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Health and Social Care Update - February 2010

03/02/10

Legal intelligence for professionals in health and social care.

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

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

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

 

Care

Publications/Guidance
Delivering better care at end of life. This report includes papers given at the Sir Roger Bannister Summit, arranged for those responsible for implementing the government’s End Of Life Care Strategy. It covers issues including commissioning, hospice and hospital care, quality markers, challenges for providers, and an account of the debate generated and identifies ten actions to help the successful implementation of the strategy

End of life care prompts: care homes - Guidance for inspectors. These prompts are designed to help inspectors evaluate how well a service is caring for people who are coming to the end of their lives. The prompts include an explanation of the difference between palliative care and end of life care.

Use of medication in care homes. This letter describes recently published research commissioned by the Department of Health as part of the patient safety programme. The research identified considerable scope for improvement of prescription, dispensing, administration and monitoring of medicines in care homes.

End of life care manifesto 2010. The National Council for Palliative Care (NCPC) have launched their end of life care manifesto, warning that without continuing radical change in the way Britain cares for dying people, increasing numbers of older people are likely to die in a distressing manner without good care.

Consultations
Charging arrangements for residential social care: consultation on issues concerning the current charging arrangements for residential social care. The Department of Health invites views on proposed amendments to the following: the National Assistance (Assessment of Resources) Regulations 1992; the National Assistance (Residential Accommodation) (Additional Payments and Assessment of Resources) (Amendment) (England) Regulations 2001; the National Assistance (Residential Accommodation) (Relevant Contributions) (England) Regulations 2001; and the Charges for Residential Accommodation Guidance. Views are sought in particular on changes regarding the treatment of personal injury compensation; the treatment of single premium investment bonds; the introduction of a new disregard for pre-paid funeral plans; and deferred self-top ups during the 12 week property disregard. Comments by April 23, 2010.

Legislation
Personal Care at Home Bill. The Personal Care at Home Bill was announced in the Queen's Speech on 18 November 2009 and has received its second reading in the House of Commons. The Bill guarantees free personal care for the 280,000 people - including those with serious dementia or Parkinson's disease - with the highest needs. It is anticipated that, subject to the passage of the Bill and the introduction of regulations, free personal care could be introduced from 1 October 2010.

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

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Children

Publications/Guidance
Young people's sexual health: the National Chlamydia Screening Programme. This report by the Public Accounts Committee examines the delivery of the Chlamydia Screening Programme, improving the efficiency of services and the Department of Health’s approach to managing a national initiative in a devolved National Health Service.

Keeping children and young people in mind: The Government's full response to the independent review of children and adolescent mental health services. This is the full government response to the final report of the independent Children and Adolescent Mental Health Services Review, setting out progress to date and plans for the future of children and young people's mental health. The response also gives examples of the outcomes expected from a good service as an aid for commissioners, providers and practitioners.

Promoting the emotional health of children and young people: Guidance for children's trusts partnerships, including how to deliver National Indicator 50. This guidance contains a detailed service specification that sets out the core support and services for children, young people and families, representing a comprehensive, strategic approach to promoting emotional health.

Changes to the childhood pneumococcal conjugate vaccine. A letter to immunisation leads and coordinators to inform them of a replacement vaccine that will be introduced into the childhood routine immunisation programme in the spring.

Promoting the Emotional Health of Children and Young People: Guidance for children's trust partnerships, including how to deliver national indicator 50. This document provides an outline of effective ways in which services can reinforce the work of parents, carers and the community in nurturing, promoting and supporting children’s emotional health. It discusses some of the key leadership and commissioning challenges, drawing on learning from local areas that have selected national indicator 50 as a priority indicator.

Keeping Children and Young People in Mind. This leaflet summarises the government’s full response to the review of child and adolescent mental health services and sets out the features of good services that all local areas should be working towards delivering.

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

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Clinical Management

Publications/Guidance
Standards for the management of sexually transmitted infections. These standards provide a framework for monitoring performance which covers the core principles of STI care, staff training, clinical assessment and management, diagnostics, information governance, links to other services, clinical governance and the engagement of patients and the public.

EEA bodies who will issue a Provisional Replacement Certificate (PRC). Overseas visitors receiving clinically necessary treatment who fail to provide an EHIC, should be asked to obtain a PRC from the appropriate liaison body in the competent member state. A PRC provides the same access to free treatment as if it was an EHIC. PRC details should also be recorded and reported for a claim to be made. A list of providers of PRCs is now available.

Guidelines for the Clinical Management of People Refusing Food in Immigration Removal Centres and Prisons. This document provides information for health professionals in prisons and immigration removal centres on the physical effects of food refusal, the most effective practical and clinical management of individuals refusing to eat and drink, legal aspects and the relevance of the Mental Capacity Act 2005. It also addresses the considerable dangers and risks associated with re-feeding individuals who have been starving but who then decide to eat again.

