NAPC News 5 March 2010

NAPC News

This week saw a meeting of Dr Johnny Marshall with members of other contractor professions and nursing to explore opportunities for collaboration.

Arrangements continue to take place for the first of three regional pilots on clinical leadership, which is scheduled to take place on 11 March in Sutton Coldfield, West Midlands. The subsequent two events will take place on 18th and 25th March in York, Yorkshire and Humber and Stansted, East of England respectively.

NHS Cash Crisis Could Hit Patient Care

The Guardian reported this week on the findings of its joint survey carried out with health think-tank, Civitas, into the deficits being run at more than a third of NHS Primary Care Trusts (PCTs). A front page story and further reporting in the body of the paper detailed a more than £130 million overspend in the NHS this year and asked how the service would be able to cope with real term reduction in budgets in the future if so many PCTs were already running deficits.

Commenting on the figures, former Labour minister, Lord Warner, said that in the 21st Century the NHS had received more than it knew what to do with. It was like giving a starving man foie gras and caviar. The NHS had not managed that largess well, he commented.

Lord Warner also identified the numbers of PCTs and the political difficulties of major service redesign as part of the reason he believed the NHS would struggle to deal with tightening finances.

Every Penny Counts

Supermarket chain, Asda, announced this week that it was to sell fertility drugs without profit, claiming that it would save patients hundreds of pounds per treatment. The retailer is to charge £1,171.41 for drugs to accompany one cycle of IVF, claiming to save customers up to £820.

Councils To Look To Control PCT Cash

According to a paper, published by think tank, London Councils, London's local authorities should be given control of PCTs' non-acute budgets. The paper suggests that the move would integrate services and allow GPs to refer to all public services, not just those run by the National Health Service. It said the move could offer direct democratic accountability and unified governance.

In the longer term, there should be a role for elected borough leaders and the mayor of London to scrutinize and influence healthcare strategy in London, the report said.

PCT Plan Deep Cuts To Primary Care

Details are emerging of PCT plans to cut millions of pounds from primary care contracts this year, despite Department of Health insistence that trusts must not slash and burn to make savings.

Documents from PCTs that have finalised financial plans for beyond 2010/11 revealed that trusts were planning to recover millions from PMS and GMs practices. A Strategic Health Authority sources said that the Department of Health expected to save £42 million from primary care contracts if the Department of Health's proposals for GP pay were accepted by the Review Body this March.

PCTs have been told by health minister, Mike O'Brien, to use this year's 5.5 per cent growth to invest in efficient, innovative services and reduce hospital costs rather than ‘slash and burn'.

But across the East Midlands SHA area, PCTs calculated that up to £37 million could be saved this year by ‘reducing the cost of primary care contracts'. Benchmarking appeared to be a common theme, with PCTs hoping to reduce spend on primary care contracts to match regional or national averages.

Board papers from NHS South Gloucestershire revealed an opportunity to save £2.7 million by reducing GMS and PMS spend to match other areas.

GPC deputy chairman said it was likely to be enhanced services that were cut - areas where the PCTs had complete control. It could also be in the form of PMS reviews. He urged trusts to invest in primary care to resolve financial challenges elsewhere and said that lowering practice funding to match national or regional benchmarks failed to recognise variation between practices. It was simplistic, he commented, to assume everyone should be prescribing in the same way as the lowest prescriber.

Complaints Rise

Complaints against GPs and dentists have risen 11 per cent in a year. Latest figures form the NHS Information Centre shows written complaints in England rose form 43,942 to 2007/8 to 48,597 in 2008/9. Of these, 14,866 were about clinical care and 11,003 were about poor communication or attitude.

Trauma Care

Trauma care has not significantly improved for more than two decades, according to a National Audit Office report which said that more than 450-600 lives could be saved every year if organisation was better. NAO comptroller and auditor general Amyas Mores, said that the Department of Health and the NHS had to get a grip on coordinating services through trauma networks, on costs and on information on major trauma care, if they were to prevent unnecessary deaths.

