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Health and Social Care Update - December 2011

06/12/11

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   Healthcare Associated Infection
  Children   Health and Safety
  Clinical Management   Information Law
  Commissioning   Inquests
  Complaints   Mental Health
  Employment/HR   Primary Care
  Finance   Prison Health
  Foundation Trusts   Regulation
  Governance   General

 

Care

Publications/Guidance
Close to home: An inquiry into older people and human rights in home care. The Equality & Human Rights Commission's inquiry has found that although many older people receive care at home which respects and enhances their human rights, this is by no means a universal experience. The inquiry uncovered areas of real concern in the treatment of some older people and significant shortcomings in the way that care is commissioned by local authorities. The report says that hundreds of thousands of older people lack protection under the Human Rights Act and it calls for this legal loophole to be closed. It questions commissioning practices that focus on a rigid list of tasks, rather than what older people actually want, and that give more weight to cost than to an acceptable quality of care. It found that very few local authority contracts for home care specify that the provider must comply with the Human Rights Act, which undermines the quality of care that older people are getting. The evidence given to the inquiry indicated that where human rights are embedded into the way home care is provided, high quality care is delivered without necessarily increasing costs. The Commission's main recommendations fall under three broad categories:
 Proper protection: closing the loophole in the Human Rights Act which would give protection to the growing number of older people receiving home care from private and voluntary sector agencies; 
 Effective monitoring: the Government, CQC and local authorities need to work together better to build human rights into home care and make sure that abuses are detected faster and dealt with more effectively; and
 Clear guidance: clear and robust guidance on human rights is needed for local authorities so they can use the opportunities they have to promote and protect older people's human rights in commissioning; older people also need guidance to help them make choices about care and to explain how their human rights should be protected.

BUPA: Ensuring local authority fee levels reflect the real costs of caring for vulnerable older people. This report shows that care home fees paid by councils have fallen by 3.9% in real terms over the last two years, hitting providers at the same time that care homes have been facing large increases in their main costs. It looks at the level of local authority fee increases needed to reverse this trend, stabilise funding, and ensure that older people get the high quality care they deserve. It estimates that an extra £1.7bn is needed in total over the next three years to fill the funding gap.

Tough inspections to root out poor home care. The Care Quality Commission has announced that it is to carry out a programme of inspections of 250 providers of home care services. The inspections will focus on the respect, care and welfare of people who receive care services in their own homes, as well as the support given to the staff providing the care. They will run alongside the CQC’s planned reviews of home care services, in addition to the 1,000-plus unannounced inspections of adult social care services the CQC carries out every month.

How can the web support carers? This report from the Princess Royal Trust for Carers looks at the way that carers use the internet. It contains a detailed exploration of the advantages and challenges of providing carer support online, as well as the pros and cons for the main types of web services that are currently being offered.

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

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Children

Publications/Guidance
Together for Short Lives. Standards framework for children’s palliative care. This document pulls together all the standards from the four care pathways, as well as the service audit tool for each pathway, into one document.

Mental health service transitions for young people highlights some of the key recommendations for improving transition, as well as the Top 10 principles for practice. These include ensuring young people are fully engaged and understand their mental health problem, treatment and support options, as well as ensuring that young people move to flexible and age appropriate services. 

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

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Clinical Management

Publications/Guidance
Caesarean section NICE has published an update to its existing guidelines on caesarean section. It is hoped that these new recommendations mean more women may avoid unnecessary surgery and that changes in practice will reduce post-operative infections. It also recognises that mental health issues, as well as physical conditions, are possible indications for caesarean section.

The care of women requesting induced abortion: evidence-based clinical guideline number 7. These guidelines are for all healthcare professionals and aim to ensure that all women considering induced abortion have access to a high quality service based on national standards. The recommendations cover commissioning and organising services, possible side effects and complications, pre-abortion management, abortion procedures and follow up care.

