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Health and Social Care Update May 2011

04/05/11

Legal intelligence for professionals in health and social care

This Update contains brief details of recent Government publications, legislation, cases and other developments relevant to those involved in health and social care work, which have been published in the last month.

If you have been forwarded this update by a colleague and would like to receive it directly, please email Claire Bentley.

  Care   Governance
  Children   Health and Safety
  Clinical Management   Mental Health
  Clinical Research   Obesity
  Commissioning   Primary Care
  Complaints   Prison Health
  Employment/HR    Regulation
  Finance    General
  Foundation Trusts   

  

Care

Publications/Guidance
Speaking up for vulnerable adults: what the whistleblowers say. This report examines whistleblowing in the UK care sector. It calls for proactive promotion of best practice in whistleblowing arrangements and the support available for whistleblowers. This includes training and guidance for managers on how to handle concerns, employers providing feedback when responding to concerns, a greater awareness of rights, zero tolerance of whistleblower victimisation, and clearer guidance about how and when to approach relevant authorities.

Making quality your business: A guide to the Right to Provide. The Right to Provide is part of a bigger vision for the future of public services. This guide aims to support people who are thinking about taking up the right to provide and has been built on the experience of healthcare staff who have been through the right to request. It sets out a process for people working in NHS Trusts who have the right to propose the development of a staff-led enterprise. The DH is encouraging staff working in social care who are thinking about the right to provide, and people working in Foundation Trusts and Arm’s Length Bodies who are interested in staff leadership to use this guide. It tries to answer some of the questions they may have about setting up a staff-led enterprise, and helps them identify the next steps they need to take, and where to find further information.
To give staff the financial support necessary to do this, the Health Secretary has announced that at least £10m additional funding is being given to the Social Enterprise Investment Fund.

Guidance on the NHS Standard Contract for Care Home Services 2011/12. This document is the Guidance on the NHS Standard Contract for Care Home Services 2011/12 and should be read in conjunction with the NHS Standard Contract for Care Homes.

Ordinary residence: guidance on the identification of the ordinary residence of people in need of community care services, England. Revised guidance on how to decide where a person is ordinarily resident for the purposes of the National Assistance Act 1948 and certain other legislation. It is applicable to local authorities with social services responsibilities and sets out how to identify where responsibility lies between authorities for the funding and/or provision of care for people aged 18 and over who are assessed as needing social care services. The guidance may also be of relevance to PCTs, NHS Trusts and NHS Foundation Trusts which are exercising local authority health-related functions pursuant to Section 75 arrangements. It also sets out the changes to the ordinary residence provisions introduced by the Health and Social Care Act 2008.

Bevan Brittan Updates
Care and Compassion of the Elderly; is the NHS meeting this challenge? In this article, Ceri Catton reviews a recent Healthcare Ombudsman’s report which calls for institutional changes in the NHS which was said to be failing to provide even basic standards of care to elderly patients. Ceri Catton examines the reasons for this and how the NHS can change its approach to elderly patients.

If you wish to discuss any of the items raised in this section please contact Carlton Sadler

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Children

Publications/Guidance
Fundamentals of commissioning health services for children. This paper looks at how some PCTs have not only reduced admissions but commissioned services which deliver better outcomes for children and young people.  

Facing the future: standards for paediatric services. This report outlines how under-investment and an increase in demand for children’s hospital services have created huge pressure across paediatric care, resulting in many NHS services operating with dangerously low levels of staff and trainee doctors left to manage wards due to a shortage in senior level consultants posts. It warns that regardless of the outcome of the current Health Bill, an extensive ‘re-design’ of children’s health care is now necessary to safe-guard positive health outcomes for children.

Strategic high impact changes: childhood obesity. The Childhood Obesity National Support Team (CONST), Strategic High Impact Changes document, captures the learning and evidence gathered from the CONST's 44 visits to local health economies across the country. It translates this learning into what the CONST believe could make the greatest impact in addressing obesity in a local area. Identifying four key areas for implementation, the document provides researched examples and references evidencing the potential impact of the suggested interventions. This document is a summary of local views on good practice. The suggested approaches are not mandatory, and reflect learnings from a snapshot in time. Where there is clear established evidence to support interventions, this has been referenced. This document is offered as a useful resource for commissioners, its use is not mandatory.

