Hepatitis in prisons

The Health Protection Agency and Offender Health produce a quarterly bulletin called 'Infection Inside' which looks at current topics regarding health protection in prisons. The current issue focuses on hepatitis to mark World Hepatitis Day on 28 July. Hepatitis affects a large percentage of the prison population and Dr Martin Lombard DH Clinical Director for Liver Disease says that 'During the course of developing a strategy for liver disease, it has become apparent that a significant proportion of people in correctional institutions may be unaware that they are at risk of developing liver disease. Data from a variety of developed countries (including England, Scotland and Ireland) shows overall HCV seroprevalence rates in correctional facilities ranging from 20-40%, with much higher rates in those prisoners with a history of IDU: data compiled by the HPA indicate that approximately 26% of prisoners were tested in 2009 and 22% of those were positive'.

For further information about work carried out by Offender Health and the Health Protection Agency in prisons see . The full version of the current bulletin ‘Infection Inside’ can be accessed below.


Clinical Audit Learning Packages on HQIP website

6 July 2011: HQIP has launched a dedicated online learning area of its website, designed to offer a range of free-to-use clinical audit learning packages with specific themes and/or audiences. Please visit


BSG Research Questions - Overview from Mark Hull

Following the Society-wide consultation about priority research questions to be submitted to NETSCC (the organisation that administers the large NIHR funding streams such as HTA, EME and SDO), the Research Committee (after consultation with the UKCRN Specialty Groups) submitted 12 research questions for appraisal by NETSCC with a view to these questions being used to commission (not fund) future research calls by NIHR. We have just received feedback from NETSCC. The number of votes gained by the 12 questions that were submitted, as well as the feedback given are now detailed on the Research Section of the BSG website

I am pleased to report that one question will be taken forward to the SDO Board for consideration and one question will be reviewed by the HTA Diagnostic panel. There were also two suggestions that research proposals be submitted directly to HTA as Investigator-led bids.

We can learn a lot about how to shape questions for future submissions from the feedback. For example, several questions were felt to be irrelevant to the HTA Programme because the research was not thought to be too ‘early’ and not address the clinical effectiveness of a technology. We will be able to strengthen future submissions in the light of this feedback.

Another bit of good news is that NETSCC also asked to evaluate the other research questions (9) that were not originally requested by NETSCC giving us even more visibility in the NIHR Programmes. The Research Committee will report any further NETSCC feedback in due course.

This is the first time that a Specialist Society has submitted research ideas to NETSCC in such a structured Society-wide manner and I would like to thank all those who helped with the BSG submission especially Julie Solomon and Peter Sime. I hope to see more commissioned calls for NIHR-funded GI and liver research appearing over the next 1-2 years as a consequence. We will certainly be repeating the exercise in the following year.

Mark Hull


Payment by Results – 2011 Update

Tim Heymann and Geoff Sandle - BSG Information Group

Payment by Results (PbR) describes the way in which hospitals are paid for what they do. The system was introduced for a limited number of hospital services in 2005/06 with the aim of providing a transparent, rules-based system for paying providers. Since then the scope of PbR has increase to cover approximately 70% of hospital services. In theory it should reward efficiency, support patient choice and diversity and encourage activity for sustainable waiting time reductions. Payments are linked to activity and adjusted for casemix. One ambition has been to ensure a fair and consistent basis for hospital funding.

Payments are linked to the HRG (Healthcare Resource Group) derived for each patient's time in hospital (the period from admission to discharge) , the resources that they need and use such as staff time, bed days and consumables. Broadly the PbR tariff reflects the actual costs of each HRG. Those costs are calculated from the national average reference costs which every NHS provider submits. The tariff can then be adjusted at Department of Health (DH) discretion each year, for instance to encourage efficiency. This year tariffs have been set at 1% below the last year's mean reference costs. They have been adjusted to promote new ways of working: for instance the PbR tariff is set at zero for patients who are readmitted within 30 days of discharge following an elective admission. That is meant to encourage safe, appropriate discharge and the development of “re-enablement” services in the community. Tariffs are also adjusted to acknowledge unavoidable differences in operating costs in different parts of the country, so are higher for care in central London hospitals than in provincial centres such as Truro. Supra regional services such as transplants, and some specialist treatments e.g. chemotherapy, specialist rehabilitation and high cost drugs do not currently have mandatory national tariffs and are left for local negotiation.


Independent EWTD Review

Issued by the News Distribution Service on behalf of NHS Medical Education England (MEE)

Professor Sir John Temple has launched his report ‘Time for Training’, an independent review of the impact of the European Working Time Directive (EWTD) on the quality of training for doctors, dentists, pharmacists and healthcare scientists.

The report was commissioned by Medical Education England (MEE) at the request of the former Secretary of State for Health Alan Johnson.

Sir John’s report concludes that high quality training can be delivered within the reduced number of hours available but fails if trainees:

  • have the major role in providing out of hours service;
  • are poorly supervised; or
  • have limited access to learning.

'Time for Training' focuses on the quality of training provided now and says any current problems will not be solved by either increasing hours or lengthening training programmes.

The Review reveals that, despite an increase of more than 60 percent in consultant numbers over the past ten years, hospitals remain too reliant on junior doctors to provide out of hours services.


More Articles...

Page 23 of 24