Health and Social Care Update May 2010

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

 

Care

Publications/Guidance
Shaping the future of care together: report on the consultation. This report summarises responses to the Government's Big Care Debate consultation on the proposals in the Green Paper ‘Shaping the Future of Care Together’.

NHS continuing healthcare practice guidance. This practice guidance supports practitioners and others with responsibilities for NHS continuing healthcare in the implementation of the National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care. It provides a practical explanation of how the Framework should operate on a day-to-day basis and cites examples of good practice.

Building the National Care Service. This White Paper sets out the Government's proposals to build a comprehensive National Care Service (NCS) for all adults in England with an eligible care need, free when they need it. The NCS will mean that people will be treated with dignity and respect, people will have control and choice over their care and they will be helped to stay in their homes for as long as possible. People who have to live in residential care will, from 2014, get their care for free after two years and there will be more help to pay the residential costs. This will be phased in three stages.

Consultations
Consultation on interim registration fees for providers of adult social care and independent health care. This consultation seeks views on a proposed fees scheme for independent healthcare and adult social care providers who will be registered under the Health and Social Care Act 2008 from 1 October 2010. The consultation closes on 16 June 2010.

Legislation
Personal Care at Home Act 2010. This Act has received Royal Assent. It comes into force on a day to be appointed. The Act will provide for those with the greatest care needs to be offered free personal care at home. Existing powers allow local authorities to provide certain community care services free of charge for up to six weeks. The Act removes this time limit in respect of personal care at home for those in the greatest need. The Government estimates that the Act would help around 400,000 people with care needs and guarantee free personal care for the 280,000 people with the greatest need. The legislation is intended to be the first step towards establishing a new National Care Service.

News
£40 million capital budget for hospices. Announces the successful hospices that will share £40m funding under the End of Life Care Strategy. The funding was made available through a competitive scheme, run on behalf of the DH by Help the Hospices. Hospices were invited to submit projects which would deliver tangible physical improvements in their care environments, and show how this would contribute to improved care provision. The press release includes a link to a list of the successful hospices.

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

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Children

Publications/Guidance
NHS services and children's centres - how to share information appropriately with children's centre staff. Sets out the framework for information sharing between all practitioners based at a children’s centre, so that information can be shared appropriately. It focuses particularly on sharing information relevant to delivering effective health services via a children’s centre. The leaflet sets out the legal context, and explains different approaches to sharing information on a case by case basis, and pre-planned bulk sharing of information. It flags the important distinction between the need for centres systemically to have access to basic personal information, and the need to share more detailed information on a case by case basis.

Children's heart surgery - the need for change. This document reviews how children’s heart surgery services are currently provided in England and suggests new ways to deliver these services so that all children have equal access to the highest standards of care.

One year on - the first report from the National Advisory Council for children's mental health and psychological wellbeing. This report looks at examples of progress of the CAMHS review, but also at the many challenges that need to be tackled if the Review recommendations are to be achieved. It outlines how the National Advisory Council will continue to work with young people, Government and the field to stimulate more open debate and to find solutions in the current economic climate.

One year on: Healthy lives, brighter futures: the strategy for children and young people’s health. This letter from Andy Burnham, Secretary of State for Health and Ed Balls, Secretary of State for Children, Schools and Families provides an update on the child health strategy which was launched a year ago.  

National Framework for Children and Young People's Continuing Care. This framework sets out an equitable, transparent and timely process for assessing, deciding and agreeing bespoke packages of continuing care for those children and young people under the age of 18 who have continuing care needs that cannot be met by existing universal and specialist services alone.

Cases
M.A.K. v United Kingdom 45901/05 [2010] ECHR 363 (ECtHR). The court held that, while there were relevant and sufficient reasons for the authorities to suspect that a child had been abused at the time when she was admitted to a hospital, a delay in consulting a dermatologist, who could have diagnosed the child's skin condition some days earlier, interfered with the right of the child and her father to respect for their family life and was not proportionate to the legitimate aim of protecting the child from harm. Also, there was no justification, in the circumstances, for a decision to take a blood test and intimate photographs of a child, against the express wishes of both her parents, while she had been alone in the hospital. Accordingly, there had been breaches of Art.8 ECHR.

News
£30 million boost for sick children's care. Announces funding for children’s hospices and children’s palliative care services, that will help hospices extend the range of their services to include more outreach. It will help the NHS continue to move their palliative care services out of hospitals and into children’s own homes.

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

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Clinical Management

Publications/Guidance
Putting quality first in the boardroom: improving the business of caring. This report is based on observations of nurse executives and their boards at six NHS trusts. The report starts by examining what is meant by the term ‘clinical quality’ and why it has the potential to be marginalised in the boardroom. It goes on to consider the dynamics of the boardroom and the role of the nurse executive. The main observations of the report relate to board members’ behaviour and attitudes to the question of discussing and improving clinical quality.

News
Revealed: new designs transform patients' privacy and dignity in NHS hospitals. Announces the launch of new design prototypes to improve patient privacy and dignity. The prototypes are the culmination of Design for Patient Dignity, a programme from the Department of Health and Design Council, which has brought together seven teams of leading UK designers and manufacturers with frontline healthcare staff to help solve privacy and dignity issues for patients. They include revolutionary "bed pods" and screening systems, modular toilets and washrooms, and a redesigned patient gown.

Majority of NHS trusts declare same-sex accommodation. Announces that 95 per cent of trusts have confirmed that they have virtually eliminated mixed-sex accommodation from hospitals across England. This follows an intensive government drive and a £100m Privacy and Dignity Fund set up by the DH last January to help trusts improve their hospital environments and patient privacy and dignity.