News
Top British designers and architects to improve privacy and dignity in NHS hospitals. The Government has launched the new Design for Patient Dignity project which teams up the DH with the Design Council to bring together some of the best minds in the design industry with those working on the frontline in the NHS, as part of a programme of works by the DH to improve patient privacy, dignity and care experience. Six teams of leading UK product, interiors, fashion and systems designers, architects and manufacturers have been appointed to work on a range of briefs that will help to improve the hospital environment and patient experience, such as new ward layouts, more dignified toileting and washing facilities, and new ways of improving the physical and emotional security of patients being transferred within hospitals.

Bevan Brittan Updates
Witness for the Defence. Jackie Linehan's guide should be given to your clinicians or others before they are called to give evidence in Court . You have been advised that you will be going to court to give evidence on behalf of a NHS Trust, what do you need to know?  Questions you may want to ask but feel afraid to do so!

Our regular round-up of noteworthy cases. This month we look at the following cases:- Fitzroy Robinson Limited v Mentmore Towers Limited and others [2009] EWHC 3070
Robert Eric Spencer v Wincanton Holdings Ltd [2009] EWCA Civ 1404
Sampla v Rushmoor Borough Council [2008] EWHC 2616 

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

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Commissioning

Publications/Guidance
Engaging and responding to your community - a brief guide to Local Involvement Networks. Local Involvement Networks (LINks) exist in every local authority area of England to give people more influence over how their local health and social care services are planned and delivered. This guide for health and social care managers explains more about LINks. It outlines how, through proactive engagement they can better understand the needs of their community. It highlights how working with the LINk should be a key part of commissioning, running and reviewing health and social care services.

Help Shape Your Local Health and Social Care: Your guide to local involvement networks. This sets out the right of members of the public to be involved in discussions and decisions about health and social care services. It also gives more information about local involvement networks.

Final report of the Expert Group on Commissioning NHS Infertility Provision. This is the final report of the independent expert group on commissioning NHS infertility provision. The key points include:
· the development of a national tariff for regulated fertility services
· a project to share information on local prices and tariffs on an anonymised basis to help PCTs assess whether their local prices are a fair reflection of the national pattern
· sharing information gained from research to help commissioners
· the availability of support for commissioners from expert patients.
Promoting health and well-being: reducing inequalities. This guide has been developed to assist commissioners to make the most of the best methods of promoting health, using the latest understanding of how they can support people to make healthy choices as individuals within the social and environmental contexts in which they live. The guide will also be of value to providers in giving insight into the commissioning process.

Regional trauma systems: interim guidance for commissioners. This document aims to provide generic information on trauma and trauma systems, and presents a proven practical and evidence-based model suitable for regional trauma systems in the UK. It is aimed at regional commissioners and other stakeholders involved in the assessment of the provision of trauma care and the reconfiguration of services to regionalised trauma systems.

Improving the health and well-being of people with long term conditions: world class services for people with long term conditions - information tool for commissioners. The main aim of this information tool is to share a common vision of what a good service for people with long term conditions should look like, and to provide some practical suggestions for commissioners to help them achieve that vision.

Education commissioning for quality. This document outlines an enhanced, comprehensive education commissioning system for non-medical and medical staff, sets principles for managing relationships between health and education more effectively, and provides guidance to build SHAs.

Commissioning early intervention support services: Guidance for commissioners. This guidance provides clarity to local authorities and primary care trusts about a new indicator for joint commissioning of mental-health promotion and early-intervention support for children and young people.

Delivering better care at end of life. This report includes papers given at the Sir Roger Bannister Summit, arranged for those responsible for implementing the government’s End Of Life Care Strategy. It covers issues including commissioning, hospice and hospital care, quality markers, challenges for providers, and an account of the debate generated and identifies ten actions to help the successful implementation of the strategy.

Consultations
Mainstreaming the Commissioning of Local Services to Address Violence Against Women and Girls: Consultation. This consultation seeks views on draft guidance to help local commissioners develop the best approach to commissioning services to prevent violence against women and girls, protect victims and potential victims and provide services to victims and perpetrators in local areas.

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

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Complaints

Publications/Guidance
Department of Health: Clarification of complaints regulations 2009. This document clarifies the position on new regulations for handling NHS and adult social care complaints that came into effect on 1 April 2009.

Healthcare for People with Learning Disabilities: Recommendations of the Parliamentary and Health Service Ombudsman. These letters from David Behan and Anne Williams to strategic health authority chief executives and directors of adult social services set out the action needed to respond to the recommendations of the 'Six Lives' report, which highlighted failings in health and social care services that led to premature and avoidable deaths of people with learning disabilities.

Bevan Brittan Portal - New!
At Bevan Brittan we have set up an e-portal to assist complaints managers in the NHS. The portal is of use to all NHS complaints managers who are often handling very sensitive and complex work. It provides tailored access to a range of up-to-date knowledge and information enabling you to have a central, structured and focused source of information on complaints.

