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Medical directors’ bulletin: August 2001 - Issue 3

Shifting the Balance of Power

Two documents have recently been prepared on shifting the balance of power to frontline NHS staff. These are:

• a discussion document, Shifting the Balance of Power: Securing Delivery (www.doh.gov.uk/shiftingthebalance).
  Comments are welcomed on the content of this document by 7 September; and
• the Human Resources Framework to support the above (www.doh.gov.uk/shiftingthebalance/hrguidance).

These documents will have significant effects on Community Trust, PCG and PCT staff, as well as those in Health Authorities and Regional Offices. It may be appropriate to hold meetings with staff to discuss the implications.

Lifelong Learning Strategy for the NHS

The first-ever comprehensive framework for learning and development for all NHS staff will be launched later this year. Covering all forms of learning, on a continuum from induction to continuing professional development, the framework will set targets to realise lifelong learning for all staff. It will also set out some of the ways in which the NHS University will become the vehicle for corporate, innovative, systematic and accredited learning to support the NHS modernisation agenda.

For further information e-mail: helen.fields@doh.gsi.gov.uk

Improving Working Lives for the Pharmacy Team - toolkit

The latest IWL toolkit Improving Working Lives for the Pharmacy Team is now available. This toolkit is the first to focus on a specific profession and comprises a series of examples of good practice, grouped around key themes. It will be of interest to all pharmacy staff, and may stimulate ideas and discussion amongst staff about how they work, and how conditions and systems could be improved - it will help to generate fresh perceptions about possible ways of working together.

Copies are available from the NHS Response Line 08701 555 455 quoting reference 24617. If you would like any further information regarding IWL or have any additional examples of good practice please contact Brian Wall 0113 2545292 brian.wall@doh.gsi.gov.uk

Investment in staff development

A £20 million investment plan has been announced to ensure that all NHS employers have the capacity to deliver continuing professional development effectively. The funding will:

• support implementation of appraisal, systematic learning and personal development planning for all staff - closely linked to clinical governance processes and re-registration requirements
• ensure that all staff have better access to training through greater emphasis on accredited work- based systems of learning, and access to modern learning resources supported by IT and library facilities.

For further information e-mail: leo.doherty@doh.gsi.gov.uk

Single assessment process

Guidance on the single assessment process for older people will be issued for consultation on Thursday August 16.

Your comments on the guidance are sought. The guidance documents can be seen at www.doh.gov.uk/scg/sap

Tackling racial harassment in the NHS

Good practice guidance on tackling racial harassment in the NHS is now available, together with the trainers’ resource pack, at www.doh.gov.uk/nhsequality.htm.

This new guidance is aimed at all staff in the NHS. It sets out the case for action and includes a national standard with provides a framework for ensuring that all NHS employers have effective policies in place to tackle racial harassment, and that these are properly supported and implemented.

For more information please call Charmaine Lawrence, Department of Health Equality and Diversity Team, on 0113 2545 696.

Tackling violence against NHS staff

Bids will shortly be invited for central funding to support new local initiatives to tackle violence against staff. The Health Secretary has said that he expects the new funding to be matched by employers.

Funds will be made available to support a wide range of initiatives, ranging from the purchase of personal alarms for staff or installing panic alarms in treatment rooms to providing staff with violence awareness or personal safety training.

For further information please contact your Regional Improving Working Lives Project Manager or Meena Paterson, Department of Health, e-mail meena.paterson@doh.gsi.gov.uk

New governance arrangements for NHS Research Ethics Committees and guidance on NHS Trust reviews

New governance arrangements for NHS Research Ethics Committees (RECs) are being published on the Department of Health website at http://www.doh.gov.uk/research/rd1/researchgovernance/corec.htm#ethics.
The new guidance expands on the standards and principles set out for RECs in the recent Research Governance Framework for Health and Social Care, and clarifies the accountability for establishment and support for RECs. All enquiries should be addressed to the Central Office for Research Ethics Committees tstacey@doh.gsi.gov.uk, who will shortly be in direct contact with HA leads for RECs about implementation timetables and plans.

The above guidance provides that ethics committee approval should be considered in parallel with regulatory approval (for medicinal products, by the Medicines Control Agency). Likewise R&D reviews (including registration and costing) undertaken in Trusts, leading to approval to carry out the project, should also be undertaken in parallel with ethical review, and within the same 60-days time period. This should be the same for industry-sponsored and externally funded non-commercial research.

