Access to NHS services for foreign nationals

-Department of Health and Home Office publish joint review findings-

A joint Department of Health and Home Office review group has published its findings on a review into access to the NHS by foreign nationals, Health Minister Ann Keen announced today.

The review, launched in 2007, set out to examine the rules on charging non-UK residents for access to NHS services in England. The government has concluded that there should not be any significant change for either primary or secondary care.

The government has now agreed on a number of proposals, which will be consulted on in the autumn:

• Asylum seekers whose claim has been refused but who are being supported because there are recognised barriers to their return home should be exempt from charges;
• Unaccompanied children, including those in local authority care, should be exempt from charges;
• UK residents may be absent from the country for up to six months in a year before being considered for charges for NHS hospital treatment;
• Working with the UK Border Agency to recover money owed to the NHS and exploring options to amend the Immigration Rules so that visitors will normally be refused permission to enter or remain in the United Kingdom if they have significant debts to the NHS; and
• Investigating the longer-term feasibility of introducing health insurance requirements for visitors.

Health Minister, Ann Keen said:

“These changes will support a clearer and fairer system of access to free NHS services that will maintain the confidence of the public and prevent inappropriate access while maintaining our commitment to human rights.

“These measures strike the right balance between controlled access, the protection and promotion of wider public health, and ensuring that the healthcare needs of the most vulnerable groups are protected.

“We remain firmly committed to the requirement that immediately necessary or other urgent treatment should never be denied or delayed from those that require it.”

The proposed changes will be put to public consultation in the autumn. The Department of Health and the Home Office will undertake separate consultations on their respective areas of responsibility, which will be linked and coordinated. Subject to the outcome of the consultation, changes will take effect as soon as possible in 2010.

(DH) Threat of beer bellies and man boobs scaring men into moderation

Concerns about health and looks are driving thousands to cut back on booze

Men are worried that drinking too much alcohol will give them a beer belly or man boobs according to a new survey for the Know Your Limits campaign published today.

Released during Men's Health Week, the statistics show that watching the waistline is no longer only the preserve of women, with more than one in three men (37%) claiming they would reduce their drinking to cut down on the number of calories they consume. Only money-saving (44%) is a bigger incentive.

The YouGov survey of almost 1,000 male drinkers over 18 in England revealed:

* One in six men (17%) are worried their drinking will lead to man boobs
* One in four (27%) are worried about getting a beer belly
* More than one in eight (13%) think their boozing is affecting their appearance
* Nearly one in ten (9%) worry that excessive drinking is affecting their sexual performance

The NHS recommends men do not regularly drink more than 3-4 units a day - equivalent to less than two pints of normal strength beer. According to the Office of National Statistics, an estimated 6.3 million men in England regularly drink above these limits*.

The YouGov survey revealed more than one in three men (36%) are worried booze is risking their long-term health, and more than one in five (22%) already feel it is affecting their general health and wellbeing.

But awareness of the specific health risks is generally worse among men than women. While most men (73%) were aware of the increased risk of liver disease associated with drinking above the recommended limits, 83% didn't know about the link with mouth cancer, 84% were equally unaware of the risk of throat cancer, and two-thirds (66%) were blind to the increased risk of stroke.

Encouragingly, when told about these risks, more than a quarter (28%) said it made them keener to cut down.

Public Health Minister, Gillian Merron said:

"Our survey shows that more and more men are worried about alcohol ruining their looks. It is encouraging that they are also thinking about their health. Men who drink too much are at risk of conditions such as liver disease and stroke, as well as getting out of shape.

"Unfortunately, the longer-term effect drinking too much can have on your health is harder to spot until it's too late.

"Our Know Your Limits campaign arms people with the facts about how many units are in their favourite drinks, to help them keep a check on how much they drink each day."

Dr Ian Banks, President of the Men's Health Forum, is backing the Government's Know Your Limits campaign.

He said: "It's clear men are more concerned about the impact of their drinking on their bodies than we might imagine. Many of us only begin to see the visual evidence of our drinking habits as we get older and start to carry excess baggage, but excessive drinking can also take its toll beneath the skin.

