Good data for Diphtheria....
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QOF 2012/13 changes

QOF guidance 2012-2013 (fifth revision)

As part of the 2012-2013 GMS contract changes, the General Practitioners Committee (GPC) and NHS Employers have agreed a number of changes to the quality and outcomes framework (QOF) effective from 1 April 2012.

The key changes are:

• the retirement of seven indicators (CHD13, AF4, QP1, QP2, QP3, QP4, QP5) releasing 45 points to fund new and replacement indicators
• the replacement of seven indicators with eight NICE recommended replacement indicators, focusing on six clinical areas namely Diabetes, Mental Health, Asthma, Depression, Atrial Fibrillation and Smoking
• the introduction of nine new NICE recommended clinical indicators, including two new clinical areas (Atrial Fibrillation, Smoking, PAD and Osteoporosis)
• the introduction of three new organisational indicators for improving Quality and Productivity which focus on Accident and Emergency attendancesamendments to indicator wording for CHD9, CHD10, CHD14, Stroke12, DM26, DM27, DM28 and DEM3inclusion of telephone reviews for Epilepsy 6Quality and productivity indicators

The six quality and productivity (QP) indicators covering outpatient referrals and emergency admissions have been agreed for a further year.

Three new QP indicators on Accident and Emergency (A&E) attendances have been introduced for one year and are aimed at reducing avoidable A&E attendances. These indicators continue to be aimed at securing a more effective use of NHS resources through improvements in the quality of primary care.

Miscellaneous changes

In addition to the above, a number of other changes have been agreed as follows:

Changes to the points values for the following indicators:

• BP4 - reduced by eight points to eight points
• BP5 - reduced by two points to 55 points
• DM2 - reduced by two points to one point
• DM22 - reduced by two points to one point
• CKD2 - reduced by two points to four points
• Smoking3 (now Smoking5) - reduced by five points to 25 points
• Smoking4 (now Smoking6) - reduced by five points to 25 points

A number of threshold changes as follows

• raising all lower thresholds for indicators currently 40-90% to 50-90%,
• raising all lower thresholds for indicators currently with an upper threshold between 70-85% to 45%,
• a number of upper threshold changes for indicators CHD6, CHD10, PP1, PP2, HF4, STROKE6, STROKE8, DM17, DM31, and COPD10lower and upper threshold changes for BP5, MH10 and DEM2
• ASTHMA3 has been renumbered to ASTHMA10 following a change to the business rules to include a new exception cluster.
• DEP4 has been renumbered to DEP6 following a change to the prevalence calculation to apply to all new diagnosis of depression from April 2006.
• MH14 has been renumbered to MH19 following a change to the business rules to include an exclusion cluster for patients already diagnosed with CVD.
• Records23 has moved into the clinical domain and the supporting business rules have been amended. This indicator is renumbered to Smoking7.
• Education1 has been renumbered to Education11 due a change to the indicator wording.Summary of Allocation of Clinical Domain points

CLINICAL DOMAIN 2012/13 QOF POINTS

• Secondary prevention of coronary heart disease 48
• Cardiovascular disease – primary prevention 13
• Heart failure 29
• Stroke and Transient Ischaemic Attack 22
• Hypertension 69
• Diabetes mellitus 88
• Chronic obstructive pulmonary disease 30
• Epilepsy 14
• Hypothyroidism 7
• Cancer 11
• Palliative care 6
• Mental health 40
• Asthma 45
• Dementia 26
• Depression 31
• Chronic kidney disease 36
• Atrial fibrillation 27
• Obesity 8
• Learning disabilities 7
• Smoking 73
• Peripheral arterial disease 9
• Osteoporosis : secondary prevention of fragility fractures 9

If you have found this informative please visit the 2020 Selection website where you will find many other relevant Factsheets in the Candidates Section

Source: http://www.nhsemployers.org The full QOF guidance is available to download from this site

Latest on the NHS Health Bill http://ping.fm/ydhfN

Clinical Therapeutics Specialist - Orphan products - Northern UK/ Southern UK/ Ireland - Excellent reward package - 4724

New Opportunity - Clinical Therapeutics Specialist - Orphan Product - New product launch opportunity.