Childhood obesity in London. This report looks at the direct costs of the current cost of publically funded treatment of childhood obesity and estimates that its associated consequences in London is £7.1 million a year.

If you wish to discuss any of the items raised in this section please contact Penelope RadcliffeTracey Lucas or Deborah Jeremiah

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Clinical Management

Bevan Brittan Events.

Practical Approaches to Implementing Effective Obstetric Practices and Adopting Risk Management Strategies to Successfully Defend Negligence Claims. This is an external event hosted by C5, for more information, please visit www.C5-Online.com/obstetricPenelope Radcliffe from Bevan Brittan is one of the speakers at this conference and her session is on  "When do Obstetric Complications Lead to Successful Claims?"
 
 

 
Bevan Brittan Updates
Claims case round-up April 2011. Gurdip Khatra takes a look at the following cases: Jones v Kaney 2011; Annie Rachel Woodland (by her Father & Litigation Friend Ian Woodland) v Beryl Stopford (1) Deborah Maxwell (2) Swimming Teachers Association (3) (2011);  Alexander v O’Brien (2011); XYZ v Portsmouth Hospitals NHS Trust (2011); and Tavenor Joe Douglas (A Litigation Friend William Robertson) v Matthew James O’Neill (2011).  

If you wish to discuss any of the items raised in this section please contact Jackie Linehan

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Clinical Research

Publications/Guidance
Exploring the interdependency between public and charitable medical research. Continuing concern about the fiscal deficit makes it likely that government funding of health and medical research will remain under scrutiny. This OHE Consulting study, commissioned by Cancer Research UK, explores the interdependence between publicly funded and charity funded medical research. In particular, it focuses on whether and how changes in the levels of government funding can affect private funding for charities, medical research and the UK economy as whole.

If you wish to discuss any of the items raised in this section please contact Deborah Jeremiah

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Commissioning

Publications/Guidance
House of Commons Health Committee: Commissioning: further issues - Fifth Report of Session 2010-11. This report scrutinises the Government's proposed health reforms and recommends a number of significant changes to the Health and Social Care Bill. The committee considers that it is crucial to get the reform of NHS commissioning right if the service is to confront the massive financial challenge it now faces. Their report contains a set of practical proposals to strengthen the Health and Social Care Bill and make it better able to meet the Government's objectives. Their proposals are designed to ensure that NHS Commissioning involves all stakeholders – not only GPs but also nurses, hospital doctors, and representatives of social care and local communities - as this broadening of the base for commissioning is vital in order to achieve the changes that are necessary to allow the NHS deliver properly coordinated healthcare. 

Fundamentals of commissioning health services for children. This paper looks at how some PCTs have not only reduced admissions but commissioned services which deliver better outcomes for children and young people.  

If you require further information about any of the items raised in this section please contact David Owens.

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Complaints

Publications/Guidance
New statement signed on NHS complaints. Monitor has signed a statement along with a number of organisations on driving improvement and learning from NHS complaints information. 

If you would like more information about the portal please contact Julie Chappell.

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Employment/HR

Publications/Guidance
Speaking up for vulnerable adults: what the whistleblowers say. This report examines whistleblowing in the UK care sector. It calls for proactive promotion of best practice in whistleblowing arrangements and the support available for whistleblowers. This includes training and guidance for managers on how to handle concerns, employers.

Equality act guidance. The new Equality Act 2010 started to come into force on 1 October 2010. The King's Fund has created a series of guidance documents to help explain the Act and provide practical examples on how the law has changed.

An updated version of the Guidance on matters to be taken into account in determining questions relating to the definition of disability under the Equality Act 2010 came into force on 1 May 2011. The Guidance, which replaces the 2006 version, was laid before Parliament in February 2011. The Equality and Human Rights Commission has also published two new guides to applying the 'positive action' provisions in the Equality Act 2010. These are the provisions that permit an employer, when selecting from two or more candidates of equal merit, to prefer a candidate with a protected characteristic which is under represented in the workforce. There is a 'quick start' guide and a more detailed 'step by step' guide available. 

