS dental services to improve the patient experience and their oral health, while also improving the working lives of dentists.

The chief dental officer, Dame Margaret Seward, led a working group involving a wide range of stakeholders, including patient representatives, dentists, the British Dental Association and NHS managers to develop the new approaches set out in the report.

Working through volunteer demonstration sites involving local dentists and NHS staff, The NHS Modernisation Agency will, over the next two years, test and develop these new ways of working to achieve;

• A greater emphasis on improving patients' experience of NHS dentistry including better communication and more prevention of dental disease to improve oral health
• Improved working lives for dentists to allow them to better provide accessible, good quality, patient-focussed care
• Greater transparency for patients so they can make informed decisions about their care, in partnership with the teams looking after them
• More flexible ways of rewarding the valuable job that dentists do and expansion of the dental team.

Copies of the report are available on the Department of Health website at www.doh.gov.uk/cdo/optionsforchange. Dentists and NHS staff interested in taking part in a demonstration site can request an application form by e-mailing Modernising.Dentistry@npat.nhs.uk

DH contact: Steven Collins steven.d.collins@doh.gsi.gov.uk

As for 2001-2, £1m is being provided nationally this year from central funds as a contribution to local investment in the development of clinical governance in community pharmacy by primary care trusts (PCTs). Guidelines, issued at the end of last year, set out the initial action required, including the appointment of community pharmacy clinical governance facilitators and undertaking a baseline assessment. They also identified the elements of a development plan to integrate community pharmacy into wider PCT clinical governance plans for 2002-3 and beyond. The guidelines can be found on the Department of Health website at www.doh.gov.uk/clinicalgovernance/communitypharmacy.htm

Revenue limit adjustments have already been issued to strategic health authorities. The £1m has been allocated in proportion to the number of pharmacies at 31 March 2002. While funds are being allocated to strategic health authorities, it is expected that the money will be spent by PCTs.

In addition, the Centre for Pharmacy Postgraduate Education (CPPE) has programmed workshops on clinical governance for pharmacists across the country for this autumn. There are still places available. Any pharmacists wanting to book a place should contact CPPE on 0161 778 4040, www.cppe.man.ac.uk or use the 24 hour automated telephone booking line on 0161 778 4024. For further details about the workshop call 0161 778 4025. A national programme of induction training for community pharmacy clinical governance facilitators is also being developed by CPPE, in collaboration with the Modernisation Agency - Clinical Governance Support Team. The programme is expected to be launched in the late autumn and will be publicised in due course.

For queries about the funding allocation for clinical governance in community pharmacy, please contact Steve Holmes on 020 7210 4938 or email Steve.Holmes@doh.gsi.gov.uk

The quinquennial review of the NHS Pensions Agency (NHSPA) is currently underway. To fully inform this work, the review team would like to hear the views and opinions of chief executives, directors of finance, directors of human resources and specialist pension staff in all NHS organisations. This note invites your comments and thoughts.

The quinquennial review is about the management of the NHSPA. It is not about reviewing the benefits or structure of the pension scheme itself. The review provides an opportunity to look at the management, performance and organisational arrangements of the NHSPA to ensure that it continues to meet the needs of its stakeholders.

The review team will look at issues such as the quality of service you receive from the NHSPA, the speed and accuracy of responses from the NHSPA, the details of your experiences in dealing with the NHSPA and your suggestions for improving the efficacy of the NHSPA. If you or your staff, would like to make any comments on the operation and administration of the NHSPA or seek further information, please contact Fiona Anderson,
Room 3E64, Quarry House, Quarry Hill, Leeds LS2 7UE. Telephone: 0113 254 6112. Email: fiona.anderson@doh.gsi.gov.uk

Delivering the NHS Plan described how explicit patient choice will be progressively introduced across the NHS. From this year we will move to publish on the internet regularly-updated information on waiting for all major treatments at all providers.

Chief executives have already identified a lead within their NHS trusts. The first submission of test data should have been made by 6 August. The first submission of actual data is due by 20 August. NHS trusts will be able to review data on nhs.uk's web development site after 8 August and trusts will be sent a link to enable them to do so. Chief executives should take the opportunity to assure themselves that they are satisfied with data quality.

In case of any technical queries, please contact either Richard Edwards on 0121 333 0274 or Simon Matthews on 0845 650 4865 at the NHS Information Authority. For queries concerning methodology contact Deborah Harrison at the Department of Health on 0113 254 6110.

Further information can be found at www.doh.gov.uk/nhsplanbookingsystems

A CD ROM has been developed for ESR, which gives an overview of the ESR project, along with demonstrations of the system, such as entering and changing an individual's personal details. The CD ROM has been circulated to all pilot sites and was distributed at the HR in the NHS conference in Birmingham on 1 - 2 July. An audio transcript of the CD ROM can be downloaded from the web-site. www.doh.gov.uk/sharedservices/news.htm. Alternatively copies of the CD ROM can be requested by e-mailing esr@doh.gsi.gov.uk or speaking to Debbie Watson on 01926 475797.

