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Policy and campaigning news - October 2006

Way Ahead 2006;10(4):2,15
  1. MS specialist posts at risk – some success stories
  2. Review of healthcare professional regulation
  3. Recent King's Fund research demonstrates neurology underfunding
  4. Goodbye Patient Forums, welcome LINks!
  5. Petitioning the PCT

1. MS specialist posts at risk – some success stories

We are delighted to share the news that some MS specialist nurses with jobs at risk have succeeded in staying in post. The key message is preparation. As Sharon Grainger, Neurology Nurse Specialist in Bath put it:

"Before my interview, I spent a considerable amount of time preparing a folder looking at referral rates, justifying a post in light of the NICE guidelines/NSF etc. Just doing it alone, made me realise how important the role was. As a result, I didn't feel particularly flustered at my 1 hour 20 minute interview."

We are well aware that some NHS Trusts have been giving contradictory messages. Therefore, we would encourage any MS specialist, both in NHS Trusts and PCTs, to contact us if you are at all concerned about actual or probable financial difficulties that may affect the funding of your post.

More ammunition for MS specialist posts comes from the new RCP audit of services, which has shown just how erratic and fragmented implementation of the National Service Framework for Long-term Conditions and the NICE Guidelines for MS has been. Contact us if you'd like to discuss how to use this information in support of your post; email Alice Hamilton or phone 01462 476700.

The MS Trust is working with the MS Society and Dr Foster's, an external intelligence gathering organisation, looking at hospital admission rates in areas where MS specialist nurses have come into post. Our belief is that the information gathered will show the value of MS specialist nurses in reducing emergency and unplanned admissions, a key target of new government policies.

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2. Review of healthcare professional regulation

A new review of the way all healthcare professionals are regulated – ie the role and workings of the Health Professional Council (HPC) and Nursing and Midwifery Council (NMC) – is available for comment by all healthcare professionals.

This new review was prompted by concerns arising from the Shipman Inquiry. Some of the major points for existing health professionals are:

  • consistent requirements for continuous revalidation of qualifications;
  • specific guidance on when specialist knowledge and skills need to be entered on the register - this is most likely to be at Grade 7 and above;
  • an improved process for investigating allegations of unfitness to practise, so that there is an agreed local level protocol as well as arrangements for adjudication at a regulatory body level. Any adjudication panel will include lay members as well as professional members specialising in the area in which an individual practises;
  • consistency between regulators in major definitions of 'good character' and 'conduct';
  • common standards are required in some areas, eg educational requirements to allow prescribing;
  • changes to the composition of regulators, replacing elected members with appointed professional members.

Consultation closed on 10 November 2006.

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3. Recent King's Fund research demonstrates neurology underfunding

The King's Fund, an independent health policy charity, has recently launched a research report, which documents starkly the differences in health spending across PCTs in England. It shows that there are differences in spending per head of population that are only partially explained by the different needs of their local population.

What this research also shows is the woefully low spend on neurology. In the financial year 2004 / 2005, the year in which the research is based, the total spend for the NHS in England was £58bn. The top three areas for spend were mental health, circulation and cancers, all three being government priority areas. These three consumed approximately 29% of all money spent. Neurology captured only £1.8bn or 3.1% of the money spent. There are 10 million people with neurological conditions in the UK. 16.5% of the population has a neurological condition but only 3.1% of the NHS spend in England goes on neurology. No wonder there are inequities and poor services.

A full copy of the report, 'Local variations in NHS spending priorities' is available from the King's Fund website.

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4. Goodbye Patient Forums, welcome LINks!

As a way of engaging patients and the public in the NHS in England, Patient Forums are due to be phased out and replaced by new bodies called Local Involvement Networks (LINks). Unlike Patient Forums,which are attached to individual NHS Trusts/PCTs, LINks will cover a geographical patch. They are due to be set up for every local authority area that has social services responsibilities, and in many cases this will be the same area as the local PCT. They will have much closer ties to local authorities, will be statutory bodies, and essentially have a scrutinising role to check that services are delivered properly and fairly. They are due to be made up of user groups, local voluntary and community sector organisations, and interested individuals.

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5. Petitioning the PCT

'Our Health, our care, our say' promised that people in a PCT should be able to raise petitions that the PCT had to take seriously. 'Health Reform in England: update and next steps' (July 2006) includes proposals about how this might work.

Given a number of safeguards, petitions may include: demand for new services, dissatisfaction with existing providers and dissatisfaction with existing provision; and they could not be used to prolong debate on proposed service reconfiguration following the outcome of a formal consultation. Included in the proposal is a threshold figure for action, of 1% of the public served by a PCT for general services, or 10% for a specialised service, such as MS-specific services.

It should be stressed that this will be consulted on later in the year and may change.

Do you have an opinion about how helpful this might be for people with MS in your area? More information is available in the national policy section of the MS Trust website, and any consultation process and dates will be notified in due course.

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