Patients will soon be allowed to buy heart drugs without a prescription.

Statins, which reduce cholesterol levels, are currently prescribed to 1.8m people who are at risk of cardiac disease, potentially saving 7,000 lives a year. The Committee on Safety of Medicines (CSM) has advised that one statin, simvastatin, should be available without prescription in a 10mg dose throughtout the UK. Simvastatin (brand name Zocor Heart Pro) has been used in the UK for 14 years and came off patent in 2003.

However, GPs have expressed concern that the move is borne out of cost, rather than clinical reasons. The dosage of 10mg has been questioned as being too low to have any significant impact and that it will be difficult to monitor patients who are buying the drugs.

The chairman of the British Medical Association's GPs committee, Dr John Chisholm, said:

‘If a drug treatment is worth taking it should be provided equitably and available to all patients at NHS expense and on the basis of need, not their ability to pay.’

Health Secretary John Reid heralded the move by claiming:

‘Coronary heart disease kills more than 110,000 people in England every year. It is the country's single biggest killer. By lowering cholesterol levels, statins can reduce heart attacks by as much as one third after three years of taking the drug.’

He confirmed that pharmacists will have to ask people a series of questions and, where appropriate, offer a range of health tests to ensure that it is safe to issue the drug. He also added that statins would still be made available on prescription.

Pharmacists have generally welcomed the CSM’s decision. Dr Gillian Hawksworth, president of the Royal Pharmaceutical Society of Great Britain, said:

‘The society welcomes the reclassification of simvastatin 10mg and believes there is a clear public health benefit to be gained from making this important medicine available through pharmacies. This switch will enhance patient care and give pharmacists more opportunity to use their skills. It will also provide a perfect opportunity to discuss other risk factors such as smoking, obesity and diet with a customer. Most importantly the public will benefit from access to primary prevention treatment without compromising on professional expertise and advice.’

Present guidelines suggest that doctors should prescribe statins for patients who have a 30 per cent chance of heart attack within the next 10 years. Simvastatin will be available to buy in monthly packs from July, with pharmaceutical companies determining the price. Reports suggest that it will cost around £5 a week, compared to £6.40 for a month’s prescription.

A new computer system deal means clinicians will no longer have to gather around x-ray films on light-boxes to diagnose bone conditions.

X-rays and images from other devices, such as fluoroscopy, magnetic resonance imaging (MRI), computerised tomography (CT) and ultrasound scanners will be stored electronically rather than printed on film and filed manually, meaning that they can be transferred almost instantly between departments and sites.

Picture archiving and communications systems (PACS) will be installed nationally in the next three years. Any clinician with a computer and internet access will be able to view the images.

Advantages of the system:

• rural patients can be x-rayed in minor injuries units and other diagnostic centres, saving trips to hospital
• less need for repeated x-rays because of problems transporting prints
• patients will not have to wait for their x-rays to be processed
• images can be viewed simultaneously in different places to allow teleconferencing with experts all over the world
• staff will no longer be exposed to hazardous film processing chemicals
• electronic storage means the images are less likely to get lost
• images can be manipulated on-screen for easy viewing

The system, which can cost between £3m and £9m to install, has been considered prohibitively expensive up until now, but according to Richard Granger, director general of NHS IT, 'We have negotiated a substantial reduction in the average price of PACS. This deal is providing better quality systems for a lower cost with increased functionality and these will be fully compliant with the NHS care record service.'

New treatments for patients with the chronic eye diseases glaucoma, age related macular degeneration and low vision are to be scrutinised around the country.

Eight sites will run pilots as part of a £4m programme, according to health minister Rosie Winterton. The schemes include:

• a seamless service from high street to hospital for glaucoma patients
• new technology
• a mobile eye care unit in Devon
• further training for optometrists so they can diagnose patients earlier, freeing up doctors

The announcement was made at a conference on managing chronic eye disease in community settings.

The NHS is hitting its targets, according to the latest figures.

The latest data confirms that the NHS has hit the government's NHS Plan targets, including ensuring that no patients should wait more than nine months for an operation. Waiting times continue to fall, with the maximum wait being half what it was in 1997.

