Health and Social Care Update - June 2012

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 and Data Sharing
Children	Inquests
Commissioning	Mental Health
Employment/HR	Obesity
Finance	Primary Care
Foundation Trusts	Regulation
Governance	General
Health and Safety

 

Care

Publications/Guidance
Frontline First Congress 2012 update. An RCN survey into the effect of the economic downturn on the quality of care provided by nurses has found that many community nurses are facing cutbacks and spending less time with patients. The report warned this will result in in many nurses reaching breaking point and a deterioration in patient care.

State of the nation 2012: England. This report from Diabetes UK shows that less than half of people with the condition are getting the basic minimum care they need, with some areas seeing only six per cent of people with diabetes getting the regular checks and services recommended by the National Institute of Health and Clinical Excellence.

The roadmap: England’s choices for the care crisis. This report sets out the options for the government as it faces questions on the state spend on care and support in future and where the money come from to fund this spend. The report explores how rising demand for care associated with population ageing will mean the proportion of GDP spent on care by the state will have to increase to maintain the current inadequate system of entitlements and support. The report concludes that there are positive choices that can be made that would result in a better, fairer system.

Patients’ preferences matter: stop the silent misdiagnosis. This paper challenges the NHS to stop the 'silent misdiagnosis' of patients’ preferences for their care and argues that by doing so it will improve health system performance as a whole. 

Improving hospital admission and discharge: for people who are homeless. This report indicates that more than 70% of homeless people are being discharged from hospital back onto the streets, damaging their health and costing the NHS money. It found that NHS staff can improve health outcomes for homeless people and save the NHS money by ensuring all patients have somewhere appropriate to stay when they are discharged from hospital.

Helping hospitals deliver better care: a new toolkit for quality improvement. A team from RAND and the University HealthSystem Consortium developed a toolkit to help hospitals enhance their quality improvement efforts using quality indicators from the Agency for Healthcare Research and Quality.

Experiences of home care services. Over the coming months, the CQC will be conducting over 250 unannounced inspections of home care services. To help the assessment of this sector, they are seeking views about experiences of home care services. There are two surveys – one for people receiving care and one for relatives and carers. Both surveys will close at the end of August 2012.

Using care bundles to improve health care quality. This paper describes the history, theory of change, design concepts, and outcomes associated with the development and use of bundles over the past decade. It reflects on what has been learned and makes suggestions for further research and implementation of the bundle approach to improving care.

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

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Children

Publications/Guidance
More for children: Munro and its implications for the voluntary and community sector (VCS). This report is designed to provide information about the impending changes to safeguarding as a result of the Munro report and the forthcoming consultation on a new edition of 'Working Together' that resonates with the voluntary and community sectors experience. The report aims to assist managers and practitioners in the voluntary care sector in developing an understanding of the contents and implications of the Munro Report in the broader context of the policies of the current government, to provide examples of good practice and service delivery which are both innovative and reflect the principles which underpin the report itself and to suggest strategies, particularly in relation to the application of evidence based practice which will better equip providers to respond to the current economic and social climate.

Listening to children's views on health provision: a rapid review of the evidence. This review provides a synthesis of up-to-date evidence on children and young people's views and experiences of health provision. The report highlights that communication between health professionals and children is often mediated via parents and guardians and makes suggestions for improvements in this area. It also calls for the inclusion of under-16s in NHS surveys in order to represent children's views on healthcare issues.

Market facilitation: guidelines for children and young people’s services. This document focuses particularly on services concerned with early intervention and prevention for children, young people and families, but it is also applicable to all children’s and young people’s services markets. 

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

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Commissioning

Publications/Guidance
Proposed abolition of the NHS Commissioning Board Authority and the transfer of employees to the NHS Commissioning Board. This letter from Richard Douglas, Director General of Policy, Strategy and Finance, to Karen Didovich Joint Chair, HR Transition Partnership Forum, seeks views on the proposed abolition of the NHS Commissioning Board Authority and the transfer of employees to the NHS Commissioning Board.

Authorisation process for Clinical Commissioning Groups (CCGs). A letter and a set of slides issued describe the authorisation process for CCGs and have been sent to primary care cluster chief executives and local authority chief executives. CCGs are due to come into statutory form from April 2013 and will need to be formally authorised.

Smart guides to engagement. NHS Networks has published three more guides in its Smart Guides to Engagement series that give practical advice to Clinical Commissioning Groups (CCGs) about the value of patient and public engagement. The guides have been co-produced by PPE experts from several organisations with support from the DH. The new guides cover:
 Community development – improving population health 
 Listening, learning and responding
 Practices and patient engagement

 Proposed clinical commissioning group (CCG) configuration and member practices. The NHS Commissioning Board Authority has published the proposed configuration and member practices for 212 proposed CCGs for the first time. This is a step forward in the work to establish the new clinical commissioning landscape by April 2013, and, along with the publication of the running cost allowances, aims to enable proposed CCGs to further develop their organisation ready for authorisation and establishment.