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

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Clinical Research

Publications/Guidance
Good practice in research and consent in research. This guidance sets out the good practice principles that doctors are expected to understand and follow if they are involved in research.

Consultations
Give and take? Human bodies in medicine and research: consultation paper. This Nuffield Council on Bioethics consultation paper seeks views on the extent to which people should be encouraged or incentivised to donate organs, eggs and sperm; the control a person providing such material should have over its future use; and whether useful comparisons can be made with people taking part in "healthy volunteer" trials. Comments by 13 July 2010.

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Commissioning

Publications/Guidance
Commissioning: fourth report of session 2009-10. This report looks at the history of commissioning, the present system and its weaknesses. It also looks at the effects of wider reforms in the NHS on commissioning and makes recommendations for the future.

Where next for commissioning in the English NHS? This report uses research evidence as the basis for examining current commissioning arrangements, analyses the nature of the ‘commissioning problem’, and sets out practical suggestions for how commissioning might be strengthened to meet the challenges ahead.

Invest in engagement. This is a new online resource designed for NHS commissioners and providers, and anyone with an interest in patient and public engagement. It provides an evidence review of the effectiveness of PPE in health and evidence-based recommendations for investing in engagement. Alongside the evidence, Invest in Engagement offers other resources including case studies, links to sources of help and policy guidance.

The NHS Performance Framework: implementation guidance 2010/11. This guidance supports the application of the NHS Performance Framework; informs SHAs as the regional system managers and PCTs as the local commissioners of NHS services of when they should intervene to address poor performance; and informs NHS organisations of the criteria against which their performance will be assessed.

Principles and rules of cooperation and competition. This document sets out revised PRCC in commissioning and provision of NHS services. The PRCC were first issued under the 2007/08 Operating Framework and are intended to support cooperation and competition in the interests of patients and taxpayers in relation to: commissioning and procurement; cooperation and collusion; conduct of individual organisations; and mergers and vertical integration. These new PRCC will supersede the original PRCC of December 2007 from October 2010 onwards.

Cross-border healthcare and patient mobility: revised advice on handling requests from patients for treatment in countries of the European Economic Area - guidance for the NHS. These Regulations, Secretary of State's Directions and guidance aim to help local health commissioners handle requests from the public to go to other European Economic Area under arrangements based on the freedom to provide services in Article 56 of the Treaty of the European Union. Cross-border healthcare and patient mobility: revised advice on handling requests from patients for treatment in countries of the European Economic Area - guidance for the NHS.

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

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Complaints

Bevan Brittan Portal
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 the portal please contact Claire Bentley.

Bevan Brittan Training
Complaints and Claims Forum. 16 June 2010 : Lcation: Fleet Place House, 2 Fleet Place, Holborn Viaduct, London EC4M 7RF.

Complaints & Claims Forum. 01 December 2010 : Location: Fleet Place House, 2 Fleet Place, Holborn Viaduct, London EC4M 7RF. 

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Data Protection

Publications/Guidance
NHS services and children's centres - how to share information appropriately with children's centre staff. Sets out the framework for information sharing between all practitioners based at a children’s centre, so that information can be shared appropriately. It focuses particularly on sharing information relevant to delivering effective health services via a children’s centre. The leaflet sets out the legal context, and explains different approaches to sharing information on a case by case basis, and pre-planned bulk sharing of information. It flags the important distinction between the need for centres systemically to have access to basic personal information, and the need to share more detailed information on a case by case basis.

Caldicott Guardian Manual 2010. The manual takes account of developments in information management in the NHS and in councils with social services responsibilities since the publication of the Caldicott report. It sets out the role of the Caldicott Guardian within an organisational Caldicott/confidentiality function as a part of broader information governance.

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

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Emergency Planning

Publications/Guidance
NHS emergency planning guidance: Planning for the development and deployment of Medical Emergency Response Incident Teams in the provision of advanced medical care at the scene of an incident. This is best practice guidance to NHS organisations for developing and deploying medical emergency response incident teams.

NHS emergency planning guidance: The ambulance service guidance on dealing with radiological incidents and emergencies. This document describes the role of NHS ambulance trusts in planning, preparing and responding to radiation incidents and emergencies involving irradiated and contaminated people.

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

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Employment/HR

Publications/Guidance
Planning and Developing the NHS Workforce. This document is designed to support strategic health authorities in leading the debate about the future shape of services and what this means for workforce skills, competences, numbers and locations.

SHA Assurance reports. SHA Assurance is designed to support the development of SHA capability and capacity. This report and its covering letter summarise the findings of the assurance process and detail the Panel's recommendations to the North West SHA following their visit. Similar reports have been published for the South East Coast SHA, the South West SHA and the East of England SHA.

Commercial skills for the NHS. Sets out a strategy for supporting staff to develop their commercial skills and for supporting local commissioners and providers by facilitating access to specialist commercial expertise and infrastructure at regional and national level. It supersedes "Necessity not Nicety – a new commercial operating model for the NHS" (May 2009).

Uniforms and workwear: guidance on uniform and workwear policies for NHS employers. In 2007, the Department of Health published 'Uniforms and Workwear: an evidence base for developing local practice'. This revision takes account of comments and feedback from employers and staff as local policies have been implemented. It re-affirms the principles of the original guidance with particular reference to staff dress during direct patient care activity.

A framework for staff engagement: An introduction to staff engagement in the NHS and guidance on starting staff engagement policy. This is an introduction to achieving staff engagement in the NHS.

Cases
Gillian Clare Mezey v South West London & St Georges Mental Health NHS Trust [2010] EWCA Civ 293  It was not permissible for an NHS trust to hold a capability hearing under the relevant disciplinary procedure where a consultant psychiatrist's competence had been vindicated by an investigation.

