National Health Service, PCT & Local Health Board News - May 2006

National Health Service (NHS), PCT & Local Health Board News - May 2006

England - Local PCT News

Blackburn with Darwen PCT - Integrated Medicines Management Programme

Stakeholders from the PCT, Social Services, voluntary services, education, GP practices and community pharmacy have attended the first meeting of the PCT's new Integrated Medicines Management Programme for People with Long-Term Conditions. Blackburn with Darwen is one of 25 organisations across the country participating in the National Prescribing Centre's IMMP project. It is designed to help NHS organisations implement an integrated approach to medicines management, thus supporting people with long-term conditions across whole health communities.

Group members from Blackburn with Darwen also attended the first national learning workshop which enabled them to network with stakeholders from other organisations in the scheme. The 25 organisations are:- Ashfield & Mansfield PCTs, Ashford PCT, Berkshire West PCTs (Reading PCT), Blackburn with Darwen PCT, Bolton, Salford & Trafford Mental Health Trust, Brighton & Hove City PCT, Coventry PCT, Eastbourne Downs PCT, East Yorkshire PCT, Epping Forest PCT, Gateshead Health NHS Trust, Gedling PCT, Great Yarmouth PCT, Guildford & Waverley PCT, Hartlepool PCT, Huntingdonshire PCT, Oxford Radcliffe Hospitals NHS Trust, Solihull PCT, South Birmingham PCT, South Gloucestershire PCT, Southampton City PCT, South Stoke PCT, Wakefield West PCT, Walsall Hospitals NHS Trust and West Norfolk PCT.

Bristol South West PCT - Walk-In Centre Trial Relocation

The Bristol City Gate Walk-in Centre, in Broad Street, will move to the Bristol Royal Infirmary Emergency Department (ED) for a six-month trial period from Monday 15 May, so that its services can be provided alongside those of the Emergency Department. The ED is one of the busiest in the region, seeing around 1,300 patients a week, and the pilot should reduce the number of patients who need to be treated there. The move should also benefit patients who attend the Walk-In Centre, as they can be referred to the ED should their condition require this. The move is being organised jointly with United Bristol Healthcare Trust, which runs the Emergency Department, and will be fully evaluated - a three-month public consultation is being proposed to run from July.

East Anglia - Diabetes

A study of the East Anglian Ambulance Trust conducted by Diabetes UK has shown that 85% of the 2,256 diabetes-related emergency callouts were for hypoglycaemia, and that almost two thirds of the people who made the emergency calls between April 2004 and March 2005 said they had not received specific education on managing hypoglycaemia in the last year. More than half of these calls were from older people, and Tracy Slater, Eastern Regional Manager for Diabetes UK, said: “Although some provision is being made to provide education for those newly-diagnosed with diabetes within the eastern region, it is often the older members of our community who are forgotten about and who need to rely on the emergency services when their treatment does not go to plan.” Suffolk West PCT has a centre providing help for diabetic patients, a website providing information, and health workers in the community working with diabetes patients to help them manage their own condition and lead a normal lifestyle. However, a spokesperson noted that “It is down to the patient to make contact with these services.”

Suffolk Coastal PCT has been participating in a national pilot which has provided structured education for new patients with Type 2 Diabetes in the east of the county. The pilot has now finished, but the PCT is working to ensure that patients still have access to the information. Colchester and Tendring PCTs are in the middle of a year-long pilot project designed to help people in north east Essex with diabetes look after themselves more effectively. A total of 2,500 adults in Colchester, Tendring and the Colne Valley are taking part in the trial and, if successful, it is hoped a personal handbook will be given to all 12,000 adults with diabetes in the area. Tendring PCT has been holding special education sessions for diabetes patients, which have dealt with managing hypglycaemia. A specialist Diabetes Centre will be part of the new Colchester Primary Care Centre, due to open this spring. A spokesperson for Colchester PCT stressed the partnership between patient and health professional, and noted that the patient also has a responsibility to themselves.

