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ADVICE TO PREGNANT WOMEN DURING THE LAMBING SEASON
Monday 27 Dec 2004
Pregnant women should avoid close contact with sheep during lambing periods, the Department of Health, the Department for Environment, Food and Rural Affairs, and the Health and Safety Executive advised today.
Pregnant women who come into close contact with sheep during lambing may risk their own health and that of their unborn child, from infections that can occur in some ewes. These include chlamydiosis (enzootic abortion of ewes - EAE), toxoplasmosis and listeriosis, which are common causes of abortion in ewes.
Although the number of reports of these infections and human miscarriages resulting from contact with sheep is extremely small, it is important that pregnant women are aware of the potential risks associated with close contact with sheep during lambing.
To avoid the possible risk of infection, pregnant women are advised that they should:
- not help to lamb or milk ewes;
- avoid contact with aborted or new-born lambs or with the afterbirth;
- avoid handling clothing, boots etc which have come into contact with ewes or lambs.
Pregnant women should seek medical advice if they experience fever or influenza-like symptoms, or if concerned that they could have acquired infection from a farm environment.
Farmers have a responsibility to minimise the risks to pregnant women, including members of their family, the public and professional staff visiting farms. Any action should be determined by their risk assessment required under the Control of Substances Hazardous to Health (COSHH) Regulations 2002 and also the Management of Health and Safety of Work Regulations 1999.
If a ewe aborts, farmers are advised to ask their veterinary surgeon to take a sample to their local Regional laboratory of the Veterinary Laboratories Agency to determine the cause. In the interests of hygiene, farmers should dispose of all afterbirths promptly and safely in accordance with relevant legislation. The EU Animal By-Products Regulations 2002 requires animal by-products, including afterbirth material, to be disposed of via an approved route such as rendering, incineration, knackers yards etc.
Notes to Editors
1. Farmers should consult their veterinary surgeon about suitable vaccination programmes and any other disease control measures in sheep.
2. The Control of Substances Hazardous to Health (COSHH) Regulations 2002 require employers to assess risks to health from harmful substances, including micro-organisms, and to take steps to prevent or control those risks, and The Management of Health and Safety at Work Regulations 1999 require employers to further assess any risks which affect pregnant women. Further advice is available from HSE's Infoline on 0870 154 5500.
3. The Department of Health advisory leaflet, While you are pregnant:
How to avoid infection from food and from contact with animals, is
available, free of charge to general medical practitioners and midwives
from:
Department of Health, Prolog, Unit 8, Sherwood Park, Annesley,
Nottingham NG15 ODJ
4. Further information is also available in the 1997 publication Infection risks to new and expectant mothers in the workplace - a guide for employers, by the Advisory Committee on Dangerous Pathogens (ref: ISBN 0-7176-1360-7). Copies are available, price £10.50, from HSE Books, PO Box 1999, Sudbury, Suffolk, CO10 2WA, or by calling 01787 881165, or via their website at www.hsebooks.co.uk
FLAGSHIP NHS SURGICAL CENTRES LEAD THE WAY IN INNOVATION AND EXCELLENCE
Friday, 24 December 2004
Five NHS treatment centres named as centres of training and innovation.
Health Minister John Hutton today named five NHS centres as leaders in the field of innovation and training in short stay elective care. The centres, which have together been awarded funding of £1.5 million per year for the next three years, will act as models of good practice in day surgery and short stay elective care in the NHS, and help drive up the proportion of procedures performed as day cases
Day surgery is an extremely popular option for patients as it means that they can recover at home, minimising disruption to their lives. It also has lower cancellation rates, and reduces many of the risks associated with inpatient hospital stay. Currently over two-thirds of NHS operations are carried out as day surgery, which also benefits the NHS, as it frees up in-patient beds.
The successful Centres of Training and Innovation are spread across England. They are located in Imperial College Faculty of Medicine and the NHS in West London, Birmingham and the Black Country SHA, South Devon Healthcare NHS Trust, North and East Yorkshire and Northern Lincolnshire SHA, and King's College Hospital, London.
John Hutton said:
"These flagship centres have demonstrated that they are amongst the leaders in their field. They have all developed new and exciting ways of working in short-stay elective care, which has led to better and faster care for patients.
"I hope that the rest of the NHS will look to these centres and learn from their experiences.
"Day surgery is not only good for patients, but also for the NHS - it fits both with our intention to reduce lengths of stay in hospital, and also to increase provision outside the acute sector. The NHS Plan predicted that around three-quarters of operations will be carried out on a day case basis by 2010, and we are on target to meet this - current figures show that the rate has gone up from 60% in 1996 to 68% in 2002/03."
The centres will become operational from April 2005.
GUIDANCE ON USE AND SUPPLY OF DIAMORPHINE
Friday, 24 December 2004
The Department of Health today advised the NHS that there is a supply problem with the opiate painkiller, diamorphine, and that stocks may rapidly reach a critical level in the next few weeks.
It issued guidance to prescribers on managing the potential shortfall of diamorphine and further information about alternative treatments for patients.
Diamorphine is used for the treatment of acute and chronic pain, for example in cancer patients and patients in intensive care and accident and emergency departments. It is also used in the treatment of people who are opioid dependant.
Diamorphine is available from two manufacturers, Chiron and Wockhardt UK. Chiron have told the Department of Health that they currently have limited supplies. It is unlikely that further supplies will be available from Chiron before the end of March. Limited supplies are also available from Wockhardt, who are expecting further stocks to be available from the end of January. The supply situation is likely to remain critical for the immediate future.
