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Welcome to the February edition of the GP Bulletin, aiming to keep you up to date with useful information for your daily work. As part of our commitment to continually improve the way in which we communicate with GPs, this edition of the bulletin has been redesigned. The aim is to present relevant information in a format that is easy to read and digest. Please send any feedback or views on the format and content of the GP Bulletin to me at sonny.dutta@doh.gsi.gov.uk I may not personally be able to respond to all your comments due to pressure of time. I do, however, read them all and take your concerns on board. If someone has cascaded this bulletin to you, we would like you to receive it directly by email. Please forward your details to gpbulletin@doctors.org.uk, giving your name, practice name and GMC number. Sonny Dutta Top newsNew vision for diabetes services Improved standards in treatment, care and support for people with diabetes have been set out in a new national service framework (NSF). The Diabetes NSF Delivery Strategy, launched on 9 January, calls for every person with, or at risk from diabetes to be offered regular check ups and appropriate treatment. It says all PCTs should provide eye screening services by 2007. Many people with diabetes currently visit hospitals for treatment. The NSF makes the case for refocussing services in primary care. National clinical director for primary care and Cheshire-based GP David Colin-Thome said: "Primary care needs to systemise its treatment of diabetics. "If practices haven’t already got regular clinics in place then they will need to be set up if no alternatives exist. There should be regular diabetic and eye reviews, circulation and neurological assessments and dietary advice. "If there are already chronic disease management programmes in place GPs are doing the optimum for their patients. But the best people to run effective clinics are nurses, whether community or practice." The Delivery Strategy gives PCTs guidance and up-to-date-information on how to improve services. It has been estimated that as many as I million people with diabetes are undiagnosed so GPs need to make those at high risk aware of the symptoms and give lifestyle advice on physical activity, diet and smoking. The NSF sets out a vision for diabetes services which leads to fewer people developing the condition, and better care for those who do, preventing or delaying the onset of complications. The delivery strategy follows the NSF for Diabetes: Standards published in December 2001. The NSF can be found at: www.doh.gov.uk/nsf/diabetes/
NSF principles in action More patients are being treated closer to their homes thanks to an innovative diabetes service in the north east of England. The Northumbria Diabetes Service is a leading example of the new NSF in action. It has set itself a target – that 85 per cent of all clinical care will take place within primary care – and this goal is being quickly achieved. The Northumbria service provides support for primary care teams throughout the district through the Newcastle and Northumbria PCT. It is responsible for providing, coordinating and developing diabetes services within GP practices and enabling them to provide more locally accessible care. For example, at the Collingwood Practice in North Shields, care of 80 per cent of its 300 diabetes patients is dealt with by the primary care team at a weekly dedicated diabetes clinic. Dr Amit Chatterjee said: "This is good for the patients because they find it more accessible and more convenient. It has naturally put pressure on our resources but is a very good system and the patients appreciate it." Network: Dr Sue Roberts on 0191 2932708. More newsNew schemes for GPs On 29 November two new schemes were launched to help boost the number of general practitioners in the NHS and improve GPs’ working lives. The flexible careers scheme The flexible careers scheme seeks to increase the number of flexible and part-time posts available within general practice. It gives GPs even greater choices about how and when they work, and enables them to strike the right balance between their work and home lives. It is open to all GPs regardless of age, but is aimed at GPs who wish to work less than 50 per cent of full time or in a more flexible way. The scheme:
The returners scheme This scheme is designed to support the return of qualified GPs to the NHS. Benefits for returners include:
For information on either of the above schemes, please contact the returners hotline on 0845 6060 345. Golden hello scheme – update The NHS GP golden hello scheme has now been revised. Changes include:
Full details of the extended scheme are now available at www.doh.gov.uk/pricare/goldenhello. Any queries to Debi Nicholson on 0113 254 5218, email debi.nicholson@doh.gsi.gov.uk or Katie Cusick on 0113 254 5850, email katie.cusick@doh.gsi.gov.uk PMS National Development Team In the summer of 2002 the PMS National Development Team joined the National Primary Care Development Team to enhance synergy across primary care development within the Modernisation Agency. Consequently the team has been dramatically restructured, and we are developing a network of 11 facilitators which will be coterminous with the NPDT centres nationally. The PMS NDT aims to support the development of primary care commissioning across the NHS health economy and can provide guidance and training to NHS colleagues.
