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Welcome to the 15th edition of the monthly CNO bulletin. These bulletins aim to provide you with updated information about relevant issues in the NHS, which will be of specific interest to nurses, midwives and health visitors. It will also enable you to obtain further detail about particular issues through hypertext links. Contents this month: Directors of nursing and lead nurses in primary care trusts who booked a place at this year's Chief Nursing Officers conference should have received details of the event, held 13-15 November at the Palace Hotel, Torquay. The theme this year is 'Moving forward and beyond – collaborating to deliver change’. For further information, please contact the Glasgows Goup on 01772 767723 or e-mail cnoconference@glasgows.co.uk 2. Website publications on CNO’s 10 key roles Two new publications on nurses’ roles will appear on the Department of Health website during November. Developing new roles for nurses and midwives – a manager’s guide presents 17 case studies of CNO’s ‘10 key roles for nurses’ (from the NHS Plan) in practice. It also provides advice on the legal, professional and liability issues involved in implementing these roles, as well as contact numbers for copies of protocols, training programmes, audit tools and other materials developed in case study sites. The booklet will also be sent to all nurse executive directors in NHS trusts and lead nurses in primary care trusts. The text can be found at www.doh.gov.uk/newrolesfornurses Information on particular aspects of new roles for nurses and allied health professionals (AHPs) can also be found on the website from November. This has been produced as part of the joint Cabinet Office/Department of Health project, Reducing burdens in hospitals, published in July 2002. The project aims to find practical solutions to remove or reduce bureaucratic burdens on frontline staff in the NHS. Following comments from frontline staff that, in some trusts, nurses are not allowed to administer medicines intravenously and AHPs are not allowed to request tests and investigations, the text describes the legal and professional requirements for these activities and highlights case studies where these roles are already in place. It can also be accessed at www.doh.gov.uk/cno/ahpsxrays.htm 3. Confidentiality consultation From October 22 2002 to January 31 2003, a major consultation will be carried out on a patient confidentiality management system for the NHS. The consultation targets those who deliver, support, research, regulate and receive NHS health care services. The aim is to canvas the widest range of opinion to ensure that the outcome works for all concerned. This consultation is being carried out on behalf of the National Implementation Programme by the Confidentiality Work stream led by Dr Anthony Nowlan, head of stakeholder relations at the NHSIA. Everyone will be affected by the outcome. The consultation proposes new ways for staff to work as well as new tools, processes and technology to support them in sharing patient information. We urge you to take part and to ensure that we receive responses from as many perspectives as possible. Organisations and individuals can participate online, through workshops and by post. Two months will be spent analysing the results and amending the proposals before publishing the results. For further information or a consultation pack online visit www.nhsia.nhs.uk/confidentiality or call the information hotline on 08453 660066 for a pre-printed or CD-ROM consultation pack. 4. Toolkit for producing patient information Information is an important part of the patient journey. The NHS Plan commitment to putting patients at the centre of care lays some firm foundations for giving patients more power, protection and choices. The Kennedy Report into the Bristol Inquiry also emphasises the need for a greater partnership between patients and professionals and making consent more patient-centred. The Department of Health, recognising the efforts organisations are making to improve patient information, has developed a toolkit to help them. This toolkit consists of guidance for written patient information and a series of templates to accompany the guidance. It was put together with the Patient Information Forum, a national group representing people working in the field of patient information in the NHS and the voluntary sector, the Royal National Institute for the Blind and the Plain English Campaign. The toolkit is available on the NHS identity website at www.doh.gov.uk/nhsidentity and is called ‘Toolkit for producing patient information’. Hard copies can be obtained from the NHS Response line on 0870 155 5455, quoting reference number 29682. We would like to find out from the NHS whether our guidance is helpful and would welcome your comments via the feedback form included in the document by 31 January 2003. Medical Devices Agency hazard notice 2002(07): risk of serious injury – incorrect assembly of respiratory equipment. See the MDA website: www.medical-devices.gov.uk 6. Prison health transferred to Department of HealthThe Home Secretary and the Health Secretary have agreed that funding responsibility for prison health services in England is to be transferred from the Home Office to the Department of Health. This responsibility will take effect from April 2003. This is the first step in a process over the next five years that will see prison health become part of the NHS. Primary care trusts will then become responsible for the commissioning of health services to prisoners in their areas. The current Prison Service funding used to provide health care for prisoners will be transferred to the Department of Health. In addition, the Department of Health will, over the next three years, allocate further resources to improve these services, rising to around an extra £46 million a year by 2005/06. Briefing information, including Q&As, have been sent to Prison Service area managers and governors and to directors of health and social care. This can be downloaded at www.doh.gov.uk/prisonhealth/pr-prison-health-trans.pdf For further information contact Lesley Rudd, Director of Nursing, Prison Health Task Force on 020 7972 4767. 