Kennet & North Wiltshire / West Wiltshire PCTs - 24hr Community Teams

The PCTs have published Pathways for Change, a consultation document on their proposals to focus health services within the local community rather than in hospitals. Proposals include: - Creating approximately six new modern Primary Care Centres - "super" GP Practices - that bring together a wider range of services under the one roof. Patients will be able to access GP services, family planning and children’s services, dental and diagnostic services all in the same facility.

Creating up to three modern New Generation Community Hospitals. These will provide a wider range of services than the current facilities, including some services that would normally be provided in the district general NHS hospitals. These include inpatient care and day surgery facilities. Setting up New Neighbourhood Teams, comprising community matrons, nurses, therapists and rehabilitation staff, which will provide 24-hour care to help people, particularly the elderly, to live independently at home.

Mental Health Foundation Trusts

Monitor, the independent regulator of NHS foundation trusts, has authorised the first mental health foundation trusts, with effect from 1 May 2006. To date, only acute care NHS trusts have applied and been authorised as NHS foundation trusts. The new trusts are:

- Oxleas NHS Foundation Trust
- South Essex Partnership NHS Foundation Trust, and
- South Staffordshire Healthcare NHS Foundation Trust North

Staffordshire Combined Healthcare NHS Trust has requested a deferral of the consideration of its application to allow further time for the trust to complete negotiations with commissioners and to address outstanding issues relating to financial controls and management.

North East / North Yorkshire Health Community - Mental Health

Every PCT in the North-East and North Yorkshire is being asked to appoint at least one Community Development Worker (CDW) to identify why black and ethnic minority communities are failing to access mental health services. Extra funds are available for this. By the end of 2006, County Durham & Tees Valley should have appointed 13 CDWs, another 17 are due to be appointed in Northumberland, Tyne & Wear, and the four North Yorkshire PCTs will share the appointment of 14 CDWs in North & East Yorkshire and North Lincolnshire.

In County Durham and Tees Valley, four areas have been identified for the CDWs:

- the asylum seeker community in Middlesbrough
- the rural areas of Durham - university students, and
- the prison and police services

North Somerset PCT - Diabetes Peer Advisers

The PCT and the Health Trust have established a Diabetes Peer Adviser Group. Peer advisers are given training so they can pass their expertise on to others, and it has been found that both patients and carers relate well to them. The concept of Peer Advisers was developed at the Isle of Wight NHS Trust by Dr Arun Baksi. In North Somerset, Peer Advisers have also become trainers on self-care courses and their knowledge has meant they have made effective suggestions for improvements in care. Eleven local diabetes patients have just completed their training at Weston Area Health NHS Trust and have qualified as Diabetes Peer Advisers. There are plans to extend the Peer Adviser model to other ongoing conditions, and Peer Advisers will also be involved in Practice-based Commissioning as it develops in North Somerset, to ensure services develop to meet people's needs.

SHA Reorganisation

The first announcement from the consultations on NHS reorganisation has been made regarding the configuration of England's Strategic Health Authorities. The number of SHAs will be reduced from 28 to 10 in July, subject to parliamentary approval. The new SHAs are:

NORTH EAST - Northumberland, Tyne & Wear - County Durham & Tees Valley
NORTH WEST - Cumbria & Lancashire - Cheshire & Merseyside - Greater Manchester
YORKSHIRE & THE HUMBER - North & East Yorkshire and Northern Lincolnshire - West Yorkshire - South Yorkshire
EAST MIDLANDS - Trent - Leicestershire, Northamptonshire & Rutland
WEST MIDLANDS - Birmingham & the Black Country - Shropshire & Staffordshire - West Midlands South
EAST OF ENGLAND - Norfolk, Suffolk & Cambridgeshire - Essex - Bedfordshire & Hertfordshire
LONDON - North Central London - North East London - North West London - South East London - South West London
SOUTH EAST COAST - Surrey & Sussex - Kent & Medway
SOUTH CENTRAL - Thames Valley - Hampshire & Isle of Wight
SOUTH WEST - Avon, Gloucestershire & Wiltshire - Dorset & Somerset - South West Peninsula

