Health and Social Care Update - March 2011

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.

07/03/2011

Claire Bentley

Claire Bentley

Associate

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   Information Law
  Children   Inquests
  Clinical Management   Mental Health
  Clinical Research   Primary Care
  Commissioning   Prison Health
  Employment/HR   Regulation
  Finance   General
  Health and Safety  

 

Care

Publications/Guidance
Care and compassion? Report of the Health Service Ombudsman on ten investigations into NHS care of older people. This report is based on the findings of ten independent investigations into complaints about NHS care for people over the age of 65 across England. It serves to illuminate the gulf between the principles and values of the NHS Constitution and the felt reality of being an older person in the care of the NHS in England. The Ombudsman’s findings show how ten older patients suffered unnecessary pain, indignity and distress while in the care of the NHS. Her investigations highlight common failures in pain control, discharge arrangements, communication with patients and their relatives and ensuring adequate nutrition. The Ombudsman concludes that "the NHS must close the gap between the promise of care and compassion outlined in its Constitution and the injustice that many older people experience. Every member of staff, no matter what their job, has a role to play in making the commitments of the Constitution a felt reality for patients."

Talking about end of life care: right conversations, right people, right time. This is the final report from the communication skills pilot project, which funded pilot sites to explore training need, provision, strategy and sustainability. The pilots carried out a training needs analysis, reviewed existing provision and benchmarked it against national competences. They then used a needs-based approach to develop new training plans. This report highlights the project’s findings and identifies key messages.

First aid for hospital food. This report states that some hospitals are falling short of acceptable standards with regards to the food served to patients. It provides several examples where hospitals have proved that it is possible to source fresh, local and organic food with no impact on cost and makes recommendations as to how other hospitals can achieve this.

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

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Children

Publications/Guidance
Health Visitor Implementation Plan 2011-15: a call to action. Sets out the full range of services that families, depending on their needs, will be able to expect from health visitors and their teams. The Implementation Plan addresses concerns that many health visitors feel undervalued and sets out what needs to be done to turn this around. It provide further detail on the ambition to increase overall numbers of health visitors by 4,200 by April 2015, and the action required in 2011/12. The Plan also reinforces the importance of the relationship between Sure Start children's centres and health visitors.

£30m funding for children's palliative services: details of successful first and second round applications. The Department of Health received in excess of 370 applications and funding of over £19m has now been allocated. All organisations that applied for this funding in Round 1 and Round 2 have now been notified of the outcome of their applications.

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

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Clinical Management

Publications/Guidance
Eliminating mixed-sex accommodation – Declaration exercise. This letter to NHS Chief Executives gives advice on how Trust Boards must comply with the requirement in the NHS Operating Framework that all providers of NHS funded care confirm whether they are compliant with the national definition "to eliminate mixed sex accommodation except where it is in the overall best interests of the patient, or reflects their patient choice". Those organisations that either do not make a declaration or declare they are not compliant will face penalties. Declarations must be made by 1 April 2011 and must be clearly visible on the Trust's website. The letter provides templates as examples of the wording in compliance statements.

Bevan Brittan Updates
Expert shopping - disclosure of earlier expert reports. Commentary by Adrian Neale on the recent case of Ricky Edwards- Tubb v J D Weatherspoon plc.

Events -

Practical Approaches to Implementing Effective Obstetric Practices and Adopting Risk Management Strategies to Successfully Defend Negligence Claims. This is an external event hosted by C5, for more information, please visit www.C5-Online.com/obstetricPenelope Radcliffe from Bevan Brittan is one of the speakers at this conference and her session is on  "When do Obstetric Complications Lead to Successful Claims?"

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

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Clinical Research

News
Lord Howe announces International Register for Health Research. Announces the launch of PROSPERO, the prospective register of systematic reviews of health and social care interventions, which the first online facility to register systematic reviews for research about health and social care from all around the world. The international register is designed to avoid the duplication of health research and will act as a guard against selective reporting of research. The register is completely free and open to the public. It was started by the National Institute for Health Research (NIHR) Centre for Reviews and Dissemination (CRD) which is funded by the DH.

