Health Management and Policy Alert

30/03/07 - Primary Care Trust Professional Executive Committees: fit for the future

This document sets out new arrangements for the PCT Professional Executive Committees (PECs).  PCTs now have the freedom to determine how PECs should be structured and operated according to local circumstances, based on a set of guiding principles for all PECs. PCTs need to implement the guidance by 1 October 2007. (DH - publications)

30/03/07 - National survey of NHS staff 2006

The Healthcare Commission has published the annual NHS staff survey. Over 128,000 staff in 326 trusts gave their views and experiences of working for the NHS in England – there was a response rate of 53%. The findings include:

• Job satisfaction: Figures show there is significant job satisfaction in the NHS, although it has edged down across all trust types.
• Violence and bullying: Violence and abuse remains unacceptably high, particularly in ambulance trusts and mental health and learning disability trusts. Hygiene control and infection: It was the second year that staff were asked about the availability of hand-washing items and figures show there is room for improvement. Discrimination: The number of staff who say they experience discrimination in the work place has increased slightly in all trust types.
• Errors, near misses and incidents: There has been a downward trend in the number of staff who said they witnessed an error, near miss or incident in the previous 12 months. There had been a slight upward trend in numbers of people saying it was reported.
• Injuries and stress: Injury or illness-related to work has decreased in all trusts, except for ambulance trusts, where it remained the same. Work-related stress has been decreasing steadily over the years and this trend continued in 2006 across all trust types.
• Appraisals: In every type of trust, a significant number of staff are not receiving appraisals or performance development reviews. Of those who said they did receive an appraisal or performance development review, most are not finding it helpful.
• Working hours and overtime: A very high proportion of NHS staff report working more than their contracted hours. 

(Healthcare Commission - press release) [BBC news item]

30/03/07 - DH publishes its business plan 2007/08

This plan outlines what the Department will do in 2007– 08 to lead and support the Government’s objectives for health and social care, and to support Ministers in their accountability to the public and Parliament.

(DH Publications)

29/03/07 - Supporting documentation for Healthcare Resource Groups version 4 (HRG4)

The Information Centre (IC) has published supporting materials for the new version of Healthcare Resource Groups, HRG4. It involves a major revision of existing groupings to take into account complex cases and to extend the scope of groupings beyond admitted care, to new clinical settings. It will be used to support NHS Reference Costs processes from April 2007. (IC - preview HRG4)

29/03/07 - A positive outlook: a good practice toolkit to improve discharge from inpatient mental health care

This toolkit provides best practice guidance to show what works in reducing the current levels of delayed discharge being experienced by adults and older people in mental health services. It focuses on the practical steps which can be taken to improve discharge.
(Health and Social Care Change Agent Team - news)

28/03/07 - Computerised Cognitive Behavioural Therapy (cCBT) implementation guidance

This guidance is designed to help the NHS make decisions on how they will implement NICE cCBT technology appraisal TA097. TA097 was published in February 2006 and recommended the use of specific cCBT products for the management of mild and moderate depression as well as panic and phobia. PCTs are expected to be able to offer the recommended cCBT programs by 31st March 2007. In order to achieve this goal, PCTs should:

• Undertake a local needs assessment;
• Purchase software licences;
• Ensure the availability of hardware for the delivery of packages;
• Ensure that appropriately trained staff are available to supervise delivery; 
• Develop referral protocols.

The guidance also gives the broader perspective of how cCBT is an essential component of the delivery of psychological therapy services. (DH - press release)

28/03/07 - Report of the vCJD Clinical Governance Advisory Group

This report, commissioned by the DH, proposes the creation of patient-focused clinical governance arrangements to standardise the care that patients at risk of vCJD receive across the country. It recommends that GPs should take the lead in commissioning care for them, supported by consultant neurologists and specialist centres such as the National CJD Surveillance Unit and the National Prion Clinic. (DH - press release)

28/03/07 - Government ends Resources and Accounting Budgeting (RAB) regime

The government has announced the reversal of RAB deductions and the replacement of cash brokerage with a formal system of loans for NHS Trusts. The move follows recommendations made by the Audit Commission to change the RAB rules for NHS trusts. In support of this change, the government also announced that it would now allocate, as planned, the £450m contingency to the NHS. This is being allocated to strategic health authorities on a fair shares basis. (DH - press release)

28/03/07 - Recommendations to improve medication safety

The National Patient Safety Agency (NPSA) has published five alert notices to improve medication safety and reduce the number of medication errors in the NHS. The five high risk notices are:

• anticoagulant medicines; 
• liquid medicines administered via oral and other enteral routes; 
• injectable medicines; 
• epidural injections and infusions; 
• paediatric intravenous infusions.

Included in the alert notices are a range of practical tools and resources to support healthcare professionals and NHS organisations with implementation. This work forms the Safe Medication Practice Work Programme for 2007-8, a joint initiative with the Department of Health and the Welsh Assembly Government. (NPSA - news)

27/03/07 - Human rights in healthcare: a framework for local action

This framework was developed by the DH in conjunction with the British Institute of Human Rights and five NHS trusts. Its aim is to assist organisations across the NHS to develop and use a human rights-based approach to support their core business of planning and delivering high quality and accessible health services for all. It is not a source of legal advice but a starting point for trusts planning to improve their practice. (DH - publications)