30 June - 6 July 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...


  • New RCGP Membership Package for Trainees
  • DH Review of NHS Care Over the Next Decade
  • Planning and Design Guidance for Primary Care Premises
  • Analysis of Medication Incidents and Patient Safety in the NHS

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


Professional

News

New RCGP Membership Package for Trainees

 

The RCGP has issued details of a new membership package, available to GP trainees from August 2007. Individuals who join the College as Associates in Training (AiTs) – a new membership category – will gain access to a wide range of RCGP resources, to help them through the GP Specialty Training Programme. They will be able to choose from one of four AiT packages, three which correspond to the level at which CCT applicants enter the training programme – year one (ST1), year two (ST2) or year three (ST3) – and one aimed at doctors applying for certification under Article 11. All the AiT packages will include:

  • Access to the e-Portfolio (a web-based learning log, where doctors can record the evidence needed for the Workplace-Based Assessment (WPBA) part of the nMRCGP)
  • A 10% discount on the Applied Knowledge Test / Clinical Skills Assessment (AKT/CSA) components of the new exam
  • Certification services (excluding those applying under article 11)
  • Subscription to a new journal for GP trainees based on the GP curriculum.
  • Subscription to the British Journal of General Practice (BJGP)

For further information and advice please contact the AiT hotline on 0207 344 307 or email ait@rcgp.org.uk.

 

NHS Care Over the Next Decade

 

The Government has announced a review of the NHS, aimed at identifying how the service can meet the challenges that lie ahead. The new Parliamentary Under Secretary of State for Health, Professor Ara Darzi, will lead the investigation and report findings before July 2008. The key areas for consideration include the involvement of NHS staff to ensure that clinical decision-making is at the heart of the service; improving patient care though joined-up services for those suffering long-term or life-threatening conditions; and delivering more accessible, convenient care, integrated across primary and secondary providers. Following the review, the Government will consider the case for a new NHS Constitution.

 

Applicants Sought for General Practice Research Award

 

The RCGP’s Scientific Foundation Board (SFB) is seeking applicants for its research awards, offered to those undertaking research projects on the care of patients in the general practice setting. The Board recently partnered with Heart Research UK and Roche Products Limited, and is particularly keen to support work in the field of cardiovascular disease; Chronic Kidney Disease (CKD); the management of obesity; and Osteoporosis. The closing date for the latest round of submissions is 31 July 2007. Grants awarded will not exceed £10,000.

 

Application Form (RCGP Website)

 

Prizes for Innovation in General Practice

 

The College offers a variety of awards to recognise and encourage innovation in general practice, and is now seeking applicants for the following prizes:

  • Patient Participation Award: recognises work in the development of patient participation in general practice in the UK. Submissions are accepted from any member of the practice team, patient group, or patient of a practice. The prize – up to the value of £3,000 - is to be used to benefit the patients of a practice or to further patient participation. The closing date for entries is 31 July 2007.   
  • GP Registrar Awards: offered for original and innovative work undertaken during the course of specialty training in the UK. Prizes range between £400 and £1,000 and are available annually for high quality work. The closing date for entries is 31 July 2007.
  • Paul Freeling Award: recognises GP educationalists who have developed new methods or ‘gone the extra mile’ to deliver high quality personal teaching to young doctors preparing for careers in general practice. The annual prize of up to £1,000 is open to Members or Fellows of the College in good standing. The closing date for entries is 31 August 2007.

RCGP Awards (RCGP Website)

Guidance

Planning and Design Guidance for Primary Care Premises

 

A new resource to help individuals involved in the planning, briefing and design of primary care premises has been created by NHS Estates. The website identifies the key considerations and actions that should be taken into account when building, and gives some guidelines on funding, procurement and design. The information is organised under the following headings: understand the national policy framework; prepare your Strategic Service Development Plan (SSDP); organise your procurement plan; develop your project brief; and establish your detailed design brief. The website replaces preceding information including the ‘HBN 36 - Local healthcare facilities' document and the 'SFA (Red Book)’.