New agreement launched to streamline research collaboration between life sciences industry, universities and the NHS. Announces the launch of the model Industry Collaborative Research Agreement (mICRA) between the pharmaceutical and biomedical industries, universities and the NHS that will help research studies involving industry, universities and the NHS to start faster by shortening the negotiation and contracting process. The model agreement has been drafted to allow it to be used as a template for contracts covering any or all stages of clinical research undertaken collaboratively, from early proposals for collaboration and throughout.

New public health school launched. The Public Health Minister has launched the National Institute for Health Research School for Public Health Research that is designed to build closer relations between researchers and practitioners across Public Health England and local authorities. The school will place an emphasis on what works practically and can be applied across the whole of England and will comprise leading academic centres of applied public health research. The competition for funding is open to academic institutions with a proven track record in applied research and evaluative practice in public health. Each member of the school will receive up to £500,000 a year.  

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

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Commissioning

Publications/Guidance
The procurement of consumables by NHS acute and foundation trusts. This report reveals that NHS hospitals often pay more than they need to when buying basic supplies. The National Audit Office attribute this to a combination of inadequate information and fragmented purchasing, resulting in a procurement process which represents poor value for money. The report estimates that at least £500m a year could be saved on consumable spending within the NHS.

An introduction to procurement and competition for GP commissioners. Procurement and competition rules have increasingly impacted on how the NHS operates and particularly on the commissioning of clinical services. The aim of this briefing is to provide an initial overview of these rules and some of the ways in which they can be used to best effect. It is designed for individuals with an interest in GP-led commissioning and who wish to understand more about the relevance and the importance of procurement and competition to their current or future roles.

Delivering health ambitions better for less: commissioning for sexual health. This document states that commissioning effective sexual health services can significantly reduce physical and emotional ill health whilst providing over £16m of regional cost savings to the NHS. This document includes recommendations for commissioners which will help improve quality and reduce cost including: health professionals having the knowledge and skills to offer women seeking contraception an informed choice and access to long-acting reversible methods; prevention and early diagnosis of sexually transmitted infections including HIV; and effective measures to reduce rates of repeat abortions. 

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
Vetting & Barring Scheme Remodelling Review – Report and recommendations. This Home Office report sets out the findings of a review of the Vetting and Barring Scheme (VBS) under the Safeguarding Vulnerable Groups Act 2006, following concerns that the Scheme was a disproportionate response to the risk posed by a small minority of people who wished to commit harm to vulnerable people. It concludes that employers have a critical role to play in ensuring safe recruiting practices but that this should be supported by a proportionate central barring scheme. It recommends a revised Scheme that retains the best features of the VBS, but will not require registration or monitoring and will only cover those who may have regular or close contact with vulnerable groups, defined as "regulated activity" in legislation. The proposed changes are set out in the Protection of Freedoms Bill, which has received its 1st Reading in the Commons.

Managing sickness absence in the NHS. The Audit Commission has published a briefing that examines the local variation and cost of sickness absence to PCTs, NHS trusts and foundation trusts. It sets out where organisations can find more help and advice in cutting sickness absence rates. It found that levels of staff sickness absence in the NHS vary dramatically across the country, with the North of England showing the highest levels. By understanding and tackling the factors causing some of this variation, the NHS could increase staff productivity, improve morale and save £290m. The briefing also points to the guidance available to help managers tackle sickness absence

Department of Health people survey results 2010. This survey is part of the annual Civil Service Survey, looking at levels of staff satisfaction in the Department of Health. It is the largest of its kind in Britain, involving nearly 400,000 staff from across the Civil Service.

Bevan Brittan Updates
Online defamation: Q&A. In these times of austerity, many public bodies are making very difficult decisions which impact on staff and service users. The increased level of awareness and scrutiny of these decisions, coupled with the prevalence of social networking sites and online forums, means that public bodies are fighting a daily battle against critical comments posted online, some of which stray into the realms of libel. Here are the most common questions we receive from our public sector clients about this issue, together with our answers.

