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Medical
directors' bulletin
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 Problems accessing information Contents Take action
Recent news
National standards and guidance
Reports
Recruitment and retention Education and training Clinical updates Medical Devices Agency Future communications and events European Working Time Directive (EWTD) Guidance has been published on implementing the European Working Time Directive (EWTD) for doctors in training. HSC 2003/001 Protecting staff; delivering services: implementing the European Working TimeDirective explains the need for urgent action by the NHS to prepare for meeting EWTD requirements. These apply to doctors in training from August 2004. Details are at: www.doh.gov.uk/workingtime HSC 2003/001 is on the COIN database Contact: Shain Clarke for guidance queries and Jackie Howard for queries about the pilots – both at: EWTD@doh.gsi.gov.uk Cardiac services review Comments are invited on The Paediatric and Congenital Cardiac Services Review which highlights several areas for improvement, including:
The review proposes a minimum number of operations each centre should perform in a year. Details at: www.doh.gov.uk/childcardiac/reviewnov02.htm Responses to: pccrconsultation@doh.gsi.gov.uk or The PCCS Review, Room 512, Wellington House, 133-155 Waterloo Road, London, SE1 8UG. Deadline: 28 February. Contact: Jamilla Rogers-Wright 020 79724716 or jamilla.rogers-wright@doh.gsi.gov.uk Bids required for Action On status The NHS Modernisation Agency is launching three new Action On programmes covering general surgery, plastic surgery and urology. Bids to be a pilot site are invited for plastic surgery and urology. The closing date is 7 March 2003. Further details about general surgery will be available soon. Application forms and details at: www.modern.nhs.uk/action-on Contact: Community care (delayed discharges etc) bill - consultation Two sets of draft regulations have been published for consultation:
The draft regulations are at www.doh.gov.uk/jointunit/delayeddischarge/index.htm Deadline for comments - 31 March Contact: hannah.burdekin@doh.gsi.gov.uk, emma.preece@doh.gsi.gov.uk or 020 7972 4358 for hard copies. Distinction awards A+ The arrangements for A+ distinction awards now need input from regional awards committees. Process and eligibility issues are described in the Guide to the NHS Consultants’ Distinction Award Scheme at www.doh.gov.uk/acda/index.htm Completed CVQs and citations should be sent to Siobhan Guascone, 531B Skipton House, 80 London Road, London SE1 6LH by 14 February, so they can be processed in time to meet the ACDA award deadline of 31 March. Occupational health smart cards (OHSC) Occupational health smart cards (OHSCs) have gone live in the Mersey and Yorkshire deanery areas. They are already operating in London, Wessex, South Western and Kent, Surrey, Sussex. All hospital trusts will be covered by March 2004. Handling human resources, occupational health and postgraduate deaneries protocols have been updated and can be found at: www.doh.gov.uk/hrinthenhs Medical directors should make sure doctors, medical staff and OH units are aware of local procedures. Contact: Barbara Levy 0113 2545524 or barbara.levy@doh.gsi.gov.uk Cancer investment investigation An exercise to track investment in cancer services is being carried out. Information on the number of new service developments funded during 2001-2003 should be returned to directors of health and social care (DHSCs) on a network basis by 28 February. A template, guidance and contacts are at: www.doh.gov.uk/cancer/trackinginvestment.htm Contact: simone.bayes@doh.gsi.gov.uk Health clearance consultation There is an opportunity now to comment on the draft guidance on health clearance for serious communicable diseases, which introduces additional clearance measures for HIV and hepatitis C for new NHS health care workers. Draft guidance is at: www.doh.gov.uk/healthclear Hard copies from: doh@prolog.uk.com Deadline for comments is 30 April. Contact: Gerry Robb 020 79725732 or gerry.robb@doh.gsi.gov.uk RECENT NEWS Pay and conditions changes Changes to the national pay and conditions of hospital medical and dental staff and doctors in public health medicine came into effect in December. Alterations have also been made to the incremental date on promotion for senior house officers financially disadvantaged on promotion to specialist registrar. Details at: www.doh.gov.uk/hrinthenhs/doctorstermsandconditions/index.htm Contact: Corrin Shepherd 0113 2545724 or corrin.shepherd@doh.gsi.gov.uk Changes to NHS pension scheme Technical changes to the way the NHS pension scheme is funded have been included in revised public spending totals. The change will see the employers' contribution rate double from seven per cent to 14 per cent. This will bring the NHS pension scheme into line with other public service schemes. Together with the NHS Pensions Agency, the Department of Health has been rolling out workshops aimed at giving practical support to human resources managers and pensions managers on the benefits of the NHS pensions scheme in supporting good HR practice. Contact: Claire O'Donnell 01752 854200 or claire.o'donnell@hemsleyfraser.co.uk Contact for pensions index: lynn.slater@doh.gsi.gov.uk Model clinical trials agreement for pharmaceutical research The Department of Health and the Association of the British Pharmaceutical Industry have agreed a model clinical trials agreement as a standard contractual framework for commercial trials involving NHS patients. The model covers the legal and financial issues raised by NHS participation in contract research sponsored by pharmaceutical companies. Only certain details need to be added or appended for use. It will be of interest to trust medical and research and development directors. The agreement and advice about its use is available at: www.doh.gov.uk/research/index.htm Queries should be addressed to: Dr Mark Lewis, commercial research and
clinical trials adviser. Supplementary prescribing Key changes to supplementary prescribing by nurses and pharmacists following doctor’s diagnosis are being introduced. Once trained, supplementary prescribers will be able to prescribe all medicines currently prescribed by doctors – except unlicensed medicines (unless part of clinical trials) and controlled drugs. Prescribing of controlled drugs will be included after legislative changes. There will be no legal limit on the conditions that may be included in supplementary prescribing. Implementation guidelines will be issued shortly. Details at: www.doh.gov.uk/supplementaryprescribing Contact: Mike Garley 0113 2546313 or mike.garley@doh.gsi.gov.uk Standardising crash call numbers The National Patient Safety Agency (NPSA) is exploring the feasibility of creating a standardised crash call number. A questionnaire has been sent to all acute trust chief executives to research the issues. Details at: www.doh.gov.uk/reducingburdensinhospitals/ Contact: Chris Ranger 0207 8688971 or chris.ranger@npsa.org.uk Clinical practice trials The Medicines Control Agency will consult on transposing the Clinical Trials Directive (2001/20/EC) into UK law. Agreement on the directive was reached in February 2001. The final version
was published in the Official Journal of the European Communities (OJEC)
on 1 May 2001. Member states have until 1 May 2003 to prepare national provisions for complying with the directive and must adopt them by 1 May 2004. Consultation runs for 12 weeks and is likely to begin in February or
March. The document will be available on the MCA and the Department of
Health's Research and Development websites: Contact: Caroline Brennan 0207 2730525 or caroline.brennan@mca.gsi.gov.uk DTC programme rolled out The expansion of the diagnosis and treatment centre (DTC) programme is expected to deliver an additional 250,000 operations a year by 2005. It includes 12 new NHS DTCs and 11 locally-led DTCs run by the independent sector, either working alone or in a joint venture with the NHS. A national procurement exercise was also announced for a series of chains of DTCs to be run by the independent sector to fill gaps in capacity identified in cataracts, simple day-case surgery and orthopaedics (knees and hips). Details at: www.doh.gov.uk/diagnosisandtreatmentcentres For a copy of the procurement prospectus visit: www.doh.gov.uk/growingcapacity Heart services review Heart services are to be reviewed during 2003-2004 against the standards laid out in the Coronary Heart Disease National Service Framework by the Commission for Health Improvement (CHI) and Audit Commission. Details at: www.chi.nhs.uk/eng/nsf/chd/index.shtml Contact: sarah-jane.wakefield@chi.nhs.uk Patient activity rates of consultants A pilot study has tested the potential for using hospital episode statistics to determine the variation in admitted patient activity rates of NHS consultants. The initial findings can be found at: www.doh.gov.uk/hes/confidentiality/index.html Contact: Linda Shurlock at linda.shurlock@doh.gsi.gov.uk Engaging patients and the public Section 11 of the Health and Social Care Act 2001 – the new duty to involve and consult patients and the public – is now in effect. Details at: www.doh.gov.uk/himp/himplegislation.htm#hea Contact: Jenny de Ville 020 72105841 or: jenny.deville@doh.gsi.gov.uk Tackling violence in primary care 85 per cent of primary care trusts have put local action plans in place for tackling violence towards GPs and their staff. All local plans should ensure GPs have access to a secure facility for the treatment of violent patients. Contact: Eileen Calline 0113 2546131 or eileen.calline@doh.gsi.gov.uk Reforming NHS financial flows The consultation document Reforming NHS Financial Flows: Introducing Payment by Results, proposed two changes to be implemented in 2003-2004. These were introduction of a national price tariff for growth activity in 15 healthcare resource groups (HRGs) and using national HRG weights (relative values) to adjust for casemix in six surgical specialities. Details at: www.doh.gov.uk/nhsfinancialreforms Contact: Financial-flow@doh.gsi.gov.uk Additions to definition set Ten services have been added to the 23 already covered by the specialised services national definition set. The definition set includes all specialist service activity subject to collaborative commissioning arrangements. It provides a useful basis for reviews and strategic planning. Details at: www.doh.gov.uk/specialisedservicesdefinitions Comments to: specialised.services.defins@doh.gsi.gov.uk Regulation of fertility treatment services Following the House of Commons Science and Technology Committee's report Developments in Human Genetics and Reproduction, the Government is now supporting the Human Fertilisation and Embryology Authority (HFEA) to introduce measures to bolster regulatory procedures, including:
The HFEA's annual funding will rise from just over £2m to £5.5m. This includes an increase in Government funding to £1.5m and approval for the HFEA to increase its licence fee income to £4m. As the Government considers it important for clinics to have adequate notice, it requires the HFEA to defer introducing the fees increase from January 2003 to April 2003. Details at: www.doh.gov.uk/assistedconception/scitechcmtteegovresponse.pdf Contact: Ted Webb 0207 9725863 or edward.webb@doh.gov.uk NATIONAL STANDARDS AND GUIDANCE Diabetes delivery strategy The National Service Framework for Diabetes: Delivery Strategy sets out a systematic programme of change – starting from April. The NSF can be found at: www.doh.gov.uk/nsf/diabetes/index.htm Contact the diabetes team at: diabetes.nsf@doh.gsi.gov.uk Suspension advice The chief medical officer (CMO) has written to all NHS chief executives about handling doctors whose conduct could give grounds for suspension. Before suspending anyone chief executives should seek advice from the National Clinical Assessment Authority. Where a patient is in danger though, suspension should be immediate. Where suspensions are longer than six months, trusts should notify regional public health directors. Contact: David.O’Carroll@doh.gsi.gov.uk Intimate examinations The chief medical officer has written to directors reminding them of GMC guidance on intimate examinations in light of recent press reports on this area. Guidance is at: www.gmc-uk.org/standards/intimate.htm General Department of Health guidance on consent is at: www.doh.gov.uk/consent/ Contact: Hugh Whittall 0207 9721435 or hugh.whittall@doh.gsi.gov.uk Nursing talent Liberating the Talents contains practical examples of how nurses are pushing forward the boundaries of work and implementing aspects of this new framework. A comprehensive resource listing provides access to websites, publications and organisations to take this forward. Details at: www.doh.gov.uk/cno/liberatingtalents.htm Hard copies: doh@prolog.uk.com or NHS Response Line 08701 555455. Emergency care checklist A checklist is available to help NHS trusts streamline the care of emergency department patients. It is at: www.doh.gov.uk/emergencycare/aetargetchecklist.htm Breast screening programme Organising a Breast Screening Programme replaces the previous national guidance, Organising Assessment. The new publication can be found at: www.cancerscreening.nhs.uk/breastscreen/publications/pm-02.html Contact: carol.gabbitas@sheffield-ha.nhs.uk Orthopaedic services Improving Orthopaedic Services, a guide