Swindon PCT - 28-day Prescribing

The PCT has introduced a Repeat Prescribing Scheme which is predicted to save £400,000 this year and a further £1m per year thereafter - patients who receive repeat prescriptions will now be given enough medication to last a maximum of 28 days. It is hoped that this will reduce the amount of medication which is wasted when prescriptions are stopped or changed, and also make it easier for GPs to review a patient's repeat medication to ensure that what is being prescribed is what is being taken. Deborah Lee, Director of Primary Care and Commissioning, said: “We understand that this may be inconvenient to a small number for patients, but there are so many people who will benefit from the scheme and we believe we can overcome the concerns of the small few who may be inconvenienced."

United Bristol Healthcare / North Bristol NHS Trusts - New Cardiac Centre

The SHA has approved plans to expand cardiac services in Bristol. The £65m project has two key elements: a new Regional Adult Cardiothoracic Centre (located at Bristol Royal Infirmary) and expanded Cardiology facilities (at North Bristol NHS Trust). The Cardiothoracic Centre at Bristol Royal Infirmary will mean that for the first time, cardiology and cardiac surgery services would be brought under one roof, enabling staff to provide much more ‘seamless’ care - staff will be able to care for patients according to their clinical needs, rather than on the basis of which specialty they fall under. A new theatre suite will enable cardiac surgical teams, cardiologists and radiologists to work together on a complex case. At North Bristol, two additional Catheter Labs will be built at Frenchay Hospital, meaning that fewer patients from the north of the city will have to travel to Bristol Royal Infirmary for angiography and angioplasty.

Wales - Local Health Board News

North Wales NHS - Centralised Management Services

A new centralised management service has been approved, providing finance, human resources, procurement and IT support services for the 3 Acute Trusts and 6 LHBs in North Wales. The unit will start operating in October and is expected to save £2m a year.

Wrexham LHB - Children's Mental Health

Following significant investment in the ADHD Service (Attention Deficit Hyperactivity Disorder), the LHB has published a strategy proposing the development of the wider child and adolescent mental health (CAMH) service in the area. The "Emotional and Psychological Well-Being Strategy for Wrexham (CAMHS) - Consultation Document" has identified the services already in place and where the gaps are. A model is proposed for the development and delivery of all CAMH services, aiming to address the issues highlighted, identifying where services require new or re-development, and where improved co-ordination across agencies and Tiers is necessary. Services may also need restructuring or redesign in order to meet these aims, and the board has approved the strategy for wider consultation.

Scotland - Local NHS News

NHS Grampian - New PET/CT Scanner

A new state-of-the-art medical PET/CT scanner has been installed at Aberdeen Royal Infirmary. This is the first high performance scanner of this kind in the UK, and its installation is the initial stage in establishing a PET (positron emission tomography) imaging service for cancer patients in Scotland. The scanner has been funded by the Scottish Executive and will lead to significant improvements in the detection and treatment of certain kinds of cancer - lung, colorectal and lymphoma. In lung and colorectal cancer, it helps determine whether surgery is appropriate and with lymphomas it can indicate whether further chemotherapy or radiotherapy is required. Now that the scanner is in place, other health boards will be sending those patients most likely to benefit from imaging to Aberdeen.

NHS Greater Glasgow and Clyde - COPD

Six new British Lung Foundation (BLF) Nurses have been recruited in Greater Glasgow to extend the early supported discharge service for sufferers of COPD. The scheme is already up and running in the north of the city and has proved a great success. It allows patients with COPD, who are admitted to hospital with exacerbations, to be sent home up to three days before they would have been previously. This is done by providing comprehensive at-home care from a dedicated BLF COPD Nurse Specialist - the treatment for a COPD exacerbation is often the same each time.

