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Health and Social Care Update - September 2011

08/09/11

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   Inquests
  Children   Mental Health
  Commissioning   Obesity
  Data/ Information Law   Primary Care
  Employment/HR   Prison Health
  Finance   Regulation
  Governance   General
  Health and Safety  

 

Care

Publications/Guidance
Environments for care at the end of life: The King's Fund's Enhancing the Healing Environment Programme 2008-2010. The King’s Fund’s Enhancing the Healing Environment (EHE) programme encourages and enables nurse-led teams to work in partnership with patients to improve the environment in which to deliver care. It has published a report that describes projects in 19 NHS trusts and one HM prison that took part in schemes to improve the environment of care at the end of life. It describes the broader EHE programme, which has been supported by the DH in a series of publications entitled 'Improving the patient experience', and goes on to present case studies of the sites that took part in the programme.

Routes to success: achieving quality environments for care at end of life. This guide identifies a number of key environmental principles to help improve privacy and dignity for patients and relatives.

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

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Children

Publications/Guidance
Safe and sustainable: Review of children's congenital heart services in England - Health Impact Assessment interim report. The Safe and Sustainable Review was instigated in response to concerns among clinicians, professional organisations and parents regarding the future resilience of the existing 11 surgical centres which currently provide paediatric cardiac surgery and whether some of these centres are performing a sufficient number of complex procedures to maintain and develop specialist skills. The Review proposed reducing the number of centres providing children’s heart surgery from 11 to either six or seven, and a formal public consultation was launched on 1 March 2011. In October 2010 the NHS Specialised Commissioning Team commissioned Mott MacDonald to carry out a Health Impact Assessment (HIA) of the reconfiguration options for children’s heart surgery, to consider the positive and negative impacts that each proposed option could have. This interim report states that concentrating surgical expertise in fewer sites and bringing non-surgical care closer to home will benefit patients. The findings of the HIA will be used, along with other evidence, to help inform the final decision about the future configuration by the Joint Committee of PCTs, the decision-making body for the Review.

Services for the identification and treatment of hazardous drinking, harmful drinking and alcohol dependence in children, young people and adults. This guide for commissioners provides support for the local implementation of NICE guidance through commissioning and is a resource to help commissioners, clinicians and managers to commission evidence based and quality services across England. It also aims to support joint commissioning and partnership working between NHS and partner organisations.

Think child, think parent, think family: interim evaluation report. This report by the Social Care Institute for Excellence evaluates the first year of implementation and aims to capture learning about how to implement the 'Think child, think parent, think family' guide and evaluate early indications of the impact of implementing the guidance in a local area. The guidance was developed to help services improve their response to parents with mental health problems and their families.

The Family Courts: Media access & reporting. This report looks at the thorny issue of reporting cases and considers the tension between concerns about "secret justice" on the one hand and the expectation of privacy and confidentiality for the family on the other hand. 

Consultations
Consultation on new child protection guidance. The General Medical Council is consulting on new draft guidance Protecting children and young people: the responsibilities of all doctors. The consultation runs from Monday 27 June 2011 to Friday 14 October 2011.

News
Government prioritises children’s oral health in new dental contract trials. Announces that 68 dental practices will trial new changes to the current dental contract, looking at ways of increasing patient access and promoting preventative dental treatments like fluoride varnish, which helps to prevent tooth decay in children.

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

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Commissioning

Publications/Guidance
NHS Commissioning Board’s People Transition Policy. This policy sets out the policies and processes that will guide the first round of appointments to the NHS Commissioning Board (NHSCB). Described as essential reading for those who think their future may be with the NHSCB, the PTP covers key information about the appointment process as well as terms and conditions. This page also inks to Q&As on the policy, and a letter from Sir David Nicholson.

Agreements between Specialised Services commissioning groups and providers. letter from Bob Ricketts, DH Director of Provider Policy, to PCT Chief Executives and Chief Executives of providers of commissioned Specialised Services on the move from separate and disparate contracting arrangements for specialised clinical services commissioning to separate SCG commissioned services contracts which will run along side the original joint PCT/SCG contracts.

NHS premises assurance model - guidance for the NHS. The Universal NHS Premises Assurance Model (PAM) gives guidance to NHS Providers on the quality, safety and also increasing efficiency and effectiveness of NHS premises. The Model can also be used by commissioners for inclusion within their Commissioning contracts at a local level and as a means for ensuring that healthcare services are being delivered from appropriate physical environments.
See also David Flory's letter to NHS Chief executives on the publication of the PAM.