NHS chief executive Sir Nigel Crisp set out how the extra £5.9 billion spent on the NHS in England has improved matters:

• 167,000 more elective operations in hospital than last year
• 197,000 more procedures carried out in primary care and outpatients
• in A&E 94 per cent of patients were seen and treated within 4 hours
• 32.7 million more prescriptions in the community and 30 per cent more statin prescriptions
• 59,000 more NHS staff, including doctors, nurses and other front-liners

Ambulance services are to undergo a strategic review following the announcement that health minister Rosie Winterton has appointed Peter Bradley to the new part-time post of national ambulance adviser.

The six-month review is expected to:

• evaluate timing procedures to ensure transparent and consistent measurement of response times
• implement the recommendations of the recent call categorisation review to ensure that patients receive a consistent service

The review will also consider how to make long-term improvements in areas such as:

• improving integration between the ambulance service and other unscheduled care providers (ie, GP out-of-hours providers)
• education and training requirements for ambulance service staff
• developing clinical indicators and outcome measures to assure quality of care

Peter Bradley (who is also London Ambulance Service chief executive and the Ambulance Service Association president) said:

‘I am excited by this challenge and delighted that the Department of Health has given us such a wide remit to build further on the improvement in ambulance services we have seen in recent years. This will not just be a review on paper. We want to see demonstrable changes and improvements.

‘The ambulance services have undergone a major transformation. Twenty years ago the ambulance service was perceived as a transport organisation. Today we are recognised as a health profession with a crucial role to play in patient care. In the past, although we were part of the NHS, we stood apart, we are now moving into a more central position.’

More health professionals will be able to prescribe medicines under new proposals announced by Health Secretary John Reid.

It is proposed that physiotherapists, radiographers, chiropodists and optometrists should be able to prescribe medicines — in partnership with a doctor — to help treat and manage conditions such as glaucoma, chronic back pain and the effects of multiple sclerosis, as well as providing pain relief for patients attending radiography sessions.

John Reid said:

‘Our proposals will enable more health professionals, working in partnership with doctors, to help patients get the right medicine more easily than ever before. This is part of our commitment to extend the responsibilities and roles of all NHS staff. By enabling all NHS staff to be all that they can be, NHS patients will be able to get the full benefit of the NHS's highly skilled workforce.’

Supplementary prescribing was introduced in April 2003. Doctors and another health professional — currently nurses and pharmacists — prescribe medicines for patients under clinical management plans. There are over 1,400 qualified and registered nurse supplementary prescribers. Around 100 pharmacists have registered as supplementary prescribers and the first has already begun to prescribe. (See NHS news: Pharmacy: supplementary prescribing starts).

The consultation is being organised by the Medicines and Healthcare Products Regulatory Agency and will last 12 weeks.

A top nurse has criticised a few younger nurses for 'being too posh to wash' after a student told him she did not want to wash patients' bottoms because 'that was someone else's job.'

Jeremy Bore, an orthopaedic nurse and chairman of the Royal College of Nursing's Exeter branch, shared the story at the RCN's conference in Harrogate and said it was distressing to find nurses who didn't want to give patients holistic care – including 'washing feet and backsides and keeping their mouths fresh when they are not able to do it themselves.'

He said that he considered the duties a privilege: 'Not even doctors and priests are allowed to become so intimate.'

Dr Beverley Malone, the college's general secretary told nurses that they were missing the point of the profession if they did not want to give intimate personal care. The government's NHS reform plans encourage nurses to take on about 20 per cent of junior doctors' work. To cope with this, they are encouraged to delegate 12 per cent of their existing work to healthcare assistants. Dr Malone feared that nurses might pass on such tasks as bathing patients and changing dressings to these less qualified assistants who work for less pay.

Such delegation, she said, would rob nurses of valuable diagnosis information: 'When I am bathing a patient, I am checking out their mental state and how they are recovering.'

Health Secretary John Reid said the DoH would counter criticism that nurses were becoming 'too clever to care'. He will insist that the basics of caring for the patient remain central to the profession.