It also has a discussion forum for use by complaints managers to share tips and knowledge with each other. You may like to take a look at the forum and see what colleagues have posted about different topics. In addition you may want to write a post/query of your own.

If you would like more information about any of the items in this section please contact Claire Bentley or Julie Chappell.

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Data Protection

Publications/Guidance
Checklist for reporting, managing and investigating Information Governance Serious Untoward Incidents. This document provides guidance for all NHS staff in managing Information Governance Serious Untoward Incidents. It should be used in conjunction with previous issued guidance and local guidance issued by the SHAs.

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
Helping trusts embed the NHS Constitution locally. The Department of Health (DH) has produced a number of materials to help NHS organisations embed the NHS Constitution and NHS Values at a local level. From 19 January 2010, all NHS organisations are under a legal obligation to have regard to the NHS Constitution in all their decisions and actions. Access the materials and case studies from NHS Employers' staff engagement web pages.

Equality Bill: making it work – ending age discrimination in services and public functions. A policy statement. This document summarises responses to the consultation document of the same name and sets out our plans for specific exceptions from the ban. For health and social care only, the document also initiates further debate on what uses of age should be able to continue, by whom and the legal way forward.

Reforming the Medical Statement: Government response to the consultation on draft regulations - The Social Security (Medical Evidence) and the Statutory Sick Pay (Medical Evidence) (Amendment) Regulations 2010. This is the government's response to a consultation on draft regulations that will support the revised medical statement. The aim is for the revised medical statement to allow a doctor to consider not only whether their patient is unfit for work, but also whether their patient may be able to do work based on the doctor’s assessment of the patient’s health condition; it also simplifies the suite of medical statements.

Consultations
Review of European Working Time Directive and impact on training. Medical Education England is reviewing the European Working Time Directive and its impact on the quality of training for doctors, dentists, pharmacists and healthcare scientists. NHS chief executives who wish to submit views are invited to do so by 15 February 2010.

Legislation
The Equality Bill: Duty to reduce socio-economic inequalities - a guide. This document is designed to form a bridge between the wording of the duty, which was published in the Equality Bill in April 2009, and the draft statutory guidance to go with it, on which the Government will be consulting in Summer 2010. It explains the background to the duty, the need for it, and how it will operate for each of the different types of public body that are covered by it. It also explains how compliance with the duty will be monitored, and answers the questions that have been put to the government in its discussions with stakeholders.

News
NHS staff survey Wave Four. This letter from Director of NHS Communications Colin Douglas states that the Department of Health has commissioned GFK, an independent research agency, to conduct a survey among NHS staff, including clinicians and nursing staff in primary and secondary care, administrative staff and senior clinical and non-clinical managers, across England.

Over 3,000 doctors will test a new system of strengthened appraisal intended to provide assurance on whether they are up-to-date with medical advances and fit to practise. The pilot scheme, which will cover doctors working in a wide range of NHS healthcare settings across England, will begin in January 2010 and run through to March 31, 2011.

Bevan Brittan Updates
Who is an “affected employee” for the purposes of TUPE? The recent case of Unison v Somerset County Council (1) Taunton Deane Borough Council (2) and South West One Ltd (3) has provided some much needed guidance as to who is an “affected employee” for the purposes of a TUPE transfer. Sarah Lamont explains more. 

Simultaneous Employment approved in Prison Officers Association v Gough (1) and Cox (2). The EAT has confirmed that an employee can be employed in two jobs with two different employers simultaneously, so long as the jobs are compatible with each other. Anne Palmer explains more.

NHS 2010-2015: From Good to Great and The Operating Framework 2010/11. Plans have been published outlining the future of the NHS in the short to medium term. Jodie Sinclair explains more about these key issues.

News Round-up. Marie- Claire Boyle reports on the latest employment news.

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Finance

Publications/Guidance
Quality accounts. This letter sets out the roles of commissioning PCTs, Local Involvement Networks and Overview Scrutiny Committees in the production of quality accounts.

Controlling public spending: the NHS in a period of tight funding. This research paper, which included a round table discussion with a number of senior academics and business leaders with expertise in the NHS, considers some of the options for the NHS in a period of tight funding.

NHS reference costs 2008/9. These documents provide details of how, and on what, almost £48 billion of NHS expenditure was used in the 2008/9 financial year.

Funding and performance of healthcare systems in the four countries of the UK before and after devolution. Political devolution means there are now four National Health Services in the United Kingdom. The health services of England, Scotland, Wales and Northern Ireland are all funded by the UK taxpayer, but have developed different systems of governance and different methods of providing healthcare. This report examines the impact of this by studying key performance indicators for the NHS in England, Scotland, Wales and Northern Ireland at three time points – 1996/7, 2002/3 and 2006/7. The report also undertakes a completely new comparison of NHS performance in the English regions and the devolved countries. This is the first time such an analysis has been conducted.