Professor Mike Richards, National Cancer Director, said:
"We have taken immediate action and are working hard to make sure that
this potential shortfall does not, as far as possible, impact on the
care and quality of life of patients.
"We are in contact with other companies to source extra supplies of morphine and other similar drugs. We are also assessing what stocks of these alternative medicines are already within the NHS to ensure that sufficient supplies of these alternatives are available.
"Patients and families should be reassured that we will do all we can to minimise the effect this disruption to supply may have."
Doctors, pharmacists and other healthcare professionals are being asked to take every possible step to conserve stocks of diamorphine injections for use in patients who have the greatest need eg. palliative care patients. Wherever possible, the use of alternative medicines should be considered.
Patients who are concerned should discuss treatment options with their doctor or phone NHS Direct on 0845 4647.
More information for prescribers is available on www.dh.gov.uk
NEW MODEL CLEANING CONTRACT WILL HELP IMPROVE STANDARDS
Thursday, 9 December 2004
New guidance to help ensure hospitals have clear and binding contracts to deliver high standards of cleaning was published today.
The guidance provides:
- A best practice guide on evaluating and awarding contracts so that quality is considered alongside price
- Revised National Specifications for Cleanliness which set out clearly the standards which hospitals should provide as a minimum
- The recommended minimum cleaning frequencies which need to be followed
- A revised Healthcare Facilities Cleaning Manual to reflect changes in cleaning technologies and practices
Health Minister, Lord Warner, said:
"Hospital cleanliness and reducing infection rates are everyone's business. This guidance sets out clearly how often different areas of a hospital should be cleaned and what level of cleanliness is required.
This means both hospitals and cleaning firms know what is expected. This is just the latest step in our drive to improve cleanliness and lower rates of infection."
Also announced today were the PEAT (Patient Environment Action Team) scores for hospitals in England. PEAT teams include people from outside the trust, infection control personnel and patient representatives and provide a local "snapshot" of environmental cleanliness and food standards on the day.
PEAT scores for England after second visit by teams
| Excellent | Good | Acceptable | Poor | Unacceptable |
| 118 (10%) | 456 (38.5%) | 583 (49%) | 24 (2%) | 3 (0.5%) |
After the first round of visits by these teams in 2004, 90 out of 1,184 hospitals rated Poor or Unacceptable for cleanliness. A range of actions were taken to improve cleanliness and after the hospitals were revisited again just 27 were found to be Poor or Unacceptable. Almost half of hospitals rated Excellent or Good. These scores allow hospitals to measure cleanliness and address specific areas of concern. A lot more work is needed to bring trusts to the highest standards - especially among those with an Acceptable rating.
Also announced today was the positive uptake of the National Patient Safety Agency (NPSA) CleanYourHands campaign which requires all hospitals to have alcohol hand rubs near every patient and CleanYourHands information posters. This has been implemented in 97 Trusts so far (nearly 1 in 3) and another 30 have signed up to take part in the new year.
Chief Nursing Officer, Christine Beasley said:
"This is another vital step in putting hospital cleanliness and infection control at the top of the agenda. To improve standards we must know when things aren't up to scratch and the new model contract helps hospitals to do this. The uptake of the CleanYourHands campaign is another encouraging sign of the staff and patients in the NHS working together to combat infection."
The national PEAT scores and new guidance on contracting cleaning can be found at www.cleanhospitals.com
World AIDS day - Europe's healthcare workers at risk
1 December 2004
Health First Europe organises special event in the European Parliament , calling for more protection of healthcare workers from sharps’ injuries
On World AIDS day, Health First Europe (HFE) held a special event in the European Parliament to raise awareness amongst decision makers and the public about the risks of sharps’ injuries to healthcare workers and the risk of infection with HIV, Hepatitis or other fatal infections. HFE urgently calls for supplementary safety requirements to address this public health issue.
Nurses, doctors and other medical staff in the EU are exposed to highly elevated levels of risk, a fact which is all too often ignored. It is estimated that 1 million injuries from needles or other sharp medical devices are suffered by healthcare workers across the European Union each year. More than 20 dangerous blood-borne pathogens are transmitted by contaminated needles, including Hepatitis and HIV. If injured by a contaminated needle, the chances of becoming infected are as high as 1 in 3 for Hepatitis B, 1 in 30 for Hepatitis C and 1 in 300 for HIV.
At invitation from Health First Europe (HFE), nurses from eight European countries met with MEPs at the European Parliament to discuss the risk of needlestick injuries and the threat that they face at the workplace every day. Existing European worker safety legislation[i] has effectively done little to protect healthcare workers from needlesticks and other medical sharps and from accidental infection. Yet, more than 80% of such injuries can be prevented through a combination of training, safer working practices and the use of medical devices incorporating needlestick protection technology, as independent studies show[ii].
“The fact that one million sharps’ injuries occur in the EU every year, not counting an estimated 60-80% of unreported incidents, is a clear sign that not enough is being done to protect our healthcare workers from injuries”, said Ria von Bönninghausen of the Standing Committee of Nurses to the EU and associate member of Health First Europe. “We want European worker safety and health directives amended and we want national authorities to be stricter in the implementation of these directives, across the EU.”
Health First Europe (HFE) fully supports recommendations made by the European Agency for Safety and Health at Work that aim at implementing the use of devices with safety features, modifying work practices and training workers in the safe use and disposal of needles[iii]. However, HFE also calls on the European Commission to work towards amending existing legislation, to include specific requirements to protect healthcare workers from sharps’ injuries. “We specifically suggest the inclusion of an additional annex to Directive 2000/54/EC, concerning biological agents. Given the seriousness of the situation, we believe that we need additional legal requirements for the management of risk in the healthcare context”, commented Imelda Read, Honorary Chairperson of HFE.
