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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 1. Neonatal intensive care review The conclusions of this review were published on 10 April for a three-month consultation. The review recommends a more structured, collaborative approach to caring for newborn babies by hospitals working closely together in managed networks. It also suggests definitions of categories of care and the designation of units that would provide the various levels of care. The review makes proposals about staffing skills, information and support to parents. Comments are invited on the report available at www.doh.gov.uk/nsf/neonatal.htm Contact: john.rutherford@doh.gsi.gov.uk or 020 7972 4139 RECENT NEWS 2. Information for patients - extension of consultant waiting times database The prospective consultant waiting times database at www.nhs.uk/waitingtimes/consultant/search.asp which went live on September 2002 with information from acute NHS trusts, was extended on 1 April 2003 to include information from non-acute trusts. Submissions to the database should be made by the last working Tuesday of each month to nhs.uk@nhsia.nhs.uk Site-specific rather than trust-wide data should be given wherever possible to assist users of the database in locating services. A waiting times information pack is available by emailing nhs.uk@nhsia.nhs.uk Contact: corinne.mcdonald@doh.gsi.gov.uk 3. An epilepsy action plan The plan, Improving services for people with epilepsy, and a letter from the chief medical officer inviting PCTs to review local epilepsy services and addressing shortfalls as part of their local planning arrangements or priorities is available at www.doh.gov.uk/cmo/epilepsy/index.htm 4. Patient and public involvement (PPI) pilots To establish communication channels, NHS trusts currently running pilot PPI forums are asked to make initial contact with the Commission for Patient and Public Involvement in Health by e-mailing communications@cppih.nhs.uk 5. Scale of productivity gains There has been a huge amount of effort right across the NHS on local delivery plans in recent months and many chief executives have been asking for a high level summary of some of the lessons emerging through the work of the NHS Modernisation Agency. People are particularly eager to know the scale of productivity gains achieved through applying service redesign techniques. A short paper summarising some of the learning so
far is at www.modern.nhs.uk/productivity/ProductivityCE.pdf
Contact: Richard Green on 07799 895195. 6. Spread and sustainability of service improvement Factors identified by staff leading modernisation programmes, produced by the NHS Modernisation Agency’s Research into Practice team, is at www.modern.nhs.uk/scripts/default.asp?site_id=24&id=6953
7. New National Confidential Enquiry into Maternal and Child Health On 1 April the Confidential Enquiry into Maternal and Child Health (CEMACH) was launched by NICE to replace the Confidential Enquiry into Maternal Deaths (CEMD) and the Confidential Enquiry into Stillbirths and Deaths in Infancy (CESDI). CEMD has required trusts and other providers to report deaths of mothers up to one year after delivery, whilst CESDI has required reports on late foetal losses, stillbirths and deaths in infancy up to 12 months. Trusts providing maternity services should continue to provide this information to CEMACH and identify a local CEMACH co-ordinator to be the established point of contact. Contact: Richard Congdon, chief executive of CEMACH - richard.congdon@nice.nhs.uk 8. Screening for diabetic retinopathy Ensuring a high quality systematic retinal screening programme will be an early priority for PCTs. This is in line with the target set in Improvement, Expansion and Reform: the next three years, the planning and performance framework for 2003–2006. Local delivery is being supported by a UK National Screening Committee (NSC) programme, developed with professional organisations and Diabetes UK, to set:
The programme detailing the national work to support local implementation is at www.nscretinopathy.org.uk Contact: josephine.taylor@doh.gsi.gov.uk 9. Support for workforce planning Three projects, aimed at integrating the support for workforce planning, have been launched by the National Workforce Information and Planning Programme (NWIPP):
The programmes are at www.healthcareworkforce.org.uk Launch details at www.doh.gov.uk/hrinthenhs/workdev-newsletter-0402.pdf
