Health and Social Care Update - October 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	Inquests
Children	Mental Health
Commissioning	Obesity
Employment/HR	Primary Care
Finance	Prison Health
Foundation Trusts	Regulation
Governance	General
Health and Safety

 

Care

Publications/Guidance
Improving health and social care support for carers from black and minority ethnic communities. This briefing paper draws attention to the experience of black and minority ethnic carers in the context of mainstream service provision and recent policy developments such as the National Carers Strategies, service user and carer involvement and the personalisation agenda. It acknowledges that marginalisation is often a consequence of lack of support for both carers and black and minority ethnic communities in health and social care. The paper brings together research evidence and examples of leading practice and emphasises the importance of addressing and not concealing existing inequalities in current changes in policy focus.

Being a young carer in rural England: summary report. This summary report gives details of research conducted with young people aged 11 to 21 years who were living with a family member with a disability and had some caring responsibilities in their families. Interviews were also conducted with local and regional policy managers and frontline support providers working directly with young people or their families in rural England. It offers suggestions to encourage new thinking among practitioners and to provoke innovative, practical solutions for young carers.

End of Life Care Strategy: Second annual report. The End of Life Care Strategy aims to improve care for people approaching the end of life whatever their diagnosis and wherever they are, including enabling more people to be cared for and die at home if they wish. It covers all adults in England with advanced, progressive illness and care given in all settings. In particular it aims to change people’s attitudes towards discussion of death and dying so that they are more comfortable with expressing their wishes and preferences for care at the end of life. The strategy also aims to support the development of services in the community so that people can choose to die at home if that is their preference. This second annual report sets out the continuing progress in implementing the strategy, highlights the need for further work and identifies the action intended for this coming year. It concludes that good progress has been made in improving end of life care but more needs to be done to make sure everyone gets the highest quality of care, in the setting of their choice.

Transforming adult social care delivery support architecture. This paper summarises the national and regional systems in place to support the implementation of the Putting People First, transformation of social care programme. ‘The Putting People First’ (PPF) concordat was published by the Department of Health in December 2007. It sets out information to support the transformation of social care, as outlined in the Health White Paper, Our Health, Our Care, Our Say: a New Direction for Community Services in 2006. It describes the vision for development of a personalised approach to the delivery of adult social care. PPF concordat is an agreement between central and local government and other key organisations about the direction for adult social care for the next ten years and beyond.

Removing the policy barriers to integrated care in England. This briefing paper by the Nuffield Trust uses five case studies of health economies in the English NHS as a basis for examining how local clinicians and managers are working together to develop closer service integration and less fragmented care for patients. The authors conclude that the reforms outlined in the NHS White Paper, such as handing groups of GPs commissioning responsibilities, accompanied by real budgets, have the potential to deliver more seamless care for patients. However, the experiences of the areas studied – Torbay, Nottingham, Redbridge, Trafford and Cumbria – indicate that policy in areas such as GP commissioning and local leadership, competition, incentives and regulation needs to be developed to better support moves towards integration. They also stress the need to involve both clinicians and members of the public in service redesign. The paper focuses on what is facilitating or impeding change and sets out proposals for policy-makers that are designed to enable more rapid progress towards developing better coordinated services. It is intended as a contribution to discussions about the direction health reform should take under the new Coalition Government following the publication of the NHS White Paper.

The Government response to Law Commission consultation paper 192. Review of the law on adult social care. This DH paper sets out the Government's response to the Law Commission's consultation on adult social care (February 2010) which contained detailed proposals for law reform. The Government agrees with the Law Commission that the legislative framework for social care is outdated and needs modernising. This document sets out the Government’s response to the consultation questions. It states that it will need to look closely at how the Law Commission’s final recommendations are implemented and any legislation to take forward reform will need to be set in the wider policy context. In particular, this will include the recommendations of the Commission on the Funding of Care and Support, but also the Government’s commitment to greater local flexibilities and the localism agenda.

Department of Health: Essence of Care 2010. Essence of Care aims to support localised quality improvement, by providing a set of established and refreshed benchmarks supporting front line care. It helps practitioners to take a structured approach to sharing and comparing practice, enabling them to identify the best and to develop action plans to remedy poor practice. This edition supersedes the previous versions originating since 2001.

Still hungry to be heard. Nearly a third (29.4%) of nurses are not confident that it would be noticed if a relative of theirs was malnourished when entering hospital, according to this report which was released as part of Age UK’s Still Hungry to be Heard campaign. The results spark fears that older people are still being left to go hungry in hospital.

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

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Children

Publications/Guidance
National Service Framework for Children, Young People and Maternity Services: Type one diabetes in childhood and adolescence. This guidance describes a care pathway for a child with type one diabetes. The 'patient journey' also provides a starting point for the development of new local strategies for managing complex childhood conditions.

Achieving equity and excellence for children. This discussion paper forms part of the process of engagement with the NHS White Paper, Equity and Excellence: Liberating the NHS. It is not a policy statement or an additional consultation but draws together information from the White Paper and the associated consultation documents to create a vision of how the proposed new arrangements for the NHS could improve services for children and young people. This document begins an ongoing dialogue on how to ensure high-quality services for children and young people. The DH welcomes views on how to achieve the best outcomes for children, young people and families.

