NAPC News 3 March 2010

Nurses Told To Be More Caring

Nurses should be more caring and compassionate towards patients in order to restore public confidence in the NHS, a government review has said. A review of nursing and midwifery commissioned by the Prime Minister and chaired by Ann Keen, the junior health minister and former nurse, recommended that ‘to restore public confidence........nurses and midwives restated their commitment to the public and service users in a pledge to deliver high quality, compassionate care.

Female Hormones To Fight Prostate Cancer

Prostate cancer that is resistant to therapy could be overcome with a treatment based on female hormones, research has suggested. The secret is to target a particular tumour molecule that responds to oestrogen. Scientists at Monash University in Australia developed a drug that selectively targeted one of two oestrogen receptors present in prostate tumours, which causes cancer cells to self-destruct when activated. The findings are published in the National Academy of Sciences.

GPs Denied Five Figure Sums On Rent

Up to three quarters of UK practices may be receiving too little notional rent, with some losing out on five figure sums each year, according to the GP press.

Practices have already received five figure uplifts after challenging the level of rent they received from their PCT, according to a firm of surveyors, which specialises in GP premises funding.,

GP Surveyors, which has worked with around 2,000 practices, considers that between 70-80 per cent of practices could challenge their notional rent and receive an uplift. The average uplift achieved is around 15 per cent, but can be up to 80 per cent, the firm claims.

The system for resolving notional rent disputes has been reformed to prevent the NHS Litigation Authority being inundated with unresolved disputes. The changes aime to stop PCTs blocking challenges by practices.

A senior surveyor from GP Surveyors said the new process for dealing with notional renta disputes had been issued a direct result of the company challenging PCTs. He cited a series of reason why practices' notional rent may be set too low. District valuers often use historic or incorrect figures for practices' floor space or can miss other features that could boost the value of the premises, he said. They might also fail to take account of existing deals with other practices.

A Sense Of Purpose Could Help to Cut Risk Of Alzheimer's

Elderly people with a strong sense of purposes in life face a reduced risk of developing Alzheimer's disease, researchers have found. New research published in the journal Archives of General Psychiatry assessed more than 900 elderly people, aged about 80 at the beginning of the study, looking at their personality traits and then followed them up an average of four years later to establish if they had developed Alzheimer's disease. The study found that people who agreed with statements such ‘I feel good when I think of what I have done in the past and what I hope to do in the future' and ‘I have a sense of direction and purpose in life' were less likely to develop the disease.

Atkins Diet Helps Heart

Controversial diets aimed at rapid weight loss can reverse life-threatening artery damage in obese people, a study has shown, Tests revealed that patients who went on the diets lost moderated amounts of weight, lowered their blood pressure and developed healthier carotid arteries, which supply the brain with blood. Unhealthier, thicker arteries, caused by fatty deposits, are associated with heart attacks and strokes.

Priorities For Quality Pilots

GP practices, community service providers, community pharmacists and out of hours providers will be expected to set out at least three, but no more than five, priorities for quality improvement each year, if pilot proposals become the template for primary care quality accounts due to be introduced next year.

Department of Health guidance published last week informed organisations participating in the pilots that they must demonstrate how their priorities responded to the needs of the local population and also show that patients and the public had been listened to.

The Framework for Quality Reports by Primary Care and Community Services Providers sets out what must be included in this summer's reports, the precursors to next year's quality accounts, which are being piloted across NHS North East and NHS East Midlands.

NHS London Makes Lead Commissioners Directors

NHS London is taking a tighter hold of its primary care trusts by employing the capital's lead commissioners as directors of the strategic health authority.
Five of the existing six acute commissioning sector chairs, who have so far split their time with running their PCT, will be made into full time directors for their patch. Meanwhile, the north west London will be led by NHS London deputy chief executive, Anne Rainsbury, NHS Westminster chief executive, Michael Stott will return to the PCT full time.

The new chiefs will be responsible for all performance management in their patch.

The changes come against the background of plans for huge and controversial service change in London, a response to poor outcomes, growing demand and investment cuts.

The Strategic Health Authority said hospital activity needed to be reduced dramatically and plans were being developed for major reconfiguration. These have prompted resistance from politicians, campaigners and some acute trusts. Proposals include mergers of several acute trusts.

The 31 London PCTs have been told to quickly develop services based in the community, often in the form of new health centres, which are opposed by existing GPs

NHS London chief executive, Ruth Carnalll said that quite a lot of progress had been made, but the SHA would like to give sector chief executives more authority over their patches without going for PCT mergers and a big reorganisation. Moving further functions to sectors, she said, would contribute to the 30 per cent cut in management costs required by the government.

Ms Carnall commented that the change would mean there was still flexibility to shape commissioning depending on proposals after the general election and it would allow PCTs to further explore joint commissioning with councils. The SHA was planning to set out models for how it could work.

Fresh Investigation Stall Branch Surgery Plans

The Department of Health has not yet approved the opening of a Kingston GP group's new branch surgery, two months after the co-operation and competition panel said it should go ahead.

In December the panel concluded that a decision made by NHS Kingston not to allow a GP practice, Churchill Medical Centre, to open a new branch surgery, was inconsistent with principles and rules for co-operation and competition. Following a six month investigation, it recommended that the Department of Health and NHS London should give the go-ahead for the surgery to open. However, in a letter to the practice, Jonathan Tringham from the Department of Health customer service centre, said it unfortunately, was not simply a case of accepting the co-operation and competition panel's recommendations without the Department of Health first considering the impact on the broader policy, the regulatory framework and the wider NHS. He commented that a further period of investigation was inevitable.

NHS London is separately reviewing how the surgery could affect the local health economy.

COPD Strategy

The Department of Health has launched a consultation on a national strategy to help tackle chronic obstructive pulmonary disease. The 10 year strategy sets out a series of recommendations on the prevention of COPD, early diagnosis and treatment, and better self- management. The consultation will run until 5 April. (www.dh.gov.uk/consultations).

PCT Network

John McIvor has been appointed chair of the NHS Confederation's PCT Network. Mr. McIvor is chief executive of NHS Lincolnshire and has been a member of the PCT Network board since its inception in 2007. He replaces Lise Llewellyn, who stepped down as chair in Januarys, but remains in her position as chief executive of NHS Berkshire East.

PMS Reviews May Force GPs Back To GMS

PMS practices could lose tens of thousands of pound a year as PCTs force them to switch to GMS contracts in an effort to make efficiency sabigns.

Dr James Kingsland, President of the National Association of Primary Care, said most PCTs wee carrying out a complete review of PMS contracts, which could see PMS contracts forced back to GMS deals. He added that the reviews could bring a ‘substantial reduction' in PMS practices' income in 2010/11. Those practices that had difficulty in demonstrating their added value would be most at risk, he said.

Dr Kingsland went on to say that PCTs' approach was ‘rudimentary' and ‘unfair' and suggested that their action did not align with world class commissioning. He warned that PMS contracts should not be seen as a ‘cash cow to go and raid' in times of financial difficulty. PMS contracts should have a strong future, but it was in the hands of PCTs becoming world class commissioners.

15,000 Young Women Need Early Cervical Examinations

Young women with possible symptoms of cervical cancers are having their diagnoses delayed by GPs who recommend a smear test rather than full pelvic examinations, Britain's leading oncologists warned.

Sir Mike Richards, the Department of Health's clinical director for cancer, told the Times that family doctors needed to fast track all suspected cases for examination.