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Welcome to the 16th 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:
1. A modernised NHS pay system The negotiators representing the UK Health Departments, NHS employers and NHS trade unions have successfully concluded negotiations on a new pay system for over a million NHS staff in the UK. Director of human resources Andrew Foster has written to chief executives and human resource directors giving more information about the new system. This letter and a summary document outlining the new system are available on the Department of Health website at www.doh.gov.uk/agendaforchange Details of the conference held at the Palace Hotel Torquay can be found at www.doh.gov.uk/cno and on the DH conference webpages at www.doh.gov.uk/conferences/index.htm Please note: The dates announced for the 2003 CNO conferences were 5th, 6th and 7th November. However, these clash with the CPHVA annual conference. The new dates for the CNO 2003 events are Wednesday 12th, Thursday 13th and Friday 14th November. The conference will be organised by the Midlands and Eastern Directorate of Health and Social Care (DHSC). Directors of nursing, lead nurses from PCTs and others within this DHSC with an interest in joining the planning team should contact Robert Tunmore on 0207 020 5079 or email robert.tunmore@doh.gsi.gov.uk 3. CNO review of independent nurse prescribing Key recommendations from the CNO review of the nurse prescribers’ extended formulary (NPEF) were announced in November. They included:
For further information on independent nurse prescribing, see www.doh.gov.uk/nurseprescribing 4. Supplementary prescribing by nurses and pharmacists On 21 November Lord Hunt announced key decisions on supplementary prescribing by nurses and pharmacists following the public consultation carried out between April and July.
The Medicines Control Agency (MCA) has extended its suspected adverse drug reaction reporting scheme (the Yellow Card scheme) to all nurses, adding around 330,000 NHS health professionals to the scheme. The scheme now accepts reports from doctors, dentists, coroners, pharmacists, nurses, midwives and health visitors. It plays an important role in identifying drug safety issues and preventing harm. The current extension is also being supported by the introduction of an electronic Yellow Card that can be used by all health professionals to enable quicker and easier submission of reports. The e-Yellow Card can be found on the MCA website at www.mca.gov.uk To strengthen the scheme further the MCA is working with NHS Direct to enable patients to report through NHS Direct telephone lines and to use NHS Direct Online. The scheme is designed to increase patient power by ensuring that reports can be made in a user-friendly way with advice on hand should it be needed. The intention is that the scheme will be rolled out across England from February 2003. For further information contact Jeremy Mean on 020 7273 0494 or jeremy.mean@mca.gsi.gov.uk 6. Nursing research - report disseminationThe first major research report of the Department’s £2 million nursing quality research programme will soon be posted on www.doh.gov.uk/research Researchers at the University of Leeds’ Nuffield Institute have carried out a comprehensive review and appraisal of the staffing and skill-mix methodologies used in general nursing settings. A summary will be circulated to nurse executive directors of NHS trusts and PCT lead nurses in the New Year. The tools discussed in the report will be available for download from the Nuffield Institute website, as well as details of a telephone helpline available to matrons and ward managers. 7. Nursing research - evaluation of the work of modern matrons The contract for this research has been awarded to a team from the University of Sheffield and the RCN Institute. The aim of the research is to:
The team will report in December 2003. The full tender can be seen at www.doh.gov.uk/research/callsforproposals.htm 8. Paediatric and congenital cardiac services review In November, the DH published the report of the review group established to examine paediatric and congenital cardiac services. The report:
Comments are invited on all aspects of the report and particularly on the number of operations each centre should perform each year, where the evidence base is slight. The full text of the report and consultation letter can be found at www.doh.gov.uk/childcardiac/ Responses should be sent by 28 February 2003 to: pccrconsultation@doh.gsi.gov.uk or The PCCS Review, Room 512, Wellington House, 133-155 Waterloo Road, London, SE1 8UG. 9. The Ill Child - new external working group A group of experts from health, social care, statutory and voluntary agencies are to collaborate to develop standards and service models for The Ill Child, which will be included in the Children's NSF. The group will be chaired by Professor David Hall, president of the Royal College of Paediatrics and Child Health and Professor of community paediatrics at Sheffield University, and Chris Town, chief executive of North Peterborough Primary Care Trust. The six working groups taking forward the development of the full children’s NSF are: The Ill Child; The Disabled Child; Children in Special Circumstances; The Healthy Child; Child and Adolescent Mental Health Services; Maternity. Standards for hospital services for children will be published shortly, along with a document on issues emerging from the external working groups. The full NSF will be published during 2003. 10. NHS University consultation Proposals for the new corporate university of the NHS – the NHSU – are outlined in the consultation document Learning for Everyone. NHSU will work closely with colleges of further education and universities, which already provide vital education and training services to the NHS. It will also form strategic partnerships with organisations such as the Open University, Learndirect and the e-Universities initiative. The new proposals will open up new learning opportunities for all staff. The plans include:
Feedback from the consultation exercise will contribute to the NHSU's first strategic plan, due to be published in Spring 2003, which will feed into the preparation of the official launch of the NHSU in Autumn 2003. Copies of the development plan Learning for Everyone are available by calling 0800 555 550. For further information or to contribute to the consultation you can write to NHSU Consultation, Room 301A, Skipton House, 80 London Road SE1 6LH, email yourviews@nhsu.nhs.uk or go to www.nhsu.nhs.uk The consultation will end on 21 February 2003. 11. Nurse leadership programme for older people Around 100 nurses in the NHS and independent sector are to take part in an accelerated leadership development programme to guide nurses working with older people. The aim of the programme is to develop the leadership potential of modern matrons or their equivalent in different settings, in order to raise standards of care for older people and raise the profile of this important field of work. Th NHS Leadership Centre will co-ordinate the project which will start early next year. Each of the 28 Strategic Health Authorities will nominate a team of three people – one each from an acute trust, a Primary Care Trust and an independent care home. These teams will carry out a work-based project to improve the care of older people within their system. Clinical care in general wards, outpatients and A&E departments, primary care and nursing homes could all be covered by this work. Development opportunities will also be offered to nurse consultants working in older people's services, making a total of around 100 leaders in this field. For more information see the special CNO bulletin on the Nurses Delivering the NSF for Older People conference at www.doh.gov.uk/cno/bulletinspecialnov02.htm 12. Practical guide for primary care Liberating the Talents – a new practical guide designed to help primary care trusts (PCTs) and frontline nurses deliver the NHS Plan – provides staff with a new framework for organising and delivering primary care nursing services so that both patients and the NHS benefit. As well as being circulated to every PCT in England, the new framework will be the subject of a variety of national workshops for all PCTs in every strategic health authority to help change happen on the ground. Copies of the framework are available from www.doh.gov.uk/cno/liberatingtalents.htm 13. Healthy start - proposals for reform of the welfare food scheme This programme provides milk and vitamins to expectant and nursing mothers, babies and children under five in low-income families. The proposals for reform make the best use of existing resources to widen nutritional choice and bring the scheme in line with the latest expert advice on nutrition. The new scheme, due to operate from 2004, proposes to exchange fixed face value vouchers for fruit and vegetables, cereal based foods, other foods suitable for weaning as well as milk and infant formula. These vouchers will replace the current milk tokens. Vitamin supplements will remain as part of the scheme. The age range will be unchanged, and the scheme will introduce a new choice of either free milk or a piece of fruit for children at nursery school. Eligible mothers will register for the new scheme with the NHS through ante-natal and post-natal clinics. Comments are invited on the proposal by Friday 13 December to healthystart@doh.gsi.gov.uk or to the Healthy Start team, room 633/4 Wellington House, 133-155 Waterloo Road, London SE1 8UG. The document is located at www.doh.gov.uk/healthystart/index.htm and is also available from the Department of Health, PO Box 777, London SE1 6XH. The expert (COMA) review of the Welfare Food Scheme is being published simultaneously with the consultation document and can be found (ISBN 011322589X) at www.tso.co.uk/bookshop For further information contact Dr Ray Earwicker on 020 7972 4504 or ray.earwicker@doh.gsi.gov.uk 14. Local compacts - improving relationships with the voluntary and community sector The Department is determined to see all NHS organisations in England signed up to a geographically relevant ‘local compact’ by 31 March 2004. A local compact should be part of the on-going consultation and involvement process of monitoring, reviewing and implementing service changes. It involves local voluntary and community organisations, local authority councillors and officials, NHS boards and staff all working together. A local compact will be a valuable mechanism for these organisations to help develop local health and social care policies and improve NHS local delivery. Chief nursing officer Sarah Mullally is the Department of Health’s compact champion. Information about the compact, local compacts and what to do next can be found at www.doh.gov.uk/compact/index.htm For further information contact Charles Perry on 020 7972 4093 or at charles.perry@doh.gov.gsi.uk 15. National Patient Safety Agency Ensuring the safety of everyone who comes into contact with health services is one of the most important challenges facing health care staff. The National Patient Safety Agency (NPSA), established in 2001, has a key role in implementing the patient safety agenda, and will run a new national system for reporting, analysing and learning from adverse events and near misses involving NHS patients. The NPSA Modernisation Directorate, headed by Dr Helen Glenister, will be instrumental in providing practical solutions to improve patient safety. Key areas currently being addressed are:
Other areas of solution design work include: wrong site surgery; clinician identifier ink stamps; latex sensitivity; ambulances carrying naloxone; hip protectors For more information please contact Samantha Adewale (PA to Helen Glenister) on 020 7868 4011 or visit www.npsa.org.uk 16. Protocol-based care information pack The Government’s vision for the future of the NHS is one of a modern service, delivering excellent care, and shaped around the needs and expectations of patients. The development of protocol-based care is a key part of this vision. The protocol-based care information pack, developed around National Institute for Clinical Excellence (NICE) guidance and other recognised standards, facilitates the translation of evidence into practice, and enables NHS staff to address the key questions of what should be done, when, where, and by whom. The pack:
The pack is available at www.modern.nhs.uk/protocolbasedcare For further information e-mail anne.hackett@doh.gsi.gov.uk or call 020 7210 5469. The National Institute for Clinical Excellence (NICE) has recently issued the following guidance to the NHS. Technology appraisals:
Inherited clinical guidelines:
For more information contact Lucy Betterton at lucy.betterton@nice.nhs.uk 18. NICE appraisal on home versus hospital haemodialysis The National Institute for Clinical Excellence (NICE) has carried out an appraisal of home versus hospital haemodialysis. NICE published its guidance on 4 October 2002. It has advised the Department of Health that the NHS will not be able to provide the equipment and infrastructure to support the expansion of home haemodialysis that is envisaged within three months of the publication of the guidance. The Department has considered this advice and has decided to issue a direction to exempt this appraisal from the direction issued on 11 December 2001 concerning the availability of funding for treatments recommended by NICE within three months of the publication of the guidance. The text of the directions can be viewed at www.doh.gov.uk/pricare/nice-ha-amending-directions-Oct02.PDF
It is envisaged that when considering your approach to the implementation of NICE’s guidance on home versus hospital haemodialysis, you will wish to be informed by the forthcoming Renal National Service Framework (NSF). We also anticipate that regional specialised commissioning groups or their successors will work with local hospital providers to develop implementation timetables for the guidance laid out in this NICE appraisal together with and in line with the forthcoming Renal NSF Delivery Strategy milestones. For further information contact Dr Nick Clarke on 0113 254 5205. 19. NICE appraisal on ultrasound locating devices for placing central venous catheters The National Institute for Clinical Excellence (NICE) has carried out an appraisal of ultrasound locating devices for placing central venous catheters. NICE published its guidance on 4 October 2002. It has advised the Department of Health that the NHS will not be able to provide the equipment and the training of sufficient healthcare practitioners from a range of disciplines required for this treatment to be available within three months of the publication of the guidance. The Department has considered this advice and has decided to extend the implementation time period to 12 months. It has issued an amending direction to the direction issued on 11 December 2001. The text of the directions can be viewed at www.doh.gov.uk/pricare/nice-ha-amending-directions-Oct02.PDF For further information contact Dr Nick Clarke on 0113 254 5205. 20. Clinical governance reporting processes Following the publication of Shifting the Balance of Power, guidance has been developed to identify new clinical governance reporting frameworks and processes for strategic health authorities and NHS trusts. The guidance will give clarity to clinical governance roles and functions, which will be further developed as new organisations and responsibilities evolve. To ensure that clinical governance and plans to improve the quality and safety of patient care are embedded within local delivery plans, clinical governance reporting processes have been aligned with the new planning framework. This high-level reporting framework will need to be supported by appropriate local mechanisms. The guidance is available at www.doh.gov.uk/clinicalgovernance/reportingprocess.htm For further information please contact Susan Went on 020 7972 5346 or susan.went@doh.gsi.gov.uk Further information on clinical governance can also be found at www.cgsupport.org 21. Midwifery return to practice - new open learning pack The Royal College of Midwives (RCM) has launched an open learning returning to midwifery practice pack, developed in collaboration with the Open University and funded by the Department of Health. The pack Midwifery – returning to practice aims to enable midwives to return to practice with confidence, targeting those areas where shortages are felt the most. It can be used either as part of a course, or on its own for resource purposes, by midwives who have taken time out. Midwifery – returning to practice will be continually updated in order to remain contemporary, dealing with midwifery issues such as the NHS Plan and modernisation. For further information call the RCM education department 020 7291 9200. 22. Improving Working Lives - guidance for AHPs and health care scientists Allied health professionals and health care scientists play a vital role in the delivery of NHS patient services. Their work underpins patient care. The recruitment and retention of qualified and motivated staff remains a priority. National initiatives encourage growth and retention of NHS staff. Local measures are equally important to make the NHS an attractive option for new recruits and encourage retention amongst existing staff. The cornerstone of local initiatives is Improving Working Lives (IWL). Launched in October, the IWL guidance for allied health professionals and health care scientists recognises the fact that implementing the IWL standard is sometimes problematical for this group, because of the specialist nature of their work and the fact that they often operate in small teams, creating particular problems around flexible working and career progression. The guidance contains information on the IWL standard, guidelines and examples of good practice, following on from earlier guidance for doctors and the pharmacy team. It can be found at www.doh.gov.uk/iwl/publications.htm or obtained from the Responseline on 08701 555 455. The main provisions of the new Community Care Bill are:
More information on the bill can be found on the DH website at www.doh.gov.uk/jointunit/delayeddischarge/communitycarebill.htm or contact Emma Preece on 020 7972 4375. 24. Developing services for carers and families of people with mental illness Forming part of the Mental Health Policy Implementation Guide, the aim of this document is to help local mental health services further develop support services for carers of people with mental health problems. It builds on Standard Six of the Mental Health National Service Framework and guidance on implementation of the Carers and Disabled Children Act 2000. Implementation of this guidance is the responsibility of commissioners and providers of health and social care mental health services as well as primary care trusts. The NHS Plan has set a commitment that by 2004, 700 more staff will be recruited to increase the breaks available for carers and to strengthen carer support networks. It is hoped that this guidance will be used by services to ensure that this is achieved. The document can be found at www.doh.gov.uk/mentalhealth/devservcarers.pdf For further details contact Kathy Billington on 020 7972 4514. 25. NHS Direct Online - internet advertising campaign aimed at men An internet advertising campaign to promote the NHS Direct Online website (www.nhsdirect.nhs.uk) to young men aged 18-34 began at the start of November and runs until 15 December 2002. A combination of banner advertisements and pop-ups will appear on websites such as www.fhm.co.uk, www.gay.com and www.itv-football.co.uk. The key message of the campaign is that NHS Direct Online can save you time and embarrassment –comprehensive health advice and information can be accessed anonymously, 24 hours a day, seven days a week, from the home or work place. For further information contact Sarah Armitage on 0113 254 5659. 26. HIV and hepatitis infections in the UK 2001: annual report The latest annual report of the Unlinked Anonymous Prevalence Monitoring Programme was published last week in the run-up to World AIDS day on 1 December. The report and accompanying letter are available at www.doh.gov.uk/hivhepatitis/report2001.htm
Printed copies of the report can be obtained, quoting reference 29815, by writing to: Department of Health, PO Box 777, London SE1 6XH; Fax: 01623 724 524; email: doh@prologistics.co.uk or by calling the NHS Response Line on 08701 555455. All the specialities involved in Phase II of the Action On programmes (dermatology, ENT and orthopaedics) are now moving from piloting new ideas to sharing their experiences. Over the next few months, guidance covering all three specialities will be produced, starting in mid-November with Action On ENT. Guidance on orthopaedics will be issued in early December, in conjunction with the Orthopaedic Services Collaborative. The Action On dermatology guide will be ready in January 2003. Copies of the Action On ENT guide will be sent to all British Association of Otorhinolaryngologists - Head and Neck Surgeons (BAO-HNS) members. Copies will also go to audiology departments, speech and language therapy departments, ENT outpatient departments, ENT wards and PCT clinical directors. All those who attended the launch events and received advance copies of the guide will be sent an accompanying CD-ROM. The guide is also available at www.modern.nhs.uk/action-on and in hard copy format by calling the NHS Response Line on 08701 555 455. Directors of the Phase III Action On specialities (general surgery, plastic surgery and urology) have been appointed and details are available on the Action On web site at www.modern.nhs.uk/action-on Further information about the Phase III specialities will be published there as it becomes available. For further information contact Eric Ludlow on 0116 222 1422 or at eric.ludlow@npat.nhs.uk 28. Retained organs - information for relatives and families The Retained Organs Commission has published a booklet for relatives and families entitled How can the Retained Organs Commission help me? The commission has also published four information leaflets:
Copies of the commission's leaflets, annual report and guidance can be found on the commission's website at www.nhs.uk/retainedorgans/ Alternatively, hard copies can be ordered by sending a fax to the commission on 020 7972 2017 or by emailing retained-organs-commission@doh.gsi.gov.uk The Retained Organs Commission will be hosting a conference on organ retention for NHS delegates on 16 January 2003 in London. Further information and joining details will be available from the commission during December 2002. For further information contact Janet Lewis on janet.lewis@doh.gsi.gov.uk Summaries of the speeches at the following events can be found at www.doh.gov.uk/conferences/index.htm
30. MD Poster for Operating Theatres In response to continued reports of injury caused by user error during the use of electrosurgery equipment in operating theatres, the Medical Devices Agency has produced a poster that is designed to promote safe team working and reduce these incidents. Copies of the poster have recently been distributed to all operating theatres via the MDA liaison officers. A pdf version can be found on the MDA website at www.medical-devices.gov.uk and further copies obtained from MDA Business services on Tel 020 7972 8360. If you wish to discuss the content of the poster please email Dr Jon Hopper of MDA's clinical team (jon.hopper@doh.gsi.gov.uk).
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