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Medical directors' bulletin: October 2002, Issue 15 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 by emailing jeffrey.graham@doh.gsi.gov.uk Contents (* indicates items which have not appeared in other NHS bulletins) General information and advice:
Consultation exercises:
Events: Safety alerts Online information for patients The nhs.uk website now provides prospective information on waiting times, broken down in the following ways:
The information is updated monthly and from April 2003 will be updated weekly. This is in line with Delivering the NHS Plan, which explained that explicit patient choice will be progressively introduced across the NHS. Consultants in your trusts should be informed that information about them is being used this way. Further information at www.doh.gov.uk/nhsplanbookingsystems or from Deborah Harrison, tel 0113 254 6110, email deborah.harrison@doh.gsi.gov.uk. Occupational health smartcard and the electronic staff record The occupational health smartcard initiative and the electronic staff record solution are working towards modernising NHS working practices in line with the government’s e-business strategy. The teams working on both projects see the two systems as complementing each other and meet regularly. They are working closely together to share information on the database requirements and installation timetables, to avoid trusts having to cope simultaneously with both installations and staff training. The initiatives will be launched as follows:
For more information about how the two projects are working together, see www.doh.gov.uk/sharedservices. For further information on the smartcard, contact Barbara Levy, tel 0113 254 5524, email barbara.levy@doh.gsi.gov.uk. For further details on the electronic shared record, contact Tracy Webber, tel 07734 163178, email tracy.webber@doh.gsi.gov.uk. National clinical audit support programme
Advice on the national clinical audit support programme has been published for chief executives and those leading on clinical governance, national service frameworks and information technology. The programme was announced as part of the Government’s response to the Kennedy Report. It addresses the need for comparative data in key areas – cancer, mental health, coronary heart disease, older people’s services and diabetes. It is being developed jointly by the Department of Health, the clinical professions and the NHS Information Authority. The advice can be found at http://www.doh.gov.uk/ipu/ncasp/index.htm. For further information contact Anne Fletcher, tel 0113 2546037, email anne.fletcher@doh.gsi.gov.uk.
The programme is currently developing the national comparative clinical audit for lung cancer. A project document containing background information to the lung cancer programme was issued for consultation on 10 September. The consultation period ends on 2 October. The document is at www.nhsia.nhs.uk/phsmi/pages/ncasp.asp?om=m1 and responses to the consultation can be sent to LUCADA@nhsia.nhs.uk. For further information contact Jill Anderson, tel 0207 972 4816. Terms and conditions for hospital medical and dental staff Terms and conditions of service for hospital medical and dental staff in England and Wales and public health doctors have been merged. The main changes are outlined at http://www.info.doh.gov.uk/doh/coin4.nsf/Circulars?ReadForm. For further information, email enquiry-box@doh.gsi.gov.uk or tel 0113 254 5710. Distinction/clinical excellence awards There has been some uncertainty about the timing of the introduction of the new clinical excellence awards scheme to replace the current distinction awards scheme. The move to the new scheme is an incremental process, but it will not formally commence until the 2004 round. The existing scheme will run for one more year, starting this month. One important change, triggered by the abolition of NHS regional offices, is that administrative support to the regional awards committees has been centralized. All nominations and reviews for the next round should therefore be sent to Siobhan Guascone in Skipton House Area 531B, 5 Floor, Skipton House, 80 London Road, London SE1 6LH. Please take every opportunity to make this change known locally and particularly to colleagues who are responsible for submitting nominations. For more information, contact Siobhan Guascone, tel 020 7973 2508, email Siobhan.Guascone@doh.gsi.gov.uk. National suicide prevention strategy England's first national suicide prevention strategy was launched on 16 September by health minister Jacqui Smith. The strategy has been developed under the direction of national director for mental health Professor Louis