for clinicians, managers and service commissioners, is now available from the NHS Modernisation Agency. Details at: www.modern.nhs.uk/action-on under ‘latest news’. Hard copies: doh@prolog.uk.com (quote MA/SIT/AO/001) Contact: Eric Ludlow 0116 2221422 or eric.ludlow@npat.nhs.uk Managing hospital outbreaks of gastro-enteritis New guidance has been published in light of the increasing number of hospital outbreaks of gastro-enteritis. Details at: www.phls.org.uk/topics_az/norwalk/hospital_srsv.pdf Contact: Sally Wellsteed 0207 9725145 or sally.wellsteed@doh.gsi.gov.uk Protocol-based care pack An information pack has been developed by the NHS Modernisation Agency and NICE to support development of protocol-based care within the NHS. It aims to spread good practice and help professionals working in community, primary and secondary care by providing practical guidance on how to develop protocols. Details at: www.modern.nhs.uk/protocolbasedcare Contact: Anne Hackett 0207 2105469 or anne.hackett@doh.gsi.gov.uk Smallpox response Interim guidelines have been published for smallpox response and management in the post-eradication era. Details at: www.doh.gov.uk/epcu/cbr/biol/smallpoxplan.htm Age discrimination benchmarking tool An age discrimination benchmarking tool has been developed. Over the next few months comments will be sought on expanding it to cover primary and social care services. Details at: www.doh.gov.uk/nsf/agediscrim.htm Contact: carl.evans@doh.gsi.gov.uk NICE schizophrenia guidelines Guidelines on the management of schizophrenia in primary and secondary care have been published by the National Institute for Clinical Excellence (NICE). Details at: www.nice.org.uk/Docref.asp?d=42460 Contact: Dr Nick Clarke 0113 2545205 or nick.clarke@doh.gsi.gov.uk New guide to medication review Room to review – a guide to medication review: the agenda for patients, practitioners and managers provides a pragmatic approach to reviewing medicines in primary care and points the way towards greater patient involvement in reviews. The guide makes particular reference to the milestones for the Older People’s National Service Framework. Details at: www.medicines-partnership.org Contact: info@medicines-partnership.org REPORTS Victoria Climbié Inquiry Report A copy of the report is available at www.victoria-climbie-inquiry.org.uk/finreport/finreport.htm Hard copies from book.orders@tso.co.uk Free copies of the summaries are available at doh@prolog.uk.com A letter from the Secretary of State for Health about immediate and follow-up actions has been sent to chief executives of local authorities and health bodies. Contact: bill.jobson@doh.gsi.gov.uk Stroke services for older people A new document What makes a good stroke service and how do we get there? summarises a review identifying key factors in developing high quality stroke services. Details at: www.doh.gov.uk/nsf/good-stroke-serv.pdf Contact: mary.hopper@doh.gsi.gov.uk Ombudsman report April-July 2002 The report identifies three main issues – record keeping, care of people with mental illness and the NHS complaints procedure (in particular clinical advice to people managing the process). All clinical directors should be made aware of the reports. Details at: www.parliament.ombudsman.org.uk/hsc/document/hicaj02/index.htm Contact: Adrian Landon 0113 2545679 or adrian.landon@doh.gsi.gov.uk Patient involvement update A report covering the Commission for Patient and Public Involvement in Health, patients forums, independent complaints advocacy, overview and scrutiny committees and the imminent new duty on the NHS to involve and consult the public is available at: www.doh.gov.uk/involvingpatients – under 'Status Report' and 'Policy Update'. Contact: meredith.vivian@doh.gsi.gov.uk Medical services in prison Good Medical Practice for Doctors Providing Primary Care Services in Prison - a useful reference for medical directors of primary care trusts – can be found at: www.doh.gov.uk/prisonhealth Research and development The annual report of the NHS R&D Health Technology Assessment (HTA) programme can be found at: www.ncchta.org/annualreport Contact: Sheila Greener 0113 2546186 or sheila.greener@doh.gsi.gov.uk Hospital episode statistics A new CD-Rom contains hospital episode statistics (HES) relating to individual organisations from 1 April 2001 to 31 March 2002. Discs are being distributed to directors. Contact: Steve Price 020 79725683 or stephen.price@doh.gsi.gov.uk RECRUITMENT AND RETENTION International doctors