Introduction
Welcome to
the sixth Edition of GP Bulletin, aiming to keep you up to date
with potentially useful information for your daily work.
Please send
any feedback or views on the bulletin to:
sonny.dutta@doh.gsi.gov.uk
Sonny Dutta
Primary Care Development Officer
GP Bulletin Editorial Team
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Guidelines
for biological attack
The Public
Health Laboratory Service issued interim guidelines on October
22 for action in the event of a deliberate release of anthrax,
botulism, plague or smallpox. See www.phls.org.uk/facts/deliberate_releases.htm
Following
consultation with the Chief Medical Officer and the Department
of Health, these guidelines have been incorporated into the PRODIGY
guidance system, and were due to be released to GP System Suppliers
during the week beginning October 29.
Further details
of PRODIGY guidance can be found at
www.prodigy.nhs.uk
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GPs
with Special Interests
Many new developments
in primary care aim to provide GPs with additional opportunities
for new ways of working that enhance their skills and improve
career
opportunities. One such development identified in the NHS Plan
is for up to 1,000 "specialist GPs" to take referrals
from their colleagues for a range of conditions. However, the
term "specialist GP" has prompted some debate and it
has been replaced by "GPs with special interests". This
change is intended to recognise that all GPs are specialist in
generalist discipline of family medicine.
Independent
research has identified that many GPs have already developed special
clinical interests outside general medical services. It will be
important to ensure these GPs are appropriately recognised and
rewarded for this work.
As part of
this process, the Department of Health is working with the RCGP
(in partnership with other Colleges, professional associations
and other stakeholders) to
develop a national accreditation framework setting out minimum
standards across a range of common special interests (in the first
instance, for example, national service framework and long wait
specialists).
The intention
is that local health economies will identify tasks for which a
GP with special interests may be suitable. They will appoint,
support, monitor and remunerate GPs, using guidance that will
be issued to PCTs shortly. The introduction of GPs with special
interests will:
- support
GPs in their professional development and allow GPs with specialist
experience and expertise to apply their skills and knowledge
to best effect for the benefit of patients and local services;
- contribute
to the aims of improving recruitment and retention in general
practice by
- adding
variety to jobs, enhancing job satisfaction and reducing the
risk of burnout for individual GPs;
- result
in more accessible and convenient services for patients;
and
- improve
management of workload between primary and secondary care.
For
enquiries, please email John Taylor on:
john.taylor@doh.gsi.gov.uk
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GP
appraisal
Appraiser
training
As part of
a comprehensive range of measures to assure the quality of care
that patients receive, all NHS doctors - GPs as well as trust-employed
doctors - are to be required
to participate in annual appraisal.
The primary
aim of appraisal is to help doctors consolidate and improve on
good performance, aiming towards excellence - not to scrutinise
them to see if they are
performing poorly. However, it can help to recognise, at an early
stage, developing poor performance or ill health, which may be
affecting practice.
Part of the
requirement for successful appraisal is the input from trained
appraisers. PCGs and PCTs have now been asked to identify suitable
GPs for a first wave of training as GP appraisers. Funding of
£2 million is being provided over two years to support this training
programme.
Appraisers
should have:
- Good interpersonal
skills
- Good knowledge
of the GP job and the context and circumstances in which it
is carried out
- A reasonable
working relationship with the appraisee
- At least
some knowledge of the GPs work throughout the year
- The confidence
of the GP community
- The confidence
of the HA or PCT
- The authority/ability
to influence wider HA or PCT decisions and ensure outcomes are
actioned
For further
details contact Victoria Jamson email:
victoria.jamson@doh.gsi.gov.uk
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Report on GP appraisal
A new report
sets out how appraisal systems for GPs might work, and provides
guidance on best practice. It also highlights the benefits in
appraisal for GPs, patients and the NHS. The report was commissioned
by the Department of Health and compiled by the School of Health
and Related Research at the University of Sheffield.
The report,
with a foreword by the Chief Medical Officer and an executive
summary, can is available at www.doh.gov.uk/gpappraisal
Printed copies
will shortly be available from The Secretary, Primary Care Support
Unit, School of Health and Related Research, University of Sheffield,
Regent Court, 30 Regent Street, Sheffield S1 4DA. Tel 0114 222
0718; email pcsu@sheffield.ac.uk
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Appraisal toolkit
A new email
bulletin service for the NHS Appraisals Toolkit (www.appraisals.nhs.uk)
has been launched. The regular e-bulletin will bring subscribers
news and notices on the development of the Toolkit, including
pre-release information as new sections are prepared
for 'go live' release.