Management of blood-exposure in personnel of public and voluntary services. Letter from Professor Matthew Cooke, National Clinical Director for Urgent and Emergency Care, seeks to clarify existing policy on the need for public and voluntary services workers, such as fire and rescue and prison services, who may be exposed to the blood of others in the course of their professional duties, to receive assessment, and treatment from NHS Accident and Emergency departments.  

Guide to using quality improvement tools to drive clinical audits. This guidance aims to help implement improvements to health services through quality improvement tools that can be applied to the clinical audit process.  

Bevan Brittan Updates
Claims case round-up. Nicola Pegg provides our usual round-up of interesting cases, including a look at whether a Claimant can sell a claim to someone else to pursue and more judicial support for standing firm against over-inflated claims.

Is your trust involved in organ transplants? If yes, it will be illegal to be involved in this activity without a licence from 27 August 2012 - Are you prepared?

Litigants in person numbers on the rise. The number of litigants in person is on the rise according to The Personal Support Unit (PSU), a voluntary organisation which provides support to litigants in person.  They have reported that such cases in the Manchester Civil Justice Centre are up by 89% in the four months to 30 September compared with 2010. 

Ten minute teaser - test your knowledge of the early stages of litigation. Julie Charlton sets out a quick brainteaser on various aspects of managing claims, for when you have a spare 10 minutes. 

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Commissioning

Publications/Guidance
Choosing a predictive risk model: a guide for commissioners in England. Predictive risk models are an important part of the strategy for managing patients with chronic illness. They are used to identify patients most at risk of future unplanned hospital admissions, and who may benefit from preventive measures. This guide is intended to help commissioners with selecting predictive risk modelling tools from an open market.

A framework for technology enhanced learning. This framework provides guidance to help commissioners and providers of health and social care deliver high quality, cost effective education, training and continuous development to the workforce for the benefit of patients through the effective use of technology as part of a blended learning process.

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
Government Response to the House of Commons Health Select Committee Sixth Report of Session 2010-11: Complaints and Litigation.

Bevan Brittan Events
Claims and complaints forum. 06 December 2011.

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

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Employment/HR

Publications/Guidance
Public health human resources (HR) concordat. The Public Health HR Concordat provides the principles and standards for managing the HR processes to support the transfer of PCT public health commissioning activity to Local authorities. It sets out the obligations of the NHS and local government employers and trade unions in managing the change.

Medical revalidation: what employers need to know and do. This briefing provides a timeline of activity so far on medical revalidation, a checklist of actions that organisations need to carry out if they are to be ready for the introduction of revalidation ready and a list of the key milestones ahead.

Generating savings by improving health and well-being: experiences in NHS trusts. This briefing features examples of good practice from across the NHS to help inform the planning of strategies to further reduce sickness absence and highlights the opportunities for financial savings that can be made through the introduction and implementation of new policies.

Enhancing employment practice to increase quality and safety. This briefing looks at a number of issues being discussed that have a direct relationship to employment practices and poses some questions for consideration with board colleagues.

Taxpayer funding of trade unions 2011. This report finds that taxpayer funding of trade unions has increased from last year and that the value of direct grants to trade unions is also higher. It includes a breakdown of NHS PCTs and trusts and local councils.

Managing industrial disputes: guidance for employers in the NHS. This guidance aims to help employers in the NHS to manage the legal, practical and operational risks presented by the threat of industrial disputes.

NHS Pension Scheme calculators published. The Department of Health is publishing pension calculators for NHS Pension Scheme members to support their understanding of the proposed changes in pension relating to the Hutton reform.

Bevan Brittan Updates
Change is most certainly afoot in the employment law world. In recent months there have been a notable number of announcements and emphatic speeches from the prime minister and his government regarding changes to employment law.  Sarah Lamont has looked into these in more detail and sets out the various proposals and suggestions. 

Employment news Round Up. Although it may not be Christmas just yet Joanna Smart is generously treating you to a bumper edition of the news round up this month, covering a mixture of legal developments from October and November 2011. 