Bevan Brittan Updates
April News Round-Up.  Marie-Claire Boyle sets out the latest employment law related news.

Employer restrained from starting capability procedure. In Mezey v South West London and St George’s Mental Health NHS Trust, the Court of Appeal has confirmed, for the first time, that an employee may use an injunction  to stop an employer from pursuing a disciplinary procedure.  Julian Hoskins examines the detail and sets out the impact of this decision.

Exit costs at the end of outsourcing contracts. A recent survey has highlighted the fact that many contractors who take on outsourced local authority services are unaware of some of the key concerns on pension costs. Christine Johnston examines the issues.

Manifesto Destiny. There are absolutely no prizes for guessing what is happening in politics on 6 May this year. But what are each of the main parties promising in terms of employment law, should they win the election? Raj Basi assesses the key policies that impact on employment law.  

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Finance

Publications/Guidance
Direct payments for health care: a consultation on proposals for regulations and guidance. The Government's response. Sets out the Government's response to the October 2009 consultation on proposals for using the powers in the NHS Act to make regulations to enable pilot sites to use personal health budgets in the form of direct payments. The consultation responses have reinforced the Government's belief that piloting and robust evaluation are essential. This is a complex and challenging policy, and it does not yet have answers to all the questions raised. Following the pilot programme and in light of the evaluation and lessons learned, there will be a further review of the regulations and guidance, if a decision is taken to roll out personal health budgets more widely. This is likely to include a further period of public consultation. Annex A sets out a number of specific changes to the proposals for regulations.

NHS continuing healthcare: refunds guidance. This guidance sets out the approaches to be taken by PCTs and local authorities when a decision is awaited on eligibility for NHS continuing healthcare or there is a dispute following a decision. It explains responsibilities for providing services during these periods and for refunding the costs of services provided.

NHS accounts guides for non-executives and governors. The Audit Commission and the Healthcare Financial Management Association have revised their guides which help non-executives and governors to get a more detailed grasp of their organisation's annual accounts. The guides explain the role of the non-executive director or governor and the external auditor. They also include an invaluable list of questions to help understand and gain assurance on the detail of the financial statements. The guides were originally developed in 2007 and have now been updated for 2010 to reflect changes following the introduction of the International Financial Reporting Standards.

 NHS trust accounts: A guide for non-executive directors;
 Primary care trust accounts: A guide for non-executive directors;
 Foundation trust accounts: A guide for non-executive directors; and
 Foundation trust accounts: A guide for governors.  

Detailed guidance for the dry-run of external assurance on the quality reports. Detailed guidance for NHS foundation trusts and their auditors to enable them to carry out the dry run of the external assurance proposals on the 2009/10 Quality Reports (or state of readiness review), as specified in para.7.74 of the Annual Reporting Manual 2009/10, issued on 16 April 2010. 

Legislation
National Health Service (Direct Payments) Regulations 2010 (SI 2010/1000). These regulations, which come into force on 1 June 2010, are made under ss.12A-12C NHS 2006, as inserted by the Health Act 2009. They allow the Secretary of State to set up pilot schemes for direct payments for health care or mental health aftercare, as part of a wider pilot programme exploring the use of personal health budgets.

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
Governors in NHS Foundation Trusts: What the law says you have to do. This is an easy read version of: Your statutory duties: a reference guide for NHS foundation trust governors (published October 2009) that examines ways in which governors can deliver their statutory duties. It sets out these duties, and provides suggested process steps to deliver them. These process steps are advisory and reflect best practice.

NHS Foundation Trust Annual Reporting Manual 2009-10 (previously titled: Foundation Trust Financial Reporting Manual 2009-10). Provides guidance to foundation trusts on producing their annual reports and accounts. This document was previously called the NHS Foundation Trust Financial Reporting Manual 2009/10 (FT FReM); it has been renamed to reflect the enhancements made to the manual following consultation on additional reporting requirements.

2009-10 annual accounts guidance for NHS foundation trusts. Guidance for NHS foundation trusts to aid in the completion of their 2009-10 Foundation Trust Consolidation templates. These templates will be used by Monitor to produce the 2009-10 Consolidated Foundation Trust Accounts.

Monitor: Compliance framework 2010-2011. Sets out the approach Monitor will take to assess the compliance of NHS foundation trusts with their Terms of Authorisation.

Consultation on seeking external assurance on the Quality Accounts of NHS foundation trusts - summary of consultation responses. Sets out Monitor's comments on the December 2009 consultation, together with a summary of responses received. The majority of respondents were supportive of the need for external assurance on the quality accounts; however there were reservations in relation to the inclusion of a Directors’ Statement in the quality accounts in 2009/10 and the timescale for the delivery of the final private report. Some concerns were also raised that further clarification was required on the criteria to support the opinion on the arrangements in place to ensure the quality accounts are fairly stated (the arrangements opinion). Monitor has amended its guidance in light of these concerns.

New foundations: the future of NHS Trust providers. This briefing compiles the results of a snapshot survey carried out by the Royal College of Nursing which aimed to evaluate the performance, engagement and quality of care in NHS Foundation Trusts in England.

NHS foundation trust annual reporting manual 2009-10. This document provides guidance to foundation trusts on producing their annual reports and accounts. It was previously called the NHS Foundation Trust Financial Reporting Manual 2009/10 and has been renamed to reflect the enhancements Monitor have made to the manual following consultation on additional reporting requirements.

