World view from the RCN International Department

Nursing perspectives and contribution to primary health care

This free publication from the International Council of Nurses sets out trends and issues in community development in primary health care from a nursing perspective. It highlights the importance of working with other sectors that have a bearing on health and presents a comprehensive role for nurses as facilitators, advocates, and key members and leaders of the health team. Real life examples are provided from nurses around the world who play key roles in community development in both developed and developing countries.

Health is global

Proposals published in March 2007 made the case for developing a global health strategy that will benefit the health of the UK population and those in the rest of the world.

That report provided a framework for developing a global health strategy and marked the beginning of a period of discussion on what are the current global health priorities, what the UK should focus on and what the global health strategy should look like. The Travel Health Forum contributed to the RCN consultation on this strategy.

Consequently Health is global: a UK government strategy was launched on 30 September by the Health Secretary Alan Johnson. The new strategy sets out the way the UK Government will work with the World Health Organization, the EU and a number of other partners to improve the health of the world's population. It is underpinned by £12 million over the next five years.

The strategy highlights the critical global health challenges that the UK and the rest of the world face and provides a clear set of actions to respond to them. New and neglected areas are addressed - the challenges of climate change, emerging diseases, links between health and foreign policy/national security and the increasing importance of non-communicable diseases in low and middle income countries. It then identifies areas for action.

Non-communicable diseases are growing global threat

World health statistics 2008, the latest annual report published by the World Health Organization, reveals a global shift in the causes of death from infectious diseases to non-communicable, chronic illnesses such as heart disease and stroke. This report indicates that causes of death from infectious diseases such as HIV, TB, malaria and neonatal infections will decline over the next 20 years. It also documents mortality levels in children and adults, patterns of morbidity and disease burdens, prevalence of risk factors like smoking and alcohol consumption, use of health care, availability of health care workers and health care financing.

Patients' rights in cross-border health care

The European Commission has published the proposed Directive on the application of patient's rights in accessing cross-border health care which, following a number of judgements by the European Court of Justice, aims to clarify a framework and provide legal certainty for member states and health care providers. The major rights and responsibilities include:

  • Patients can seek hospital health care abroad with prior authorisation and then claim for reimbursement.
  • Patients do not need prior authorisation to seek non-hospital health care abroad.
  • Member states are responsible for the quality and safety of the health care provided in their country including a system for redress and compensation.
  • Member states must have a system of appropriate professional indemnity or similar cover.
  • There is a requirement to mutually recognise prescriptions issued by an authorised person for a named patient.

The RCN considers this proposed legislation will only work if the EU puts in place information systems that make patients aware of their care entitlement abroad and the quality of care available. This should allow those considering treatment in other parts of the EU to make an informed choice.

Euro eHealth initiatives support medical assistance abroad

The European Commission has announced two initiatives aimed at supporting the safety and quality of care for people needing medical assistance when travelling or living abroad. These are a recommendation on cross-border inter-operability of electronic health record systems and the Smart Open Services that will deliver it. The principles for both initiatives are to facilitate better health care for all EU citizens and for health care providers to co-operate extensively with each other, and their suppliers, to ensure these services are well-connected.

Quicker diagnostic test for mdr-TB

People who have multi-drug resistant tuberculosis in low resource countries will have access to a far speedier diagnosis through an initiative announced by the World Health Organization. A new test reduces the diagnostic time taken to confirm mdr-TB from two-to-three months down to just two days. This test requires countries to have equipped laboratories, trained staff and second-line drugs. The first two countries to implement this test by the end of 2008 are Lesotho and Ethiopia. During 2009-2011 the test will be phased into14 other countries.