Just what the doctor ordered? As many of you will be aware there has been a great deal of case law on the issue of holiday entitlement to those on long term sick leave.  It is now clear that those workers on sickness absence continue to accrue their annual leave entitlement during this time and that they can to take annual leave at the same time as being absent due to sickness.  However the area which is less clear cut is whether an employee on sickness absence can claim holiday pay where they have failed to give notice to take the leave to their employer. The latest in the string of sickness cases is Fraser v St George’s NHS Trust which has provided some clarification on this potentially confusing, yet important, issue; Lara Feghali has reviewed the case and sets out the implications for employers below.

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
The financial cost of healthcare fraud: what data from around the world shows. This report investigates the true financial cost of fraud to the NHS. It estimates that the NHS loses £3 billion per year in fraud and in light of financial pressures, minimising fraud has the potential to aid with efficiency savings.

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

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Foundation Trusts

Bevan Brittan Events
Governance for Foundation Trusts 8 December

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
What makes a top hospital? Leadership. This is the third in a series of publications centred around quality in hospital services. This report looks at the features of leadership that are found in top performing acute organisations.

Bevan Brittan Events
Governance for Foundation Trusts. 08 December 2011.

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

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Healthcare Associated Infection

Publications/Guidance
Designs help combat hospital bugs. Four new bedside furniture designs to reduce healthcare acquired infections are available for the NHS to purchase after testing showed positive patient and staff feedback.

Showcase hospitals local technology review reports. This report is part of the Healthcare Associated Infections Technology Innovation Programme. Under the programme, a range of infection-related technologies or products are being evaluated at showcase hospitals to help NHS decision makers and budget holders to target their infection control investments and select effective technologies.

Antimicrobial stewardship: start smart - then focus. The aim of this guidance is to provide an outline of evidence-based antimicrobial stewardship in the secondary healthcare setting. Following this guidance will help organisations to demonstrate compliance with Criterion 9 of The Health and Social Care Act 2008: Code of Practice on the prevention and control of infections and related guidance.

The Healthcare Associated Infections (HCAI) Technology Innovation Programme: Showcase hospitals report no. 8: Otex laundry system. The Otex Laundry System was evaluated at University Hospital Southampton NHS Foundation Trust (formerly Southampton University Hospitals NHS Trust) and this report details the outcomes. The report also includes a template business case for use by any Trust considering using this product. 

Guidelines for the management of norovirus outbreaks in acute and community health and social care settings. This guidance gives recommendations on the management of outbreaks of vomiting and/or diarrhoea in hospitals and community health and social care settings, including nursing and residential homes.

Prevention and control of healthcare-associated infections (HCAIs) quality improvement guide. The guide offers advice on management or organisational actions to prevent and control HCAIs in secondary care settings. It is aimed at board members working in (or with) secondary care. It may also be of use to senior managers, those working elsewhere in the NHS, as well as those working in local authorities and the wider public, private, voluntary and community sectors.  

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Health and Safety

Publications and Guidance
Hospital Guide 2011. Dr Foster, the UK’s leading health information company, has published the 2011 Hospital Guide, the 10th edition of the guide, revealing for the first time levels of medical staffing in hospital at nights and weekends. The Hospital Guide shows that patients are less likely to get treated promptly and more likely to die if they are admitted to hospital at the weekend. The chances of survival are better in hospitals that have more senior doctors on site. But some hospitals with A&E departments have few senior doctors in hospital at weekends or overnight. The guide identifies trusts with low levels of staffing and high mortality.

A process for rapid learning: sharing experience when things go wrong in out-of-hours services - reflections one year on. This paper reviews the collaborative work of ten out-of-hours providers over the past year. It highlights the benefits of rapid learning and some of the key issues around how providers learn and share information within organisations and across the wider out-of-hours system.

Designs help combat hospital bugs. Four new bedside furniture designs to reduce healthcare acquired infections are available for the NSH to purchase after testing showed positive patient and staff feedback.

