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Medical directors' bulletin: September 2002, Issue 14 Welcome to the latest e-bulletin for medical directors. It aims to provide a practical summary of NHS developments, with access points for further information. Please tell us of any improvements you’d like to see. Please send feedback to jeffrey.graham@doh.gsi.gov.uk Contents (* indicates items which have not appeared in other NHS bulletins) Training and development issues:
Staffing issues:
Items for consultation:
For information:
Safety alerts Leadership Centre courses for medical and clinical directors The second year of the NHS Leadership Centre’s courses for medical and clinical directors is about to start. These courses are commissioned by the NHS Leadership Centre, and delivered by the Centre for Health Planning and Management at Keele University, together with colleagues from the University of York and Sheffield Hallam University. There are three programmes for medical directors:
There is also a new programme for those in the relatively new roles of deputy and associate medical directors. It is designed to equip participants with the knowledge and skills to understand themselves as leaders, and to manage these challenging roles. Finally, the programme for clinical directors and other senior medical managers enables participants to more fully understand the nature and demand of more senior medical leadership roles, and to gauge their own relative strengths and development needs. All programmes have a clear emphasis on leadership, with significant time set aside for individual and group reflection. For further details, and to reserve places, contact Sue Wilkinson at Keele University on 01782 583191, email s.a.Wilkinson@keele.ac.uk, or visit www.medical-leadership.org. NHS360 goes online Questionnaires and feedback reports to support the 360 degree feedback system in the NHS have been launched online. The questionnaire is based on the Leadership Centre’s new competencies. Although not specifically designed for consultant feedback, it should be helpful to clinicians seeking feedback on the leadership and management aspects of their role. About 20 pilot NHS360 projects are running in the service this summer and the360.co.uk expects to make refinements before the system is commercially available this September. The costs will be £250 to train an ‘administrator’ to operate the system, plus £50 per feedback report. For details, see www.the360.co.uk/nhs. To access a sample feedback report, use the password rxg3yw39. For questions, comments or suggestions, e-mail nhs@the360.co.uk. Recruitment of doctors from abroad The Department of Health’s international recruitment campaign has identified nearly 600 doctors who are considered suitable to work in the NHS as consultants or GPs. Nearly 50 doctors are already in post. The department is working closely with the General Medical Council, the Specialist Training Authority and the Joint Committee on Postgraduate Training for General Practice in an attempt to place these doctors on the full and specialist registers and to obtain a certificate of equivalent experience. A series of pen pictures
of doctors available for interview in Portable
Document Format To request a cv of any of the candidates listed, please contact Jahna Sullivan on 0207 406 5739. International recruitment conference and jobs fair Recruitment of consultants and GPs from international sources is the focus of a conference to be run by the Department of Health on 29 and 30 October at York Racecourse. For further information, contact the organisers, Chamberlain Dunn, on the conference hotline, tel 020 8334 4525; fax 020 8332 7201; e-mail mail@chamberdunn.co.uk. On the following day, 31 October, a jobs fair will be held at the same location. The aim is to invite 150 doctors from outside the UK, with a particular emphasis on hard-to-fill specialties. Organisations who want to have a stand at the jobs fair should e-mail Karen.Westwood@sthkhealth.nhs.uk by 20 September. Joint appraisal for clinical academics with NHS contracts An NHS consultant appraisal scheme has been designed as part of the process of closer joint working between universities and the NHS. The documentation is designed to support the requirements of the General Medical Council’s revalidation procedures. It should be used for all appraisals involving consultants who are employed jointly by the NHS and a university, beginning with the appraisal round for 2002/3. The scheme is at www.doh.gov.uk/nhsexec/consultantappraisal/index.htm. For further information contact John Cowles at apprcom@doh.gsi.gov.uk or at Room 2E56 Quarry House, Leeds LS2 7UE. European working time directive Pilot trusts Eighteen trusts have been selected from 428 bids to pilot innovative solutions for implementing the working time directive for junior doctors. The Department of Health will also work with a number of other trusts and bidders with a view to developing a small number of additional pilots covering areas not included in the bids selected so far. For further information, e-mail Shain.Clarke@doh.gsi.gov.uk. Details are at www.doh.gov.uk/workingtime/index.htm.
