Chief Executive Bulletin: 13 - 19 October 2000
Issue 37
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Hard copy versions of these publications can be ordered from the NHS Responseline 0541 555 455.
Contents:
NHS interest
1. HSC 2000/32 Decontamination of Medical Devices
2. Consultation On Establishing National Hip And Knee Joint Replacement Registry
3. Junior Doctors' Hours: Improving Doctors' Working Lives
4. Priority Treatment for War Pensioners
5. National HRM Development programmes - Information sessions
NHS and Social Care interest
6. Guidance For Health Professionals On The Care Of Patients With Creutzfeldt-Jakob Disease (CJD)
7. CI(2000)18 "Who's Looking After The Children?" Report Of The Inspection Of Registration And Inspection Arrangements For Under Eights Day Care Services
Social Care interest
8. LASSL (2000)12 Draft Requirements Of Information Systems For Children's Personal Social Services
9. Revisions to PSS PAF data for 1999-2000
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NHS interest
1. Decontamination of medical devices
19/10/00 - HSC 2000/32
HSC 1999/179 emphasised the importance of implementing guidance on the cleaning and sterilization of medical devices to reduce the risk of transmission of infectious agents. HSC 1999/178 stated that effective cleaning of surgical instruments prior to sterilization is of the utmost importance in reducing the risk of transmission of vCJD via surgical procedures.
Following the issue of HSC 1999/179 and the reissue of guidance on the complete process of decontamination of medical equipment, a snapshot survey of current decontamination practices in a small number of healthcare premises in England has been carried out. A more comprehensive review of decontamination provision across the health service now needs to take place so that plans for the future can be based on national findings.
This circular identifies some immediate steps that should be taken, without waiting for the outcome of the review, and medium-term actions required to ensure that decontamination is carried out effectively.
It also sets out the information needed to gather a robust picture of decontamination provision nationally and describes the support available to assist NHS trusts, Health Authorities and Primary Care trusts in delivering the actions required.
Link to HSC 2000/32
The annexes referred to in this circular will be available from 20 October 2000 at website www.nhsestates.gov.uk.
"Decontamination Guidance" CD-ROM issued with HSC 1999/179, and available on NHSnet at nww.doh.nhsweb.nhs.uk/health/decontamination-guidance.htm
HSC 1999/123:Governance in the new NHS: Controls assurance statements 1999/2000 risk management and organisational control.
HSC 1999/178: Variant Creutzfeldt Jakob Disease: minimising the risk of transmission.
HSC 1999/179: Controls assurance in infection control: decontamination of medical devices.
HSC 2000/002: The management and control of hospital infection.
Forthcoming HSC: Controls assurance statements 2000/2001 and establishment of the controls assurance support unit.
MDA DB 2000(04) http://www.medical-devices.gov.uk/db2000(04).pdf Single-use medical devices: Implications and consequences of reuse.
MDA SN 2000(18) http://www.medical-devices.gov.uk/sn2000(18).htm Handling of surgical instruments on loan from another organisation
Guidelines for Implementing Controls Assurance in the NHS. Guidance for Directors (Nov. 1999)
Controls Assurance Standards 1999/2000: Risk Management and Organisational Controls: Infection Control Standard
Ref. 22609 Will be mailed to HA Directors of Public Health, Consultants in Communicable Disease Control, NHS Trust Medical Directors, Directors of Nursing, Chief Pharmacists and Chairs of Infection Control w/c 23/10/00.
2. Consultation on establishing national hip and knee joint replacement registry
A consultation exercise on the establishment of a national hip and knee joint replacement registry (NJR) was launched on 18 October 2000. The consultation period will run until 31 January 2001. Comments can be made via the DH website, www.doh.gov.uk/joint_registry
Should we decide to proceed, establishing a registry could lead to:
earlier review of patients with joint replacements
regular monitoring of performance of these new joints; and
faster identification of those joint replacements that perform badly.
monitoring how well individual hospitals both in the NHS and private sector perform in this area of healthcare.
Importantly, such a registry could help inform the development of indicators to support the Performance Assessment Framework, which we have set out in the NHS Plan and would fit entirely with improving quality through clinical audit, clinical governance and promoting 'An Organisation with a Memory'."
The consultation exercise comes in response to recommendations in April 2000 relating to hip replacements from the National Audit Office (NAO) and by the National Institute for Clinical Excellence (NICE).
3. Junior Doctors' Hours: Improving Doctors' Working Lives
>From Steve Barnett, Deputy Director of Human Resources, NHS Executive to Regional Directors for action on reducing junior doctors' hours and improving their living and working conditions. The letter highlights Ministerial priorities in this area, in particular the setting up of Improving Junior Doctors' Working Lives Action Teams, which are to be fully functional by 1st December 2000 when the new juniors' contract comes into effect. The Action Teams are to replace the New Deal regional task forces, and will be part of the performance management process.