Monitor has published detailed guidance for the dry run of external assurance on quality reports.   The dry run of proposals (or state of readiness review) that will be undertaken on the 2009/10 Quality Reports will require NHS foundation trusts to:

• include a brief description of the key controls in place to prepare and publish a Quality Report in the Statement on Internal Control in the 2009/10 published accounts;
• sign a proforma Statement of Directors’ Responsibilities in respect of the 2009/10 Quality Report to provide to their auditors (this is not required to be published in the 2009/10 Quality Report);
• provide their auditors with a paper which explains the arrangements the trust has put in place to prepare and publish the Quality Report against Monitor’s guidance (it is anticipated that this will include the relevant trust board paper which the board considered to allow the chief executive to sign the statement that the Quality Accounts are accurate, which is a requirement under the Department of Health’s regulations); and
• submit a copy of their auditors’ report on the outcome of the dry run to Monitor and to the trust’s board of governors. 

 

Bevan Brittan Updates
Detailed Guidance for the Dry-Run of External Assurance on the Quality Reports. Monitor has recently issued a detailed guidance for the Dry-Run of External Assurance on Quality Reports. The guidance sets out the requirements of Foundation Trusts and their Auditors, and gives details of the criteria that Monitor require Foundation Trusts to be judged against. It is very important that Foundation Trusts act upon the guidance, as it they are required to undertake the dry-run. In addition, the guidance sets out positive obligations on them to provide certain information to their Auditor and fairly tight timetables from submission of the Quality Report to Monitor by the Foundation Trust, to the submission of the Auditor's report.

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

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Governance

Publications/Guidance
Putting quality first in the boardroom: improving the business of caring. This report is based on observations of nurse executives and their boards at six NHS trusts. The report starts by examining what is meant by the term ‘clinical quality’ and why it has the potential to be marginalised in the boardroom. It goes on to consider the dynamics of the boardroom and the role of the nurse executive. The main observations of the report relate to board members’ behaviour and attitudes to the question of discussing and improving clinical quality.

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Healthcare Associated Infection

Publications/Guidance
MRSA screening - operational guidance 3. The guidance contained in this letter is aimed primarily at Chief Executives and Directors of Performance. It will also be of interest to Finance Directors, Directors of Nursing and Medicine, Directors of Infection Prevention and Control and their teams, medical microbiologists, laboratory managers, bed managers and those running pre-admission clinics and admission units.

C. Difficile Methodology. This update gives information on progress in reducing C.difficile infections and a new objective.

Consultations
Consultation on the Health and Social Care Act 2008 Code of Practice for healthcare, including primary care, and adult social care on the prevention and control of infections and related guidance. This consultation seeks views on a code of practice and supporting guidance that will help providers of healthcare, including primary care, and adult social care to plan and implement how they prevent and control healthcare-associated infections. It sets out criteria that the Care Quality Commission will use to assess compliance with the registration requirement. The consultation closes on 24 June 2010. 

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

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Inquests

Publications/Guidance
Guidance for Coroners and Donor Coordinators Working with Coroners. This guidance encourages the development of local protocols to optimise organ donation.

Cases
Glennys Jones (Applicant) v HM Coroner for the Southern District of Greater London (Respondent) & Deshminder Virdi (Interested Party) [2010] EWHC 931 (Admin) It was appropriate for an open verdict to be quashed and a new inquest ordered where there had been insufficient inquiry made into the means by which a deceased came to die from fentanyl toxicity. There was also a wider public interest in a full inquiry given that there had been a considerable number of deaths in the United States and the United kingdom linked to unintended overdoses of fentanyl.

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
Implementing recovery: a methodology for organisational change. This paper helps mental health services to measure how well placed they are to support the people who use them. It sets out the three stages a service needs to reach on ten key challenges to become fully focused on recovery. It allows mental health services, their users and their commissioners to judge how well they are doing in meeting each of the ten challenges.

Valuing People Now delivery plan 2010-11. The delivery plan for 2010-11 has been published together with a range of materials to support the implementation of Valuing People Now, the cross government strategy for people with learning disabilities. The plan sets out the key priorities for 2010-11, in particular, to improve employment and housing opportunities and better health outcomes for people with learning disabilities and their family carers.

Voting rights for detained patients. This Guidance Note is to give information to NHS Trusts and independent hospitals on the voting rights of detained patients, and to advise patients of their entitlement to vote, and how they may register to vote.

Attitudes to Mental Illness 2010. This report presents the results of the latest survey on public attitudes to mental illness.

Mental health system reform: towards delivering New Horizons and Quality and Productivity. This letter relates to the range of systems reforms that come into effect in 2010/11 and that will affect how mental health services are commissioned, performance managed, and incentivised to deliver improvements in quality, efficiency and responsiveness.

Acute awareness: improving hospital care for people with dementia. This report looks at the key issues for NHS trusts in improving care for patients with dementia, the majority of whom will have been admitted for another condition. It showcases the innovative work that NHS trusts and cross-agency partnerships are undertaking in this area to enhance patient care and describes how significant improvements can be achieved in terms of both the quality and efficiency of patient care.

Update on the Latest Developments on Payment by Results for Mental Health, and Clarification of Implementation. This letter provides an update on the latest developments on payment by results for mental health, as well as clarifying the timescales for its implementation.

Human rights training materials and human rights resources. This resource forms a suite of training materials designed for use in training sessions for frontline workers - primarily health and social care workers - supporting people with a learning disability. The resources will assist trainers and interested parties as to the range of materials available.

Housing rights resource pack. This suite of resources covers many subjects around different housing options available for people with learning disabilities.

Towards 'Fulfilling and rewarding lives': the first year delivery plan for adults with autism in England. This plan sets out the governance structure and the actions, with timescales and responsibilities, that will be taken in the first year to support the implementation of the strategy for adults with autism in England.