Emerging NHS clinical commissioning groups and commissioning support services. This report contains details of a customer survey which was carried out with proposed clinical commissioning groups (CCGs) and NHS commissioning support services (CSSs). Findings show that over 90% of proposed CCGs are very or quite confident that the arrangements they are putting in place for commissioning support will allow them to achieve authorisation. Just over a half say they expect to source at least 50% of their commissioning support through NHS CSSs, with around a further quarter sourcing 30%-49%. The report also suggests that the majority of CCGs intend to carry on with the same CSS during 2012/13, with one in ten wanting to exercise choice.

Clinical commissioning group (CCG) indicative running cost allowances. This briefing note looks at the indicative running costs allowances for 212 proposed CCGs for 2013-14. The running costs allowance for CCGs has already been set at up to £25 per head of population per year. This limit meets the requirement to reduce system wide administration costs by one third, and ensures spending on running costs is kept to a reasonable level and NHS funding is focused on providing high quality services for patients and the public.

Clinical commissioning group authorisation: draft guide for assessors undertaking desk top review. This guidance is an accompaniment to Clinical commissioning group authorisation: draft guide for applicants and outlines the key stages of assessment; principles, approach and methodology of assessment; and the published domain definitions, criteria and authorisation thresholds. In addition, a financial governance tool has been published to help CCGs collect the evidence required for their application for authorisation and to put in place the financial governance arrangements required from 1 April 2013.

Long term conditions (LTCs) compendium of information: third edition. This publication is aimed at commissioners as well as health and social care professionals, to provide the evidence for improving care and outcomes for people with LTCs. It updates the second edition of the compendium published in January 2008. It contains the latest statistical data on long term conditions, links to the LTC QIPP workstream and provides data from the ongoing evaluation of the Whole System Demonstrator Programme on telehealth and telecare. It also showcases examples of innovative projects across the country. 

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
Back pain management: occupational health practice in the NHS in England - a national clinical audit – round 2. This report highlights the need for all NHS staff to be given good advice about back pain. It finds that musculoskeletal problems such as back pain account for 40% of sickness absence amongst NHS staff and costs approximately £400 million per year. It looks at how occupational health professionals cared for NHS staff who are experiencing back pain and found that the care and management occupational health professionals give to staff suffering with back problems has improved in the three years since the previous audit in 2008.

Review of the tax arrangements of public sector appointees. This review identifies the number of off-payroll engagements worth more than £58,200 per annum across government and made recommendations to improve the transparency of these kind of arrangements. This document constitutes the submission to this review in respect of NHS organisations.

Senior salaries review body: market facing pay. This report reviews the case for market-facing pay based on written evidence from the Department of Health. The report sees a strong case for this within the Agenda for Change staff groups of the NHS, the case for which is detailed in the evidence to the NHS Pay Review Body. Pay for Very Senior Managers (VSMs) is currently different, and the report argues that these differences should continue as the Arms Length Body (ALB) sector is in a state of flux. The inclusive development of a new pay framework for NHS VSMs has just been completed, and the report concludes that this will be fit for purpose for current and emerging ALBs in the NHS.

Department of Health pay framework for very senior managers in arms-length bodies - special health authorities and executive non-departmental public bodies. A pay framework, a job evaluation handbook and question and answers for very senior managers in arms length bodies (special health authorities and executive non-departmental public bodies).

Education, training and workforce planning: first report of session 2012/13. This report states that Government plans to reform education, training and workforce planning in the NHS are unclear and lack detail. It examines and makes recommendations on areas such as: the challenge of workforce planning, the organisation of education, training and workforce planning, and the funding of education and training.

Further evidence on market-facing pay. This report argues that introducing market facing pay for very senior managers would risk limiting the pool of available talent and would jeopardise recruitment to these roles.

Managing industrial disputes: guidance for employers in the NHS. The guidance on industrial disputes has been updated to reflect the upcoming industrial action proposed by the BMA. It provides advice and guidance for employers within the NHS.

Handling concerns about a practitioner's behaviour and conduct: an NCAS good practice guide. This guidance sets out principles and practical steps for handling concerns regarding poor professional behaviour and conduct within the NHS.

Pay framework for very senior managers in Arms Length Bodies (ALBs). This new pay framework for very senior managers in SHAs and Executive Non-Departmental Public Bodies (ENDPBs) is based on job evaluation and the Senior Salaries Review Body report on the pay of ENDPB chief executives. It should be implemented in all ALBs in line with the guidance on implementation contained within it.

Legislation
Health Education England (Establishment and Constitution) Order 2012 (SI 2012/1273). This Order, which comes into force on 28 June 2012, establishes a new Special Health Authority called Health Education England (HEE) and provides for its constitution. HEE will provide national leadership for the education and training of the health and public health workforce and be responsible for carrying out the SoS's functions to secure an effective system for education and training.

