27 November - 3 December 2007 

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A Weekly Bulletin of Professional News, Guidance and Policy for Primary Care

Professional Clinical England Wales
Scotland Northern Ireland


Word Version

Headlines...


  • College Member Sought for RCGP International Committee .....
  • Conference on Sexual Health and Contraception in General Practice .....
  • Improving Out-Of-Hours Reporting Of Abnormal Test Results .....
  • Core Skills for Practice Management .....

Guidance featured in Seven Days is uploaded weekly to the RCGP Non-Clinical Guidance Database for General Practice.


Professional

News

Increased Testing for Sexually Transmitted Infections (STIs) in General Practice

 

According to a Health Protection Agency (HPA) report, the prevalence of HIV has increased to 73,000, despite encouraging developments in the prevention of sexually transmitted infection (STI). Findings show a third of those infected with HIV remain undiagnosed; that the historical concentration of HIV cases in London is now less apparent (following a major shift in the geographical distribution of infected persons over the past decade); and a steady increase in heterosexual transmission has taken place (especially in the black ethnic minority groups). Evidence of increased STI testing in general practice is noted, along with the need for better data collection to monitor screening in primary care.

 

Testing Times - HIV and Other Sexually Transmitted Infections in the UK (HPA Publication, 2007)

Commenting on the report, Dr Ewen Stewart, chair of the RCGP Sex, Drugs & HIV Task Group, said: “GPs have an important role in increasing levels of HIV testing in the population. In order to do this, we need to be pro-active about raising the issue with people who may have been at risk and then carrying out the test in general practice”. The Group has produced resources – including a Blood Borne Virus (BBV) Testing Proforma - to help GPs carry out HIV testing.

 

Conference on Sexual Health and Contraception

 

The RCGP Sex, Drugs and HIV Task Group is holding a one day conference to help practitioners improve sexual health services in primary care. It will provide advice, information and the opportunity to discuss many important issues. Topics include the HPV vaccine, supporting women with unplanned pregnancy, diagnosing HIV, genital dermatology, and young people and sexual health. It takes place at the Burlington Hotel, Central Birmingham, on 1 February 2008. For more details contact kosborn@rcgp.org.uk or call 01264 366872.

 

College Member Sought for International Committee

 

The RCGP International Committee is seeking to appoint a College Member to support its overseas activities. Duties include participating in three meetings each year (plus occasional smaller group meetings); providing practical support to assist with the delivery of services; and responsibility for particular international programmes. The appointment would be for three years in the first instance - and applicants should be active in general practice and able to demonstrate an interest in international relations. For further information, contact Claire Burden, International Manager, at cburden@rcgp.org.uk or on 0207 344 3141.

Guidance

Improving Out-Of-Hours Reporting Of Abnormal Test Results

 

The Royal College of Pathologists (RCPath) and the RCGP have published advice to improve the reporting of abnormal test results out-of-hours. It was issued in response to instances where laboratory staff have been unable to contact an appropriate GP regarding unusual results; and recommends that:

  • GPs who request tests must provide sufficient patient and clinical information to enable effective communication between the lab and the out-of-hours provider.
  • Stakeholders should work together, at local level, to ensure good communication during this period.
  • PCTs must inform the laboratory of arrangements for making contact with a GP out-of-hours.
  • Engagement and dialogue must be promoted across the whole local urgent care network.

Out-of-Hours Reporting of Abnormal Laboratory Test Results to Primary Care (RCPath and RCGP Publication)

 

Core Skills for Practice Management

 

The NHS Alliance has published a report - the Nuts and Bolts of Practice Management – outlining the core skills and knowledge required by Practice Managers to successfully run the surgery. It contains sections on the basic principles of business; re-shaping services through initiatives (such as Practice Based Commissioning); and working with patients. It was written by Practice Managers and copies can be downloaded from the Alliance website or obtained from admin@nhsalliance.org (a fee of £10 will be charged to non-Alliance members).

 

A Practice Managers Network has also been established by the Alliance, to help influence policy and procedure in the NHS by working with the DH and Government. For further information, contact w.evans@nhsalliance.org.


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Clinical

News

Tackling Delays in Cancer Treatment

 

A comprehensive five year plan to improve NHS cancer services has been announced by Health Secretary, Alan Johnson. It will focus on prevention, faster treatment, extended screening, fast-track drug approval and extended services to increase the number of cancer survivors. In particular, the Government will investigate delays at the GP stage of cancer treatment.