"Most of us enjoy a drink from time to time, and that's fine. But more men ought to be aware that drinking a couple of pints of beer or sharing a bottle of wine most days of the week can push them over the recommended limits, increasing their risk of liver disease, cancer, heart disease and stroke."

Chris Sorek, Chief Executive of the DrinkAware Trust said: "Men are clearly worried about how alcohol affects their looks so Men's Health Week is an ideal opportunity to get back into shape and start calculating alcohol calories on Drinkaware's website.

"Whether it's drinking with friends in the pub or relaxing at home, it's crucial men keep track of units to avoid their looks deteriorating and serious health problems including liver and heart disease, cancer, and reduced fertility. Sticking to the recommended daily unit guidelines, taking 48 hours off after a heavy session and doing regular exercise will also help men keep the beer belly - and major illnesses - at bay."

In 2007/08, there were more than 863,000 alcohol-related hospital admissions, an increase of 69% since 2002/03. Of these, 62% were for men.

Fewer than a third of men (31%) in the YouGov survey reported keeping track of their units. But a drinks calculator at http://www.nhs.uk/units does the maths for you, helping drinkers stick within their limits.

(DH) New Health Secretary sets out vision for a people centred NHS - New emphasis on quality, innovation and prevention

A new era in the National Health Service that builds on targets achieved and prioritises quality of care was set out by new Health Secretary Andy Burnham today.

Addressing an audience of senior NHS leaders and managers at the NHS Confederation's annual conference, Mr Burnham pledged a 'deep clean' of superfluous national targets in favour of clearer, simpler standards and said that quality was "the route map through the funding challenges on the horizon".

Mr Burnham described the impact of the economic downturn on the NHS as a "moment of opportunity, not threat" and set out how improving the quality of health services - with a greater focus on preventing illness and disease - will lead to both a better patient experience and greater efficiency, helping the NHS meet the financial challenges ahead.

Announcing work to develop and introduce a new minimum standard for the NHS to eliminate all preventable MRSA infections, Mr Burnham said:

"The NHS has made huge progress. But I want it to go from good to world-class, moving away from numbers and towards what matters most - the patient's experience.

"On MRSA, infections have been reduced by 65% since 2003. I have asked the National Quality board to help develop a new minimum standard that will ensure all hospitals drive down MRSA bloodstream infections to the levels currently being achieved by the best performers - making the NHS even safer for staff and patients. I want this to be fairer - taking into account local differences - based on clear evidence and developed together with NHS staff and stakeholders.

"Reducing infections makes sense not just for patients, but for the NHS's finances too. Cutting cases of MRSA and C. difficile not only saves many lives, it also saved the NHS at least £75 million last year."

The Health Secretary also announced that from 2010-11 the top performing NHS Primary Care Trusts will be rewarded with greater freedom and flexibility to enable them to deliver more improvements, more quickly to their local communities.

This elite group of PCTs who have made the most significant impact in improving the quality of healthcare in their local communities, ensuring patients get the best possible treatment and leading the way on preventing disease - for example quitting smoking services - will benefit from greater control over how they operate.

Mr Burnham added:

"Innovation, efficiency, productivity and prevention are what should drive the next stage in creating a people-centred NHS. The best primary care trusts are ably demonstrating that they can respond to the health needs of the people they serve - in particular, tackling the causes of ill health as well as treating it.

"In line with Lord Darzi's Next Stage Review, I want these top performers to have even further powers, with greater freedoms and more scope to innovate - for instance being able to set longer term plans and preferential access to the new Innovation Fund.

"We cannot underestimate the importance of preventing disease. It is estimated that if PCTs improve their performance on key health outcomes such as smoking, alcohol, cardio vascular disease mortality, diabetes and stroke over the next five years this could result in a 10-15% reduction in health inequalities."

(DH) Review of the effect of European working time directive on junior doctor training

A review into the quality of training for junior doctors in the light of the implementation of the European Working Time Directive was announced by Health Secretary Alan Johnson today.

The review will consider the concerns raised by some professionals that the introduction of a 48-hour working week may have a detrimental effect on junior doctors' training, particularly on the training they receive while at work.

The Health Secretary has asked Medical Education England (MEE), the independent advisory board on medical training, to commission the Post-graduate Medical Education and Training Board (PMETB), the independent regulator of standards of training, to work with stakeholders to identify areas where changes to training might be necessary as a consequence of reduced working reduced hours.