But where the European Commission has a decisive role to play in developing the legal framework for a better protection of healthcare workers, EU Member States are equally called upon to consistently apply and enforce the highest standards of safety. Where sharps’ injuries are concerned, the level of protection provided for healthcare workers across the EU varies greatly. The adoption in recent years of specific protection measures in countries such as France, Germany or Spain has been an encouraging development. However, Health First Europe (HFE) warns that sufficient protection measures are not being implemented, or are not even being considered, by the majority of healthcare providers across the EU.
“Action must be taken now to reduce the risks of sharp’s injuries to healthcare workers across the EU”, says Bert Van Caelenberg, Secretary General of Eurofedop, the European Federation of Public Service Employees, and member of Health First Europe. “It is the responsibility of the EU Member States but also of the European Commission to ensure that no disparity exists in the protection provided to our workers, anywhere in the EU.”
For more information, contact:
Maya Parikh or Elodie
Mohen
Health First Europe
Secretariat
Chaussée de Wavre 214d
1050 Brussels
Tel: +32
(0)2 62 61 999
Fax:+32 (0)2 62 69 501
Email: info@healthfirsteurope.org
[i] Applicable: EU Council Directives 89/391/EEC, 89/655/EEC and 2000/54/EC
[ii] Compare for example : Advances in Exposure Prevention ; vol.3, no.4 ; Libourne study GERES day_09/2001
[iii] European Agency for Safety and Health at Work recommendations can be found in FACTS Issues 29 Safety and Health Good Practice on-line for the Healthcare Sector ISNN 1681-2123.
REID WELCOMES UNIONS' SIGN-OFF FOR AGENDA FOR CHANGE
23 November 2004
Health Secretary John Reid today welcomed the collective decision by the NHS unions to endorse Agenda for Change, the new pay reform package for more than 1.2 million NHS staff.
Earlier this month both UNISON and Amicus members voted in favour of Agenda for Change, following on from earlier endorsement from other organisations including the Royal College of Nursing (RCN), the Royal College of Midwives, GMB and the Chartered Society of Physiotherapists.
Agenda for Change will be rolled out across the country from 1 December this year.
Benefits of the pay reforms include:
- the NHS minimum wage has been increased to £5.69 an hour.
- from 2003-05, all staff benefit from a 10 per cent pay deal over three years.
- a newly registered nurse will earn broadly the same as a newly qualified teacher.
John Reid said:
"I'm delighted that the NHS unions have agreed to proceed with Agenda for Change. Their decision is further positive endorsement of the biggest pay reform in the history of the NHS."
"Agenda for Change is not just a great deal for staff, but good for patients too. Agenda for Change means more opportunities for staff to enhance their skills and work more flexibly, so patients will experience better, faster care and get more choice by having treatments at times more convenient to them."
"Along with the new contracts we have introduced for consultants and GPs, Agenda for Change is the final piece in the jigsaw, bringing greater quality to the heart of all the care that the NHS provides."
A Practical Guide to Developing New Nursing Roles in Surgery
Wednesday 9 March 2005, The Royal College of Surgeons, London
16 November 2004
This practical, one day conference brings together case studies and presentations to examine the role of nurse led surgery, for Consultant Surgeons and Nurses.
Cost:
£330 + VAT (£387.75) for NHS and private healthcare organisations.
£450 + VAT (£528.75) for commercial organisations
Contact details:
Tel: 020 8541 1399
Fax: 020 8547 2300
Email: info@healthcare-events.co.uk
Website: www.healthcare-events.co.uk
Health Professions Council announces 13th profession to be regulated
18 October 2004
The Health Professions Council Register opened today to operating department practitioners (ODPs). ODPs are the 13th profession to be regulated by the HPC and the first to come onto the Register since the HPC began operating under its new rules in July 2003.
The Association of Operating Department Practitioners applied to the Council to be regulated in April 2003. A recommendation was made by the Council to the Department of Health that ODPs should be regulated by the HPC. The Department of Health then launched a consultation on the regulation of Operating Department Practitioners. This consultation ran from 1/8/2003 to 14/11/2003. The legislation was debated and passed by the Scottish and English Parliaments and was approved by the Privy Council in July 2004.
On the day of the transfer, all operating department practitioners whose names appear on Part 1 of the AODP register will be automatically transferred onto the HPC Register. The Grandparenting window will be open until 17th October 2006.
The AODP remains as the professional body and will continue to promote and represent the profession and its members.
Norma Brook, President of the HPC Council said "We are delighted to welcome operating department practitioners to the Register and hope this will be the first of many aspirant professions to join the HPC. I am looking forward to working closely with the AODP and to welcoming three new members of Council."
MANDATORY CRIMINAL RECORD CHECKS TO KEEP NHS PATIENTS SAFE
13 October 2004
Health Minister John Hutton today announced that all eligible new recruits into the NHS must undergo checks on their criminal record under a new measure to increase patient safety.
From early next year, Criminal Records Bureau (CRB) checks will become mandatory for every new recruit with access to patients as part of their normal duties.
Staff requiring checks will include all medical, nursing and other staff with direct patient contact, as well as staff whose work provides access to patients, such as cleaners and maintenance workers.
The checks will trawl information held on the Police National Computer and the records held by the Department for Education and Skills to help NHS employers assess the suitability of candidates.