 

Primary and Social Care Premises: planning and design guidance (NHS Estates Website)


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Clinical

Announcements

College Response to Dementia Report

 

A review of dementia services in England has been published by the National Audit Office (NAO), highlighting that the illness has not been given the priority status it deserves within the NHS and the DH. It reports that early identification and intervention are known to be cost-effective, yet between 33-50% of patients never receive a formal diagnosis. Two thirds of the GPs surveyed for the report felt it was important to look for early symptoms of dementia but only 31% felt they had enough training to diagnose and manage the disease. The document made a number of recommendations including the need to improve the management of services and support in the community. It also called on the Royal College of Psychiatrists and the RCGP to take the lead in developing a multi-professional protocol for diagnosis and early intervention of suspected dementia.

 

Improving Services and Support for People with Dementia (National Audit Office)

 

The College will be studying the recommendations of this report and will take steps to improve educational and clinical support for GP practices through its Continuing Professional Development scheme - which will cover important topics including dementia - and through its newly established Clinical Innovation and Research Centre. RCGP Chair Professor Mayur Lakhani said, “As a practising GP, I have seen first hand the distressing nature of dementia and its devastating impact not only on the patient, but also their family. GPs are on the side of patients here but are hampered by a lack of good and readily available services for patients and carers, which is the real issue. We disagree with the report’s interpretation that GPs’ own attitudes are a barrier to better care. We think this is overstating the case. GPs maintain a register of patients with dementia and use memory tests where this is clinically indicated, but dementia poses particular diagnostic challenges in the early stages. However, we agree that the health and social care system collectively needs to do much more and that there is considerable scope for improvement.”

 

Many Patients with Heart Failure Undiagnosed

 

A comprehensive review of heart failure services in England, conducted by the Healthcare Commission, has shown that whilst provisions have improved in recent years, many patients go undiagnosed. The document reports better access to diagnostic services and key treatments; wider availability of specialist heart failure services and guidelines on services; more consideration of end-of-life needs; and more comprehensive education and support arrangements. However, it calls for commissioners and providers to work together in local communities to ensure that all patients with heart failure are identified.

 

“PCTs and GPs need to monitor the number of patients they deal with in comparison to national statistics.  Symptoms and treatments need to be recorded and followed up by GPs. The care provided also needs to be audited so lessons can be learnt and improvements made”, said Anna Walker, Chief Executive of the Healthcare Commission, in response to the findings.

 

Pushing the Boundaries: improving services for patients with heart failure (Healthcare Commission Report)

Guidance

Analysis of Medication Incidents and Patient Safety in the NHS

 

A detailed analysis of NHS medication incidents, reported between January 2005 and June 2006, has been issued by the National Patient Safety Agency (NPSA). It describes the types of medication incidents that can be prevented and includes examples of cases which have caused severe harm to patients. Section five of the report reviews medication incidents in the community. Seven priorities for action to improve the safe use of medicines are identified including:

  • Improving staff skills and competences
  • Minimising dosing errors
  • Ensuring medicines are not omitted
  • Making sure the correct medicines are given to the correct patients
  • Documenting patients’ medicine allergy status

Safety in Doses: medication safety incidents in the NHS (Patient Safety Observatory)


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England

Announcements

Assessing and Managing Risk Among Mental Health Service Users

 

Guidance on the assessment and management of risk among mental health patients has been published by the DH. The framework focuses on three main areas - violence (including antisocial and offending behaviour), self-harm and suicide, and self-neglect – and outlines a number of tools to enable professionals to implement best practice when dealing with these issues.  

 

Best Practice in Managing Risk (DH Document)


In a separate but related development, the DH has published a report, conducted by the market research company Taylor Nelson Sofres (TNS), examining people’s thoughts on mental illness, comparing data collected during 1994-2007. The latest findings showed no significant changes in the proportion of people consulting a GP over mental illness. People aged 45-54 were found to be the most likely to consult their GP over such issues, whilst those aged 65-74 were the least likely to seek advice on mental health problems.