Out with old? FAQs on the repeal of the DRA. The default retirement age is being pensioned off this year and employers have not been given much time to prepare. Nicola Stibbs answers ten frequently asked questions about the repeal of the default retirement age, which is being phased out from April.

Repeal of the DRA – important change to regulations. The default retirement age (DRA) is due to be abolished next month.  The government has today published new regulations on the transitional arrangements for the repeal of the DRA which dramatically change the previous transitional arrangements.

Employment news round-up - February 2011. Chloe Edwards provides a summary of employment law news, including information on employment tribunal reform, Trevor Phillips’ ‘Really Bad Guys’, and the latest on the Bribery Act and a new Acas discussion paper on the future of employee relations.

Knowledge and power. Francis Bacon said that “knowledge is power”, but if an employer delegates the power to dismiss to a manager, to what extent is that manager deemed to have knowledge of all the relevant facts?  Accordingly to the Court of Appeal, a manager undertaking a dismissal is not deemed to know everything that is known to the employer generally, or all its employees. John Moore reports. 

Bevan Brittan Events
Bevan Brittan is running a series of seminars at each of its offices on managing redundancies in line with equalities legislation, including the new public sector duty to promote equality. For more information and booking details, please email sam.russe-jones@bevanbrittan.com 

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

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Finance

Publications/Guidance
NHS pricing transparency: Do you know how much you are paying for clinical goods? This letter from Jim Easton provides examples of variance of prices paid for products. He invites NHS Trusts to consider joining a benchmarking club to find out what prices are being paid elsewhere in the NHS. Being transparent about prices paid is an important first step to making savings across the service. A new procurement diagnostic tool, produced in collaboration with the Foundation Trust Network, is also available, allowing NHS Trusts to identify procurement strengths and weaknesses immediately, and explaining how to improve procurement to make savings.

Directions concerning all transactions involving property 2011. This letter from David Flory, Deputy NHS Chief Executive, contains directions to Strategic Health Authorities and Primary Care Trusts pursuant to sections 8 and 272(8)(b) of the National Health Service Act 2006 (the 2006 Act).

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

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Health and Safety

Publications/Guidance
The 'Never Events' list for 2011/12. "Never events" are very serious, largely preventable patient safety incidents that should not occur if the relevant preventative measures have been put in place. This paper sets out the list for use in the NHS in 2011/12 and provides further guidance for how the "never events" policy should be implemented. It should be used in conjunction with the NHS Standard Contracts 2011/12. There are 25 "never events" on the expanded list, including the original eight events from previous years, some of which have been modified, and building on the draft list published in October 2010.

Bevan Brittan Updates
Are your "Sharps" policies and procedures up to scratch? Over 1 million needlestick injuries are estimated to occur in the EU each year. These injuries are gaining increasing recognition as a major hazard on the health and safety horizon. They are the most frequent occupational hazard for nurses, doctors and other healthcare workers  and have the potential to have devastating consequences. In addition, needlestick injuries are estimated to cost each NHS Trust around £500,000 per year. 

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Information Law

Publications/Guidance
How health systems make available information on service providers: experience in seven countries. This report reviews and discusses information systems reporting on the quality or performance of providers of healthcare ('quality information systems') in seven countries: Denmark, England, Germany, Italy, the Netherlands, Sweden and the United States. Data collection involves a review of the published and grey literature and is complemented by information provided by key informants in the selected countries using a detailed questionnaire. Quality information systems typically address a number of audiences, including patients (or respectively the general public before receiving services and becoming patients), commissioners, purchasers and regulators.

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

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Inquests

Cases
Forrest v (1) Lord Chancellor (2) Lord Chief Justice [2011] EWHC 142 (Admin) (Admin Ct). The court held that in circumstances where members of a coroner's administrative staff were employed by a local authority, he did not have exclusive powers over them. His erroneous view of the legal relations between him, his staff and the local authority had led him to behave in a high-handed and aggressive manner which was not compatible with his continuing as a coroner.  

