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Medical directors' bulletin: November 2001- Issue 5 Trust services
Trust servicesAction on bed-blocking Investment of £300m has been announced over this year and next as part of a programme designed to end widespread bed-blocking. It will allow over 2,000 older people to leave hospital, rather than having to wait after their treatment is finished, and will free up 1,000 beds this year alone. The investment is linked to radical reform of the way NHS and social services work together, underpinned by a new agreement between the statutory and independent social care sectors, health care and housing. See www.doh.gov.uk/buildingcapacity Reforming emergency care A new approach to emergency care in the NHS is set out in the Reforming Emergency Care report, published last month. It envisages new solutions to service problems, through coordination of services across the system to improve patient-centred care. See www.doh.gov.uk/capacityplanning/reform.htm National adult heart and lung transplant service The government's proposals for developing a national heart and lung transplant service are set out in a new document. It seeks views on whether the quality framework proposed is appropriate, how the service can best be organised to maximise the number of transplants available, ways to improve the working conditions of staff, how to ensure a consistent and sustainable service, and how to achieve the best possible outcomes for patients. See www.doh.gov.uk/ncts/index.htm Renal National Service Framework: views wanted! Please pass this information to all staff in renal units, A&E departments, intensive care units, diabetes clinics, transplant coordinators, pharmacists, dieticians, counsellors, renal service commissioners, and relevant enquiries/information sections. A National Service Framework is being developed to improve renal service. An interactive website (www.doh.gov.uk/nsf.renal.htm) offers information about the scope of the NSF, and members of the External Reference Group. More importantly, it also seeks views from service providers and users, who can contribute to the discussion area or suggest a standard for inclusion in the NSF. Guidance on safe administration of intrathecal chemotherapy New guidance on the administration of intrathecal chemotherapy has been issued for immediate implementation throughout the NHS. Since 1985 at least 13 patients have died or been paralysed as a result of the accidental intrathecal administration of Vincristine, which was intended for intravenous administration. The new guidance requires all NHS Trusts to confirm their current position to Regional Office cancer leads by November 30 2001. By December 31 2001, all Trusts where intrathecal chemotherapy is administered must ensure safe practice is introduced. Implementation will be monitored by Regional Officers, who will report to the Chief Medical Officer on compliance. The Guidance and Health Service Circular For further information, please see Reference Guide to Consent for Examination or Treatment at www.doh.gov.uk/consent Violent patients National guidelines have been issued on withholding NHS treatment from violent and abusive patients. As part of applying a zero tolerance approach to violence against staff, all NHS Trusts must consider the need for local policies and procedures by April 2002. The guidance is at www.nhs.uk/zerotolerance The related health service circular, which provides a policy framework to help trusts, is available at [link] or from the NHS Responseline, tel 087011 555455. For further information, contact Meena Paterson (0113 254 5758, email meena.paterson@doh.gsi.gov.uk) or Eileen Calline (tel 0113 254 6131, email eileen.calline@doh.gsi.gov.uk Coronary heart disease information strategy The information systems required to support improved coronary heart disease services, and the action needed, are identified in a new CHD Information Strategy. See www.doh.gov.uk/ipu/strategy/nsf.3.htm Complaints and clinical negligence Consultation on the review of the NHS Complaints Procedure ended last month and the responses are now being analysed. A White Paper is expected in the New Year on proposed reforms to the system for dealing with clinical negligence claims, following consideration of the issues raised by the Chief Medical Officer's Advisory Group. Contact for further details: Carolyn Heaney, tel 0113 254 6123 (email carolyn.heaney@doh.gsi.gov.uk) Management of possible exposure to CJD through medical procedures A consultation document prepared by the CJD Incidents Panel seeks views on proposals on when to inform people about their possible exposure to CJD; how to prevent further possible spread of CJD; how to follow up possibly exposed people; when to remove contaminated instruments from use; and how to publicise incidents. It is available at www.doh.gov.uk/cjd/consultation Further information from Philippa Edwards on 020 7972 5324. Out of Area treatment adjustment and specialised services Last month's bulletin mentioned the new policy for 2002/3 of removing all specialised services from the national OATs matrix and incorporating them into service agreements. Further guidance on action needed to implement this policy has now been issued for NHS Trusts and others. See [link] Research governance framework Each research-active NHS organisation has been asked to prepare a local implementation plan for compliance with the new Research Governance Framework. For any NHS care organisation that does not have access by December 2001 to systems for notification of R&D and for checking ethical approval and informed consent, its chief executive is required to decide whether or not R&D should continue, and to report to the Department of Health. A national implementation plan is at www.doh.gov.uk/research Charges for access to health records Following a review, charges levied by the NHS for providing individuals with access to their health records have been maintained at current levels. The maximum fee is £10 for records held on computer and £50 for paper records or other media. Further information: www.doh.gov.uk/nhsexipu/confiden/index.htm NHS Beacons Learning Handbook