There is currently a considerable variation in the checking policy of NHS employers. At present, only staff who work with children are legally obliged to have CRB checks.
John Hutton said:
"We want to do all we can to ensure the safety of patients receiving treatment on the NHS. Checks on the criminal records of new recruits will help us achieve this aim. The security of patients must always be our top priority.
"The results of the checks will help NHS employers make safer recruitment decisions and give the public extra piece of mind."
A recent survey of NHS employers showed a good level of support for the introduction of mandatory CRB checks, including from Berkshire Healthcare NHS Trust.
Hugh Chapman, Associate Director of Human Resources, Berkshire Healthcare NHS Trust, said:
"It is our policy that our recruitment team carry out criminal records checks on behalf of Berkshire Healthcare NHS Trust and six Primary Care Trusts across Berkshire for all new recruits into posts working with vulnerable adults, adolescents and children. In addition, we also check administrative staff who may be in contact with patients in the course of their duties."
Jim Gee, Chief Executive of the NHS Counter Fraud and Security Management Service, a Special Health Authority which has responsibility for all policy and operational matters relating to the prevention, detection and investigation of fraud and corruption and the management of security in the NHS, said:
"Criminal Records Bureau checks will be a useful tool in preventing NHS fraud. Over the last five years, a number of fraud cases have involved individuals concealing criminal records to gain employment. These checks will make this harder for new NHS recruits. We believe these checks will help our work in reducing losses to fraud and make a safer and more secure NHS."
VCJD: FURTHER PRECAUTIONARY MEASURES ANNOUNCED
21 September 2004
Selected groups of patients are this week being notified about the results of a risk assessment exercise for blood plasma products.
The notification exercise, which relates to the possible transmission of variant Creutzfeldt-Jakob disease through blood products, was announced by Health Secretary John Reid on September 9.
To reduce the risk of onward transmission through surgery, selected patients have been told that, because they have received certain batches of plasma products in the past, they could be at a small increased risk of carrying the vCJD agent.
This advice is highly precautionary and is based on recommendations made by the expert CJD Incidents Panel.
These patients (and their healthcare professionals) are being advised that they have in the past received batches of plasma products which were derived from blood donated from someone who has later gone on to develop vCJD. As a precautionary measure, a number of steps should be taken to reduce any possible onward patient-to-patient transmission of vCJD.
People who may be affected are:- Some people with haemophilia and other bleeding disorders. All of these people (around 6,000) will receive letters about the background to this exercise to keep them fully informed. The number who may be affected directly is estimated to be around 4,000 people
- A small group of people suffering from primary immunodeficiency, estimated to number around 50 people
- A small number of people who have been treated with large quantities of particular plasma products for a range of conditions (e.g. secondary immunodeficiency).
It is not possible to know exact numbers of people in any of these groups until the patient records have been examined. This process began on 9 September.
Although any additional risk to these people is likely to be very small, it is necessary to take some simple steps to minimise any chance of passing on the infection.
These steps include not donating blood, tissue or organs, and ensuring they tell their doctors and dentists if they undergo treatment in future.
The situation has arisen because, since December last year, two instances have been reported where vCJD is suspected to have been passed on by blood transfusion.
Blood donated by a small number of people who went on to develop vCJD has been traced. People who received direct, one-to-one transfusion of 'whole blood' from these donors were contacted earlier this year and told about any additional risk they may face.
Now plasma from these same donors used to manufacture products such as clotting agents has also been traced. Plasma products are manufactured from pools of many thousands of donations, greatly reducing any risk of vCJD being passed on.
A detailed risk assessment has been undertaken which has recommended the groups listed above are notified that they might face a slightly increased risk.
This notification process is taking place this week.
A dedicated NHS Direct helpline has been set up to answer queries about this issue. Its number is 0845 850 9850
Chief Medical Officer Sir Liam Donaldson said:
"Throughout our handling of the issue of vCJD we have adopted a highly precautionary approach, taking a series of steps as new evidence became available to maximise the protection of the public.
"This risk assessment continues this approach and identifies three groups of patients who need to know that they may be at a small increased risk of developing vCJD than the rest of the population who ate beef during the 1980s and 1990s.
"This information will enable these people and their doctors to take the necessary steps to minimise the risk of onward transmission of vCJD."
Health Secretary John Reid said:
"Two principles have guided my department's handling of the issue of vCJD and its possible transmission through blood - maximum caution and maximum openness.
"That is why, since the first report of suspected transmission via whole blood transfusion last December, we have taken further steps to maximise the safety of the UK's blood supply.
"We have also been open with the public, Parliament and health professionals about each step we have taken and the expert advice behind it. We are continuing this approach today by announcing the results of this risk assessment exercise."
John Reid added:
"We have, however, been concerned to do everything practicable to ensure the patients directly affected are informed by the specialist doctors who care for them, so they can be given all appropriate information and support.
"I know this information may be difficult to absorb, which is why we are working with their doctors and other clinicians, to ensure they have the information and support they need."
This exercise has been undertaken by the Health Protection Agency on behalf of the Department of Health. Further relevant material has been placed on the HPA website, www.hpa.org.uk
The exercise is based on the recommendations of the independent CJD Incidents Panel. The panel drew on a risk assessment by Det Norske Veritas Consulting, published at www.dnv.com/consulting/news_consulting/RiskofInfectionfromvariantCJDinBlood.asp.