News
Hospitals must cut services to stay afloat, watchdog warns. William Moyes, who stepped down as executive chairman of Monitor in the week beginning 25 January 2010, has warned that hospitals will have to reduce services, sell off buildings and move into smaller premises to cope with financial pressure in the next few years. While political parties have promised to protect NHS funding and avoid service cuts, Mr Moyes said it was inevitable that some hospitals would have to make cuts to stay afloat.

Bevan Brittan Updates
Contract Review; How effective are your contracts? - Legal Challenges and Opportunities for Smarter Government and Operational Efficiency. In this fifth article looking at the legal challenges facing public sector organisations to deliver Smarter Government and Operational Efficiency, we consider the significant efficiency savings to be made through contract review. Whilst some efficiency savings take time to deliver and can require major restructuring of services or new procurements, others can produce much quicker results. 

Income Generation – Charging and Trading. In this latest article looking at the legal challenges facing public sector organisations to deliver Smarter Government and Operational Efficiency, we consider opportunities for income generation. Whilst efficiency savings are achievable through a range of difficult and potentially unpalatable methods, income generation is achievable by identifying additional areas where charges can be imposed or increased or through outright trading.

Shared Services – Drivers, Challenges and Options. The term “shared services” is increasingly being used in the context of local authorities and health bodies to refer to collaboration between different autonomous public sector organisations which is designed to improve efficiency/reduce costs/fight off enforced restructuring. It is also often used in the context of public sector bodies collaborating with each other in order to procure a private sector partner for the provision of some services through outsourcing or the delivery of asset schemes. Regardless of the context used, the pressure on public authorities to collaborate is increasing. The need to find further efficiency savings will inevitably force organisations to look again at the opportunities to deliver services more effectively. 

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

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Foundation Trusts

Publications/Guidance
PbR data assurance framework: findings from the accident and emergency pilots. The Audit Commission reviewed accident and emergency (A&E) data for Payment by Results (PbR) purposes in eight acute trusts to see if they should extend the PbR data assurance framework to cover A&E activity. This briefing sets out the findings from the pilot review.

Monitor and NHS foundation trusts: An introduction for Parliamentarians and their staff. The document sets out Monitor's approach to parliamentary engagement with its regulatory regime and details the ways in which Monitor interacts with Parliament and MPs, and the information it can offer about NHS foundation trusts.

News
The Monitor January newsletter is now available.

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

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Governance

Publications/Guidance
Governance of equalities, diversity and human rights diagnostic. The Audit Commission have developed a new governance tool to help organisations improve the well-being and outcomes for citizens and users who need it most and strengthen their capacity to deliver equalities, diversity and human rights priorities.

Care Quality Commission: Letter to the Heart of England NHS Foundation Trust. This letter from Care Quality Commission Investigations Manager Sarah Seaholme to Chief Executive of Heart of England NHS FT Dr Mark Goldman deals with concerns regarding governance and safety of patients.  

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Health and Safety

Publications/Guidance
Care Quality Commission: Letter to the Heart of England NHS Foundation Trust. This letter from Care Quality Commission Investigations Manager Sarah Seaholme to Chief Executive of Heart of England NHS FT Dr Mark Goldman deals with concerns regarding governance and safety of patients.

Checklist for reporting, managing and investigating Information Governance Serious Untoward Incidents. This document provides guidance for all NHS staff in managing Information Governance Serious Untoward Incidents. It should be used in conjunction with previous issued guidance and local guidance issued by the SHAs.

Health and Safety Executive: Electric profiling beds in residential and nursing homes. This study was requested by the Health and Safety Executive to investigate the use and practicability of electric profiling beds for the control of manual handling risk in a care setting.

Cases
R (on the application of Butler & Anor) v HM Coroner for the Black Country District [2010] EWHC 43 (Admin). Whilst a coroner's powers as to the scope of investigation during an inquest were wide, they were not unlimited. Where a forthcoming inquest was to be in the "traditional" style, involving consideration of the means by which the deceased came to his death, rather than issues of accountability or responsibility for the death, the coroner had adopted an unlawfully wide approach in indicating that evidence from police officers and health and safety evidence should be adduced and that a verdict of unlawful killing could properly be left to the jury.

Consultations
Health Protection Regulations: consultation report. This is the response to a DH consultation which sought comments on proposals for three sets of regulations to be made under the amended Public Health (Control of Disease) Act 1984, taking forward the modernisation of health protection law. The regulations cover notification of hazards, safeguards for individuals and updated local authority powers. Subject to Parliament, it is planned that the regulations will come into force on 6 April 2010 (except certain provisions in the Notification Regulations which are planned to come into force on 1 October 2010).

News
Top British designers and architects to improve privacy and dignity in NHS hospitals. The Government has launched the new Design for Patient Dignity project which teams up the DH with the Design Council to bring together some of the best minds in the design industry with those working on the frontline in the NHS, as part of a programme of works by the DH to improve patient privacy, dignity and care experience. Six teams of leading UK product, interiors, fashion and systems designers, architects and manufacturers have been appointed to work on a range of briefs that will help to improve the hospital environment and patient experience, such as new ward layouts, more dignified toileting and washing facilities, and new ways of improving the physical and emotional security of patients being transferred within hospitals.

