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National Health Service, PCT & Local Health Board News
- February 2007
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National Health Service (NHS), PCT & Local Health Board
News - Feb 07
England - Local PCT News
Bournemouth and Poole PCT - Heart
Failure
The Better Together service is a joint initiative between
the PCT, Marie Curie Cancer Care and the British Heart Foundation (BHF) which
was launched last September. It aims to provide the best possible care for
heart failure patients and allows them to be cared for at home in the final
stages of their illness. Elaine Rouse, Poole BHF Heart Failure Nurse, said that
one of the benefits of the scheme was that she now felt more aware and
confident in dealing with end-of-life issues with patients. The main expense is
the cost of a Marie Curie nurse on night shift, and this is split between the
local PCT and the BHF. It is hoped that the year-long pilot will pave the way
for more joint working on diseases such as COPD.
Cambridgeshire PCT -
Medicines Management
A report from Sue Ashwell, the PCT's Chief
Pharmacist, will be presented to the PCT board this month outlining the
proposed development of the Cambridgeshire Approach to the Management of
Prescribing and Prescribing Costs. The introduction of a county-wide primary
care Red List is one examples of how the new strategy for appropriate,
effective and affordable prescribing will be implemented. There has been a
great deal of progress in improving the quality and cost effectiveness of
prescribing in Cambridgeshire over the last three years and Medicines
Management teams have helped practices reduce costs by around
£2m.
However, there are still significant variations in
prescribing costs between areas and practices which are not easily explained.
This is currently being explored, and the Red List is one step in that process
of adjustment. The Red List has been circulated and was implemented from 1st
January 2007, operating alongside a Cambs-wide Primary Care Formulary which was
developed at the request of the PEC and in partnership with local hospitals.
The PEC has agreed to provide ongoing support for the Medicines Management team
in engaging practices more actively in managing their prescribing budget as
part of Practice- Based Commissioning.
Doncaster PCT - Unplanned Care
Following a 12-week consultation, Doncaster PCT has approved
changes to its local unplanned care services which will see the current
Accident and Emergency Department at Doncaster Royal Infirmary split between
two distinct functions. One section will be based on the American-style
Emergency Room, dealing with serious and life-threatening conditions like heart
attack and trauma. The Unplanned Care Centre, which will be the first of its
kind, will treat less urgent cases such as sprains, cuts and bruises.
Patients will ring a single number (yet to be agreed) and will then be
connected to an appropriate healthcare professional (GP, nurse, pharmacist
etc). The current 999 number will be retained for emergencies, and assurances
were given that the call centre personnel will be well-trained and
locally-based. The changes will be introduced over the next two years, and
should by up and running by 2009.
Eastern & Coastal Kent tPCT -
MS Nurse
MS sufferers in Sittingbourne have expressed their support
for Nurse Specialist Sylvie Hurst, who runs an MS clinic at the Memorial
Hospital (ex Swale PCT). It is feared locally that the funding for the MS Nurse
Specialist is under threat.
Haringey tPCT - Community Pharmacies
Seven community pharmacies in central Crouch End have united
against the PCT's proposals to move GPs from the area into the new Hornsey
Central Hospital development. The development will also house it's own
community pharmacy.
Lewisham PCT - Community Pharmacy
Anti-Coagulation Service
Lewisham PCT has been working with local
pharmacies for the past 18 months to expand services for patients who take
blood-thinning medication. Six pharmacies now provide an anti-coagulation
service which saves patients having to attend a hospital. More than 500
patients are using this service, and it is anticipated a further 500 patients
will join the programme by May. Kath Howes is Lead Pharmacist for the
community-based anti-coagulation service. She said that most patients think the
pharmacy is an appropriate place to monitor their condition, and they get to
see a pharmacist for longer than they did under the old system. "But on top of
that, appointments cost less in the community, so we are using resources more
appropriately."
Pharmacies running clinics are:
- Day Lewis
Pharmacy, 443 Downham Way
- Lloyds Pharmacy, 48 Randlesdown Road
- Wise
Pharmacy, 363 Sydenham Road
- Logans Pharmacy, 465-467 New Cross Road
-
Baum Pharmacy, 10-12 Manor Park Parade
- Sheel Pharmacy, 296-298 Lewisham
High Street
Milton Keynes PCT - Choose and Book
It is
being reported that the PCT has requested all future referrals, with a few
exceptions, are to be sent via Choose and Book, and that it has made
arrangements for any letter or fax referral to Milton Keynes General to be
returned to the referring GP.
Norfolk PCT / Great Yarmouth &
Waveney PCT - Out-of-Hours
The PCTs have invited expressions of
interest from Out-of-Hours providers for a comprehensive OOH service for their
populations, commencing from August 2007. The current GP out-of-hours service
is provided by Anglian Medical Care.