Office of the Public Guardian: amendments to secondary legislation - Response to Consultation. Following a consultation proposing changes to secondary legislation to ensure the Mental Capacity Act 2005 meets its aims and objectives, two statutory instruments have been laid in Parliament which are due to come into force on May 1, 2010. The changes include: reducing the security bond discovery period after a client's death from seven to two years for all new bonds taken out on or after May 1, 2010; adding local housing allowance to the list of benefits that qualify a customer for exemption from Office of the Public Guardian fees; and allowing the Public Guardian to investigate enduring power of attorneys.

My name is not dementia. The Alzheimer's Society has undertaken a new project focusing on quality of life in dementia. This new report presents the findings of the first stage of this project. The research was carried out by the Mental Health Foundation over 2009/10 and aims to better understand key quality of life indicators for people with a dementia diagnosis. A literature review has been published alongside this report.

NHS standard contract for high secure services 2010/11. The DH has issued a new standard contract for high secure services for use from April 2010 by the three Specialised Commissioning Groups responsible for commissioning high secure services to cover the services provided at Ashworth, Rampton and Broadmoor High Secure Hospitals, with guidance. It should be read alongside with the contract guidance published to support the implementation of the NHS standard contract for mental health and learning disability services.

Update on the latest developments on PbR for Mental Health, and clarification of implementation timescales. This Dear Colleague letter from Bob Alexander, Director, NHS Finance and Bruce Calderwood, Director, Mental Health Policy, provides an update on the latest developments on Payment by Results (PbR) for Mental Health, as well as clarifying the timescales for its implementation.

Confident communities, brighter future: a framework for developing wellbeing. This DH report sets out the first framework for mental well-being and aims to provide an evidence base from which local authorities and the NHS can act to reduce inequalities and improve mental health in their areas.

Valuing People Now Delivery Plan 2010-11.This marks the progress made in the first year of Valuing People Now, the cross-government strategy for people with learning disabilities. It also recognises that there is still more to do to improve the lives of people with learning disabilities and their family carers. The Delivery Plan sets out the key priorities for 2010-11, in particular, to improve employment and housing opportunities and better health outcomes for people with learning disabilities and their family carers.

One year on - the first report from the National Advisory Council for children's mental health and psychological wellbeing. This report looks at examples of progress of the CAMHS review, but also at the many challenges that need to be tackled if the Review recommendations are to be achieved. It outlines how the National Advisory Council will continue to work with young people, Government and the field to stimulate more open debate and to find solutions in the current economic climate.

Legislation
National Health Service (Direct Payments) Regulations 2010 (SI 2010/1000). These regulations, which come into force on 1 June 2010, are made under ss.12A-12C NHS 2006, as inserted by the Health Act 2009. They allow the Secretary of State to set up pilot schemes for direct payments for health care or mental health aftercare, as part of a wider pilot programme exploring the use of personal health budgets.

News
First "Health and Criminal Justice Tsar" announced. Professor Louis Appleby has been appointed the first National Clinical Director for Health and Criminal Justice, responsible for delivering the Government's action plan, "Improving Health, Supporting Justice", which aims to address health and social care problems as early as possible in a person's contact with the criminal justice system and to develop more effective interventions for offenders. His deputy, Dr Hugh Griffiths, will take on responsibility for wider mental health issues.

Bevan Brittan Updates
Barber v Croydon LBC - the gateway opens again. In our last edition of Housing Landscape we considered some of the practical effects on social housing providers following the recent cases of Kay v Lambeth, Weaver and Doherty in view of the likelihood that public law defences were likely to be increasingly relied on by tenants in housing disputes. This article examines the decision of the Court of Appeal in Barber v Croydon LBC on 11 February 2010 - a case in point.

Bevan Brittan Training
Mental Health. 03 November 2010 : Location: Kings Orchard, 1 Queens Street, Bristol BS2 0HQ

Mental Health. 20 October 2010 : Location: Interchange Place, Edmunds Street, Birmingham B2 2TA

Mental Health. 12 October 2010 : Location: Fleet Place House, 2 Fleet Place, Holborn Viaduct, London EC4M 7RF 

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

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Obesity

Publications/Guidance
Healthy Weight, Healthy Lives: a research and surveillance plan for England - update on progress. This document includes an overview of key strategic developments and partnerships on developing the evidence base on obesity since the publication of Healthy Weight, Healthy Lives: a research and surveillance plan for England. It recognises that developing the evidence base is an ongoing progress and a long-term venture. However, even within this first year, considerable progress has been made in terms of building upon existing infrastructure and investments.  

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

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Primary Care Trust

Publications/Guidance
The NHS performance framework: implementation guidance 2010/11. The aim of this guidance is to support the application of the NHS Performance Framework; to inform SHAs as the regional system managers and PCTs as the local commissioners of NHS services of when they should intervene to address poor performance; and to inform NHS organisations of the criteria against which their performance will be assessed.

Improving oral health and dental outcomes: developing the dental public health workforce in England. This report gives guidance on developing the dental public health workforce to enable PCTs and SHAs to promote oral health, increase access to dental services and secure safe, high quality dental services which meet the needs of the local population.

Primary Care Trust procurement guide for health services. Sets out expectations of PCT Boards on the use of procurement to improve services for patients. The guidance is consistent with law, including the application of the UK Public Contracts Regulations to commissioning of health services and reflects overarching principles of transparency, proportionality, non-discrimination and equality of treatment. The guide is referenced in the NHS Operating Framework for 2010/11. It should be read in that context and in conjunction with the revised Principles and rules of cooperation and competition and the national standard contracts guidance.

