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Personal
Medical Services update
A series of
local workshops are to be run to support the development of the
fifth wave of Personal Medical Services (PMS) agreements.
Run by the
PMS National Development Team, through its network of PMS facilitators,
the workshops will look at the legal and financial framework of
PMS agreements. They will also cover processes for developing
successful local agreements that reflect practice, and service
developments that benefit patients and staff.
The PMS helpline
offers advice and support for practices - 0845 9000008.
The PMS National
Development Team is also recruiting more PMS facilitators. Further
details will be available shortly.
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Information
for British nationals travelling overseas
A new campaign
aims to encourage British travellers to make appropriate health
preparations before going overseas.
The campaign,
run by the Foreign and Commonwealth Office (FCO), is targeting
British nationals who travel abroad to visit friends and relatives
during the UK winter. Research shows that as many as 57 per cent
of those going overseas fail to take out adequate travel insurance.
Many travellers also fail to consult their GP about health care
precautions and vaccinations.
An information
postcard will be issued to encourage travellers to prepare better
backed by the FCO’s ‘Know Before You Go’ campaign.
The FCO would
welcome the support of primary care teams in getting the key messages
to those travelling overseas. This could involve making campaign
leaflets available in waiting rooms and travel clinics (particularly
the ‘checklist for travellers’ and ‘British consular services
abroad’ leaflets and ‘visiting friends and relatives’ postcard),
or giving the FCO website address or travel advice notices to
patients. Leaflets are supplied free of charge.
The FCO website
www.fco.gov.uk/knowbeforeyougo
contains useful information and tips for travellers, including
regularly updated travel advice notices for every country in the
world.
To order
a supply of leaflets please contact Chris Kimber at the FCO on
020 7008 0102 or consular.publicity@gtnet.gov.uk
for more information.
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The
Primary Care Collaborative: a report on its first two years
The Primary
Care Collaborative published a report on its first two years at
the end of September. This describes the achievements of participating
practices and primary care trusts.
The collaborative
was established as a change agent with a remit to deliver rapid
improvement in patient care through the tools and techniques of
quality improvement. Two years on it looks like a success. Results
include:
- a fourfold
reduction in mortality for patients with coronary heart disease
in PCTs in the first collaborative waves, compared with those
not involved
- the average
waiting time to see a GP in practices across all four waves
has reduced by over 60 per cent
- the average
waiting time to see a GP in wave 4 practices has reduced by
64 per cent in just 10 months
- the average
waiting time to see a practice nurse in practices across all
four waves has reduced by over 50 per cent.
The results
reinforce the Government’s expectation that given the right skills,
knowledge and the opportunity to learn from one another, people
and organisations are able to deliver sustainable, responsive,
patient focussed improvement. The primary care collaborative has
delivered on this expectation.
For further
information on the collaborative, please contact the National
Primary Care Development Team on 0161 236 1566 or visit the website
www.npdt.org
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Modernisation
of primary care out-of-hours services – further developments
A further
step has been taken in the modernisation of primary care out-of-hours
services.
Under new
regulations that took effect from 1 November, PCTs now have statutory
authority to plan and co-ordinate implementation of an integrated
out-of-hours service, and for approving local out-of-hours service
providers against the Carson review quality standards. The regulations
also give GMS GPs the opportunity to delegate full responsibility
for their patients in the out-of-hours period to providers which
are PCT-accredited and approved, or to another GP.
Guidance is
being prepared to explain in more detail the regulations, the
changes, and the effects for PCTs, GPs and organised providers
of out-of-hours primary care services. The guidance also explains
in particular how the accreditation process which the regulations
introduce differs from that envisaged in the earlier guidance
issued in June 2002:
- the out-of-hours
accreditation handbook
- roles and
responsibilities
- quality
standards.
The first
two documents are being updated for reissue. The quality standards
are unchanged.