NHS Cervical Screening Programme: Implementing HPV triage for women with mild or borderline cervical screening test results and HPV test of cure - Advice to the NHS. Improving Outcomes: A Strategy for Cancer said that the Government will roll out Human Papilloma Virus (HPV) testing across England as triage for women with mild or borderline cervical screening test results and as a test of cure for treated women. The Operating Framework for the NHS in England 2011-12 states that commissioners should work with their local services and NHS Cancer Screening Programmes to implement HPV testing as triage for women with mild or borderline results, leading to a more patient centred service and major cost savings. This document aims to give practical, evidence based advice on implementing HPV triage and test of cure across the NHS Cervical Screening Programme. It is suggested that SHAs work in close collaboration with their PCTs, primary care services, pathology services and screening services to develop plans to deliver HPV triage and test of cure.

Diagnostic tool for emerging clinical commissioning groups. The NHS has developed a new developmental, self-assessment tool to enable emerging clinical commissioning groups to understand and reflect upon their values, culture, behaviours and wider organisational health.

Child weight management programme and training providers framework. This framework includes nine pre-qualified training provider organisations. It has been developed to support local commissioning of weight management services for children and young people. The providers all offer training in the delivery of specific approaches to weight management in at risk, overweight and obese children and young people. The documents that follow provide further information on how to use the framework, information on each of the providers, details of how PCTs and partner organisations can ‘call off’ services from these providers and a set of template documents to support commissioners. The framework was developed in 2008 under the previous Government and so the framework documentation refers to the previous Government’s strategy Healthy Weight, Healthy Lives. Although this strategy is no longer current, the framework itself is still valid and available for use until April 2012.

Home oxygen services. This letter from Professor Sue Hill, the Chief Scientific Officer, provides an update on the re-procurement of Home Oxygen Services (HOS) in England, particularly the separately-commissioned Assessment and Review services and future arrangements for the commissioning of the overall HOS contracts.

Department of Health response to the legal opinion published by 38 Degrees on the application of procurement and competition law. In July 2011 the lobbying group 38 Degrees engaged Harrison Grant solicitors and barristers Stephen Cragg and Rebecca Haynes to give their legal opinions on two aspects of the Health and Social Care Bill: the removal of the Secretary of State for Health’s Duty to Provide or secure provision of NHS services, and the impact of competition and procurement law on the NHS.
This paper sets out the DH's response to the second Opinion. The DH does not agree with all the conclusions reached within the legal analysis. In particular:

  about the future capacity and capability of commissioners to comply with procurement law and the steps being taken to address this;
  the conclusions drawn from the BetterCare case about the likely applicability of domestic and European competition to NHS commissioners;
  the allegations that the Bill would lead to a system geared heavily in favour of private companies; and, would do nothing to prevent so-called 'cherry picking'; and
  the ability of the provision in the Bill to, for example, preclude 'cherry-picking'.


The DH has also published its response to the first Opinion on the Duty to Provide. The DH does not agree with some important aspects of the legal analysis on the effect of the provisions of the Bill, nor 38 Degrees' description of what the advice means. In particular:

  the Secretary of State's accountability for the NHS and his powers in relation to the NHS are not reduced as extensively as suggested - the Government is not "washing its hands" of the NHS;
  the duty on the Secretary of State in relation to the promotion of autonomy ("the hands off clause") does not restrict the Secretary of State as severely as the analysis suggests;
  the DH does not agree that the Bill would mean there would be fragmentation, an increase in the "postcode lottery" and no national Health Service. The Bill confers various duties and powers on the Secretary of State, the Board and clinical commissioning which will ensure a national Health Service.

Commissioning London’s HIV services. This report prepared by Civitas focuses on the commissioning of HIV services in London, documenting the findings of semi-structured interviews conducted with key stakeholders in late 2010. It found a fairly broad consensus on how the commissioning of HIV services should be organised in London; and on the future model of HIV care.

Guidance for commissioning integrated urgent and emergency care: a whole system approach. This guidance prepared by the Royal College of General Practitioners aims to provide clear, practical advice and information for commissioners of urgent and emergency care services, to help them take a strategic approach, which is patient-centred and focused on improving clinical outcomes.

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

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Data/Information Law

Publications/Guidance
How health care organisations are using data on patients' race and ethnicity to improve quality of care. This study of eight hospitals, health plans, and community health centers looks at data on patients’ race and ethnicity as part of efforts to address health care disparities. It found that the organisations vary in their approaches to defining and measuring disparities and in their ability to design effective disparity-reduction programs. The authors conclude that a lack of common standards governing the collection, analysis, and use of racial and ethnic data may hamper the ability of health care organisations nationally to design programs that effectively address inequities in patient care.