Sharps safety: RCN guidance to support implementation of the EU Directive 2010/32/EU on the prevention of sharps injuries in the health care sector. This guidance covers the law on sharps injuries, including the European Directive 2010/32/EU and its underlying principles as well as its requirements on health care providers. It includes information on preparing an organisation, introducing risk assessments, selecting and evaluating safety-engineered devices and what employers should be doing to comply with the directive. It also includes a checklist to help safety representatives assess organisational and ward/departmental level compliance with the directive.

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

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Information Law

Bevan Brittan Updates
Data Protection breaches in the headlines again. A report published today has again highlighted the regularity with which the Data Protection Act 1998 ("DPA") is being breached by public sector organisations.  A report by Big Brother Watch details that between 2008 and 2011, 132 local authorities in the UK lost data in over 1000 separate incidents. 

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

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Inquests

News
The post of chief coroner will no longer be abolished.

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

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Mental Health

NEW! Bevan Brittan Mental Health Extranet. Free resource for Bevan Brittan NHS clients. Bevan Brittan has a wealth of mental health knowledge it would like to share with NHS clients. We have therefore developed an online searchable extranet designed to bring various sources of mental health information and guidance into one place.

Bevan Brittan Mental Health Forum
There is also a forum on the extranet for use by members to share knowledge and information. If you would like information about how to access the  Bevan Brittan Mental Health Extranet  please email Claire Bentley by clicking here. Issues currently being discussed are:- 
 Cheshire West and Chester - Deprivation of liberty.  Join the discussion here.
 Deprivation of Liberty Safeguards - Are they adequate? Reference to the Radio 4 programme on 24 November. Join the discussion here.
 Interim Hospital Orders - Timescales. A practical query in relation to detention. Join the discussion here.
 s117 Best Practice Issues. Discussion about how long aftercare continues and what happens when patient moves out of area. Join the discussion here.
 Mental Health Act Scrutiny Committees. Join the discussion here.
 When an urgent DOLs authorisation starts. Join the discussion here.
 Charging Policies. Join the discussion here.
 Appointment/reappointment and review of Hospital Managers. Join the discussion here.
 Meaning of hospital treatment. Join the discussion here. 

Publications/Guidance 
National audit of psychological therapies for anxiety and depression: national report 2011. This report into the care received by patients with anxiety and depression across more than 350 NHS-funded psychological therapy services in England and Wales has revealed good overall standards of care, but substantial variation in quality. The audit collected data from 357 services and over 10,000 people in therapy for anxiety and depression and measured ten standards, including patient satisfaction, effectiveness of therapy, waiting times and number of treatment sessions offered.

Listening to experience. Between Autumn 2010 and Summer 2011, Mind’s independent inquiry heard evidence from 400 service users and professionals in relation to acute mental healthcare in England and Wales and prepared this report.

A report by the Health Service Ombudsman and the Local Government Ombudsman about the care and support provided to a person with Down’s syndrome. This describes how Mr J’s basic human rights were ignored after he was detained unnecessarily in hospital for months and was then moved into inappropriate locked accommodation until his death. See news summary

Government response to a report from the Office of the Children's Commissioner. On 23 June 2011 the Office of the Children’s Commissioner (OCC) published ‘I think I must have been born bad’, a report into the emotional well-being and mental health of children and young people in the youth justice system. The report contained 19 principal recommendations for the Ministry of Justice (including the National Offender Management Service), the Youth Justice Board and the Department of Health.

Safer prescribing in prisons: guidance for clinicians. This guidance looks at a number of clinical areas and highlights issues such as medication misuse by patients and medications being traded between inmates. It has been written to assist clinicians working in prisons but it also has relevance for clinicians working in other secure environments such as forensic physicians and custody nurses; consultant psychiatrists; pain clinic prescribers; hospital prescribers and general practitioners who work with offenders.

With money in mind: the benefits of liaison psychiatry. This briefing outlines the benefits that the Birmingham RAID liaison psychiatry service has brought in terms of cost savings and improved health and well-being for patients. It will be of particular interest to all those who commission and provide acute hospital and mental health services.