Three territories:-

1. Northern England & Scotland

2. Southern England & Wales

3. Ireland

As a medical sales professional launching a new entity in to the market is one of the most thrilling and challenging career landmarks. For our client, there is just one chance to bring their new product to market; hence we are in search of an elite salesperson who can establish a breakthrough treatment in key centres across your territories. You must:
- Thrive in a fast-paced working environment
- Be able to work with your internal and external stakeholders to drive through results
- Understand the market dynamics, particularly around funding and use of Orphan status products
- Have sound planning skills with strong commercial judgement
- Be motivated by the ultimate goal of improving patients’ lives

Critical to your success will be the ability to remove any barriers to usage of the specialist product so as all relevant patients who would benefit have access to the drug. You would need to;
- Develop and execute specific account plans
- Communicate disease and product knowledge effectively
- Create a long-term ‘partnership’ and value propositions with all key stakeholders

This is a high profile sales role requiring a range of transferable skills and knowledge; it is likely you can demonstrate the following:
- A proven track record of sales success in your pharmaceutical/biotech career to date
- Experience of selling in a highly specialist market (Orphan products, other high cost:low volume areas)
- An understanding of the healthcare regulatory environment
- Excellence in selling skills, account management and networking
- Prior product launch experience will be an advantage
- Degree level education
- Valid UK driving license (max 6 pts)
You will need to able to cover your territory effectively so a willingness to travel/stay overnight, as the business requires, is a must.

The successful person will be joining a new sales team and be at the forefront of future growth plans for this ambitious company. On offer is a top end basic salary plus an extensive benefits package.
To be considered for this exciting vacancy please send your CV to administrator@2020selection.co.uk or call our specialist team on 0845 026 2020.

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Superb Opportunity - Hospital Sales Representative - Portfolio of specialist IV products - North East and East Midlands, England

Hospital Sales Specialist - Basic to £45k, OTE £60k++An opportunity to develop your talents working for a leading global Healthcare Company. Our client is currently looking for a Sales Specialist to develop the business in key hospital accounts throughout the North East, Yorkshire and East Midlands. Although a large geographical area this is a focused and targeted role with an emphasis on key account management.
This organisation has built an enviable portfolio of products and services that push back the frontiers of medical care and ultimately ensuring a better quality of life for people everywhere.
This opportunity for a Sales Specialist is an integral part of a specialty sales team reporting to the National Sales & Marketing Manager. You would be fully supported by internal functions such as marketing, customer services, logistics and shared services; YOU would be the interface of the company and the customer. With a drive for increased Patient Safety, in the NHS, when administering medication, our client is an excellent position to develop partnerships in hospital trusts. This role will involve selling new as well as some established products and services.
Key responsibilities would include:- Developing and implementing appropriate strategies for agreed customer targets with the objective of driving sales results and achieving or exceeding budgets. - To identify key finance and clinical decision makers within Consortia, Hospitals and Units and arrange meetings to promote relevant products and services - Gathering intelligence on customer plans and purchasing intentions and recommend responsive, timely and appropriate action.- Maintaining a high level of knowledge of the therapy area and related products - In conjunction with the National Sales Manager and wider commercial management team, provide informed input into/manage the tender process.- Calling on key customers as per your business plan (Clinical/Aspectic/Purchasing Pharmacists, Procurement, Clinicians, Specialist Nurses)
To be considering for this exciting opportunity you are likely to have- Previous hospital sales experience (2 years)- Knowledge/Experience of NHS structure & buying processes - Life sciences degree, nursing qualification, business degree (or equivalent experience in UK healthcare market for minimum of 2 years)- ABPI qualification and/or willing to study if required.
In return for your expertise if successful you will be offered a competitive salary & excellent benefits package including an uncapped bonus scheme. You will also receive first rate training and ongoing development.
To discuss this role in more detail please contact us on 0845 026 2020 or alternatively please submit your details by emailing administrator@2020selection.co.uk

NHS Patient Safety - Reducing Medication Errors

How can Pharmaceutical Companies contribute to improving NHS Patient Safety?

