30 October - 12 November 2007 

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

Professional Clinical England Wales
Scotland Northern Ireland


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Headlines...


  • College Response to Fitness to Practise Consultation .....
  • Early Diagnosis of Psychosis in Young People .....
  • Editors and Authors Sought for RCGP e-Learning Project .....
  • Arrangements for the GP Patient Survey 2008 in England .....

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


Professional

News

College Response to Fitness to Practise Consultation

 

The RCGP has opposed the change in the standard of proof (from criminal to civil) in its response to the GMC’s Fitness to Practise consultation. Although it welcomes the opportunity to comment on the draft guidance, it is disappointed that there has been no debate on this issue, and re-iterates its response to the Shipman Inquiry:

 

“It is our view that any decision that could deny a doctor his/her livelihood, or severely restrict his/her ability to do so, should have the higher test (i.e. criminal standard) attached to it. This is based on the concept that the procedures should be tested against the criteria of proportionality and fairness to the doctor and the public.”

 

Fitness to Practise Consultation (GMC Website)

 

Early Diagnosis of Psychosis in Young People

 

Guidance to help practitioners achieve earlier diagnosis of psychosis in young people has been launched by the RCGP and the Royal College of Psychiatrists. It lists key symptoms which may signal the onset of psychosis, with the aim of facilitating a smoother pathway between primary care practitioners and mental health specialists. Recent research has highlighted that early symptom recognition can reduce progression to psychosis, and in some cases prevent the onset of a disabling psychotic illness.

 

Early Detection in Psychosis (Guidance on the NIMHE Website)

Editors and Authors Sought for RCGP e-Learning Project

 

The RCGP is seeking editors and authors to produce a set of e-learning modules to help GP trainees with the new curriculum and assist family doctors with Continuing Professional Development (CPD). Each module will be based on one of the GP curriculum statements and will be developed in partnership with e-Learning for Healthcare. The project is being lead by Dr Bill Reith, Chair of the Postgraduate Training Board, and Dr Adrian French, Clinical Project Lead. For further information contact Kate Tunnicliffe at postgraduatetraining@rcgp.org.uk.

Consultation on Managing Staff Sickness and Ill-Health Retirement

 

A consultation on proposals to manage NHS staff sickness and ill-health retirement has been launched by NHS Employers and NHS trade unions. Proposals include a framework to support employers in managing sickness absence and covers structured review processes, rehabilitation, phased return, redeployment, occupational health support, and monitoring. The deadline for comments is 21 January 2008 and feedback should be submitted on a dedicated online response form.

 

Staff Sickness and Ill Health Retirement Benefit (NHS Employers Press Release)

 

New Health and Social Care Regulator Announced in Queen’s Speech

 

The creation of a new regulator - with a remit to ensure clean, safe, high-quality services - has been announced in the Queen’s speech. The Care Quality Commission - also known as Ofcare - will cover adult social care as well as health services; and will bring together some functions of the existing Healthcare Commission, the Commission for Social Care Inspection and the Mental Health Act Commission. Bills to reform the regulation of human embryology and to improve services for vulnerable children and young people were also announced.

 

Queen's Speech Transcript (10 Downing Street Website)

General Practice Key to Future Success of NHS

 

“The future of the NHS is likely to depend on what happens with general practice” writes Professor Roger Jones, FRCGP, in the November editorial of the British Journal of General Practice (BJGP). He calls on the Government and its advisors to appreciate the important role general practice has in demand management and cost containment. Professor Jones works at the Department of General Practice and Primary Care at King’s College London.

 

Dismantling General Practice (BJGP Article: Vol 57:860-861)

 

Call for Doctors to Provide Ethnicity Data

 

The GMC is compiling ethnicity data about all doctors practising in the UK, to ensure it fulfils its statutory duties and responsibilities under the Race Relations Act and other important legislation. It is calling on practitioners to provide information on their ethnicity (which will remain confidential) for use in diversity data analysis.

 

Ethnicity Data Collection Leaflet (GMC Press Release)


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Clinical

News

NICE Welcomes New Topic Referral

 

NICE has welcomed the referral of additional topics by the Secretary of State for Health for its forward work programme. New guidance to be developed includes the management of alcohol dependence; the recognition and diagnosis of Coeliac disease in adults; and the prevention of cardiovascular disease.