Work is in hand on common paperwork to link REC approval and Trust review.

Extension of independent nurse prescribing

An update on developments in nurse prescribing is on the Department of Health’s nurse prescribing website (www.doh.gov.uk/nurseprescribing). This gives early warning of action needed in the NHS over the coming months, and asks NHS organisations to consider which nurses would be most suitable for early consideration for nurse prescribing training from early 2002 onwards.

NICE guidance

On the 26 July the National Institute for Clinical Excellence issued guidance to the NHS on the appropriate use of Cox II inhibitors for the treatment of Arthritis. Full details at http://www.nice.org.uk/cat.asp?c=18033

In addition NICE is consulting on the way forward for the four National Confidential Enquiries (Maternal Deaths, Stillbirths & Deaths in Infancy, Perioperative Deaths and Suicide & Homicide by People with Mental Illness). Views on the proposed arrangements for the investigation of deaths in specific circumstances should be forwarded to NICE. Full details at http://www.nice.org.uk/Docref.asp?d=18183

Consent - leaflets for patients

Following the publication of guidance on consent for health professionals in March, the Department of Health’s ‘ good practice in consent’ initiative has now produced a range of patient leaflets entitled Consent - what you have a right to expect. Different versions of the leaflet have been produced for adults, for children/young people, for people with learning disabilities, for parents and for relatives/carers.

Copies are available for order from the NHS Response Line from Friday 20^th July: please call 08701 555 455 or email doh@prolog.uk.com. The leaflets are also available on the internet at www.doh.gov.uk/consent Translations of the leaflets into a range of leaflets and alternative formats will be available shortly.

Reference numbers: Child Consent 24473, Adult Consent 24472, Parent Consent 24474, Relatives Consent 24476,
consent for people with learning disabilities 24464.

National Clinical Assessment Authority starts work

Detailed guidance on the role of the National Clinical Assessment Authority Authority will be published in the autumn. This will include advice on how, and under what circumstances, health authorities and trusts will be able to refer a doctor to the NCAA for assessment.

In the meantime, the NCAA has published an information sheet for the NHS at www.doh.gov.uk/ncaa

For further information e-mail: kcinamon@ncaa.nhs.uk

National Patient Safety Agency

Twenty-five hospitals are starting trials of a new national system for reporting failures, mistakes and near misses across the health service.

The system will ultimately cover the whole country. It will be run by the new independent body, the National Patient Safety Agency, set up on the recommendation of an expert group on learning from error in the NHS.

The NPSA is to be chaired by Professor Rory Shaw, medical director of Hammersmith Hospital. A key part of its task is to encourage a culture in which everyone involved in healthcare is happy to report and discuss incidents. The agency will start to receive details of adverse incidents in the New Year; in the meantime, any local incidents should be handled under existing arrangements.

Further details: www.npsa.org.uk

GMC’s Fitness to Practice committee decisions

This is a reminder that decisions of the General Medical Council’s Fitness to Practice committees, previously notified to the Service, are posted on the NHS Web at www.doh.nhsweb.nhs.uk/nhs/gmc.htm

Decisions of the following GMC committees are available on this site: Interim Orders Committee; Committee on Professional Performance; Health Committee; Preliminary Proceedings Committee; Professional Conduct Committee and Registration Committee.

Queries or requests for further information regarding committee decisions should be addressed to the Committee Section, Fitness to Practice Directorate, General Medical Council, 178 Great Portland St, London W1N 6JE. Telephone: 020 7915 3552

Additional information is available on the GMC website at www.gmc-uk.org

Operating Department practitioners in the NHS

In March 2000, the Department of Health issued good practice guidance recommending that only Operating Department Practitioners whose names appear on the voluntary register held by the Association of Operating Department Practitioners (AODP) be employed in the NHS, and that only bank and locum staff similarly registered be employed. It also asked NHS employers to support their staff in gaining registration within 12 months.

AODP recently operational problems in dealing with registration enquiries due to the voluntary liquidation of their contractor. A new contractor has now been engaged. Contact details are: AODP, Lewes Enterprise Centre, 112 Malling Street, Lewes, East Sussex, BN7 2RJ. Tel 0870 7460984.

For further information e-mail: office@aodp.org Website address: www.aodp.org

Occupational Health Smart Card pilot scheme

A scheme will start shortly to pilot the use of smart cards for junior doctors in educationally approved training posts. Smart cards will record pre-employment checks data, such as a record of police checks and GMC registration details, together with occupational health and immunisation records for medical staff.