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Accreditation
training
A
series of training conferences is now underway to
support Assessing PCTs to prepare them for taking
on their new roles. For Assessing PCTs who will
become involved in accreditation visits to providers
from January 2003, national conferences are being
held in December 2002. The RCGP is organising all
the training and is in the process of inviting Assessing
PCTs to events.
For any queries
around accreditation (or training) please contact your local out-of-hours
co-ordinator or email OOHAccreditation@doh.gov.uk
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GPs
with a special interest - update
The Department
of Health is now funding a new Modernisation Agency/National Primary
and Care Trust Development team (NatPaCT) to take forward development
of GPs with a Special Interest.
The team comprises
Carol Limber as team leader and Karen Harrison and Catherine Eldred
as coordinators. They will be helping PCTs NHS trusts and strategic
health authorities to implement GPs with a Special Interest, working
closely with the National Primary Care Development Team.
The team will
initially concentrate on:
- working
with the Royal College of General Practitioners and all key
stakeholders to produce a further 10 clinical frameworks in
specific areas such as emergency care, mental health, child
protection and diabetes
- producing
a step-by-step guide to implementing GPs with a special interest
- linking
closely with developing national work around nurses with specialist
interests, to produce similar generic frameworks
- supporting
local teams to establish GPs, nurses with an interest.
For more information
on GPs with a Special Interest, including the generic frameworks
and the clinical frameworks as they develop, go to www.doh.gov.uk/pricare/gp-specialinterests.
Further information from Ann Atkinson, tel 0113 254 3845, email
Ann.Atkinson@doh.gsi.gov.uk.
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Guidance
for the appointment of GPs with a special interest in ear nose
& throat (ENT)
The latest
national guidance for the appointment of GPs with special interests
has now been published. This guidance provides advice to primary
care trusts, GPs and the public on the appointment of a GP with
a special interest in ENT.
It provides
advice on the following areas:
- core activities
and competencies required
- type of
patients suitable for the service
- facilities
that must be present to deliver that service
- clinical
governance, accountability and monitoring arrangements
- evidence
of successful acquisition of those competencies
- induction,
support and continuous professional development arrangements
for the GP
- local guidelines
on the use of the service
- monitoring
and clinical audit arrangements.
The guidance
is now available, together with the national framework for implementing
a scheme for GPs with a special interest at www.doh.gov.uk/pricare/gp-specialinterests
If you have
any queries please contact the Department of Health’s national
reference group secretariat for GPs with a special interest at
gpwsi@doh.gsi.uk
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Healthy
Start: proposals for reform of the welfare food scheme
On 28 October
the Department of Health issued a consultation document on reform
of the 60-year-old welfare food scheme. This scheme currently
provides milk and vitamins primarily to expectant and nursing
mothers, babies and under-fives in low-income families.
The proposals
are for reform of the scheme to make the best use of existing
resources (£142m), to widen nutritional choice and bring the scheme
up to date in line with latest expert advice on nutrition. The
proposed new scheme – ‘Healthy Start’ – will come into effect
in 2004. It is based on fixed face value vouchers exchangeable
for fruit and vegetables, cereal based foods, and other foods
suitable for weaning, as well as for milk and infant formula.
Vitamin supplements will remain part of the scheme.
The age range
covered by the scheme will be unchanged. There will be a new choice
of either free milk or a piece of fruit for children at nursery
school. Eligible mothers and carers will register for the scheme
through NHS ante-natal and post-natal clinics.
Comments are
invited on the proposals by 13 December. They should be sent to
healthystart@doh.gsi.gov.uk
The full consultation document is available at www.doh.gov.uk/healthystart
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Local
five-a-day initiatives
The
Department of Health is publishing two handbooks
to support the delivery of local five-a-day initiatives.
The
handbooks have been produced following completion
and evaluation of the local five-a-day pilots. These
pilots were set up to test the feasibility and practicalities
of implementing area-wide evidence-based community
approaches to improve access to, raise awareness
of, and increase consumption of fruit and vegetables.