Better protection for vulnerable adults. The DH has announced that it is planning new legislation requiring every local area to have in place a Safeguarding Adults Board – a body made up of the local social services authority, the police, the NHS and working with all other groups involved in protecting vulnerable adults. The Board will ensure that vulnerable adults who suffer abuse will have quick and easy access to the people who can help them best. The announcement follows the publication of Safeguarding adults: report on the consultation on the review of No Secrets.

The UK is to officially recognise April 28 as Workers Memorial Day to commemorate those who have died, been seriously injured or made ill through their work. the day has been informally recognised since 1992 and it is hoped that the official recognition will raise awareness.

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

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Healthcare Associated Infection

Publications/Guidance
Pandemic (H1N1) influenza: A summary of guidance for infection control in healthcare settings. This document is an updated version of Pandemic Flu: A summary of guidance for infection control in health care settings, which was issued in September 2007. It is specific to the current pandemic influenza virus, pandemic (H1N1), and thus represents current guidance.

Pandemic influenza: Summary infection control guidance for ambulance services during an influenza pandemic. This document sets out concise summary guidance for infection control for the ambulance services during a pandemic. It is equally applicable to lay responders, who should adopt the same infection control and hygiene measures.

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

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Inquests

Publications/Guidance
Coroners and Justice Act 2009: Encouraging or assisting suicide. This circular explains the provisions on encouraging or assisting suicide in section 59 of the Coroners and Justice Act 2009, which come into force on 1 February 2010.

Coroners and Justice Act 2009: Key provisions commencing on 1 February 2010. This circular sets out the key provisions of the Coroners and Justice Act 2009 that come into force on 1 February 2010.

Witness Anonymity Provisions of the Coroners and Justice Act. This circular gives information on provisions relating to witness anonymity in the Coroners and Justice Act 2009, which come into effect on 1 January 2010.

Legislation
Coroners and Justice Act 2009. An Act to amend the law relating to coroners, to investigation of deaths and to certification and registration of deaths; to amend the criminal law; to make provision about criminal justice and about dealing with offenders; to make provision about the Commissioner for Victims and Witnesses; to make provision relating to the security of court and other buildings; to make provision about legal aid and about payments for legal services provided in connection with employment matters; to make provision for payments to be made by offenders in respect of benefits derived from the exploitation of material pertaining to offences; to amend the Data Protection Act 1998; and for connected purposes.

Cases
R (on the application of Butler & Anor) v HM Coroner for the Black Country District [2010] EWHC 43 (Admin). Whilst a coroner's powers as to the scope of investigation during an inquest were wide, they were not unlimited. Where a forthcoming inquest was to be in the "traditional" style, involving consideration of the means by which the deceased came to his death, rather than issues of accountability or responsibility for the death, the coroner had adopted an unlawfully wide approach in indicating that evidence from police officers and health and safety evidence should be adduced and that a verdict of unlawful killing could properly be left to the jury.

News
A coroner has said that surgeons who live too far away from hospitals are putting patients' lives at risk. Greater Manchester coroner John Pollard has written to the National Patient Safety Agency (NPSA) citing the case of a man in which a contributing factor to his death was delays from the on-call surgeon and anaesthetist to get into hospital. Both doctors lived more than 40 miles away from the hospital they were working at. NHS Employers head of programmes David Grantham said: "It is a national requirement for key medical staff who undertake emergency 'on-call' work to live a reasonable distance or travel time from their workplace."

Bevan Brittan Updates
Witness for the Defence. Jackie Linehan's guide should be given to your clinicians or others before they are called to give evidence in Court . You have been advised that you will be going to court to give evidence on behalf of a NHS Trust, what do you need to know?  Questions you may want to ask but feel afraid to do so! 

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
Postnote: diagnosing dementia. This briefing outlines current diagnostic practices, research into newer tools and service provision proposals that aim to increase early diagnosis of dementia.

Promoting the Emotional Health of Children and Young People: Guidance for children's trust partnerships, including how to deliver national indicator 50. This document provides an outline of effective ways in which services can reinforce the work of parents, carers and the community in nurturing, promoting and supporting children’s emotional health. It discusses some of the key leadership and commissioning challenges, drawing on learning from local areas that have selected national indicator 50 as a priority indicator.

Keeping Children and Young People in Mind. This leaflet summarises the government’s full response to the review of child and adolescent mental health services and sets out the features of good services that all local areas should be working towards delivering.

Healthcare for People with Learning Disabilities: Recommendations of the Parliamentary and Health Service Ombudsman. These letters from David Behan and Anne Williams to strategic health authority chief executives and directors of adult social services set out the action needed to respond to the recommendations of the 'Six Lives' report, which highlighted failings in health and social care services that led to premature and avoidable deaths of people with learning disabilities.