Alan Johnson said:

"Everyone's overriding objective is the quality and safety of patient care. We are also concerned for our workforce and the hours they work. We want to provide doctors with a good work life balance and we do not want a return to junior doctors working excessive hours.

"There is no evidence that greater numbers of trainees are failing their end of year assessments where 48 hour working has been introduced.

"Also no junior doctor can become a consultant until the appropriate Royal College has issued a Certificate of Completion of Training (CCT). This is an essential safeguard, ensuring medical training remains of the highest standard.

"However, given the concerns raised by some professional groups it is important that there is an independent and objective assessment of whether the introduction of the European Working Time Directive fully into the NHS will necessitate changes to the current system of postgraduate medical training."

Chairman of Medical Education England, Sir Christopher Edwards, said:

"MEE is delighted that the Secretary of State for Health, by asking MEE to commission a review by PMETB, is being proactive in trying to ensure that the introduction of the European Working Time Directive does not have an adverse effect on high quality medical training.

"This will be discussed as a main agenda item at the next meeting of MEE on June 8th. After this we will be submitting to the Secretary of State Alan Johnson our proposals for both the programme and the timetable for this review."

(DH) Abortion statistics, England & Wales: 2008

The following National Statistics were released today by the Department of Health:

Abortion Statistics, England & Wales: 2008 Main findings:
In 2008, for women resident in England and Wales:

* the total number of abortions was 195,296, compared with 198,499 in 2007, a fall of 1.6%

* the age-standardised abortion rate was 18.2 per 1,000 resident women aged 15-44, compared with 18.6 in 2007

* the abortion rate was highest at 36 per 1,000, for women age 19, the same as in 2007

* the under-16 abortion rate was 4.2 and the under-18 rate was 18.9 per 1,000 women, both lower than in 2007

* 91% of abortions were funded by the NHS; of these, just over half (58%) took place in the independent sector under NHS contract

* 90% of abortions were carried out at under 13 weeks gestation; 73% were at under 10 weeks

* medical abortions accounted for 38% of the total

* 1,988 abortions (1%) were under ground E, risk that the child would be born handicapped

Non-residents:

* in 2008, there were 6,862 abortions for non-residents carried out in hospitals and clinics in England and Wales (7,099 in 2007)

                     2007               2008
All abortions        198,499 (100%)     195,296 (100%)
3-9 weeks            139,144 (70.1%)    142,645 (73.0%)
10-12 weeks          38,998 (19.6%)     33,661 (17.2%)
13-19 weeks          17,430 (8.8%)      16,101 (8.2%)
20-21 weeks          1,726 (0.9%)       1,615 (0.8%)
22-23 weeks          1,066 (0.5%)       1,150 (0.6%)
24 weeks and over    135 (0.1%)         124 (0.1%)

See this link for detailed figures.
http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsStatistics/DH_099285

(DH) Government responds to Archer Inquiry

The Government today responded to the independent inquiry into contaminated blood supplies in the 1970s and 1980s.

In a Written Ministerial Statement, Public Health Minister Dawn Primarolo set out the Government's response to the Archer Inquiry into individuals infected by HIV and hepatitis C through infected NHS blood and blood products.

The response includes:

* there will be a significant increase in annual payments to £12,800 for individuals infected with HIV, in addition to the £45 million already given out in lump sums and discretionary payments;

* further support for the Haemophilia Society of £100,000 per year for the next five years; and

* a commitment to review the financial relief for individuals affected by hepatitis C in five years.

Tough measures are already in place to prevent similar events happening in the future. To ensure all patients with bleeding disorders who may have been infected have been identified, a look back exercise will be undertaken.

Minister for Public Health, Dawn Primarolo said:

"I would like to offer my deepest sympathy to all those who suffered in this tragic episode. Sadly, it was not possible to effectively test for these viruses in the 1970s and early 80s and we deeply regret that these events occurred following NHS treatment.

"Steps to safeguard blood products against HIV and hepatitis C have been in place since 1985. Every reasonable step to minimise risks from blood transfusion has been taken and robust screening measures are in place to protect patients.

