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PCTs
and prescribing
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Advice to PCTs on their responsibilities
regarding prescribing, medicines management
and pharmaceutical services in their area has
been put out by the National Prescribing Centre
(NPC). It is aimed at PCT chief executives,
professional executive committee chairs and
prescribing advisers.
The guidance covers medicines management,
clinical governance, routes to medicines service
delivery, community pharmacy, information and
knowledge, involving people — and sets
out PCT responsibilities under each of these
headings. There are overviews of government
policies, national projects and sources of
information.
The NPC says it should help executives identify
any areas where action has yet to be taken.
The guidance also includes a list of updated
competencies for pharmacists working in primary
care.
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Negotiations
on the Pharmaceutical Price Regulation Scheme
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The government expects to enter
into bilateral negotiations with the Association
of the British Pharmaceutical Industry (ABPI)
later this year on the future of the Pharmaceutical
Price Regulation Scheme (PPRS), which governs
profit levels achieved by pharmaceutical companies
from sales to the NHS.
In the meantime it has put out a discussion
paper on the scheme. It is seeking views on:
- rolling forward the 1999 version of the
PPRS without change
- a number of aspects of the scheme that
could be amended through negotiation
- the potential for deregulation
- alternative proposals
The Department of Health is asking for responses
by 31 October.
At the same time it has published the results
of a study into the extent of competition in
the supply of branded medicines to the NHS.
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Further
information
DoH website: PPRS
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Supply
and reimbursement for generic medicines
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A second consultation paper
put out by the Department of Health covers
the future of generic medicines in the NHS.
It proposes arrangements for the long-term
supply of generics to primary care in England.
The proposal would replace the current maximum
price scheme. The document sets out in detail
how the new scheme would affect each part of
the supply chain from manufacturer and wholesaler
to community pharmacy, and seeks views on specific
issues.
The consultation will run until 31 October.
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Improvements
made in hospital food and cleanliness
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The results of the latest annual
hospital food and cleanliness inspections show
that hospitals are improving their services.
Catering is judged on aspects including presentation,
quality, choice, portion size and access to
drinks and snacks.
Cleanliness relates to tidiness and general
presentation of the hospital and its staff,
encompassing decoration, use of signs, toilets,
furniture, linen, grounds and car parking facilities.
Hospitals are graded by the traffic light
system — green signifies patient expectations
are always met, amber represents room for improvement
and red warns of an urgent need for improvement.
The assessments are carried out by independent
patient environment action teams (PEAT), composing
of voluntary NHS managers, nurses, patient
and patient representative organisations and
members of the general public.
Health minister, Lord Norman Warner said:
‘Keeping hospitals clean and tidy is
not a one-off exercise and the importance of
the Clean Hospitals campaign has been maintained
during 2002 to make sure things continue to
improve. I am pleased to see that standards
of cleanliness and food in the NHS are continuing
to rise.’
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National cleanliness
assessment results |
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Red (poor) |
Amber (acceptable) |
Green (good) |
| 2002 |
0 (0%) |
317 (40%) |
464 (60%) |
| 2003 |
0 (0%) |
188 (21.6%) |
681 (78.4%) |
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National food
assessment results |
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Red(poor) |
Amber(acceptable) |
Green(good) |
| 2002 |
14 (2%) |
554 (81%) |
118 (17%) |
| 2003 |
0 (0.%) |
479 (56.3%) |
372 (43.7%) |
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PCTs
to fund and commission dentistry by 2005
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The DoH has announced that
the funding and commissioning of local NHS
dental services is to be taken over by primary
care trusts. The change in policy is to counteract
the fall in the number of PCTs that do not
offer NHS services to patients. PCTs will be
handed a £1.2bn budget to instigate local
dental contracts.
In 2005 the Dental Practice Board will be
replaced by a special health authority (currently
in shadow form) for England and Wales.
Health minister Rosie Winterton announced
the plans at a visit to a Streatham dentist.
Over 2,500 people in Southwark, Lambeth and
Lewisham have gained access to an NHS dentist
since a pilot scheme for personal dental services
(PDS) opened in 1998.
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Key
roles of allied health professionals announced
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In order to improve patient care the DoH
has published a list of 10 key roles for allied
health professionals (ie, physiotherapists,
dieticians, radiographers etc). Outlining their
core responsibilities, the roles were developed
by representatives from allied health professionals
(AHPs).
Launching the roles, Rosie Winterton said:
‘Caring for a sick patient involves
a team effort. The work undertaken by AHPs
is vital to the NHS, and we hope these 10 key
roles will offer them the recognition and support
they deserve. By using these roles as guidance,
AHPs will be able to extend and develop new
roles for themselves and move towards new ways
of working.’