They can demonstrate ‘added value’ , for example, by either offering products which contribute directly to making the administration of medicines safer by helping to reduce:-

a.Making the drug up to the wrong strength
b.Using the wrong diluent
c.Microbial or other forms of contamination
d.Labelling errors
e.Administration by the incorrect route by clearer design/packaging of the product

The products which are commonly offered as part of a compounding service include:-
a.Cytotoxics
b.Antibiotics
c.Inotropes
d.Potassium solutions
e.TPN
f.Unlicensed medicines

In addition, the provision of non-promotional training/educational services to healthcare professionals in the form of Continuing Professional Development events and nurse advisor teams helps to educate NHS staff on how to administer medicines more

a.Confidently
b.Accurately
c.Competently


The Department of Health (DH) has issued the following list of ‘Never Events’ for 2012-13. The list is circulated to a wide range of NHS managers, clinicians and healthcare professional allied to medicine.

The document authors are the DH’s Patient Safety and Investigations unit. The purpose of the document is to highlight certain events which are deemed to be very serious risks to the standard of care to patients, but most importantly avoidable.

The document forms part of the wider DH’s Patient Safety Agenda policy and should be read in conjunction with the NHS Standards Contract for organisations providing services to the NHS
1.Wrong site surgery
2.Wrong implant/prosthesis
3.Retained foreign object post-operation
4.Wrongly prepared high-risk injectable medication
5.Maladministration of potassium-containing solutions
6.Wrong route administration of chemotherapy
7.Wrong route administration of oral/enteral treatment
8.Intravenous administration of epidural medication
9.Maladministration of Insulin
10.Overdose of midazolam during conscious sedation
11.Opioid overdose of an opioid-naïve patient
12.Inappropriate administration of daily oral methotrexate
13.Suicide using non-collapsible rails
14.Escape of a transferred prisoner
15.Falls from unrestricted windows
16.Entrapment in bedrails
17.Transfusion of ABO-incompatible blood components
18.Transplantation of ABO incompatible organs as a result of error
19.Misplaced naso- or oro-gastric tubes
20.Wrong gas administered
21.Failure to monitor and respond to oxygen saturation
22.Air embolism
23.Misidentification of patients
24.Severe scalding of patients
25.Maternal death due to post partum haemorrhage after elective Caesarean section
Source: http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_132352.pdf

You can read the whole document if you wish, but the indicators within the specific areas where the Pharmaceutical Industry has opportunities to work in conjunction with the NHS includes:-

4.Wrongly prepared high-risk injectable medication
· Death or severe harm as a result of a wrongly prepared high-risk injectable medication.
· High-risk injectable medicines are identified using the NPSA’s risk assessment tool1. A list of high-risk medicines has been prepared by the NHS Aseptic Pharmacy Services Group using this tool2. Organisations should have their own list of high-risk medications for the purposes of the “never event” policy, which may vary from the NHS Aseptic Pharmacy Services Group list, depending on local circumstances.
· A high risk injectable medicine is considered wrongly prepared if it was not; o prepared in accordance with the manufacturer's Specification of Product Characteristics;

1 NPSA High Risk Medication Risk Assessment Tool, 2007, available at
http://www.nrls.npsa.nhs.uk/EasySiteWeb/getresource.axd?AssetID=60097&type=full&servicet ype=Attachment

2 Pharmaceutical Aseptic Services Group. Example risk assessment of injectable medicines. 2007. Available at http://www.civas.co.uk/
· This event excludes any incidents that are covered by other “never events”.
· Where death or severe harm cannot be attributed to incorrect preparation, treat as a Serious Untoward Incident.

5. Maladministration of potassium-containing solutions
Death or severe harm as a result of maladministration of a potassium-containing solution.
Maladministration refers to;
selection of strong potassium solution instead of intended other medication,
wrong route administration, for example a solution intended for central venous catheter administration given peripherally,
infusion at a rate greater than intended.

Setting: All healthcare settings.
Guidance: - Patient safety alert – Potassium chloride concentrate solutions, 2002 (updated 2003), available at http://www.nrls.npsa.nhs.uk/resources/?entryid45=59882

6. Wrong route administration of chemotherapy
Intravenous or other chemotherapy (for example, vincristine) that is correctly prescribed but administered via the wrong route (usually into the intrathecal space).