"In addition to the £150 million already given out in lump sums and discretionary payments to those infected with HIV and hepatitis C, financial help for those infected with HIV will rise to £12,800 per year."

The full response to Lord Archer's report has been placed in the Library of the House.

In keeping with the Government's commitment to make information available that relates to this period, the remaining 468 relevant documents have been placed on the Department of Health website:
http://www.dh.gov.uk/en/FreedomOfInformation/Freedomofinformationpublicationschemefeedback/FOIreleases/DH_076693

(DH) Agreements secured for pre-pandemic vaccine for the UK

Agreements have been signed between the UK Government and vaccine manufacturers to secure supplies of up to 90 million doses of pre-pandemic H1N1 vaccine before a pandemic begins, the Department of Health announced today.

The deals signed between Secretary of State for Health, Alan Johnson, GlaxoSmithKline, and Baxter, will enable production of pre-pandemic vaccine to begin as soon as possible.

The agreements could provide enough vaccine to protect the most vulnerable in our population before a pandemic is likely to arrive, without affecting our supply of seasonal flu vaccine.

Secretary of State for Health, Alan Johnson said:

"The localised cases of swine flu found in the UK have so far been mild, and our strategy of containing the spread with anti-virals appears to have been effective in reducing symptoms and preventing further spread of infection.

"Scientists tell us that as yet we don't know enough about this novel strain, or whether it's likely to mutate, but that this virus has the potential to become a pandemic and we can't predict how serious that would be. We have an opportunity to secure vaccine in advance of a pandemic wave. We have Advance Purchase Agreements to provide vaccine for the entire UK population which will take effect when Phase 6 pandemic is declared. It will then take over a year for all the vaccine necessary to be provided.

"These additional arrangements provide the opportunity by December this year to have enough pre-pandemic vaccine to protect at least half of the population from swine flu. This will however depend on when and if the manufacturers switched from seasonal to H1N1 pandemic specific vaccine production at a time after Phase 6 is declared by the World Health Organisation, as this will take precedence over pre-pandemic contracts."

If a pandemic is declared, Advance Supply Agreements signed by the Government with GSK and Baxter in July 2007, will enable the UK to purchase up to 132 million doses of pandemic specific vaccine, when it becomes available.

(DH) New health taskforce to spot signs of violence against women

A new taskforce of health professionals working together to spot early signs of violence and abuse against women and girls, investigate the scale of the problem and ensure victims across the NHS get the support they need was announced today by Home Secretary Jacqui Smith and Health Secretary Alan Johnson.

The taskforce has been set up in response to issues raised during the Violence against Women and Girls consultation which began in March. The Government recognises that victims may talk more freely with health professionals about their fear of violence - even when they are not ready to take the next step to reporting the crime. The Government wants to make sure that health professionals are prepared to give victims of violence and abuse information about local support services. The taskforce will also look at helping health workers to identify women at risk earlier and how they can offer these women support to reduce repeat victimisation.

Professor Sir George Alberti, former National Clinical Director for Emergency Access and Service Design, will lead the work of the taskforce. The taskforce will comprise health professionals, NHS managers and representatives from the public, social services and voluntary sector.

Alongside this, the Government also pledged to double funding for the 24-hour National Domestic Violence helpline, bringing total support to £1 million for this year.

Home Secretary Jacqui Smith said:

"Violence against women and girls is completely unacceptable and we must all see it as our duty to step in and help someone who is at risk. This is not limited to friends and family; as we said in our consultation document, we need a wide range of workers on the frontline to be alert to the signs of violence against women and girls and able to provide support.

"I want to make sure that vulnerable women or victims who access healthcare can also get help and advice about protecting themselves as well as information about local support services.

"That is why we need this new taskforce - violence against women and girls is a public health issue affecting the lives of thousands of NHS patients every year and we need to do all we can together to prevent violence from occurring."

Health Secretary Alan Johnson said:

"Almost one in three women will experience domestic violence at some point during their lives and nearly one in four will experience some form of sexual assault. This taskforce will bring together health professionals and women's organisations to help tackle violence against women and girls by responding to its early signs and supporting its victims.

"Many women who have suffered violence and abuse turn to GPs and A&E for support and treatment - the taskforce will help us to ensure that all NHS staff are trained to care for women and girls and help prevent further abuse.