Consent and confidentiality in clinical genetic practice: guidance on genetic testing and sharing genetic information. This report aims to guide healthcare professionals through the legislation that applies to the use of genetic data and samples. Included in the guidance are worked examples, based on real cases illustrating how complex situations can be dealt with in practice. A key focus of the report is to illustrate how the family can be important in what otherwise might seem to be individual decisions. 

Cases

Consultations
Liberating the NHS: An information revolution - Summary of responses to the consultation. This is the summary of responses to the consultation on transforming the way patient information is collected, analysed and used by the NHS and adult social care services.

Fundamental review of data returns: A consultation on the recommendations of the review. This consultation seeks views on proposals to implement the recommendations set out in the 'Equity and Excellence: Liberating the NHS' review. It aims to reduce red tape by cutting unnecessary data collections across the NHS.

If you wish to discuss any of the items raised in this section please contact James Cassidy

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Employment/HR

Publications/Guidance
NHS staff Management and health service quality. Presents findings from a research project into the experience of NHS staff at work. It suggests recommendations to improve staff management in order to raise care standards.

Advice for line managers on supporting employees with long-term medical conditions. This guide provides advice to employers and line managers on supporting employees coping with a chronic health condition in the workplace. There is also a similar fact sheet for employees.

Health visitor implementation plan - summary. On 8 February 2011 the DH published the Health Visitor Implementation Plan 2011-15 - A call to Action that provides the detail to support the Government's commitment to recruit an extra 4,200 health visitors by 2015. The plan sets out the vision of the new health visiting service, the call to action for the stakeholders involved, the pathway to 2015 and information about the work programmes that will support the implementation. NHS Employers has now produced an at-a-glance summary of the Health Visitor Implementation Plan which details the purpose, vision, roles, timelines, programmes of work and accountability throughout implementation.

NHS Pension Scheme - Commons Library Standard Note. This note looks at recent reviews of the NHS pension scheme.

NHS equal pay toolkit. The toolkit is designed to support employers by providing key information by pay bands which allows organisations to analyse their workforces in a number of different ways.

NHS national graduate management training scheme: payback - return on investment for the NHS graduate scheme. This report finds that the NHS graduate management training scheme generates savings per trainee in the tens of thousands of pounds, and retains more trainees than other private and public sector schemes. The first section of the report uses electronic staff records to produce accurate data on the retention and progression of trainees within the NHS. The second section looks at return on investment of trainees whilst on the scheme. It includes a number of case studies showing how trainee projects are designed to support the quality, innovation, productivity and prevention (QIPP) agenda.

Shape of the medical workforce: informing medical training numbers. The report makes recommendations to inform the future recruitment to medical training over the medium term. It is supported by medical specialty recommendations, presented as 57 combined fact and summary sheets containing more detailed analyses for each specialty. An explanation for all the recommendations can be found in each specialty summary sheet, which builds on the evidence presented in each fact sheet

Cases
Lim v Royal Wolverhampton Hospitals NHS Trust [2011] EWHC 2178 (QB) (QBD). L, consultant anaesthetist employed by the defendant NHS Trust, applied to the court for an injunction to restrain the Trust from holding a capability hearing unless and until an assessment panel of the National Clinical Assessment Service had determined that his professional performance was so fundamentally flawed that no educational and/or organisational action plan had a realistic prospect of success. He also sought to restrain the Trust from proceeding to hear and determine allegations of misconduct which were alleged to have taken place more than four years previously. L contended that a capability panel hearing without first referring the matter to NCAS would breach a new national policy, Maintaining High Professional Standards in the Modern NHS (MHPS) through a local policy in documents HR27 and HR28, which had contractual effect.
The court held that the Trust's policy HR27, which was consistent with MHPS Pt IV, was clear: the Trust could not proceed to a capability hearing about L before it had referred the matter to NCAS for assessment and the NCAS assessment panel had advised that no action plan had a realistic chance of success. Accordingly the Trust would be in breach of contract if it were to proceed to a capability hearing of L's case before an NCAS assessment panel had advised in terms set out in HR27. 

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

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Finance

Publications/Guidance
NHS financial year 2010/11 - A summary of auditors' work. Provides a view of the overall financial performance of the NHS in 2010/11. The report summarises the audit of the 2010/11 accounts for SHAs, NHS trusts and PCTs, and looks at auditors' conclusion on the value for money arrangements in place in each organisation. It also reviews the progress made by PCTs and NHS trusts in delivering their cost improvement programmes. For 2010/11 the auditors focused their review on whether the organisation has proper arrangements in place for securing financial resilience and for challenging how it secures economy, efficiency and effectiveness.