The Good Medical Practice Framework for appraisal and revalidation. This framework sets out the broad areas which should be covered in medical appraisal and on which recommendations to revalidate doctors will be based.

NHS trusts failing to tackle staff obesity. A new report published today by the Royal College of Physicians (RCP) and the Faculty of Occupational Medicine has revealed that only 15% of NHS trusts have a policy or plan to help combat staff obesity.

Legislation
Equality Act 2010 (Public Authorities and Consequential and Supplementary Amendments) Order 2011 (SI 2011/1060). This Order, which came into force on 4 April 2011, amends the Equality Act 2010 by adding additional bodies to the list in Schedule 19 of public authorities which are subject to the public sector equality duty under s.149 of the Act. The additional bodies include a number of health bodies such as Foundation Trusts, NHS Trusts, PCTs, SHAs, Monitor and the CQC. The Order also adds a Part 4 to Schedule 19, listing cross-border Welsh authorities.

Bevan Brittan Updates
Bribery Act Guidance. Organisations which are currently setting up, or have set up, their anti-bribery procedures in time for the implementation of the Bribery Act in July must take note of the final guidance on preventing bribery which has now been published by the Ministry of Justice.  This will be of relevance to all those involved in HR and management generally, in the private and (to a lesser extent) the public sector, as John Moore explains.

Employment news round-up - April 2011. Lara Feghali provides a summary of employment law news this month, including information on the draft guidance for agency workers, an update on recent case law concerning discrimination on the grounds of sexual orientation and religion or belief, and details of increases to the National Minimum Wage.

Mothers in law. Mothers are, as we all know, special.  And the law acknowledges them as such, in that it allows employers to afford ‘special treatment’ to pregnant women and mothers, without that amounting to unlawful discrimination against men.  But the EAT has recently curbed the extent to which that ‘special treatment’ may be allowed; and this may have wider implications beyond the facts of this particular case.  Sarah Lamont looks at the detail.  

If you wish to discuss any of the items raised in this section please contact David Widdowson,  Julian Hoskins or Sarah Michael.

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Finance

Publications/Guidance
Letter to finance directors of foundation trusts re accounting for Transforming Community Service transactions. This letter outlines the accounting procedures for Transforming Community Services in statutory financial reporting, quarterly reporting and annual plans.

NHS Foundation Trust accounts: A guide for non-executives and governors - April 2011 Update. This Audit Commission publication includes additional questions for non-executive directors and governors, describing the main changes since the previous guides were published in 2010. It complements two documents published in 2010, Foundation Trust Accounts: A Guide for Non-executives and Foundation Trust Accounts: A Guide for Governors. These documents guide the reader step by step through a set of foundation trust annual accounts as they are prepared under International Financial Reporting Standards.

Incorporating Multiple Criteria in HTA: Methods and processes. Decision makers need to consider multiple criteria when considering what a health care system should pay for, or how much it should pay: health gain of course, but also the quality of patients’ experience of care, impacts on social equity and wider social considerations, and the quality of the evidence base. This new OHE book discusses how that might be done via a range of multi-criteria decision analysis (MCDA) methods and provides examples from current practice in the UK and internationally.

Hospital inpatient waste identification tool. This tool provides a systematic method for frontline staff, financial staff and leaders to identify clinical and operational waste and subsequently prioritise and implement waste reduction initiatives that will result in cost savings for the organization.

Freedom of Information report on waste management. This report is the result of a Freedom of Information request on waste management in the NHS between 2008-2010. It reveals that the NHS could potentially save up to £5.5m a year if healthcare organisations improve the way that they dispose of waste.

National Health Service Landscape Review. The Commons Public Accounts Committee has published a report that examines the accountability and value for money risks and implications of the Health and Social Care Bill. The Committee found that that many critical issues regarding abolition of the current structure of commissioners of health services and the regional organisations that oversee them, and the creation of the NHS Commissioning Board and GP commissioning consortia, have yet to be resolved. It notes that, most importantly, the DH has not yet got a framework to deal with failure in the system, be it on the provider side or the commissioning side. It states that it is imperative that the DH puts in place clear and transparent policies for dealing with failure of commissioners or providers to ensure patients are protected and value for money is assured. High quality risk management will be crucial if the change programme is to be delivered to time and budget and to realise its intended benefits, especially during the transition stage. The report provides an overview of aspects of the reforms where Parliament requires clarification and draws out a number of risks associated with the transition to the new model that need to be managed. The Committee intends to review the progress of the reforms at regular intervals and this report signals the sorts of issues it will want to examine in future.