"We are also continuing to support the National Domestic Violence helpline for women so they can safely get the help they need at any time."

Professor George Alberti said:

"Violence and abuse against women and girls is an enormously important and rather a neglected area. I am delighted to have been invited to lead this taskforce to help better support victims and protect them from further harm.

"The taskforce will bring together people with a range of different skills and experience to help tackle violence and abuse against women and girls. We will also ensure that the voices and experiences of victims themselves are properly represented."

(DH) First step towards Swine Flu vaccine prototype achieved

The first step towards producing a European prototype of a swine flu vaccine has been achieved by the Health Protection Agency (HPA), Health Secretary Alan Johnson announced today.

On a visit to the HPA's National Institute of Biological Standards and Control (NIBSC) this morning, Alan Johnson learnt that researchers have sequenced the full genetic code of the virus. This is critical in understanding how the virus operates and identifying the crucial parts of the virus that can be used in vaccine manufacture.

Researchers hope that European manufacturers will be able to take delivery of candidate vaccine prototypes in the coming months so preliminary steps to mass vaccine production can begin.

The NIBSC is the only centre in the UK and one of a handful around the world developing vaccine prototypes for the European vaccine manufacturers. In the US, efforts are focused through the Centre for Disease Control.

In July 2007, the Government signed advanced supply agreements, which will enable the UK to purchase up to 132 million doses of pandemic specific vaccine, when it becomes available. The advanced supply agreements are worth £155.4 million over four years. Under these contracts, GSK and Baxter are committed to supplying a pandemic influenza vaccine as soon as the pandemic strain is identified and made available by the World Health Organization.

The HPA researchers will also work with sister organisations to compare the characteristics of this virus with other samples to gain a greater understanding of how flu infects people and how it can quickly change to evade our immune systems.

Health Secretary Alan Johnson said:

"A significant step towards protecting the world's health against swine flu has been taken.

"The speed with which vaccine prototypes can be created to combat potential pandemics is testimony to the dedication and world-class expertise of Health Protection Agency researchers.

"We have been preparing for the possibility of a pandemic for some time. We now look to the vaccine industry to produce the required quantities of vaccine as quickly as possible."

Professor Maria Zambon, Director of the Health Protection Agency's Centre for Infections, said:

"We are continuing to learn more and more each day about swine flu. The pure sample of virus that we have isolated, together with its genetic fingerprint, will be important resources as scientific organisations join forces on the development of an effective vaccine.

"The rapid assessment of this virus will ultimately help us to make future decisions regarding the health implications of swine flu."

(DH) Public information update from Department of Health

Swine Flu - Thursday 7 May 6pm

A Department of Health spokesperson said:

"Two new cases of swine flu have been confirmed in England today. One new case is an adult from the East of England region who recently returned from the United States. The second is a school-aged child from the London region.

"Both patients have already received antivirals and are recovering at home. Close contacts of these cases are also receiving antivirals as a precautionary measure.

"There are now 34 confirmed cases in the UK - 30 in England and four in Scotland.

"It is right that we are preparing for the possibility of a global pandemic. The UK's arrangements are continuing to ensure that we are well-placed to deal with this new infection."

Further information

If you have flu like symptoms and are concerned, stay at home, if you can go online check your symptoms on the symptom checker on http://www.nhs.uk or call the swine flu information line on 0800 1 513 513. If you have taken these steps and are still concerned call your GP or NHS Direct.

KEY ISSUES

CURRENT SITUATION

* There are now 34 confirmed cases in the UK - 30 in England and four in Scotland.

* The arrangements in place across the UK are continuing to ensure that we are well-placed to deal with this new infection.

* At present, there are 1518 confirmed cases across the world. Twenty-nine deaths from swine flu have been confirmed in Mexico, and two in the US.

* There is not yet evidence of sustained person to person transmission - that is to say, different people in the community who have no obvious link to each other catching this disease.

* Ten people who are not known to have travelled to Mexico have caught the virus in the UK from other infected people who are close contacts. We can reasonably expect the number of such cases to increase considerably over the coming weeks.

* Of the UK cases, 12 are children. Following expert assessment, four schools closed on the advice of local health protection officers in order to contain any potential outbreak.