Bevan Brittan Events
Bevan Brittan is running an Inquest law update seminar in the London office on 15 June 2011 from 9am -12.30pm. More information will be available in the next HSC Update.

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
No health without mental health. The cross-Government Mental Health Outcomes Strategy was launched on 2 February 2011. Key points are:

  Strategy intends to mainstream mental health and reduce stigma;
  It places the emphasis on early intervention and prevention. Key to reducing the estimated £105 billion annual cost of mental ill-health to the economy is to intervene early to stop problems developing and to prevent illness through public mental health and well-being actions;
 The strategy is intended to enable more decisions to be taken locally, with people having more choice and information to meet their individual needs;
 Children and teenagers who show signs of anxiety and depression are to be offered talking therapies. £400m has been set aside for extending the adult programme across England by 2015 and for developing an equivalent treatment model for children.  

The Government hopes that this strategy will ensure that by 2014:

 more people will have good mental health;
 more people with mental health problems will recover;
 more people with mental health problems will have good physical health;
 more people with mental health problems will have a positive experience of care and support;
 fewer people will suffer avoidable harm; and
 fewer people will experience stigma and discrimination. 

See also the supporting documents:

 Call to action. Mental health problems affect one in four people at some time. As well as being a major cause of distress for individuals and their families, they cost society an estimated £105bn every year through lost productivity and avoidable costs for the criminal justice system, as well as the costs of care and support. The signatories to this statement recognise there is an urgent need for co-ordinated action and pledge to work together to deliver the shared objectives in the Government’s mental health outcomes strategy;
 Impact assessment. Describes interventions based on work by the London School of Economics and sets out their expected cost savings for the NHS, and the wider public sector, of the mental health outcomes strategy, No Health Without Mental Health.
 Delivering better mental health outcomes. Describes in detail the shared objectives to achieve better mental health and well-being, and the interventions needed in each case;
 The economic case for improving efficiency and quality in mental health. Outlines the opportunities to make value for money savings in delivering mental health services using the quality, innovation, productivity and prevention approach, and by promoting early intervention and prevention of mental health problems;
 Talking Therapies: A four-year plan of action. Outlines how the Government’s commitment to expanding access to psychological therapies will be delivered in the four years from April 2011, with business continuity during structural reform of the NHS. There is also an Impact assessment that presents evidence of the estimated costs and benefits of the Government’s expansion of talking therapies arising from the 2010 Comprehensive Spending Review.

Post-traumatic stress disorder treatment for services veterans. The National Assembly for Wales' Health, Wellbeing and Local Government Committee has issued a report that examines the adequacy and suitability of services in Wales for veterans of the armed services suffering from post-traumatic stress disorder (PTSD). It identifies problems with the identification of PTSD in veterans, a lack of data, and inadequate and inappropriate services for veterans with PTSD. The report states that gaps in veterans’ medical notes caused by the Ministry of Defence (MoD) failing to disclose information are resulting in many veterans with PTSD being misdiagnosed by GPs. The Committee’s inquiry found that ex-service patients suffering from PTSD are often not asked the right questions by healthcare professionals because crucial pieces of information are missing from their files. Although defence organisations consider these notes to be confidential, proper provision of them could significantly speed up the diagnosis of PTSD. It calls on the Welsh Government to work with the MoD to ensure that this information is transferred, with an opt-out system for veterans who request one. The report also highlights the prevalence of substance misuse amongst veterans and the incidence of this and PTSD co-occurring. It recommends that the Welsh Government ensures that veterans with PTSD also have timely access to substance misuse treatment.

Working with personality disordered offenders: A practitioners guide. Guidance by the National Offender Management Service advises on working with personality disordered offenders, explaining how to manage people and the impact on staff wellbeing. The guidance is particularly relevant to those dealing with offenders presenting a high risk of committing violent or sexual offences.