Getting personal? Making personal budgets work for people with dementia. This report found that more than three quarters of people with dementia who receive social care support at home are not using direct payments or other personal budgets. It calls for the personal budget system to be adapted to meet the specific needs of people with dementia.

Mental Health Payment by Results Readiness Review. The development of a Payment by Results approach to provider reimbursement in mental health services has been going on for a number of years. The aim of this review was to provide an assessment of commissioners’ and providers’ readiness to deliver the Department of Health policy commitment that adult mental health Payment by Results currencies should be used for commissioning and reimbursement purposes from April 2012. The review was carried out by seeking the views of a wide spread of people in mental health trusts, commissioners, local authorities and the independent sector, as well as national stakeholders.

Being sectioned (in England and Wales). This leaflet was produced by the Royal College of Psychiatrists in November 2011.

Reducing violence and aggression in A&E. According to the National Audit Office, violence and aggression towards frontline hospital staff is estimated to cost the NHS at least £69 million a year in staff absence, loss of productivity and additional security. This project aimed to use a design-led approach in order to help reduce violence in A&E departments.

NHS pension scheme calculator – Agenda for Change. This calculator is for Agenda for Change staff, including special classes and Mental Health Officers. It can be used to get an illustrative estimate of how the proposed reforms might affect your pension.

Report from the Forensic & Challenging Behaviour Product Review Sub Group September 2011. This report summarises the work undertaken by the Forensic and Challenging Behaviour Product Review Sub Group over the past twelve months. It builds upon two strands of work previously undertaken, the first being the development of a clinically derived set of descriptors piloted by a group of London Medium Secure Units and the second being a modification of the Mental Health Clustering Tool (MHCT) and the 21 Clusters mandated for use in Working Aged Adult and Older Peoples services, piloted by two Trusts in the North East of England.

National audit of psychological therapies for anxiety and depression: national report 2011. This report into the care received by patients with anxiety and depression across more than 350 NHS-funded psychological therapy services in England and Wales has revealed good overall standards of care, but substantial variation in quality. The audit collected data from 357 services and over 10,000 people in therapy for anxiety and depression. It measured ten standards, including patient satisfaction, effectiveness of therapy, waiting times and number of treatment sessions offered.

Mental health service transitions for young people highlights some of the key recommendations for improving transition, as well as the Top 10 principles for practice. These include ensuring young people are fully engaged and understand their mental health problem, treatment and support options, as well as ensuring that young people move to flexible and age appropriate services.

Payment by Results quality and outcomes indicators. This report has been produced by the Quality and Outcomes Sub Group of the Product Review Group for the Mental Health Payment by Results (MH PbR) project. It describes the progress made to date in responding to the request from the National Project Board for MH PbR to develop an approach that ensures quality indicators and outcome measures are an integral part of the PbR process, and in particular that they encourage the correct incentives.

Cases
R (on the application of Modaresi) v Secretary of State for Health and Ors. [2011] EWCA Civ 1359.  An application for a review under the Mental Health Act s.66(1) had to be made within 14 days of a patient's detention. However where the expiry date fell on a date that was not a working day the time limit was extended. The approach in Mucelli v Albania (2007) EWHC 2632 (Admin), (2008) 1 WLR 2437 was equally applicable to time limits in relation to s2 detention.

Cheshire West & Chester Council v P (by his litigation friend the Official Solicitor) [2011] EWCA Civ 1257 (CA). The Court of Appeal has allowed the council's appeal against the Court of Protection's declaration that P's care plan involved a deprivation of his liberty for the purposes of Art.5 ECHR. Simon Lindsay has prepared a summary of this case which is available on the Bevan Brittan Mental Health Extranet.

Re RB (Adult); A London Borough v RB (Adult) (No 4) (2011). More information on this case is available on the Bevan Brittan Mental Health Extranet.

Rabone (in his own right & as Personal Representative of the Estate of Melanie Rabone) v Pennine Care NHS Trust. More information on this case is available on the Bevan Brittan Mental Health Extranet.

