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CNO remains on board Chief nursing officer Sarah Mullally will continue to be a member of the Department of Health Board – ensuring nurses voices continue to be heard at the top. NHS chief executive Sir Nigel Crisp confirmed this in a letter to the Nursing Times which ran a story on the issue. He said: "I have now had the privilege of working with Sarah Mullally for two years. As chief nursing officer she plays a very effective role across the whole work of the Department and the NHS, contributing to corporate decision making as well as leading on her own areas. I want to see this continue under any change. CNO will continue to sit on the Departmental Board and to report directly to me. "We want to see nurses with the power to make a difference. And we want nurses to be not just working for the NHS, but centrally involved in shaping its services." Prescribing – new powers for nurses The Department of Health is introducing supplementary nurse prescribing from April 2003. This will involve forming a voluntary partnership between a doctor (the independent prescriber) and a nurse or pharmacist (the supplementary prescriber). To ensure the partners are fully aware of the patient’s needs, a 'clinical management plan' will be written outlining exactly what drugs and treatment they require and when. Extended nurse prescribers have been prescribing to patients since last year but supplementary prescribing will increase the number of medical conditions they can write for under doctor direction. Patients with asthma, diabetes, coronary heart disease and high blood pressure will be among those who benefit. This improved teamwork will speed up the prescription processes, so that both staff and patients gain from a more efficient system. A guide to implementing supplementary prescribing is at www.doh.gov.uk/supplementaryprescribing Information on competencies for supplementary prescribing is at: www.npc.co.uk Supplementary prescribing case study – how one nurse clinician is maximising the benefits of her prescribing powers With more than 24 years’ nursing experience Kate Cernik is convinced of the value of offering patients a complete package of care. But until last year the nurse clinician at Appleton Primary Care Trust in Cheshire had to ask a GP to write a prescription for her patients if they needed one. The introduction of extended nurse prescribing (ENP) changed that. After 25 days of university-based training and 12 days supervision with her GP mentor, she qualified. Since then she has been able to offer a full service to patients with minor injuries and ailments. Under ENP Kate can prescribe, without asking a GP, from an extended list of medicines - the Nurse Prescribers’ Extended Formulary. And with the launch of supplementary prescribing next month, Kate will be able to increase the range of medical conditions for which she can prescribe. She will attend a two day top-up course to give her the skills to do this. A doctor will still diagnose the patient, but Kate will then work with the doctor and the patient to draw up a ‘clinical management plan’ outlining the medicines and treatment needed for continuing care. "Supplementary prescribing will mean I can prescribe for more medical conditions and it will be particularly useful for chronic disease management," said Kate. "It means I will be able to continue the work I start and, for nurses in general, it gives us more autonomy." More information on supplementary prescribing is at: www.doh.gov.uk/supplementaryprescribing Nurses leading reform The strength of the nursing workforce to lead and implement changes to patient care in the NHS has been highlighted in the NHS Modernisation Board’s annual report. This status report is a comprehensive review on the progress being made to modernise the health service, concluding that "the NHS of the 21st century is still evolving" and on schedule to deliver the 10-year NHS Plan. The board said: "Excellent progress has been made in recruiting and retaining nursing staff." The latest figures show that there are now almost 40,000 more nurses working in the NHS than in 1999. The board also highlighted the capacity of nurses to adapt to change, explore different ways of working and deliver better quality patient care. For instance, nurse-led services such as walk-in centres and NHS Direct are now handling an increasing number of calls. While modern matrons, introduced following the NHS Plan, are now helping to deliver more patient-centred care. Heather Drabble, a board member and director of nursing at Sheffield Teaching Hospitals NHS Trust, said: "Nurses are now delivering many of our clinics - something which capitalises on their skills, frees up colleagues and meets patient needs. "I am particularly pleased to see how nurses have been leading modernisation and increasingly engaging with patients and the public in meaningful partnerships." The board report recognised that the NHS is changing in order to value its staff more through initiatives like Improving Working Lives, which offers more flexible careers for nurses, and the Changing Workforce programme, which is enabling nurses to develop their skills and take on new roles and responsibilities. However, the implementation of pay modernisation reforms over the next year was seen as critical to continued progress. Royal College of Nursing general secretary Beverly Malone, who is also on the board, said: "Nurses deliver the majority of direct care and have been leading modernisation in so many areas of health care…A new pay and career system is urgently needed to give patients the plentiful, well educated, motivated and rewarded nursing workforce they need." The board report is available at: www.doh.gov.uk/modernisationboardreport Meeting the A&E waiting targets The NHS Plan target is to ensure that by December 2004, 100 per cent
of patients are admitted, discharged or transferred within four hours
of arriving in A&E.