North East Essex PCT - Community
Pharmacy Weight Loss Programme
The PCT has launched a free weight
loss programme which is being provided through eight community pharmacists:
four in Colchester and four in Tendring. People taking part in the programme
will be seen on an individual basis in a private consulting area, will have
their weight, BMI and blood pressure recorded, and will be given information on
nutrition, lifestyle and physical activity. The programme runs for 12 weeks.
The PCT Health Promotion Co-ordinator is Mel Idroos. She said: “Those
taking part must be motivated and committed to making lifestyle changes and
they will be supported in losing 5% to 10% of their body
weight."
Participating pharmacies are:
(Colchester)
-
Alliance Pharmacy, Long Wrye Street
- Sainsbury's Pharmacy, Tollgate West
- Crouch End Pharmacy, Crouch Street
- Day Lewis Pharmacy, St
Christopher Road
(Tendring)
- Day Lewis Pharmacy, The Triangle,
Frinton-on-Sea
- GP Pharmacy, The Green, Great Bentley
- Day Lewis, The
Parade, Halstead Rd, Kirby Cross
- Alliance, North Road,
Clacton
North Yorkshire & York PCT - Suspension of Procedures
The North Yorkshire and York LMC has written to the PCT about its plans
to limit a wide range of procedures to exceptional cases only. Patients who
have been referred to secondary care for certain operations will have their
cases submitted to a Prior Approval Panel. The procedures include IVF,
epidurals for back pain, lumbar spine x-rays, joint injections, vasectomies and
removal of non-malignant skin lesions.
The LMC has already objected
strongly to these proposals and voiced fears that any medics who are on this
panel could be sued by patients. A spokesman from the PCT said the organisation
would be responding directly to the LMC, was continuing to talk to GPs and
hospitals, and welcomed their comments. He stressed that there was no outright
ban on any procedure.
South Staffordshire Healthcare NHS Trust -
Bi-Polar Disorder
Staff in Wombourne were concerned that they were
not adequately meeting the needs of the large number of people in the Seisdon
peninsula with Bi-Polar Disorder. They arranged a two-day workshop at St
David's House, which included information on medication from a pharmacist, and
advice on effective self-monitoring of mood disorders. It is hoped this will
lead to fewer admissions and greater involvement of patients in their own care,
in collaboration with their GP and other members of their care team. The
intention now is to provide ongoing support by promoting and organising a
monthly Bi-Polar support group.
Suffolk PCT - CHD Prescribing
Orchard House Surgery will save £11,760 pa after changing
cholesterol-lowering drugs. Dr Wace explained that he informed around 120
patients of the change to a better value medicine, and then spent a couple of
hours over one evening making the switch.
Swindon PCT - Smoking
Cessation
The PCT has been working with Yates Bar in Bridge Street
to offer drop-in Stop Smoking sessions in the pub on a Tuesday lunchtime. The
idea is to help people give up before the ban on smoking in indoor public
places comes into effect on 1 July.
Worcestershire PCT -
ADHD
Concerns have been raised by the Citizens Commission on Human
Rights (CCHR) over the number of children in Worcestershire who are being
prescribed psychiatric medication for ADHD. The CCHR is a psychiatric watchdog
group, and it reports that during 2005/6, a total of 7,760 prescriptions for
ADHD drugs were written across the county, costing £364,000.
Dr
Richard Harling, Consultant in Public Health at Worcestershire PCT, said that
if a child or adolescent needs treatment with medication for ADHD then these
medicines should all be considered as possible choices. "Treatment should only
be started after a specialist who is an expert in ADHD has thoroughly assessed
the child or adolescent and confirmed the diagnosis. Once treatment has been
started it can be continued and monitored by a GP. Clinicians in Worcestershire
work to the NICE recommendations to ensure that all children and adolescents
get the care that they need."
Wales - Local Health Board News
Conwy & Denbighshire NHS Trust - New
Cardiac Catheter Unit
The new Cardiac Catheter Unit has been opened
at Ysbyty Glan Clwyd, which will save some patients from having to travel as
far as Manchester for treatment. This is one of six new units to have opened in
Wales following government and lottery funding:
- Princess of Wales
Hospital, Bridgend
- Morriston Hospital, Swansea
- University Hospital
of Wales, Cardiff
- Royal Glamorgan Hospital, Llantrisant
- The Royal
Gwent Hospital, Newport
- Glan Clwyd Hospital,
Bodelwyddan
Swansea NHS Trust / LHB - Chronic Pain Clinic
Morriston Hospital's Chronic Pain Clinic may close because of a
reduction in funding - new patients are already having to travel to Cardiff for
treatment. The clinic has been funded on an ad-hoc basis for the past four
years and has cost approximately £340,000. Sue Heatherington, the Chief
Executive of Swansea LHB, has called for more chronic pain services to be sited
within the community. It is thought that chronic pain blights the lives of one
in five people in Swansea, and ranges from severe back pain and arthritis to
migraines and pins and needles following strokes
Wales - Free
Prescriptions
Prescriptions in Wales, which are currently £3
per item, will be free from 1 April 2007. Dr Brian Gibbons, the Health
Minister, said that one of the main reasons for this policy was to ensure that
people are not deterred from getting their medication because of cost -
especially those with chronic illness who are on modest incomes. "The move
removes all the unfairness surrounding the present outdated 1968 exemption
system where, for example, a diabetes patient automatically gets all
prescriptions free but a cystic fibrosis sufferer doesn't."