Guidance: GP extended hours access. Guidance for PCTs on maximising the availability of GP extended opening hours. The guidance should be read in conjunction with the Primary Medical Services (Directed Enhanced Services) (England) Directions 2010 (the DES Directions) and the amendments to the Statement of Financial Entitlements (SFE).

Practice Based Commissioning Group and Independent Leads Survey: Wave 2. This is the second wave of research for the new practice based commissioning (PBC) survey, conducted between February and March 2010. The previous PBC GP practice survey (August 2007 – September 2009) asked GP practices for their views of PBC. For this new survey, lead individuals within PBC groups and independent practices have been invited to take part as they are ideally placed to provide informed feedback as to their organisation’s experience of PBC locally. The aims of the survey are to get feedback from practices on their perception of the support offered by their PCT and on the clinical and financial engagement of practices with PBC.

The DH has issued Pharmacy in England: building on strengths - delivering the future - Regulations under the Health Act 2009: pharmaceutical needs assessments. Information for primary care trusts that provides information to assist PCTs in publishing their pharmaceutical needs assessments. It explains and expands on the regulations.

Health inequalities in ex-coalfield and industrial communities. This publication looks at the issue of regeneration of former coalfield areas. It asks whether health has been overlooked in the past, and how former coalfield areas might move forward in tackling health inequalities. The document is targeted at councillors with a health remit, as well as council and PCT staff with a responsibility for health improvement and reducing health inequalities.

Talking it through: the importance of communications when discussing local service change. This report discusses how PCTs can communicate important decisions locally in a transparent way to help improve public understanding and constructive involvement. Although this report focuses on communications during local service reconfigurations, some of the findings can be applied to other high-profile local decisions such as drug funding. 

Developing tariffs for integrated sexual health services. This briefing document outlines the development of the London Sexual Health Programme tariff which is an agreed set of currencies for integrated sexual health services to be paid by PCTs to providers of sexual health services.

NHS continuing healthcare refunds guidance. This DH guidance sets out the approaches to be taken by PCTs and local authorities when a decision is awaited on eligibility for NHS continuing healthcare or there is a dispute following a decision. It explains responsibilities for providing services during these periods and for refunding the costs of services provided. 

Legislation
National Health Service (Performers Lists) Directions 2010. These Directions, which come into effect from 1 April 2010, require PCTs to review procedures for managing Performers Lists within three months and to implement any changes by the end of the financial year 2010/11. This follows the recent GP Out of Hours report and the inquest into the death of David Gray. The Directions need to be read in conjunction with the National Health Service (Performers Lists) Regulations 2004 (SI 2004/585) and subsequent amendment.

Bevan Brittan Updates
Department of Health Recommendations to PCTs in relation to Out of Hours Services The Department of Health has recently undertaken a review of the current arrangements for general practice out of hours ("OOH") services, and published the findings of its review in January 2010 (the "Review"). The Review makes a number of recommendations to PCTs as both commissioners and providers of OOH services.

New Performers Lists Directions: PCT List Management Procedures due for Review. The Secretary of State has issued Directions to PCTs which require PCTs to review and implement a range of procedures in relation to the management of Medical, Dental and Ophthalmic Performers Lists.  The Directions require PCTs to undertake a series of reviews by 1 July 2010, to implement the relevant procedures at the earliest opportunity, but no later than 31 March 2011, and to continually undertake reviews moving forward. To assist PCTs, we have produced a short guide to the Directions explaining what PCTs need to do now and over the next 12 months.

Bevan Brittan Training
Untwist your List. With the raft of recent changes affecting primary care performers list management, the onus is on PCTs more than ever to ensure that their Performers lists are fit for purpose. 18 May 2010 : Registration: 9.30am Seminar: 10am - 12.30pm. Location: Fleet Place House, 2 Fleet Place, Holborn Viaduct, London EC2M 7RF  

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
Independent Advisory Panel on Deaths in Custody. This is the website of the independent advisory panel on deaths in custody. The panel will play an important role in helping to shape government policy in this area through the provision of independent advice and expertise to the Ministerial Board on Deaths in Custody.

Cases
Akhmetov v Russia (No.37463/04) [2010] ECHR 441 (ECtHR). The court held that, where a prisoner had been receiving conservative treatment for his rare and complex medical condition but the prison authorities were aware that the recommended radical treatment was not possible within the penitentiary system, their delay in seeking such treatment in a civilian hospital, with the consequence that the condition became irreversible, breached Art.3 of the European Convention on Human Rights 1950.

News
First "Health and Criminal Justice Tsar" announced. Professor Louis Appleby has been appointed the first National Clinical Director for Health and Criminal Justice, responsible for delivering the Government's action plan, "Improving Health, Supporting Justice", which aims to address health and social care problems as early as possible in a person's contact with the criminal justice system and to develop more effective interventions for offenders. His deputy, Dr Hugh Griffiths, will take on responsibility for wider mental health issues.

Bevan Brittan Training
Annual Prison Health Update. 09 December 2010 : Location: Fleet Place House, 2 Fleet Place, Holborn Viaduct, London EC4M 7RF 

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

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Regulation

Publications/Guidance
New registration guidance for adult social care and independent healthcare. All adult social care and independent healthcare providers that carry on regulated activities must apply to be registered with CQC under a new registration system from 1 October 2010. The CQC have now opened the first two 'application windows'. The How to apply and How to complete your application form booklets provide important information. The CQC have also developed an e-learning module to guide applicants through the correct procedures.

Monitor: Compliance framework 2010-2011. Sets out the approach Monitor will take to assess the compliance of NHS foundation trusts with their Terms of Authorisation.