* A fifth school and a linked nursery decided to close on their own volition after two pupils at the school were confirmed to have the disease, though they had not been at school when symptomatic.

Is it a mild infection and therefore no cause for concern?

* We must not be complacent. It is too soon to assume it will be a mild infection. We don't know the profile of the virus and we are closely monitoring each case that comes up.

* Everyone who has contracted the virus in this country has been diagnosed early and treated with antivirals, which reduce the severity of symptoms.

* The flu virus changes character very rapidly. They essentially evolve with the 'fast forward' button switched on. That means the flu virus is unstable. It can pick up and swap genetic material, which can dramatically change its character - increasing the severity of symptoms. The virus could change in the autumn so we need to plan for all eventualities.

STEPS THE GOVERNMENT IS TAKING TO CONTAIN THE VIRUS

* We know a great deal more about these issues than the governments who had to deal with the pandemics of the last century.

* However, we still don't know enough about the nature of this specific virus. At present, leading scientific experts in this country and across the world are urgently studying who this virus is most likely to affect, whether it will mutate and the possibility of its re-emergence in the autumn as a more dangerous strain.

* While it seems that those who have developed the disease outside Mexico have generally only experienced mild symptoms, there has been a second death in America of a woman who had chronic underlying health conditions.

* The Health Protection Agency and the Scientific Advisory Group on Emergencies, which is jointly chaired by the government's Chief Scientist Professor John Beddington and Professor Sir Gordon Duff (Chair of the Scientific Pandemic Influenza Committee), are clear that it is still too early for confident predictions about the possible severity of this flu in the UK.

* The current containment phase means that all those who contract the virus have been given antivirals to aid recovery, and close contacts - whether they have symptoms or not - are given antivirals prophylactically to reduce their chance of developing the disease and spreading it further.

* This strategy has been adopted because there is good scientific evidence that in the early stages it will stop some outbreaks and delay for as long as possible the establishment of an epidemic.

* However, through this approach, we can only hope to delay a more widespread outbreak, we cannot stop it altogether.

SCHOOLS

* Pupil welfare is paramount. If schools and other childcare settings close at the right time, the spread of infection could be significantly reduced.

* The decision to close a school should be made in conjunction with the local health protection experts.

* For schools that are closed, arrangements will be put in place by Ofqual and exam awarding bodies to ensure that all pupils are treated fairly. These procedures are already in place.

* We recognise the enormous disruption that school closure can cause pupils, parents and staff. Parents should be reassured that the Department of Children, Schools and Families have well-established plans, including procedures to handle any disruption to exams.

PUBLIC INFORMATION CAMPAIGN

* As the World Health Organisation has made clear, one of the critical elements of any country's response to this situation is how the public are kept informed of developments; the steps they can take to protect themselves; and what they should do if they or a family member falls ill.

* A mass public health campaign has begun with print, television and radio advertising.

* Leaflets are being delivered to every home with information about the outbreak and the preventative measures people can take. Recorded information is available on the Swine Flu Information Line (0800 1 513 513).

TAMIFLU

* We currently have treatment courses for around 50 per cent of the population. This is one of the highest levels in the world. The stockpile is being conserved for treatment. We are increasing our stockpile to cover 80 per cent of the population.

* Where suspect cases are being identified, arrangements are in place to ensure between Primary Care Trusts and the Health Protection Unit that tamiflu is made available locally. Health Protection Unit stocks are being replenished from the stocks held by the Emergency Preparedness Division of the Department of Health and stocks are available.

Has the Government banned pharmacists from giving out Tamiflu?

* We have not withdrawn Tamiflu from over counter sales but, because we are increasing our stocks, pharmacists won't be able to buy any more at the moment. Normal supplies of tamiflu in pharmacists are usually relatively small as prescription is normally restricted by NICE guidelines.

ANTIBIOTICS
* We are increasing our stockpiles of antibiotics, which are essential for treating any potential complications caused by swine flu so that we have enough to cover 30 per cent of the population by September.

FLU LINE

* To make sure we can distribute antivirals effectively, we are working to get the Flu line up and running as quickly as possible, and it will be ready by the autumn.