More for less 2009/10: are efficiency and productivity improving in the NHS? The Audit Commission has produced a number of reports, analyses and updates, as part of the ‘More for Less’ series, looking at how NHS money has been spent, whether PCTs have been successful in keeping more patients out of hospital, and whether hospitals have become more efficient.

How is the NHS performing? Quarterly monitoring report. This monitoring report is the first of a regular quarterly review, which will combine publicly available data on selected NHS performance measures with views from a panel of finance directors on the key issues their organisations are facing. The indicators covered in the report include: key performance challenges, workforce and redundancies, and waiting times.

Price benchmarking and reducing non-pay spend. This letter from Jim Easton, National Director for Improvement and Efficiency invites NHS trusts to consider joining the Product Pricing Project to find out how the prices they are paying for a sample of clinical products compares with other trusts participating in the project. In addition, NHS chief executives are also invited to join a workshop with the Department of Health to gain practical examples of how they can save money through improved procurement and input into the national procurement strategy. 

Legislation
Statement of Financial Entitlements (Amendment) Directions 2011. These amending Directions, which came into force on 1 April 2011, are the latest in a series of changes made to the Statement of Financial Entitlements published in April 2005. The primary purpose of the amendment is to implement changes in the fee levels in the GMS Statement of Financial Entitlements effective from 1 April 2011. The fees are based on the changes set out in Barbara Hakin's letter to SHA Chief Executives and PCT Chief Executives of 11 March 2011.

If you require further information about any of the items raised in this section please contact David Owens.

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Foundation Trusts

Publications/Guidance
NHS Foundation Trust accounts: A guide for non-executives and governors - April 2011 Update. This Audit Commission publication includes additional questions for non-executive directors and governors, describing the main changes since the previous guides were published in 2010. It complements two documents published in 2010, Foundation Trust Accounts: A Guide for Non-executives and Foundation Trust Accounts: A Guide for Governors. These documents guide the reader step by step through a set of foundation trust annual accounts as they are prepared under International Financial Reporting Standards. 

Contract dispute resolution: advice for NHS foundation trusts. This advice from Monitor summarises the dispute resolution procedure for NHS FTs.  

If you require further information about any of the items raised in this section please contact Vincent Buscemi.

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Governance

Publications/Guidance
The NHS Performance Framework: Implementation guidance - April 2011. This guidance: supports the application of the NHS Performance Framework; informs SHAs as the regional system managers and PCTs as the local commissioners of NHS services of when they should intervene to address poor performance; and informs NHS organisations of the criteria against which their performance will be assessed.

Transforming Community Services: Demonstrating and measuring achievement: Community indicators for quality improvement. This document introduces 43 indicators for quality improvement for voluntary, local use in a community setting. These carefully chosen quality indicators will assist local service improvement and help to raise the standard of care delivered to patients and communities.

If you require further information about any of the items raised in this section please contact Vincent Buscemi.

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Health and Safety

Publications/Guidance
Extension of mandatory surveillance to E.coli bloodstream infections, June 2011. The Department of Health is introducing a mandatory requirement for all NHS acute trusts to report E.coli bloodstream infections diagnosed after 1 June 2011. To support organisations in making these returns, Health Protection Agency guidance and information on data input and definitions will be made available in the near future.

Safe management of healthcare waste. Second edition of the best practice guide to the management of healthcare waste, updating the 2006 Health Technical Memorandum (HTM) 07-01. The key changes include: an update to statutory requirements; a focus on the waste hierarchy through procurement practices; a drive to address the carbon impact related to waste; the integration of new sector guides on GPs, dental practices, and community pharmacies; an emphasis on practical advice through case study examples (in particular on offensive waste streams), and more by way of staff training material; and, a review of terminology used for healthcare, clinical and non-clinical wastes. 

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Mental Health

Publications/Guidance
Complaints - Written answers and statements 27 April 2011. This table shows the total number of complaints received by mental health trusts in England in each of the last five years.