Link to letter
4. Priority Treatment for War Pensioners
Despite the reminder in the Chief Executives' Bulletin for the period 10-16 March 2000, there have been cases where the guidance in HSC(97)31 has not been followed. Chief Executives should ensure that all staff involved in the referral process are aware of the requirements of HSG(97)31. This will include:
general practitioners
hospital consultant medical staff
medical secretaries.
HSG(97)31 sets out the arrangements under which NHS hospitals should ensure that they give priority treatment to war pensioners, both as inpatients and as outpatients, for examination or treatment relating to the condition for which they receive a war pension. A HREF="http://194.189.27.190/doh/coin4.nsf/d06aa2d76da4c1d6002568560064952b/7721d3f7b856e5b5002564c80051f98b/$FILE/31HSG.PDF">Link to HSG(97)31
5. National HRM Development programmes - Information sessions
Further to the e-mail sent out on the 11th October regarding the National HRM Development programmes - Information sessions, we would like to inform Chief Executives in the West Midlands that their regional session is being held in conjunction with Trent Region on the 23rd October.
NHS/Social Care Interest
6. Guidance For Health Professionals On The Care Of Patients With Creutzfeldt-Jakob Disease (CJD)
New guidance for healthcare workers on caring for patients with Creutzfeldt-Jakob disease is on the Department of Health website at www.doh.gov.uk/cjd/cjdguidance.htm. This will also be of interest to social services professionals and other local authority staff. It complements advice on care planning in the document "CJD: Good Practice Guidelines for Social Services Professionals" produced by the CJD Support Network in conjunction with the Association of Directors of Social Services in November 1998
7. CI(2000)18 "Who's Looking After The Children?" Report Of The Inspection Of Registration And Inspection Arrangements For Under Eights Day Care Services
This inspection report is particularly timely, as local council registration and inspection responsibilities for regulating under eights services will transfer to the new OFSTED Early Years Directorate in September 2001. The inspectorate has worked closely with both DfEE and OFSTED in undertaking this programme of inspections, and the report has been designed to ensure that the findings contribute helpfully to the transfer. It is clear that there are many improvements which local councils can properly be asked to undertake in the run up to the handover. However, in consultation with OFSTED, we have ensured that we are not suggesting any improvements that would not be helpfully assimilated into the development work of the new Early Years Directorate.
Link to CI(2000)18
Ref. 22479 CI letter, 22477, Report, 22478 Summary leaflet. Mailed to HA and NHS trust Chief Executives and Directors of Social Services
Social Care Interest
8. LASSL (2000)12 Draft Requirements Of Information Systems For Children's Personal Social Services
This letter announces the posting on the Quality Protects website of draft documents which set out the core information requirements of systems needed to support the delivery of children's personal social services. The purpose of the documents is to define the information requirements in a consistent and methodical manner and, as such, they form the basis of a high-level specification.
The website address is: www.doh.gov.uk/qualityprotects/info/publications/coreinformationreq.htm
Link to LASSL (2000)12
Ref. 22537. Copies sent to LA Chief Executives and Directors of Social Services 18/10/00.
9. Revisions to PSS PAF data for 1999-2000
The dataset for the publication "Social Services Performance in 1999-2000" that we issued on 13 October was finalised on 22 September. No data received after that were included. The last deadline we gave SSDs was 13 September and any data submitted by then were included.
We have decided to allow just two types of changes to be included in the next release of KIGS at the end of November (updates to the Internet spreadsheets will be issued at the same time).
The first category is where SSDs were unable to supply data in time for inclusion and were therefore awarded the lowest performance band with an M for missing data. Kevin Wrake is E-mailing Key Statistics contacts in all SSDs that did not make complete returns saying that, if they can let him have the missing data (some already have) by 31 October, we will include them in KIGS and on the Internet at the end of November, revising their performance banding as appropriate.
He is also E-mailing Key Statistics contacts in all SSDs saying that some SSDs failed to correctly complete cells on the Key Statistics spreadsheet which indicated whether or not they used an alternative source to RAP for indicators C29-32 and that, if they are one of these and let us know by 31 October, we shall include corrected data and bandings in KIGS and on the Internet at the end of November.
We shall not be including any other revisions in the end November KIGS release. We shall, however, pass onto SCR any revisions that we are made aware of so that they can be taken into account in their monitoring, annual reviews and performance assessment meetings.
We also plan to issue revised unit cost indicator data in the Spring, based on the final RO3 data, at the time that we publish those data. We have not yet decided whether to issue any revisions to other indicators then or whether to do this only when we publish the 2000-2001 data in 12 months time.
For further information contact Kevin Wrake (E-mail [log in to unmask], telephone 020 7972 5599)."
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