Linda McCarron is the Service Manager for the scheme. She said: “The nurses running this service will be known as BLF Nurses - these are nurses who have specialist respiratory care knowledge and are able to offer patient support in this area.” Catherine Kelly is the BLF Nurse Manager. She said: “We are delighted to be working in partnership with NHS Greater Glasgow and Clyde to ensure patients with COPD receive the highest level of care at home.” BLF is funding the nurses for the first 13 months, after which NHS Greater Glasgow and Clyde will continue the funding. It is estimated that 13,000 people in Greater Glasgow are living with COPD.

Scotland - Organisational Changes

There have been major organisational changes in Scotland this month, as well as the continued formation of CHPs (Community Health Partnerships) and CHCPs (Community Health & Care Partnerships). ARGYLL & CLYDE was dissolved on 31 March 2006. NHS Highland has absorbed the parts of the health board area which fall within the Argyll & Bute Council area, and the remainder has been transferred to NHS Greater Glasgow.

NHS LANARKSHIRE now has 2 Community Health Partnerships (North and South) which both operate from Divisional Headquarters at Strathclyde Hospital. These CHPs replace the LHCC structure and the Primary Care Operating Division. The 16 hospitals which were originally shown under the PCO Division have now been moved to the Acute Division.

North CHP incorporates the following LHCCs: Airdrie, Coatbridge, umbernauld & Kilsyth, Motherwell, Wishaw/Newmains/Shotts
South CHP incorporates the following LHCCs: Clydesdale, East Kilbride, Hamilton/Blantyre/Larkhall, Rutherglen/Cambuslang

NHS HIGHLAND launched a public consultation regarding a change of name following the reorganisation. The majority of respondents supported retaining the name NHS Highland, although the board has yet to decide on the matter.

NHS Highland now has 4 CHPs: Mid Highland CHP, North Highland CHP, South East Highland CHP, Argyll & Bute CHP (formally Argyll & Bute LHCC, and Lomond LHCC from NHS Argyll & Clyde)
NHS GREATER GLASGOW & CLYDE has changed its name from NHS Greater Glasgow in order to more accurately reflect the boundary changes, and has 9 CHP/CHCPs: East Dunbartonshire CHP, East Renfrewshire CHP, West Dunbartonshire CHP, West Glasgow CHCP, East Glasgow CHCP, North Glasgow CHCP, South East Glasgow CHCP, South West Glasgow CHCP, Inverclyde CHP

Four LHCCs have been moved into NHS Greater Glasgow & Clyde from NHS Argyll & Clyde: Levern Valley LHCC (incorporated into East Renfrewshire CHP), Paisley LHCC (incorporated into East Renfrewshire CHP), West Renfrewshire LHCC (incorporated into East Renfrewshire CHP), Inverclyde LHCC (now Inverclyde CHP)

There is no longer a Primary Care Division within NHS Greater Glasgow & Clyde, and all CHPs show under the NHS Board. One Acute Services Division has replaced the previous three Acute Divisions. NHS WESTERN ISLES has not yet established a CHP. There were plans to create a CHSCP (Community Health and Social Care Partnership) but the council is not in agreement and the NHS Board may decide to establish a CHP on its own - the situation is still uncertain. NHS ORKNEY has not yet established a CHP, although the process is in its final stages and approval was scheduled for late January 2006.