A simple guide to Payment by Results. Provides an introduction for newcomers to PbR. This version is an update to the guide published September 2010; and reflects changes to PbR arrangements in 2011-12. The annexes include a brief overview of the structure and funding of the NHS in England.

Cost of service inquiry for dispensing practices. In February 2010, the DH commissioned PwC to undertake a study to ascertain both the income derived from, and the costs incurred by, a dispensing GP practice in providing dispensing (pharmaceutical) services in England, and thus to arrive at an estimate of the overall profit for such services. The final report (dated September 2010) resulting from this work has now been published.

The NHS Bursary Scheme twelfth edition. This edition outlines the support arrangements for the academic years starting on or after 1 September 2011 and before 1 September 2012.

Warning signs for organisations in transition. This briefing prepared by Healthcare Financial Management Association contains a checklist of ‘red-light’ issues that audit committees need to be on the lookout for during transition.

Legislation
Statement of Financial Entitlements (Amendment No.2) Directions 2011. Make a small number of minor changes to Annex D (Quality and Outcomes Framework) of the Statement of Financial Entitlements as published in the Statement of Financial Entitlements (Amendment) Directions 2011 which were effective from 1 April 2011.

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

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Governance

Publications/Guidance
Community services governance indicators: Monitor's requirements for 2011/12. This document summarises Monitor’s requirements for community services governance indicators for 2011/12. It contains a detailed summary of the consultation responses, including the individual comments received and Monitor’s response to each point.

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

Hospital emergency response checklist. This tool prepared by WHO comprises current hospital-based emergency management principles and best practices and integrates priority action required for rapid, effective response to a critical event based on an all-hazards approach. The principles and recommendations included in this tool may be used by hospitals at any level of emergency preparedness.

Health and Safety Executive: Getting to grips with hoisting people. This publication explains the problems associated with hoisting people and sets out guidance to deal with them. It covers fixed, mobile and overhead hoists. The advice is intended for health and social care providers or other organisations who move and handle people and will help them to comply with their legal duties. 

News
Common clinical language for NHS will help improve patient care and safety. Announces that the Information Standards Board for Health and Social Care has approved the use of SNOMED Clinical Terms as a fundamental standard. It has notified all NHS organisations, independent providers and information system suppliers of the need to use SNOMED CT when providing care. SNOMED CT is a comprehensive, multilingual clinical healthcare terminology that is already widely used in the UK for the exchange of clinical information, including the Choose and Book service for hospital appointments and for patients’ Summary Care Records. It is managed and maintained internationally by the International Health Terminology Standards Development Organisation.

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Inquests

Publications/Guidance
Improving the process of death certification. This letter from Professor John Newton to Directors of Public Health provides an update on the national reforms to death certification under the Health and Social Care Bill. The Bill includes an important amendment to the Coroners and Justice Act 2009 transferring responsibility for the appointment of medical examiners and related activities from PCTs to local authorities.
The DH has also published guidance Death certification reforms: New duty on local authorities that provides an overview of the death certification reforms and an update on work to prepare for implementation of these reforms from April 2013.  

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

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Mental Health

Publications/Guidance
The University of Manchester School of Medicine has published the National Confidential Inquiry into suicide and homicide by people with mental illness.

Think child, think parent, think family: interim evaluation report. This report by the Social Care Institute for Excellence evaluates the first year of implementation and aims to capture learning about how to implement the 'Think child, think parent, think family' guide and evaluate early indications of the impact of implementing the guidance in a local area. The guidance was developed to help services improve their response to parents with mental health problems and their families.

Making shared decision-making a reality: No decision about me, without me. This report from the King's Fund is concerned with shared decision-making in the context of the decisions made between individual patients and individual clinicians. It outlines the importance of communication skills and sets out how clinicians might approach consultations to arrive at shared decisions. It also suggests that tools that help patients to make decisions are just as important as guidelines for clinicians.

The Family Courts: Media access & reporting. This report looks at the thorny issue of reporting cases and considers the tension between concerns about "secret justice" on the one hand and the expectation of privacy and confidentiality for the family on the other hand.
Older people in care homes: sex, sexuality and intimate relationships. The Royal College of Nursing has published new guidance to help nursing staff work effectively with issues of sexuality, intimate relationships and sex, particularly for older people living in care homes.

Personal health budgets: the views of service users and carers. This report by the NHS Confederation Mental Health Network examines the views of mental health service users and carers. It outlines the frustration that people feel with the level of involvement that mental health services currently offer, but shows that their opinions of personal health budgets are mixed. There is scepticism over how this national policy can effectively change the current culture of provision on the ground. With the evaluation of personal health budgets due to be published in October 2012, the report gives recommendations for how Government and local NHS organisations should proceed.

