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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
TAKE ACTION Medicines Management Services Collaborative - fourth wave Primary care trusts are invited to apply to be a fourth wave site for the National Medicines Management Services (MMS) Collaborative Programme which will begin in October 2003. Two new elements are being introduced:
Further details and application forms are available from www.npc.co.uk/mms or the national programme director Richard Seal at Richard.seal@npc.nhs.uk The deadline for applications is 27 August. Report on safe sedation practice In November 2001 an Intercollegiate Working Party published its report on Implementing and Ensuring Safe Sedation Practice for Healthcare Procedures in Adults. The report made a number of recommendations, including that each hospital should nominate two consultants to collaborate in the local implementation of sedation guidelines. NHS Trusts are advised that these recommendations should be complied with to provide safe sedation. The full report can be found at www.rcoa.ac.uk/publications Domestic violence consultation The Safety and Justice consultation paper seeks views on the Government's proposed strategy for tackling domestic violence. It is based around three elements - prevention, protection and support. The Government is keen to hear the views of healthcare professionals and managers on what is needed to develop and sustain effective responses to victims of domestic violence. The consultation paper is at www.homeoffice.gov.uk and the consultation exercise ends on 12 September. Consultation on children's services In April, the paper Emerging Findings was published setting out some of the early thinking on the development of the National Service Framework (NSF) for Children, Young People and Maternity Services. The NSF will set standards across health and social care services. It has three key objectives: to put children and families at the centre of care; to develop effective partnership working so that the needs of the child are always considered and to deliver needs-led services. The Children's NSF team would welcome your views on the findings by 10 August - now extended from 10 July. The paper is at www.doh.gov.uk/nsf/children.htm You can send your comments in writing to: Claire Phillips, Children's National Service Framework, Room 526, Wellington House, 133-155 Waterloo Road London SE1 8UG, or by e-mail to MB-Childrens-NSF@doh.gsi.gov.uk RECENT NEWS Primary care trusts and GPs are about to begin discussions about implementing the new GMS contract after the vote in favour of the contract by GPs last month. Some aspects of the contract will be implemented as early as possible. These will include revised seniority payments which are designed to reward the experience of senior GPs. Full implementation of the contract is expected to come into effect from April next year, subject to legislation. GPs can also expect extra funding to enable them to prepare for the introduction of the quality and outcomes framework next year. The first directed enhanced services - those aimed at improving access, preparing quality patient information and providing support for staff dealing with violent or abusive patients - will also be introduced. The Department of Health has now written to all PCTs asking them to nominate a lead GMS contact and gear themselves up for full implementation. They should begin by talking to all GPs about the services they intend
or would like to provide under the new contract. And they should be making
arrangements to replace services that some practices may no longer wish
to provide, such as out-of-hours arrangements. Practices (and personal
medical services' providers) are expected to tell their PCTs by the end
of September whether they intend to opt out of out-of-hours work under
the arrangements to be introduced with the new contract. Lead officers have been established in every strategic health authority to manage the implementation of the contract and the Department of Health will be producing a comprehensive action plan later in the summer. Seven out of 10 GPs voted on the contract and of those almost 80 per cent were in favour. New clinical negligence system proposed A new system for handling cases of clinical negligence in the NHS has been proposed by the Government's chief medical officer. In his report Making Amends, Sir Liam Donaldson recommends the creation of A new NHS Redress Scheme to speed up the clinical negligence. Under the plans, a national body building on the work of the NHS Litigation Authority will administer the redress scheme offering remedial treatment, rehabilitation and care where needed; explanations and apologies; and financial compensation where appropriate. Under the proposals, the redress scheme will be initially applied to NHS hospitals and, if successful, the Department of Health will consider extending it to primary care. A period of consultation will now follow until October after which a definitive statement of policy will be issued. The full report is at www.doh.gov.uk/makingamends Advances in genomics and in genetic technology will clearly make a difference to health care. Increased understanding of the molecular and genetic basis of disease will alter how we categorise, seek to prevent and treat a wide variety of disease. The timescale and magnitude of this change is uncertain. But, over time, genetics will become increasingly relevant to virtually all clinical areas and across primary, secondary and tertiary care. The genetics White Paper Our inheritance, our future - realising the potential of genetics in the NHS was launched on 24 June. It sets out a comprehensive plan that will help the NHS prepare the ground so that patients can benefit from future advances in genetics. Text of the full White Paper and executive summary are available at www.doh.gov.uk/genetics/whitepaper.htm Contact: geneticswhitepaper@doh.gsi.gov.uk Or Diana Paine on 0207 972 5864 Diana.Paine@doh.gsi.gov.uk or Dr Alison Hill on 0207 972 5380 alison.p.hill@doh.gsi.gov.uk