This service
works in tandem with the other NHS Appraisal Toolkit e-communications
- enquiries@appraisals.nhs.uk
can be used for any general enquiries.
There will
also be a new email 'list' for those experts with access to the
pre-launch 'beta' versions of the Toolkit. This list will facilitate
discussion about appraisal, and will
allow users and experts to watch the NHS Appraisal Toolkit take
shape under peer guidance.
To subscribe
to the NHS Appraisal Toolkit e-bulletin Announce, contact enquiries@appraisals.nhs.uk
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Cutting
bureaucracy
New guidance
was published in October that will avoid unnecessary GP visits
by accident victims seeking a formal record of their injuries.
Solicitors
are being advised that they should not automatically direct all
accident victims to visit their GP after an accident, unless they
need diagnosis or treatment.
Where solicitors
want simply to obtain a record of accident injuries, they are
now advised to consider other methods first - for example, taking
photographs of the injuries. The new advice is backed by the Law
Society and other legal associations, as well as the BMA and RCGP.
The guidance
is expected to save GPs up to 202,000 appointments a year, plus
an extra 5,000 hours, annually. It is one of the 30 measures set
out in the Cabinet Office report, Reducing GP Paperwork,
issued earlier this year.
The guidance
can be seen at
www.cabinet-office.gov.uk/regulation/PublicSector/guidance.htm
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GP
recruitment and retention/ Improving Working Lives
On 2 November,
Health Minister John Hutton announced a package of measures to
boost GP numbers and make primary care a better place to work.
They include:
- A commitment
on the pay of trainee GPs to ensure their pay rises in line
with that of junior hospital doctors.
- An increase
in locum cover for family doctors on maternity, paternity and
adoptive leaves - effective from 2 November 2001.
- The extension
of a £100m NHS childcare provision initiative to cover primary
care.
- A move
to ensure practice nurses receive pay-awards that are comparable
to their colleagues working in hospitals. Further details at
www.doh.gov.uk/pricare/practicenursepay
The rolling
out of the "Golden Hello" scheme that will give
£5,000 to every GP who joins the NHS, with an extra payment of
up to £5,000 if they work in an under-doctored area.
Guidance for
Health Authorities and Primary Care Groups and Trusts is now available
and they have been asked to make the first payments to qualifying
GPs as soon as possible. A copy of the guidance, together with
a form for GPs to apply for a Golden Hello
payment, is available at www.doh.gov.uk/pricare/goldenhello
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National
Clinical Assessment Authority - update
The NCAA was
established in April to provide a service to the NHS in managing
poorly performing doctors. It will take referrals from doctors'
employers - NHS Health Authorities, Hospital Trusts, Primary Care
Groups and Trusts.
The Authority
has completed its first six-month 'establishment phase'. It has
established its headquarters' team and function; devised and consulted
on draft operational
guidelines and assessment protocols with the NHS, the medical
profession and other relevant parties; and provided expert advice
and guidance
to referring Trusts and Authorities.
The NCAA has
now entered its 'prototype assessment phase'. During this phase,
it will identify 20 referred cases to undergo a comprehensive
assessment procedure to be under way before March 31 2002. It
will continue to take referrals from NHS doctors' employers and
to provide expert advice and guidance.
More information
on when and how to refer cases to the NCAA, and details about
how the referral and assessments processes will operate, are available
from the Authority's website: www.ncaa.nhs.uk
Mail
to ncaa@ncaa.nhs.uk
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Consultation
on NHS screening standards for infectious diseases in pregnancy
The offer
of screening for rubella antibody, syphilis, HIV and hepatitis
B is an integral part of antenatal care in England. The Antenatal
Subgroup of the UK National Screening Committee has now produced
generic and specific screening standards for each of the four
diseases, in consultation with the Public Health Laboratory Service
and the relevant expert groups.
Comments are
now invited from all professionals involved in antenatal screening.
The draft standards are available at www.nsc.nhs.uk/hottopics/hottopics_ind.htm
All comments
should be sent to Helen Janecek, project manager, UK National
Screening Committee - Antenatal Subgroup, Royal College of Obstetricians
and Gynaecologists, 27 Sussex Place, Regent's Park, London NW1
4RG or emailed to hjanecek@rcog.org.uk
by January 31 2002.
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Tackling
Coronary Heart Disease
The information
systems needed to develop first-class cardiac care throughout
the country are set out in a new strategy published by the Department
of Health.
The Coronary
Heart Disease Information Strategy recognises the pivotal role
of primary care in the successful delivery of the CHD National
Service Framework. It describes
a number of initiatives intended to support general practice in
this process.