Consultation on seeking external assurance on the Quality Accounts of NHS foundation trusts - summary of consultation responses. Sets out Monitor's comments on the December 2009 consultation, together with a summary of responses received. The majority of respondents were supportive of the need for external assurance on the quality accounts; however there were reservations in relation to the inclusion of a Directors’ Statement in the quality accounts in 2009/10 and the timescale for the delivery of the final private report. Some concerns were also raised that further clarification was required on the criteria to support the opinion on the arrangements in place to ensure the quality accounts are fairly stated (the arrangements opinion). Monitor has amended its guidance in light of these concerns.

Monitor business plan 2010-2011. This business plan for 2010-11 builds on Monitor’s corporate plan for 2009-2012. It refines Monitor’s overall goals and sets out a detailed agenda for the coming year.  

Cases
Southall v General Medical Council [2010] EWCA Civ 407 (CA). The court held that the General Medical Council's Fitness to Practise Panel had provided inadequate reasons for their finding that a consultant paediatrician was guilty of serious professional misconduct where it was alleged that he had accused a mother of drugging and murdering one of her children.

Consultations
Consultation on interim registration fees for providers of adult social care and independent health care. This consultation looks at the proposed fees scheme for independent healthcare and adult social care providers who will be registered under the Health and Social Care Act 2008 from 1 October 2010. The consultation closes on 16 June 2010.

News
Appointment of new Chair of Monitor - the Independent Regulator of NHS Foundation Trusts. The DH has announced that Steve Bundred, Chief Executive of the Audit Commission, has been appointed as the new Chair of Monitor. The appointment is for a term of four years, from 1 May 2010 to 30 April 2014.

Second wave of NHS trusts registered under new system for monitoring standards. The CQC has announced plans to give a further 211 NHS trusts a licence to provide services under a new, tougher system for regulating standards in the NHS. For 10 of these trusts, registration will be conditional on further action being taken to address concerns about the safety and quality of care. The regulator will register the remaining 201 trusts without conditions, but it stresses that no trust can be complacent and all must ensure that standards are maintained at all times. This press release contains a full list of trusts, including all mental health and ambulance trusts.

Bevan Brittan Training
Regulation. 29 September 2010 : Location: Kings Orchard, 1 Queens Street, Bristol BS2 0HQ

Regulation. 16 September 2010 : Location: Fleet Place House, 2 Fleet Place, Holborn Viaduct, London EC4M 7RF

Regulation. 14 September 2010 : Location: Interchange Place, Edmunds Street, Birmingham B2 2TA 

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

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General

Publications/Guidance
Mutual benefit: giving people power over public services. In this report, the Government sets out how it will accelerate opportunities for mutuals to develop and flourish across three key areas of public services, including health care.

Requested allocation of a deceased donor organ. This framework document provides advice about the circumstances in which a request for an allocation of a deceased donor organ to a close relative or friend could be considered in exceptional circumstances and when the needs of other patients should take precedence over that request for the allocation. It outlines a change to allocation policy which must be implemented consistently across the whole of the UK and must comply with law including the Human Tissue Act 2004 and the Human Tissue (Scotland) Act 2006.

Healthcare for single homeless people. This paper presents the results of analysis aimed at better understanding the health needs and relative healthcare costs of people who are homeless or living in certain types of insecure or short-term accommodation. Different models for provision of primary care services to this client group are discussed and the barriers experienced in accessing mainstream primary care are set out. Four models of care are described, ranging from outreach services to a fully integrated primary and secondary care model. The current take-up of these models is discussed and ranges from one third of PCTs which provide no specialist homelessness primary care services to a group of PCTs which provide a specialist homelessness primary care service with registration.

Cancer awareness: the impact of sexual orientation. This report provides the results from a survey of 1600 heterosexual, gay, lesbian and bisexual respondents, using the CR-UK Cancer Awareness Measure. The results highlight the differences in cancer awareness between different sexual orientation groups. The report will be of interest to people involved in early diagnosis of cancer, researching, commissioning or delivering interventions.

Valuing People Now delivery plan 2010-11. The delivery plan for 2010-11 has been published together with a range of materials to support the implementation of Valuing People Now, the cross government strategy for people with learning disabilities. The plan sets out the key priorities for 2010-11, in particular, to improve employment and housing opportunities and better health outcomes for people with learning disabilities and their family carers.

Personalisation through person - centred planning. This joint good practice guidance published by the Putting People First and Valuing People Now teams has been developed to help local areas understand how person-centred planning can help to deliver Putting People First. It includes a range of tools and good practice examples on person centred planning and support planning to help give people more choice and control over their lives.

NHS standard contracts. A number of additional documents and guidance to support the standard NHS contracts for acute hospital, mental health, community and ambulance services have been added to the DH website. They include Deeds of Variation and guidance to enable changes over to the new 2010/11 contracts. There is also a new standard contract for high secure services for use by the three Specialised Commissioning Groups responsible for commissioning high secure services to cover the services provided at Ashworth, Rampton and Broadmoor High Secure Hospitals, with guidance.

The DH has issued Pharmacy in England: building on strengths - delivering the future - Regulations under the Health Act 2009: pharmaceutical needs assessments. Information for primary care trusts that provides information to assist PCTs in publishing their pharmaceutical needs assessments. It explains and expands on the regulations.

Self-assessment management tool for delivery of information prescriptions. This self-assessment tool for managers covers the steps an organisation needs to take to provide information prescriptions, as well as helping to identify the organisational and workforce support needed.

Health Profile of England 2009. The Health Profile of England (HpoE) provides national and regional data, which local areas can compare against their own Health Profiles. There is a section of international comparisons. The HPoE is intended for public service professionals and officials within the local community. It outlines the areas which have shown recent improvements as well as areas where challenges remain.