 

Comprehensive Strategy for NHS Cancer Services (DH Press Release)

Guidance

Treating Primary Hypercholesterolaemia with Ezetimibe

 

NICE has issued guidance on the use of ezetimibe to treat primary hypercholesterolaemia (high concentrations of cholesterol in the blood) and recommends that it should be:

  • Taken on its own by patients who would normally be given a statin but can not due to contraindications or intolerance
  • Co-administered with initial statin therapy, where cholesterol is not controlled after an increase in the initial statin dose, or where an increase is limited by intolerance

This advice should be read in conjunction with existing guidance on the initiation of statin therapy (NICE technology appraisal guidance 94) and other relevant NICE clinical guidelines.

 

Ezetimibe for Primary Hypercholesterolaemia (NICE Guidance)

 

Use of Inhaled Corticosteroids to Treat Chronic Asthma in Children

 

NICE has also issued advice on the use of inhaled corticosteroids (ICS) for the treatment of chronic asthma in children under the age of 12. It recommends that:

  • If an ICS is considered appropriate - the least costly product, suitable for an individual child, is recommended.
  • If an ICS and a long-acting beta-2 agonist are considered appropriate - the use of a combination device is a recommended
  • option. Decisions on its use, or the use of two agents in separate devices, should be made on an individual basis (taking into consideration therapeutic need and the likelihood of treatment adherence). If a combination device is chosen, the least costly, that is suitable for the individual child, is recommended.

Inhaled Corticosteroids for the Treatment of Asthma in Children Under the Age of 12 (NICE Guidance)

 

Reducing Errors When Dispensing Medicines

 

The National Patient Safety Agency (NPSA) has issued two booklets to help reduce human error when dispensing medicines. They focus on key areas known to contribute to mistakes – dispensary design and layout; and the presentation of information (particularly on dispensing labels). Each publication makes a number of recommendations and provides practical examples of how to put these into practice.

 

Guide to the Design of Dispensed Medicines (NPSA Booklet)
Guide to the Design of the Dispensing Environment  (NPSA Booklet)

 

Fire Risk With Paraffin-Based Skin Products

 

The NPSA is also alerting healthcare staff to the potential fire risk when prescribing, dispensing or administering paraffin-based skin products. Bandages, dressings and clothing in contact with these products are easily ignited with a naked flame or cigarette. It calls for doctors to inform patients about the potential risks when treatment is first prescribed.

 

Fire Hazard with Paraffin-Based Skin Products on Dressings and Clothing (NPSA Rapid Response Report)

 

Parent Guide to Childhood Immunisations

 

Information on immunisations required up to the age of 13 months - especially those administered at two, three and four months of age – has been issued by the DH. It contains answers to common questions; information on the childhood immunisation programme; and a description of the signs and symptoms of meningitis and septicaemia.

 

A Guide to Immunisations Up to 13 Months of Age (DH Publication)


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England

Announcements

Preventing the Spread of Viruses During Flu Season

 

“Catch It, Bin It, Kill It” is a new DH campaign, aimed at encouraging the public to practise correct respiratory and hand hygiene when coughing and sneezing, ultimately preventing the spread of viruses during the colds and flu season. It will run until spring 2008 and A4 posters publicising the campaign will be distributed to GP surgeries, hospitals and NHS Walk-in Centres.

 

Catch It, Bin It, Kill It - Respiratory and Hand Hygiene Campaign, 2007-2008 (DH Website)

Parliamentary News

New Inquiry on Health Inequalities

 

The Commons Health Select Committee has launched a new inquiry, examining the NHS’ contribution to reducing health inequalities, particularly through primary care and public health services. It will focus on several areas, including the Quality and Outcomes Framework and Practice-based Commissioning. Comments should be sent to healthcommem@parliament.uk by 9 January 2008.

 

Health Inequalities Inquiry - Terms of Reference (UK Parliament Website)

 

Recognising Allergy in the Early Stages

 

The Government has welcomed the House of Lords Science and Technology Committee report on allergy (published 26 September 2007), highlighting its commitment to helping alleviate the burden of allergic disorders. In particular, it outlined the need for GPs and other primary care professionals to have sufficient clinical knowledge and support systems to recognise allergy in the early stages; and be to differentiate between serious allergies requiring specialist interventions and those that can be managed in primary care.