Setting: All healthcare premises.
Guidance: - HSC2008/001: Updated national guidance on the safe administration of intrathecal chemotherapy, available at http://www.dh.gov.uk/en/publicationsandstatistics/lettersandcirculars/healthservicecirculars/dh_ 086870 - Rapid Response Report NPSA/2008/RRR004 using vinca alkaloid minibags (adult/adolescent units), available at http://www.nrls.npsa.nhs.uk/resources/?entryid45=59890

7. Wrong route administration of oral/enteral treatment
Death or severe harm as a result of oral/enteral medication, feed or flush administered by any parenteral route.
Setting: All healthcare settings.
Guidance: - Patient Safety Alert NPSA/2007/19 - Promoting safer measurement and administration of liquid medicines via oral and other enteral routes, 2007, available at http://www.nrls.npsa.nhs.uk/resources/?entryid45=59808

8. Death or severe harm as a result of intravenous administration of epidural medication.
A broader “never event” covering intravenous administration of intrathecal medication or The “never events” list 2012/13 9 intrathecal administration of intravenous medication is intended once the deadlines for Patient Safety Alert 004A and B actions have passed.
Setting: All healthcare premises.
Guidance: - Patient Safety Alert NPSA/2007/21, Safer practice with epidural injections and infusions, available at http://www.nrls.npsa.nhs.uk/resources/?entryid45=59807 - Safer spinal (intrathecal), epidural and regional devices - Parts A and B, available at http://www.nrls.npsa.nhs.uk/resources/?EntryId45=65259

9. Maladministration of Insulin
Death or severe harm as a result of maladministration of insulin by a health professional. Maladministration in this instance refers to when a health professional
uses any abbreviation for the words ‘unit’ or ‘units’ when prescribing insulin in writing,
issues an unclear or misinterpreted verbal instruction to a colleague,
fails to use a specific insulin administration device e.g. an insulin syringe or insulin pen to draw up or administer insulin, or
fails to give insulin when correctly prescribed.

Setting: All healthcare settings.
Guidance: - Rapid response report – Safer administration of insulin, 2010, available at http://www.nrls.npsa.nhs.uk/alerts/?entryid45=74287 - NHS Diabetes – Safe use of insulin, 2010, available at http://www.diabetes.nhs.uk/safe_use_of_insulin/ - NHSIII Toolkit – Think Glucose, 2008, available at www.institute.nhs.uk/thinkglucose - NHS Diabetes guidance - The Hospital Management of Hypoglycaemia in Adults with Diabetes Mellitus, 2010, available at http://www.diabetes.nhs.uk/document.php?o=1037

19. Misplaced naso- or oro-gastric tubes
Death or severe harm as a result of a naso- or oro-gastric tube being misplaced in the respiratory tract.
Setting: All healthcare premises.
Guidance: - Patient safety alert – Reducing harm caused by misplaced nasogastric feeding tubes, 2005, available at http://www.nrls.npsa.nhs.uk/resources/?entryid45=59794 - Patient safety alert – Reducing harm caused by misplaced naso and orogastric feeding tubes in babies under the care of neonatal units, 2005, available at http://www.nrls.npsa.nhs.uk/resources/?entryid45=59798&q=0%c2%acnasogastric%c2%ac


Please visit the 20:20 Selection website if you have found this article helpful, as we regularly update the articles in our Factsheet section
http://www.2020selection.co.uk/

Hospital Sales Representative Opportunity in Yorkshire

Springboard your career with a New Job in medical sales – Key Account Manager, Hospital Sales Representative, Yorkshire (North Yorks, York, Wakefield, Leeds, Hull, East Riding)

An opportunity to take your career forward selling to specialist customers in secondary care and also pulling this through with selected primary care customers with a relevant interest; this is a key account management role with responsibility for the sales and market share growth of a specialist product on your territory.

You would be working for an established yet evolving pharmaceutical company who are focused on developing lasting business partnerships with their customers in the NHS.

This position does require that you are ABPI qualified and have a proven track record of delivering against your targets in your career to date. If you have worked this territory and have proven your ability in key hospital accounts then this will be a distinct advantage. Importantly you will be;
- Highly motivated, enthusiastic and driven to succeed
- Have excellent business planning skills
- Be able to develop relationships and networks within your key accounts
- Want to be part of a high performing specialist team
- Be willing to go the extra mile to differentiate yourself, your product and company within the marketplace.

On offer will be an attractive basic salary, car, bonus and other benefits associated with the pharmaceutical industry. 2011 has been an exciting year in this organisation; be part of it in 2012.
The team at 20:20 Selection Ltd is here to discuss your background and suitability for this fantastic opportunity. Call us on 0845 026 2020 or you can also email administrator@2020selection.co.uk with your CV.