Appleby. It will ensure that steps are being taken to meet the target of reducing the death rate from suicide and undetermined injury by at least a fifth by 2010. The strategy is at www.doh.gov.uk/mentalhealth/suicideprevention.htm. Copies can also be ordered from Department of Health Publications, PO Box 777, London SE1 6XH. For further information contact Keith Foster, tel 0113 254 3817, email keith.foster@doh.gsi.gov.uk. Dealing with harassment by NHS service users As part of the ‘zero tolerance’ campaign to tackle harassment of NHS staff by service users, all NHS human resources directors have been issued with copies of campaign posters and the new guidance, Dealing With Harassment by NHS Service Users - A guide for NHS Managers. The guidance applies to all grades and levels of staff working in the NHS. It explains how to recognise harassment and the steps that can be taken to prevent and address it in the NHS workplace. The guidance and posters are available at www.nhs.uk/zerotolerance or from doh@prolog.uk.com (quote job 29014). For further information, contact Meena Paterson, email meena.paterson@doh.gsi.gov.uk, tel 0113 254 5758; or Eileen Calline, email eileen.calline@doh.gsi.gov.uk, tel 0113 254 6131. The NHS has agreed a three-year copyright licence with the Copyright Licensing Agency. The central licence allows all NHS organisations in England to photocopy a wide range of books, magazines and journals. The licence allows 15 copies to be made for any purpose, and 25 copies for a single meeting of a designated committee. It also allows copying of one chapter of a book and any number of articles from a theme issue journal. It includes the photocopying of photographs and illustrations. Making further copies requires clearance from the agency’s rapid clearance service, which invoices organizations directly. Further copies, including a list of excluded works, is available at www.cla.co.uk or from Veronica Fraser, tel 0113 254 6047, email veronica.fraser@doh.gsi.gov.uk. Taking blood specimens from those involved in road traffic accidents The Police Reform Act 2002 contains new powers for taking blood specimens from those involved in road traffic accidents, who are unable to consent, to test for levels of alcohol or drugs. The new powers came in to force on 1 October. Medical staff who may be responsible for the care of those involved in road traffic accidents, in particular accident & emergency staff, should be made aware of the new provisions. Guidance from the Department of Health is available at http://www.doh.gov.uk/consent/praguidance/index.htm. For further information contact Hugh Whittall, tel 020 7972 1435, email hugh.whittall@doh.gsi.gov.uk. NHS international fellowship scheme The Department of Health is beginning the second round of the NHS international fellowship scheme. Adverts are appearing this month in the Lancet and the BMJ as well as in Europe, North America, Australia and New Zealand. 150 international fellowships are offered in clinical practice working as a consultant in cardiac anaesthesia, imaging, clinical oncology, psychiatry, histopathology and thoracic surgery. Any trusts with suitable vacancies should contact their Directorate of Health and Social Care lead as soon as possible. The leads are:
There will be a meeting on 5 November in central London for all trusts interested in taking part in the next round of the scheme. Further details are at www.nhs.uk/fellowships and www.doh.gov.uk/international-recruitment, or contact Claire Davies, email claire.davies@doh.gsi.gov.uk, tel 0113 254 5889. Any enquiries from potential candidates about the scheme should be directed to the recruitment specialists, tel 00 44 191 223 5678 (24 hours) or email nhsinternationalfellowship@tmp.com for an information pack. Candidates can apply on line at www.nhs.uk/fellowships. Prevention and control of blood-borne virus infection Good Practice Guidelines for Renal Dialysis/Transplantation Units: Prevention and Control of Blood-borne Virus Infection was published on 13 September. The guidelines are based on the recommendations of a working group set up for the Department of Health by the Public Health Laboratory Service. They replace those issued in 1972 on preventing hepatitis B virus transmission in renal dialysis and renal transplantation units. Since then, new blood-borne viruses have been identified, including HIV and hepatitis C. The guidance is at www.doh.gov.uk/cmo/renalguide/index.htm. Hard copies are available from Department of Health, PO Box 777, London SE1 6XH, tel 08701 555 455, fax 01623 724524 (quote reference 29117). For further information contact Ruth Hickson, tel 020 7972 6506, email ruth.hickson@doh.gsi.gov.uk.