'Count me in' census 2009. The Care Quality Commission (CQC) has published this report which recommends that the NHS, councils and wider community bodies should work together to improve preventative services to ensure that they meet the mental health needs of people from black and minority ethnic groups. To reduce the risk of admission and detention, the report underlines the need for better needs assessments and bespoke community-based services.

Adult autism strategy consultation: a summary of the submissions received in response to the online consultation. The consultation on the future strategy for adults with autistic spectrum conditions (ASC) closed on 15 September 2009. Over 1,100 responses were received, including people with ASC, families and carers, voluntary sector organisations and health and social care bodies. This report highlights the findings from the consultation including the importance of training, awareness raising and better diagnosis pathways.

Pandemic flu training module for Mental Health Trusts, Tertiary and associated Specialist Trusts. This guidance is based on the recently updated guidance for mental health services on planning and responding to an outbreak of pandemic flu.
The Second Year of the Independent Mental Capacity Advocacy Service: 2008-09. This is the annual report on the second year of operation of the Independent Mental Capacity Advocacy Service.

Overarching report of findings from the Adult Autism Strategy consultation activities. The consultation on the future strategy for adults with autistic spectrum conditions (ASC) closed on 15 September 2009. Over 1,100 responses were received, including from people with ASC, families and carers, voluntary sector organisations and health and social care bodies. This document is a summary of the findings from the consultation, setting out the approach taken, and the key themes and priority actions identified by respondents.

Improving dementia services in England: an interim report. According to this report, dementia has not been given the support expected after publication of the Department of Health’s dementia strategy, Living well with dementia, and there is a risk that value for money will remain poor unless these weaknesses are addressed.

Keeping children and young people in mind: The Government's full response to the independent review of children and adolescent mental health services. This is the full government response to the final report of the independent Children and Adolescent Mental Health Services Review, setting out progress to date and plans for the future of children and young people's mental health. The response also gives examples of the outcomes expected from a good service as an aid for commissioners, providers and practitioners.

Promoting the emotional health of children and young people: Guidance for children's trusts partnerships, including how to deliver National Indicator 50. This guidance contains a detailed service specification that sets out the core support and services for children, young people and families, representing a comprehensive, strategic approach to promoting emotional health.

Commissioning early intervention support services: Guidance for commissioners. This guidance provides clarity to local authorities and primary care trusts about a new indicator for joint commissioning of mental-health promotion and early-intervention support for children and young people.

News
Top British designers and architects to improve privacy and dignity in NHS hospitals. The Government has launched the new Design for Patient Dignity project which teams up the DH with the Design Council to bring together some of the best minds in the design industry with those working on the frontline in the NHS, as part of a programme of works by the DH to improve patient privacy, dignity and care experience. Six teams of leading UK product, interiors, fashion and systems designers, architects and manufacturers have been appointed to work on a range of briefs that will help to improve the hospital environment and patient experience, such as new ward layouts, more dignified toileting and washing facilities, and new ways of improving the physical and emotional security of patients being transferred within hospitals.

A study published in the journal Archives of Internal Medicine suggests that elderly people should train with weights to help them carry out everyday tasks and improve their concentration. The research looked at group of women with an average age of 70 and asked a portion of them to take a class using weights once or twice a week. It found these women had a 13 per cent better level of cognitive function than women who took a toning and stretching class.

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

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Primary Care Trust

Publications/Guidance
The standard NHS contracts for acute hospital, mental health, community and ambulance services and supporting guidance 2010/11. The NHS standard contracts for Mental Health and Learning Disability, Ambulance Services, Acute Hospital and Community Services were published on 18 January 2010 and will apply to agreements between PCTs and all types of provider delivering NHS funded services from April 2010. The contracts support the NHS Operating Framework for 20010-2011 and should be read in conjunction with the Principles and Rules for Co-operation and Competition and the PCT Procurement Guide. A model consortium agreement and associated guidance have been updated and are published alongside the contracts. A standard format national variation will be issued for use by PCTs and providers on existing contracts, which will reflect the policy priorities outlined in the 2010/2011 Operating Framework.

The revised National Framework for NHS Continuing Healthcare and NHS-funded nursing care. This letter draws the attention of PCTs and SHAs to two aspects of the revised National Framework for NHS Continuing Healthcare and NHS-funded nursing care in terms of governance and commissioning.

Guidance for GPs on private screening. The UK National Screening Committee has launched its guidance for GPs on private screening. This guidance is designed to inform GPs about the issue of screening, in order to help with advising patients about private screening services.

Immunisation survey. This letter from Senior Campaigns Manager of NHS Immunisation Information Steve Thorogood highlights a research programme to examine the attitudes and awareness of primary care givers to immunisation.

News
GP extended opening hours. PCTs are expected to continue expanding extended opening hours in GP practices, particularly for patients of practices who are not offering this service. This letter gives more information. The current DES rolls forward in 2010/11 and PCTs are asked to submit plans saying how they will make full use of the resources available for extended opening.

