ACHCEW's work on the new Patient and Public involvement structures over the past two years has enjoyed very high visibility - so high perhaps that it might have given the impression that that is all we have been doing.
ACHCEW Update aims to correct that impression. Like National Plan News our main focus will inevitably be on issues around abolition and the transition, but we will also be highlighting other important areas of ACHCEWs ongoing work.
We hope you like ACHCEW update and find it useful. If you have any comments or there are any issues you feel we ought to include please feel free to contact me.
PATIENT AND PUBLIC INVOLVEMENT FACING ‘DISASTER’?
Politicians of all political parties are seeking urgent answers from Ministers since it was revealed that the Department of Health have been planning to allocate far too little resources to allow the new Commission for Patient and Public Involvement and Patients’ Forums to deliver their functions.
The Department has been planning on the basis of there being just 600-700 staff to support 600 Patients’ Forums working from 28 ‘local’ offices. There had been ministerial commitments to PCT Patients Forums being local one-stop shops, operating from around 300 local offices. Currently, CHCs in England have 700 staff to support 184 CHCs delivering fewer functions than Patients’ Forums. See our website for further briefings on patients and public involvement www.achcew.org.uk or contact the ACHCEW office.
A&E OR NOT A&E?
Peter Walsh and Angeline Burke (Senior Policy Advisor) have met the A&E ‘tsar’ Sir George Alberti this month to discuss issues arising from the ‘Casualty Watch’ exercise. Top of the list was the ‘grey area’ of the status of ‘assessment’ or ‘observation units’. CHCs have found great inconsistency in the use of these units. There is no national definition, guidelines or protocols for them. Many trusts listed patients in these units as waiting for admission or discharge from A&E.
Others were confused about the status of their own patients in these units – first recording them as waiting for admission to a ward and later insisting that they had been admitted. Sir George agreed that this was an important issue and also gave assurances that the Department would be seeking to monitor different waiting times consistently and report them publicly. He agreed with ACHCEW that the waiting time to be assessed by a doctor was even more important than waiting time on a trolley. Both he and a recent report by the BMA (‘Waits and Measures’) agreed with what CHCs have been saying for years – that what is needed most is more staff and more hospital beds.
PREPARING FOR THE NEW SYSTEM OF SCRUTINY
ACHCEW is actively engaged in helping those responsible for the new system to benefit from the knowledge and experience of CHCs. A resource pack has been produced for councillors taking on new responsibilities on health Overview and Scrutiny Committees (OSCs), and CHC staff and members are being trained to deliver training for local OSCs. ACHCEW has also played an active and constructive role as members of the Transition Advisory Board, which is advising the Department of Health on implementation of the new system of patient and public involvement in England. In Wales, where consultation on the future of CHCs was allowed, CHCs are going from strength to strength. The new Health (Wales) Bill guarantees their future plus an enhanced role and a stronger national association.
MENTAL HEALTH BILL
ACHCEW submitted a comprehensive response to the draft Mental Health Bill, and shares the concerns of partner organisations in the Mental Health Alliance, psychiatrists and many others about the implications of the proposals for people with mental health problems. Like others, we were initially relieved not to see the Bill covered in the recent Queen’s Speech, but now understand that the Health Secretary Alan Milburn still intends to push forward with some of the controversial proposals. ACHCEW continues to take an active part as a member of the Mental Health Alliance and will seek to achieve improvements to the proposals.
MONITORED DOSAGE SYSTEMS
ACHCEW has written to the Department detailing concerns about pharmacists charging for the preparation of monitored dosage systems (MDS) also sometimes known as ‘blister packs’. These systems enable patients to take the right dosage at the right time. ACHCEW believes that the charges may be unlawful under the NHS Act 1977 and the Disability Discrimination Act 1995. There is no provision in the NHS Act that makes it lawful to charge users for the supply of medication in MDS. The Disability Rights Commission has stated that: "Charging disabled people for blister packs if they cannot take their medication without them is therefore likely to be unlawful."
Following a meeting with the Disability Rights Commission, the Commission has agreed to take up this issue as a matter of urgency.
A TAX ON ILLNESS?
Following the publication of ACHCEW’s briefing A Tax on Illness? ACHCEW was invited to join a pan-voluntary sector campaign, convened by The Parkinson’s Disease Society, to abolish prescription charges. ACHCEW in now playing a leading role in the campaign.
LOOKING FOR A PAL
Although a Patient Advice and Liaison Service (PALS) should have been set up in every NHS Trust and PCT in the country by April 2002, there is still no central list of where PALS have actually been set up. The Department of Health do not have this information and have indicated that it is the responsibility of Strategic Health Authorities to monitor PALS. ACHCEW has therefore written to all Strategic Health Authority Chief Executives to ask for a comprehensive list of NHS Trusts and PCTs in their areas, showing which have established PALS (with contact details) and which have not.
This is just the first step in a proposed project to look at the outcomes of different PALS models with a view to informing the Department of Health’s work on the development needs of PALS.
General Medical Council: doctors’ fitness to practise procedures
The GMC is continuing to review its fitness to practise procedures. Currently there are three separate fitness to practise processes: conduct, health and performance. The new model will be a streamlined, unitary scheme which is intended to enable a doctor’s fitness to practise to be considered in the round. The new process will be divided into two stages, "investigation" and "adjudication", and these will be separate functions. ACHCEW is broadly in agreement with these proposals. However, it remains to be seen whether the new system will speed up the procedure sufficiently to retain public confidence. We continue to input into the review process.
During recent months the legal department has been involved in developing briefings and consultation responses in a number of areas. These include a response to the Coroners Review, which was set up as a result of the enquiry into death certification following the Harold Shipman case. In this we have detailed the concerns relayed to us by CHCs and made suggestions for changes to the system which we feel would make it more accessible to users. We also highlighted the varying standards of coroners throughout the country and the need for more universal standards to be enforced.
Also under development is a briefing for CHCs regarding the LIFT schemes (Local Initiative Finance Trusts). These schemes are the means by which the government aims to finance, through private investors, the building of new primary care premises, including but not limited to, GP surgeries. This briefing will outline the process by which the projects are being developed, possible pitfalls and areas of concern within this process; it will also suggest ways in which we believe CHCs can push for better public and patient involvement. This will include examples of best practice from the areas already involved in LIFT projects.
A new Human Rights briefing will also be available soon. The briefing will detail and update recent developments in Human Rights law and practice within the NHS.
The Right to Care campaign conference on long term care will bring together local people from around the country, to record their experiences and encourage local campaigning for free personal and nursing care.
More information: Paul Evans, NHS Support Federation 0207 6330801