Efficiency in mental health services: supporting improvements in the acute care pathway. This briefing provides a guide to support local mental health communities to gain a better understanding of their local acute care pathway for adult mental health and, where necessary, to help come up with solutions that provide better value for money. It focuses on how organisations can use benchmarked data on bed usage, with additional local data where appropriate, to improve the efficiency of the acute care pathway. It has been designed for use in any mental health system, wherever they are on the performance scale and whatever their service configuration and their demographic and geographical circumstances.

The Government's response to 'Raising our sights: services for adults with profound intellectual and multiple disabilities', a report by Professor Jim Mansell. The Government has published its response to 'Raising our sights: services for adults with profound intellectual and multiple disabilities', by Professor Jim Mansell (March 2010). Professor Mansell's report responded to concerns raised in the consultation for 'Valuing people now', that needs were not sufficiently being addressed for adults with profound intellectual and multiple disabilities.

The NHS standard contracts for acute hospital, mental health, community and ambulance services and supporting guidance 2011-12 (effective from 1 April 2011). DH has published the new NHS Standard Contracts for Acute Services and for Mental Health and Learning Disability Services that apply to all new agreements from 1 April 2011. The contracts support and reflect the NHS Operating Framework for 2011/12 and should be read in conjunction with the Principles and Rules for Co-operation and Competition and the PCT Procurement Guide. The NHS standard contracts cover agreements between PCTs and all of provider delivering NHS funded services. Deeds of Variation for the 2009-10 and 2010-11 contracts will be published shortly, and also new standard contracts for Community Services and Care Homes.

Proposals on changes to the Office of the Public Guardian fees in 2011/12. A consultation on the Office of the Public Guardian (OPG) fees 2011/2012 which aims to ensure that the OPG fee policy remains fair, equitable and proportionate to the services being provided whilst at the same time reflecting the current economic climate. The proposed changes will help ensure that the fee structure remains fair and equitable whilst fully covering OPG costs. Views are now being sought - the consultation closes on 21 May 2011.

Mental health promotion and prevention: The economic case. This helped the Department of Health assess the case for investment in this area and plan its new mental health strategy launched on 2 February 2011.

Keeping personal budgets personal: learning from the experiences of older people, people with mental health problems and their carers. This report from the Social Care Institute for Excellence (SCIE) presents findings from research into the experiences of using personal budgets for older people, people with mental health problems and their carers, with suggestions for good practice and future improvement.

Transitions in mental health care. This guide is for health and social care professionals working with young people with emotional and psychological problems who are receiving care and support from child and adolescent mental health services (CAMHS) but have reached an age where they will need to move on to adult services.

Diversion: the business case for action. Many people in the criminal justice system have complex mental health needs which are poorly recognised and inadequately managed. Large numbers end up in prison: a high-cost intervention which is inappropriate as a setting for mental health care and ineffective in reducing subsequent offending. Diversion can be within or outside the justice system and need not replace sanctions for any offence a person has committed. This report, written with Rethink and the Royal College of Psychiatrists, shows that even with intensive community supervision for up to two years, diversion from custody is still much cheaper than just a few weeks in prison. And there is growing evidence that well-designed diversion schemes can help to reduce reoffending by one third.

Planning mental health services for young adults - improving transition. This guide has been produced to assist current and future commissioners of health and social care services for young people in their planning, reviewing and delivery of mental health services for adults and young people. It takes as its focus the need for improved transition in terms of both outcomes and processes.

Cases
Re AB; D Borough Council v AB [2011] EWHC 101 (CoP). The court looked at the question of what is the legal test to be applied in determining whether an individual has the mental capacity to consent to sexual relations. The court held that capacity to consent to sex remains act specific and requires an understanding and awareness of:
 The mechanics of the act
 That there are health risks involved, particularly the acquisition of sexually transmitted and sexually transmissible infections
 That sex between a man and a woman may result in the woman becoming pregnant.
 The court made a declaration that the individual did not have capacity to consent to sexual relations. The declaration was interim and the matter was to return to court in nine months after the local authority had provided the individual with sex education in the hope that he thereby gained capacity. See in particular paras.42 & 52. 