We would like to introduce the new team structure:
National team:
All queries to the national team should be directed to emma.baranowski@npdt.nhs.uk Regional facilitators:
All facilitators can also be contacted at firstname.lastname@npdt.nhs.uk We are in the process of appointing to the following areas and if you have any queries or development needs from these areas please contact the national team or the helpline:
If you have any queries please contact the PMS national helpline on 0845
9000008 or visit us at www.doh.gov.uk/pmsdevelopment News in briefNew PMS waves planned Two new waves of personal medical services (PMS) contracts will be launched on 1 April and 1 October 2003. More than a third of all GPs are now working to PMS contracts. PMS provides GPs with enhanced personal and professional development, more choice and flexibility. Patients receive quicker and easier access to a range of specialist services. The PMS contract is locally driven, allowing professionals to negotiate their terms of contract according to local demands. In some areas practices have restructured or work together to develop new services. Over 9,300 GPs are currently working to PMS in 2,500 schemes. www.doh.gov.uk/pricare/pca.htm A network of facilitators has been set up to support development and integration of PMS services in primary care. More information on the PMS National Helpline 0845 9000008 or at www.doh.gov.uk/pmsdevelopment More funding for walk-in centre pilots NHS walk-in centre pilots have been so successful they have secured another three years of funding and confirmed as a mainstream service. A total of 42 centres are now fully established. They were developed as centrally funded three-year pilots with an annual contribution from the Department of around £30m. The new funding comes in recognition of their services to a wide range of people and their contributions to their PCTs’ achievement of the primary care access target or reducing pressure in A&E minor injury treatment. In line with Shifting the Balance of Power, the new funding has been added to PCTs’ new three-year resource allocations. MDA and MCA merger The Medical Control Agency (MCA) and the Medical Devices Agency (MDA) merge from 1 April. The new body – the Medical Healthcare products Regulatory Authority (MHRA) – will build on the strengths of the MCA, which has made a major contribution to protecting public health, according to a National Audit Office (NAO) value for money report. The NAO study – published on 15 January 2003– said the MCA had achieved international recognition for its work and was one of the leading medicines regulators in the European Union. www.nao.gov.uk The DigestAccess to primary care services by the homeless There have been recent suggestions about homeless people being unable to register with a GP. One of the reasons commonly cited for this is that GPs or their staff are under the impression that it is necessary to have a permanent address in order to register with a GP. This is not so. NHS medical primary care services are available free
to everyone who is ordinarily resident in the UK, including anyone who
is homeless. To that end GPs are reminded that patients do not need to
have a permanent address to register with a GP or a PMS pilot provider.
Day surgery The British Association of Day Surgery is holding a meeting entitled "New Partnership" on 21 March in London. It will bring together senior managers from SHAs, PCTs and acute trusts with clinicians involved in delivering day surgery. This is a part of the strategy to reduce waiting times and improve patient care. Further detail can be found at http://www.bads.co.uk/ Impotence drugs update New impotence treatment Tadalafil (Cialis) has been added to schedule 11 of the NHS (general medical service) regulations. From 1 February 2003 the drug will have the same prescribing restrictions as other treatments for impotence on the NHS. The oral mucolytics currently on schedules 10 and 11 will be removed on the same date. GPs will be allowed to prescribe these drugs where appropriate from 1 February. Contact: Janet Smith 0113 254 6601 or janet.smith@doh.gsi.gov.uk Action On initiative expanded A scheme to encourage innovation and good practice in specialities with long waits has been expanded. Action On, run by the NHS Modernisation Agency, has already achieved success in ophthalmology, dermatology, ENT and orthopaedics. Now it is being expanded to cover general surgery, plastic surgery and urology. Health communities are being invited to bid to become plastic surgery and urology pilot sites. Funding of up to £75,000 is available. www.modernnhs.nhs.uk/scripts/default.asp?site_id=30 Contact: Eric Ludlow on 0116 222 1422 or eric.ludlow@npat.nhs.uk Education quality assurance – new DH team A quality assurance team has been appointed within the Department of Health