 

New Topic Referral (NICE Website)

 

Hepatitis C and HIV Rates Increase Among Injecting Drug Users

 

Findings from a new report on injecting drug users (IDUs) show that almost half are now infected with hepatitis C; HIV rates have increased to one in 75 since the start of the decade; and injecting into the groin (associated with higher levels of infection and risk) has become more common. The Health Protection Agency (HPA) report explores risk and protective behaviours, viral and bacterial infections, and further sources of information.

 

Infections Among Injecting Drug Users in the UK (HPA Document Report, October 2007 Update)

Ethical Aspects of Cognitive Enhancements

A discussion paper on the future development and use of cognitive enhancements has been issued by the BMA’s Ethics Department. It aims to promote informed debate on the topic and covers the use of nutritional supplements, pharmaceutical products, brain stimulation, neurotechnology, and genetic selection and manipulation. It also considers the ethical and social implications of cognitive enhancements, and considers how to respond to the opportunities and challenges it presents.

Boosting your Brainpower: ethical aspects of cognitive enhancements (BMA Ethics Department Report)

Rates of Tuberculosis (TB) Remain Stable

The first UK-wide annual report on TB, published by the Health Protection Agency (HPA), reveals that the number of reported cases in 2005 and 2006 were very similar. Commenting on the findings, Ibrahim Abubakar (Head of the Tuberculosis Section at the HPA’s Centre for Infections) stated that it is too early to decide whether this is a sign of a slow down. The document contains a range of statistics on TB, and information on drug resistance and treatment outcomes.

Tuberculosis in the UK (HPA Report)

Guidance

Assisting Patients Who Obtain IVF Medication Abroad

 

The Medical Protection Society (MPS) has issued a statement following reports that some female patients are obtaining IVF medication abroad and asking their GPs to administer it. The Society advises doctors to:

  • Justify their decision whether to assist or not
  • Keep accurate records of any discussions that have occurred
  • Not prejudice the patient’s care because they had treatment abroad
  • Realise that refusing treatment may be in the best interest of the patient
  • Explain why no assistance is being offered (if this is the case) and look into other options (such as referral)

Patients Who Have Elective Fertility Treatment Abroad (MPS Website)


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England

Announcements

Arrangements for the GP Patient Survey 2008

 

The DH has issued a “Dear Colleague” letter to all practices confirming arrangements for the delivery of the 2008 GP Patient Survey. It covers issues relating to extracting patients’ details, the Data Protection Act, patients who opt out, and FAQs. Surgeries that are not already signed up but wish to do so, are advised to contact their PCT immediately; while those who want to opt out must alert the DH by emailing GPPatientSurvey@dh.gsi.gov.uk by 30 November.

 

GP Patient Survey Arrangements (DH Letter)

 

In a similar but separate development, the DH has issued a new questionnaire pack for use in the remaining three waves of the National Patient Choice Survey. Each will contain an Ipsos-MORI covering letter, a reply paid envelope and a one page survey. Enquiries should be directed to Kate Meeds, Choice Survey Manager, on 0113 2545312.

 

National Patient Choice Survey: new questionnaire - waves 10, 11 and 12 (DH Website)

 

Support for Professionals Safeguarding Children

 

A secure web-based discussion forum, for named and designated health professionals responsible for safeguarding children, has been developed by the Care Services Improvement Partnership (CSIP) on behalf of the DH. It covers guidance, training, information and research; and will be developed in response to the needs of its users. The SAIF (Support and Information Forum) has a clinical moderator - Dr Jan Welbury, a consultant paediatrician and designated doctor – and practitioners can apply to join the group by contacting Denise Snow at denise.snow@dh.gsi.gov.uk.

 

Less Women Require Repeat Cervical Screening Test

 

The percentage of inadequate cervical screening samples fell from 7.2% in 2005/2006 to 4.7% in 2006/2007, according to statistics published by the Information Centre for health and social care (IC). Findings show more women are getting test results back quicker and have faster access to follow-up care if required.