JOB SHOPS 2004 SET TO BOOST NHS STAFF NUMBERS ACROSS ALL CAREERS
DIARY DATE: NHS CAREERS NATIONAL JOB SHOP DAY - 23 SEPTEMBER 2004
This now well established annual event, co-ordinated by NHS Careers, provides opportunities for people of all ages looking for a new job or career to meet and talk with current NHS staff working in some of the hundreds of different careers available.
Job Shops give all healthcare professions, including operating theatre practitioners, the opportunity to promote their own speciality or career to people who may not be familiar with that profession's particular role in the healthcare team.Having a representative from your particular field of interest in attendance at a local Job Shop event means that there will be someone there to talk to visitors in detail about what the job could entail, and about training and career progression.
Last year, an estimated 30,000 people travelled to over 300 local Job Shop events the length and breadth of England. Events are organised on a local level, supported by the Department of Health and the services of the NHS Careers response line and website (0845 60 60 655; www.nhs.uk/careers).
Everyone is welcome, from would-be medical illustrators and photographers who could help create training manuals and text books to train future surgeons, radiographers who could one day save the lives of cancer patients through early recognition and treatment of tumours, to potential healthcare scientists who might one-day echo the achievements of the discoverers of MRI or DNA!
But along with careers in nursing, midwifery, healthcare science and the allied health professions, there are opportunities for Managers, IT and finance specialists, estates surveyors and facilities supervisors, housekeepers, caterers, plumbers, electricians and joiners - in fact almost anything you can do outside the NHS, you can do inside it. Everyone has a crucial part to play in delivering a healthy NHS both in our hospitals and in the community.
If last year is any indication, the types of events will vary considerably, from bright yellow recruitment buses and displays in shopping centres to larger events held in football stadiums, lecture halls and even a racecourse! One Workforce Development Confederation ran an exclusive web - based event in collaboration with local internet cafes, whilst further local support was lent to the campaign by JobCentre Plus and Connexions partnerships.
This year, alongside such continuing partnerships, for anyone who can't visit a Job Shop, the introduction of the NHS E-recruitment service will provide even easier access to current job vacancies in the NHS (www.nhs.uk/jobs).
For updates on locations and times for local Job Shop events, as well as details of the local organisers, keep logging on to www.nhs.uk/careers (FROM 23 AUGUST 2004)
For further media information about NHS Careers National Job Shop Day, to interview local Job Shop organisers, or NHS staff in any of the other hundreds of NHS careers, please contact:
Beverley Bailey on 0208 870 4301.
NEW ADVICE ISSUED ON THE USE OF MOBILE PHONES IN HOSPITALS
July 29th, 2004
Updated guidance on the use of mobile phones was today issued to hospitals by the Medicines and Healthcare products Regulatory Agency (MHRA). The new advice is necessary to take account of developments in mobile technology and the growing communication needs of patients, visitors and hospital staff.
The advice reinforces existing MHRA guidance that a total ban on mobile phones in hospitals is not necessary. It recommends measures that hospitals should introduce to balance the risks of mobile phones interfering with critical devices and the desire for better communication in hospitals.
Prof. Kent Woods, Chief Executive of the MHRA said:
"Mobile communication technology is particularly fast moving, resulting in a wider range of communication equipment becoming available. We have recognised that hospitals need to be updated and advised as to what action to take in light of these advances. Some mobile devices can cause interference with critical medical equipment and it is important these are turned off where a risk exists.
However, there is no reason why mobile technology can't be used in designated areas of hospitals where there is little or no risk of interference with critical medical equipment.
"Mobile technology can be an easy and quick way for staff to communicate and help them to deliver the best possible care to patients. Overly restrictive policies can act as obstacles to this beneficial technology so this updated advice will help ensure that hospitals reap the benefits of mobile technology without compromising patient safety."
The new guidance recommends that:
- Hospitals should identify staff to manage how mobile technology is used within the hospital and to identify interference risks.
- Hospitals should consider designating areas where staff and visitors can use mobile phones safely.
- Particular mobile wireless systems which have a low interference risk with medical equipment (such as wireless network technology) could be issued to doctors and other hospital staff and comprehensively managed. Interference problems are reported to MHRA
For more information and the latest advice please visit the MHRA homepage
UPDATE ON PRECAUTIONS TO PROTECT BLOOD SUPPLY
July 23rd, 2004
Following advice from the Committee on the Microbiological Safety of Blood and Tissue (MSBT) further measures to reduce the risk of transmission of variant Creutzfeldt Jakob Disease (vCJD) via blood transfusion were announced today.
Following the first resport of a possible transmission of vCJD from person to person via blood in December 2003 it was recommended that recipients of blood transfusions since January 1980 be excluded from donating blood in the future. This precautionary measure was implemented from April 5th this year.
Today two further groups who have received transfusions since January 1980 will be added to those excluded from giving blood in the future. They are: donors who are unsure if they have previously had a blood transfusion; and apheresis donors who have previously had a blood transfusion. Apheresis donors are a small pool of committed donors who make frequent attendances to centres to donate blood, where machine processing removes only certain blood components, and the rest is returned to the donor.
When actions were taken in April 2004 neither of these groups were excluded until any potential impact on the blood supply became clearer. However, it has become apparent that the impact on blood supplies is small and MSBT has therefore recommended that these additional groups can be excluded. These new exclusions will take effect from 2nd August 2004.
In a separate development, a second case of possible transmission of vCJD from person to person via blood tranfusion has now been confirmed by the National CJD Surveillance Unit. A patient in the UK received a blood transfusion in 1999 from a donor who later went on to develop vCJD. The patient died of causes unrelated to vCJD but a post mortem revealed the presence of the vCJD agent in the patient's spleen.