They are:
- The Health
Informatics Programme (HIP), which supports clinical governance
of CHD in primary care;
- PRIMIS,
which enables primary care teams to critically examine their
CHD activity;
- The practice-based
Registers Development Programme, which aims to generate greed
national definitions for established CHD and those at significant
risk;
- PRODIGY,
which provides up-to-date evidence-based recommendations for
the management of conditions.
Further details
of the strategy can be found at: www.doh.gov.uk/nhsexipu/strategy/nsf/3.htm
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The
Renal National Service Framework
The Department
of Health is developing a National Service Framework (NSF) to
improve renal services. An interactive website (www.doh.gov.uk/nsf/renal.htm)
provides information about the scope of the NSF and the make-up
of the External Reference Group. It
also encourages service providers, users and stakeholders to add
their views, through contributing to the discussion area or suggesting
a standard for inclusion in the NSF. To help promote the NSF,
it also includes a printable poster/handout for display.
Please pass
this information on to all staff who might have contact with renal
patients. For
further information contact Jane Verity at jane.verity@doh.gsi.gov.uk
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New
Arrangements for Managing Primary Care Contractors
Health Authorities
will shortly be setting up and populating their new General Medical
Services Supplementary Lists. One of the results will be that
GP locums will have access to the NHS Pensions scheme.
These changes
are part of a package that the Department of Health is bringing
in to further improve the quality and management of primary care
services. Most of these new arrangements came into force on December
1.
The measures
concern the four Family Health Service contractor professions
(GPs, dentists, pharmacists and optometrists) and can be summarised
as:
- the abolition
of the NHS Tribunal
- changes
to the regulation of the medical, pharmaceutical, optical and
dental lists, which introduce new HA powers of suspension, removal
from and refusal to admit
to these lists;
- the introduction
of HA Supplementary Lists of non-principals working in General
Medical
Services (from December 1), Pharmaceutical Services, General
Optical Services and General Dental Services (all during the
first half of 2002);
- the introduction
of a HA Services List (during the first half of 2002) for those
practitioners performing Personal Medical Services and Personal
Dental Services;
- the setting
up of a new Family Health Services Appeal Authority (FHSAA).
These decisions
will move to PCTs within no more than 12-15 months. These moves
are only part of a series of new arrangements designed to support
doctors and protect
patients. Only a very small number of practitioners are likely
to be removed or suspended under the arrangements; most doctors
will benefit through increased clinical
and management support.
For further
details, please contact Steve Rowlands, email: steve.rowlands@doh.gsi.gov.uk
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Get
the Right Treatment Campaign
This year's
Get the Right Treatment campaign started on November 12 and will
run to January 31.
The campaign
is being repeated this year to try to continue to change public
behaviour. In addition to promoting self-care, pharmacy, NHS Direct
(and in some areas NHS Walk-in Centres), it also encourages appropriate
and responsible use of GP
surgeries during normal opening hours and out of hours.
To support
the press ads, internet advertising and media relations, a campaign
toolkit has been circulated to NHS communication leads for local
use. In addition, generic posters can be ordered from the NHS
Responseline on 08701 555 455. Further
leaflets, setting out when and how the various healthcare options
should be used, are also available.
PCGs and PCTs
that recently ordered up to 500 free copies of the NHS Direct
Healthcare Guide, the handy reference book which works alongside
the telephone service,
will shortly receive the new edition. The Guide has been reprinted
following focus group research. Available free to the public,
it covers over 40 symptoms or problems which people call NHS Direct
about. It is a particularly relevant 'communication tool' over
the winter months that can be targeted at those who need it most.
Extra copies can be ordered at a cost price of 55p by email: Peta.wolstencroft@doh.gsi.gov.uk
For further
information on the Get the Right Treatment campaign see: nww.doh.nhsweb.nhs.uk/commsnet/winter2001/index.htm
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Meningitis
- practices serving Muslim communities
A campaign
has been launched to prevent meningococcal infection associated
with the annual Hajj pilgrimage to Saudi Arabia. Practices in
West Yorkshire, Greater Manchester/Lancashire, Birmingham, West
Midlands, Leicester/Nottinghamshire and
London which
have their leaflet racks managed by Waiting Room Information System
(WIS) will automatically receive supplies of the new leaflet,
Guard against meningitis and save lives at Hajj or Umrah this
year. Other practices, especially those with a Muslim population
in the catchment area, are strongly advised to order supplies
of the leaflet and A3 poster.