Conference The second conference on implementing the working time directive took place on 9 July. Delegates identified nine areas as key to successful implementation:
The Department of Health will be discussing dissemination of good practice with the British Medical Association, NHS Confederation and the royal colleges. Senior house officer modernisation Unfinished Business, the chief medical officer's report on proposals for reform of the senior house officer (SHO) grade, was published for consultation on 21 August. The report acknowledges longstanding problems with the grade and offers a new approach to SHO training. This new approach will see pre-registration house officers and doctors at the start of their careers entering foundation programmes, which will give them broad-based experience before they make major career choices. They will then enter well-structured and managed SHO programmes designed to produce high-quality trainees ready to go on and become general practitioners or consultants. The report is available at www.doh.gov.uk/shoconsult/index.htm. The consultation period lasts till 22 November. For further information contact Andrew Matthewman at andrew.matthewman@doh.gsi.gov.uk. Removal and retention of human organs and tissue The Department of Health and the Welsh Assembly Government have published a consultative report, Human Bodies, Human Choices, on the law relating to human organs and tissue. A second report includes a draft code of practice on the import and export of human body parts. Both reports are for consultation, with a closing date of 17 October. See them at www.doh.gov.uk/tissue/review_of_law.htm. Printed copies are available from NHS Responseline on 08701 555455. Hepatitis C strategy A consultation paper outlining a hepatitis C strategy for England was published in August. The closing date for comments is 15 November. Hepatitis C has emerged over recent years as a significant public health issue. The strategy proposes raising professional and public awareness of hepatitis C and strengthening services for its prevention, diagnosis and treatment. The consultation paper is at www.doh.gov.uk/cmo/hcvstrategy. For hard copies, contact the NHS Responseline on 08701 555455. For further information, contact Gerry Robb on 020 7972 5732, e-mail gerry.robb@doh.gsi.gov.uk. Services for people using sign language Proposals for making services more responsive to people who use sign language as their main means of communication have been published for consultation. A Sign of the Times: Modernising Mental Health Services for People who are Deaf is at www.doh.gov.uk/mentalhealth/signofthetimes.htm or is available via NHS Responseline, tel 08701 555455 quoting 27966/A sign of the times. It is also available in a British sign language video by contacting Bob McDonald, e-mail bob.mcdonald@doh.gsi.gov.uk. Proposed standards for NHS helpline guidelines The Commission for Health Improvement (CHI) is seeking the views of all NHS organisations in England and Wales on proposed standards for NHS helpline guidelines. CHI is developing mandatory guidelines following its investigation into a case last year, where anxiety was expressed about the role and purpose of a health authority’s helpline. The proposed standards are at www.chi.gov.uk/eng/latestnews/008.shtml. Please e-mail comments and existing help line policies to margaret.tozer@chi.nhs.uk. Day surgery operational guide An operational guide has been published to help managers and clinicians look at ways to increase day surgery rates. The guide is available at www.doh.gov.uk/daysurgery. As well as providing the least possible disruption to patients’ lives, day surgery offers the potential to increase NHS capacity. The NHS Plan envisages a 75% day case rate; the current rate is 68%. The Audit Commission has estimated that the NHS could increase day surgery operations by 120,000 a year. The new guide is an aid to considering ways of increasing day case rates – whether through new builds, using current services better or managing current pathways more effectively. It covers patient preferences and selection, day surgery activity, accommodation, management, staffing, primary care trusts and funding. Medical directors are asked to make best use of the guide and to ensure it is cascaded to all staff involved in day surgery. The guide is part of a day surgery strategy launched by the government in January 2002. Other elements are:
For further information contact Paul Woods, tel 020 7972 4811, or Kate Bowe, tel 020 7972 4010. Diagnosis and treatment centres A ‘trailblazer’ wave of ten diagnosis and treatment centres (DTCs) was announced in August. DTCs will contribute to the rapid, large-scale capacity increase required in the NHS, by leading new ways of delivering services. The ten new DTCs will be operational by 2004 and will treat more than 25,000 extra cases a year. They are in addition to the first wave of nine DTCs announced earlier this year and due to be operational by the end of 2002, treating an extra 32,000 cases a year. Further information about DTCs and the Modernisation Agency’s programme to support their development is at www.modernnhs.nhs.uk/dtc. Introducing payment by results Delivering the NHS Plan announced changes to the way money will flow through the NHS from 2003/4, including the introduction of payment linked to results. The changes will mean that:
Further information on the changes, which will start next year, is at http://www.doh.gov.uk/financialreforms/index.htm. Overseas treatment – update Draft guidance for the NHS on referring patients overseas is at www.doh.gov.uk/international/overseastreatment.htm. The Department of Health recommends that local NHS organisations should use the lead commissioning arrangements. The lead commissioners are Guy’s and St Thomas’ Trust (contact Kevin Thorogood, tel 0207 922 8159, e-mail kevin.thorogood@gstt.sthames.nhs.uk), who deal with capacity in Belgium, Germany and Northern Europe; and Kent and Medway Health Authority (contact Peter Huntley, tel 01304 205 706, e-mail Peter.Huntley@ekentha.nhs.uk), who deal with France, Spain and Southern Europe in general. NHS commissioners have been advised not to enter into contracts with Operations Abroad, a commercial organisation marketing services as an intermediary to arrange overseas NHS treatment, until a corporate diligence process has been completed by the Department of Health. Postgraduate medical education and training board Following consultation on proposals for a new Medical Education Standards Board, the government has issued a statement of policy (see www.doh.gov.uk/medicaltrainingintheuk/pmetpolicy.htm). The proposed board has been re-named the Postgraduate Medical Education and Training Board. It will have a medical majority, but patient and NHS representation at board level will ensure that patients’ interests are addressed, and that NHS postgraduate medical training needs are met. The board will have the flexibility to draw in expertise from a range of stakeholders, including the royal colleges and postgraduate deans, who will be involved in the postgraduate medical education and training process. The board will replace the existing authorities for postgraduate medical education and training, the Joint Committee for Postgraduate Training in General Practice and the Specialist Training Authority. For further details, e-mail Matthew Fagg at matthew.fagg@doh.gsi.gov.uk. NHS improvement leaders’ guides Three new guides for NHS improvement leaders have been published by the NHS Modernisation Agency. The guides are aimed at everyone who wants to improve the care and experience of patients. They form a set of principles designed to create the best conditions for improvement in healthcare and ideally should support a programme of training in improvement techniques. The latest guides look at managing the human dimensions of change; involving patients and carers; and sustainability and spread. All the improvement guides are available at www.modern.nhs.uk/improvementguides. For further information contact Mike McBride, tel 0116 222 1410, e-mail improvementguides@npat.nhs.uk. Chlamydia screening programme Ten locations will take forward the first phase of a national chlamydia screening programme, as proposed in the national strategy for sexual health and HIV. The sites will share £1.5 million to help set up the screening programme, which will primarily target women aged 16-24 who access sexual health services. Recent data issued by the Public Health Laboratory Service showed that in 2001, chlamydia became the most common sexually transmitted infection seen in sexual health clinics, with a total of 71,055 diagnoses. A summary report of the pilots is at www.doh.gov.uk/sexualhealthandhiv/chlamydscreenpilot.htm. Paper copies can be obtained from Chlamydia Screening Programme, Room 580D, Skipton House, 80 London Rd, London, SE1 6LH. Further information from Dr Alison Austin, tel 020 7972 1527, e-mail Alison.Austin@doh.gsi.gov.uk. Flu immunisation advertising campaign The flu immunisation advertising