Need 2 Know: Measuring wellbeing. This briefing provides a basic 'need to know' introduction to measuring well-being. It looks at various definitions of well-being, summarises previous work on measuring wellbeing across the UK, and sets out the potential benefits of creating authoritative well-being indicators.

Count me in 2010. This report presents the results of the 2010 national census of inpatients and patients on supervised community treatment in mental health and learning disability services in England and Wales. It calls for organisations outside of the healthcare sector to help improve mental health and wellbeing among black and ethnic minority people.

Commissioning services for women and children who experience violence or abuse: a guide for health commissioners. This guidance is designed to support health commissioners – in particular those commissioning primary care, mental health services, maternity care and sexual health services – to improve the commissioning of services for women and children who are victims of violence or abuse. It provides suggested outcome measures, case examples (including service specifications to download) and advice on how to include the needs of victims of violence in Joint Strategic Needs Assessments – with the aim of managing the transition and developing these services in a way which will help them to adapt to the changes to the NHS and public health.

Mental health promotion and mental illness prevention: the economic case. Mental ill health is the largest single cause of disability in the UK, contributing almost 23% of the overall burden of disease compared to about 16% each for cancer and cardiovascular disease. The economic and social costs of mental health problems in England are estimated at around £105 billion each year.

Good Practice Procedure Guide: The transfer and remission of adult prisoners under s47 and s48 of the Mental Health Act. This guidance sets out the process for both the transfer to secure inpatient treatment and where appropriate, remission to prison, for Immigration Act detainees to and from inpatient treatment under the Mental Health Act.

Environmental Design Guide: adult medium secure services. The guidance describes overarching principles for the design of adult medium secure inpatient services in addition to setting out the security requirements for these services.

Children and Young People’s Emotional Wellbeing and Mental Health National Support Team - the learning: 'What good looks like'. This document is based on the learning from the Team’s visits as well as the evidence of what works. It outlines the key elements of ‘What good looks like’ in terms of improving outcomes locally for the emotional wellbeing of all children and young people and children and young people with a specific mental health need.

Talking therapies: a four-year plan of action. This briefing by the NHS Confederation summarises the main points of 'No health without mental health' and outlines the key questions that boards should ask themselves.

NICE have produced new primary care tools to help implement their anxiety guidance. These include clinical case scenarios - case studies that can be used as a basis for discussions on how the recommendations should be applied in practice and a guide to resources for service users - a summary of the online resources that are available to help service users with GAD.

Section 67 of the Mental Health Act 1983 gives the Secretary of State for Health a discretionary power to refer cases involving certain patients subject to the provisions of the Act to the First-tier Tribunal. On page 4, the paragraph headed 'References by the Secretary of State for Health to the First-tier Tribunal and on page 5, the paragraph headed 'Information required to support the request' have been amended to show the relevant links on the Ministry of Justice website.

National audit of dementia services - Establishment of memory services. This is a letter from National Clinical Director for Dementia Alistair Burns. It notifies primary care trust medical directors of a proposed data collection exercise on the establishment of memory services starting in May 2011.

Consultations
Self-harm (longer term management): consultation. A clinical practice guideline on Self-harm (longer term management) is being developed for use in the NHS in England, Wales and Northern Ireland. Registered stakeholders for this guideline are invited to comment on the provisional recommendations via this website. Consultation dates: 12 April to 7 June 2011. .

Cases
A v (1) A Local Authority; (2) A Care Home Manager; (3) S [2011] EWHC 727 (COP). The Court of Protection directed that a report from the Court of Protection Visitor on both capacity and best interests of an individual, who had objected to his continued deprivation of liberty at a named nursing home for the elderly and mentally infirm, should be produced by the Court of Protection Visitor and funded by the Court of Protection. 

If you wish to discuss any of the items raised in the above section please contact Simon Lindsay   

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Obesity

Publications/Guidance
Childhood obesity in London. This report looks at the direct costs of the current cost of publically funded treatment of childhood obesity and estimates that its associated consequences in London is £7.1 million a year.

NHS trusts failing to tackle staff obesity. A new report published today by the Royal College of Physicians (RCP) and the Faculty of Occupational Medicine has revealed that only 15% of NHS trusts have a policy or plan to help combat staff obesity.