Many trusts are experiencing difficulties because of the widely publicised delays in processing applications for disclosures by the Criminal Records Bureau. The Department of Health is in negotiation with the Home Office over measures to improve or alleviate the situation. Meanwhile guidance has been prepared to assist trusts – see www.doh.gov.uk/crb/index.htm. If there are particular problems in dealing with the Criminal Records Bureau, contact Karen Lea, tel 0113 254 7351, email karen.lea@doh.gsi.gov.uk, or Gordon Fleck, tel 0113 254 6575, email gordon.fleck@doh.gsi.gov.uk. They may be able to help with particularly urgent cases or other problems that cannot be resolved locally.
Launch of the integrated care network To promote service improvement through integration of local authority and NHS services, a new integrated care network will be launched on 24 October. The network is a joint initiative of the Department of Health and the Office of the Deputy Prime Minister, with non-government partners. It will create a central information resource, develop action learning sets, provide consultancy, spread good practice and arrange national information meetings.
Retained Organs Commission guidance A guidance and information update note for trusts has been issued by the Retained Organs Commission. It sets out good practice guidance, primarily on support for families affected by organ retention, performance management issues, and issues relating to the retention and disposal of human organs and tissue. See www.nhs.uk/retainedorganss/index.htm. The website also includes the commission’s annual report, and details of the extension of the organization for a further year to March 2004. For further information, contact Susan Tokley, tel 020 7972 2483.
Transfer of public health laboratories Major decisions to put public health laboratories at the heart of the NHS have been taken by NHS chief executive Nigel Crisp and the chief medical officer, Sir Liam Donaldson. The decisions include the transfer of most public health laboratories within the Public Health Laboratory Service to local NHS trusts by 1 April next year. A document setting out the decisions taken is at http://www.doh.gov.uk/cmo/laboratories/appendix-b.htm. For further details contact Jonathon Morrell, tel 020 7972 2104.
National clinical director for emergency access Professor Sir George Alberti has been appointed as the first national clinical director for emergency access. Sir George was president of the Royal College of Physicians until July this year, professor of medicine at University of Newcastle upon Tyne and professor of metabolic medicine at Imperial College. He was co-chairman of the national service framework on coronary heart disease. His main responsibilities in his new role will include advising on the improvement of emergency services in line with policy set out in the Reforming Emergency Care strategy; engaging with clinical colleagues across the NHS; and helping with interventions in individual trusts as appropriate. For further information contact Jim Fowles, tel 020 7210 5921, email jim.fowles@doh.gsi.gov.uk.
Richard Granger, formerly of Deloitte Consulting, has been appointed director general of NHS information technology (IT). He will be responsible for implementing the NHS information and technology programme – one of the world's largest IT developments. The programme means that patients will benefit from more efficient services, including electronic transfer of test results and information between health professionals, electronic booking and electronic transfer of prescriptions. Mr Granger, who has extensive experience of delivering IT systems and services in the public sector, was latterly the lead client service partner for the UK government at Deloitte Consulting.
The National Treatment Agency, the special health authority responsible for increasing the quality, capacity and availability of treatment for drug misuse, has published several new items. These include:
Details at www.nta.nhs.uk. Paediatric intensive care funding Funding to implement all aspects of the strategy described in the document Paediatric intensive care: A framework for the future (1997) has been increased to £25 million. The increase in funding is required to ensure sufficient paediatric intensive care capacity throughout the year. The need to address high dependency care provision for children (often a precursor to, or step down stage from intensive care) has been raised by the professions and within the service. New guidance on addressing the provision of high dependency care for children can be found at www.doh.gov.uk/nsf/paediatr.htm. For further information, email jane.scott@doh.gov.gsi.uk.