Procedure for the transfer from custody of children and young people under the Mental Health Act 1983 in England. Outlines the procedure for transferring any child or young person who is: detained in custody in pursuance of any sentence or order for detention; or remanded in custody or who is otherwise detained in custody, to and from hospital under the Mental Health Act 1983. The protocol sets out mandatory requirements for establishments regarding the identification and transfer of children and young people, and explains the procedures to be followed by the other agencies involved in the process. Note that the protocol does not apply for those young people remanded to local authority accommodation under s.23 of the Children and Young Persons Act 1969.

Community mental health services survey 2011. CQC has published the results of its survey which looked at the experiences of people receiving community mental health services. This briefing note highlights the key findings. For the full results, see the CQC website.

Call for evidence: Not for profit delivery of deputyship services. The Office of the Public Guardian is asking care charities and other not-for-profit organisations for their views on whether they could provide ‘deputies’ to protect the interests of people who lack mental capacity through illness or after an accident. Deputies are appointed by the Court of Protection when there is either a dispute over who should look after their affairs, or they simply have no one else to turn to. Almost all deputies are currently lawyers, although the work is not always of a legal nature. Responses must be submitted by 27 October 2011.

Alzheimer's in the news. This report by NHS Choices looks back over coverage of Alzheimer’s disease in the mainstream media in the past four years at some of the more important stories, including those that were wide of the mark. The report also identifies key themes and common problems in the news and aims to help readers judge future reports for themselves. Finally, it asks leading experts what research and experimental treatments they predict will be making headlines in the months and years to come.

Cases
Re PH; PH v A Local Authority (2011) EWHC 1704 (Fam). The Court considered whether a man suffering from Huntingdon's Disease had the capacity to make decisions about his residence, care and treatment. The Court made the following declarations:
i) PH lacked capacity in relation to the question on whether or not he should be accommodated for the purposes of being given care and treatment; and
ii) PH lacked capacity to make a decision as to his residence and care.

WCC v GS [2011] EWHC 2244 (COP). The Court of Protection found that an 83 year old woman with dementia lacked capacity to conduct litigation, to make decisions in respect of her care requirements, to decide where she wanted to live and to decide issues relating to contact with her family. In order to determine her best interests the court considered s.4 MCA 2005, the Code of Practice and relevant best interests cases. The court also set out the types of conditions that need to be borne in mind when considering contact conditions.

CX v A Local Authority [2011] EWHC 1918 (Admin) (Admin Ct). See also Local Government Lawyer report. CX applied for a writ of habeas corpus ad subjiciendum arising from his detention as a patient in a mental hospital. CX had been detained under s.3 of the Mental Health Act 1983 on the application of an approved mental health professional (AMHP), employed by the local authority. CX contended that his detention was unlawful because the AMHP had failed to consult properly with CX's nearest relative, his mother, and also because his mother only withdrew her objection to the application for his detention because she was misled as to her statutory rights. The court held, granting a writ of habeas corpus, that the consultation with CX's mother was not sufficiently informed to satisfy the requirement of the Act that the nearest relative be consulted before the section 3 application was made. Also, the mother's withdrawal of consent was initiated by incorrect and misleading advice that she could only maintain her objection in the face of a displacement application if she was legally represented in the court proceedings which would follow.

Manchester City Council v G and E (by his litigation friend the Official Solicitor) [2011] EWCA Civ 939 (CA). The Court of Appeal has upheld the Court of Protection's decision to depart from the general rule regarding costs of proceedings and to order that a local authority pay the costs of Deprivation of Liberty proceedings. The court had been entitled to find that the local authority's conduct in removing E unlawfully and its late concession of unlawfulness amounted to misconduct so that a departure from the general rule in Rule 157 of the Court of Protection Rules was appropriate.

Consultations
Response to consultation on proposed changes to the Mental Health Act 1983 and its associated secondary legislation. In September 2009 the DH consulted on proposals for temporary changes to the 1983 Act which could be introduced, if necessary, in the event of an influenza pandemic which had a severe impact on health and social care services. In the light of the consultation comments, the Department concluded that all of the proposed temporary amendments to the 1983 Act should be included in the package of contingency measures. It has also included some further amendments to s.5 of the 1983 Act in response to consultation comments. The full finalised list of potential temporary changes which would require legislative change can be found at Annex C of this Response.