National clinical director for emergency access Professor Sir George Alberti has produced a checklist/toolkit to help trusts and staff improve A&E waiting times. It is available at www.doh.gov.uk/emergencycare/aetargetchecklist.htm The NHS Modernisation Agency Emergency Services Collaborative programme
also supports staff to identify and deal with the constraints that have
the biggest impact on improving patient care and reducing waiting times
in A&E. The first national report and programme case studies are at:
Nurses Day on 12 May 2003 – call for local school visit co-ordinators Would you like to help influence children and young people's services locally and inform the Children's NSF? The Department of Health in collaboration with the Royal College of Nursing and the Community Practitioners and Health Visitors Association is supporting nurse visits to schools through local networks around Nurses Day. Past nurse visits have provided a realistic and positive image of modern day nursing, challenged negative stereotypes about what they do, where they work and how they work with other members of the NHS team. If you are interested in becoming a co-ordinator or want to be involved in a local visit send your contact details by e-mail to: CNO-Bulletin@doh.gsi.gov.uk or contact Robert Tunmore 020 7210 5079 by Monday 14 April. A website www.learnaboutnursing.org will help put teachers in touch with local co-ordinators who will contact nurses to arrange visits. The Department of Health is updating its teaching and learning resources
on this site ready for Nurses Day. The website will also include a "Verse
for a nurse" competition for seven to 11-year-olds and be linked
to the Department of Education and Skills (DfES) website for teachers
www.teachernet.gov.uk Smallpox vaccination of regional rapid response groups An information pack for healthcare workers administering or receiving smallpox vaccination is now available. The pack contains information and practical tools needed by vaccinators and vaccinees to carry out vaccinations and ensure optimal follow-up. Included are a tracking form for the vaccine, sample vaccination certificate, health diary and national registration form as well as information on the possible complications of the vaccination and their treatment. The pack is available at: www.doh.gov.uk/smallpox/vaccination Mental health services - workforce design and development Best practice guidance to help local health and social care systems produce a Joint Workforce Plan, coherent with the Local Strategic Service Plan, is being published as part of the Policy Implementation Guide for mental health services. It aims to set out the principles and methodology by which localities can estimate the demand for staff across the statutory sector. It will take account of the contribution made by the independent sector, and match it against expected supply of staff. See www.nimhe.org.uk Child and adolescent mental health services (CAMHS) Improvements The vision for CAMHS improvements is set out in Improvement, Expansion and Reform: the Next Three Year Priorities and Planning Framework 2003-06 published in October 2002. It sets out the overall vision of achieving comprehensive CAMHS by 2006, to include mental health promotion and early intervention, and increase CAMHS by at least 10 per cent each year across the service according to agreed local priorities. Local delivery plans should specify steps that need to be taken to achieve this goal. More details at www.doh.gov.uk/planning2003-2006/ and CAMHS grant guidance on the COIN database
Graduate primary care mental health workers Trent Workforce Development Confederation together with the Department of Health’s Mental Health Programme has commissioned higher education institutes (HEIs) across the country to create training courses for 1,000 new graduate primary care workers. They will be appointed by 2004 to support GPs and primary care teams in providing care for people with mental health problems. Each course provider has formed partnerships with local primary care trusts, service users and carers, and other mental health services, to ensure course content, teaching methods and outcomes can develop quality primary care workers. More information at www.doh.gov.uk/mentalhealth Starter home initiative Are you are a health worker unable to live near where you work? Are you fed-up with rented accommodation and dream of a home of your own? If so, the Starter Home Initiative could be for you. The Government has made £250 million available to help 10,000 key workers - particularly health staff, teachers and police - onto the property ladder by 2004. The scheme has been set up for people who cannot afford to buy homes near work, especially in London, the south east and areas of the east and south west. So far, more than 2,000 workers have bought their own homes through Starter Home Initiative funding. To find out more visit www.housing.odpm.gov.uk or call the helpline on 0207 944 3626 and leave your details to receive a reply. NHS childcare strategy The NHS