Inquiries
Mr I and the provision of Mental Health Services, following a Homicide committed in June 2009. Healthcare Inspectorate Wales (HIW) has published its report following a review of a homicide carried out by Leyton Williams in the Tremorfa area of Cardiff on 6 June 2009. There were two victims - one was Anthony Kitely who sadly died. The other was Mr I's mother who suffered grievous bodily harm. More information is available on the Bevan Brittan Mental Health Extranet.

Legislation
Mental Health (Discrimination) Bill. Second reading - the general debate on all aspects of the Bill - took place on 25 November.

News
Lord Toby Harris, Chair of the IAP, appears in the latest edition of ‘The Solution’, the online magazine for Black Mental Health UK. The foreword, written by Lord Harris, focuses on the significant amount of work still needed to be done, to reduce the number of detained patients dying of natural causes in secure mental health settings.

Offer psychological interventions to people who self-harm.

Bevan Brittan Training
 Claims and complaints forum. 06 December 2011. An audience with a Claimant Lawyer & The Annual Clinical Risk CPR and Case Law Review.
Part 1- The Clinical Risk Team is delighted to welcome Phillippa Luscombe and Grainne Barton from the Clinical Negligence and Personal Injury Team at Penningtons Solicitors. Philippa and Grainne will give a fascinating insight into how Claimant lawyers investigate and approach claims and also provide a Claimant perspective on how we can work better together to save costs without compromising access to justice.
Part 2 - The Clinical Risk Team will provide an update on the year’s case law and amendments to the Civil Procedure Rules. We will also consider the practical implications for you as a result of changes in the law.

 Injunctive Relief in Best Interest Cases. 02 February 2012. If you are a member of the Bevan Brittan mental Health Extranet and would like to attend this training session being taken by Michael Mylonas of 3 Serjeants Inn please contact  Claire Bentley.

 Bevan Brittan Annual Mental Health Seminar. Bevan Brittan Birmingham Office 28 February 2012. More information about this half day seminar will be available in the next HSC Update

 Bevan Brittan Annual Mental Health Seminar. Bevan Brittan London Office 14 March 2012. More information about this half day seminar will be available in the next HSC Update

Bevan Brittan Training Slides
 The Price of Death: An Update on Quantum in Fatal Cases. This training session by Alexander Hutton of Hailsham Chambers took place on 28 November. If you would like to access the training notes and slides they can be obtained from the Bevan Brittan Mental Health Extranet.

 Annual Inquest Seminar. Bevan Brittan’s Inquest Update this year focussed on the impact of recent key cases upon healthcare related deaths, such as Savage v South Essex Partnerships NHS Trust [2010] and Rabone v Pennine Care NHS Trust [2010]. There was an update in relation to the implementation of the Coroners and Justice Act 2009.  We have been working closely with healthcare organisations across the UK and we discussed the changes that have already been made as a result of key decisions/legislation and explored how those yet to come into force will affect healthcare organisations. If you would like to access the slides they are available on the Bevan Brittan Mental Health Extranet site.

 Mental Health Act 1983 Update. Hannah Taylor has been providing training to clients on the Mental Health Act  1983. If you would like to access the slides they are available on the Bevan Brittan Mental Health Extranet.

 Section 117 Aftercare - The training slides prepared for this training session by Susanna Rickard of 3 Serjeants Inn can be obtained from the Bevan Brittan Mental Health Extranet. 

 MHA and MCA Interface, Deprivation of Liberty, DOLS Issues and Case Law prepared by Paul Barber. These slides can be accessed from the Mental Health Extranet site. They cover the following:-

 Purpose of the Legislation
 How do the two Acts operate
 Is there deprivation of liberty
 What is deprivation of liberty
 If there is deprivation of liberty which route should be taken?
 The eligibility assessment

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

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Primary Care

Publications/Guidance
Tough inspections to root out poor home care. The Care Quality Commission has announced that it is to carry out a programme of inspections of 250 providers of home care services. The inspections will focus on the respect, care and welfare of people who receive care services in their own homes, as well as the support given to the staff providing the care. They will run alongside the CQC’s planned reviews of home care services, in addition to the 1,000-plus unannounced inspections of adult social care services the CQC carries out every month.