A £165 million investment programme in new cancer equipment has been launched, alongside a £50m drive to eliminate long waits for NHS orthopaedic patients. National cancer director Professor Mike Richards has sent a report on cancer investment to ministers. The report shows that while there was a shortfall in cancer investment in 2001-2002, this was corrected in 2002-2003 in line with the commitments set out in the NHS Cancer Plan. Details at www.doh.gov.uk/cancer/index.htm or contact Simone Bayes on 020 7972 4765 or at simone.bayes@doh.gsi.gov.uk The funding for NHS orthopaedic services will be used to modernise operating theatres and buy new equipment. Children under 18 should not be treated with the drug Seroxat (paroxetine), the Medicines and Healthcare Products Regulatory Agency (MHRA) has warned. MRHA recently launched an inquiry into antidepressant drugs. New evidence shows there has been an increase in the rate of self harm and potentially suicidal behaviour among teenagers when Seroxat is used to treat their depression. More at www.mhra.gov.uk Disease secretariats transferred The Secretariats of the UK Advisory Panel for Health Care Workers Infected with Blood-Borne Viruses (UKAP) and of the Creutzfeldt-Jakob Disease Incident Panel have recently both been transferred from the Department of Health to the new Health Protection Agency (HPA). Further information including contact details can be found at www.doh.gov.uk/cjd This information should be forwarded specifically to: occupational health teams, infection control teams, microbiologists, neurologists, neuro-surgeons and ophthalmic surgeons. Phased roll-out of recombinant clotting factors A working group has been established by the Department of Health to advise on the phased introduction of recombinant clotting factors for the treatment of haemophilia patients. Details are at www.doh.gov.uk/blood/rcfwg or contact Zubeda Seedat on 020 7972 5143 or zubeda.seedat@doh.gsi.gov.uk Public health alert on gonorrhoea Chief medical officer Sir Liam Donaldson has issued a public health alert on the implications of the increase in ciprofloxacin-resistant gonorrhoea. More at www.doh.gov.uk/publich.htm New waiting, booking and choice information online New information on waiting, booking and choice has been added to the Department of Health's website. This section sets out the vision and strategy for delivering the reforms needed to ensure patients obtain faster and more convenient access to health care. The website highlights some of the tools available to managers and gives examples of trusts who are making real strides in giving their patients a better experience of NHS services. It is at www.doh.gov.uk/waitingbookingchoice Functions formerly performed by regional junior doctors' action teams were mainstreamed into strategic health authorities on 1 April. It is important to note that responsibilities now include appropriate participation in the appeals mechanism described in the terms and conditions of service, as well as in the twice-yearly monitoring returns. It is essential that these tasks are carried out so that the NHS can meet its contractual responsibilities to junior doctors. A letter explaining the necessary action is at www.doh.gov.uk/juniordoctors Further details from Mike Beattie on 0113 254 5711 or at mike.beattie@doh.gsi.gov.uk This report sets out the background, process and outcomes of the testing of a four-tier model for the delivery of diagnostic and therapeutic radiography services. Details available at www.doh.gov.uk/radiography/skillsmix-june03.htm Review of thrombolysis targets The Department of Health has published a review of the Coronary Heart Disease National Service Framework thrombolysis targets. The document confirms the importance of early thrombolysis and outlines the success of the NHS in delivering faster treatment. It also provides a checklist of good practice developed by the CHD Collaborative and emphasises the need for NHS ambulance services and acute hospitals to work even more closely to secure better and faster care for heart attack patients. The review is available at www.doh.gov.uk/heart/thrombolysis/review Audit of patient care following a heart attack The second report of an audit on the care of patients who have been taken to hospital in England following a heart attack was published by the Royal College of Physicians (RCP) on 18 June. The results in this second MINAP (Myocardial Infarction National Audit Project) report cover the period 2002-2003. The full results are at www.rcplondon.ac.uk/pubs/books/minap/ Screening for haemoglobinopathies The NHS Plan set out a commitment to new and effective screening programmes for women and children including a new national linked antenatal and neonatal programme for haemoglobinopathies. A development programme is in place and is consulting on a number of processes for the screening of newborn babies for sickle cell disorders and women for sickle cell disorders and thalassaemia in the antenatal period. For details of the consultation go to www.kcl-phs.org.uk/haemscreening and click on 'consultation' at the bottom left of the page. Further details from josephine.taylor@doh.gsi.gov.uk Developments on ambulance services A letter sent to ambulance services detailing the support being developed and actions taken in this area by the Department of Health and NHS Modernisation Agency is at www.doh.gov.uk/emergencycare Intermediate care and community equipment - change to charging regime Part II of The Community Care (Delayed Discharges etc) Act 2003 came into force on 9 June. New regulations mean that social services departments can no longer charge for intermediate care services (for up to six-weeks, after which the old charging regime applies), minor adaptations costing £1,000 or less and for community equipment. This will improve access to services and make integration of these, and similar NHS services in pooled budgets, easier. Access to integrated services should support older people to remain living in their own home and contribute to effective discharge from