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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
Safety notices
Future communications and events
TAKE ACTION New incentives package for consultants Health secretary Alan Milburn has announced a new framework of consultant incentives and rewards aimed at better rewarding consultants who do most for NHS patients. The Department of Health is launching a consultation on the package with a view to implementing it from April 2003. Implementation leads in each Directorate of Health and Social Care (DHSC) will be gathering views from NHS organisations. Further information at www.doh.gov.uk/consultantscontract New maternity leave arrangements New statutory arrangements for maternity leave come into force for those giving birth on or after 6 April 2003. Employers are reminded that they will need to change their current procedures and apply the new rules. The main changes are:
Full details of the changes are available at
www2.dti.gov.uk/er/maternity.htm Bids required for Action On general surgery The NHS Modernisation Agency is inviting bids from health communities
to become pilot sites for its Action On programme in general surgery.
Revenue funding is available for the duration of the pilot site projects
which tend to run for about 18 months. The closing date for bids is 16
May 2003. www.modern.nhs.uk/scripts/default.asp?site_id=30&id=8926 Delayed discharges intensive work programme The Change Agent Team's intensive work programme tackles the underlying causes of delayed discharges through whole systems change. Expressions of interest to take part in the third phase of the programme are invited from directors of social services and chief executives of PCTs and NHS trusts. The deadline for expressions of interest is 31 March 2003. www.doh.gov.uk/changeagentteam/supportprog.htm National Patient Safety Agency (NPSA) In June 2002 the NPSA commissioned a project to establish the causes
of infusion device incidents and identify solutions to prevent their recurrence.
The NPSA wants to recruit a small number of trusts to test and evaluate
four proposed solutions. Funding is available to support this process. RECENT NEWS Unfinished Business - consultation response published Unfinished Business - the Chief Medical Officer's (CMO) report containing proposals for reform of the senior house officer (SHO) grade - was published separately in each of the four home countries for consultation on 22 August 2002. The report generated a lot of interest and more than 370 replies were received. A UK policy statement has been prepared jointly by the four UK health departments in response to the consultation process. It indicates how the modernisation of postgraduate medical education will be taken forward in the context of the wider workforce reforms. The policy statement is at
www.doh.gov.uk/shoconsult/shoconsultresponse.pdf Doctors' and dentists' renumeration The Department of Health's evidence to the Review Body on doctors' and dentists' renumeration for 2003 was published on 23 January 2003. The full text of the evidence is at www.doh.gov.uk/reviewbodies/index.htm Continuing Care - Ombudsman report The Ombudsman's report on continuing care - published on 20 February 2003 - contains potential implications for strategic health authorities. Further information is at www.doh.gov.uk/jointunit/ccc.htm Contact: william.vineall@doh.gsi.gov.uk or monica.acheampong@doh.gsi.gov.uk Dr Sue Roberts has been appointed as the first national clinical director for diabetes after her work as part of a team drawing up the NSF for diabetes. She will be responsible for ensuring local NHS trusts achieve the NSF's eye screening and check up targets as well as providing national leadership. Nine pilot areas to speed up diagnosis and treatment for people most at risk of developing diabetes have also been announced by the Government. Clinicians working in the pilots - all inner city areas - will be using blood sugar level screening on overweight patients over 40 who have heart disease or who have had a stroke. British National Formulary (BNF) March 2003 There will be a slight delay in the central distribution of BNFs following problems at the Pharmaceutical Press. Copies are due to go out in the first half of April. Changes to the BNF since the last edition can be seen under 'What's new?' at www.bnf.org.uk Cleaner hospitals, better food Standards of cleanliness in hospitals have improved and patients are receiving better food, new figures show. The first set of results from NHS food inspections and the latest ratings from the national hospital clean-up campaign show that almost 60 per cent of hospitals now have 'good' standards of cleanliness and have been graded green under the latest traffic light ratings. The remaining 40 per cent have achieved 'acceptable' standards and are