campaign will launch on 1 October. It aims to encourage people over 65 and those in at-risk groups to make an appointment for their free flu jab. The campaign includes national TV and press advertising featuring Sir Henry Cooper. An information pack has been produced to help local NHS campaigns. It can be seen online at www.nhs.uk/flu. Hard copies of the pack are available by emailing doh@prolog.uk.com. Safeguarding children in whom illness is fabricated or induced Following wide consultation, the government has issued Safeguarding Children in whom Illness is Fabricated or Induced: Supplementary Guidance to Working Together to Safeguard Children (1999). The guidance is intended to provide a national framework for local action, and is addressed to all agencies and professionals whose work brings them into contact with children and families. The guidance at www.doh.gov.uk/acpc/safeguardchild.htm. Hard copies are available from Department of Health, PO Box 777, London SE1 6XH. Restrictive physical interventions for people with learning disability Guidance has been issued on the need for service providers to have effective policies and training for staff working with people who may have behavioural episodes where restrictive physical intervention is necessary for safety reasons. A limited number of printed copies are available from Department of Health Publications, PO Box 777, London SE1 6XH. Fax: 01623 724524. E-mail doh@prolog.uk.com. NHS dentistry: options for change A new report sets out opportunities to test new ways of working within NHS dental services to improve patient experience and oral health, while also improving the working lives of dentists. See www.doh.gov.uk/cdo/optionsforchange. NHS smoking cessation service About 120,000 smokers successfully quite in the last year after receiving help from NHS smoking cessation services. The services are central to the delivery of reductions in cancer and coronary heart disease. Details on the smoking cessation figures are at www.doh.gov.uk/public/stats3.htm. National programme for IT in the NHS A new IT procurement strategy for the NHS aims to streamline the process and accelerate the introduction of IT. There is also a consultation document on an integrated care records service, seeking NHS feedback on the proposed way forward for electronic records and national standards to ensure integration across all organisations and care settings. Both documents are at www.doh.gov.uk/ipu/whatnew. Unlicensed urabe mumps vaccine The Committee on Safety of Medicines has advised that urabe mumps vaccine is associated with an unacceptable risk of aseptic meningitis and that the Medicines Control Agency (MCA) should object to importation of unlicensed mumps vaccine containing the urabe mumps strain. The risk of urabe mumps vaccine meningitis has been recognised for over 10 years. UK studies have shown the risk of urabe mumps meningitis to be at least 1 case per 3,800 doses. Due to this risk, MMR vaccine containing urabe mumps strain has not been used in the UK since 1992. Since then, the only MMR vaccines used in the UK have contained Jeryl Lynn mumps strain, which has not been shown to be associated with meningitis. Unlicensed medicines may be imported by licensed importers following notification to MCA, who may object if there are safety or quality concerns or an equivalent licensed product is available. A medical practitioner may prescribe an unlicensed medicine to meet the special needs of his individual patients on his direct personal responsibility. MCA contacted importers of urabe mumps vaccine on 6 August, notifying them that the vaccine should not be imported. For further information e-mail rafe.suvarna@mca.gsi.gov.uk. Quality of life for Thalidomide-impaired people The changing health and social care needs of Thalidomide-impaired people are investigated in a report produced by the Thalidomide Society. Copies are available from Vivien Kerr at the Thalidomide Society at 19 Central Avenue, Pinner, Middlesex HA5 5BT, tel 020 8868 5309, e-mail info@thalsoc.demon.co.uk. Patient prospectus The first patient prospectus, titled Your Guide to Local Health Services, will be produced in October – an important step in providing key NHS information to the local population. Primary care trusts are the lead organisations in this project. A template and guidance are available at www.doh.gov.uk/patientprospectus. Reducing burdens in hospitals Practical ways to free up time for frontline hospital staff are identified in a report published jointly