Northern Ireland - Local NHS News

Belfast City Hospital Trust - Cancer Centre

The radiotherapy and chemotherapy services provided at Belvoir Park Hospital have now transferred to the new Cancer Centre at Belfast City Hospital. Part of the new development is a £4m Oncology and Haematology Day Hospital (The Bridgewater Suite) which was opened during 2003. The Day Hospital includes:

- 13 Consulting Rooms
- 4 Nurse Assessment/Clinical Rooms
- 40 Space Day Hospital
- Apheresis Suite - Medical Records Facility

Also, a new purpose-built pharmacy, designed for the preparation of chemotherapy, has been constructed. There are five clean rooms with isolators (including one room set aside for gene therapy). A 30-bed inpatient haemato-oncology unit (with ten Bone Marrow Transplant Rooms) opened in 2001 at Belfast City Hospital, and the Trust recently hosted a major symposium to celebrate the 25th anniversary of Ireland’s first bone marrow transplant. New Haematology Laboratory accommodation has been constructed on the same floor as the Oncology and Haematology Day Hospital, and is adjacent to the new pharmacy facility.

Mid Ulster LHSCG - Asthma/Diabetes

The LHSCG has funded a review of asthma patients by Community Pharmacists in Draperstown. The project involved reviewing medication, educating asthmatics about their condition and encouraging them to manage their own care effectively. The review was implemented by pharmacists from O’Kane’s Chemists following a series of meetings with GP Dr Karen Harkin, and Practice Nurse Siobhan Dan, from Draperstown Surgery. Dr Harkin and Ms Dan identified a target age-group of patients who often found it hard to attend the asthma clinic at the surgery, perhaps due to work or school commitments. These patients were then invited to visit the pharmacy for a review at a time that was available to them, which included weekends and evenings. The LHSCG, in partnership with the Locality Pharmacy Group, has also piloted an early screening service for people with who may be at risk of developing diabetes. The service was available in ten pharmacies in the area and a total of 536 people were screened during the three-month pilot.

Northern Ireland - Funding for Cancer Drugs

Health Minister, Shaun Woodward, has announced additional funding of £6m for specialist drugs used in the treatment of cancer. This is part of £21m of funding over the next two years. In November 2005, £9m was allocated to fund specialist drugs and this has been increased to £11m for 2006/7, with a £10m (previously £5m) in 2007/08. This extra £7m will be allocated to Boards to tackle local drug pressures and to provide specialist medicines to meet the needs of people living with a range of severe conditions such as osteoporosis and pulmonary hypertension. In February, an allocation of £2m was announced for disease modifying therapies for Multiple Sclerosis, and in March a further allocation of £6m was announced for patients currently waiting to start treatment with anti-TNF drugs for severe inflammatory arthritis.

Northern Ireland - Interface Pharmacist Network (Specialist Medicines)

The Interface Pharmacist Network Specialist Medicines (IPNSM) has launched a new website, intended to improve communication between those involved with specialist medicines in the Northern Ireland Health & Personal Social Services. The new website contains the latest versions of:

The new website contains the latest versions of:

- The Red/Amber List
- Shared Care Guidelines
- Guidance Documents
- Forms
- Newsletters

A Specialist Medicine is defined as one which has significant pharmacological complexity and/or rarity of use to make the prescribing of the medicine relatively uncommon in the community. The website can be found at: www.ipnsm.n-i.nhs.uk

South & East Belfast HSS Trust - Community Treatment & Care Centres

The HSS Trust is developing three Community Treatment & Care Centres in South Belfast, East Belfast and Castlereagh. Phase One of The Arches Centre in East Belfast was opened in August 2004 and work on Phase Two is currently underway. This is expected to be fully operational in early 2006. The Bradbury Centre in South Belfast is now open, providing a one-stop approach for services which were previously spread across various locations.

The third Community Treatment & Care Centre for Castlereagh will be built in the grounds of Forster Green Hospital, adjacent to the Forestside Complex. Miss Patricia Gordon, CE of South & East Belfast HSS Trust, said: “These new Centres could also provide excellent locations for the development of new outpatient clinics normally provided in hospital. Using the latest in video and tele-medicine technology it will be possible to link the patient, consultant and GP - thus avoiding a trip to the local hospital in many instances”.

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