Handbook
1, A local five-a-day initiative: increasing
fruit and vegetable consumption –improving health,
has been produced for commissioners of health
improvement. The handbook draws together the
evidence on the health benefits of fruit and vegetables
in the diet, current consumption levels, and the
influences on consumption. It will also be of interest
to project managers and co-ordinators within primary
care trusts who are setting up their own local five-a-day
initiatives, as well as staff in partner organisations
including local authorities, industry and the voluntary
sector.
Handbook
2, A local five-a-day initiative: a handbook
for delivery, has been written for those
responsible for planning and implementing local
five-a-day initiatives to increase fruit and vegetable
consumption. This handbook draws together the
lessons learnt from the research about food-based
community interventions – particularly from the
five-a-day pilot initiatives – and outlines the
practical steps involved in planning a local five-a-day
initiative.
To download
the handbooks and for further information on the five-a-day pilot
initiatives visit www.doh.gov.uk/fiveaday
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Call
for expressions of interest in developing one-stop sexual health
services
Expressions
of interest are being sought from services wishing
to develop a primary care led one-stop shop for
sexual health services.
Development
and evaluation of three models for services providing advice,
contraceptive and genito-urinary services on a single site was
one of the actions set out in the sexual health and HIV strategy’s
implementation action plan. One of the models to be evaluated
is a specialist primary care led service. The criteria against
which services will be selected can be found at www.doh.gov.uk/sexualhealthandhiv
Services
expressing an interest should have all or most of
the elements set out in the specifications already
in place, and should welcome comprehensive independent
evaluation. The evaluation is expected to run until
January 2006, when a final report will be produced.
Some funding may be made available to each of the
three participating services to further develop
aspects of their provision.
Expressions
of interest should be sent by 31 December 2002 to Andrea Duncan,
sexual health team, room 580D Skipton House, 80 London Road, London
SE1 6LH or email: andrea.duncan@doh.gsi.gov.uk.
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New
guide to medication review
The taskforce
on medicines partnership and the national collaborative medicines
management services programme have published a new and practical
guide to medication review.
Room to
review – a guide to medication review: the agenda for patients,
practitioners and managers provides a pragmatic approach to
reviewing medicines in primary care, and points the way towards
greater patient involvement in reviews. The main target audience
is practitioners and managers responsible for commissioning and
providing these services. The guide makes particular reference
to the milestones for the Older People’s National Service Framework.
Downloadable
copies of the guide and accompanying web-based tools are available
at www.medicines-partnership.org
Further details
from, email: info@medicines-partnership.org
or Richard Seal, richard.seal@npc.nhs.uk
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Code
of conduct for NHS managers
Following
the consultation exercise earlier this year, the code of conduct
for NHS managers was launched by Nigel Crisp at the Institute
of Health Management Conference on 9 October.
The code should
apply to all senior managers employed by the NHS. NHS employers
have been asked to incorporate it into the contracts of senior
managers at the earliest practicable opportunity, and to include
it in the employment contracts of new appointments to that group.
While the
code does not apply to self-employed GPs, the principles of the
code should be adopted in employment contracts of the managers
they employ.
The code and
a document on implementation can be found at www.doh.gov.uk/nhsmanagerscode
For any queries please contact Jenny Smith on 0113 2545825, email
jenny.smith@doh.gsi.gov.uk
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Protocol-based
care information pack
A tool to
support NHS staff in developing protocol-based care has been
prepared by the Modernisation Agency and National Institute
for Clinical Excellence (NICE).
Healthcare
professionals have long recognised the value of protocols as
tools for improving the efficiency of patient care. Developed
around NICE guidance and other recognised standards, the new
information pack is designed to help staff turn evidence into
practice by addressing the key questions of what should be done,
when, where, and by whom.
The pack
does not represent formal NICE guidance to the NHS, but aims
to spread good practice. Aimed at professionals working in community,
primary and secondary care, it offers practical guidance on
how to develop protocols. It links this with the wider agenda
for service modernisation, and suggests other sources of advice,
knowledge and support.