Getting it right for children and young people - Overcoming cultural barriers in the NHS so as to meet their needs. This independent review by Sir Ian Kennedy concentrates on understanding the role of culture in the NHS. It focuses on those areas where there are cultural barriers to change and improvement. It examines the NHS’s position in a wider system of care and support, so as to understand and improve the NHS’s provision of services to children and young people. The review has uncovered many cultural barriers standing in the way of improving services for children and young people. These were created, and operate, at a number of levels, from Whitehall, through regional and local organisations, to contacts between individual professionals, and with children, young people and those looking after them. Sir Ian makes several recommendations for improvement.

Guidance on regulating childcare in women's refuges. This Ofsted guidance assists the National Business Unit, inspectors and the Compliance, Investigation and Enforcement Team in carrying out registrations, inspections and compliance investigations of childcare provided in women’s refuges, in line with the protocol with the Women's Aid Federation.

Being a young carer in rural England: summary report. This summary report gives details of research conducted with young people aged 11 to 21 years who were living with a family member with a disability and had some caring responsibilities in their families. Interviews were also conducted with local and regional policy managers and frontline support providers working directly with young people or their families in rural England. It offers suggestions to encourage new thinking among practitioners and to provoke innovative, practical solutions for young carers.

A model for service provision for pregnant women with complex social factors. The care that women should be offered during pregnancy is outlined in NICE clinical guideline 62 ('Antenatal care'). However, pregnant women with complex social factors may need additional support to use antenatal care services. This guideline describes how access to care can be improved, how contact with antenatal carers can be maintained, the additional support and consultations that are required and the additional information that should be offered to pregnant women with complex social factors.

Normal birth as a measure of the quality of care. This report draws together evidence that highlights how giving birth without major medical procedures can be used as a measure of good midwifery care. The report also gives practical actions to guide the planning of service developments which increase opportunities for normal birth - whether at home, in a birth centre or in a hospital setting - without compromising safety or women’s experiences.

£30m funding for children’s palliative care: second round of funding applications. Those organisations that applied for funding through round one have now been notified of the outcome of their application. The second round of funding applications closed on Thursday 30th September. For round two, as with round one, funding for communications activities will be given only a very limited range of circumstances. No communications activities exceeding £25,000 in support of a single project will be funding. Round two will also consider applications from local organisations wanting to host square table discussions, to cover the direct cost of these discussions. Further details on the funding, a template for proposals and frequently asked questions document is also available.

National Child Measurement Programme 2010/11. This letter from the Chief Medical Officer outlines the revised template results letter and media pack produced to support the National Child Measurement Programme 2010/11.

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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Commissioning

Publications/Guidance
Best practice guidance for managing appointment slot issues within Choose and Book. This document is aimed at commissioners and all providers (Acute Trusts, PCTs, the independent sector) with directly bookable services on Choose and Book. It informs them about the process they have to follow when patients, referrers or the National Appointments Lines are unable to book an appointments on Choose and Book because there are no appointment slots available with their chosen provider.

The principles of GP commissioning: a General Practitioners Committee statement in the context of "Liberating the NHS". This statement from the British Medical Association (BMA) outlines their views on what the fundamental principles underlying the development of GP commissioning should compromise. The BMA argue that these principles should be used to define policy, inform debate and negotiations and ensure that good medical practice is enshrined within the proposed White Paper changes to the NHS.

Update on commissioning activity. This paper focuses on the Royal College of General Practitioners' current and future engagement with commissioning, and suggests potential ways to support their members in the delivery of the reforms suggested in the White Paper. It is not a comprehensive review of the White Paper and does not in any way pre-empt the results of the RCGP consultation process on the White paper.

Lord Howe: 'GP commissioning: making it happen'. Transcript of a speech given by the Parliamentary Under Secretary of State for Quality Lord Howe to the King’s Fund on 7 September 2010 in which he talks about the shift of power in commissioning NHS services from PCTs to GP practices.

Draft guidance on NHS commissioning and contracting of adult and neonatal critical care services in 2011-12. From 2011-12, the Department of Health plans to mandate the currencies that all providers and commissioners must use for contracting adult and neonatal critical care services. Commissioners and providers will contract for adult and neonatal critical care services using the Healthcare Resource Group (HRG) currencies. These are based on the adult and neonatal critical care minimum datasets. In advance of the publication of the 2011-12 tariff, this guidance provides further information on implementing a 'national currency : local price' NHS contract for critical care.

GP commissioning consortia: building a better healthcare system for patients. This paper is the first in a series of white papers exploring how GP commissioning consortia can meet the new responsibilities they will face under the proposed government reforms for the NHS. It also suggests how the process of transferring the various tasks and functions from PCTs can be managed. This paper also maps out how sector relationships are likely to change in this new shift from PCTs to GP commissioning consortia.