Bevan Brittan Updates
Update - Transitional arrangements for the HESC Chamber. The Family Health Services Appeals Authority was abolished on 18 January 2010 and its functions transferred to the Health, Education and Social Care (HESC) Chamber of the First-tier Tribunal. This Update informs PCTs of the transitional arrangements for cases that are pending on the date of transfer and for new cases after that date, and advises them on the practical steps that they should take. 

Update - The transfer of the Family Health Services Appeal Authority (FHSAA) to the Tribunals Service from January 2010. The functions of the FHSAA will transfer to the Health, Education and Social Care (HESC) Chamber of the First-tier Tribunal in January 2010. This article summarises the effect of the changes for PCTs' List Management functions and activities, sets out their practical implications, and advises PCTs on the steps that they should now take in light of these changes.

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

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Prison Health

Publications/Guidance
Patient Advice and Liaison Services in Prison: A toolkit and good practice guidance for implementing patient advice and liaison services in a secure setting. This toolkit and good practice guidance covers the implementation of the patient advice and liaison service in a secure setting. It is designed to be read by commissioners and providers of healthcare in the criminal or youth justice sectors.

Enhancing the Healing Environment Programme: Extension of HM Prisons and Young Offenders Institution Programme in England and Wales. This document gives information on the extension of the enhancing the healing environment programme to a further group of 10 prisons and young offender institutes in 2010, with the aim of improving the environment in which healthcare is delivered within the prison service.

Guidelines for the Clinical Management of People Refusing Food in Immigration Removal Centres and Prisons. This document provides information for health professionals in prisons and immigration removal centres on the physical effects of food refusal, the most effective practical and clinical management of individuals refusing to eat and drink, legal aspects and the relevance of the Mental Capacity Act 2005. It also addresses the considerable dangers and risks associated with re-feeding individuals who have been starving but who then decide to eat again.

Cases
The Queen on the application of DK Claimant v Secretary of State for the Home Department. The failure, by medical practitioners acting for the secretary of state, to consider whether a prisoner might receive treatment which was likely to alleviate or prevent deterioration of his mental health was fatal to the secretary of state's decision to transfer him from prison to hospital under the Mental Health Act 1983 s.47.

News
Ministry of Justice figures reveal that almost 100,000 criminals were jailed in 2008, a rise of 5 per cent on 2007. According to the statistics, 141,000 people were sentenced to custody in 2008 - the highest number since 1979 - despite falling crime levels.

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

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Regulation

Bevan Brittan Training - February 2010
Preparing for the New Regulatory System: Registration, Inspection, Compliance and Enforcement. During the course of 2010 onwards, the Care Quality Commission will extend the scope of its regulatory remit over providers of health and adult social care services in both the public and independent sectors.  All providers who undertake “regulated activities” will be required to be properly registered under the Health and Social Care Act 2008.  The key changes will be:-
 NHS Providers:  registration which, to date, has been based solely on compliance with the Code of Practice on Healthcare Associated Infections (HCAIs), will be extended from April 2010 and measured against a new set of requirements and standards governing all aspects of the running of the organisation.  These requirements will replace the Standards for Better Health.
 Social Care and Independent Healthcare Providers: from October 2010 (on the basis of the current timetable) services will require registration under the 2008 Act, rather than the Care Standards Act 2000.
This will mean:-
 A wider scope of services requiring registration. 
Applications having to be made for registration to enter the new system.
 A new set of registration requirements and guidance to comply with.
 A new judgment tool which will inform regulatory decisions.
 Wider and more robust enforcement tools for the regulator.

Following on from our successful October 2009 seminars on regulation, Bevan Brittan is running three additional free training sessions on the New Regulatory System at our Birmingham office from 10am - 12.30pm on 24 February 2010, at our London office from our London office from 10am -12.30pm on 3 March 2010 and at our Bristol office from 10am -12.30pm on 4 March 2010.

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

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General

Publications/Guidance
Government response to the consultation on Safeguarding Adults: The review of the no secrets guidance - Written ministerial statement. This is a written ministerial statement to Parliament by Care Minister Phil Hope on 19 January 2010. He sets out the Government’s programme of actions in response to a consultation on the no secrets guidance that sets out the responsibility of local authorities to investigate and take action when a vulnerable adult is believed to be suffering abuse.

Conservative Party draft manifesto 2010: Our reform plan for the NHS. Sets out the Conservatives' reform plan to make the changes the NHS needs, based on the methods of the post-bureaucratic age – decentralisation, accountability and transparency. 