rated yellow. Better hospital food patientexperience.nhsestates.gov.uk/bhf/bhf_content/home/home.asp Introduction of supplementary prescribing The Department of Health plans to introduce supplementary prescribing from April 2003. Nurses have started training and pharmacists will begin to train from spring this year. Supplementary prescribing by nurses and pharmacists may drastically change the pattern of care provision for many patients with long term health conditions. Chief executives have been asked to ensure it is taken forward within their trust as quickly as possible. A guide to the implementation of supplementary prescribing is at www.doh.gov.uk/supplementaryprescribing/index.htm Contact: Martin Teff 0113 254 6318 or martin.teff@doh.gsi.gov.uk New money for recombinant clotting factors More haemophilia patients will be treated with recombinant clotting factors following an £88 million investment announced by the Department of Health. The DH will be developing an implementation plan with NHS haemophilia commissioners, clinicians and patients' representatives. Guidance will be issued to PCTs later this year. Contact: Charles Lister 0207 972 3764 or charles.lister@doh.gsi.gov.uk Learning Disability Development Fund - capital allocations The White Paper Valuing People: A New Strategy for Learning Disability
for the 21st Century announced that there would be a learning disability
development fund of £20 million capital a year. Information about the Learning Disability Development Fund is available at www.doh.gov.uk/learningdisabilities/lddf.htm Contact: Elaine Cooper 0207 972 4499 or elaine.cooper@doh.gsi.gov.uk Major expansion of patient choice programme Health Secretary Alan Milburn announced a major expansion of the patient choice programme during a speech to trust chief executives on 11 February 2003. View the speech at www.doh.gov.uk/speeches/milburnfeb03choice.htm Contact: Sarah Dahlgren on 0113 254 5655 or sarah.dahlgren@doh.gsi.gov.uk National Patient Survey Programme - 2003 Chief executives are reminded that during Spring 2003, the following national patient surveys will be taking place
Results will be collated by the NHS survey advice centre and will be used for the 2003 performance indicators and star ratings. The NHS survey advice centre website, www.nhssurveys.org, gives further information about the survey timetable and action required by trusts. Contact: NHS surveys advice centre 01865 208127. Changes in the Department of Health The following is a note from NHS Chief Executive Nigel Crisp: I am working with colleagues in the Department to shape and manage a number of changes which we will be making during the next financial year. The direction of travel is already clear:
Much of this change is already happening. I have already written to staff in the department setting out initial thinking about how we might start reshaping the whole departmental organisation in response to these changes. The changes will affect the department as a whole. However, one change that will affect the NHS directly is the intention to integrate the performance management role of the directors of health and social care with central delivery and performance functions so as to give a national drive on delivery. None of this is immediate. All the current arrangements for your accountability to Directorates of Health and Social Care (DsHSC) for personal and operational performance and planning will continue in place. NATIONAL STANDARDS AND GUIDANCE Waiting times guidance on reasonableness for written and verbal offers
of appointments and admission offers has been published by the Department