Bowater v Northwest London Hospitals NHS Trust [2011] EWCA Civ 63 (CA). The court held that an employment tribunal had been entitled to find that the summary dismissal of a nurse for making a lewd comment during restraint of a patient was unfair and outside the band of reasonable responses open to the NHS Trust employer. The Employment Appeal Tribunal had made a mistake in substituting its own views for those of the tribunal when finding that the tribunal's decision was perverse.

Haworth (A Bankrupt by her Litigation Friend the Official Solicitor) v (1) Cartmel (Trustee in Bankruptcy) (2) Revenue & Customs Commissioner [2011] EWHC 36 (Ch). The court annulled a bankruptcy order where the bankrupt had lacked capacity at the time of personal service of both the statutory demand and bankruptcy petition owing to long-term chronic mental impairment, which included an irrational phobia of opening mail. The court also considered the relevance of the disability discrimination legislation, and its jurisdiction to hear the application in circumstances where it had already twice been refused.

R (Hertfordshire CC) v Hammersmith & Fulham LBC; JM (Interested Party) [2011] EWCA Civ 77 (CA). See the Bevan Brittan update on this case.

P (aka MIG) and Q (aka MEG) (By their litigation friend the Official Solicitor) v Surrey CC; Equality & Human Rights Commission (Intervener) [2011] EWCA Civ 190. The Court of Appeal has given guidance on the criteria that should be considered when determining whether care arrangements made by a local authority in respect of individuals who lacked mental capacity engaged Art.5 ECHR.

Consultations
Consultation on the joint Department of Health/ National Offender Management Service Offender Personality Disorder Pathway Implementation Plan. Seeks views about a new pathway approach for the treatment and management of offenders with serious personality disorders. The consultation closes on 12 May 2011.

News
Section 141 of the Mental Health Act to be abolished. The Mental Health Act 1983 s.141, which states an MP must be automatically removed from Parliament if they have been detained under mental health legislation for more than six months, is to be abolished.

Government adviser sacked for questioning mental health strategy funding. The Government has sacked an independent national health adviser for questioning in the Guardian whether the money for its mental health strategy was new or came from the existing NHS budget.

PSIGE (The faculty of old age psychology BPS/DCP) has published a special edition of its newsletter covering national initiatives on providing psychological therapies for older people.

Father wins right to have autistic son living at home.

Bevan Brittan Updates
Courts Clarify who is the Responsible Authority for the Purposes of s.117 Aftercare under the Mental Health Act 1983. On 15 February 2011, the Court of Appeal provided clarity as to who the responsible authorities are for the purpose of s.117 aftercare under the Mental Health Act 1983 (the "Act") in the case of R (on the application of Hertfordshire County Council) v London Borough of Hammersmith & Fulham and JM [2011] EWCA Civ 77.

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

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Primary Care

Publications/Guidance
QMAS underpayments – Revenue resources and cash limit adjustments to compensate PCTs in 2010/11. This letter from Richard Armstrong, Head of Primary Medical Care Commissioning Development Directorate, to PCT Directors of Finance, highlights an error within the Quality Management and Analysis System (QMAS) which has resulted in GP contractors being underpaid. There is a spreadsheet showing PCT code, practice code and amount due.

PCT cluster implementation guidance. This publication provides guidance to the NHS on the creation of PCT clusters, as announced in 2011/12 Operating Framework and outlines the process of consolidating management capacity, with single executive teams each managing a cluster of PCTs.

The IRIS case study. The IRIS intervention provides a staff training and support programme to bridge the gap between the voluntary sector and primary care, to harness the strengths of each, and to provide an improved domestic violence service. Local champions are essential to promote the service among their professional peers and encourage implementation. This report documents early experiences of implementing a successful primary care domestic violence service.

Future ownership and management of PCT-owned estate by aspirant Community Foundation Trusts (CFTs): frequently asked questions. This paper aims provide helpful prompts on issues related to transfer of PCT-owned estate to CFTs. It should be noted that NHS LIFT and PFI interests are excluded for the time being from this process.