Letter to all SHA and PCT chief executives about the proposals for GP-led commissioning. This is a letter from Dame Barbara Hakin, National Managing Director of Commissioning. She refers to a letter from Secretary of State for Health Andrew Lansley to GPs about the proposals for GP commissioning, reiterating the intention that the formation of consortia would be a bottom up approach, led by GP practices.

Next steps on GP-led commissioning. The Secretary of State for Health has written this letter to GPs about the proposals for GP commissioning and reiterating the intention that the formation of consortia would be a bottom up approach, led by GP practices.

Bevan Brittan Update
The Health White Paper - Unravelling the commissioning web. The Health White Paper is introducing radical changes in commissioning both in the creation of new commissioning bodies and how commissioning is to be carried out. In this article, John Chapman looks at three fundamental questions that are relevant to both commissioners and providers

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

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Employment/HR

Publications/Guidance
Department of Health: Staff experience. Increasing evidence shows that there is a clear relationship between staff satisfaction and patient satisfaction. It is not possible to provide the highest quality of care for patients without a high quality workforce where the staff can really make a difference. This page gives more information.

Working and training in the National Health Service – a guide for international medical graduates thinking about working or training in the UK. This web-based guidance is aimed primarily at overseas-qualified medical practitioners from outside of the European economic area. NHS organisations can use the guide as part of their recruitment and induction material. The guide aims to make doctors and dentists from outside the UK aware of the opportunities available and to help them understand the immigration processes and requirements. It includes details of sources of further information and where to check for up-to-date details of immigration and other requirements.

A framework for managing staff costs in a period of spending reduction. This paper sets out a framework for effective management of staff costs in a challenging environment of cost reduction in public services. It builds on the high level principles set out in the National Audit Office’s short guide to structured cost reduction.

BMA cohort study of 2006 medical graduates (fourth report). The fourth report of the BMA's Cohort Study, which traces the career progression of 430 medical graduates who qualified in 2006, shows that junior doctors now spend more time carrying out administrative tasks than they do in formal training. The BMA Cohort Study provides information on the career pathways of the first doctors who have come through a new system of training doctors introduced in 2006 created as part of Modernising Medical Careers.

Liberating the NHS: managing the transition. NHS Chief Executive Sir David Nicholson has written to NHS and local authority chief executives and other interested parties providing further information about the proposed changes set out in the NHS White Paper, and the role of leaders in the NHS in the coming weeks and months.
Sir David's communication includes an FAQ document to provide answers to questions that have arisen during recent engagement with the NHS leadership community, a timeline setting out key dates and a list of regional appointments as referenced in his letter.

Preparing for change: implementing the new pre-registration nursing standards. The new standards for education from the Nursing and Midwifery Council provide the framework for pre-registration nurse education programmes and will determine how the future nursing workforce is trained. This briefing outlines the timetable for the change and highlights the roles employers and key partners need to undertake. It provides learning from previous changes to education policy, ideas for ensuring success in your organisation and questions to help you assess how ready you are for the change.

The CIPD, in conjunction with Acas and the Health & Safety Executive, have produced a guide for employers on 'Work Related Stress: What the Law Says'.

Consultations
Equality Act 2010: The public sector equality duty - promoting equality through transparency. The public sector equality duty has a key role in ensuring that fairness is at the heart of public bodies’ work and that public services meet the needs of different groups. The 2010 Act also gives ministers the power to impose specific duties, which are legal requirements designed to help public bodies meet their obligations under the public sector equality duty. This paper seeks views on draft regulations for the specific duties and the list of public bodies that will be subject to the general and specific duties. The consultation closes on 10 November 2010.

Consultation on equality and human rights. The CQC and EHRC are seeking views on draft guidance on equality and human rights for inspectors and assessors to use when they monitor providers according to the CQC's standards and registration requirements. The consultation closes on 12 November 2010.

News
Consultant pay rewards scheme to be reviewed. announces that the Government is to conduct a UK-wide review of the Clinical Excellence and Distinction Awards scheme, first introduced in 1948, which recognises and rewards the exceptional contribution of NHS consultants, over and above that normally expected, to the values and goals of the NHS and to patient care. The review will be led by the independent Review Body on Doctors' and Dentists' Remuneration and has been asked to submit recommendations to the UK Health Ministers by July 2011. The press release includes the terms of reference.

Bevan Brittan Updates
A MARS a day helps you work... The Social Partnership Forum (which comprises the Department of Health, NHS Employers and NHS Trade Union) published, on 2 September, a nationally applicable Mutually Agreed Resignation Scheme (MARS).  The purpose is to assist Trusts in cost and workforce reduction, service redesign and efficiency needs. The scheme will allow employees to agree with their employer to leave Trust employment on specified terms. We have prepared a briefing note which considers how in practice this will work and the options available. Click here to view.

Am I being unreasonable...? Sarah Michael looks at the duty to make reasonable adjustments for disabled employees and job applicants.  How should adjustments be assessed, following recent guidance from the EAT?  How will the requirement to make adjustments change following the introduction of the Equality Act 2010? In particular, how should employers deal with their obligation to make adjustments during the recruitment process, given the new prohibition on asking prospective employees about their health? 