The ten key roles
1) To develop extended clinical and practitioner roles which cross professional
and organisational boundaries
2) To be a first point of contact for patient care, including single assessment
3) To diagnose, request and assess diagnostic tests, and prescribe — working
with protocols where appropriate
4) To discharge and/or refer patients to other services — working with
protocols where appropriate
5) To provide consultancy support to others promoting the AHP contribution
to patient independence and functioning, training, developing, mentoring, teaching,
informing and educating health care professionals, students, patients and carers
6) To manage and lead teams, projects, services and case loads, providing clinical
leadership
7) To develop and apply the best available research evidence and evaluative
thinking in all areas of practice
8) To play a central role in the promotion of health and wellbeing
9) To take an active role in strategic planning and policy development for
local organisations and services
10) To extend and improve collaboration with other professions and services,
including shared working practices and tool
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GPs
with special interest now exceed 1,000
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Over 1,250 GPs with special
interest (GPSI) are now working in England,
exceeding an NHS Plan target by a year. Patients
can be referred to GPSIs in specialisms such
as cardiology and dermatology, avoiding the
need to visit a hospital consultant.
It is hoped that GPSIs will soon be joined
by other health professionals (such as nurses)
with special clinical interests.
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Advertising
ban on non-prescription medicines lifted
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The current ban on advertising
over the counter (OTC) medicines for a number
of conditions is to be removed. The lifting
of the ban will allow drugs that can already
be purchased through pharmacies and general
retailers to be advertised to the public.
 Health
minister Lord Norman Warner said:
‘Removing the restrictions on promoting
non-prescription medicines to the public has
the potential to bring real public health benefits
by giving more power and information direct
to patients.’
The new ruling does not affect the strict
ban on direct to consumer advertising of prescription
only medicines.
Advertising restrictions are to be removed
from medicines for:
- Bone diseases
- Cardiovascular diseases
- Diseases of the liver, biliary system and
pancreas
- Endocrine diseases
- Genetic disorders
- Joint, rheumatic and collagen diseases
- Psychiatric diseases
- Serious disorders of the eye and ear
- Serious gastrointestinal diseases
- Serious neurological and muscular diseases
- Serious renal disease
- Serious respiratory diseases
- Serious skin disorders
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Waiting
lists stay below a million
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For the first time in a decade,
waiting list figures fell below 1m in March
and figures for June show that waiting lists
have continued to remain under the target.
Health minister John Hutton said:
‘The health service is on course to
ensure that by 2005 no one should have to wait
longer than six months for an operation.’
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A short
guide to foundation trusts
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The DoH have produced a Short
guide to NHS foundation trusts which
contains 10 key points. They specify that
foundation trusts:
- will be firmly part of the NHS and subject
to NHS standards, performance ratings and
systems of inspection
- will be established in law as independent
public benefit corporations
- will be democratic
- will prevent privatisation of the NHS
- will operate within a clear accountability
framework
- will be there to treat NHS patients, not
to make profits or to distribute them
- will be at the cutting edge of the government’s
commitment to devolution and decentralisation
in the public services
- are not about elitism
- will work in partnership with other NHS
organisations
- will be able to direct their services
more closely to the communities they serve
with freedom to develop new ways of working
that reflect local needs and priorities
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2002
prescription statistics published
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Statistics for prescriptions
dispensed in England have been published. The
research for 2002 concludes:
- The net ingredient cost (NIC) of prescriptions
dispensed was £6,847 million (an increase
of 11.9 per cent or 8.5 per cent in real
terms on 2001)
- 617m prescriptions were dispensed (an increase
of 5.1 per cent on 2001)
- The average NIC per prescription was £11.10
(an increase of 6.5 per cent or 3.2 per cent
in real terms on 2001)
- There were on average 12.5 prescriptions
per head of population (11.9 in 2001)
- 85.7 per cent of prescription items dispensed
were free to patients (85.4 per cent in 2001)
- 76 per cent of prescriptions were written
generically (74.1 per cent in 2001)
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Patient
choice consultation launched
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Patients, user groups, and
NHS and social care staff have been invited
by NHS chief executive Sir Nigel Crisp to take
part in a national consultation. Their views
are sought on how the delivery of health and
social care can:
- offer more choice
- become more responsive to patients
- tackle health inequalities
The consultation ends in November, at which
point the Health Secretary will learn of the
findings.
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Payment
by results consultation
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Payment by results consultation:
preparing for 2005, published on 7 August 2003,
identifies the key decisions needed for implementing
the next stage of payment by results and outlines
how it will apply to foundation trusts (from
April 2004) and NHS trusts (from April 2005).
In the consultation, the DoH sets out the
next stages of moving to a nationally agreed
set of prices for healthcare procedures provided
for NHS patients. The move to a national tariff
is being phased in and will advance the government's
concepts of patients' choice and of a variety
of providers delivering healthcare to NHS patients.
Questions that need answers include whether
a standard costing model should be set up and
if the audit/inspection regime for costing
should be formalised.
The consultation — aimed at NHS trusts,
PCTs and strategic health authorities — ends
on 31 October.
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External
link