7. Chief nursing officer’s special award for prison nursing Barry Sidaway, cluster lead nurse at HMP The Verne in Dorset, received the prestigious chief nursing officer’s special award for prison nursing, sponsored by HM Prison Service, at the Nursing Standard Nurse 2002 Award. Determined that his staff should discover, as he had, the benefits of education, Barry found a way round the difficulty of work pressures in the prison service. With little time available to allow individuals to attend courses outside the six prisons for which he is responsible, Barry’s solution was to bring the university to the prison. His drive and negotiating skills led to the first work-based learning programme set up inside a UK prison. Staff can now choose from 25 courses, offered via Bournemouth University and the local workforce development confederation. If enough nurses are interested in a course not on the list, Barry says he will do what he can to provide it. "I saw a potential for improvement as prison health care had become isolated from the nursing profession," he says "Staff of all grades now have access to education in the workplace." The judges found this "truly inspiring". For further details of the award winners visit www.nursing-standard.co.uk/events/nsawards.htm 8. New resource for older people's champions Calls for increased support and explanation of the role of NSF Champions followed publication of the National Service Framework for Older People in March 2001 and the development of a local implementation structure, which brought together health and social care organisations and local older people’s champions into Local Implementation Teams (LITs). A new resource, or toolkit, provides champions with information to support them in promoting the interests of older people in developing health and social care services in line with the requirements of the NSF. Different types of champion have different levels of knowledge about the NHS and social services and, to some extent, different information requirements. The resource provides material that should be helpful for all types of champions – clinical, non-executive, NHS, councillor and older people's representatives. There are also plans to offer other support to champions – the Modernisation Agency is planning a leadership programme, for example. The toolkit can be found at www.doh.gov.uk/nsf/olderpeople.htm For further information contact Carl Evans on 020 7972 4134 or carl.evans@doh.gsi.gov.uk Keep Warm Keep Well is a national campaign to reduce cold-related illnesses and deaths this winter among vulnerable people, including the elderly and those with chronic heart and lung conditions. Keep Warm Keep Well forms part of an integrated NHS and social care communications programme for this winter, combining public information about the use of health services with specific calls to action and advice on self care and prevention. This includes the campaign to encourage flu immunisation among people who are 65 and over and those at risk from underlying health conditions. The Keep Warm Keep Well Winter Warmth Advice Line Freephone 0800 085 7000, Textphone 0800 085 7857 offers advice on staying warm and keeping well in winter and information about the financial help available to them. The free Keep Warm Keep Well winter guide (available in several languages) can be ordered from the advice line and provides similar information and details of other helpful organisations. For further information, visit www.doh.gov.uk/kwkw/index.htm 10. Flu Immunisation advertising campaign The Flu Immunisation advertising was launched on 1 October 2002. The campaign aims to encourage people over 65 and those in ‘at risk’ groups, to make an appointment for their free flu vaccination. The campaign includes national TV and press advertising featuring Sir Henry Cooper, and is supported by public relations activity. Leaflets and posters supporting the campaign are available to order free of charge. Practice managers should have received sample materials and an order form, but details of the campaign and an order form are also at www.nhs.uk/flu For more information about the advertising campaign, please contact Katie Foreman by e-mailing katie.foreman@doh.gsi.gov.uk 11. Launch of the national women's mental health strategy – Women's mental health: Into the mainstream The development of a women's strategy forms part of the Government's commitment to address inequalities in the delivery of mental health services. The aim of the consultation document is to provide information, generate discussion and outline a strategic direction to mainstream women's mental health care needs. To provide equity of service to all, gender differences in women and men need to be recognised and addressed across planning, commissioning, service organisation and delivery, research and evaluation. Women's Mental Health: Into the Mainstream focuses on gender differences that are relevant to women, but many of the principles outlined are relevant to all age groups and to men, too. The public consultation, from October to December 2002, provides an opportunity for the Department of Health to listen to the views of all stakeholders across health and social care. Written comments are invited and a number of listening events will be held around the country. The document