Consultation on allocation options for distribution of additional funding to local authorities for: Local HealthWatch, NHS Complaints Advocacy, PCT Deprivation of Liberty Safeguards. Seeks views on options for allocate funding for four duties which will pass under the Health and Social Care Bill from the NHS and DH to local authorities for Local HealthWatch, NHS Complaints Advocacy and PCT DOLS. The consultation sets out two options for the distribution of funding, proportionate either to the size of the working age population or to the need for state-supported social care. Under both methods a further adjustment is proposed to fund the minimum spend for smaller local authorities, such as the Isles of Scilly and Rutland, by taking some money off larger areas. The consultation closes on 24 October 2011.

News
National search for new ideas to improve the lives of people with dementia. The Design Council and the DH have launched a national challenge that will fund teams to develop new design-led ideas for products and services that make lives simpler, better and more enjoyable for those with dementia and their carers. Living Well with Dementia will offer five teams a share of £360,000 alongside professional support to develop working prototypes and business models over the next five months. The challenge aims to recruit teams with a variety of expertise, including designers, social entrepreneurs, businesses, service providers, support groups or individuals who may already have good ideas. Further details can be found on the Design Council website.

The Low Incomes Tax Reform Group has responded to the HMRC consultation "Incapacitated person - a modern definition". They believe that specific provision in tax law may not in fact be needed at all, given the general laws of incapacity and representation already in place.

The Human Rights in Healthcare website has been launched as part of the Human Rights in Healthcare programme. The aim of the website is to promote a human rights based approach in health and social care and be a web resource where people interested in, and preferably passionate about, a human rights based approach to healthcare can share experience, learn and make links on line.

CQC announces new Acting Together programme to involve people who use services in its work. The CQC has announced a new partnership scheme, Acting Together, that enables CQC to call on people who use services to advise on and contribute to its work. Acting Together includes involving people as Experts by Experience on inspections of health and social care services and in visits to monitor the use of the Mental Health Act. The first three partners for the scheme are Age UK, Challenging Behaviour Foundation and Choice Support. Choice Support is leading a consortium of smaller and user-led organisations that includes Voiceability, Living Options Devon, Advocacy Alliance Bedford, Skills for People, Advocacy Experience, Inclusion North, and Hersov Associates. Agreements are being finalised with other user-led organisations to work with the CQC and further announcements will be made later in the summer.

From 1 September 2011 amendments to s.2 of the Corporate Manslaughter and Corporate Homicide Act 2007 will come into force, extending prosecution for corporate homicide to cover all deaths in police custody suites, prison cells, mental health detention facilities, young offenders institutions, immigration suites and Ministry of Defence institutions.

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
Child weight management programme and training providers framework. This framework includes nine pre-qualified training provider organisations. It has been developed to support local commissioning of weight management services for children and young people. The providers all offer training in the delivery of specific approaches to weight management in at risk, overweight and obese children and young people. The documents that follow provide further information on how to use the framework, information on each of the providers, details of how PCTs and partner organisations can ‘call off’ services from these providers and a set of template documents to support commissioners. The framework was developed in 2008 under the previous Government and so the framework documentation refers to the previous Government’s strategy Healthy Weight, Healthy Lives. Although this strategy is no longer current, the framework itself is still valid and available for use until April 2012.

A rapid review of the National Child Measurement Programme. In Spring 2011, the Thomas Coram Research Unit were commissioned by the DH to undertake an independent review of the NCMP. TCRU were asked to take stock of the progress and challenges in the delivery of NCMP by drawing on existing research and evidence, and by engaging directly with local practitioners involved in the delivery of the NCMP. This report provides a summary of the approach and findings from the review.

If you would like more information about this section please contact Julie Chappell. 

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Primary Care

Publications/Guidance
PCT estate: future ownership and management of estate in the ownership of Primary Care Trusts in England. Sets out the arrangements for the future of the PCT-owned estate and its transfer to new owners on the abolition of PCTs in April 2013 under the Health and Social Care Bill. This document updates and supersedes the FAQs relating to the future ownership and management of PCT-owned estate by aspirant Community Foundation Trusts (CFTs), published on 16 February 2011.

Shared operating model for PCT Clusters. This publication supports the development of PCT Clusters to help ensure they deliver their twin objectives of overseeing and accounting for delivery during transition and supporting the development of the new system. The document sets out the need for moving towards a more consistent way of operating in some areas during the transition and preparation for the establishment of the NHS Commissioning Board. Structured around six key business areas, it also sets out where there are processes or functions that all PCT Clusters will need to perform and where it is important that there is consistency between them.

