Primary Care Pharmacy March 2000 Vol 1 No 2 p62
Round up
Information in focus
A review of recent Health Service Circulars (HSCs) and other useful documents that are of relevance to prescribing and primary care pharmacy
By Alison Astles, MRPharmS, DipPresSci
The health service circular (HSC) "Clinical governance: quality in the new NHS" (HSC 1999/065) follows on from "A first class service: quality in the new NHS" and gives information and guidance on the implementation of clinical governance over the next five years. It clearly describes the networks and resources that primary care pharmacists can use (and be part of) to lead quality in the NHS. If you want to understand what clinical governance means in practical terms for your primary care group (PCG), this is the paper to read.
"Primary care groups: taking the next steps" (HSC 1999/246) outlines the steps necessary for PCG development and guidance on moving to PCT status. On the prescribing front, it describes the need to award realistic prescribing budgets to practices.
The main points are that incentive schemes may be extended beyond prescribing to other aspects of commissioning and sharing of practice level information is encouraged.
It is important to read Annex D (PCG/PCT prescribing and budget setting 2000/1), as it gives details of the budget setting process.
"Improving quality in primary care: supporting pharmacists working in primary care groups and trusts" is a useful document produced by the National Primary Care Research and Development Centre (Manchester) and the National Prescribing Centre (Liverpool). It provides a guide to how pharmacists can work towards quality in medicines management and to developments in other areas. It covers prescribing indicators, managing repeat prescribing, guidelines, formularies, managing in new drugs, changing practice and gives some information sources.
To order a copy telephone the NPCRDC order line on 0161 275 7126 or email communit@fs1.cpcr.man.ac.uk.
HSC 1999/176 is entitled "National Institute for Clinical Excellence: initial work programme". This sets out the work programme for the NICE for 1999 and early 2000, and describes how it will go about making its appraisals. NHS bodies are asked to continue with local arrangements for managed introduction of new drugs that are not being referred to the NICE, or where the drug precedes the NICE guidance. There is useful information on the NICE website at www.nice.org.uk.
"Supporting doctors, protecting patients" is a consultation document on procedures for preventing, recognising and dealing with poor clinical performance of doctors in the NHS in England. Separate consultations are underway in Scotland ("Suspensions - a new perspective"), Wales and Northern Ireland.
Professional self-regulation needs to adapt to survive and this document puts forward some ideas for modernisation of procedures to detect and manage poor performance. Primary care pharmacists need to be aware of the new mechanisms as they develop.
A good, readable summary of "National priorities guidance 2001/01-2002/03" (HSC 1999/242) is available on the net. The priorities outlined in the circular include:
- Improving health - smoking, drug abuse, teenage pregnancy
- Saving lives - cancer, coronary heart disease and stroke
- Fast and convenient services - waiting lists, primary care
- Vulnerable people - mental health, older people, children
- Modernisation - quality, staff, information technology
"Planning for health and health care" (HSC 1999/244) gives guidance on taking forward health improvement plans, service and financial frameworks, joint investment plans and primary care investment plans. Useful but only read it if you are heavily involved in commissioning or are very keen to find out how it all fits together.
HSC 1999/243 entitled "Health authority revenue cash limits 2000/01" gives notification of the cash limit set for your health authority and indicates how far the health authority is from its fair share of resource, according to weighted capitation formulae. Essential reading for consideration of prescribing cost growth.
"Continuing professional development: quality in the NHS" (HSC 1999/154). This document sets out a framework for continuing professional development (CPD) and how this will support the clinical governance agenda. The main action points for health organisations are:
- Audit current arrangements and investment in CPD
- Develop a locally managed CPD system
- Have personal development plans for most health professional staff in place by April, 2000
- Promote multidisciplinary working
- Strategic goals for CPD should support clinical governance
This is a useful guide to confirming that arrangements for CPD for you, and your staff, are up to scratch.
A full list of HSCs can be accessed on the Department of Health website at http://tap.ccta.gov.uk/doh/coin4.nsf.