Childcare Strategy is a key element in improving the working lives of staff. More than 250,000 NHS staff have children under 14 and more nurses and doctors would return to the NHS if they could get help with childcare. NHS childcare co-ordinators are developing local schemes to provide quality, affordable and accessible childcare and to offer advice and support. Some 125 co-ordinators are now in place across the country, another 50 are currently being appointed. There are 120 schemes open or in the pipeline providing 5,200 places. A database of local childcare co-ordinators is at www.doh.gov.uk/iwl Epilepsy action plan The Epilepsy Action Plan aims to improve services for people with epilepsy, their families and carers. It follows publication of the National Clinical Audit of Epilepsy-Related Deaths, set up to establish whether deficiencies in the standard of clinical management, or in the overall health care package, could have contributed to deaths. The voluntary organisation, Epilepsy Bereaved, project managed the audit and published the full report. The report is available at: www.sudep.org A National Institute for Clinical Excellence (NICE) summary is at: www.nice.org.uk/pdf/epilepsyreport.pdf The Epilepsy Action Plan is at www.doh.gov.uk/cmo/epilepsy 360.co.uk The NHS Leadership Centre wants to clarify it has not accredited the private company 360.co.uk as a provider of its 360 degree assessment and feedback quality framework. The company has been advised repeatedly that it does not have permission to use the NHS Leadership Qualities Framework and is not to give the impression that it has either endorsement or accreditation from the NHS Leadership Centre in any way. If you wish to implement the NHS Leadership Qualities Framework and have any concerns about whether you are using the preferred 360 degree material of the NHS Leadership Centre contact Catherine Guelbert at catherine.guelbert@doh.gsi.gov.uk. Patient Choice programme More patients in more areas of the country will get increased access to health services, under a new Government ‘Choice’ initiative. Health secretary Alan Milburn announced a major expansion of the patient Choice programme during a speech to trust chief executives on Tuesday 11 February. It follows the success of two pilot schemes covering heart and cataract surgery. Five a day Free promotional material is now available from the Department of Health on the recommended Five a day diet to help cut the risks of many chronic diseases. The Government’s Five a day programme aims to raise awareness of the health benefits of eating more fruit and vegetables and to encourage people to eat more. It includes work with the food industry and national and local health, education and consumer organisations, to improve access to fruit and vegetables and provide clear, consistent consumer information. A poster, portion indicator cards and leaflet are now available. More information at www.doh.gov.uk/fiveaday This month, chief nursing officer Sarah Mullally talks about the new arrangements for nurse supplementary prescribing and cutting waiting lists in A&E. Nurse prescribing "This is a very exciting time for nurse prescribing. Courses for ‘extended formulary’ nurse prescribing have been running for more than a year, and a wide range of nurses and midwives in both primary and secondary care have now been trained. "As nurses you have long-awaited the chance to prescribe medicines rather than having to seek GP or doctor approval. These new powers have speeded up processes to benefit both patient care and NHS efficiency. Following my review of medicines in the Nurse Prescribers’ Extended Formulary, the Department of Health and the Medicines Control Agency will soon consult on adding more to the list. "The first courses for nurse supplementary prescribers started in January. This will allow nurses to increase the range of medical conditions for which they can prescribe and allow them to treat patients with long-term conditions or health needs. "I would encourage all nurse executive directors and PCT lead nurses to look carefully at their workforce and services. If a service can be improved, patient care enhanced, or a team’s skills better utilised by a supplementary prescribing partnership, then this is the time to nominate nurses for the centrally funded training. Details on how to do this are at: www.doh.gov.uk/supplementaryprescribing A&E: Everyone’s business "By December 2004 the NHS Plan target is to ensure that all patients
are admitted, discharged or transferred within four hours of arriving
in A&E. Have your say ……………. We also want to hear your views on the subjects covered in the bulletin - for example, this month, on the Diabetes NSF Delivery Strategy launch. You can email chief nursing officer Sarah Mullally direct at We'll use your feedback to develop and shape future bulletins. It will also contribute to understanding better the views of NHS employees on current issues. Please be assured that all feedback is confidential and that any opinions quoted will be featured anonymously.