can be found at www.doh.gov.uk/mentalhealth/women.htm Copies of the full-length version and/or summary can be obtained from: Department of Health, P.O. Box 777, London SE1 6XH, tel 08701 555455, e-mail doh@prolog.uk.com For further information, contact Kathy Billington on 020 7972 4514 or kathy.billington@doh.gsi.gov.uk 12. Mental Health Bill – feedback from nurses There were a wide range and number of responses to the draft Mental Health Bill from nurses, gathered through workshops, roadshows, trust visits and direct e-mails and correspondence. The consultation period ended on 16 September 2002. A report that pulls together these responses can be found at www.doh.gov.uk/cno/mhbillresponse.htm While this report reflects many of the issues raised by the RCN, UNISON and the CPNA, their responses were analysed separately and therefore not all aspects appear here. For further information, or to respond to the report, please contact rachel.munton@doh.gsi.gov.uk 13. Nursing research and development The new £2 million programme of research for nursing, set up this year under the Department’s policy research programme, has recently issued two calls for proposals. The first, in August, was for a substantial programme of research on four themes:
The second, in September, was for a project to evaluate the extension of independent nurse prescribing. The programme has already funded a review of the evidence base for cancer nursing, a review of skill mix and planning tools for use by ward managers (to be published shortly on the CNO website), and the second stage evaluation of the nurse consultant role. A contract has recently been awarded for a further project in this programme – evaluation of the implementation of the ‘modern matron’ role in the NHS. Details can be found on www.doh.gov.uk/research/callsforproposals.htm The new nursing and midwifery strand of the service delivery and organisation programme of research is also underway, funded by £450,000 per year as announced by the health secretary at CNO’s conference last year. The commissioning group for this strand has commissioned and recently received a report on patients’ and stakeholders’ views of the prioritisation of research topics in nursing and midwifery. Projects will be commissioned based on the priorities framework identified in the report. For further information, see www.sdo.lshtm.ac.uk Applications for the first set of capacity building awards for nurses, midwives and allied health professionals, announced in May this year, have now closed. The researcher development awards and post doctoral awards are intended to identify individuals of outstanding potential early in their research careers, and provide them with support in a research training environment. More than 200 applications were received and interviews were held at the end of October and early November. 14. Launch of ADR reporting by nurses Health Minister Lord Hunt has launched a new extension to the ‘Yellow Card’ scheme to enable nurses to report adverse drug reactions (ADRs). Previously, only doctors and pharmacists could report ADRs to the scheme, which is run by the Medicines Control Agency (MCA). All nurses and midwives are now able to report. Nurse and midwife prescribers will particularly welcome the opportunity to report on adverse reactions that may arise from their own prescribing. All reporters are encouraged to use the new electronic form (the ‘eYC’) to submit their reports, although paper yellow cards, found in the back of the British National Formulary and Nurse Prescribers’ Formulary, can still be submitted. A comprehensive education pack for nurses, including self-test questions, is available on the MCA website, and provides full information on what, when and how to report – see www.mca.gov.uk Upstart! highlights news and evidence of best practice within Sure Start programmes, featuring methods that programmes can draw upon, and acts as a focal point for the Sure Start community. It is aimed at all those involved in Sure Start, including those working directly with families in Sure Start programmes, partner organisations and those involved in an administrative capacity. Upstart! is published every two months by the Sure Start Unit and edited by The National Early Years Network. Copies can be obtained from DfES Publications on telephone 0845 602 2260, fax 0845 603 3360 or e-mail dfes@prolog.uk.com 16. Strategic health authorities children's leads meeting The Child Health Policy Team at the Department of Health will be holding a meeting for all directorates of health and social care and strategic health authority children's leads on 6 November 2002 from 10:30 to 15:30 in London. The purpose of the meeting is to provide an opportunity for children's leads to hear the latest policy developments within the department regarding children, such as the National Service Framework for Children. It will be a forum for the Department of Health to hear about your issues and agree on how to work together effectively in the future. A timetable of the event can be found at www.doh.gov.uk/cebulletin/stha.htm Please bring this event to the attention of your organisation's children's lead. To register or for more information contact Jamilla Rogers-Wright on 020 7972 4716 or jamilla.rogers-wright@doh.gsi.gov.uk 17. Meeting PCT child protection responsibilities – NatPaCT seminars Sound child protection systems and services demand robust management and focused, supportive and sensitive leadership. NatPaCT, the National Primary and Care Trust Development Programme, is organising nine child protection seminars to provide time and space for lead directors with responsibility for child protection to explore their responsibilities and understanding of the PCT role in this demanding field. Who should attend?