HR directorate to streamline, integrate and improve the impact of external quality assurance on education. Sandy Goulding leads the team, supported by four senior quality assurance co-ordinators representing the North, Midlands, London and South. The team will work with stakeholders to develop a shared framework for quality assurance. www.doh.gov.uk/hrinthenhs/learning/section3/aboutus.htm Education quality assurance - reviews published Prototype reviews of six NHS-funded education programmes have been published. The Quality Assurance Agency for Higher Education (QAA), under contract with the Department of Health, conducted reviews of nursing and allied health professional education in higher education institutions. The department is now working with the nursing and midwifery council, health professions council and NHS workforce development confederations to build the results into the national quality assurance programme. www.doh.gov.uk/hrinthenhs/learning/section3/majorreview.htm Back pain web launch An Internet information service has been launched to provide better public information on back pain. Research for the Doctor Patient Partnership (DPP) has showed that nearly two thirds of people would go to their GP for back problems. With 60 per cent of the population reporting problems, this is a huge burden for primary care. The ‘Beating Back Pain’ campaign provides support information and a booklet for patients to prevent and manage pain. PCT ratings revealed Primary care and mental health trusts are to receive their first NHS performance ratings this summer. The ratings show how well local NHS services are performing. PCTs and mental health trusts will join acute, specialist and ambulance trusts in this year’s tables. www.doh.gov.uk/performanceratings NHSnet upgrade GPs are to benefit from a £45 million upgrade to the NHSnet. The network, which carries over 100 million messages a month, is to be transferred to broadband access. This will speed up online appointment booking and prescription transfers. It will also improve access to electronic health records. The bandwidth upgrade is due to be completed by March 2004. www.nhsia.nhs.uk/nhsnet/pages/connecting/bandwidth/upgrades.asp Allocations for PCTs A three-year package of £148 billion will be paid directly to 304 PCTs for the first time in April. This is a cash increase of almost one third. The figure means no PCT will receive less than a 28 per cent increase in funding. The average PCT budget is expected to grow by almost £42 million. The allocation will put 75 per cent of the NHS budget under the control of primary care. Price freeze for generic drugs The maximum price scheme for generic drugs will not change this year following consultation with manufacturers. The Department of Health says the scheme has contributed significantly to price stability. It estimates that pegging the price has saved the NHS £330m a year since it was introduced in August 2000. Publication of Chief Executive’s report The Chief Executive's Report to the NHS, was published in December 2002. It found that eight out of 10 GP practices offer appointments within 48 hours. There are more nurses and acute beds than ever before. The report highlights a rise in calls to NHS Direct, increased use of walk-in centres and reductions in maximum waiting times. www.doh.gov.uk/public/stats1.htm Role of CHAI – update Details of the role and remit of the Commission for Healthcare Audit and Inspection (CHAI) are expected to be published soon. The new watchdog will combine inspection work of the Commission for Health Improvement (CHI), the value for money work of the Audit Commission and the private health care inspection duties of the National Care Standards Commission. CHAI will be chaired by Sir Ian Kennedy, whose report into children’s heart surgery in Bristol called for a more integrated inspection process. Steriliser guidance The Medical Devices Agency (MDA) has produced new guidance on the purchase, operation and maintenance of all types of bench-top steam sterilizers. Guidelines are intended for potential buyers, current owners and users. www.medical-devices.gov.uk or contact Lisa Robery on 0207 972 8297. Sex lottery campaign A new £4m public information campaign has been launched to raise awareness of the risk of sexually transmitted infections among 18-30 year-olds. The two-year drive ‘Don’t play the sex lottery – use a condom’ is aimed at young adults on low incomes, highlighted as high risk. A web site www.playingsafely.co.uk has been developed to provide information to the target group. The campaign is part of the national strategy for sexual health and HIV. The strategy can be found at www.doh.gov.uk/sexualhealthandhiv/index.htm Medical Devices Agency Hazard notices
Device alerts
Safety notices
Device bulletins
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