News
Doctor's surgery becomes legal advice centre. Reports that a GP practice in Surrey has set up an innovative legal advice surgery with Surrey legal firm Venters providing mediation and family law services for separating couples.  

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

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Prison Health

Publications/Guidance
Emergency access to establishments for ambulance services. This letter from DH Offender Health and National Offender Management Service refreshes guidance issued in 2004 regarding the access of emergency ambulance services into prisons. It follows a recent report by the Prison Probation Ombudsman on learning into deaths from circulatory diseases that highlighted the need to minimise the delays that can be encountered in getting an emergency response to prisoners.

Support for alcohol-misusing offenders. This policy paper identifies areas and practical examples of how, in a changing and uncertain policy and commissioning landscape, the joint commissioning and delivery of alcohol interventions for offenders in the community might be productively developed.

Bevan Brittan Updates
Deaths in prison custody statistics - What do they tell us? On 2 January 2011 the Ministry of Justice announced that there were 58 apparently self inflicted deaths among prisoners in England and Wales in 2010, but what do the statistics really tell us about mental health in prison?

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

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Regulation

Publications/Guidance
Enabling excellence - Autonomy and accountability for health and social care staff - Command paper 8008. Sets out the government strategy for reforming and simplifying the system for regulating healthcare workers in the UK and social workers and social care workers in England.

News
Regulator demands immediate improvement at Plymouth Hospitals NHS Trust. Following a visit by inspectors to Derriford Hospital, run by Plymouth Hospitals NHS Trust, the Care Quality Commission (CQC) found that important check-lists recommended by the World Health Organisation and the National Patient Safety Agency were not being effectively used by surgical teams across some operating theatres. It is critical that these key checks are completed without exception as failure to do so may result in increased risk to patient safety. The CQC required that the Trust address this issue immediately, and it has put in place steps to do so. They have also told the Trust that if it does not demonstrate full and consistent compliance with safety check lists from this point forward, their next steps may include prosecution or closure of services.

New excellence scheme for adult social care. The CQC has announced plans to develop a new scheme to recognise excellence in adult social care. The scheme, set to be launched in April 2012, will be CQC-owned, but delivered by other organisations under licence. A consultation on how to define excellence in adult social care will launch in May, building on work carried out for CQC by the Social Care Institute for Excellence. The scheme will be voluntary and will involve a proportionate charge. CQC will seek expressions of interest to deliver the scheme in the spring, and will welcome bids from across the private and voluntary sector. CQC will publicise the excellence award on its own website from April 2012, alongside its own reports on whether or not a provider is meeting essential standards. A user-friendly ‘provider profile’ for every CQC-registered adult social care service will be launched this summer.  

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

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General

Publications/Guidance
Transforming Community Services transformational guides. The DH has published six TCS reference guides that utilise up to date evidence-based research from the Health Services Management Centre and experiential knowledge from clinical innovation in practice. The guides relate to 6 key specific areas of practice: health, wellbeing and reducing inequalities; children, young people and families; acute care closer to home; long term conditions; rehabilitation services; and end of life care. The guides are for use by frontline clinicians, commissioners and providers and are based around a framework of ambition, action and achievement. The guidance also includes six transformational attributes which practitioners and teams need to demonstrate in order to meet the requirements of the high performing practitioner-partner-leader roles.

NHS joins forces with designers to tackle violence and aggression in A and E departments. Designers are to rethink the design of hospital Accident and Emergency departments in a bid to develop innovative new ways to reduce violence and aggression towards NHS staff, which is estimated to cost at least £69m a year in staff absence, loss of productivity and additional security.

Health Visitor Implementation Plan 2011-15: a call to action. Sets out the full range of services that families, depending on their needs, will be able to expect from health visitors and their teams. The Implementation Plan addresses concerns that many health visitors feel undervalued and sets out what needs to be done to turn this around. It provide further detail on the ambition to increase overall numbers of health visitors by 4,200 by April 2015, and the action required in 2011/12. The Plan also reinforces the importance of the relationship between Sure Start children's centres and health visitors.