hospital. LAC(2003)14 Changes to Local Authorities Charging Regime for Community Equipment and Intermediate Care Services and Qualifying services regulations (intermediate care and community equipment) are at www.doh.gov.uk/jointunit/delayeddischarge/ under 'legislation'. Further details from steve.hards@doh.gsi.gov.uk The Government intends to extend the life of community health councils until 1 December 2003 rather than 1 September. Details are available at www.doh.gov.uk/involvingpatients/index.htm or contact Eileen Exeter on 0113 254 6096 or David Mowat on 020 7210 5995 National Patient Safety Agency (NPSA) video The NPSA is launching a new patient safety induction video, the first of a series of tools being developed to promote safer healthcare in the NHS. The video provides a practical introduction to patient safety and an insight into how each staff member responsible for delivering care can contribute to a safer environment. The video is intended for use in staff induction programmes to raise awareness of patient safety issues. Details at www.npsa.nhs.uk/news/allNews.asp or contact Stella Zeggeon on 020 7927 9561 Prison health development network This network has now been established. Details and a full membership list are available at www.doh.gov.uk/prisonhealth/development-network.pdf Independent review of coroner services The report Death Certification and Investigation in England, Wales and Northern Ireland, was published on 4 June. It is at www.official-documents.co.uk/document/cm58/5831/5831.htm The Cabinet Office has published an interim review on civil emergencies at www.ukresilience.info/contingencies/dwd/index.htm NATIONAL STANDARDS AND GUIDANCE Occupational health smart cards (OHSC) The OHSC system for hospital doctors in training is now 'live' in the deanery areas of London; Kent, Surrey, Sussex; Wessex; South Western; Mersey; Yorkshire; North Western and Northern. Installations in West Midlands, Oxford and the Trent areas are all imminent and remaining hospital trusts will be covered by March 2004. The induction of new doctors in August gives employing trusts an ideal opportunity to capture photographs for doctors currently awaiting card issue. Your trust induction programme should reflect that requirement, together with a procedure for updating existing cards for the new intake. Guidelines and information leaflets on local handling are at www.doh.gov.uk/hrinthenhs under Occupational Health Smart Cards (OHSC). For more information contact barbara.levy@doh.gsi.gov.uk The booklet What To Do If You're Worried A Child Is Being Abused has been developed to assist practitioners to safeguard and promote the welfare of children. It also contains an appendix covering the legal issues affecting exchange of information. It is targeted at all those who have contact with children and their families in their work. The full booklet should be issued to all child protection named and designated professionals, with the summary distributed to all other relevant staff. These are available at www.doh.gov.uk/safeguardingchildren/index.htm or obtained in hard copy at 08701 555455. Further information is also available from the Victoria Climbié Inquiry response team on 020 7972 4977. A new dedicated website now exists to support modernisation of primary care out-of-hours (OOH) services. Published on this website is information which explains the statutory framework for OOH modernisation and the responsibilities of strategic health authorities, PCTs and OOH providers. The site is at www.out-of-hours.info/ Contact: mark.cockerton@out-of-hours.info Amendments to directions for PMS pilots Implementation of Pilot Schemes (Personal Medical Services) (Amendment) (no. 2) Directions 2003 came into force on 5 June. The above amendment gives directions to existing or new PMS pilots on the employment of an independent nurse prescriber or a supplementary prescriber under a PMS pilot scheme. The amendment permits PMS pilots operating within specified PCT repeatable prescribing areas to include repeatable prescribing within existing or new PMS pilots. More at www.doh.gov.uk/nhsrepeatdispensing/ For further information on supplementary prescribing contact mike.garley@doh.gsi.gov.uk Guidance on safe working with CJD and BSE Revised guidance for healthcare and laboratory workers on safe working with transmissible spongiform encephalopathies (TSEs) such as Creutzfeldt-Jakob Disease (CJD) and bovine spongiform encephalopathy (BSE) has been published. The guidance is from the Advisory Committee on Dangerous Pathogens and
the Spongiform Encephalopathy Advisory Committee and should be read by
those concerned with, or responsible for, the management of work that
involves a risk of exposure to TSE infectivity. It should also be read
by those with responsibility for infection control and for the re-processing
of medical devices. Overview and scrutiny of health guidance Guidance to support the local authority overview and scrutiny powers to review health services is now available. It outlines the legal powers for local authority overview and scrutiny committees, the duties on the NHS to support those powers and offers good practice guidance on undertaking the scrutiny process in the context of health and health services. A guidance note is also included which gives advice on undertaking scrutiny of substantial changes to health services, prior to the abolition of community health councils. The guidance is available at www.doh.gov.uk/involvingpatients/scrutinyofhealth-guidance.pdf Guide for disabled people and carers The Department of Health publication - A Practical Guide for Disabled People or Carers - has been revised and updated. It is available at www.doh.gov.uk/disabledguide/ or free from doh@prolog.uk.com NHS Information Authority healthcheck A new online high level efficiency and performance toolkit for all NHS organisations is now available. Register at www.nhsia.nhs.uk/phsmi/ohc/ SAFETY NOTICES MDA/2003/016 - medical gas regulators and flowmeters Further information at www.mhra.gov.uk
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