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Risk
of pneumococcal meningitis in non-vaccinated cochlear implant
patients
Patients with
cochlear implants may be at increased risk from pneumococcal meningitis,
especially if not previously vaccinated, according to new evidence.
The Department of Health is now recommending that pneumococcal
vaccine is given to all patients with cochlear implants to minimise
this risk.
Clinicians
implanting cochlear implants and relevant general practitioners
have been advised through a Medical Devices Agency (MDA) device
alert (DA2002(09) to determine the pneumococcal vaccination status
of both existing and prospective cochlear implant patients, vaccinating
as necessary using an appropriate pneumococcal vaccine in line
with the current Department of Health policy for patients at increased
risk. Such patients should receive:
23-valent
pneumococcal vaccine for adults and children aged two or older
(the vaccine is not efficacious in children under two years)
or
heptavalent
pneumococcal conjugant vaccine (Prevenar®) if the child is
under two years of age. Such children should be revaccinated with
23-valent pneumococcal vaccine after the age of two.
This advice
is relevant to all cochlear implanted patients including those
who have previously suffered from pneumococcal meningitis or a
pneumococcal infection.
All occurrences
of meningitis in cochlear implant patients should be reported
to the MDA adverse incident centre (Tel: 0207 972 8080; email:
mb-mda-aic@doh.gsi.gov.uk)
providing where possible details of the implant manufacturer and
model together with appropriate clinical data, including the vaccination
status of the patient if known.
The full contents
of the device alert are available on the MDA website www.medical-devices.gov.uk
Enquires or requests for further information should be made to
Dr Susanne Ludgate, Medical Director, Medical Devices Agency,
Tel 0207 972 8123; email: susanne.ludgate@doh.gsi.gov.uk
Advice on
vaccination issues should be directed to Dr Karen Noakes on 0207
972 1528 or karen.noakes@doh.gsi.gov.uk
OSCAR
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,
specialty 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.
Sue Howson
of New Forest PCT found PAT extremely helpful in identifying local
commissioning patterns and areas for improved performance. She
said: "In developing health care and challenging existing
structures, knowledge is everything. Too often in the past information
has been either inadequate or anecdotal. PAT was a huge step forward
and enables both informed commissioning and strategic planning
for the future. I look forward to using the increased analytical
power in OSCAR to even greater effect."
Training courses
on how to use OSCAR will soon be available.
For further
information about the courses please email Marion Miller at the
NHS Information Authority marion.miller@nhsia.nhs.uk
To register
and use OSCAR now, go to www.oscar.nhs.uk
Developing
primary care premises dedicated web site launched
A new web
site makes it easier to find information about primary care premises.
Primary care, to date, has been hidden under the capital and procurement
section of the NHS Estates web site and the information available
on it has also been limited. Recognising this and the difficulties
people have had with locating the information they require, NHS
Estates has established a dedicated primary care section. This
can be accessed through the NHS Estates home page (www.nhsestates.gov.uk/primarycare/index.asp)
and provides quicker and easier access to an expanded range of
information about primary care premises investment.
The new look
primary care section went live on 6 September. 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
on:
primary
care investment options guide to capital and revenue funding
routes for the provision of premises
estate
development advice and tools that may be used to develop an
estate strategy and the variety of premises which may be developed
guidance
guidance on design and building modern premises that enable
expanded services and provide best value for money
initiative
a look at the initiative in progress to aid investment in primary
care premises ie. GP registrar Initiative, diagnostic treatment
centres, NatPaCT and research & development projects, EU Health
Property Network
NHS LIFT
providing detailed advice on the LIFT initiative together with
a list of sites involved and NHS Estates contacts for advice and
expertise
GP developments
providing advice to those GPs seeking to develop practice premises
in conjunction with the wider primary care team.
The primary
care section will provide useful, consolidated information on
a whole range of items.
For further
information, please contact Jas Barn Policy Support Manager,
NHS Estates on 0113 254 7213 or
jas.barn@doh.gsi.gov.uk
Personal
medical services (PMS) progress
Enthusiasm
for PMS continues it is estimated that the fourth wave of pilots
will increase the number of GPs working in PMS to approx 29 per
cent. The second phase of the fourth wave of PMS pilots is due
to go live tomorrow in what looks set to be the biggest wave since
3b.