For an outline programme and to register your interest visit http://www.natpact.nhs.uk/news/index.php?article_request=156 For further information contact John Callaghan on 0113 254 3802 or john.d.callaghan@doh.gsi.gov.uk 18. e-Health and the Department of Health: the wider picture This e-health conference will give a broader view of current e-health issues and provides an opportunity to learn about some important new initiatives in health care. It will be run by the Medical Devices Agency on 11 November 2002 in London. A number of DH individuals involved with e-Health will provide a wide and varied insight into the use of this new technology. The programme aims to address how clinicians will need to change the way they practice medicine. Professionals from all aspects of healthcare are welcome to attend. For further information, including the application form, visit www.medical-devices.gov.uk 19. Human Rights Act 1998 – free study guide and seminars A revised study guide to explain the provisions of the Human Rights Act 1998 is now available from the Lord Chancellor’s Department. The department is also hosting a series of free local seminars about the Act that are open to anyone who needs to know more about the legislation. The Act impacts on the work of many front-line services including health, social services, planning and education. Venues for the series of half-day roadshows around the country are:
For more information or copies of the guide visit www.humanrights.gov.uk or call 020 7210 2670. Please ensure this information is forwarded to legal departments. The Department of Health, in conjunction with McKesson and their technology partner, Avoca Systems Ltd, has launched OSCAR (Online System for Comparative Analysis and Reporting) – an NHSnet service to help PCTs and other NHS organisations to benchmark performance and make informed commissioning and strategic planning decisions. OSCAR contains quarterly updated information on all admissions to every provider in England. It creates interactive graphs and tables illustrating national and local admitted patient care data at the click of a button. It builds on the lessons learnt from developing PAT (Performance Analysis Toolkit). PAT has given primary care organisations access to timely and accurate data to inform service provision and to benchmark the performance of their local providers against other organisations. Analyses of elderly care, re-admissions, waiting times and admission management are available on OSCAR at various levels, including PCT, provider, speciality and health reference group (HRG). PCT chief executives and their nominated representatives can also access practice level data to assess local services in more detail. Advanced benchmarking displays, indicative budget analyses and outpatient data will soon be included on the site, providing a comprehensive picture of service provision in the PCT area. Training courses on how to use OSCAR will soon be available. To register and use OSCAR now, go to www.oscar.nhs.uk For further information about the courses, please email Marion Miller at the NHS Information Authority – marion.miller@nhsia.nhs.uk 21. Developing primary care premises – dedicated website launched A new website makes it easier to find information about primary care premises. NHS Estates has established a dedicated primary care section. It provides quicker and easier access to an expanded range of information about primary care premises investment. The website can be accessed through the NHS Estates home page at www.nhsestates.gov.uk/primary_care/index.asp The site provides a means for all those associated with primary care premises issues – strategic health authorities, primary care trusts, primary care clinicians and staff, those involved in the development of premises and others – to have access to appropriate advice and guidance, including:
For further information, please contact NHS Estates policy support manager Jas Barn on 0113 254 7213 or jas.barn@doh.gsi.gov.uk 22. PMS – support and self-help for PCT development In order to help a PCT determine its own development needs, the National Development Team (NDT) has devised a self-help tool – the Personal Medical Services (PMS ) Competency Framework. The framework helps PCTs understand the areas of expertise required to implement and support PMS and to assess where training and development is needed, at both an individual and organisational level. The NDT also runs a national PMS facilitator network:
National and local details can be found by visiting www.doh.gov.uk/pmsdevelopment, contacting a member of the team or calling the PMS helpline: 0845 9000008 23. Environmental Health 2012: A key partner in delivering the public health agenda This report, published by the Health Development Agency (HDA), produced in partnership by the Chartered Institute of Environmental Health (CIEH), was launched at the annual CIEH conference on 11 September. It explores the projected growth of environmental health officers’ role in improving the public’s health and reducing health inequalities over the next ten years. The report also sets out a number of recommendations for action, including calls for national bodies with leadership roles in environmental health and public health to support the strategic vision and its implementation. In addition, it makes the case for continuing to support the development capacity of environmental health practitioners. The report will be widely distributed as a consultation document. Comments are invited from environmental health and public health practitioners on the strategic vision and other issues raised. The report is available at www.hda-online.org.uk in the publications section. Comments should be sent to ian.gray@hda-online.org.uk At the second national teaching PCTs event, held on 11 September, a new website was launched, www.doh.gov.uk/pricare/teachingpcts The aim of the site is to provide a network for teaching PCTs (TPCTs) to develop contacts and share their experience. For further details, please contact Helen Hamilton on 0113 2546052 or by email at helen.hamilton@doh.gsi.gov.uk 25. NHS Magazine and Primary Care magazine November's NHS Magazine and Primary Care magazine will cover:
Primary Care magazine will cover:
See www.nhs.uk/nhsmagazine/primarycare The Department of Health's assistant chief nursing officer also runs a regular column in Primary Care magazine. 26. Launch of the Emergency Care Collaborative Health Minister David Lammy and Professor Sir George Alberti, national clinical director for emergency access, launched the first wave of the new Emergency Care Collaborative on 8 October. Run by the NHS Modernisation Agency, the Collaborative is a national programme for reducing delays and improving the patient and carer experience. It will focus on the whole system of emergency care and will help all A&E departments in England to meet the NHS Plan target – a maximum of four hours from a patient’s arrival to admission, transfer or discharge. The programme will run until August 2004 in six waves of roughly 35 sites each. Each wave will last 14 months. Some will overlap so that every site can complete its work and contribute to meeting the NHS Plan target by the end of 2004. Frontline staff will be directly involved in leading, testing, implementing and measuring changes that benefit both patients and staff. More information can be found at www.modern.nhs.uk/emergency 27. NHS Alliance fifth annual conference and exhibition The conference examined the success of shifting the balance of power for professionals and the public and in improving patient care and outcomes. The Secretary of State for Health Alan Milburn addressed delegates on the power of primary care trusts in the new NHS structure. Harry Cayton, the Department of Health's director of patient experience and public involvement, spoke about supporting patients and building services around them. Sarah Mullally, the department's chief nursing officer for England, discussed the role of the family health nurse during a session on improving nursing. To read the speech summaries visit www.doh.gov.uk/conferences/nhsalliance5.htm 28. National Association of Theatre Nurses congress Kerry Basnett, redesign facilitator at the NHS Modernisation Agency, and Johanna Reilly, programme manager at the NHS Modernisation Agency, addressed delegates at the National Association of Theatre Nurses Annual Congress. Kerry discussed the work and learning of the agency’s national theatre project and shared with delegates the outcomes of this project on patient care, resources, theatre utilisation and staffing. Johanna, former project manager for the theatre project in Manchester, now programme manager for the north, shared her experience of being involved in the project. To read the speech summaries visit www.doh.gov.uk/conferences/nattheatrenurses.htm 29. Models of emergency care conference The models of emergency care conference focused on progress in reforming and modernising emergency care, with key speeches from David Lammy MP, Dr Stephen Shortt and Dr David Dawson. To read the speech summaries visit www.doh.gov.uk/conferences/mod-emerg-care-con.htm 30. See & Treat events See & Treat is a system of streaming services in A&E departments that can have a profound impact on waiting times for patients. A number of national workshops have been organised around the country that will provide an opportunity to find out more about See & Treat and to hear the first-hand experiences of those who have implemented it. The workshops will:
Further details and a reply slip to attend the events can be found at www.modern.nhs.uk/emergency 31. NHS Direct, and NHS Direct Online – flagship services for e-government November 2001 saw the launch of NHS Direct Online's enquiry service, aimed specifically at providing health information, rather than dealing with symptomatic enquiries. In the first nine months of the project, however, almost one quarter (4,310) of enquiries received were symptom-based, thus highlighting a demand for a clinical version of this service to be developed . A ‘Proof of Concept’ pilot project is underway to test the viability of introducing an online clinical enquiry service. To direct and support the development of the service, a project team has been formed. The interactive services manager, who is responsible to the NHS Direct Online Board for the delivery of the project by March 2003, will chair the project team. This service will be able to deal with the symptomatic type of enquiries using a web-chat medium. This is an exciting and challenging opportunity, providing an extension to current nursing practices and new ways of working. It will offer users of the service a secure, confidential one-to-one web-based consultation with a nurse advisor within a controlled environment. This will be a first, using evolving technology to support and empower patients who choose to use the web to access services. Another function of the pilot project will be to ensure integration with the NHS Direct telephone service and with NHS Direct nurses. One of the key elements will be the development of appropriate training and educational packages for nurses to help them use the system efficiently. Two senior nurses and five nurse advisors have been appointed. Initial training for nurse advisors is due to commence at the beginning of October 2002 with limited system and user testing from November 2002 until March 2003. The results of the pilot project will be submitted in a final report allowing the NHS Direct Online Board to assess whether the ‘concept has been proven’, to monitor progress, identify risks and recommend possible ways forward from April 2003 onwards. For further details, contact:
Alternatively, you can write to Gerard at NHS Direct Online, Strawberry Fields, Berrywood Business Village, Tollbar Way, Hedge End, Hampshire, SO30 2UN.
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