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
Re:Actions: A third review of healthcare in the community for young people who offend. This report by the Care Quality Commission and Her Majesty’s Inspectorate of Probation looks at how Youth Offending Teams (YOTs) help provide health services to the children and young people they work with. It found that access to and management of health services for this group have improved since the last review in 2009. The review assessed whether young people had their physical, emotional and mental health needs assessed on contact with YOTs, as well as their need for alcohol and substance misuse support programmes. It also looked at how YOTs work with health partners and how well children and young people’s health needs are provided for as they move in and out of the criminal justice system.

News
From 1 September 2011 amendments to s.2 of the Corporate Manslaughter and Corporate Homicide Act 2007 will come into force, extending prosecution for corporate homicide to cover all deaths in police custody suites, prison cells, mental health detention facilities, young offenders institutions, immigration suites and Ministry of Defence institutions.

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

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Regulation

Publications/Guidance
Educating health visitors for a transformed service. This document provides guidance for education commissioners, higher education institutions and lecturers on ensuring that health visitors have appropriate theory knowledge and skills to deliver the new service vision. This guidance provides a framework of topics which will support future practitioners to fulfil the needs of the service and does not affect the absolute requirements of the regulatory body.

News
CQC announces new Acting Together programme to involve people who use services in its work. The CQC has announced a new partnership scheme, Acting Together, that enables CQC to call on people who use services to advise on and contribute to its work. Acting Together includes involving people as Experts by Experience on inspections of health and social care services and in visits to monitor the use of the Mental Health Act. The first three partners for the scheme are Age UK, Challenging Behaviour Foundation and Choice Support. Choice Support is leading a consortium of smaller and user-led organisations that includes Voiceability, Living Options Devon, Advocacy Alliance Bedford, Skills for People, Advocacy Experience, Inclusion North, and Hersov Associates. Agreements are being finalised with other user-led organisations to work with the CQC and further announcements will be made later in the summer. 

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

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General

Publications/Guidance
Choice of NHS funded hospital services in England. This Working Paper from the Cooperation & Competition Panel examines which factors matter to patients and their GPs when they choose a hospital for treatment. The analysis shows how the incentives created by choice and competition will play out.

Improving the process of death certification. This letter from Professor John Newton to Directors of Public Health provides an update on the national reforms to death certification under the Health and Social Care Bill. The Bill includes an important amendment to the Coroners and Justice Act 2009 transferring responsibility for the appointment of medical examiners and related activities from PCTs to local authorities.
The DH has also published guidance Death certification reforms: New duty on local authorities that provides an overview of the death certification reforms and an update on work to prepare for implementation of these reforms from April 2013.

A summary of the health harms of drugs. This guide for drug and treatment professionals provides up-to-date scientific evidence on the health harms arising from licit and illicit substance misuse. It outlines acute chronic problems associated with each substance.

No vaccine, no cure: HIV and AIDS in the United Kingdom. This report claims that the current priority given to preventing HIV and AIDS in the UK is inadequate and a new priority must be given to prevention policies if the epidemic is to be stemmed. It says that the numbers accessing care have trebled since 2000 and that HIV and AIDS remains one of the most serious public health issues confronting the Government at the start of the 21st century. 

Provisional Accident & Emergency Quality Indicators for England. Experimental statistics by provider for April 2011. In April 2011 a new set of clinical quality indicators was introduced to replace the previous four hour waiting time standard, and measure the quality of care delivered in A&E departments in England. This is the first publication of data on the Accident and Emergency clinical quality indicators, drawn from A&E data within provisional Hospital Episode Statistics. The data relate to A&E attendances in April 2011 and draw on just under 1.4m detailed records of attendances at major A&E departments, single speciality A&E departments (e.g. dental A&Es), minor injury units and walk-in centres in England. This report sets out data coverage, data quality and performance information for 5 A&E indicators: Left department before being seen for treatment rate; Re-attendance rate; Time to initial assessment; Time to treatment; and Total time in A&E.

Risk stratification and next steps with DH risk prediction tools – Patients at risk of re-hospitalisation and the Combined Predictive Model. Letter from Stephen Johnson, Deputy Director Head of Long Term Conditions on use of a risk prediction approach in order to identify those people who are the most regular users of hospital services and therefore at risk of re-admission. There are a wide range of risk stratification models in use across the NHS.

Rolling out the NHS 111 service. Following the launch of the first pilots of the NHS 111 service, NHS Deputy Chief Executive David Flory and National Director for Improvement and Efficiency Jim Easton have written to SHAs to request confirmation of plans for full roll-out of the NHS 111 service in each region by April 2013. SHA chief executives should discuss with commissioners the options for rolling out NHS 111 in their area, and respond to the letter by 23 September 2011 with firm plans.