Planning for contract transfer. Following a detailed assessment of contract transfer risk with a small sample of PCTs, the Department of Health has developed a national framework and timescale for contract transfer and some supporting tools to assist PCT and SHA clusters to manage this process.

Non-clinical substance misuse services in contracted adult prisons (England). This letter provides more information on the position of NHS Primary Care Trusts responsibility for the funding of substance misuse services in relation to adult contracted prisons in England.

NHS not making the break for carers: a report on the implementation of the Carers Strategy by primary care trusts. This research shows that spending on carers by PCTs has fallen by £2.4m this year. In November 2010 the Government allocated an extra £400m over four years to provide support for carers and this report seeks to establish how PCTs have invested the added funding this year. It also finds that PCTs have defied Government by not publishing plans and budgets as was requested – only 26% have published updated plans, and 13% have published budgets for 2011/12. It also finds that only 4% of PCTs have not budgeted any investment in services for carers in 2011/12. 

Strengthening primary care: recent reforms and achievements in Australia, England and the Netherlands. This briefing provides a summary of a study which examined quality improvement strategies in countries which have gone through recent health care reforms.

Cases
Royal Brompton & Harefield NHS Foundation Trust v Joint Committee of Primary Care Trusts and Croydon PCT [2011] EWHC 2986 (Admin) (Admin Ct). The court held that a consultation exercise concerning the reconfiguration of children's congenital heart services in England was unlawful as it breached the legitimate expectation relating to the scoring of the hospitals concerned.  

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
Learning from PPO investigations: Violence reduction, bullying and safety. The Prisons and Probation Ombudsman (PPO) has published a report on learning from violence reduction and safety.

The IAP have published their statistical analysis of all recorded deaths in state custody between 1 January 2000 and 31 December 2010. This is the first time that all recorded deaths in state custody have been broken down by ethnicity, gender, age and cause of death and presented together in a single format.

Safer prescribing in prisons: guidance for clinicians. This guidance looks at a number of clinical areas and highlights issues such as medication misuse by patients and medications being traded between inmates. It has been written to assist clinicians working in prisons but it also has relevance for clinicians working in other secure environments such as forensic physicians and custody nurses; consultant psychiatrists; pain clinic prescribers; hospital prescribers and general practitioners who work with offenders.

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

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Regulation 

Publications/Guidance
Monitor's new role. Monitor has set up a web page that provides information on its proposed new role as the sector regulator for health in England. Its core duty will be to protect and promote patients' interests. There are also further details on its main functions, as proposed in the Health and Social Care Bill. See also the information sheet The Health and Social Care Bill: Monitor's evolving role.

Professional boundaries: guidance for social workers. The aim of this guidance is to increase public protection by supporting social workers to practise ethically and safely by encouraging reflection on professional boundaries issues. The GSCC’s analysis of its conduct cases has shown that professional boundaries breaches are a recurring trend. Data collected by the GSCC shows that misconduct in about a fifth of all its cases involved inappropriate relationships which is one of a number of ways in which professional boundaries can be crossed.

The Care Quality Commission: Regulating the quality and safety of health and adult social care. This report finds that the Care Quality Commission had a difficult task in establishing itself and has not so far achieved value for money in regulating the quality and safety of health and adult social care in England.

Consultations
Developing the new NHS Provider Licence: A Framework Document. Monitor has published a consultation document on its proposed future role in licensing health care providers. If the Health and Social Care Bill becomes law, Monitor will probably need to license providers relatively quickly - by October 2012 for NHS foundation trusts and April 2013 for all other health sector providers. The consultation ends on 12 December 2012.

Bevan Brittan Updates
Glimpse of the future? Monitor reveals proposed licensing regime. The Health and Social Care Bill 2011 (the "Bill") will not complete its passage through Parliament for some months and may be further amended. However Monitor has started to prepare for its new role as regulator of NHS healthcare providers, should the Bill become law.