Strategic high impact changes: childhood obesity. The Childhood Obesity National Support Team (CONST), Strategic High Impact Changes document, captures the learning and evidence gathered from the CONST's 44 visits to local health economies across the country. It translates this learning into what the CONST believe could make the greatest impact in addressing obesity in a local area. Identifying four key areas for implementation, the document provides researched examples and references evidencing the potential impact of the suggested interventions. This document is a summary of local views on good practice. The suggested approaches are not mandatory, and reflect learnings from a snapshot in time. Where there is clear established evidence to support interventions, this has been referenced. This document is offered as a useful resource for commissioners, its use is not mandatory.

Cases
R (Condliff) v North Staffordshire PCT [2011] EWHC 872 (Admin) (Admin Ct). The court held that a PCT's individual funding request policy, which provided that non-clinical, social factors could not be taken into account in determining exceptionality, did not breach the European Convention on Human Rights 1950 art.8 because the right to respect for private and family life was not generally engaged in healthcare resource allocation.

If you would like more information about the portal please contact Julie Chappell.

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Primary Care

Publications/Guidance
GP Extended Hours Access Scheme Directed Enhanced Service – 1 April 2011 to 31 March 2012. Guidance for PCTs to support them in implementing the amended Extended Hours Access Scheme under the Primary Medical Services (Directed Enhanced Services) (England) (Amendment) Directions 2011, which will run from 1 April 2011 to 31 March 2012.

Cost-effective prescribing: Better Care Better Value (BCBV) indicator on statins. Guidance on the use of the prescribing Better Care Better Value Indicators, especially in relation to the indicator for statins. The guidance clarifies that the indicators are not intended for use as targets. It should be read in conjunction with the guidance on the GP contract for 2011/12.

Cases
R (Condliff) v North Staffordshire PCT [2011] EWHC 872 (Admin) (Admin Ct). The court held that a PCT's individual funding request policy, which provided that non-clinical, social factors could not be taken into account in determining exceptionality, did not breach the European Convention on Human Rights 1950 art.8 because the right to respect for private and family life was not generally engaged in healthcare resource allocation.

If you wish to discuss any of the items raised in the above section please contact David Owens.  

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Prison Health

Publications/Guidance
News
Prison health to improve as result of national IT system. Reports that healthcare staff in prisons will be better placed to tackle the challenging health needs of prisoners as a result of a national prison healthcare IT system now installed in all prisons and young offender institutions across England. All clinicians now have ready access to up to date medical information making it less likely that the physical and mental health needs of prisoners and young offenders go undetected. Prisoners will also benefit from improved continuity of care as they move between prisons, with medical records immediately and securely transferred from one prison to another. Over 5,000 healthcare staff are using the system at 136 English prisons and young offender institutions, including three immigration centres where the NHS is responsible for healthcare. The final prison to go operational with the system was HMP Feltham at the end of last month.

If you wish to discuss any of the items raised in this section please contact Nadia Persaud.

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Regulation

Cases
Rauniar v General Medical Council [2011] EWHC 782 (Admin) (Admin Ct). The court held that the GMC's Fitness to Practise Panel had been entitled to suspend a doctor's registration for 12 months where he had failed to comply with retraining conditions previously attached to his registration, and he had not demonstrated sufficient personal effort to address deficiencies in his performance.

Karwal v General Medical Council [2011] EWHC 826 (Admin) (Admin Ct). K appealed against her conviction by the GMC's Fitness to Practise Panel on three out of 26 allegations of dishonesty. The Panel concluded that she had knowingly made to a professional colleague false representations about an investment scheme so as fraudulently to reassure him that £188,000 he had been promised would be paid. The court held, dismissing the appeal, that K's dishonesty, even though unconnected with the practice of medicine, provided a clear and proper basis for a finding that her fitness to practise was impaired, as it undermined the profession's reputation and public confidence.

White v Southampton University Hospitals NHS Trust [2011] EWHC 825 (QB) (QBD). The court held that the GMC's Fitness to Practise Directorate was a quasi-judicial body, so a letter sent by a medical director to the GMC expressing concerns about a doctor's probity and conduct was, accordingly, subject to absolute privilege giving him immunity from suit in the doctor's libel claim. 

