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Delivering public health

Encouraging children to eat well and exercise regularly is at the heart of a major new strategy for improving the nation's public health.Delivering Choosing Health: making healthier choices easier sets out how the recent public health White Paper, designed to help people of all ages to live healthier lifestyles, will be implemented locally.Six key areas needing action have been identified - reducing the number of people who smoke, cutting obesity levels, improving sexual health services and access to them, improving people's mental health and well-being and encouraging sensible drinking.Primary care trusts, working with key local partners, such as councils and voluntary organisations, will have a big responsibility for setting and delivering health improvement targets in their particular area.In another aspect to the White Paper, NHS trust boards are responsible for implementing guidance on how their hospitals become a smoke-free environment by 2006.As part of the drive to improve public health, the Health Development Agency is supporting hospitals in protecting patients, staff and visitors from the effects of smoking with a step-by-step guide published last January.It states that all enclosed NHS buildings must be smoke-free within two years; some trusts are going to include its grounds in its policy.Guidance for smoke-free hospital trusts identifies steps which trusts must take.In addition, primary care trusts (PCTs) are receiving a record £135 billion to tackle key health inequality issues identified in Choosing Health.

Transforming long-term conditions care

People with long-term conditions will benefit from the measures set out under a 10-year framework and a separate new model of social care.

The National Service Framework for Long Term Conditions, which focuses on neurological conditions, will transform health and social care services in England and help people with conditions such as Parkinson's disease, motor neurone disease, epilepsy, multiple sclerosis and acquired brain and spinal cord injuries to live as full and independent a life as possible.

Also, a new care model to shape the way NHS health and social care services treat millions of patients with long-term conditions has been launched.

Currently there are 17.5 million people in the UK with long-term incurable conditions, such as diabetes, asthma and arthritis, which can be controlled by medication and therapies.

Supporting People with Long Term Conditions - An NHS and Social Care Model to support local innovation and integration is designed to improve the quality of life of such patients, as well as prevent premature deaths and reduce emergency hospital visits.

In this last respect the strategy is key as it precedes the Government's 2008 target of reducing the number of beds used by emergency inpatient admissions by five per cent.

The model is based on a three-tier framework designed around the different needs of people with long-term conditions from those who can develop the skills for self-care to case management for patients with the most complex needs.

A new type of health professional, community matrons will lead on case management. The NHS is committed to recruiting 3,000 such professionals by March 2007.

Extending choice for cataract patients

NHS patients needing a cataract operation will now have a choice of alternative treatment providers after being referred.

As part of the Government's patient choice initiative, millions of pounds of extra investment has ensured all cataract patients now have their first operation within three months, and most within six weeks.

All patients will now, for the first time, be able to choose from at least two providers when referred for an operation. By December, that choice will have been extended to four or five providers.

The three-month maximum wait for treatment has been achieved four years ahead of the target set out in The NHS Plan in 2000. This is down to a £73 million government investment, providing extra NHS operations, and the use of independent sector treatment centres, which have performed an extra 13,000 operations.

PCTs are responsible for implementing cataract choice at referral and local arrangements for implementation should include establishing key milestones against which progress can be monitored by SHAs.

Guidance on the key commissioning issues, which takes account of the new arrangements, is set out in the Choose and Book Delivery Framework.

NHS improvement

Staff in the NHS performed 'magnificently' last year, according to NHS chief executive Sir Nigel Crisp.

Service modernisation and improvements in the NHS continue to bring benefits to patients but more work is still required, said Sir Nigel in his end of 2004 report.

He said that there had been record falls in waiting times and continuing falls in premature deaths from coronary heart disease, cancer and suicide.

Patient satisfaction levels were also high - and rising - in relation to hospital, ambulance, mental health and primary care services. NHS Walk-in Centres, NHS Direct and Treatment Centres are giving patients new and easier access to health care.

The first Children's Commissioner in England

Professor Al Aynsley-Green has been appointed as the first Children's Commissioner in England.

Prof Green, currently the national clinical director for children and

Nuffield Professor of Child Health at Great Ormond Street Hospital and the

Institute of Child Health, will act as an independent voice for children and young people, to champion their interests and bring their concerns and views to the national arena.

For more information please email janet.coull-trisic@dfes.gsi.gov.uk

Obituaries: Brian Booth, Sally Hornsby

It is with regret that we heard about the deaths of Brian Booth, chair of Lancashire Teaching Hospitals NHS Trust since August 2002 and of Sally Hornsby, a non-executive of East Elmbridge & Mid Surrey PCT since April 2002.  Our sympathies go to their family and friends.

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