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Medical directors’ bulletin: October 2001 National Service Framework for long-term conditionsA meeting to determine the scope and content of the new National Service Framework (NSF) for long-term conditions will take place on November 12. The new NSF will have a particular focus on the needs of people with neurological disease and brain and spinal injury. It will help ensure that services are better organised and more focused towards the needs of people with long-term health conditions. With the help of leading clinicians, managers and staff, the Department of Health will set national standards and define service models to help ensure seamless provision across service boundaries, including the health-social care boundary. The NSF will be published in 2004 for implementation in 2005. See www.doh.gov.uk/nsf/longterm.htm Down Syndrome screeningThe government has announced a Down Syndrome screening programme as part of the modernisation of neonatal and antenatal screening.The UK National Screening Committee has recommended that all pregnant women, irrespective of age, should be offered second trimester serum screening. A network of regional coordinators is being set up across the country to ensure proper management of local programmes. For further information, see www.nelh.nhs.uk/screening/dssp/programme.html or contact Mrs Pat Ward, programme manager, on 01536 481902, email paward@freenet.co.uk Patient confidentialityA change to the law on the use of patient-identifiable information has been introduced through Section 60 of the Health and Social Care Act 2001.The government has made it clear that informed consent is the fundamental principle governing the use of such data by the NHS or research community. However, it recognises that there are some situations where informed consent cannot be obtained. Section 60 provides the Health Secretary with the power to ensure that patient-identifiable information needed to support essential NHS activity can be used without patients' consent. This is intended as a transitional measure, whilst consent or anonymisation procedures are developed. The Act provides numerous safeguards for patients, and does not set aside the NHS's obligations under the Data Protection Act 1998. A new Patient Information Advisory Group will advise the Secretary of State on confidentiality issues. For further information, see www.doh.gov.uk/nhsexipu/confiden or contact Sean Kirwan on 0113 254 6019. Treatment of patients in the EUPrimary Care Trusts will in future have the option of securing treatment for NHS patients in other European countries, Health Secretary Alan Milburn has announced. But this can only happen where it meets the patients' wishes and their needs as defined by a full clinical assessment.Mr Milburn stressed that authorities would be expected to apply the same principles to European providers as to private providers in this country, including patient safety, quality, aftercare arrangements and complaints. Domestic law also needs to be clarified to ensure it conforms with recent European judgements. Better Blood Transfusion conferenceA conference on October 29 aims to help set the priorities for blood transfusion in the NHS for the next three to five years.The conference is being hosted by the four UK Health Departments, the National Audit Office and the National Blood Transfusion Services. It will explore how the service can modernise the management of patients, improve safety, develop the evidence base and strengthen hospital transfusion committees. An important issue that will be considered is how to avoid unnecessary use of blood in clinical practice, in the face of decreasing supplies and donor numbers. See the conference website at www.doh.gov.uk/bbt2 Demand and capacity managementThe NHS Modernisation Agency is leading a national workshop programme on demand and capacity management.The programme is aimed at NHS leaders and people who are facilitating or teaching local modernisation programmes and projects. Demand and capacity management is a priority development area for the agency. These skills are fundamental to achieving and sustaining NHS Plan targets in emergency access, outpatient and inpatient waiting times and booked admissions. The workshop programme is at www.nhs.uk/npat/workshop.asp Managing change in the NHSTwo publications on managing change in the NHS have been commissioned by the NHS Service Delivery and Organisation National R&D Programme.The first, Organisational Change: A review for health care managers, professionals and researchers, is a review of models of change management to help managers, professionals and researchers find their way around the literature and consider the evidence available about different approaches to change. The second, Making Informed Decisions on Change: Key points for health care managers and professionals, is a booklet, drawing on the review, which aims to encourage managers and professionals to reflect on and share what helps and hinders successful change to improve the quality of services. Copies of both publications, which are free, are available at www.sdo.lshtm.ac.uk/whatsnew.htm or from NCCSDO, tel 020 7612 