Intellectual property in the NHS A new document sets out how NHS trusts and primary care trusts can exploit intellectual property generated by NHS employees. The NHS as an innovative organization: a framework and guidance on the management of intellectual property in the NHS has been sent to finance directors. It can be seen at www.innovations.nhs.uk. For further information contact Dr Tony Bates, email Tony.Bates@ubht.swest.nhs.uk.
The Department of Health has completed a corporate diligence process on the company Operations Abroad, mentioned in last month’s medical director bulletin. As a result, the department has advised NHS lead commissioners for overseas treatment that they should not invite Operations Abroad to tender for contracts to treat NHS patients overseas.
For further information contact Tim Baxter, tel 020 7210 5740, email Tim.Baxter@doh.gsi.gov.uk.
Mapping mental health services for children and adolescents A national child and adolescent mental health service-mapping tool is about to be set up nationally. Its purpose is to improve the mental health of children and adolescents by building up a comprehensive picture of services and, through an annual exercise, map service changes over time. NHS trusts and child and adolescent mental health service managers are being asked to coordinate the process for the first exercise. Full details at www.dur.ac.uk/service.mapping/ChASM/brief.php. For further details contact Claire Hartley, tel 020 7972 4857, email claire.hartley@doh.gsi.gov.uk.
More information is now available on the second phase of the health and social care change agent team’s work programme. Three ‘learning and service improvement networks’ will be established to share information about what does and doesn’t work, and to carry out development locally. The networks will cover care pathways, integrated discharge planning, intermediate care and housing-based models of care, including alternatives to hospital care. The programme is set out at www.doh.gov.uk/jointunit/workprogletteraug02.htm. For further details contact Roy Harry, tel 020 7210 5005.
Non-NHS employment - doctors and dentists in training grade posts Instructions have been issued to deaneries and employing authorities to guarantee continuity of service for doctors and dentists working in non-NHS organisations as part of their formal training. A letter outlining the instructions is at http://www.info.doh.gov.uk/doh/coin4.nsf/Circulars?ReadForm. For further details email enquiry-box@doh.gsi.gov.uk or tel 0113 254 5710.
Health action plans for people with learning disabilities Good practice guidance has been issued on health action plans and health facilitation, as part of the Valuing People strategy to address health inequalities experienced by people with learning disabilities. The HAP guidance is produced in three parts:
All versions and a flyer with details of where to obtain hard copies can be found at www.doh.gov.uk/publications/pointh.html and www.doh.gov.uk/learningdisabilities/healthactionplans.htm For further information contact Elaine Cooper, email elaine.cooper@doh.gsi.gov.uk.
Performance management and commissioning of high security psychiatric services A new report sets out arrangements for the devolution of performance management of high security services to strategic health authorities, and revised arrangements for commissioning these services. See www.doh.gov.uk/mentalhealth/highsecurityservices.htm.
The Action On ENT team has published recommended baseline standards for local health economies. They can be found at http://www.doh.gov.uk/actionon/. For hard copies, contact Genaya Playford, tel 020 7972 2965.
Trauma Audit and Research Network The Trauma Audit and Research Networkwas established in 1990 to audit and research injury and systems of care for trauma patients. Its overall aims fit well with the clinical governance agenda. In particular, trusts are required to put in place arrangements for monitoring and improving the quality of health care they provide. Continuous trauma audit is an integral part of this process. Currently, participation in the network runs at 49 per cent of trauma-receiving trusts. Details of how to become a member can be found at www.tarn.ac.uk. For further details contact Paul Woods, tel 020 7972 4811, email paul.woods@doh.gsi.gov.uk.