The pack is
due to be published on 3 December and is available at www.modern.nhs.uk/protocolbasedcare.
For further information email anne.hackett@doh.gsi.gov.uk
or telephone 020 7210 5469.
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NHS
appraisal toolkit
An online
resource to support appraising and appraisee GPs in the NHS
was launched this week by the Department of Health. The NHS
appraisal toolkit brings together advice, guidance, best
practice, practice tools and access to a community of peers
in the appraisal arena.
Available
free of charge, the toolkit will be a valuable resource on several
levels. The background information will be useful to anyone
working within the NHS who is interested in appraisal, including
GPs, appraisers and trainers. It provides general guidance on
the process and practice of appraisal.
Some parts
of the toolkit are secure and confidential, designed to support
individuals’ preparation of their pre-appraisal documentation.
This part of the toolkit is available for use by any registered
GP.
The toolkit
will help doctors prepare for their appraisal meetings in the
context of local and other priorities. It will also help to
develop an accurate picture of local learning needs that can
help education providers and facilitators as they plan their
programmes.
The appraisal
toolkit can be accessed via its own website at www.appraisals.nhs.uk
or via the joint appraisal and revalidation website at www.appraisaluk.info
or www.revalidationuk.info
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GP
appraisal – honorary contract for appraisers
Since April
2002, responsibility for establishing GP appraisal has rested
with PCTs. The GPC is keen for GPs to be indemnified for undertaking
appraisal and has agreed a form of words to this effect with Haringey
Teaching Primary Care Trust. This clause is within an honorary
contract for GP appraisers, and is available at www.haringeypct.nhs.uk
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NHS
Alliance Fifth Annual Conference
The conference
examined the success of shifting the balance of power for professional
and the public and in improving patient care and outcomes. Health
secretary Alan Milburn addressed delegates on the power of primary
care trusts in the new NHS structure.
Key points
from Alan Milburn’s speech:
The secretary
of state for health said primary care could lead the reform
and shaping of modern healthcare.
The health
secretary said people in other countries see this country’s
primary care services, especially family doctors who are the
backbone of the NHS, as something to envy.
He said
real progress was being made in primary care and in recent years
significant achievements had been made that can be shared by
everyone in the NHS.
"In
primary care itself, waiting times are coming down – three in
four patients can see a GP within two working days," he
said.
On organisational
changes he told delegates the establishment of strategic health
authorities and PCTs had gone better than many people had expected.
"Bold
steps to radically reform the health service are now needed
if we are to secure the improvements in health care that our
country needs," he said.
The Secretary
of State talked about addressing decades of under investment
in both the NHS and social services.
"The
Budget on April 17th marked a watershed for both…for
the NHS it is worth remembering that while six years ago NHS
funding was falling in real terms, by 2008 it will have doubled
in real terms."
From April
2003, PCTs will be in charge of three-quarters of the NHS budget,
able to commission services as they see fit.
PCT budgets
will increase and there will be less ring fencing by central
government of local budgets.
Local health
services will be able to put together a single delivery plan
for the medium term, rather than the short term.
Budgets
for PCTs will be allocated for three years not one, which will
allow the service to plan with certainty to increase capacity
over the longer term.
"Three
year budgets will enable PCTs to develop longer term agreements
with hospitals and other providers," the health secretary
told delegates.
Mr Milburn
said PCTs now have the explicit freedom to purchase care from
the most appropriate provider.
"A
modern NHS is one where patients need to have power. And that
means they have to have choice. So if their local NHS hospital
can’t offer them a short enough waiting time but another hospital
can, then they can decide to choose with the help of their GP."
The health
secretary went on to say that PCTs would be given help to develop
their commissioning role.
He said:
"PCTs need their local hospital, but not at any price.
Hospitals need to deliver and PCTs need to demand the right
standards of service, it is time for PCTs to stand up for themselves.
It is time to shift the centre of gravity in the NHS."