The poster
in English, and the leaflet, available in English, Arabic, Bengali,
Gujarati, Somali, Turkish and Urdu, can be ordered by faxing 01623
724524 or emailing doh@prolog.com
For more on the campaign, see Chief Medical Officer's Letter
at www.doh.gov.uk/cmo/cmo0105.htm
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Primary
Care Cancer Leads
More than
180 cancer leads have now been appointed within primary care organisations.
This follows the launch of a joint initiative between the Department
of Health and Macmillan Cancer Relief to invest a total of £3
million each year for three years, for the appointment of a lead
clinician for cancer within each PCG/T. The funding is to enable
the lead clinician to have dedicated time to raise the standard
of cancer care within the PCG/T and to contribute to the development
of cancer networks.
From April
2001, each Health Authority received £5,000 per PCO so that PCGs
and PCTs could appoint a primary care cancer lead. Initially,
the five key roles of the Cancer
Lead will be:
- To
provide strategic leadership within the PCG/T in line with the
NHS Cancer Plan to develop services for cancer patients
- To raise
the standards of cancer care within the PCG/T in collaboration
with the Clinical Governance Lead
- To contribute
to network development and, where appropriate, to represent
the PCG/T
and primary care in the cancer network
- To contribute
to the development of network service delivery plans in order
to streamline patient care
For further
information, contact Gillian Batt, email: gillian.batt@doh.gsi.gov.uk
To obtain
copies of the Macmillan Support Programme, email EConnelly@macmillan.org.uk
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National
PCTDevelopment Programme
Back in October
saw the formal launch of a National PCT Development Programme
and Team, established under the leadership of Dr Barbara Hakin,
Chief Executive, Bradford South and West PCT. It will establish
a programme of organisation and personal
development that supports PCTs, and ultimately Care Trusts, to:
Deliver on
their core functions
- Take on
from former Health Authorities the additional responsibilities
envisaged within 'Shifting the Balance of Power'
- Establish
inter-locking federations of Primary Care Trusts that will act
as a forum to ensure that all PCTs, often acting in collaborations,
have a sustainable infrastructure for
the future In addition, the programme will build on existing
PCT development programmes
through:
- The development
of effective PCT leaders (Chief Executives/Chairs/Clinical Leaders/Patients'
Champions and others)
- Identifying
a framework of organisational and personal competencies for
a PCT and its staff
- Mapping
existing development programmes, and providing a signpost for
PCTs to sources of further advice and guidance
- A structured
programme of organisational development that can be tailored
to meet local needs
- Putting
in place a mechanism for achieving effective two-way communications
between ministers/centre and frontline clinicians and managers
For further
details contact the Project Manager, Nick Hall, via e-mail on
nick.hall@doh.gsi.gov.uk
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PMS
'listening events'
The National
Personal Medical Services Development Team held four listening
events during November, to canvas the views of PCTs, HAs and professionals.
These events generated a great deal of interest, resulting in
each meeting being heavily over- subscribed.
A report has
gone to health minister John Hutton, summarising key issues raised.
It also outlines actions by the government and the PMS National
Development Team to address these issues. The report has been
sent to all participants and is available at www.doh.gov.uk/pricare
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MDA
Safety Notices
Therapeutic
diathermy (deep heat) warning for all active implants
Two non-UK
patients implanted with deep brain neurostimulator systems
have recently died after they
had received therapeutic diathermy.
The Medical Devices Agency
has issued a safety notice which
reminds GPs not to forward patients
with active (powered) implants
for short wave and microwave
therapeutic diathermy (also
called deep heat treatment) as
applied by physiotherapists.
The safety
notice does not apply to surgical diathermy or ultrasound diathermy.
Active implants include neurostimulators, cardiac pacemakers/defibrillators
and all implants with implanted lead systems. If therapeutic diathermy
is used close to an implanted drug pump it may also cause over/under
infusion of drugs. A detailed safety notice is available at: www.medical-devices.gov.uk
For further
information, please email
mail@medical-devices
Other recent
safety alerts
For full details
see www.medical-devices.gov.uk.
Recent notices include:
|
DEVICE ALERTS
|
|
|
DA2001(05)
|
Recall
of Specified Batches
of Zirconia Ceramic Femoral
Heads for Use in Hip Replacements
|
|
DA2001(06)
|
Hylamer
Polyethylene Components
Sterilised by Gamma-Irradiation in
Air
1.
Hylamer Duraloc Acetabular Liners
2.
Hylamer Ogee Acetabular Cups
3. Hylamer
Global Shoulder
Glenoid
Components
|
|
SAFETY NOTICES
|
|
|
SN2001(19)
|
Safe
Use And Disposal
of Sharps
|
|
SN2001(20)
|
Blood
Sampling From Small
Infants |
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