Are you ready for action? At the recent TUC Congress, union delegates backed joint industrial action if "attacks" on jobs, pensions and public services go ahead “to support and co-ordinate campaigning and joint union industrial action, nationally and locally, in opposition to attacks on jobs, pensions, pay or public services".

News round-up September 2010. Tim Woodward takes a look at some of the key provisions of the Equality Act coming into force in October; annual statistics for the EAT; the EAT and reasonable adjustment and lastly Acas and TUC have published a guide on mediation.

Protecting your Business Documents – Privilege after Akzo Nobel. The long awaited decision of the ECJ in the Akzo Nobel case has been handed down, and to no-one’s great surprise, the Court has held that legal advice privilege will not apply to communications between in-house lawyers and their internal clients, at least in the context of competition investigations by the Commission. 

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

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Finance

Publications/Guidance
Improving data quality in the NHS: Annual report on the PbR assurance programme 2010. This Audit Commission report summarises the results of the Payment by Results (PbR) data assurance programme since it began in 2007. For the last three years, the Audit Commission has looked at over £200m worth of payments for inpatient treatments. The report finds that the accuracy of clinical coding has improved since 2007. The coding error rate has dropped from 16%to 11% in three years, which shows that NHS organisations have made real progress in tackling the quality of their data. But there remains wide variation between the best and worst performing trusts, even if the gap is narrowing. Errors are continuing to affect payments. The Commission estimates that of the £21bn spent on the four specialties it's audited for three years, £1bn (5%) was paid wrongly. To continue to improve data quality, the report makes a series of recommendations for PCTs and NHS trusts to consider.

Community Pharmacy Contractual Framework Funding for 2010-11. This letter from Bob Alexander, NHS Director of Finance sets out the implications for the NHS following agreement on the community pharmacy contractual framework 2010/11 funding settlement . The DH states that PCT chief executives will wish to consider the local implications, whilst SHA chief executives may wish to discuss this with their directors of finance.

Community Pharmacy Contractual Framework (CPCF) Funding for 2010/11. This letter from Bob Alexander, NHS Director of Finance sets out the implications for the NHS following agreement on the community pharmacy contractual framework 2010/11 funding settlement . PCT chief executives will wish to consider the local implications, whilst SHA chief executives may wish to discuss this with their directors of finance.

International Financial Reporting Standards (IFRS): learning lessons from the audit of the IFRS-compliant NHS accounts 2009/10. Significant financial report issues arose during the 2009/10 audit of IFRS-compliant NHS accounts. This briefing paper summarises the overall findings of the Audit Commission; it reviews the issues that arose and highlights those that will require particular attention from NHS bodies in the future.

A simple guide to Payment by Results. The aim of this guide is to provide an introduction for newcomers to PbR, from NHS health professionals, managers and administrators, to people engaged in academic study and interested members of the public both in the UK and abroad.

Improving quality and productivity in the NHS whilst facing the financial pressures. This joint statement from the Academy of Medical Royal Colleges, Healthcare Financial Management Association and the NHS Confederation outlines their views about how NHS organisations across the UK can drive quality and productivity whilst facing financial pressures. The statement highlights that it is crucial for the issue to be addressed in ways that are constructive in order to help maintain the gains in quality, access and activity that have already been achieved over the past decade.

Requirement for NHS organisations to publish expenditure over £25,000. This letter informs SHA directors of finance that, as part of the government commitment to greater transparency, there is a requirement to publish online all expenditure over £25,000. They are asked to bring the letter and guidance to the attention of PCTs and NHS trusts in their region.

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

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Foundation Trusts

Publications/Guidance
Progressing to NHS Foundation Trust (FT) status. This letter provides further information on the Secretary of State’s request to Chairs and chief executive for their personal commitment and leadership in bringing their organisations to Foundation Trust status as quickly as possible.

NHS foundation trusts: review of three months to 30th June 2010. Monitor requires each NHS foundation trust board to submit a quarterly report. Performance is monitored against these reports to identify where potential and actual problems might arise. Based on these reports, Monitor assigns each NHS foundation trust with financial and governance risk ratings. These risk ratings are designed to indicate the risk of a failure to comply with the foundation trust’s terms of authorisation. This is the first quarterly report of 2010-11 and is based on data submitted by the 130 NHS foundation trusts authorised at 30 June 2010.

Transforming community services: transactions guidance for NHS Foundation Trusts. This document provides guidance for NHS foundation trusts, which are undertaking ‘Transforming Community Services’ transactions, on Monitor’s regulatory process for reviewing such transactions. It is largely based on Monitor’s Compliance Framework, to which NHS foundation trusts considering transactions should continue to refer.

Key themes from stage two of Monitor’s Annual Plan Review 2010. This paper outlines common themes identified by Monitor which emerged from the second stage of its review of foundation trusts’ annual plans covering the years 2010-11, 2011-12 and 2012-13, which was carried out by independent advisers.

Consultations
Liberating the NHS: Regulating healthcare providers - A consultation. Deadline date: 11 October 2010 This consultation seeks views on foundation trusts and the establishment of Monitor as an independent economic regulator for health and adult social care.