After the first person to person transmission of vCJD was indentified it was expected that further cases may follow. This second case is of particular scientific interest as the patient had a different genetic type to that so far found in patients who have developed vCJD. A detailed account of the case will be appearing in The Lancet medical journal shortly.
Precautions already in place to protect the blood supply include:
Since 1997 all cases of vCJD that are reported to the National CJD Surveillance Unit and diagnosed as having 'probable' vCJD, result in a search of the National Blood Service blood donor records. If the patient has given blood, subsequently any stocks of that blood are immediately destroyed.
Since 1998, plasma derivatives, such as clotting factors, have been prepared from plasma imported from the USA.
Since October 1999, white blood cells (which may carry the greatest risk of transmitting vCJD) have been removed from all blood used for transfusion.
In August 2002 we announced that fresh frozen plasma for treating babies and young children born after 1st January 1996 would be obtained from the USA.
In December 2002, the Department of Health completed its purchase of the largest remaining independent US plasma collector, Life Resources Incorporated. This secures long-term supplies of non-UK blood plasma for the benefit of NHS patients.
The Secretary of State for Health John Reid said:
"We are continuing to follow a highly precautionary approach. Although people may have concerns about the implications of this announcement, I would emphasise again that the exclusion crieteria are being tightened because of a small but unquantifiable risk. People should continue to have a blood transfusion when it is really necessary. Any slight risk associated with receiving blood must be balanced against the significant risk of not receiving that blood when it is most needed.
"People who can, should continue to give blood. Blood donation is a safe procedure and people should continue to donate blood regularly. We place great value on those who already donate and would welcome new donors."
NEW MRSA FIGURES PUBLISHED
July 14th, 2004
Latest data from the Department of Health and the Health Protection Agency show that reports of MRSA have increased by 3.6% in England over the last year. The results from the third year of the mandatory surveillance scheme for Staphylococcus aureus show the number of blood stream infections caused by both sensitive strains, and also strains resistant to methicillin (MRSA) broken down by regions and also by each acute NHS Trust.
The main findings from April 2003 to March 2004 show:
Reports of blood-stream infections caused by MRSA have increased from 7,384 in 2002/03 to 7,647 in 2003/04. This represents a 3.6% increase during the last year.
The percentage of Staphylococcus aureus resistant to methicillin (MRSA) has remained stable at approximately 40% over the first 3 years of mandatory surveillance. However the total number of S. aureus infections (both methicillin-sensitive and methicillin-resistant) has increased and the number of blood stream infections caused by methicillin sensitive strains increased by 9.2% from 10,683 in 2002/0303 to 11,664 in 2003/04. Over the last year, the rate of MRSA in some general acute trusts has increased, while the rate in some specialist trusts had decreased. There are limitations in comparing rates with other Trusts, as the rate of MRSA can be affected by a number of factors including the types of patients treated in a Trust ('case mix') and the predominant strain of MRSA in the Trust.
Health Secretary John Reid said:
'Today's publication of the latest MRSA rates, hospital by hospital, on the internet is an important part of giving patients more information about this problem.
'It is clear from these figures, and from today's National Audit Office report, that some parts of the NHS have to do more to control this threat and match the achievements of hospitals which maintain low MRSA rates.
'The NAO report is an important reminder that everyone in the NHS needs to keep infection control at the top of their agenda.'
John Reid added:
'The plans I set out earlier this week will help us to bring all hospitals up to the level of the best. We want to give patients a greater role. And front-line staff like matrons will have more power to improve infection control. We are also making clear to hospital managers they will be judged on their performance in reducing MRSA infection rates.
'We will also be boosting the scientific research effort to ensure every possible means of detecting and destroying superbugs is fully explored.'
Professor Pat Troop, Chief Executive of the Health Protection Agency said:
'The increase we have seen in these infections over the last decade is caused by a combination of reasons including the fact that through the advances in modern medicine we are now able to keep patients alive for longer, but this means carrying out more invasive procedures which can lead to infection and also through the emergence of epidemic strains of MRSA (notably EMRSA 15 and 16) which can be more difficult to control.
'The most effective way of controlling the spread of both Staphylococcus aureus and MRSA in hospitals is through early detection and appropriate isolation and treatment. Prevention of cross infection is of paramount importance, which will include good hand hygiene and healthcare professionals should ensure they always wash or decontaminate their hands thoroughly in-between treating patients.
'We welcome the initiatives announced this week by the Secretary of State for Health, which build on the Agency's current programme of work. This includes; rolling out of mandatory surveillance of infections associated with hospitals, looking at mortality associated with MRSA and finding ways of looking at the virulence of different strains of MRSA.'
Data for each hospital trust is available on the Department of Health website at http://www.dh.gov.uk/publications
The mandatory surveillance scheme for monitoring S.aureus and MRSA was introduced by the Department of Health in April 2001. The Health Protection Agency Local and Regional Services (LARS) collect the data and it is analysed by the Agency's Communicable Disease Surveillance Centre (CDSC)
The NHS Acute Trusts are categorised by General Acute Trusts (those providing general acute healthcare), Specialist Trusts (Trusts who receive patients from other Trusts for specialist treatment) and Single Specialty Trusts. (Trusts undertaking particular specialties such as orthopaedics or children's services).
The data by each Trust is expressed as the number of reports of blood stream infections per 1,000 bed days. This is calculated using bed occupancy data which individual Trusts supply to the Department of Health. This applies to overnight admissions only.