Contact: Laura Maley at NWIPProgramme@gmconfed.org.uk 10. Transfer of secretariat The secretariats of the UK Advisory Panel and the Creutzfeldt-Jakob Disease Incident Panel have been transferred from the Department of Health to the new Health Protection Agency (HPA). Further information at www.doh.gov.uk/cjd/incidentspanel.htm 11. National Burn Bed Bureau The bureau improves access to services for people with burn injuries. It is available 24 hours on Tel 01384 215576 / Fax 01384 215580. Further details: mark.curran@wmas.nhs.uk or sue.williams@wmas.nhs.uk 12. National Clinical Assessment Authority chairman Bob Nicholls was appointed chairman of the authority with effect from 1 May 2003. The appointment is for a period of four years (to 30 April 2007). The authority helps the NHS in dealing with concerns about the performance of doctors and dentists. Further information on the authority is at www.ncaa.nhs.uk 13. Call for human rights leads The NHS Litigation Authority now provides an information service for the NHS on human rights issues which affect health care delivery. To provide an effective service, chief executives have been asked to provide the authority with contact details for at least one person in every PCT/trust who is responsible for human rights matters. Contact: Katharine.Wright@nhsla.com or telephone 020 7430 8797.Information about the Human Rights Act is available at www.nhsla.com and www.doh.gov.uk/humanrights/index.htm NATIONAL STANDARDS AND GUIDANCE 14. Use of human tissue and organs The following documents are available at www.doh.gov.uk/tissue
A video explaining why post mortems may be needed after a child’s death is also available. A video on adult post mortems is planned. Hard copies available from: doh@prolog.uk.com Contact: gemma.pearce@doh.gsi.gov.uk or clare.lynley@doh.gsi.gov.uk 15. Consultants’ advisory appointment committees A list of frequently asked questions on consultants’ advisory appointment committees is now available at www.doh.gov.uk/appointmentprocedures/index.htm Queries: Enquiry-Box@doh.gsi.gov.uk 16. Practitioners with a special interest GPs, nurses and allied health professionals with special interests are now beginning to play a major role in improving access to services for patients. The NHS Modernisation Agency, the Department of Health and the Royal College of GPs have been taken a major lead in these developments and have now produced a step-by-step guide and nationally agreed frameworks in key areas including emergency care, mental health, diabetes, child protection, epilepsy and dermatology. The frameworks and step by step guide are at www.doh.gov.uk/pricare/gp-specialinterests Further information and contact details are at www.gpwsi.org 17. Advice about Operations Abroad A statement has been issued following the recent court case between the Department of Health and the company Operations Abroad, regarding the treatment of NHS patients’ abroad. The full statement is available at www.doh.gov.uk/international/overseastreatment.htm Contact: sarah.walter@doh.gsi.gov.uk or on 020 7210 5664 18. Getting the right start The first standard of Getting the right start: the National Service Framework (NSF) for Children, Young People and Maternity Services was launched last month. The new standard covers the design and delivery of hospital services for children, the safety and quality of care, and will help to ensure children are cared for in child-friendly hospitals. The NSF emerging findings consultation document was also launched to signal the direction of travel for the full NSF. They are available at www.doh.gov.uk/nsf/children/gettingtherightstart.htm Contact: lawrence.tallon@doh.gsi.gov.uk or on 020 7972 4129 19. Community Care (Delayed Discharges etc.) Act The Community Care (Delayed Discharges etc.) Bill received royal assent on 8 April. Part 1 of the act places new duties on the NHS and local authorities around patient discharge. This will be implemented in shadow form in October 2003. Charging for delays will not start until January 2004. The new £50 million delayed discharge grant will be distributed to councils as soon as possible. Part 2 will make certain items of community equipment and intermediate care free to users. This intention is to implement this provision in May. The draft regulations are at www.doh.gov.uk/jointunit/delayeddischarge/consultfeb03draftqualservregs.pdf
