For the first time patients are to be allowed to directly report unpleasant drug side effects to the medicines watchdog, the Medicines and Healthcare Products Regulatory Agency (MHRA).

Direct patient reporting is be rolled out immediately with the MHRA responsible for piloting different methods of collecting the information, from using the internet to making relevant forms available in GP surgeries.

Adverse drug reactions (ADRs) were previously only reported by health professionals to the Committee on Safety of Medicines, via the yellow card scheme. Direct patient reporting is one of a series of recommendations made by experts who have reviewed the scheme, which have been published to coincide with the scheme's 40th anniversary. On announcing the new plan, health minister Lord Warner said:

‘Patients want and deserve to play their full part in making medicines safer. The yellow card system is recognised as one of the best spontaneous reporting schemes for adverse drug reactions in the world. By introducing direct patient reporting we will improve the scheme even further. Systems will be set up to allow patients to report any unexpected effects of their medication easily and quickly to the experts who monitor drug safety so that we can better protect public health.’

Other recommendations made in the yellow card scheme review to be put out for consultation include:

• academics and researchers to access yellow card data (providing their proposals are approved by scientific and ethics committee)
• MHRA to publish anonymous, aggregated data on their website on a regular basis
• MHRA to further raise the awareness of health professionals about the importance of reporting ADRs

Amid fears that we are frittering away our lives sprawled on the couch waiting for heart disease and diabetes to carry us off, the government has told us we need to get out more.

New recommendations say that everyone should take at least five half hour sessions of moderate exercise a week.

Chief medical officer Sir Liam Donaldson said that this could be taken in bursts of at least ten minutes, or by doing all the daily activity in one session.

The report, At least five a week, explains the public health benefits of an active lifestyle for all ages, and also outlines the risks surrounding physical activity, which include sunburn and attacks from animals.

Suggestions for moderate activity include using the stairs instead of the lift, walking or cycling to work or school and weekly leisure activities such as swimming, football or going to the gym.

The Ramblers’ Association has launched their own initiative, Britain on the Move, a programme of walking events to encourage people to take gentle exercise.

Volunteers in clinical trials will be protected from bad clinical practice, research misconduct and fraud by European law.

Although most drug trials in the UK meet internationally agreed standards, new European-wide regulations will now safeguard the rights, safety and wellbeing of patients.

The European clinical trials directive, which came into effect on 1 May, states that researchers must report all serious adverse reactions to the Medicines and Healthcare Products Regulatory Agency (MHRA), which will monitor trials and has the power to stop them if volunteers are at risk.

Health minister Lord Warner said:

'We have worked closely with research interests and industry to minimise bureaucracy and to address any concerns about possible burdens of the new regulations. A better regulatory system inevitably involves some increase in the demands placed on those conducting trials, but ultimately it is in the best interest of both volunteers who participate in the trials and for patients who use the powerful drugs involved.'

The Department of Health press release 2004/0160 says the UK has strongly argued the case for allowing each country to decide how they will monitor their own trials.

A nurse led scheme to help older people improve and maintain their health being piloted in nine English PCTs is showing results.

The Evercare programme was developed in the US and reduced hospital admissions by 50 per cent among older people. Specially trained nurses identify and monitor at-risk older people. The pilot scheme began in April 2003 and will run until August 2004. A report of progress up to the end of February was published this week.

The DoH lists the advantages as:

• Advanced primary care nursing roles improve collaboration between GPs and geriatric consultants
• Patients can be monitored and educated so that they can avoid a stay in hospital
• It addresses the needs of patients in the community and uses primary care as the main way of delivery, in line with government policy in this direction

The PCTs involved are:

• Airedale
• Bexley
• Bristol North
• Bristol South and West
• Halton
• Luton
• South Gloucestershire
• Walsall
• Wandsworth

An advice pack focusing on informing patients will help A&E departments improve their service.

Recent research has shown that letting patients know how the department works and how their treatment is progressing is a key to improving their experience and, ultimately, improving their outcome (see NHS news: Attractive décor eases A&E pain).

The toolkit offers hints on signposting, leaflets and interpreting as well as giving details of more innovative schemes such as having an A&E housekeeper to take charge of patient comfort.

The issues of the 2004 Choosing health? public health consultation have been raised by 350 people at a national health inequalities conference held in London.

In addressing the DoH conference, Health Secretary John Reid reaffirmed the government’s commitment to tackling health inequalities:

‘Our responsibility is to create the conditions where disadvantaged people feel able to make healthier choices. But nothing happens unless people make those choices. Our task is to help everyone make that choice and to recognise that within the existing policy framework millions of people continue to experience significantly poorer health than the general population. The figures of life expectancy show this at a glimpse. It remains the case that a boy born in Manchester is likely to die on average 8.5 years earlier than a boy born in Rutland.’

Mr Reid committed himself to improving people’s health across the UK, adding that:

‘We need the health of the poorest to improve at a faster rate. As well as thinking about the particular health issues like smoking, obesity, and mental health, it means thinking about the delivery of services and the systems that create barriers to health and health choices.’

Numerous programmes addressing health inequalities were showcased at the conference. These included:

• New deal community kitchen in Newcastle running healthy cook and eat sessions to get across the healthy eating message in an informal way
• South Asian communities initiative in Manchester working with the local minority ethnic community to target pregnant smokers

The NHS national programme for information technology (NpfIT) has announced the creation of a new support academy to help NHS staff with new technology.

The academy will include simulators which will mock-up environments such as hospital wards and GPs’ surgeries where clinicians will learn how to use new systems with actors playing the role of patients. The system will teach its first students this month.