For further information about MRSA please go to www.hpa.org.uk
More needs to be done to improve transfusion safety
July 6th, 2004
A national body is needed to advise the government on priorities for improvements in transfusion safety according to the seventh annual Serious Hazards of Transfusion (SHOT) report.
480 adverse events were reported to SHOT in 2003, against 363 the previous year (an increase of 32%).
This figure relates to reports from 195 hospitals in the UK, and is set against the fact that in the year about 3.5 million blood components were issued by blood services to hospitals in the UK.
According to the authors, preventable human errors are still happening within hospitals. Of the adverse incidents reported, 75% were caused by patients being transfused with blood components that did not match their requirements or were intended for another patient ("wrong blood" incidents). One patient may have died as a result.
59 case reports involved patients less than 18 years old and the authors especially highlight a lack of awareness of the special needs of children receiving transfusions.
The report's authors say that hospital Trusts could help to counter these problems by: providing resources to remedy transfusion errors; establishing and supporting hospital transfusion teams; providing education and training for safe transfusion practice, and putting in place mechanisms for the communication of information regarding special transfusion requirements.
Commenting on this year's report, the chair of SHOT's Steering Group, Dr Hannah Cohen, said: "Participation in SHOT must be active. Trust chief executives, risk managers, consultants and strategic health authorities are among those who must establish mechanisms to address the issues raised in our report."
"We have also identified a need for greater resources to be made available to Trusts and for better training and education alongside the establishment of a national body with relevant expertise and resources to advise on transfusion safety."
Some of the other key actions recommended by SHOT include:
• An open learning and improvement culture to be developed
• hospital transfusion teams must be established and supported
• hospital blood bank laboratory staffing must be sufficient for safe transfusion practice
• mechanisms for appropriate and timely communication of transfusion information must be put in place
• electronic aids to transfusion safety should be assessed and developed at national level
• hospital risk management committees must ensure that all staff undertaking blood sampling have received the necessary training and have their practical competency formally assessed and recorded
• paediatric units undertaking transfusion must ensure that staff are educated in the special transfusion requirements of children.
• blood transfusion safety must be included in the curriculum for student nurses and medical undergraduates as well as trainee doctors and nurses.
Dr Cohen said: " The most important contribution which could now be made to the safety of blood transfusion would be an initiative to improve the safety of the bedside pre-transfusion checking procedure. This will require investment in education and audit, and also in evaluation and implementation of suitable information technology. "
Further information: www.shotuk.org
Experts from across Europe to present at the Nosocomial Waterborne Diseases Workshop at the Hammersmith Hospital, London
June 25th, 2004
Experts from across Europe will come together to review the current state of Nosocomial Waterborne Diseases on Saturday 10th July at the Hammersmith Hospital.
Whilst MRSA is a disease covered extensively in the media, waterborne diseases such as those cased by Legionnella spp, Pseudomonas Aeruginosa, and Cryptosporidium Aspergillosis bacteria, go largely unreported. This workshop aims to inform attendees of these 'silent epidemics.'
Presentations include an overview on current strategies to improve water quality in hospitals, safety plans for hospitals and point of use filtration in high risk areas. Preventative measures against Pseudomonas Aeruginosa, the risk of Legionnaire's Disease in hospital water systems, and the threat posed by Cryposporidium will also be covered.
Other talks include an investigation as to whether Nosocomial Aspergillosis is waterborne, and a clinical evaluation of the protection offered by the new PALL-Aquasafe Shower Head Filters against Legionella spp.
The meeting will take place from 9.30am to 4.00pm in the Wolfson II Lecture Theatre, at the Wolfson Conference Centre, Hammersmith Hospital, and will cost £150 to attend.
The workshop is being sponsored by PALL Medical, which launched the PALL-Aquasafe Shower Head Filter in May.
To find out more details and to register, please visit: http://www.filtration-net.com/mlsf/register.htm
NEW PROPOSALS TO IMPROVE SAFETY OF ANAESTHESIA
May 13th, 2004
New proposals to reduce the risk of anaesthetic tubing becoming blocked during operations, were published on the 10th May 2004.
Following 11 similar NHS cases where tubing had become blocked, the Chief Medical Officer, Sir Liam Donaldson set up an Expert Group in July 2002 to look into the issue. The group, chaired by Professor Kent Woods, has now completed its work and produced a new report - 'Protecting the Breathing Circuit in Anaesthesia'.
The report examines the background to the incidents that formed part of Operation Orcadian, a major linked police investigation. It considers technical issues relating to equipment and other relevant matters; behavioural factors; investigating and learning from adverse incidents; and security.
The expert group has concluded that the key elements for avoiding similar incidents in the future are:
- to keep small disposable plastic waste out of areas where patients are being anaesthetised;
- to protect vulnerable patient breathing circuit (PBC) components by keeping them individually wrapped until use;
- to raise awareness of potential safety issues by guidance, training and clear labelling of the relevant equipment;
- to make sure staff carry out routine checks by guidance and training.
and
Chief Medical Officer, Sir Liam Donaldson said : "Thankfully incidents where anaesthetic tubing becomes blocked are rare but when it does happen the outcome can be very dangerous for the patient or even fatal. This is the first time that the risks have been examined in depth. The Expert Group has made some very practical and achievable recommendations that will significantly help to improve patient safety in this area of healthcare".