Transparency in Outcomes: A framework for the NHS - A consultation.Deadline date: 11 October 2010. This consultation seeks the views of those working in the NHS, patients and the public in developing the NHS outcomes framework to hold the NHS commissioning board to account for delivering better health outcomes.

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

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Governance

Publications/Guidance
Leadership needs of medical directors and clinical directors. The King’s Fund conducted a survey of clinical and medical directors to find out what skills they believed they need to face future challenges. This report summarises the findings.

The foundations of good governance. In the NHS described by the coalition Government’s recent health white paper, foundation trusts will become even more distinctive within the NHS. They will be the only board-led NHS organisations with unique freedoms to set their own direction and the means by which they will follow it. As a consequence, much more will be expected of them, as laid out in this briefing document.

Improving quality and productivity in the NHS whilst facing the financial pressures. This joint statement from the Academy of Medical Royal Colleges, Healthcare Financial Management Association and the NHS Confederation outlines their views about how NHS organisations across the UK can drive quality and productivity whilst facing financial pressures. The statement highlights that it is crucial for the issue to be addressed in ways that are constructive in order to help maintain the gains in quality, access and activity that have already been achieved over the past decade.

The intelligent board 2010: patient experience. This report challenges NHS boards and non-executive directors to review the way they treat patient experience.

Consultations
Transparency in Outcomes: A framework for the NHS - A consultation.Deadline date: 11 October 2010. This consultation seeks the views of those working in the NHS, patients and the public in developing the NHS outcomes framework to hold the NHS commissioning board to account for delivering better health outcomes.

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

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Health and Safety

Publications/Guidance
Managing serious incidents in National Screening Programmes. This guidance is endorsed by the National Patient Safety Agency and its purpose is to make explicit the requirements for national screening programme related serious incidents and to provide clarity and understanding for all staff providing NHS funded care.

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

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Inquests

Publications/Guidance
Third summary of coroners' reports to prevent future deaths. Summary of reports by coroners to prevent future deaths and responses from organisations. This publication gives details of coroners’ reports and responses received from organisations asked to consider action to prevent future deaths during the period between 1 October 2009 and 31 March 2010.

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
Community mental health survey results. The Care Quality Commission have published the results of a survey looking at the experiences of more than 17,000 people who had contact with specialist community mental health services between July and September 2009. According to the survey, the majority of respondents are generally very positive about the health and social care worker they had seen most recently for their mental health condition. However, the findings also show that some had not been involved as much as they would have liked in some aspects of their care.

Improving Access to Psychological Therapies (IAPT) year one sites data review. Improving Access to Psychological Therapies is a programme designed to make psychological therapies for common mental health problems widely available. Following pilot work in Doncaster and Newham, the first wave of rollout sites started operation in 2008. This report is a study of their work in the year from October 2008 to September 2009. Allowing for varying start times, this was roughly their first full year of operation.

Cross-border Transfers of Patients Under the Mental Health Act. This document outlines the considerations for the transfer of a patient from England to Scotland, Northern Ireland, the Channel Islands or the Isle of Man.

Section 67 of the Mental Health Act. One document on this page outlines the Secretary of State for Health's discretionary power to refer cases involving certain patients to the First-tier Tribunal. Another sets out when patients and their relatives may apply.

Patterns of specialist mental health service usage in England. This report analyses mental health service usage by age and gender, and by region/sub-region. The data comes from an administrative source, the Mental Health Minimum Dataset, which provides information on the number of people aged 18 and above who were in contact with NHS specialist mental health services in a year.

World Alzheimer report 2010: the global economic impact of dementia. Dementia costs the world $604 billion a year - 1% of the global GDP - according to this report. The figures, published by Alzheimer's Disease International, also suggest that there will be a further 85% increase in costs by 2030 as the number of people with dementia continues to rise.

Quality Outcomes for People with Dementia: Building on the work of the National Dementia Strategy. This document presents the department’s revised implementation plan for ‘Living well with dementia: A National Dementia Strategy’, which was published in February 2009. It updates the previous implementation plan for the strategy published in July 2009.

Prison mental health: vision and reality. This publication aims to examine what has been achieved in prison mental health over recent years from a number of different personal perspectives and individual observations of working in England. It looks at the specific achievements of inreach teams and of efforts to divert offenders from custody. It also looks more broadly at the rapid growth of the prison population during the same period and the treatment of offenders with mental health problems outside as well as inside prison.

Consultations
Psychosis with substance misuse: guideline consultation. A clinical practice guideline on Psychosis in conjunction with substance misuse: the assessment and management of psychosis with substance misuse is being developed for use in the NHS in England, Wales and Northern Ireland. Registered stakeholders for this guideline are invited to comment on the provisional recommendations via this website. Individuals and organisations not registered as stakeholders are not able to comment. NICE recommends that you register as a stakeholder or you contact the registered stakeholder organisation that most closely represents your interests and pass your comments to them. Consultation dates: 10 August – 5 October 2010.