However, he
did stress that if patients who usually buy non-prescription medication over
the counter changed their behaviour radically, it could have a detrimental
impact on the NHS as a whole, and especially those most in need of free
prescriptions. People who are registered with a Welsh GP, and Welsh patients
registered with an English GP who have an entitlement card, can get their
prescriptions free from a Welsh pharmacist.
Scotland - Local NHS News
NHS Grampian - Substance Misuse
Moray CHP is trying to help the growing number of heroin addicts
requiring methadone by appointing a new GP who will be able to prescribe the
treatment. Newspaper reports have highlighted the case of a patient who has
been unable to register with a methadone replacement programme because her
local GP in Aberlour no longer offers the service, and because she is not
registered with the GPs in Dufftown and Elgin who do.
Andrew Fowlie,
General Manager of Moray CHP, has said that the new GP is due to be appointed
in the coming weeks. He will not be attached to any particular surgery, but
will prescribe the treatment himself and support other GPs who already do so.
There are between 50 and 60 people on methadone programmes in the area, nearly
double the number three years ago, when there were no more than
30.
NHS Greater Glasgow & Clyde - Substance Misuse
A
new treatment, developed at the University of Miami, is to be introduced to
Glasgow in an attempt to help young people with addiction problems. The
treatment, Multi-Dimensional Family Therapy (MDFT), includes family therapy
sessions and involvement techniques as well as traditional methods.
Professionals from Miami have been training 10 members of staff from the
Glasgow Addictions Service, which is a partnership between NHS Greater Glasgow
and Clyde and Glasgow City Council. The service will begin once their training
ends in February.
Gemma McNeill is Senior Officer with the Glasgow
Addiction Service, which is hoping to include 40 young people and their
families in the pilot. If successful, MDFT will be rolled out across Glasgow.
Scotland is one of only five European countries to be exploring MDFT - the
Netherlands, Belgium, Switzerland, Germany and France are also in the process
of training staff.
NHS Tayside - Chronic Pain Service
It
is reported that NHS Tayside might stop accepting referrals to its Chronic Pain
Service from Raigmore Hospital (NHS Highland) because local patients are
experiencing longer waiting lists. The Tayside Integrated Pain Service is run
by a team of doctors, nurses and psychologists and deals with both acute and
chronic pain. Pain clinics are located across Tayside and can be found at:
- Strathcaro Hospital, Angus
- Ninewells Hospital, Dundee
-
Perth Royal Infirmary
Raigmore Hospital, provides an acute pain service
for people recovering from operations, but does not offer a chronic pain
service for long-term patients such as amputees, those with nerve injuries or
complex back problems. Consideration has been given to establishing a clinic in
Inverness with a visiting consultant - NHS Highland would have to pay for the
service. NHS Highland currently uses the services of both NHS Tayside and NHS
Grampian.
Northern Ireland - Local NHS News
Eastern HSSB - Smoking Cessation
Smokescreen is a newsletter published by the HSSB providing
information and advice to people who want to give up smoking. Topics include
where people will and won't be able to smoke from April, and contact details
for specialist support to stop smoking.
Northern Ireland - Reform of
Public Administration (RPA) / Commissioning
The final consultation
on the Health and Social Services Reform Order has begun and will end on 11
April 2007 - it will create a single Health and Social Services Authority, 7
primary care-led Commissioning Groups and a new Patient and Client Council.
Following the public consultation exercise which ended in December 2006, the
Minister for Health and Social Services, Paul Goggins, has also announced the
formation of a Joint Committee to prepare for Local Commissioning. The
committee will include representatives from the four existing Health and Social
Services Boards.
Mr Goggins said: "Local health and social care
professionals will play a leading role in planning and buying services that are
responsive to the needs of the local community".
Southern HSSB -
Stroke Services
A report on stroke services within the HSSB area
was recently given to the board. Both Daisy Hill and Craigavon Area Hospital
have dedicated stroke units with multi-disciplinary teams, and there are
community rehab services with Big Lottery funding.
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