Email is the fastest and most cost-effective way for us to send The CNO Bulletin to you. Anyone with access to an email address can subscribe and we want to encourage more readers. How to subscribe:
Please provide the email address you would like to use, your name, job title, full name of organisation, full postal address with postcode, plus phone and fax numbers. These details will be stored on a database held by the Department of Health database for future mailings of this bulletin. If you are a nurse director and your contact details change, email us at: dh-test-emails@doh.gsi.gov.uk For all other nurses, midwives and health visitors, tell us about changes to your contact details by emailing us at doh_cno_amendments@talkingnumbers.com Did you see the news about…? If you missed an announcement or new development of interest to you, the chances are it could be listed in The Digest. Nursing Advisory and Development Group within NIMH(E) Nurses are being helped to put policy into practice and helped to solve local challenges in developing services through the National Institute for Mental Health in England NIMH(E)’s eight development centres and national programmes of work. The newly formed Nursing Advisory and Development Group (NADG) within NIMH(E) aims to anticipate the nursing contribution to policy development and implementation, and provide expert consultation, commentary and communication on mental health nursing matters. More information at www.nimhe.org.uk See Diary for NADG meeting dates.
National Institute for Mental Health in England (NIMH(E)) – update Six NIMH(E)s development centres are now open with another two expected to be running by the end of March. NIMH(E)’s first paid fellow appointments have been announced. Their role is to help ensure the institute fulfils its commitment to work effectively across all aspects of mental health. For more information see: www.nimhe.org.uk/development.asp Mental health awards The first positive practice awards for mental health, announced by Health Minister Jacqui Smith last June, will be made in: recovery; improving access and choice; modernising mental health services; making a difference; care programme approach (CPA) and lifetime achievement. More information from Ingrid.Steele@doh.gsi.gov.uk or at www.nimhe.org.uk Support, time and recovery (STR) workers Mental health patients will be helped to lead ordinary lives by support, time and recovery workers. STR workers are volunteers and former NHS workers who listen, help and support mental health patients with everyday practical needs to aid their recovery. Guidance on the introduction of STR workers in mental health services is at: www.doh.gov.uk/nsf/mentalhealth.htm or www.doh.gov.uk/nsf/mentalhealthstrguide.pdf Contact John Allcock on 020 7972 4224 or john.allcock@doh.gsi.gov.uk Person-centred care for children, young people and expectant mothers An update on workforce planning and development relating to children and maternity services is at www.doh.gov.uk/cgwt/chworkforce.htm It stresses the importance of supporting innovative solutions to develop more staff working differently across health, social care and education agencies. Feedback to claire.armstrong@doh.gsi.gov.uk margherita.d'cruz@doh.gsi.gov.uk and alison.ryder@selwdc.nhs.uk
Personality disorder- new guidance The National Institute for Mental Health in England (NIMHE) has published Personality Disorder: No longer a diagnosis of exclusion which provides policy implementation guidance for developing services for people with personality disorder. The guidance makes treatment of personality disorder part of the legitimate business of mental health services. It is at www.nimhe.org.uk and www.doh.gov.uk/mentalhealth/personalitydisorder.htm Contact Onur Yelekci on 020 7972 4689 or onur.yelekci@doh.gsi.gov.uk New statutory arrangements for maternity leave Employers should be aware of new statutory arrangements for maternity leave for those giving birth on or after 6 April. Main changes:
Employers will need to change current procedures and apply the new rules. Full details are at www.dti.gov.uk/er/individual.htm. Contact Jeremy Orr on 0113 254 5770 or jeremy.orr@doh.gsi.gov.uk Dealing with child abuse (Operation Ore) Cases of health care workers alleged to have accessed internet paedophile sites should be considered on an individual basis. Trusts, local education and social service departments should have arrangements in place for dealing with child abuse under the provisions of Working together to safeguard children available at: www.doh.gov.uk/pub/docs/doh/safeguard.pdf Trusts should follow existing procedures and guidance. A reminder for action has been sent to HR directors. This is at www.doh.gov.uk/hrbulletin/hrbulletin53.htm#2 For more information e-mail mb-hrd-hrb@doh.gsi.gov.uk Health and social care awards The Health and Social Care Awards recognise some of the best examples of