Consultations
Monitor consultation on community service governance indicators and quality governance assessments in transactions. The consultation also includes questions about including, on a proportionate basis, the Quality Governance Framework into Monitor’s review of transactions. The consultation closes on 29 June 2011.

If you wish to discuss any of the items raised in this section please contact Carlton Sadler

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General

Publications/Guidance
NHS emergency planning guidance: planning for the management of burn-injured patients in the event of a major incident: interim strategic national guidance. This publication gives best practice guidance to NHS organisations in planning, preparing and responding to incidents and emergencies that give rise to burn injuries regardless of cause, source or nature. This includes chemical, biological and radiological incidents. The principles apply regardless of the number of patients being treated and covers both adults and children.

Stop smoking service delivery and monitoring guidance 2011/12. This document provides best practice guidance relevant to the provision of all publically provided stop smoking interventions and sets out fundamental quality principles for the commissioning and delivery of services which can be used to inform the development of local commissioning and provision arrangements. It also includes full details of the data requirements for local stop smoking services.

Guidance for staff responsible for care after death (last offices). This guidance is intended to aid training and development for organisational protocols for this area of care. It also aims to provide a consistent view that accommodates England’s diverse religious and multicultural beliefs.

Working together for a stronger NHS. This document provides an overview to the proposed NHS reforms and explains how the public can get involved in the process.

Customer insight work on maternity and early years. This report is a synthesis of three pieces of qualitative about the experience of expectant and new parents. The three projects explored how parents feel about the pregnancy and parenthood journeys and their expectations of the health service.

Spirituality in nursing care: a pocket guide. This is a guide to enable nursing staff to address questions about the spiritual part of care. This guide hopes to define spiritual care, provide tips on preparing to give spiritual care and lists where to seek further information.

Bribery Act 2010 - guidance about procedures which relevant commercial organisations can put into place to prevent persons associated with them from bribing. The MoJ has announced that the Bribery Act 2010 will come into force on 1 July 2011. The Act includes a new offence which can be committed by commercial organisations which fail to prevent persons associated with them from bribing another person on their behalf. An organisation that can prove it has adequate procedures in place to prevent persons associated with it from bribing will have a defence to the offence. This statutory guidance explains the policy behind the new offence and aims to help commercial organisations understand what sorts of procedures they can put in place to prevent bribery. The MoJ has also published a quick start guide that sets out the key points.

Bribery Act 2010 - guidance about procedures which relevant commercial organisations can put into place to prevent persons associated with them from bribing. The MoJ has announced that the Bribery Act 2010 will come into force on 1 July 2011. The Act includes a new offence which can be committed by commercial organisations which fail to prevent persons associated with them from bribing another person on their behalf. An organisation that can prove it has adequate procedures in place to prevent persons associated with it from bribing will have a defence to the offence. This statutory guidance explains the policy behind the new offence and aims to help commercial organisations understand what sorts of procedures they can put in place to prevent bribery. The MoJ has also published a quick start guide that sets out the key points. .

Consultations
Proposals for making the NICE clinical guideline development process more efficient. This consultation document sets out proposed changes to the process for developing NICE clinical guidelines. After taking into consideration comments received from the guideline developers, stakeholders and the wider public, and subject to approval of the NICE Board at their meeting in September 2011, changes to the development process will be incorporated into ‘the guidelines development methods manual’. The manual is due to be updated and published 2012. Changes to the process will take effect from October 2011. The consultation closes on 19 July 2011.

Working together for a stronger NHS. The Government has launched a "listening exercise" on NHS modernisation, with an opportunity to "pause, listen, reflect on and improve" its plans to reform the NHS as set out in the Health and Social Care Bill. This document describes why the provision of health and care needs to change and the Government's plans to modernise the NHS. It invites reader to get involved in the process. There will be events running in every part of the country over the next two months which will give people a chance to get involved – from specific events for NHS staff, to others involved with the NHS, and those already involved in making change. More information is on the Modernisation website.
The Government has also announced the creation of the NHS Future Forum, consisting of a range of stakeholders chaired by Steve Field. They will oversee the listening process and produce a report for the Government on the key issues raised. The debate will focus upon four key areas:

  • The role of choice and competition (led by Steve Buggs from the Voluntary sector);
  • Patient involvement and public accountability (led by Geoff Alltimes CE of Hammersmith and Fulham LCB);
  • Professional leadership and integration (led by Kathy McClean, MD from East Midlands SHA); and
  • Education and Training (led by Julie Moore from UHB).

