Medicopolitical digest

Michael Howard said the bill would be changed so that the approval of a special commissioner–a High Court judge–was obtained before a surveillance operation began where there were reasonable grounds for thinking that it could affect legal, medical, or journalistic privilege, or where the operation involved intrusion into residential dwellings, offices, or hotel bedrooms. He said that prior approval would not be necessary in urgent cases, though the commissioner would have to be notified as soon as reasonably practical after the authorisation had been given by a chief constable.

The changes, Mr Howard said, would provide an oversight system that fully recognised the sensitivity of the operations but ensured that police and customs officers would be able to deploy the most sophisticated methods necessary to achieve effective results against serious crime such as drug trafficking, kidnapping, terrorism, and fraud.

Postgraduate body consults on multiprofessional working
The organisation which advises the health secretary on the delivery of postgraduate medical education in England is consulting on multiprofessional working in the health service.

Multiprofessional working and learning: sharing the educational challenge from the Standing Committee on Postgraduate Medical and Dental Education (SCOPME) is the first report from an inquiry which the committee started in 1995 into the educational issues involved in promoting multiprofessional cooperation and teamwork in health care.

The committee sent out a general letter of inquiry, took evidence from individuals, and held two workshops. It has issued a questionnaire with the consultation document and hopes to collect examples of multiprofessional working and learning in practice so that it can illustrate its final report with real life examples.

SCOPME says that there are no "off the shelf packages" that will provide all the answers but suggests that it is time for a set of principles to be laid down. This should incorporate–for example–the need to devolve authority to the most appropriate level; members of one profession having respect for the others; and professionals working together in an atmosphere of openness.

The consultation document quotes the government's white paper, The NHS: A Service with Ambitions, which was published in November 1996: "Modern health care relies increasingly on teamwork: the development of multi-professional teams, working not only in hospitals and primary care settings, but across the traditional boundaries of health and social care, is a key priority."

Multiprofessional working and learning: sharing the educational challenge is available from the Standing Committee on Postgraduate Medical and Dental Education, 1 Park Square West, London NW1 4LJ.

Nurse prescribing scheme to be extended
A further 1200 nurses in 10 trusts will take part in the nurse prescribing scheme from April. The pilot project, in which community and practice nurses can prescribe selected medicines, will then be extended throughout England from April 1998. Nurse prescribing was originally introduced in eight Bolton GP fundholding practices in October 1994 and was extended in April 1996 to a whole district community NHS trust in Bolton, where 140 nurses are taking part. Under the scheme community and practice nurses appropriately qualified as district nurses or health visitors, and who have undertaken the nurse prescribing training course, are able to prescribe items from a nurse prescribers' formulary.

View larger version (93K): [in this window] [in a new window]   More nurses will soon be prescribing NIGEL BARKLIE/IMPACT PHOTOS

Government admits to shortages in defence medical services
A minister has admitted that there are shortages in key areas of the defence medical services, particularly among surgeons, anaesthetists, and operating theatre nurses.

Lord Henley, minister of state at the Department for Education and Employment, said during an exchange of questions in the House of Lords last week that at 1 April the shortfall of surgeons in the Royal Air Force would be five against a requirement of 28; in the army the figure was 13 against a requirement of 45. The minister reported that the government was reviewing the defence medical services to ensure that they were appropriately manned and equipped.

Lord Walton of Detchant told the house that the progressive closure of service hospitals had had an adverse effect on the recruitment and retention of medical and nursing personnel in the defence services and that despite the passage of the Reserve Forces Act some NHS trusts were reluctant to release medical personnel for training.

Baroness Park of Monmouth drew attention to the 1996 report of the armed forces pay review body which expressed concern about the low morale, falling retention rate and reduced promotion and career prospects. And Lord Bramall–a former field marshall–warned that "if something is not done soon the damage to the medical and nursing services in the armed forces may be irreparable."

Prescribing and supply of medicines to be reviewed
The NHS Executive has set up a review team to look at prescribing and supply of medicines. The team has been given the following terms of reference: to develop a policy framework on circumstances in which health professionals might undertake new roles in prescribing and supplying medicines; to advise on the likely impact of any proposed changes on clinical outcomes, patient convenience, and costs; to consider the possible implications for legislation and for professional training and standards; and to advise on the supply or administration of medicines by nurses under group protocols and on any safeguards which should apply.

The team, which will be chaired by Dr June Crown, president of the Faculty of Public Health Medicine, has been asked to make recommendations on the final item within four months and on the others within a year.

Medicopolitical digest is prepared by Linda Beecham

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