dedication and personal commitment of staff working in health and social care. The 2003 awards scheme closing date is 2 May 2003. More details are on the awards website at: www.modern.nhs.uk/healthandsocialcareawards Application packs are available from Vicky Aspell on 0116 222 5168 or vicky.aspell@npat.nhs.uk Discharge from hospital - good practice guide Discharge from Hospital: Pathway, Process and Practice is a good practice guide that updates and builds on the 1994 Hospital Discharge Workbook. It is available at: www.doh.gov.uk/hospitaldischarge Hard copies from doh@prolog.uk.com Contact john.crook@doh.gsi.gov.uk or jenny.mudge@doh.gsi.gov.uk Working better together - a good employment guide for midwives The Royal College of Midwives RCM has published a guide to highlight examples of good collaborative working between midwifery, human resource managers and RCM stewards. For a copy contact the RCM at 15 Mansfield Street, London, W1G 9NH, on 020 7312 3535. Allergy UK Allergy UK now offers factsheets on What is Allergy and Allergy Testing, Asthma, Eczema and Rhinitis, in Urdu, Punjabi, Bengali, Gujarati and Hindi. Copies of posters advertising this service are available from Allergy UK, 30 Bellegrove Road, Welling, Kent, DA16 3PY on 020 8303 8525 or e-mail info@allergyuk.org National director for diabetes and screening pilots Dr Sue Roberts, a consultant physician based at the Diabetes Resource Centre of the Northumbria Health Care Trust, has been appointed as the new national clinical director for diabetes. In addition, nine pilot areas will speed up diagnosis and treatment for people most at risk of developing Type 2 diabetes. Clinicians working in the pilots in Liverpool, Bradford, Leicester, Haringey, Portsmouth, Coventry, Bristol, Luton and Sunderland will be at the forefront of implementing the Diabetes National Service Framework Delivery Strategy. NHS professionals A Special Health Authority is being established to tackle the costs of temporary staffing agencies. It will give NHS Professionals – the service’s in-house staff agency – a stronger national management structure. It will be in place before the end of the year and provide a national service to the NHS, helping trusts to best manage their temporary staffing needs. More information is at www.doh.gov.uk/about/specialhas.htm Patient Focus: Improving the patient experience Patient Focus is a new monthly newsletter from parliamentary under secretary of state for health David Lammy. It aims to highlight the positive impact of patient and public involvement in health as part of the wider improving the patient experience programme. The full bulletin is at www.doh.gov.uk/involvingpatients To subscribe e-mail contact details to doh_ppi_subscription@talkingnumbers.com Conference briefing Latest entries on the Department of Health’s conference pages website include summaries of speeches made at the Chief Executive's Conference on 11 February and at the Beyond Workplace Nurseries - Second Annual NHS Childcare Conference on 12 February, both in London. Diary NADG meeting The first meeting of the newly formed Nursing Advisory and Development Group (NADG) within the NIMH(E) is in York on Wednesday 19 March from 6pm. The next meetings are in Bristol on 25 June, Birmingham on 17 September and Manchester on 3 December. Each meeting will start with an open forum where local mental health nursing issues can be raised. Visit www.nimhe.org.uk or contact carol.bavington@doh.gsi.gov.uk or the department’s director of mental health nursing Rachel Munton at: rachel.munton@doh.gsi.gov.uk Conferences Leadership Centre NHS Leadership Centre Annual Conference – ‘Revolution, Evolution, Resolution’ – 11 April 2003, Queen Elizabeth Conference Centre, Westminster, London. A conference for all who are, or who aspire to be clinical leaders. Call 020 7874 0542 for a brochure and booking form or book at www.nhsleadershipconference.co.uk Recruit, retain and return A Department of Health conference, ‘Recruiting and Retaining the Wider Healthcare Team’, is designed to bring together primary, secondary and social care workers in recruitment, retention and return. The conference is at the Institute of Physics, 76 Portland Place, London on Thursday 3 April. The programme combines practical workshops and presentations from top national colleagues including national director for older peoples services Professor Ian Philp and deputy director of human resources Professor Maggie Pearson. It is chaired by deputy director of HR (Policy), David Amos. This conference puts the wider health care team at the top of the agenda and aims to update managers, recruiters, educators and other stakeholders on:
The conference is subsidised by the department, fees start at £50 plus VAT for NHS employees. More information from the conference hotline 020 8334 4525 or book at www.chamberlaindunn.com
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