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

Bevan Brittan Online Resources
NEW! Bevan Brittan Mental Health Portal. Bevan Brittan has a wealth of mental health knowledge it would like to share with clients. We have therefore developed an online resource which has been designed to bring various sources of mental health information and guidance into one place. The aim is simple - to keep professionals in mental health up-to-date with what is happening in an ever changing landscape. If you would like more information please contact Claire Bentley.   

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Obesity

Publications/Guidance
Shedding the pounds: obesity management, NICE guidance and bariatric surgery in England. This report details the results of an exercise undertaken by the Office of Health Economics looking at trends in obesity, current provision of bariatric surgery in England with particular reference to the NICE clinical guideline for obesity, and potential economic benefits that could be achieved through adherence to the NICE guideline.

News
Surgery for obese could 'save millions of pounds.' Following NICE guidance on bariatric surgery could save the economy hundreds of millions of pounds and the NHS around £56 million every year, leading surgeons have said.

A woman has succeeded in a landmark attempt to force the NHS to fund her gastric bypass operation. Berkshire East Primary Care Trust originally refused to offer Hazel Kent the operation as her body mass index was too low, but has now agreed to fund the operation after she threatened legal action.  

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

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Primary Care

Publications/Guidance
Best practice guidance for managing appointment slot issues within Choose and Book. This document is aimed at commissioners and all providers (Acute Trusts, PCTs, the independent sector) with directly bookable services on Choose and Book. It informs them about the process they have to follow when patients, referrers or the National Appointments Lines are unable to book an appointments on Choose and Book because there are no appointment slots available with their chosen provider.

The principles of GP commissioning: a General Practitioners Committee statement in the context of "Liberating the NHS". This statement from the British Medical Association (BMA) outlines their views on what the fundamental principles underlying the development of GP commissioning should compromise. The BMA argue that these principles should be used to define policy, inform debate and negotiations and ensure that good medical practice is enshrined within the proposed White Paper changes to the NHS.

Lord Howe: 'GP commissioning: making it happen'. Transcript of a speech given by the Parliamentary Under Secretary of State for Quality Lord Howe to the King’s Fund on 7 September 2010 in which he talks about the shift of power in commissioning NHS services from PCTs to GP practices.

Effective use of vaccines. This letter aims to inform SHA and PCT Immunisation leads on the work done on VESPA (Vaccine Efficiency Savings Programme Audit) and advises of future developments.

Midwifery 2020: delivering expectations. The Midwifery 2020 programme was commissioned in 2008 by the Chief Nursing officers for England, Wales, Northern Ireland and Scotland. This document is the final report of the programme. It underpins the vision of how midwives can lead and deliver care in a changing health care environment, reflecting policy and service direction. It also identifies the changes required to the way that midwives work, their role, responsibilities, education and/or professional development to meet the vision.

General Practitioners Committee guide to the NHS White Paper - GP consortia commissioning: initial observations. This document sets out how GPs in England could progress with making consortia arrangements. This guidance covers areas such as: determining commissioning population size, responsibilities and governance, funding and budget setting and ensuring probity.

The impact of incentives on the behaviour and performance of primary care professionals. This report is the result of a study on the influence of incentives on the behaviour of primary care professionals. Using incentives can produce benefits for patients but it may also have complex and unintended outcomes. The aim of this study is to produce evidence to help policy makers design incentive structures which help to maximise outcomes for patients.

GP commissioning consortia: building a better healthcare system for patients. This paper is the first in a series of white papers exploring how GP commissioning consortia can meet the new responsibilities they will face under the proposed government reforms for the NHS. It also suggests how the process of transferring the various tasks and functions from PCTs can be managed. This paper also maps out how sector relationships are likely to change in this new shift from PCTs to GP commissioning consortia.

Letter to all SHA and PCT chief executives about the proposals for GP-led commissioning. This is a letter from Dame Barbara Hakin, National Managing Director of Commissioning. She refers to a letter from Secretary of State for Health Andrew Lansley to GPs about the proposals for GP commissioning, reiterating the intention that the formation of consortia would be a bottom up approach, led by GP practices.

Next steps on GP-led commissioning. The Secretary of State for Health has written this letter to GPs about the proposals for GP commissioning and reiterating the intention that the formation of consortia would be a bottom up approach, led by GP practices.

Department of Health: What to expect after vaccinations. This leaflet explains the common side-effects of vaccinations that might occur in babies and young children up to five years of age. It is intended for nurses and other immunisation practitioners to download and print out for parents and guardians when their children are being immunised.

Delays in deliveries of seasonal influenza vaccine 2010. This letter informs GP surgeries that there has been delays in deliveries of some seasonal influenza vaccines due to packaging problems. Affected surgeries should in the first instance try to reschedule their clinics in line with the updated delivery schedules. Failing that, surgeries should try to contact other flu manufacturers to see if they can provide stocks to cover clinics planned for October.

Consultations
Liberating the NHS: Commissioning for patients - Consultation on proposals. Deadline date: 11 October 2010 This consultation seeks views on how proposals for putting local GP practices in charge of commissioning services, to best meet the needs of local people, should be implemented.