 

Statistics on the Cervical Screening Programme 2006/2007 (IC Publication)

Caring for Disabled People During their Transition to Adulthood

 

A good practice guide - outlining the roles, responsibilities and duties of service providers working with disabled young people during their transition to adulthood - has been published by the Department for Children, Schools and Families (DCSF) and the DH. It was written by the Council for Disabled Children and highlights the need for all services to work together to ensure disabled young people get the support they need. It covers the role of GP commissioning in developing a local, multi-agency service delivery protocols; and emphasises that GPs should be involved in the transition planning process, as they will become the first point of contact for young people who have previously received therapies in their school environment.

 

Key Information for Professionals on the Transition Process for Disabled Young People (Every Child Matters Website)

 

Improving the Care Environment for Patients

 

The DH has published guidance to help healthcare staff improve their care environment for patients. It contains suggestions for best practice in the areas of access; maintenance (including tidiness and cleanliness); infection control; and making the patient feel reassured.

 

Essence of Care: benchmarks for the care environment (DH Document)

Update Your NHS Choices Practice Profile

 

All practices in England should now have received a pack detailing how they can edit their own data on the NHS Choices website. The release of the update site will take place on 19 November and surgeries may want to use the next 10 days to update their details before it goes live (although they can edit their data now or in the future) – visit www.nhs.choices/yourprofile to make profile amendments. Further information can be obtained at gp@nhschoices.nhs.uk or on 0845 402 3089

Parliamentary News

Stronger Links Between Communities and Health Services

 

The Local Government and Public Involvement in Health Bill - which updates and strengthens the duty on NHS bodies to involve and consult local communities about changes to services - has received Royal Assent. As of April 2008, 150 Local Involvement Networks (LINks) will replace existing Patient and Public Involvement Forums and their co-ordinating body, the Commission for Patient and Public Involvement in Health (CPPIH). LINks will help communities influence key decisions about local health provisions and hold services to account.

 

Local Government and Public Involvement in Health Bill (DH Press Release)


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Wales

Announcements

Patients Want Internet Contact with GPs

 

Four out of five regular internet users would like to contact their GP online, according to research commissioned by Informing Healthcare - the Welsh Assembly Government programme to improve patient services through better use of IT. Users would like to order repeat prescriptions, book an appointment or update their details if such facilities were available online. Results indicated that women aged between 30-59 are likely to be the biggest users of internet health services. Results from the study, conducted during July and August 2007, will inform the development of My Health Online - a new website enabling patients to undertake health-related tasks electronically and see their information through a secure web site.
 
Welsh Patients Want Internet Contact with their GPs (NHS Wales Press Release)

CMO Calls for Greater Use of Primary and Community Care

 

Health is getting better in Wales according to the first report from the Chief Medical Officer (CMO), Dr Tony Jewell. It reports improved infant mortality rates, increased life expectancy and less deaths from circulatory disease. Recommendations include greater use of primary and community care to manage chronic long term conditions and implementing measures to reduce sexually transmitted infections.

 

Chief Medical Officer for Wales Publishes Annual Report (NHS Wales Press Release)

 

Decrease in the Number of Adults Who Smoke

 

The Wales Centre for Health has published baseline data against which the effects of the ban on smoking in enclosed public places can be measured. It shows the percentage of adults who smoke has fallen over the last 30 years; and includes statistics on smoking during pregnancy and the use of smoking cessation services.

 

Smoking in Wales: current facts (Wales Centre for Health)

 

Extra Funding for Health Services

 

The Welsh Assembly Government has announced an additional £1.2 billion funding for health services over the next three years, increasing the total health budget to over £5.65 billion by 2008. Allocations include £7.5m for better management of chronic, long-term conditions and £17m to improve accessibility for patients. Emphasis is being placed on prevention and health improvement, and part of the budget will be used to maintain the Welsh Assembly Government’s free prescriptions policy.

 

Extra Funding to Improve Health in Wales (Welsh Assembly Government Press Release)

 

Increase in the Uptake Rate of Second Dose MMR

 

New figures published by the National Public Health Service for Wales (NPHS) show that uptake rates for childhood vaccines (to the year ending 31 March 2007) either stayed the same or increased. The percentage of children having the 5 in 1 vaccine before their first birthday increased to 95.3% and the highest uptake rate for the second dose MMR vaccine was recorded at 76.5% – although this still falls short of the 95% target.