Liquid Detergent Capsule To Blame For Wave Of Eye Injuries

Doctors have warned of a recent wave of eye injuries caused by children coming into contact with the liquid inside detergent capsules. The capsules accounted for 40 per cent of eye chemical injuries in under-fives at the Western Eye Hospital, Imperial College Healthcare NHS Trust in London, last year.

Guy's and St Thomas' Poisons Unit also received 192 enquiries relating to liquid detergent capsules during 2007/8.

Although the majority of relevant cases of eye injury were treated without further complications, the doctors reveled that one child seen recently sustained extensive burns to the cornea, as their eye was not flushed out with sterile water until they had reached the emergency department.

Writing in the British Medical Journal, the study authors noted that some manufacturers had made their hazard labels more prominent, but greater consumer awareness was required to reduce injury, they said. Such concentrated cleaning products should be kept out of the reach of children and immediate irrigation was crucial to reduce the risk of clinically significant injury.

Football Fans At Risk Due To Lack Of Stadium Defibrillators

Many football stadia in Europe do not have defibrillators to treat spectators who suffer heart attacks, new research in the European Heart Journal has found.

A study of 187 top sporting venues in ten countries found that more than a quarter did not have on-site defibrillators and even more had no medical action plans or CPR training programmes in place.

The study authors claimed that the lack of preparedness was probably due to poor attention to safety procedures rather than financial constraints, as they had only looked at the top clubs with good resources.

Vitamin D Recommended For Severe COPD

Patients with severe COPD should take vitamin D supplements, Belgian researchers have suggested. Wim Janssens and colleagues from Leuven University measured serum vitamin D levels in a group of 414 people aged over 50 years.

Among 262 patients with COPD, the degree of vitamin D deficiency was correlated with severity of lung symptoms. In addition, COPD patients with two copies of a particular variant of the vitamin D binging gene rs7041 were at higher risk of vitamin D deficiency, the researchers found.

The team concluded that patients with severe COPD, particularly those carrying at risk rs7041 variants warranted vitamin D supplementation.

Vitamin De deficiency in COPD is thought to be a consequence of increased skin ageing secondary to smoking and reduced sunlight exposure as a result of exercise intolerance.

Stored Vitamins Go Off In A Week

Vitamins and health supplements can become useless in as little as a week if stored in kitchen and bathrooms, researchers warned yesterday. They are ruined by high humidity and degrade within days, even if they are stored in pots with their lids tightly secured. Opening and closing packaging allows moisture in and destroys the product.

Magnetic Pulse Relief For Migraines

Millions of migraine sufferers could find relief through a device that delivers a magnetic pulse to the back of their heads. Researchers found that people who suffered from migraine ‘with aura', when spots in front of the eyes or pins and needles precede the headache, can benefit from the treatment.

A study published in Lancet Neurology, found that after two hours, 40 per cent of htose with the genuine implement said they did not have any pain compared with 22 per cent of those with a sham device. Pains found it easy to use and there were no side effects.

Arthritis Drug Too Costly For England

According to the press, thousands of rheumatoid arthritis sufferers in England could be condemned to a ‘lifetime of pain' after the drugs rationing body, NICE, turned down a last option treatment, available in Scotland. RoActemra is widely used in Europe and the US for patients who have failed to respond to other medication and was approved for use in Scotland in January. But NICE, which covers England and Wales, said it was too expensive for patients here, even thought according to manufactuers, Roche, it costs £25 per day, the same as existing treatments.

Nurses Could Be Primary Care Gatekeeper

Nurses should be the first point of contact for most people seeking to visit a GP practices, RCN Scotland has said.

It cited a report by a nurse consultant, which found that 90n per cent of out-of-hours consultations could be carried out by appropriately trained nurses.

Theresa Fyffe, Director of RCN Scotland said that since 2004, the vast majority of GP practices had opted out of providing out of hours services. Highly qualified and skilled nurse practitioners had met this challenge and offered appropriate care and treatment to patients. If nurses could provide such services in out of hours, they could also provide the same level of high quality care during the day.