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
Prison mental health: vision and reality. This publication aims to examine what has been achieved in prison mental health over recent years from a number of different personal perspectives and individual observations of working in England. It looks at the specific achievements of inreach teams and of efforts to divert offenders from custody. It also looks more broadly at the rapid growth of the prison population during the same period and the treatment of offenders with mental health problems outside as well as inside prison.

The Patel report: reducing drug-related crime and rehabilitating offenders. A report by Professor Lord Patel of Bradford OBE, chair of the independent Prison Drug Treatment Strategy Review Group has been produced on drug treatment and interventions in prison and has been submitted to Ministers in the Home Office, the Ministry of Justice and the Department of Health in response to the drug strategy consultation. The report focuses on drug treatment and interventions for people in prison, people moving between prisons and the continuity of care for people on release from prison. The report outlines the evidence gathered and work carried out by the Review Group and summarises their conclusions and recommendations.

The CIPD, in conjunction with Acas and the Health & Safety Executive, have produced a guide for employers on 'Work Related Stress: What the Law Says'.

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

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

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Regulation

Publications/Guidance
Analysis of consultation on assessments of quality in 2010-11. This report presents the analysis of a consultation on the framework for Care Quality Commission assessments of health and social care commissioners in 2010-11 and beyond.

Consultations
Liberating the NHS: Regulating healthcare providers - A consultation. Deadline date: 11 October 2010 This consultation seeks views on foundation trusts and the establishment of Monitor as an independent economic regulator for health and adult social care.

Consultation on equality and human rights. The CQC and EHRC are seeking views on draft guidance on equality and human rights for inspectors and assessors to use when they monitor providers according to the CQC's standards and registration requirements. The consultation closes on 12 November 2010.

Public service ombudsmen. The Law Commission is conducting a review of the law relating to the public services ombudsmen. This consultation paper contains detailed provisional proposals for reform. The consultation period will run until 3 December 2010.

News
Registration support for providers of dental services. Announces that the CQC is extending its national contact centre's opening hours and publishing new guidance on registration to help support primary dental providers preparing to apply for registration. All providers have to be registered from 1 April 2011. The Newcastle-based centre will now open from 8.30am to 8pm Monday to Thursday, from 8.30am to 5.30pm on Friday and from 8am to 4pm on Saturdays. CQC has also issued new guidance for the providers of primary dental services that provides more information on the application process, which has been refined following a series of pilot projects. CQC is expecting applications from more than 8,500 providers.

Bevan Brittan Updates
The Health White Paper - A New Regulatory Order? The Health White Paper makes a commitment to move to a new system of control based on economic and quality regulation, and commissioning and payment by results, instead of national and regional management. At the same time, the Government has indicated a clear intention to significantly reduce the overall burden of regulation in both the health and social care sectors. Neil Grant examines the proposed regulatory changes, looking at the key objectives behind the reforms, how the new regulatory landscape will look and operate, and when the changes will come into effect. 

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

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General

Publications/Guidance
Regional Trauma Networks: Clinical Advisory Group document. This report contains advice on the planning and designing of networks by the NHS Clinical Advisory Groups for major trauma to their colleagues in the NHS. The report is hosted on the East Midlands Strategic Health Authority website, along side other relevant supporting information.

Protocol for ordering, storing and handling vaccines. This protocol applies to all staff involved in immunisation. It aims to ensure that vaccines are stored and managed properly so that immunisation is carried out safely and efficiently.

On the face of it: a review of the organisational structures surrounding the practice of cosmetic surgery. This report reviews variations in organisational structures surrounding the practice of cosmetic surgery and takes a critical look at areas that have been identified where the organisation of care of cosmetic surgery patients can be improved. It investigates policies surrounding advertising and consent; the structure and case-mix of teams providing cosmetic surgery, the number and types of procedures performed; the provision of post-operative follow-up; policies, facilities and protocols and policies for clinical audit.

NHS car parking: response to consultation. Sets out the Government's response to the consultation on the implementation of free NHS hospital car parking for inpatients, which looked at a limited range of options around a premise of mandatory free parking for the majority of patients or visitors to NHS hospitals. The Government considers that the introduction of widespread free parking would have adverse consequences including congestion and capacity problems, and lack of future investment, that would compromise the convenient access that people say is their most important need. It considers that Trust boards should continue to be responsible for developing local parking policies that reflect the circumstances of their location and the needs of the local community. The Government does, however, see the provision of appropriate concessions for patients whose healthcare needs require extended access to hospitals as fundamental to a patient centred NHS. This response sets out a number of levers through which it believes that such fair policies can be supported and maintained, and challenges hospital trusts collectively and individually to review their current policies to ensure that they are consistent with these principles and standards.

Moving beyond sponsorship: Interactive toolkit for joint working between the NHS and the pharmaceutical industry. To enable NHS organisations and the pharmaceutical industry to work together in the interests of patients, the Ministerial Industry Strategy Group recommended that the Department should develop an interactive toolkit to support joint working so as to improve patient outcomes. The purpose of this toolkit is to encourage NHS organisations and staff to consider joint working as a realistic option for the delivery of high-quality healthcare and a way to drive efficiency in the delivery of services in both primary and secondary care, and to provide the necessary information and have easy access to the tools which will help to enter into joint working. The initial version of the toolkit was published in March 2008. Following feedback from users, the toolkit has been updated to include some new templates as well as more examples of good practice for reference. This toolkit should be used in conjunction with the document "Best practice guidance for joint working between the NHS and the pharmaceutical industry".
The templates are all available on the DH website.