Contact: hannah.burdekin@doh.gsi.gov.uk or ruth.marshall@doh.gsi.gov.uk 20. Guidance on Commissioning arrangements for specialised services This guidance supports advice given in Shifting the Balance of Power: The Next Steps (January 2002) which emphasises that PCTs should act collaboratively when commissioning specialised services and strategic health authorities should oversee and performance manage these collaborative arrangements. In particular, this guidance gives advice regarding the continuing role of the Regional Specialised Commissioning Group (or equivalent collaborative commissioning group) and also provides some examples of good practice. The guidance is available at www.doh.gov.uk/commissioning/specservices03.htm 21. Mental health trust and primary care trust performance indicators Following the announcement of final performance indicators in December for acute, specialist and ambulance trusts, final lists for mental health and primary care trusts were announced on 31 March. Further details on performance ratings 2003 are at www.doh.gov.uk/performanceratings/2003/ and www.chi.nhs.uk/eng/ratings/index.shtml 22. UK national stockpile - patient group directions (PGDs) PGDs for the stockpiled antibiotics, chemical countermeasures and potassium iodate are now available at www.doh.gov.uk/epcu/pgd.htm Other PGDs will be published as they are developed. The Department of Health is in the process of developing a training strategy but in the meantime NHS trusts may find the PGDs useful for emergency planning. Contact: Judith Field on 020 7972 3785 or judith.field@doh.gsi.gov.uk 23. Patient referral to Belgium A bilateral agreement is now in place, establishing a framework for the referral of NHS patients to Belgium. This has major implications for any NHS trust seeking to contract care in any health care organisation in Belgium. Details at www.doh.gov.uk/international/overseastreatment.htm Contact sarah.walter@doh.gsi.gov.uk or on 020 7210 5664 24. Developing NHS Direct The current organisational structure of NHS Direct has been reviewed to decide what would be the best structure for the service in the future. Full details at www.doh.gov.uk/developingnhsdirect/ Contact: phillip.thomas@doh.gsi.gov.uk or on 0113 254 6317 25. Copying letters to patients Information and choice are integral components of the drive to improve patients’ experience. The Department of Health is making a step-change in strengthening accountability to individual patients through delivery of the commitment in The NHS Plan (paragraph 10.3) that letters between clinicians about patients will be copied to the individual concerned as of right. Good practice guidelines on copying letters are available at www.doh.gov.uk/patientletters/goodpractice.pdf
26. Consent Order: Mental Health Act 1983 (R on the application of SSG and Liverpool City Council and SofS for Health) The effect of this consent order, concerning same sex partners and nearest relative under the Mental Health Act 1983, has caused some confusion over the relevance of the consent order to the wider field. Guidance, confirming that the order should be treated as a considered declaration of the law by the High Court, is at www.doh.gov.uk/mhact1983/consentorders.htm Contact: Melissa.Merritt@doh.gsi.gov.uk SAFETY NOTICES 27. Medical Device Alerts 2003/008 - external pacemakers: models – E4162, E4164, E4165 and E4166 (manufactured by APC Medical Ltd). 2003/009 - hospital bed: Hill-Rom Evolution 150BO was issued on 8 April 2003. 2003/010 - infra-red ear thermometer - home use, was issued on 16 April 2003 for action. 2003/011 - blood glucose meter test strips: Roche Accu-Chek Advantage II, was issued to NHS trusts and social services for action on 16 April 2003. 2003/012 - all biphasic defibrillators (all manufacturers), was issued to NHS trusts for action on 17 April 2003. Details of all alerts at http://devices.mhra.gov.uk 28. Device bulletins MDA DB2003 (01) - adverse incident reports 2002. MDA DB2003 (02) - infusion systems. MDA DB2003 (03) - guidance on the safe use of wheelchairs and vehicle-mounted passenger lifts. MDA DB2003 (04) - safe use of ambulance stretcher trolleys issued in March 2003. These device bulletins are available at www.mhra.gov.uk FUTURE COMMUNICATIONS AND EVENTS 29. Prison health Prison Health Newsletter (Spring 2003) is available
at www.doh.gov.uk/prisonhealth/newsletters/newsletter11.pdf
A hard copy of the document can be obtained from doh@prolog.uk.com
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