Older people in care homes: sex, sexuality and intimate relationships. The Royal College of Nursing has published new guidance to help nursing staff work effectively with issues of sexuality, intimate relationships and sex, particularly for older people living in care homes.

PFI approvals and Deeds of Safeguards. DH guidance on the use of Deeds of Safeguard as a means of enabling trusts to secure funding from PFI-lenders and investors for the largest PFI-scheme proposals.

Human rights: practical guidance. This new Equality and Human Rights Commission online resource aims to help public sector bodies and organisations carrying out public functions and advocacy. It focuses on nine public sectors areas: adult social care; children's services; health; housing; education services; local government; criminal justice, courts and prisons; policing; and immigration and asylum. It draws together learning materials about the human rights obligations of the public sector and how to successfully implement these. The materials include tried and tested examples of how to consider human rights in public service delivery as well as case studies, informal guidance, inspection standards and impact assessments.

Making shared decision-making a reality: No decision about me, without me. This report from the King's Fund is concerned with shared decision-making in the context of the decisions made between individual patients and individual clinicians. It outlines the importance of communication skills and sets out how clinicians might approach consultations to arrive at shared decisions. It also suggests that tools that help patients to make decisions are just as important as guidelines for clinicians.

Health and Social Care Bill 2011. This briefing outlines four areas which the RCN believe must be addressed: bureaucracy and red tape; cuts to patient care and nurses’ jobs; waste in the NHS; and private income and bonuses.

Health and Social Care Bill: third reading and report stage briefing. This briefing summarises the Royal College of Surgeons views on the amended Health and Social Care Bill ahead of its third reading and report stages in the House of Commons. It supports the aims of the reforms to modernise the healthcare system by cutting bureaucracy and giving patients and their clinicians the right to decide the best treatment on an individual basis.

Consultations
Consolidation and review of the Misuse of Drugs Regulations 2001. This Home Office consultation seeks comments on proposals to consolidate and review specific provisions under the Misuse of Drugs Regulations 2001 and on the accompanying impact assessment.

Healthy lives, healthy people: Consultation responses. Summary of responses to the December 2010 consultations:
  Healthy lives, healthy people: our strategy for public health in England;
  Healthy lives, healthy people: consultation on the funding and commissioning routes for public health;
  Healthy lives, healthy people: transparency in outcomes - proposals for a public health outcomes framework; and
  Review of public health professional regulation.

News
Innovative care could help over 15 million people with long-term conditions. The Health Secretary Andrew Lansley has spoken about how new approaches to emergency callouts and sharing information can help people with long-term conditions manage their condition better and save unnecessary hospital visits.

Licences to drive up organ donation. Announces that from 1 August 2011, people will have to answer questions about organ donation before they can complete their driving licence application through the DVLA website. It is hoped that the change will double the percentage of people choosing to join the organ donation register when applying for a driving licence.

Implementing radiographer reporting. NHS Employers are encouraged to get involved in implementing radiographer reporting to realise benefits for patients. Following the 2010 Spending Review, the DH announced they would be encouraging training of radiographers to report on straightforward x-rays, freeing time for consultant radiologists to assess more complicated images. This suggestion by the public through the spending challenge process could lead to an estimated saving of £7.9m per year. According to the Society and College of Radiographers, currently 6% of the their profession undertake reporting. Employers should take this opportunity to work alongside the radiology and radiography professions to look at ways in which radiographer reporting can be implemented for the benefit of the patient and the organisation.

The Human Rights in Healthcare website has been launched as part of the Human Rights in Healthcare programme. The aim of the website is to promote a human rights based approach in health and social care and be a web resource where people interested in, and preferably passionate about, a human rights based approach to healthcare can share experience, learn and make links on line.

Record £800 million for groundbreaking research to benefit patients. Announces funding for "early stage" health research which will fund advances in diagnosis, prevention and treatment, benefiting patients with diseases such as cancer, diabetes and heart disease. The 31 awards include funding for four new Biomedical Research Units which specialise in dementia research.

An app a day - Andrew Lansley launches a call for ideas for new health apps and maps. The Health Secretary has launched a call for new ideas for health apps that would help patients make informed decisions about their care. Everyone, including patients, doctors, nurses and other health professionals and app developers, is invited to submit new ideas of health apps and online maps they think would be useful.

Bevan Brittan Training
Joint Risk Management Seminar. Tuesday 20 September 2011.  Esther Kaikai from the NHSLA and Joanna Lloyd from Bevan Brittan LLP will provide an update on the NHSLA's Risk Management Initiative and consider patient safety issues.  There will be a case study session.

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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