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Dear Colleague

I wrote to you on 21 March and 15 April with information about the recruitment of PCAs. I thought that it might be helpful to now write again to clarify a number of points raised during our current round of CHD Choice 'roadshows', to give you more details about the national training and networking event, and to ask about your progress to date on recruitment. I have sent this letter to Patient Care Adviser contacts where I have them and to Chief Executives. I would be grateful if this letter could be passed on to anyone else who may need to see it.

Numbers
Some centres have asked how many Patient Care Advisers there should be at each Trust. Trusts can recruit more than one PCA if they feel that this is necessary. A rough estimate, by Maree Barnett in the Heart Team, suggests that an 'average' patient would take about ten hours of a Patient Care Adviser's time (some patients would need much more). This would cover prioritising patients for Choice, liaising with consultants, organising where the operation will take place, pre-admission work-up, overseeing arrangements for travel and transfer to rehabilitation, and audit. It does not include administrative tasks such as finding notes and arranging travel logistics, which would need dedicated administrative support. The time needed per patient would also depend on what other arrangements were in place for activities such as rehabilitation, and case management. PCAs will also need to offer advice to patients who are not clinically suitable for Choice.

It may also be worth clarifying that in the few cases where Trusts are unlikely to be 'exporting' patients, a PCA will still be necessary to ensure that any incoming patients receive the support they need. Each Trust will need to have at least one person who is identifiable as a PCA and some may need more.

Funding
There have been a number of queries about funding. Funding for PCAs and their administrative support is included in the allocations which have been made to StHAs, as set out in the letter Additional Revenue Allocations - Revascularisation 2002-03. Detailed funding arrangements, of course, will need to be made on the basis of local needs, and we recommend that lead commissioners fund PCAs to cover both 'importing' and 'exporting' circumstances.

Role flexibility
Most of the queries about the PCA posts themselves have been about the degree of flexibility in the role and lines of accountability. PCAs need to work within their local setting, and there may be existing posts, for instance, liaison nurses, which can be adapted to fit the requirements in the PCA job description. However, offering independent informed choice to patients in this way will be an entirely new function and the time and skills to deliver in this role should not be underestimated. The document Extending Choice for Patients - Advice and Information makes it clear that to help the PCA to be an independent advocate for the patient, they should be accountable to the local Patient Advocacy and Liaison Service (PALS).

National training and networking event
Some concerns have been raised about the national training event for PCAs. This is not intended to replace local induction and training, which is of course absolutely vital to the success of the CHD Choice Scheme. The national gathering is intended to provide an opportunity for PCAs to meet one another, as well as Patient Choice Trustees, and to begin to develop their own networks. The event will also give PCAs the chance to discuss some of the detailed aspects of the scheme such as central information requirements and monitoring patient care experience. The training will take place on 19 and 20 June at the Thistle hotel, Lancaster Gate, London.

Progress on appointments
We know that some Trusts have not yet been able to appoint a PCA. I am sure that contingency arrangements are being thought through so that the Choice Scheme will be up and running by 1 July. If no formal appointment is likely to be made before the national meeting, on 19 and 20 June, please send someone who will be undertaking the role in the meantime.

I should be grateful if you could supply the name and contact details (address, telephone and email where available) for your delegate(s) to the national event, so that joining instructions can be sent to them.If you have not yet appointed a PCA but expect to do so by 19 June, in time for the training I would be grateful if you could let me know. A short form is attached for this purpose - please send this back to me by 6 June at the latest.

I am of course happy to discuss any of the above.

Helen Causley
Workforce Project Manager Heart Team
020 7972 4391

21 March 2002

PATIENT CARE ADVISERS - CHOICE INITIATIVE IN HEART SURGERY

As you know, the Choice Initiative in Heart Surgery will start operating from July 2002. Essential to the success of the initiative will be the role of the Patient Care Adviser. Each cardiac centre will need to have at least one Patient Care Adviser and they will need full-time administrative support. Funding for Patient Care Advisers will be included in the Choice allocations which will be notified in due course.

To facilitate the recruitment of Patient Care Advisers, the Heart Team in the Department of Health is placing a general advert in the Health Service Journal and the Nursing Times to appear next week. A draft copy of the advert is attached. We hope that the placing of a central advert will minimise costs by preventing the need for each Trust to place adverts.

The advert requests that those interested in a post as a Patient Care Adviser supply contact details and indicate the centre(s) in which they are interested. I will then forward their contact details to you in the week beginning 8th April.

The exact nature of the Patient Care Adviser role will be for local discretion, though draft job and person specifications were contained in Extending Choice for Patients - Information and Advice on Establishing the Heart Surgery Scheme.

Similarly, you will be able to use your own local recruitment procedures, and will wish to use your own application forms with those who have expressed interest. Timescales for recruitment will also be for local discretion, though clearly the timetable will be quite tight to aim to have Patient Care Advisers in post for July 2002. A possible timetable would be for Trusts to send their application forms out at the end of the week beginning 8th April and allow two weeks for applications, enabling sifts and interviews to be held in May and appointments to be made. It is currently planned to hold a national training day for Patient Care Advisers in the week beginning 3 June. Patient Care Advisers will be expected to attend this event even if they have not yet taken up post by this date.

I would be grateful if you could pass this letter on to whoever will deal with the recruitment of your Patient Care Adviser(s). If you would like me to send details of those who have expressed an interest in a post at your centre to a particular person, please let me know. I am of course happy to deal with any queries about this process.

Helen Causley
Workforce Project Manager
Heart Team
Enclosures:
Draft job advert
Draft job and person specifications

15 April

PATIENT CARE ADVISERS - EXPRESSIONS OF INTEREST

Further to my letter to Chief Executives of cardiac centres of 21 March, I am writing to send you the expressions of interest for a Patient Care Adviser post at your Trust I have received in response to the national advert placed in the Health Service Journal and Nursing Times.

As I explained previously, the exact nature of the Patient Care Adviser role is for local discretion, though draft job and person specifications were contained in the Extending Choice for Patients - Information and Advice on Establishing the Heart Surgery Scheme. As these posts are to be locally recruited, please advise those who have expressed interest in these posts according to your local procedures.

I indicated previously that a national training day was being planned for the week beginning 3 June. To allow appointees more notice of this training, it is now planned to hold national training on 19 and 20 June, probably in London. A further follow-up day is scheduled for 31 July. These training days will provide detailed information on the workings of the scheme, explore the key issues and allow Patient Care Advisers to meet each other. You may want to alert candidates of these dates.

I am happy to deal with any queries about this process.

Helen Causley
Workforce Project Manager
Heart Team