 

Government Response to the House of Lords Science and Technology Committee Report on Allergy (The Stationery Office)


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Wales

Announcements

Information Sharing between GP Practices and Out-of-Hours Medical Staff

 

An initiative which has improved information sharing between GP practices and local out-of-hours providers in Gwent is to be extended to north-west Wales and south-west Wales. The scheme enables patient information, held on GP practice computer systems, to be viewed by on-call medical staff. Roll-out to the rest of the country will take place incrementally.

 

Electronic Health Record Improves Out-of-Hours Care in Wales (National Public Health Service for Wales Website)

 

Launch of Stop Smoking Services

 

A free support programme to help people quit smoking has been launched by Chief Medical Officer, Dr Tony Jewell. “Stop Smoking Wales” - formerly the All Wales Smoking Cessation Service – offers local weekly meetings and information on topics such as nicotine replacement therapy and other pharmaceutical alternatives. The scheme is to receive extra funding from the Welsh Assembly Government and will expand its services in specialist areas such as maternity and mental health. For further information visit www.stopsmokingwales.com or call 0800 0852219.

 

Launch of Stop Smoking Wales (National Public Health Service for Wales Website)

 

New Health Encyclopedia for Welsh Speakers

 

NHS Direct Wales has translated its online English Health Encyclopaedia into the Welsh language - offering information on over 650 health conditions and advice on when to seek medical help.

 

Welsh Health Encyclopedia (NHS Direct Wales Website)


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Scotland

Announcements

Views Sought on Asthma and Head Injury Guidelines

 

The Scottish Intercollegiate Guidelines Network (SIGN) has published two pieces of draft guidance for consultation this week. The first is an update of the “British Guideline on the Management of Asthma”, developed by SIGN and the British Thoracic Society, and first published in 2003. Three sections have been revised - diagnosis, pharmacological management and non-pharmacological management – and a new section on managing difficult asthma has been added. Views are sought on the evidence base supporting the recommendations and comments should be sent to gaynor.rattray@nhs.net by 7 January 2008.

 

British Guideline on the Management of Asthma (SIGN Guidance)

 

The second piece of draft guidance is on the early management of patients with a head injury and replaces the previous version published in 2000 (known as SIGN 46). It takes into account recent developments in this area and contains sections on assessment and classification; referring patients to hospital (highlighting advice for GPs in remote and rural areas); the principles of management; and follow up care. Comments should be sent to roberta.james@nhs.net by 7 January 2008.

 

Early Management of Patients with a Head Injury (SIGN Guidance)

 

Increase in Infectious and Sexually Transmitted Diseases
 
Information Services Division (ISD) Scotland has published three sets of statistics this week. The first looks at notifiable infectious diseases - showing an increase in the number of children with measles and rubella and a fall in the number of cases of mumps. The second notes that sexually transmitted diseases (STDs) continue to rise; and the third reports good progress in the uptake of long acting reversible contraception (LARC) - although overall rates are still low.

 

Notifiable Infectious Diseases (ISD Scotland Publication)
Sexually Transmitted Infections and Other Sexual Health Information (ISD Scotland Publication)
LARC Uptake, 2003/2004 – 2006/2007 (ISD Scotland Publication)

 

Report on NHS Checks for Overseas Staff

 

NHS Boards have a high level of compliance with pre-employment screening procedures for staff recruited from outside the European Economic Area (EEA). Findings from the Auditor General for Scotland show the percentage of personnel files containing proof of pre-employment checks ranged from 90-99%.

 

Overseas Staff in the NHS – Pre-Employment Checks (Audit Scotland Publication)

 

Increase in the Number of Dispensing Practices

 

Following a request under the Freedom of Information Act, ISD Scotland has released data to the Dispensing Doctors’ Association (DDA), which shows an increase in the number of dispensing practices from 127 to 130.

 

Dispensing Practices in Scotland (DDA Press Release)


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Northern Ireland

Parliamentary News

Views Sought on Draft Healthcare Budget

 

Health Minister, Michael McGimpsey, is meeting with frontline health service staff to hear their views and concerns about the draft budget. In a series of meetings, which will be held in the run-up to Christmas, the Minister will listen to comments from staff involved in different areas of the service, including primary and community care.

 

Minister to Consult with Frontline Healthcare Staff on Draft Budget (DHSSPS Press Release)


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