by the Department of Health and the Cabinet Office. The ideas have come from frontline staff, and are agreed outcomes rather than recommendations. Full copies and one-page summaries of the report are available at www.doh.gov.uk/reducingburdensinhospitals. For hard copies or queries please contact Vicky Lawrence, tel 020 7276 2194, or e-mail psinfo@cabinet-office.x.gsi.gov.uk. Role of healthcare professions within critical care services The role of allied health professionals and healthcare scientists within critical care services is set out in a new working paper published by the Modernisation Agency. The paper is at www.modern.nhs.uk/criticalcare. For further details contact Jill Chapman, tel 0116 222 5119, e-mail jill.chapman@npat.nhs.uk. Improving the use of clinical databases A new website lists clinical databases and offers an independent assessment of their scope and quality. It is supported by the Nuffield Trust and the Department of Health, with the aim of widening access to clinical databases and improving their quality. The directory is at www.lshtm.ac.uk/docdat. Further information from Mary Payne or Professor Nick Black at the London School of Hygiene and Tropical Medicine, e-mail mary.payne@lshtm.ac.uk or nick.black@lshtm.ac.uk. Equipment services for older and disabled people The Audit Commission has published a follow-up report to its 2000 study of equipment services for older and disabled people. The reports are at www.audit-commission.gov.uk. Further information and sources of help for the NHS and social services are at www.icesdoh.org. Single assessment for older people and the care programme approach The Department of Health has issued a note of clarification on the relationship between the single assessment process for older people and the care programme approach. See www.doh.gov.uk/scg.sap. NICE guidance The National Institute for Clinical Excellence has issued new guidance on two issues:
Boosting GP numbers and improving working lives A package of measures has been launched to boost GP numbers and make primary care a better place to work. These include a delayed retirement scheme and the extension of the hospital doctors’ flexible careers scheme to primary care. For further details see press release 2002/0313 at http://www.doh.gov.uk/newsdesk/index.html. National specialist commissioning annual report Successes and key lessons of the work of the eight regional specialised commissioning groups during 2000-2001 are contained in the annual report of the national specialist commissioning advisory group. See www.doh.gov.uk/nscag/reports.htm. Distinction awards annual report A complete list of distinction award holders and those consultants who received awards in 2001 is set out in the ninth annual report of the advisory committee on distinction awards. See http://www.doh.gov.uk/acda/annual.htm#2001. This is the penultimate round of distinction awards before they are succeeded by the clinical excellence awards scheme in 2004. Commission for Health Improvement investigation The Commission for Health Improvement has completed a report of a special investigation into hospital services for elderly patients at a trust in Portsmouth. The report, which makes important recommendations about care of the elderly, is at http://www.chi.nhs.uk/eng/organisations/south_east/gosport/index.shtml. Extending choice for patients: heart surgery pilot A note summarising the monitoring arrangements and information systems to support the choice initiative for heart surgery has been posted at www.doh.gov.uk/extendingchoice/monitoring.htm. Personal Medical Services pilots Applications have been invited for a fifth wave of Personal Medical Services (PMS) pilots. A letter outlining the application procedure is at www.doh.gov.uk/pricare/pca.htm. For further information contact Eve Whittingham, tel 0113 254 5848 or Eve.Whittingham@doh.gsi.gov.uk. Safety alerts
The National Patient Safety Agency issued an alert in July, setting out action to prevent accidental overdose with intravenous potassium. See www.npsa.org.uk.
MDA DA2002(09) – risk of pneumococcal meningitis in non-vaccinated cochlear implant patients MDA DB2002(05) – decontamination of endoscopes MDA SN2002(22) – Oxford major electric and hydraulic hoists – risk of mast failure MDA SN2002(21) – Oxford Major, Maxi and Midi patient hoists fitted with Oxford Digital Weighscales: risk of spreader bar detachment Full details of all these notices are at www.medical-devices.gov.uk.
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