Conservative Party: A healthier nation - policy green paper no.12. Sets out the Conservatives' manifesto on public health, in which they state that they will devolve much greater responsibility for tackling problems like obesity, drug use and teenage pregnancy to communities . It includes proposals for localised funding that will separate the public health budget from the budget for NHS services and devolve much more of the public health budget to local authorities and their health service partners. They will be paid a public health success payment for tackling problems like infant mortality, childhood obesity and sexually transmitted infections, and given financial rewards for reducing the future burden of disease and cost. Also, local directors of public health will manage budgets and will be obliged to commission local bodies, like schools, businesses, councils and GPs, to promote healthy living. With money behind them, they will have the power to recruit and pay innovative local organisations, whether businesses or charities, to start to implement new ways of promoting healthy choices and behaviour.

Civil Litigation Costs review - Jackson report. Lord Justice Jackson's review of civil costs litigation, published on 14 January 2010, proposes wide-ranging reforms including: increasing damages in personal injury and other civil claims by 10 per cent; capping success fees in "no win no fee" cases at 25 per cent, payable by claimants from damages; scrapping referral fees paid by lawyers to claims companies; ending the principle of "loser pays"; fixed fees for accident claims up to £25,000; and annual reviews of lawyers' hourly rates and fixed costs. See the Law Society response, Bar Council response and the Judicial web site.

Making policy count: developing performance indicators for health and social care partnerships. This position paper updates on work underway to develop new performance indicators for adult social care and health and care partnerships. It sets out its context, recent progress, and asks for stakeholder support through comments and offers to pilot work. Feedback will not be compiled formally, but individual queries could be addressed on the project website.

Alcohol: first report of session 2009-10, Volume 1: report, together with formal minutes. This report looks at the impact of alcohol on health, the NHS and society and the government’s responses to the rise in binge drinking and alcoholism.

Choosing your Hospital leaflets and poster. These documents explain the right to choose from any hospital in England (including some independent hospitals) that offers suitable treatment at NHS standards and costs.

Leading together better. This IDeA-sponsored report explores the nature of partnership working between local authority Directors of Adult Services, Children's Services and Public Health. It aims to promote a discussion about the role of other council and public services in promoting health and tackling health inequalities. It focuses on how collaboration can be improved and how other key strategic partners can be better engaged in improving health. It reveals a positive picture of partnership working to improve health outcomes.

Making policy count: developing performance indicators for health and social care partnerships - position paper. This paper updates on work underway to develop new performance indicators for adult social care, and health and care partnerships. It sets out its context, recent progress, and asks for stakeholder support through comments and offers to pilot work.

The new EU Remedies Directive: proven procurement is of the essence. New EU rules which improve access to rapid and effective review procedures for suppliers who allege that public authorities have breached procurement rules have taken effect in the UK. This briefing aims to raise awareness amongst NHS managers involved in procurement of the key changes to the rules and to highlight new provisions in the law which public authorities can use to protect themselves from challenge.

Consultations
The Human Fertilisation and Embryology Act 1990: Disclosure of identifying information - Report of second public consultation. This report summarises the responses received during a consultation on amendments made to draft regulations that establish a procedure for authorising the disclosure of identifying information held by the Human Fertilisation and Embryology Authority, for research purposes, where it is not practicable to obtain consent to the disclosure from the persons to whom the information relates.

NHS car parking: consultation on improving access for patients. This consultation seeks views on the implementation of free NHS hospital car parking for inpatients. The closing date for comments is 23 February 2010.

Legislation
Social Security (Medical Evidence) and Statutory Maternity Pay (Medical Evidence) (Amendment) Regulations 2010. SI 2010/137: New rules concerning the completion of a doctor's statement for health-related social security benefit claims

News
NHS Constitution now backed by law. All NHS organisations must have regard to all the rights and pledges in the NHS Constitution when making decisions about the services they provide to patients, as from 19 January 2010, under the Health Act 2009.

Support for thalidomide survivors. The Secretary of State for Health Services Mike O'Brien has announced that the Government will fund a £20m three-year pilot scheme to address the health needs of Thalidomide survivors. The scheme will be operated by the Thalidomide Trust.

Tax Health Plan. Medical professionals who contact HM Revenue and Customs (HMRC) by March 2010 to make a voluntary disclosure will be able to put their tax affairs in order simply and on the best available terms under a new Tax Health Plan which will operate in two stages: from 11 January to 31 March 2010, medical professionals can register their intention to make a voluntary disclosure with HMRC; and by 30 June 2010, those who have registered must have made their disclosure as well as arrangements to pay all tax interest and penalties due. The HMRC will carry out targeted investigations aimed at medical professionals who have not come forward by 31 March 2010 and substantial penalties or even criminal prosecution could follow for those who have undeclared tax liabilities.

Department of Health appoints Clinical Director for Informatics. Announces that Charles Gutteridge, Medical Director at Barts and the London Trust and a consultant haematologist there and at Newham General Hospital, has been appointed as the first national clinical director for informatics. He will take up his appointment in January 2010.

Bevan Brittan Updates
Mr Justice Jackson I presume? The report is here and could be good news for Defendants (or at least worse news for Claimant lawyers...)? In his article, Matthew Trinder looks at 10 of the most relevant highlights from the Jackson Report published on 14 January 2010.   

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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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