With over 30,000 cards to issue, the exercise is being tackled on a region-by region rolling basis, beginning in the current financial year in London and the West Midlands. The project team will begin soon in those regions to identify, through site survey questionnaires, key local HR and Occupational Health staff and IT requirements for data entry and data storage.

Letter (6 July 2001)

For further details e-mail: barbara.levy@doh.gsi.gov.uk

NHS staff vacancy survey: March 2001

The results of the March 2001 NHS Staff Vacancy Survey have been analysed. The main results and messages from the survey are:

Consultants: a slight increase in the vacancy rate, from 2.8% in March 2000 to 3.0% in March 2001. In an expanding workforce, a short-term increase is to be expected.

Qualified nurses: A fall in the vacancy rate from 3.9% to 3.4%, showing that recruitment and retention efforts are starting to bear fruit.

Qualified allied health professionals and scientists: An increase in the vacancy rate for AHPs from 3.6% to 4.3%. All scientific, therapeutic and technical staff (which includes the AHPs already mentioned) showed an increase in vacancy rate from 2.9% to 3.3%. These results are disappointing - return to practice initiatives have been extended, and international recruitment will be rolled out to these staff groups.

The survey is at www.doh.gov.uk/public/vacancysurvey.htm

Further information from madelaine.watson@doh.gsi.gov.uk

Integrating sickness certification into hospital discharge and outpatient processes

Hospital trusts are now expected to integrate a simple sickness certification procedure into hospital discharge and outpatient processes. This follows the publication of the joint Cabinet Office/Department of Health report, Making a Difference: Reducing General Practitioner Paperwork.

The report (www.cabinet-office.gov.uk/regulation/PublicSector/Index.htm) also includes details of the intention to extend the power to certify sickness certification to nurse practitioners.

Letter from Neil McKay (31 July 2001)

NHS Plus

NHS Trusts have been invited to propose their occupational health departments for membership of NHS Plus, the network which will provide NHS occupational health services to other employers.

The scheme is designed to build a service to employers - particularly to small and medium-sized firms, which are unlikely to have their own occupational health services - whilst also enhancing OH services to the NHS itself. Income generated will be available to Trusts for reinvestment in improved health services.

Further information: Elizabeth Johnson, NHS Plus programme manager, tel 020 7972 4274/1304, fax 020 7972 4425,
email elizabeth.Johnson@doh.gsi.gov.uk

Cochrane-Health Libraries Group Prize

Entry forms are now available for the 2001 Cochrane-Health Libraries Group Prize, which supports the use of evidence to improve patient care and the role of information services in supporting clinicians. The prize (£5,000) is to be shared equally between the person or unit submitting the entry and the library or information service providing the information cited.

Entries should take the form of case reports of how evidence has improved patient care, and should be based on information from any of the databases forming the Cochrane Library and show what changes were made in the health care of one or more people using such information.

Entry to the competition is open to all UK residents, whether clinicians or patients. The competition closes on 24 August 2001.

Contact: Jackie Manners, tel 01903 212414, fax 01903 206031, email jackiemanners@hotmail.com

Doctor Online - NHS Litigation Authority

The NHS Litigation Authority has stated that consistent use of Doctor Online, the free patient information service on the NHS Net, could enable a Trust to attain Standard Three of the patient information element of CNST.

This could potentially save a Trust significant insurance premiums.

Doctor Online is the most comprehensive, peer-reviewed information service in the country. It is found at nww.doctoronline.nhs.uk and comprises over 1000 patient information leaflets. It covers 92% of presentations to the secondary level, hundreds of drugs, dozens of procedures, and children’s stories.

For more information, contact mailto:enquiries@doctoronline.nhs.uk

Safety Notices

The following Safety Notices have been issued recently by the Medical Devices Agency:

• MDA SN2001 (22) Counterfeit Intraocular Lenses - www.medical-devices.gov.uk/sn2001(22).htm
• MDA SN2001 (21) Ferno Mk 1, Mobyle Carry Chair - Risk of Frame Collapse Due to Failure of Pivot Pins
  - www.medical-devices.gov.uk/sn2001(21).htm
• MDA SN2001(20) Blood Sampling from Small Infants - www.medical-devices.gov.uk/sn2001(20).htm
• MDA SN2001(19) Safe Use and Disposal of Sharps - www.medical-devices.gov.uk/sn2001(19).htm

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copyright: © | published: Mar. 24, 2002