Professor Kent Woods, Chair of the Expert Group said: "I am pleased to have had the opportunity to chair this Expert Group. This has been a wide-ranging and challenging task. The Group is aware that much progress has been made in the field of patient safety since the tragic death of Tony Clowes in 2001. However, we have been able to identify a number of new suggestions for improvement in design, wrapping, and storage of devices; training; and security; and to contribute to revised guidance issued by the Association of Anaesthetists of Great Britain and Ireland".
The report highlights the role of design, wrapping and storage of medical devices as well as staff training to ensure routine checks are carried out. It is also vital that there are systems in place so that staff report and learn from incidents.
The Chief Medical Officer has accepted those recommendations aimed at the Department of Health and strongly commends the other recommendations to the National Patient Safety Agency, the Medicines and Healthcare products Regulatory Agency, the Royal College of Anaesthetists and NHS Trusts.
The Expert Group's report is available at www.dh.gov.uk/publications.
The Association of Aneasthetists of Great Britain and Irelands guidance is available at www.aagbi.org/pdf/Check_Anae_Equip.pdf
E-RECRUITMENT DOES THE JOB FOR THE NHS
April 22nd, 2004
NHS online recruitment goes national after successful trial
Health minister John Hutton today launched the national roll out of an online recruitment service for the NHS, which allows the public to search and apply for NHS jobs on one website.
The launch follows a successful trial of the website (www.nhs.uk/jobs) which attracted hundreds of thousands of visits to see NHS jobs in just three months. A daily total of around 500 jobs are displayed, 24,000 job seekers are registered with the service and over 3000 have applied for jobs on-line.
John Hutton said: "To build on our success in increasing the numbers of key staff in the NHS we need to make it much easier for people to find out what jobs are available. We also need to speed up recruitment so that people can access the rewarding careers that the NHS has to offer.
"I am delighted that the trial of the service has been such a success. Rolling out the service nationally will not only help the NHS to recruit the people it needs, but also help candidates to find and apply for the jobs they want with easily and quickly." Already around a hundred NHS organisations across the country have confirmed dates for taking up the service, which offers immediate access to millions of job seekers. The first employers to join the service in April and May are in the North West, West Yorkshire, London and the South East, the South West and Birmingham.
Department of Health figures suggest that as many as a quarter of a million people find new jobs in the NHS each year. The new service will streamline and modernise the process of recruitment, which is so fundamental to developing and maintaining the NHS workforce.
The service is one of a number of Department of Health initiatives that will radically improve recruitment and retention of staff in the NHS.
Comprehensive Female Sterilisation Website Launched
March 19th, 2004
For all women considering contraceptive methods including sterilisation, there is now a comprehensive resource available. www.femalesterilsation.com is the first online resource for women, which provides information, advice and guidance regarding female sterilisation, contraception and health care related issues. The website recognises that women are all individuals. Their choice of contraceptive method will be determined by a variety of factors: your age, your sexual lifestyle, your current relationship, your family status, your medical history and how important it is to you - either medically or psychologically - to prevent pregnancy, either permanently or temporarily.
NOTTINGHAM, England, March 19/PRNewswire/ --
Health Professions Council launches Standards of Education and Training and approvals process consultation
March 11th, 2004
The Health Professions Council (HPC) has launched a UK-wide consultation on its Standards of Education and Training, and the approvals process.
The Standards of Education and Training are the over-arching guidance to education providers on how to ensure that their programmes will enable those who successfully complete them to qualify for admission to the HPC's Register. The approval and monitoring of programmes and education providers is a statutory duty of the Council.
Health professionals, the public, education providers and employers are encouraged to discuss the HPC's proposals on how it will exercise its educational and training powers under the Health Professions Order 2001.
The consultation document says, "The powers of the Order give us an opportunity to create a simpler and more transparent, effective and economical system. We are proposing to move to a multiple programme approach rather than individual programme approval."
The Standards of Education and Training will be supplemented by curriculum guidance which will be developed in collaboration with relevant stakeholders, in particular, with the professional bodies.
The Health Professions Council is also launching its consultation on the structure of the register.
More information about the consultation is available on the HPC website :
http://www.hpc-uk.org/consultation/set_approvals.htm
You can download the full consultation document from this page.
Regulation of Health Care Staff in England and Wales
March 5th, 2004
This consultation document sets out the Government's proposals for extending regulation to a wider range of healthcare staff, seeks views on them and invites further debate. Published on 2 March 2004 ref 33768 the document is available from the Department of Health Website at: www.dh.gov.uk/consultations
PROPRIUS Education Forum
January 22nd, 2004
PROPRIUS Education Forum - 3rd March 2004
At the Queen Eleanor Hotel, Northampton
Following the outstanding successes of recent Education Forums, the PROPRIUS committee is pleased to advise of the next PROPRIUS Education Forum.
The programme at this year's Forum will reflect current issues relating to all aspects of education in operating department practice, as well as other important topics, such as: a workshop session on mentorship needs of students, mentors, managers and HEIs, the Skills for Health standards review update and the work of the Patient Safety Agency.
The PROPRIUS Education Forum is to be held in the Queen Eleanor Premier Lodge (Northampton South), Newport Pagnell Road West, Wootton, Northampton; situated 2 miles from junction 15 of the M1 and B526, close to the roundabout of the A508 and A45. Free on-site parking is available.
The Full Cost is Student £15, Member £30, Non-member £45 and includes the Education Forum, morning tea, afternoon coffee, and lunch.
Bookings to: PROPRIUS, PO Box 151, Westpark, PLYMOUTH, PL6 8WA
Enquiries to: Mrs Jean Hinton email: hintonj@edgehill.ac.uk Tel: 07815 468474