The ESR web-site has also been comprehensively reviewed and updated to reflect the latest project information - www.doh.gov.uk/sharedservices

Department of Health contact: Hester Cleghorn, communications assistant, Shared Services
Tel: 0113 2547713 Fax: 0113 2547798

As previously notified in the Chief Executive Bulletin 107 of 7 March and 115 of 2 May 2002, responsibility for issuing prescription prepayment certificates (PPCs), medical (MedEx) and maternity (MatEx) exemption certificates in England will transfer to the Prescription Pricing Authority (PPA) from 1 October 2002

The PPA is posting an update letter to strategic health authority chief executives. The PPA is also sending a letter to GPs and pharmacists and an invitation to register with the PPA to those pharmacists who currently sell PPCs on behalf on their strategic health authority.
Copies of all these letters can be accessed at www.ppa.org.uk

Contact for enquiries Moira Wilson (PPA) 0191 203 5515

Around 120,000 smokers successfully quit in the last year after receiving help from NHS smoking cessation services. Figures released on 8 August show that of the 220,000 smokers in England who set a quit date between April 2001 and March 2002 over half - around 120,000 had successfully given up at the 4 week follow up stage - this is against a target of 50,000 successful quitters. The target for this year is 100,000 to successfully quit through the services.

The smoking cessation services are central to the delivery of reductions in cancer and coronary heart disease. The continued expansion of these services is a key part of the strategy to tackle the big killers and to reduce inequalities in health. Public health minister Hazel Blears has commented that these are encouraging results and are a tribute to the hard work and professionalism of the people who run these services.

Details of the smoking cessation figures can be found at the Department of Health's statistics website www.doh.gov.uk/public/stats3.htm. Further information is also available on the Department of Health's tobacco policy website www.doh.gov.uk/tobacco

Responses to our two surveys are now overdue:

• the census survey of all NHS secondary and tertiary healthcare and ambulance trusts is intended to deliver data on the progress trusts have made in implementing clinical governance and the benefits that have flowed from it. We shall produce a brief feedback report for all participating NHS trusts. Questionnaires were due to be returned by 31 July, except where later dates have been agreed. The Manchester Centre for Healthcare Management (MCHM), who are carrying out the survey on behalf of the NAO, have sent reminders to all trusts that have neither returned their completed questionnaire nor been in contact with MCHM. Your co-operation is requested in ensuring that returns are made as soon as possible. Enquiries should be addressed to Helen Beachy at the Manchester Centre for Healthcare Management on 0161 275 2926, or helenb@fs1.dev.man.ac.uk .
• the survey of NHS Board members and senior managers at 100 NHS Trusts is expected to deliver valuable insights into the implementation of clinical governance. Again, we shall produce a brief feedback report for all participating NHS Trusts. Questionnaires were despatched on 31 May, and were due for return within two weeks. The Health Services Management Centre, Birmingham are about to send reminders to directors and senior managers who have not responded, and to chief executives of trusts where fewer than 50 per cent of questionnaires have been returned. Your co-operation is requested in achieving a high response rate for this survey.

Enquiries should be addressed to Tim Freeman at the Health Services Management Centre, Birmingham on 0121 414 7050, or t.freeman@bham.ac.uk.

The report of the review of the Rehabilitation of Offenders Act 1974 has been published by the Home Office. The review makes a number of recommendations, including the proposal that the period before an offence becomes 'spent' is reduced to a fixed period of much shorter duration. The effect of this would be, for example, that someone sentenced to a prison term of 30 months under current arrangements would have a rehabilitation period of 10 years but under the review proposals, this would be reduced to two years. Comments on this proposal have been specifically requested.

The Department is co-ordinating a response from the NHS to the review. If you wish to submit any comments, please send them to karen.lea@doh.gsi.gov.uk by Tuesday 10 September.

The review can be found on the Home Office website at www.homeoffice.gov.uk/roareview.htm

One of the key features of the new national programme for IT in the NHS is the shift to more corporate and national approaches on the procurement and provision of IT to support care.

We have now published a summary of the new procurement strategy aimed at streamlining the whole process and accelerating the introduction of IT. There is also a consultation document on an integrated care records service that seeks NHS feedback on the proposed way forward for electronic records and national standards to ensure integration across all organisations and care settings.

To access both documents please go to www.doh.gov.uk/ipu/whatnew

The Committee on Safety of Medicines (CSM) has advised that Urabe mumps vaccine is associated with an unacceptable risk of aseptic meningitis and that the Medicines Control Agency (MCA) should object to importation of unlicensed mumps vaccine containing the urabe mumps strain.

Unlicensed medicines may be imported by licensed importers following notification to MCA, who may object if there are safety or quality concerns or an equivalent licensed product is available. A medical practitioner may prescribe an unlicensed medicine to meet the special needs of his individual patients on his direct personal responsibility. MCA contacted importers of urabe mumps vaccine on 6 August, notifying them that the vaccine should not be imported.

The risk of urabe mumps vaccine meningitis has been recognised for over 10 years. UK studies have shown the risk of urabe mumps meningitis to be at least 1 case per 3,800 doses.