7980; fax 020 7612 7979; email sdo@lshtm.ac.uk National pay for managersPay arrangements for managers on national terms whose pay is reviewed from September 1 each year are set out in a letter to health authority chief executives. They will be implemented in light of Nigel Crisp's earlier letterClinical attachments for overseas qualified doctorsThe BMA has issued new guidelines for those involved in organising and supervising clinical attachments or working with overseas-qualified or refugee doctors. The BMA's Refugee Doctor Liaison Group helped write them, and the GMC approves them.Trusts considering or already offering clinical attachments should use the guidelines to ensure that the personal, financial and legal aspects are fully covered. For more information, click here or e-mail julie.mcmillan@doh.gsi.gov.uk Appointment of Consultants RegulationsConcerns have been raised with the Department of Health about effective mechanisms for dealing with alleged breaches of the Appointment of Consultant Regulations.The regulations should be followed in all instances. A good practice guide builds on the regulations, and provides further guidance on applying them. Chief executives of employing authorities are responsible for ensuring that all consultant appointments are fully compliant with the regulations. This element will be emphasised in any redraft of the guidance. For more information contact patricia.saunders@doh.gsi.gov.uk Out of area treatment and specialised servicesFrom 2002/3, a common approach across all regions is to be adopted on incorporating specialised services into service agreements. This is to minimise potential disputes between commissioners and provider trusts.Further details are set out in a letter to chief executives and finance directors: Children and adolescents who try to harm, hurt or kill themselvesThis Office for National Statistics report sets out further analysis from a national survey in 1999. It presents prevalence rates of self-harm among children and adolescents aged 5-15.See the report at www.stastics.gov.uk/products/p7373.asp NHS Bursary SchemeThe fourth edition of the NHS Bursary Scheme includes a range of amendments to the current student support arrangements.The document is available at www.doh.gov.uk/hcsmain.htm Education in palliative careProposals from the cancer network for education and support for district and community nurses in the principles and practice of palliative care have been approved.A national evaluation of the programme will start in the autumn. In addition, a national conference in the winter will allow all networks to share expertise. Details at www.doh.gov.uk/cancer/edusup.htm or email sue.hawkett@doh.gsi.gov.uk Reforming the NHS complaints procedureA ‘listening document' suggests ways to improve the complaints procedure for patients in England. It summarises suggestions made after a two-year evaluation study of the existing procedure.See the document at www.doh.gov.uk/nhscomplaintsreform/index.htm Polymerase Chain Reaction (PCR) techniqueSome confusion has been caused by media coverage about the revocation of one of Roche's patents on the PCR technique — widely used by the NHS in laboratory diagnostic services.The patent that was revoked is not one of the two licensed for NHS use. Trusts should therefore maintain royalty payments to Roche. The Surveillance NetworkThe Department of Health has altered its advice to laboratories on participation in a surveillance network for antimicrobial resistance run by Focus Technologies Inc. (TSNtm — ‘The Surveillance Network').A 1999 circular, based on a Court of Appeal judgement, advised that participation in this network could be illegal. However, a subsequent ruling by the Court of Appeal has clarified the law, and the Department is of the opinion that there are currently no legal impediments to the participation of NHS laboratories in this network. Cleft lip and palate servicesGuidance has been sent to all Trusts to assist with making appointments at the new cleft lip and palate centres. This follows the reconfiguration of cleft services in light of the recommendations set out in the 1998 Clinical Standards Advisory Group, and on the advice of the Cleft Implementation Group led by Dr June Crown.Community equipment servicesThe government is providing £105 million for the NHS to improve community equipment services up to 2003/4. Extra money has also been provided to local councils, to enable them to contribute to the expansion of these services — which are integral to many modernisation initiatives, especially around inappropriate admission.A new Guide to Integrating Community Equipment service sets out milestones to be achieved. It is available at www.doh.gov.uk/scg/communityequipment.htm Safety noticesThe following safety notices have been issued recently by the Medical Devices Agency:Oesophageal Stent: increased potential for fracture. See www.medical-devices.gov.uk/sn2001(25).htm Patients with active/powered implants: risk of serious injury from therapeutic
diathermy treatment. Battery charges with faulty 13A plugs, branded as Sonnenschein, Lomax or Sunrise. See www.medical-devices.gov.uk/sn2001(24).htm
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