  • The Government's response to the recommendations in Front Line Care: the report of the Prime Minister's Commission on the Future of Nursing and Midwifery in England. Sets out the Government's response to the Commission's 20 recommendations, clustered into seven themes: the socio-economic value of nursing and midwifery, high quality compassionate care, health and wellbeing, caring for people with long-term conditions, promoting innovations in nursing and midwifery, nurses and midwives leading services, and careers in nursing and midwifery. The response includes the following recommendations:
  • more autonomy for nurses and midwives;
  • new contractual right for staff to raise their concerns direct to the Care Quality Commission;
  • to hold NHS organisations to account for the development of skills for nurses and midwives;
  • to develop leadership fellowships for nurses and midwives to ensure that leadership talent in nursing and midwifery is spotted and nurtured; and
  •  to ensure that there are nationally funded clinical academic training schemes to help nurses and midwives progress into stimulating research careers.

News
Twenty centres to put health visitors at the heart of the community. Announces that 20 'Early Implementer Sites' will showcase the new service model for health visiting, which has been developed with the profession, and was recently set out in the Government’s Health Visitor Implementation Plan 'A Call to Action'. Health visiting teams in these areas will work with other local health and children’s services, as well as with families themselves, so that by April 2012 they can provide this dynamic new service in ways and at times and places that suit their local community. The initiatives are part of the Government’s commitment to increase the health visitor workforce by 4,200 by 2015 and are backed by education institutions, NHS Careers and SHAs who will be on hand to advise and support on local opportunities. 

NHS tracks more infections. The Health Protection Agency has published the first set of mandatory monthly data for meticillin sensitive Staphylococcus aureus (MSSA) blood stream infection. The new data comes after last year’s commitment to ensure patients have access to a wider range of information about healthcare associated infections (HCAIs) to improve transparency and help drive down infections. There were 738 cases of MSSA in January 2011 and 675 in February 2011. At the same time the latest HPA monthly data show a 29 per cent reduction in cases for MRSA and a 23 per cent reduction in cases for C. difficile between February 2010 and February 2011. The DH has also announced that mandatory surveillance would also be extended to include E. coli data from June 2011.

Radical approach to drugs recovery piloted. The Home Office's Drugs Strategy, published in December 2010, included a new approach to the local delivery of drug interventions that would incentivise the system to deliver on recovery outcomes. The DH has now announced that eight areas will pilot a Payment by Results (PBR) scheme for drugs recovery for adults that rewards providers who support individuals to recover from their dependence by using clear outcomes for the individual, their families and communities.

Bevan Brittan Updates
Expert shopping – an end to 2 for 1 offers? We will all be familiar with CPR 35.4, which states that no party may call an expert or put in evidence an expert’s report without the court’s permission.   Where an expert has been identified and their report is disclosed post proceedings, then to change the identity of their expert, a party must apply to the Court. 

Jackson goes forth: the end of 'no win, no fee', but what else? The 29 of March is remembered for several important events in history: the day on which the last US combat troops departed South Vietnam in 1973; the day in 1886 on which Dr John Pemberton brewed the first ever batch of Coca-Cola in his Atlanta back-yard; and the day, in 1981, that thousands of people ran, limped and sweated their way through the inaugural London Marathon. All notable occurrences, justly recorded and remembered. But for those of us defending NHS Trusts against clinical negligence actions, the date will be remembered for another reason: as the date the Government announcing the death knell for ‘no-win, no-fee’ CFAs which have been such a blight on the litigation landscape for the last decade or so.   

If you wish to discuss any of the items raised in this section please contact Claire Bentley.

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Disclaimer

This update is intended to give general information about legal topics and is not intended to apply to specific circumstances. Its contents should not, therefore, be regarded as constituting legal advice and should not be relied on as such. In relation to any particular problem that you may have you are advised to seek specific legal advice.

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