Prescription prepayment certificates People who have to pay for more than five prescriptions in four months or 14 items in 12 months may find it cheaper to buy a prescription charge pre-payment certificate. A new information poster on this topic is now available for display. The poster can be viewed at http://www.doh.gov.uk/nhscharges/hc20poster.pdf. Posters are available free of charge from Department of Health, PO Box 777, London, SE1 6XH, fax 01623 724 524, or from the NHS Responseline, tel 08701 555 455. For further information on prescription charges contact Veena Kavia, tel 0207 210 5925, email veena.kavia@doh.gsi.gov.uk.
Destruction of controlled drugs in GP practices The establishment of strategic health authorities and primary care trusts has made it necessary to authorise new groups to witness the destruction of controlled drugs in GP practices to comply with the Misuse of Drugs Regulations 2001. Details are at www.doh.gov.uk/pricare/cddestruction/index.htm. For further information contact Gul Root, email gul.root@doh.gsi.gov.uk. Mental Health Act 1983: court judgment The recent House of Lords judgment in the case of R v Manchester City Council ex parte Stennett and two other actions has confirmed Department of Health guidance that Mental Health Act 1983 s117 aftercare should not be charged for. Those authorities that have made such a charge will wish to seek advice on the extent of their liability.
Senior house officer grade reform Unfinished Business, the chief medical officer’s report on proposals for reform of the senior house officer grade was published for consultation on 21 August. The report acknowledges longstanding problems with the grade and offers a new approach to training. This will see pre-registration house officers, doctors at the start of their careers, entering foundation programmes which will give them broadly-based experience before they make major career choices. They would then enter well-structured and managed programmes designed to produce high-quality trainees ready to go on and become general practitioners or consultants. The report is at www.doh.gov.uk/shoconsult.
Recovery of NHS costs in cases involving personal injury compensation The Department of Health has published a consultation document on the recovery of NHS costs in cases involving personal injury compensation. NHS costs are already recovered in cases where a person injured in a road traffic accident makes a successful claim for personal injury compensation. The Law Commission has already consulted on the principle that the NHS should have the right to recover its costs in all cases where personal injury compensation is paid. This consultation is concerned with how the scheme might operate if it was introduced. It is estimated that extending the road traffic scheme could generate up to £120 million per year, which would be paid direct to NHS trusts providing treatment. The consultation document is at www.doh.gov.uk/nhscosts/index.htm. The closing date for comments is Friday 8 November. For further information contact Tracy Morton, tel 0113 254 5380.
Governance in the NHS – national conference The next national conference on governance in the NHS will take place on Monday 4 and Tuesday 5 November at the International Convention Centre, Birmingham. It will provide organisations with an opportunity to build on their 2001/02 controls assurance work, understand the proposals for the 2002/2003 requirements and consider the implications of the next phase of the converging governance agenda. The second day will feature up to 12 interactive workshops. While aimed at NHS board members, the event is equally relevant to all professionals with responsibility for, or an interest in, governance, internal control and risk management issues. Day two will be of particular relevance to those charged with implementing aspects of the governance agenda in their organisations. Programme and registration details are available at www.doh.gov.uk/riskman.htm. Online bookings can be made at www.casu.org.uk/conference. For further information contact Lorraine Thomas, email lorraine.thomas@doh.gsi.gov.uk, tel 0113 254 5255.
Improving operating theatre performance The NHS Modernisation Agency’s operating theatre & pre-operative assessment programme is staging a conference on improving operating theatre performance. The event will be run on two dates - in Manchester on Wednesday 27 November, and in London on Monday 2 December. The conference is aimed at clinicians and senior managers who have a responsibility for improving operating theatre performance and reducing cancelled operations. The day will be workshop-based and free of charge (limited to two people per trust). The topics covered will include cancelled operations, optimising short stay, in-patient & emergency surgery, improving pre-operative assessment, employee satisfaction and morale. The workshops will also look at diagnostic treatment centres, day surgery, scheduling and capacity & demand. For further conference details and a registration form, email lou.woolley@npat.nhs.uk.
Safety alerts The following alerts have been issued recently by the Medical Devices Agency:
Further details at www.medical-devices.gov.uk.
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