* In the meantime, we are finalising plans for an alternative system that we aim to use in the short term, should the virus become more widespread more quickly.

* The interim arrangements we are putting in place will mean that people with symptoms can be assessed quickly, and antivirals made available so that they can start treatment within 48 hours of symptoms developing. We will co-ordinate local arrangements with primary care trusts for assessment and collection, web access and also the potential for phone services.

* It is critical that any system is robust and as thoroughly tested as possible before it is made operational.

VACCINE

* Scientists are now much closer to developing a vaccine strain from the virus.

* But while the first strain of the vaccine may be ready in a matter of weeks, developing this into a useable vaccine will take several months.

* The UK government and the Devolved Administrations already have agreements in place with manufacturers to supply stocks of a vaccine as soon after production begins as possible. In the meantime, we will continue to get expert advice on what will be the most effective vaccine strategy, and what would best protect us if the virus returned in a more virulent form in the autumn.

* We also need to assess the effects on the availability of the seasonal flu vaccine this winter.

LEVEL FIVE AND PREPAREDNESS

What does level five mean?

* Phase five indicates that WHO considers a global pandemic to be imminent, whereas at phase four a global pandemic is not inevitable. This means there has been person-to-person spread but it is still localised.

* We are still not in a pandemic phase.

Preparedness

* We have been preparing for the possibility of a pandemic for a number of years and are among the most prepared countries in the world.

* The NHS has developed its planning from a national, local and individual level and our plans are robust and advanced.

FACEMASKS

* There is no convincing scientific evidence that the widespread issue of facemasks to healthy members of the public can stop this disease spreading. Moreover, they give can false reassurance, and can encourage people to ignore basic and straightforward hand hygiene measures which have proven effectiveness.

* However, specialist and other types of facemasks are useful for frontline NHS staff who are caring for infected patients, if they are the appropriate type; worn correctly; changed frequently; removed properly; disposed of safely and used in combination with good hygiene measures.

* Although we have a supply of facemasks for NHS staff, we do need more. have ordered an additional 227 million surgical facemasks and 34 million respirators, which, if used properly, can prevent transmission to NHS staff who are in close and frequent contact with patients.

WEBSITES

Key websites

Directgov (http://www.direct.gov.uk/swineflu) the primary government website for essential cross-government swine flu messages; NHS Choices (http://www.nhs.uk) the primary public-facing health information and advice service; the Department of Health website (http://www.dh.gov.uk) the home of content relating to health and care professionals; and Business Link (http://www.businesslink.gov.uk/swineflu) the home of business-related information. The dedicated Swine Flu page on the FCO website is at: http://www.fco.gov.uk/en/travelling-and-living-overseas/swine-flu

(DH) UK adopts new growth charts based on breast-fed babies

New growth charts launched for National Breastfeeding Awareness Week

All newborn babies and children up to four years old will have their growth measurements plotted on new charts from this week. The launch of the charts, which have been developed for the Department of Health by the Royal College of Paediatrics and Child Health, based on the World Health Organisation's work, coincides with National Breastfeeding Awareness Week (10 - 16 May) and replaces current measures which are based predominately on babies fed with formula milk.

Research shows that breast-fed babies tend to gain weight at a healthier pace and are less likely to become obese in later life. The new charts will play an important role in establishing breastfeeding as the norm and will be included in the Personal Child Health Records, which parents of every newborn are given. They will help parents and healthcare professionals identify children at early risk of obesity and provide important reassurance for parents of breast-fed babies, who are likely to gain weight more slowly.

The new charts include parent-friendly instructions and a chart specifically for premature babies. As babies can lose and gain weight at different rates during birth and two weeks, it is recommended that they are not measured during this time. The charts also help make more reliable predictions of a child's adult height.

Dr Sheila Shribman, National Clinical Director for Children, Young People and Maternity at the Department of Health said,

"Breastfeeding is the best form of nutrition for infants. It gives health benefits for both the baby and the mother - even after they are no longer breastfeeding. It protects against stomach bugs and chest infections, provides perfect nutrition for the first six months, and reduces the likelihood of becoming obese in later childhood.

"The new UK-WHO growth charts will not only provide more accurate measurements for infant growth of breastfed babies, but will also help healthcare professionals and parents to identify early signs of overweight or obesity and provide support."