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

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General

Publications/Guidance
Reducing violence and aggression in A&E. According to the National Audit Office, violence and aggression towards frontline hospital staff is estimated to cost the NHS at least £69 million a year in staff absence, loss of productivity and additional security. This project aimed to use a design-led approach in order to help reduce violence in A&E departments.

Tackling violence and anti-social behaviour in the NHS. NHS Protect, the Crown Prosecution Service and Association of Chief Police Officers have agreed a stronger response to violence against NHS staff.

The UK influenza preparedness strategy 2011. This strategy describes the Government's approach for responding to an influenza pandemic. It updates and replaces the previous guidance 'Pandemic flu: a national framework for responding to an influenza pandemic 2007'.

An involving service: Ambulance responses in urban and rural areas. This NHS Confederation briefing aims to help NHS organisations engage with local leaders, communities and other public services about the issues and challenges ambulance services face in rural areas. It sets out some of the solutions that rural ambulance services have devised to help them deliver high-quality urgent care to rural communities, and is intended to start a conversation with local leaders and other public services about how best to work together for patients.

QOF briefing 2012-13 changes. PCC has developed a briefing explaining the QOF changes that will be coming into effect in 2012/13.

Case management - What it is and how it can best be implemented. Report by the Kings Fund examining how case management can improve delivery of integrated care for people with long-term conditions.

New approaches to supporting carers’ health and well-being. This report presents the findings of an independent evaluation of the National Carers’ Strategy Demonstrator Sites programme. It evaluates 25 demonstrator sites around the country that either developed new and innovative services for carers or extended existing provision where effective arrangements were already in place.

Community nursing: transforming health care. The RCN has published nine case studies of excellent community nursing to inform, inspire and persuade people to scrutinise their current community nursing services and identify how they can be both expanded and enhanced. The case studies not only illustrate how people’s health and life styles can be improved, but how community nurses can also provide the most marvellous end of life care within people’s homes.

European Strategic Action Plan on antibiotic resistance. The UK Government, along with other European Union member states, has agreed this new World Health Organization (WHO) initiative on antibiotic resistance in recognition that ‘together we will have greater impact’.

Joining up health and social care. At a time when the whole of the public sector must find significant savings, the report says that integrated working across health and social care offers opportunities for efficiencies and improvements to services. Without it, there is a risk of duplication and ‘cost-shunting’ where savings made by one organisation or sector create costs for others. And a lack of integrated working means that people are less likely to receive the best care. But the briefing also finds that the NHS and councils have made patchy progress in improving this joint working across health and social care. The briefing offers guidance to local partnerships, setting out a list of questions to consider, and suggestions for interventions that might help. Case studies show how some areas have embraced partnership working and used local data and benchmarking to establish how and where to make improvements. NHS and social care partnerships can benchmark their performance against others by using the tool that accompanies the briefing.

The cost of caring. This survey of over 4,000 carers found that almost 47% were being made ill by money worries.

Consultations
PFI reform: Call for evidence. On the 15 November 2011 the Government’s intention to reform the Private Finance Initiative (PFI) was announced by the Chancellor. The Government intends to conduct a broad based engagement process and is now inviting all interested parties to respond to a call for evidence on the reform of PFI and to bring forward proposals for a new approach to using the private sector in the delivery of public assets and services.

Management of HIV-infected healthcare workers: a paper for consultation. The national guidance which presently restricts healthcare workers infected with HIV from performing invasive clinical procedures has been reviewed by a joint working group. This consultation paper seeks views on recommendations from the working group for changes to the current policy on HIV-infected healthcare workers. The working group’s report is being published alongside this consultation paper, together with a consultation impact assessment and a draft equality analysis, which will be reviewed in the light of the consultation responses. The closing date for comments is 9 March 2012.

Bevan Brittan Events
Claims and complaints forum. 06 December 2011  

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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