Community engagement report for the Health Foundation. This report looks at how communities are defined and addresses barriers that some communities face when accessing health services. There is a key focus on maternity, where the report finds there are specific obstacles around engagement.

Engaging communities for health improvement: a scoping study for the Health Foundation. A community engagement project involves talking to people in different communities about what they want and need from their healthcare services. This report looks at community engagement projects and provides some ideas about what can make them work well.

Pillars of the community: the RCN's UK position on the development of the registered nursing workforce in the community. This policy statement highlights 27 core conditions that the Royal College of Nursing believes should be satisfied for community services to survive and develop as more care is delivered closer to home, while helping health services throughout the UK to become more efficient.

Adaptation to climate change in NHS organisations: what you need to know. This guidance summarises the current knowledge on adapting to climate change in NHS organisations. It describes what climate change adaptation is, why it is a priority for the NHS and how organisations can include adaptation in their Sustainable Development Management Plans.

'Equity and Excellence: Liberating the NHS' - opportunities and challenges. In this commentary paper, the Bow Group Health Policy Committee outline their response to Equity and Excellence: Liberating the NHS – the Health White Paper, which sets out the Government's long-term vision for the future of the NHS in England. The analysis focuses on five key areas, which feature prominently in the White Paper. These include GP commissioning, quality and outcomes, public health, efficiency savings and QUANGOs, and value and innovation.

Telehealthcare toolkit. This is a support aid for NHS staff to help make a viable business case for the introduction of new technology to assist with the provision of healthcare in the home. This toolkit gives suggestions, information and advice about how to make ideas for technological changes in home healthcare provision become a reality.

Meeting the healthcare needs of veterans: a guide for general practitioners. The Royal College of General Practitioners, The Royal British Legion and Combat Stress have launched guidance to support GPs in identifying and meeting the healthcare needs of veterans more effectively - including accessing the priority treatment to which all veterans are entitled for service-related conditions.

Rising to the challenge: creating momentum through QIPP in the new NHS. This guide is provided as a practical resource for healthcare professionals to help them prepare for and, most importantly, deliver the improvements in efficiency and performance required by all UK healthcare organisations.

Consultations
Equality Act 2010: The public sector equality duty - promoting equality through transparency. The public sector equality duty has a key role in ensuring that fairness is at the heart of public bodies’ work and that public services meet the needs of different groups. The 2010 Act also gives ministers the power to impose specific duties, which are legal requirements designed to help public bodies meet their obligations under the public sector equality duty. This paper seeks views on draft regulations for the specific duties and the list of public bodies that will be subject to the general and specific duties. The consultation closes on 10 November 2010.

News
111 - The new number for the future of non-emergency health services. Announces the launch of the NHS 111 service, which guides patients to a locally available service or provides appropriate advice and information 24 hours a day, 365 days a year. The number can be used when someone needs help fast but it is not life threatening, or when they do not know who to call. The new 111 service has been launched initially in County Durham and Darlington; calls are handled by North East Ambulance Service NHS Trust, who also handle 999 calls. It will also be launched in three other pilot areas in 2010: Nottingham City, Lincolnshire, and Luton. A full assessment of the service in these areas will guide the national roll out of the NHS 111 service.

Government implements saving ideas submitted through the Spending Challenge. Announces that three ideas submitted to the Spending Challenge by members of the public and public sector workers will be implemented as policy by the Government. One of the ideas being implemented is to reduce the number of CRB checks for junior doctors by taking a more commonsense approach across the NHS, so that junior doctors are not checked repeatedly over a short space of time. This will save up to a £1m a year and cut administrative burdens for the NHS.

The GBP 12.7 billion scheme to give every patient in England an electronic medical record will cease to be a centralised national programme and will be devolved to the NHS.

The Government announced on September 16, 2010 that patients in England will continue to pay for hospital car parking, refusing to back a promise made by the previous Government to scrap the charges in England. This is the government's response to the consultation on the implementation of free NHS hospital car parking for inpatients.

Bevan Brittan Training
Medical Law seminar. 12 October 2010 : Registration: 9.15am, Seminar 9.30am - 11.30am. Location: Fleet Place House, 1 Fleet Place, Holborn Viaduct London EC4M 7RF. Click here for more information.

Complaints and claims forum. 01 December 2010 . Location: Fleet Place House, 2 Fleet Place, Holborn Viaduct, London EC4M 7RF. Further details to follow.
register your interest in this event.

Bevan Brittan Online Resources
NEW! Bevan Brittan Mental Health Portal. Bevan Brittan has a wealth of mental health knowledge it would like to share with clients. We have therefore developed an online resource which has been designed to bring various sources of mental health information and guidance into one place. The aim is simple - to keep professionals in mental health up-to-date with what is happening in an ever changing landscape. If you would like more information please contact Claire Bentley.    

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

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