Health visitor implementation plan 2011-15: a call to action, February 2011. This Plan sets out a call to action to expand and strengthen health visiting services.

Measuring impact in health improvement: an accessible guide for health practitioners. This guide has been developed for practitioners working for councils and public health organisations who have been given the task of evaluating the impact of a project or initiative. It provides guidance on the process of designing, implementing and disseminating an impact assessment and information on the range of tools and help that is available. It aims to be a practical guide, helping you to design and conduct effective and appropriate impact assessment.

Health services for the armed forces and veterans. This letter from Alan Hall, Department of Health Director of Performance, reminds SHA chief executives of the actions required to meet the Military and Veterans Health requirements contained in the Operating Framework 2011/12. All Ministry of Defence medical centres have now been issued with an NHS Practice code, which will be published and maintained in the Organisation Data Service GP Practice file from February 2011.

Best practice for ensuring the efficient supply and distribution of medicines to patients. This guidance has been developed and is supported by eleven organisations following detailed consideration of the current problems with the supply chain, especially those caused by increased exports of medicines from the UK. It sets out best practice for ensuring the efficient supply and distribution of medicines to patients.

Alcohol use disorders: diagnosis, assessment and management of harmful drinking and alcohol dependence. Over 1m people in England are dependent on alcohol, but every year there are over 940,000 people who are either not seeking help, do not have access to the relevant services, or whose symptoms are not being appropriately identified by healthcare professionals. In an attempt to improve the situation, NICE has published guidance outlining how the NHS should diagnose, assess and treat the condition.

Female genital mutilation: multi-agency practice guidelines. New multi-agency practice guidelines on tackling and preventing female genital mutilation for healthcare practitioners across all sectors, but particularly in GP practices, and midwifery, gynaecology, neo-natal and anti-natal services. Their awareness is crucial to creating the joined-up approach needed to safeguard girls and women from harm, and ensuring those affected receive the physical and mental health care they need.

Guidance on the microbiological safety of human organs, tissues and cells used in transplantation. This guidance updates and replaces the guidance issued in 2000 by the Advisory Committee on the Microbiological Safety of Blood Tissues and Organs for Transplantation (MSBTO). The role of MSBTO has now been replaced by the Advisory Committee on the Safety of Blood Tissues and Organs (SaBTO), whose role is to advise on reducing to a minimum the avoidable risk of transmission of infection through transplantation. The guidance has been written by a working group after extensive consultation. 

Information and communications technology (ICT) in government: landscape review. This review looks at how government uses ICT to deliver public services. The review, the purpose of which is to inform the debate about government's new use of ICT, gives an overview of existing uses, as well as initiatives and changes underway.

Cases
CB v Sussex County Council [2010] UKUT 413 (UT AAC). The Upper Tribunal Administrative Appeals Chamber ruled that a failure to comply with a witness summons would result in a fine of £500, payment to be made in 28 days unless appealed. If the payment was not made within the specified time a term of seven days' imprisonment would be imposed.

British Pregnancy Advisory Service v Secretary of State for Health [2011] EWHC 235 (Admin) (Admin Ct). The court held that for the purposes of the Abortion Act 1967 s.1, a pregnancy was not "terminated by a registered medical practitioner" where the registered medical practitioner prescribed an abortifacient drug with the intention of terminating a pregnancy and the administration of that drug to the pregnant woman was a treatment for the termination of pregnancy.

Bevan Brittan Updates
Let the music pay. A recent amendment to the Copyright, Designs and Patents Act 1988 means that not-for-profit organisations, including charities, local and central government, NHS Trusts, voluntary organisations and social enterprises, are now obliged to pay a licence fee for the performance of sound recordings in public.

Judicial Review - a very public affair. Judicial Review (JR) is a public law proceeding where the High Court is required to consider the legality of a decision or action of a public body.  It can only be brought by a person or organisation that has sufficient interest in the decision which has been taken. 

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

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