 

Attitudes to Mental Illness 2007  (DH Report)

 

Effective Practice Based Commissioning: case studies

 

Two case studies, showing how Practice Based Commissioning (PBC) helped clinicians meet the 18 week target from GP referral to the start of treatment, have been issued by the DH.

 

Practice Based Commissioning and 18 Weeks: how to create win-wins (DH Leaflet)

Parliamentary News

New Ministerial Team at the DH

 

The DH’s new Ministerial Team has been appointed and comprises the following individuals:

  • Rt Hon Dawn Primarolo (Minister of State): was Paymaster General between 1999 and 2007, after being Financial Secretary to the Treasury.
  • Ben Bradshaw MP (Minister of State and Minister for the South West): previously Minister of State at Department of Environment, Food and Rural Affairs
  • Professor Sir Ara Darzi (Parliamentary Under Secretary of State): a surgeon specialising in the field of minimally invasive and robot-assisted surgery
  • Ann Keen MP (Parliamentary Under Secretary of State): formerly Parliamentary Private Secretary to the Chancellor of the Exchequer
  • Ivan Lewis MP (Parliamentary Under Secretary of State): continues his junior ministerial post at the DH, which he has held since May 2006

Mental Health Bill Passed with Main Government Proposals

 

The new Mental Health Bill completed its passage through Parliament on 4 July with all the main government proposals intact. It makes several improvements to previous legislation including new powers to place patients on Community Treatment Orders (which ensures they comply with their treatment). It also strengthens patients' rights by providing advocacy support for anyone detained and requires children and young people to be treated in an environment that is suitable for their age.


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Wales

Announcements

Guidance on Screening NHS Workers for Communicable Diseases
 

Guidance on screening new NHS health care workers for tuberculosis (TB), hepatitis B, hepatitis C and HIV has been issued by the Welsh Assembly. Staff new to the service will be tested for tuberculosis and hepatitis B, and offered vaccinations if required. Whilst individuals undertaking ‘exposure prone procedures’ that carry an increased risk of cross infection (such as surgery) must be cleared for hepatitis C and HIV.

 

Screening Measures for New Healthcare Workers (Welsh Assembly Press Release)

 

Action to Improve Care for Diabetic Children

 

Whilst the management of children and young people with Type 1 Diabetes is of a high standard in Wales, problems arise during the transition from paediatric to adult care. New Government guidelines address this issue; and also provide advice on the most effective way to plan and deliver Type 1 Diabetes services to young people.

 

Guidelines to Improve Care for Diabetic Children (Welsh Assembly Press Release)

Parliamentary News

Fairer Compensation System for NHS Patients

 

Health Minister, Edwina Hart, unveiled proposals to simplify the NHS redress process, making the system more coherent and accessible for patients seeking compensation for clinical negligence. The measure will also enable NHS bodies to remedy their own mistakes and learn from them. The new system will not be compulsory, so patients will have the option of settling through the new process or taking legal action.

 

NHS Redress Measure (Welsh Assembly Press Release)


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Scotland

Announcements

Care of Mental Health Patients Involved in Substance Abuse

 

A review of the available guidance on the care and support of patients with co-occurring substance misuse and mental health problems has been published for consultation by the Scottish Executive. In 2006, Ministers established an Advisory Group to review and update available guidance, and provide practical recommendations on improving services for this group and their families. They found that service users felt GPs and Primary Health Care professionals had an important role to play in their care. The report makes a number of recommendations, including the following set that are specifically aimed at primary care:

  • Screening procedures for co-morbidity should be put in place, with appropriate responses for the identification of problems in general practice and across Primary Care.
  • An Enhanced Service for Alcohol Misuse should be developed.
  • Individuals with co-morbid disorders should have equal opportunities to accessing mainstream psychological therapies in Primary Care.
  • Individuals with mental health problems and severe substance misuse problems should have the same commitment to chronic disease management as individuals with other chronic disorders.

This consultation closes on the 13 September 2007.

 

Delivering for Mental Health Mental Health and Substance Misuse (Scottish Executive Document)


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Northern Ireland

Announcements

No announcements.

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Email: info@rcgp.org.uk
Tel: 020 7581 3232 ext: 240

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