The NHS Beacons Learning Handbook Volume 4 profiles up-to-date information on 154 Beacon organisations across a variety of themes. It also includes information on the Health and Social Care Award winners and other best practice schemes. For a free copy, visit www.nhs.uk/Beacons or email nhsbeacons@statusmeetings.co.uk Health Service Commissioner's report The Health Service Commissioner has published his 'Investigations Completed' report, covering the period April to July 2001. The report is an invaluable source of information for the NHS, both for improving services and as a training resource. In his foreword, the Commissioner raises two key themes emerging from his investigations: care provided in accident and emergency (including support and supervision of junior clinical staff), and investigating and handling complaints. See The Health Service Ombudsman site Specialised services provided for residents of Scotland From April 1 2002, the National Services Division of the Common Services Agency, NHS Scotland, will take responsibility for negotiating service agreements with NHS Trusts in England for specialised services provided for residents of Scotland. NHS Trusts which have provided specialised services for Scotland residents within the last three years should write to NSD with details of activity and costs by November 20 2001. NSD will then contact NHS Trusts to agree service agreements for 2002/3. Write to: National Services Division, Room D118, Trinity Park House, South Trinity Road, Edinburgh EH5 3SE. Tell 01311 551 8936; fax 01311 551 2855. NHS developmentIntermediate care investment As part of the additional funding for intermediate care announced in the NHS Plan, new capital investment of around £66 million is available over the next two years to support the development of intermediate care and, particularly, a growth in bed numbers. It is expected that NHS Trusts or PCTs/PCGTs will be asked to submit bids via Regional Offices by early to mid December. The ability of projects to deliver significant increases in capacity within the specified timescale will be a key criterion. It will also be important to integrate any development proposal within a whole-system approach that local partners are signed up to, and to ensure maximum benefit for patients and for overall system capacity. 'Modelshire' beds planning tool Modelshire II, the updated planning tool for estimating future requirements for beds and community care, is now available. The new version incorporates Local Variation Analysis data for 1999/2000 and information about residential and nursing home beds. The model can be accessed through www.doh.gov.uk/nbi. Queries about its operation should be addressed to modelshire@doh.gsi.gov.uk Ministerial speeches In a speech to the Fabian Society on October 25, Secretary of State Alan Milburn emphasised the government's drive for decentralisation and empowerment in the NHS. He announced that from next year, patients whose operation is cancelled at the last minute and who are not re-admitted within 28 days will have the power to choose an alternative hospital. Click here for full text In a further speech, to the Annual Social Services Conference, the Secretary of State said he expected to see significant reductions in delayed discharges over the next year following the new £30 million investment to tackle bed-blocking. He also announced details of a new performance rating system for social services. Click here for full text StaffingNational 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 International recruitment NHS employers are strongly advised to adhere to the new Code of Practice in the international recruitment of healthcare professionals across all disciplines. The Code's purpose is to promote high standards, and to prevent targeted recruitment from developing countries which are themselves experiencing shortages of healthcare staff. It is available at www.doh.gov.uk/international-nurse/code.htm NHS Professionals Guidance has been published to help inform and support NHS Trusts with their work to implement Professionals, the coordinated NHS-led approach to temporary staffing. The guidance is available at www.doh.gov.uk/iwl/nhsprofessionals.pdf, with hard copies available from the NHS Responseline on 08701 555455, ref 25532. Team bonuses Ten sites have been selected to pilot the use of team bonuses in NHS organisations. They represent a broad range of Trusts, team types and reward schemes. Haygroup management consultants will assist the pilot sites in implementation and evaluate the outcomes. Bids for a second wave of pilot sites will shortly be invited from three-star acute Trusts: these are likely to begin in April 2002. Click here for further details Leadership programme for executive directors The new leadership programme for executive directors is a one-week development event that will run from Monday January 14 at Leeds University Business School. The event is part of the first nationally-commissioned programme from the Centre. Focusing on leading complex health services in rapidly-changing environments, it aims to broaden awareness and understanding and to allow directors to assess their longer-term development needs. It is suitable for those thinking about a career move either to a more complex director role or a chief executive post. The programme is being provided by the Kings Fund, Leeds University Business School and the Nuffield Institute for Health, and is fully funded by the centre. Directors wishing to take part should send a summary of their cv, a short letter setting out how they will benefit from taking part, and a letter of support from their chief executive. Closing date November 30. Send to Manjit Phull, NHS Leadership Centre, 40 Eastbourne Terrace, London W2 3QR. Tel 020 7725 2724 or email manjut.phull@doh.gsi.gov.uk This is part of a wider development programme for executive directors, which will include a year-long programme beginning in spring 2002. To register an interest, contact Manjit Phull on email as above. Safety alertsRecent safety alerts issued by the Medical Devices Agency:
Click here for the Safety alerts
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