on the web A series of pen pictures of doctors suitable for interview are being placed on the international recruitment web site and will be updated fortnightly. Details at: www.doh.gov.uk/international-recruitment/ under ‘medical recruitment’. Contact: claire.davies@doh.gsi.gov.uk ENT special interest New guidance on the appointment of a GP with a special interest in ENT can be found at: www.doh.gov.uk/pricare/gp-specialinterests Contact: gpwsi@doh.gsi.uk EDUCATION AND TRAINING Induction courses for overseas doctors The Department of Health funds induction courses to help overseas doctors overcome problems trying to adapt to their new environment and the NHS. Details at: www.doh.gov.uk/hrbulletin/hrbulletin31flyer.pdf Contact: Stuart Merritt 0113 2545952 GPs with a special interest – update A programme to take forward the development of GPs with a special interest will be run jointly by the NHS Modernisation Agency and the National Primary and Care Trust (NatPaCT) development team. Details at: www.doh.gov.uk/pricare/gp-specialinterests Contact: Ann Atkinson 0113 2543845 or Ann.Atkinson@doh.gsi.gov.uk CLINICAL UPDATES Update on magnetic resonance imaging The Medical Devices Agency has updated guidelines on magnetic resonance imaging in response to a rise in the number of reported adverse incidents, particularly burns and equipment incompatibilities. Guidance is under ‘latest news’ at: www.medical-devices.gov.uk BCG vaccine Statens Serum Institute (SSI) Marketing authorisation for BCG Vaccine SSI has been granted by the Medicines Control Agency (MCA) under the Mutual Recognition Procedure and will shortly be available in the UK. While BCG Vaccine SSI is essentially similar to the Evans BCG Vaccine Intradermal, there are two major changes that medical, nursing and pharmacy staff must be aware of before using the vaccine. Details are outlined in the full letter, reference PL CO (2002)1, available on the COIN database MEDICAL DEVICES AGENCY Medical device alerts - new format The Medical Devices Agency has introduced a new format medical device alert to replace previous hazard notices, device alerts, safety notices and pacemaker technical notes issued. Details at: www.medical-devices.gov.uk Hazard notices HN2002(08) – Invacare Ltd – Storm powered wheelchair – risk of drive wheel becoming detached HN2002 (09) – possibility of over infusions with IVAC 591, 597, 598 and 599 infusion pumps Safety notices MDA/2003/001 – reporting adverse incidents and disseminating – medical device alert SN2002 (33) – arjo trixie patient hoists – risk of instability and user injury SN2002 (34) – patient hoist, Liftmaster models 110, 160 and 190 – risk of injury due to detachment of hoist boom, standing aid or seat SN2002 (32) – hill-rom variable height resuscitaire radiant warmer – safe connection of gas cylinders SN2002 (35) – removal of Implantable Cardioverter Defibrillators (ICDs) SN2002 (30) – ureteric stent degradation by light SN2002 (31) – inappropriate use of breathing filters, HMEs and HMEFs in breathing circuits – risk of inadequate ventilation SN2002 (29) – tracheostomy tube holders – kapitex trachi-hold – recall notice FUTURE COMMUNICATIONS AND EVENTS Information reader box (IRB) All future communications/collections of data from the Department of Health (with certain exceptions) must carry an IRB displaying a unique reference number. Relevant central communication/return without an IRB and reference number is likely to be unauthorised and can be legitimately ignored. Cancer conference update The Cancer Services Collaborative (CSC) will host a major conference Modernising cancer services – Excellence in patient care on 7 March at the International Conference Centre, Birmingham. Information and online booking at: www.modern.nhs.uk/cancer or http://195.40.181.94/cscconference/home.asp Action On bulletin An electronic news bulletin covering the work of the NHS Modernisation Agency's Action On programmes is now available. The monthly bulletin @ction online will include information on:
Subscribe at: www.modern.nhs.uk/scripts/actiononline/default.asp?site_id=30 Contact: Eric Ludlow 0116 2221422 or eric.ludlow@npat.nhs.uk CHI news bulletin The Commission for Health Improvement (CHI’s) latest monthly bulletin is available at: www.chi.gov.uk/eng/latestnews Plans for a staff opinion survey from 2003 and an announcement on the new CHAI are included. To be added to the mailing list e-mail: bulletin@chi.nhs.uk
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