MMR vaccine containing urabe mumps strain has not been used in the UK since 1992 due to this risk. Since then, the only MMR vaccines used in the UK have contained Jeryl Lynn mumps strain, which has not been shown to be associated with meningitis. For further information contact at rafe.suvarna@mca.gsi.gov.uk

Details

In a year that culminated in the first performance ratings for local council social services, this year's Chief Inspector's Annual Report draws on that information and a range of inspection and performance review activity of the Social Services Inspectorate (SSI), to provide an assessment of performance across England. This year's report has a regional focus. It also provides information about the activities of SSI.

www.doh.gov.uk/ssi/ciann-11.htm

Contact - carolyn.denne@doh.gsi.gov.uk

Ref. Annual report 28768, CI(2002)11 28812. Mailed to chief executives of local authorities with PSS responsibilities, health authorities, NHS trusts, primary care group and trusts.

This grant will be available to Councils with Social Services Responsibility (CSSRs) who wish to develop a treatment foster care programme. The grant is intended for use to pump prime the development costs of such programmes which will provide effective interventions for young people with anti-social behaviour and severe behavioural problems within a structured living environment. Training in the effective interventions will be provided to the health and social services staff and carers in the successful programmes.

Local authorities should only bid if they have evidence of existing joint planning arrangements across social care, health and education and youth justice services.

Full details of the criteria will be found in the circular, hard copies of which can be obtained from Helen Jones, Room 142, Wellington House, London SE1 8UG, Tel: 020 7972 4530, email: helen.jones@doh.gsi.gov.uk

LASSL(2002)7

The Department of Health commissioned the King's Fund to produce a guide to help assess how well local services that support carers meet five key quality standards.

The guide can be used to support a quick self-check of the extent to which standards are being met or a more formal and comprehensive review.

A summary of the guide and how to order it is available in the What's new section of the Government's carers website at www.carers.gov.uk

For more information about carers issues please contact Rose Cofie on 020 7972 4991. If you need further information about the guide, please contact Penny Banks on 020 7307 2682 at the Kings Fund.

Funding is available from the Whitehall-wide Evidence Based Policy Fund and sponsoring government departments for a research programme to pilot the integrated children's system with social services and relevant partner agencies. The system offers a coherent framework for assessment, planning, intervention and review of children using social services. The multi-agency research will examine whether the integrated children's system:

• supports interagency working
• facilitates information sharing
• strengthens social work practice and processes
• provides the information needed to support planning processes at individual and strategic levels
• assists the use and development of performance management;
• provides the foundation for achieving better outcomes for children.

A letter to chief executives of councils with social services responsibilities providing information on the project and criteria for participating in the pilot is available on www.doh.gov.uk/integratedchildrensystem/briefings.htm

Further information about the integrated children's system is also available on the above website.

Any queries please contact Hedy Cleaver at hedy@vsvboats.com

This notice advises local councils that the Department will publish on 8 August the Promoting Independence Grant Determination and Guidance. The guidance draws the attention of local councils to the conditions for the Promoting Independence Grant for 2002-2003.

The determination and guidance are available on the Department's website at
www.doh.gov.uk/scg/independencegrant

DH contacts: helen.woodhead@doh.gsi.gov.uk or mike.sosnowski@doh.gsi.gov.uk

Social services departments will need to be aware that, as from 28 October 2002 the rules for Invalid Care Allowance (ICA) are changing. The announcement was made in autumn 2000 following the publication of the Report of the National Strategy for Carers.

Carers aged 65 or over will be able to claim for the first time. Claims can be accepted from now on, but entitlement can only begin from 28 October.

Entitlement to ICA will continue for up to 8 weeks after the death of the disabled person being cared for.

From April 2003, the name of the benefit is changing to 'Carer's Allowance'. Existing customers do not need to reclaim.

For further information about these changes contact Marion Hutt on 020 7962 8678 or visit the Department of Work and Pensions website

I am writing to let you know that ministers have decided to further postpone the commencement date of the regulations and national minimum standards relating to:

• Residential Family Centres
• Domiciliary Care Agencies

until 1 January 2003.

As you know, the target date for the application of these regulations and standards was 1 July 2002. Following the consultation, it did not prove possible to publish the regulations and standards in their final form in sufficient time to allow agencies a reasonable length of time to gear up for implementation and so this was postponed until 1 September. There is insufficient time now to publish in time for a September start. Therefore we now intend to publish at the end of September so that the regulations and standards will come into force on 1 January 2003.

NB this item was placed in Bulletin 128, item 28 in error.
Last weeks bulletin said:
"(I am pleased to announce the publication of the above guidance issued under section 7 of the LASS Act 1970.

This guidance identifies appropriate policies and supplementary practice guidance for those LASSD or Independent sector agencies who manage adult placement schemes. It should be read in conjunction with the National Minimum Standards for Adult Placements)"

Due to technical difficulties this will not appear until 16 August. A link will be made available in the Chief Exec bulletin that week. Apologies for any inconvenience.

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: 8 August, 2002