 

NPHS Annual COVER Report, 2006-2007 (NPHS Website)

Parliamentary News

HPV Vaccine Added to the Routine Immunisation Programme

 

The Welsh Assembly Government has announced that the human papilloma virus (HPV) vaccine will be added to the routine immunisation programme from September 2008, and will be offered to all girls aged 12-13 years old. A two-year catch-up campaign will run alongside this for girls up to the age of 18 and will start in autumn 2009. The HPV vaccine protects against strains 16 and 18 of the virus which are responsible for around 70% of cervical cancers.

 

HPV Vaccination to be Offered in Wales (National Public Health Service for Wales Website)


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Scotland

Announcements

Profile of Adults with Long-Term Health Conditions

A detailed profile of the characteristics, circumstances and support needs of adults with long-term health conditions has been produced using data from the Scottish Household Surveys (1999-2006) and the Scottish Health Survey (2003). It reveals that in 2005-2006, 23.6% of adults reported having some form of long-term condition. The most common impairments were related to heart problems, blood pressure, circulation and arthritis.

Characteristics of Adults with Long-Term Health Conditions (Scottish Government Publication)

HPV Immunisation Programme - Coverage Extended

Plans to extend the coverage of the HPV immunisation programme have been announced by the Scottish Government. As previously stated, all girls aged 12-13 will be immunised from September 2008; and now girls aged 14-17 will be included in the scheme.

 

Cervical Cancer Vaccine (Scottish Government Press Release)

Parliamentary News

Extra Funding for Primary Care Premises

 

Health Boards are to get an extra £23m to improve and modernise primary care premises. This investment is part of the Primary and Community Care Premises Modernisation Programme, which has already provided £138m for infrastructure development.

 

Funding Boost for Primary Care Premises (Scottish Government Press Release)

 

New Target of 15-Week Wait

 

The Scottish Government has introduced a new 15-week maximum wait for both outpatient consultations and hospital admissions. This marks the next step in delivering the 18-week patient journey, from GP referral to treatment, by 2011.

 

Waiting Time Milestone Set (Scottish Government Press Release)

 

Bill to Modernise Public Health Legislation

 

The Scottish Government has introduced a new Bill to modernise the country’s public health legislation. It will ensure full compliance with the International Health Regulations 2005 - which broaden the scope of action beyond infectious diseases to those caused by contamination (such as biological, chemical and radiological). Key provisions in the Bill include powers to quarantine a person; to order someone to have the least intrusive or invasive medical examination to achieve a public health outcome (no consent required); and to disinfect, disinfest or decontaminate a person if necessary.

 

Public Health etc (Scotland) Bill (Scottish Government Press Release)


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Northern Ireland

Announcements

Health Inequalities Gap Widens

 

Statistics published by the Department of Health, Social Services and Public Safety (DHSSPS) show a continuing gap in health inequalities in Northern Ireland - particularly in teenage birth rates, infant mortality levels and standardised death rates due to circulatory diseases and cancer. The findings are from the Inequalities Monitoring System, which assesses the differences in mortality, morbidity, utilisation of and access to health and social care services across the country.

 

Health and Social Care Inequalities Monitoring System Second Update Bulletin 2007 (DHSSPS Report)

 

Consultation on  the Minimum Age of Sale of Tobacco Products

 

Health Minister, Michael McGimpsey, has launched a 12 week consultation on amending the minimum age of sale of tobacco products. Views are being sought on the following options: continuing with the current age limit of 16; increasing it to 17; or increasing it to 18. The consultation will run to 18 January 2008, and comments should be sent to lorraine.mcilwrath@dhsspsni.gov.uk.

 

Consultation on Age of Sale of Tobacco Products (Northern Ireland Executive Consultation Document)

Campaign to Tackle Domestic Violence

 

The second domestic violence action plan has been launched in Northern Ireland by Health Minister, Michael McGimpsey, and Criminal Justice Minister, Paul Goggins. It builds on the work of the first plan (published in 2005) and includes new guidance to help health professionals assist those caught up in domestic violence.

 

Second Domestic Violence Action Plan (Northern Ireland Office Website)


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