Full text
of Alan Milburn’s speech: http://www.doh.gov.uk/speeches/nhsalliance5.htm
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NHS
must highlight "prevention as well as cure"
Health
secretary Alan Milburn set out the five next steps to focus
the emphasis of health care towards prevention as well as
cure in a speech to the Faculty of Public Health Medicine
on 20 November. He also announced details of an accelerated
drive to combat smoking.
To read a
summary of his speech visit www.doh.gov.uk/conferences/tack-health-ineq.htm
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Family
Doctor Books
Family Doctor
Books are magazine-style resources for patients. They are designed
to provide supplementary information for patients to read in their
own time, following consultation with a doctor about their condition.
Published
in association with the BMA, Family Doctor Books are peer-reviewed
by independent assessors. They are priced at £3.50 and are available
from pharmacies throughout the UK, or from the website www.familydoctor.co.uk.
Further information
from Family Doctor Publications Ltd, PO Box 4664, Poole BH15 1NN.
Tel 01202 668330, fax 01202 668331, email Familydoctor@btinternet.com.
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Postgraduate
courses in research methods in health
The University
of Southampton’s faculty of medicine, health and biological science
is offering a number of interrelated postgraduate courses in research
methods in health.
The courses
are modular in structure, enabling participants to take them at
a variety of levels. They can be taken as short stand alone, unaccredited
modules, or built via modules into certificates, a diploma and/or
a full MSc.
The taught
modules available are:
- Foundations
modules 1 & 2 - starts 9 January 2003
- Statistics
and epidemiology modules - starts 29 April 2003
- Qualitative
methods and putting research into practice module - starts
16 September 2003
The courses
have been designed to be applicable to all health professionals
whose role includes carrying out, appraising and implementing
research. This includes physiotherapists, nurses, occupational
therapists, doctors, especially the Calman trainees, managers
(in trusts, health authorities, primary care) and all other health
professionals.
The overall
aims of the programme are:
- to promote
sound knowledge and understanding of a wide range of research
methods and strategies
- to enable
health professionals to be discerning readers of research documents
- to foster
a climate in which evidence based practice is the standard
- to help
health professionals conduct high quality research.
For further
details or an application form please contact the course administrator
on 023 8079 6439, email reshealth@soton.ac.uk.
Website: www.som.soton.ac.uk/about/courses/reshealth
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MSc
in allergy
The school
of medicine at the University of Southampton is offering a full
MSc course in allergy which is suitable for GPs and specialist
nurses. The course consists of six taught modules and a dissertation
module, and can be studied on a part-time basis.
The full MSc
is made up of 180 credits at HE4. The course is run by distance
learning (with the exception of the research methods module),
with set teaching days at Southampton General Hospital. Modules
can be taken individually.
Modules offered
include:
- Mechanisms
and management of allergic disease (1) (40 credits) PGEA approval
for 44 hours
- Mechanisms
and management of allergic disease (11) (40 credits) PGEA approval
for 44 hours
- Research
methods in health (40 credits)
- Skin disease
and its management (20 credits)
- Nasal disease
and its management (20 credits)
- Introduction
to respiratory (20 credits)
- Research
dissertation (60 credits)
For further
information see www.som.soton.ac.uk/about.courses/allergy
or contact Dr Jill Warner, 02380 796941 (email jaw4@soton.ac.uk)
or Mrs Brenda Colwell, 02380 796379 (email b.colwell@soton.ac.uk)
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Primary
Care magazine
This month’s
Primary Care magazine can be found at www.nhs.uk/nhsmagazine/primarycare.
The December/January edition will cover:
- financial
incentives to bring GPs back to the NHS
- modernising
out-of-hours care
- a new framework
for nursing in primary care
- Getting
to grips with commissioning responsibilities
- Service
planning in the new three-year financial cycle.
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Conferences
The following
events have taken place over the last month. Visit www.doh.gov.uk/conferences
to read summaries of the main speeches:
- Primary
care trust regional management event
- Children’s
National Service Framework Conference
- Institute
of Healthcare Management conference
- Implementing
the National Service Framework for Older People tour
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