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Medical directors' bulletin: May 2002, Issue 11 Welcome to the latest edition of the bulletin for Medical Directors. It provides a practical summary of the latest developments in the implementation of the NHS Plan and in your area of work in the NHS - keeping you up to date as well as providing access points for further information. Please help us make this bulletin as useful as possible by telling us of any improvements you'd like to see. Please send feedback to jgrahao@doh.gsi.gov.uk ContentsN.B. Items marked * have not previously appeared in other Department of Health bulletins.
Staffing issues: For information: Guest editorial from National Clinical Director for Primary Care and GP, Runcorn, Professor David Colin-Thome It is a pleasure to write this editorial, as it gives an opportunity to stress how essential it is for primary care and the hospital service to put aside previous and artificial separateness. The structural division has often hampered effectiveness in patient care. Given the role of primary care trusts in total funding of the local NHS by 2004 if not earlier, there is now a sharper focus to the need for better integration. We do now have many practical opportunities to work better together - for instance:
There are as many informal opportunities which will require locally-generated initiative. I have concentrated here on bio-medical and doctors' issues, but of course primary care will also need to work closer with our other clinical and social care colleagues. The Department of Health has set up a primary care policy board, which I chair, and which I will ensure works across all the boundaries of care. Consultant contract negotiationsThere has been good progress in negotiations on a new consultant contract. The government's proposals for the new contract are designed to reward consultants making the biggest contribution to service delivery and improving health services. In the government's proposals, key elements of the contract will include:
The Department of Health and the NHS Confederation are holding workshops on NHS pay modernisation for NHS directors during June and July. Issues to be addressed will include:
The events are being run twice (morning and afternoon) on each of the
dates below: To book, call Nicci Lawrence at the NHS Confederation on 020 7959 7262. Working time directiveEmployers are reminded about the application of the Working Time Directive regulations, which came into force in October 1998 in respect of career grade doctors employed on national terms and conditions of service. The directive means that no career grade doctor can work more than 48 hours, unless they volunteer to do so. This agreement does not apply to doctors in training. Full details are in Advance Letter (MD) 6/98 Working Time Directive Agreement for Career Grade Doctors, which can be found via COIN at www.doh.gov.uk/publications/index.html Consultation on supplementary prescribingThe Government has set out proposals for supplementary prescribing by pharmacists and nurses, following diagnosis by a doctor. A consultation paper has now been issued, with comments requested by 9 July 2002. See www.doh.gov.uk/supplementaryprescribing Abortion notification form changesThe Abortion (Amendment) (England) Regulations 2002, which come into force on 18 April, introduce a change to the abortion notification form HSA4. This follows a consultation with the NHS, private sector and other organisations in August 2000. The key changes are:
Each NHS trust medical director will receive 500 copies of the form, together with a detailed response to the consultation, the new regulations and a guidance note on completing the form. Future supplies of the new form should be ordered as necessary (contact details are on the back of the form). All old versions of the form should be destroyed. For further information see www.doh.gov.uk/hsa4/index.htm or e-mail HSA4@doh.gsi.gov.uk Retained Organs Commission information leafletsThree new leaflets for patients are available at the Retained Organs Commission website (www.nhs.uk/retainedorgans/index.htm). They are:
For printed copies of these, or the earlier leaflet (Tissue blocks and slides), fax your order to Calvin Down at the Commission on 020 7972 2017. Priority treatment of war pensionersIn 1997 the NHS was advised that priority should be given to people receiving a war pension for examination or treatment that relates to the condition for which they are receiving the pension, unless there is another case that requires clinical priority. Veterans' organisations involved with the War Veterans Affairs Task Force have raised concerns that not all trusts are complying with this guidance. Trusts have been asked to remind relevant staff of these arrangements. Further information from Paul Woods at paul.woods@doh.gsi.gov.uk Configuring hospitalsA programme to support NHS organisations considering the configuration of hospital services has been set up by the Department of Health and the Modernisation Agency. A framework for configuring hospitals will be published in the autumn. A website is being developed at www.doh.gov.uk/configuringhospitals Further information from Helen Lovell at helen.lovell@doh.gsi.gov.uk West London Breast Screening ServiceThe Commission for Health Improvement (CHI) has published its report of its investigation into the West London Breast Screening Service. The report makes 37 recommendations for change, including six aimed specifically at trusts managing breast screening units and commissioning health organisations. The report is at www.chi.nhs.uk/eng/organisations/london/hammersmith/index.shtml An action plan, giving details of the Department of Health's response to the recommendations and the action that will be taken to implement them, will be placed on CHI's website. Introducing modern matronsA report setting out progress made in introducing modern matrons was published last month. It can be found at www.doh.gov.uk/modernmatrons Workforce Development ConfederationsA new document (www.doh.gov.uk/workdevcon/guidance.htm) updates the functions of workforce development confederations and shows how they will relate to postgraduate deaneries and strategic health authorities. Treating NHS patients overseasThe pilot scheme to treat NHS patients overseas has drawn to a close. However, it is expected that some patients will continue to travel abroad to help trusts at risk of breaching waiting times guarantees. The Department of Health has therefore set up lead commissioning arrangements to ensure high quality and good value commissioning overseas. These are based in the London and the South, as these are the areas of greatest pressure on waiting times, though NHS trusts elsewhere will be recommended to approach them if they wish to use overseas capacity. The contacts are:
Developing effective medicines management A practical resource, aimed at supporting the NHS locally in the development of effective medicines management services, has been produced by the National Prescribing Centre in collaboration with the National Primary Care Research and Development Centre. The guide is available from www.npc.co.uk or nww.npc.ppa.nhs.uk Modernising supply in the NHSTo address significant differences in purchasing performance across the NHS, the NHS Purchasing and Supply Agency is leading a fundamental reorganisation. This centres on the creation of a 'middle tier' of purchasing to bridge the gap between national and local level purchasing. See nww.pasa.nhs.uk/corporate/publications/modernising_supply_april_2002_exec.doc Principles for best practice in clinical auditNICE has launched a publication to support NHS staff implementing clinical audit project. Principles for best practice in clinical audit details the methods, tools, techniques and activities related to each stage of clinical audit. An electronic version of the book is at www.nice.org.uk Patient choice: information for patientsRegularly updated information on waiting for all major treatments at all NHS providers is to be published on the internet this year. Each trust has been asked to identify a lead to submit data to the Department of Health. By September, the nhs.uk website will provide prospective information on waiting times from all acute trusts, by consultant; by inpatient, outpatient and day case; by speciality and major sub-speciality; updated on a weekly or monthly basis. Further information at www.doh.gov.uk/nhsplanbookingsystems Extending choice for patientsNational Clinical Director for Heart Disease Dr Roger Boyle has replied to responses on the publication of Extending Choice for Patients: information and advice on establishing the heart surgery scheme. See www.doh.gov.uk/extendingheartchoice/index.htm Commissioning freedoms of Primary Care TrustsHealth service circular 2002/007 reinforces the discretion of PCTs in commissioning care for patients. See COIN at www.doh.gov.uk/publications/index.html Prescription charges: new arrangements for issuing certificatesResponsibility for issuing prescription prepayment certificates, medical and maternity exemption certificates in England will transfer to the Prescription Pricing Authority from 1 October 2002. See www.doh.gov.uk/prescriptioncharges/newarrangements.htm Recovery of NHS costs following road traffic accidentsThe Department of Health has published a consultation document on increasing charges for the recovery of NHS costs following road traffic accidents. See www.doh.gov.uk/rta_charges/nhscosts.htm Further information from NHS income generation manager Tracy Morton on 0113 254 5380. Consent to treatment formsNew consent to treatment forms and accompanying information were introduced on 1 April. To help reduce costs, a central production point has been provided: The print specifications will also be made available on the consent website (www.doh.gov.uk/consent/index.htm) to allow for local production. National occupational standards for healthcare scientistsThe National Occupational Standards Project in Healthcare Science is developing standards for competent performance for all identified disciplines in the sector. To discuss further or to register interest, contact the project chair, Dr Sue Hill, tel 0121 627 2088, e-mail susan.hill@university-b.wmids.nhs.uk) or visit the project website at www.noshcs.co.uk 1st international encephalitis conferenceThe Encephalitis Support Group is staging the first-ever conference focusing exclusively on encephalitis this autumn in the UK. The event takes place on 10 and 11 September at Keele University. Full details from www.encephalitis-international.org/ or from the group on 01653 699599, e-mail conference@encephalitis-international.org New national contract for GMSAfter intensive work by the NHS Confederation and the GP Committee of the BMA, the BMA is now consulting GPs on an agreed framework for a new national contract that was published on Friday, 19 April. The agreed framework is available at www.bma.org.uk Self-monitoring of anti-coagulation therapyThe testing strips for Coaguchek, a system to enable patients to monitor their anti-coagulation therapy, will be prescribable on the NHS from the beginning of May. The associated Coaguchek meter will not be prescribable. Patient self-monitoring is expected to be initiated in specialist clinics in most cases. Consensus clinical guidance has recently been issued by the British Society of Haematology. Further details are on the BMJ website at www.bmj.com/cgi.content/full/323/7319/985 Health Professions CouncilThe new Health Professions Council was established on 1 April. It has replaced the Council for Professions Supplementary to Medicine, and will initially regulate 12 professions. More details at www.hpcuk.org Safety alertsThe following safety notices, hazard notices and device alerts have recently
been issued by the Medical Devices Agency: Full details at www.medical-devices.gov.uk
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