of Health's access directorate branch. Contact: Matthew Birkenshaw 0113 254 5554 or matthew.birkenshaw@doh.gsi.gov.uk Health and Social Care Act Section 11 Strengthening Accountability Involving Patients and the Public is available at www.doh.gov.uk/involvingpatients/index.htm This outlines policy and practice guidance to support the new duty on the NHS to implement Section 11 of the Health and Social Care Act 2001. Hard copies will be sent to patient and public involvement leads in SHAs, PCTs and NHS trusts this month (March). Contact: Jenny De Ville 020 7210 5841 or jenny.deville@doh.gsi.gov.uk New national minimum standards for care homes for adults (18-65) and older people were published on 18 February 2003. They follow last year's consultation exercise proposing amendments to a small number of physical environment standards. Most of the standards are unchanged, and the new standards apply from 1 June 2003. The relevant documents are: Care Homes for Older People: National Minimum Standards - www.doh.gov.uk/ncsc/carehomesolderpeople.pdf Care Homes for Adults (18-65) - The Care Homes Regulations 2001 (updated) - Contact: Adults kirt.ghelani@doh.gsi.gov.uk Older people alan.probett@doh.gsi.gov.uk NHS financial flows reforms - Service Level Agreement (SLA) guidance New guidance has been published to show how SLAs can deliver the NHS financial flows reforms. It includes a model SLA which is recommended for agreements covering up to £250,000. Larger agreements can be based on the model. The guidance shows how activity and resources can take account of the new arrangements for 15 target health care resource groups and the (minimum of) six specialties which need to be commissioned on the basis of case mix, adjusted cost and volume agreements. www.doh.gov.uk/nhsfinancialreforms/sla.htm Contact: Marianne Monie 0207 210 5681 or marianne.monie@doh.gsi.gov.uk Person-centred care for children, young people and expectant mothers An update on workforce planning and development in relation to children and maternity services is available at www.doh.gov.uk/cgwt/chworkforce.htm It stresses the importance of supporting innovative solutions to develop more staff working differently across health, social care and education agencies. Feedback to claire.armstrong@doh.gsi.gov.uk;
Margherita.d'cruz@doh.gsi.gov.uk; Support, time and recovery (STR) workers in mental health Guidance on the introduction of STR workers in mental health services has been issued. The role of STR workers is to be flexible in providing the support service users want by giving them time, thereby aiding their recovery. It is intended that they will help users lead an ordinary life, assisting them in their everyday, practical needs. www.doh.gov.uk/nsf/mentalhealth.htm Contact: John Allcock 0207 972 4224 or john.allcock@doh.gsi.gov.uk Dealing with child abuse (Operation Ore) Cases of health care workers alleged to have accessed internet paedophile sites should be considered on an individual basis. Trusts, local education and social service departments should have arrangements in place for dealing with child abuse under the provisions of Working together to safeguard children available at www.doh.gov.uk/pub/docs/safeguard.pdf Trusts should follow existing procedures and guidance. A reminder for action has been sent to HR directors and can be accessed at www.doh.gov.uk/hrbulletin/hrbulletin53.htm#2 For further information email mb-hrd-hrb@doh.gsi.gov.uk Safety testing of mammographic X ray equipment The Health and Safety at Work Act 1974 states that it is the duty of every employer to ensure as far as is reasonably practicable, the health, safety and welfare at work of their employees. Equipment should be checked for all aspects of safe operation including electrical and mechanical. The Recommended Standards for the Routine Testing of Diagnostic X-ray Imaging Equipment published by the Institute of Physics and Engineering Medicine (IPEM) suggests that electrical and mechanical safety tests are required in addition to radiation safety tests. A copy of the report is at www.cancerscreening.nhs.uk/breastscreen/publications/me-egn-or0301.html Or contact the National Office of the NHS Breast Screening Programme on 0114 2711060 for a free hard copy. SAFETY NOTICES
These alerts were issued on 13 and 21 February 2003 to chief executives of NHS trusts and PCTs and the National Care Standards Commission (NCSC). They were also issued to liaison officers of all trusts and the NCSC for action and onward distribution. For further information on the role and nomination of liasion officers email bs@medical-devices.gov.uk
These alerts were issued on 12 and 13 February 2003. Contact: NHS Estates, Centre of Healthcare Engineering and Science,
nhs.estates@doh.gsi.gov.uk FUTURE COMMUNICATIONS AND EVENTS The Health and Social Care Awards recognise some of the best examples of dedication and personal commitment of staff working in health and social care. The 2003 awards scheme closing date is 2 May 2003. More details are available at www.modern.nhs.uk/healthandsocialcareawards Application packs are available from Vicky Aspell 0116 222 5168 or vicky.aspell@npat.nhs.uk
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