Professor Terence Stephenson, President of Royal College of Paediatrics and Child Health said:

"The new charts have given us the opportunity to give growth charts a complete facelift and for the first time, position breastfeeding as 'the norm'. We hope they will be the stimulus for healthcare professionals to explain to women best practice for healthy growth and in turn, encourage more women to breastfeed their children"

(DH) New National Director for NHS Flu Resilience appointed

Ian Dalton has been appointed the new National Director for NHS Flu Resilience at the Department of Health, Health Secretary Alan Johnson announced today.

Mr Dalton, currently Chief Executive of NHS North East, will take up this newly created position with immediate effect, reporting to NHS Chief Executive David Nicholson.

The establishment of this new role follows the recent Swine Flu outbreak. Mr Dalton will be responsible for ensuring that all NHS organisations in England build on the robust planning that is already in place to deal with a flu pandemic, that NHS front line organisations are supplied with adequate equipment and drugs, and leading on appropriate vaccination programs.

Health Secretary Alan Johnson said:

"We have been preparing for the possibility of a pandemic for a number of years and the World Health Organisation says we are among the most prepared countries in the world.

"We already have robust arrangements in place that are continuing to ensure we are well-placed to deal with Swine Flu. The appointment of Ian Dalton will support the vital operational side of our plans by ensuring every NHS organisation in England is in the best possible position to protect the population.

"Ian Dalton is highly respected in the NHS and brings a wealth of skills and experience to this challenging role. I am extremely pleased to be welcoming him to the Department."

NHS Chief Executive David Nicholson said:
"The NHS has done a good job so far handling the swine flu challenge and we have clear plans in place for responding to future developments. Ian's many years of senior management experience mean he is well placed to ensure the NHS is prepared and can continue to protect and care for people."

Ian Dalton said:

"Preparing for and dealing with the threat of pandemic flu is extremely important. The NHS is well placed to deal with such an eventuality and I am looking forward to working with colleagues throughout England to ensure the NHS continues to respond appropriately to any developing
situation."

Mr Dalton will remain substantive in his current post as Chief Executive for NHS North East and will return to this role in due course. David Stout, currently Director of Finance and Communications, will be appointed as Acting Chief Executive for NHS North East.

(DH) Work begins to eliminate mixed sex accommodation in NHS

Building work to continue the progress made and finally eliminate mixed-sex accommodation in hospitals across England has started with over 700 projects planned across 200 organisations, Health Secretary Alan Johnson announced today.

The work is part of the government's pledge to ensure that men and women will not have to share sleeping areas, bathrooms or toilets when admitted to hospital and that their privacy and dignity is upheld whenever possible.

Some improvement works started in April after Alan Johnson allocated a £100 million Privacy and Dignity Fund to all Strategic Health Authorities (SHAs) in England. This followed approval of their plans on how best to eliminate mixed sex accommodation in hospitals in their areas.

Approximately £40 million of the funding has been allocated for new and refurbished same-sex sanitary facilities such as bathrooms, with the remainder spent on other work including:
* Erecting separating walls
* Provision of same-sex lounges,
* Improved partitions
* Approved pan-trust bed management systems.

Health Secretary Alan Johnson said:

"We have made great progress, however our message is clear- over the coming months we only expect to see mixed sex accommodation where it is clinically justified and from next year those trusts who fail in this duty will be financially penalised.

"It is simply unacceptable for top quality treatment by our finest surgeons, doctors and nurses to be undermined by a sub-standard mixed sex environment that patients find unsettling, uncomfortable and undignified.

"We are committed to providing patients with high quality care that is safe, effective and which puts a patient's privacy and dignity at its core. Everyone working within the NHS has a clear duty to ensure that this is not just implemented, but maintained."

Peter Carter, Chief Executive & General Secretary of the Royal College of Nursing (RCN), said:

"Nurses strive to provide high quality, dignified care at all times, but mixed sex wards have often been a major obstacle. Eliminating mixed sex accommodation would be a hugely significant step towards dignified patient care for all."

To ensure that the improvements are delivered to a high standard and on time; a national improvement team has been set up to support hospitals and monitor all improvement works.