The use of overseas doctors in providing out-of-hours services. This report is an inquiry into the arrangements for out-of-hours general practice.

A high-performing NHS? A review of progress 1997 - 2010. As the general election approaches, the NHS has emerged as one of the most important issues for voters. Using official data, government reports and academic research, this report evaluates the NHS in England from 1997 to 2010.

Health priorities for an incoming government. This report sets out the three areas that The King’s Fund believes the new government should focus on. These are: responding to the financial challenge facing the NHS, improving the quality of health care, and promoting well-being and independence.

London Health Inequalities Strategy. Following consultation, the Mayor has published his first Health Inequalities Strategy. An accompanying 'action plan', First Steps to Delivery, explains how the plan will be delivered.

General Election - 2010 guidance. Sir David Nicholson, NHS Chief Executive, has sent a letter to Chief Executives of NHS Trusts, SHAs and PCTs with information on conduct and procedures during the General Election period. It includes an updated guidance note for NHS organisations and advice on where to direct further queries. The overarching principle is that NHS staff should not be asked to engage in activities which are likely to call into question the political impartiality of their organisation or could give rise to criticism that public resources are being used for party political purposes. it covers issues such as: public appointments, consultations and stakeholder engagement, public meetings, capital expenditure announcements, publicity, handling information requests and external communications.
There is also similar guidance to Arm's Length Bodies Chief Executives.

Fixing NHS IT: a plan of action for a new government. This report maps out an action plan for NHS IT to assist policy makers determine the way forward. It claims that the government could save £1bn by realigning the NHS IT programme and boosting its performance.

Cases
R (March) v Secretary of State for Health [2010] EWHC 765 (Admin) (Admin Ct). The court held that the Government's reason, articulated in answers given by the Secretary of State for Health, for rejecting an independent inquiry's recommendation that ex gratia payments to NHS patients treated with contaminated blood should match the higher level of compensatory payments made by the Irish government had contained a material error of fact and the decision was quashed.

Legislation
National Health Service (Pharmaceutical Services and Local Pharmaceutical Services) (Amendment) Regulations 2010 (SI 2010/914). These regulations, which come into force on 24 May 2010, make amendments to the framework Regulations which govern the provision of NHS community pharmaceutical services. They give effect to the provisions in the National Health Service Act 2006 which require PCTs to develop and publish pharmaceutical needs assessments. The amendments also make some unrelated technical changes to the framework Regulations, including correcting an error which allowed a PCT, in certain circumstances, to grant dispensing rights to a doctor when that surgery is within 1.6km of an existing pharmacy.

News
New patient rights in force. Reports that from 1 April 2010, all NHS patients in England have new legal rights to fast treatment, enshrined in the NHS Constitution. Patients have the legal right to start treatment by a consultant within 18 weeks of GP referral and to be seen by a specialist within two weeks of an urgent GP referral for suspected cancer or, if this doesn’t happen, and where patients request it, the NHS will be legally obliged to take all reasonable steps to offer them a range of alternative providers.

The NHS goes global. The DH has announced the launch of a new organisation, NHS Global, that will help NHS organisations to make the most of the global opportunities on offer. The total global market for healthcare was around $4.1 trillion in 2007 and is growing at a significant rate. NHS Global will build on the success of organisations such as BBC Worldwide, which markets programmes abroad and invests money back into the BBC. Some NHS organisations are already sharing their expertise internationally, such as the NHS Institute and Moorfields Eye Hospital. The Department of Health has begun preliminary work with NHS organisations to bring products to market and will launch a call across the system for further ideas to be submitted for consideration by NHS Global. It will also consult with NHS staff and stakeholders on how to ensure that NHS Global maximises benefit for patients in the UK.

The Centre for Workforce Intelligence (CWI) is to be established to aid social care and NHS bodies deliver more efficient and patient-centred care by helping the bodies plan workforces around changing resources, by reducing bureaucracy and moving as much healthcare as possible from hospitals and into homes and communities. The CWI will: encourage best practice in workforce planning in NHS and social care services; provide research and advice to NHS and social care planners, clinicians and commissioners; ensure those involved in workforce planning contribute to the collection of, and use, high quality data, analysis and modelling; and attain awareness of labour market issues that could have an impact on care pathways.

NHS continues strong performance. Announces the publication of the Quarter 3 (October – December 2009) performance report that shows that the NHS met a number of key commitments on healthcare priorities at the end of last year, and continues to demonstrate strong financial management.

Large variations in medical cover in hospitals at night. Research carried out by the Royal College of Physicians has identified large variations in the provision of medical cover at night, with some doctors being responsible for up to 400 patients. The study, to be published later in the year in Clinical Medicine, examined the makeup of clinical teams in hospitals in England and Wales and the number of patients for which each team was responsible. It found that, at night, doctors were responsible for an average of 61 patients, but the range was from 1 to 400.

Bevan Brittan Training
Healthcare. 17 June 2010 : Location: Interchange Place, Edmunds Street, Birmingham B2 2TA

What does the economy and the election mean for the NHS Estate - London. 11 May 2010 : Registration: 9.30am Seminar 10am - 12.30pm. Location: Fleet Place House, 2 Fleet Place, London EC4M 7RF

What does the economy and the election mean for the NHS Estate - Bristol. 13 May 2010 : Registration: 9.30am Seminar: 10am - 12.30pm. Location: Kings Orchard, 1 Queen Street, Bristol BS2 0HQ

What does the economy and the election mean for the NHS Estate - Birmingham. 19 May 2010 : Registration: 9.30am Seminar: 10am - 12.30pm. Location: Interchange Place, Edmund Street, Birmingham B3 2TA 

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