PMS pilots
are an integral part of the Governments modernisation of the
NHS. The Prime Minister made clear at the 30 April 2002 PCT conference
that PMS is here to stay as a separate and complementary option
to the new GMS contract. The flexibility of the local PMS contract
gives providers of primary care services the scope to find new
ways of addressing local issues.
Building on
the success of previous waves, the Department of Health announced
a fifth wave of piloting arrangements on 14 August 2002, to become
operational in April next year. Applications are now invited and
should be submitted by 1 November. A timetable and associated
documents, including the proposal proforma, are available at www.doh.gov.uk/pricare/pca.htm
PMS
support
A national
PMS facilitator network run by the National Development Team (NDT)
can offer support in the following areas:
providing
a point of contact for the NDT for local practices and PCT managers
providing
help and advice answering queries from practices and PCT managers
supporting
the local PMS leads network
supporting
the NDT in organising and running local awareness raising events
working
with the NDT to identify training needs at a local level
supporting
the national PMS NDT helpline (0845 9000008)
A range of
training programmes is organised and run by the team including:
PMS agreement
training
PMS finance
training
PMS awareness
for all
PMS for
strategic health authorities
as well as
locally specific events.
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.
In order to
help a PCT determine its own development needs, the NDT has devised
a self-help tool the 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. Help can
also be obtained by contacting the team or accessing the website.
Update
on premises funding for GP registrar initiative
Project managers
have now all virtually completed their site surveys of the first
wave of potential GP registrar (GPR) sites from the deaneries.
The priority
remains to improve areas which do not have enough GPs by providing
net extra GPRs. The scheme is funded using premises money and
the deaneries are targeting the key practices where this can be
brought about.
A robust monitoring
and control plan has been implemented. The first wave of deanery-approved
schemes has started and there are now over 20 surgeries throughout
the country where site work has commenced.
A pilot site
was started in the North West at Lambgates Surgery, Hadfield,
Glossop and the lessons learned have been passed onto the project
managers to be used nationally in the NHS Estates primary care
team. The local voluntary training scheme trainer at Lambgates,
Dr Lindsay Palmer, who welcomed the new GP registrar Dr Francis
Barnie to the practice, commented that she was "very pleased
with the efficient way in which the initiative was working. The
scheme has also meant the re-introduction of GPR training into
the area."
Tameside &
Glossop is a high priority based on the DH listing of GPs per
head of population. With support from the Manchester deanery,
several more local sites within the PCT have been added to the
approved list since this scheme started.
Under Shifting
the Balance of Power, local PCTs will be brought on board to manage
future schemes and the role at the centre will be in facilitating
the process, offering guidance and monitoring the delivery of
the initiative. With a central overview of the situation nationally,
significant in-roads in support of the GPR initiative are now
apparent.
For further
details on the initiative, please contact Simon Arden-Davies on
0113 2547 174 or sardendb@doh.gsi.gov.uk
Environmental
Health 2012: A key partner in delivering the public health agenda
Environmental
health officers will have a new, greater role in promoting the
publics health and reducing inequalities.
A new report
published on 10 September by the Health Development Agency (HDA),
explains the strategy. Environment Health 2012 A key partner
in delivering the public health agenda was produced in partnership
by the Chartered Institute of Environmental Health (CIEH) and
was launched at the annual CIEH conference on 11 September.
The report
explores the projected growth of environment health officers
role in improving the publics health and reducing health inequalities
over the next ten years. Based on this, the strategic vision envisages
that environmental health practitioners will:
play
lead roles in local authority community health and wellbeing strategies
and actively contribute to the public health agenda of NHS primary
care trusts
be key
partners in protecting and improving the health and quality of
the lives of individuals and communities and reduce health inequalities
tackle
the wider determinates of population health by identifying, controlling
and preventing current and future risks.
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.
Report co-author
Ian Gray said: "Environmental health Officers have a wealth
of public health knowledge and skills and they have a unique contribution
to make through their prime focus of maintaining the health and
wellbeing of communities. We hope that the reports strategic
vision and recommendations will help to move the practice of environmental
health towards a future where it is based on a modern health development
agenda, best practice and evidence of what works."
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 and comments should be sent to ian.gray@hda-online.org.uk
Teaching
PCTs web site
At the second
national teaching PCTs event, held on 11 September, a new web-site
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
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