Health Education England Regulations 2012 (SI 2012/1290). These regulations, which come into force on 28 June 2012, provide for the membership and procedure of HEE as a Special Health Authority. 

The National Health Service Trust Development Authority Directions 2012. These directions give the NHS Trust Development Authority the power from 1st June 2012 to set themselves up, recruit staff, design processes and issue guidance in preparation for carrying out their functions of overseeing NHS trusts and supporting them to become foundation trusts, and taking over appointments from the Appointments Commission from 1st October 2012.

Consultations
Equality Act 2010 consultations. The Home Office has issued two consultations on proposals to reduce burdens on business by repealing some provisions in the Equality Act 2010:
 Equality Act 2010 - Consultation on employer liability for harassment of employees by third parties. Seeks views on proposals to repeal s.40(2)-(4) of the Equality Act 2010 which makes employers liable for harassment of their employees by third parties over whom they do not have direct control, such as customers or clients.
 Equality Act 2010 - Consultation on repeal of two enforcement provisions. Seeks views on proposals to repeal employment tribunals’ power under s.124(3)(b) to make wider recommendations in discrimination cases, and the procedure for obtaining information (s.138).  Both consultations close on 7 August 2012. 

Minimum standards for healthcare support workers and adult social care workers in England. Skills for Health and Skills for Care have been commissioned by the Department of Health to jointly convene a project to develop a code of conduct and standards which set out high-level proficiencies for the role and expectations around: healthcare support workers (reporting to registered nurses and midwives); and adult social care workers (working in support of health and social care professionals, independently, for Care Quality Commission registered residential care providers, or as domiciliary care workers in England). The on-line consultation is live between 25th May and 29th June 2012. 

Consultation on the training standards and code of conduct for healthcare support workers. This consultation is the result of project commissioned by the Department of Health which aims to develop a code of conduct and standards which set out high-level proficiencies for the role and expectations around healthcare support workers and adult social care workers. Views on this will be accepted until 29th June 2012. 

Bevan Brittan Updates
BMA announces industrial action will take place on 21 June. Yesterday the British Medical Association (“BMA”) announced that, following a ballot amongst its members, there will be a 24 hour period of industrial action on 21 June.

At Her Majesty's request . In keeping with the jubilee theme, Gemma Hill reports on the Queen’s Speech which was delivered at the State Opening of Parliament on 9 May.  As always, it sets out the Government’s legislative programme going forward, which, we were told "will focus on economic growth, justice and constitutional reform". Within the various announcements made during the speech there were a number of employment-related Bills which are set out in more detail in this article.

Judgement published in Mattu v University Hospitals of Coventry and Warwickshire NHS Trust . We last reported on this case back in October of last year, following the hearing in the High Court. The decision of the High Court was that Dr Mattu’s dismissal was not carried out in breach of contract and, further, that Article 6 of the European Convention on Human Rights was not engaged during the disciplinary process as his dismissal did not prevent him from practising as a consultant cardiologist. They held that that he would only be so prevented if the General Medical Council removed or suspended his registration.

When can compulsory retirement be justified. As promised in last month’s edition, Alessandra Gettins has produced a detailed case report on the recent decision in the Supreme Court in the case of Seldon v Clarkson Wright and Jakes which looked further into the area of direct age discrimination and on what grounds it can be objectively justified.

News Round Up. Jaspal Basra takes a whistle-stop tour of a few of the more prominent employment law announcements and cases from this month, including the Governments response to the consulation on the reform of the Equality and Human Rights Commission; the judgement in the EAT case of Seawell Ltd v Ceva Freight (UK) Ltd concerning TUPE provisions; and the recently amended identification checking guidelines from the Criminal Record Bureau. 

Bevan Brittan Events
HR Workforce Forum. 12 June 2012 : 5.30pm - 7.30pm. Location: Inner Temple, EC4Y 7HL. The HR Workforce Forum is an interactive peer group for Directors of Human Resources. Invitations for this Forum are also extended to Medical Directors.

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

Back to top   Finance 

Publications/Guidance
The roadmap: England’s choices for the care crisis. This report sets out the options for the government as it faces questions on the state spend on care and support in future and where the money come from to fund this spend. The report explores how rising demand for care associated with population ageing will mean the proportion of GDP spent on care by the state will have to increase to maintain the current inadequate system of entitlements and support. The report concludes that there are positive choices that can be made that would result in a better, fairer system.

A glossary for NHS finance and governance. This briefing covers a variety of terms regularly used by both commissioners and healthcare providers when discussing the key areas of NHS finance and governance.

How is the NHS performing? Quarterly monitoring report. This quarter’s monitoring report looks back at how the NHS performed during the first year of the spending squeeze. This is the fifth quarterly monitoring of a series which aims to provide a regular update on how the NHS is coping as it grapples with the evolving reform agenda as well as the more significant challenge of making radical improvements in productivity.

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

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Foundation Trusts 

Publications/Guidance
Establishment of the NHS Trust Development Authority. This impact assessment outlines the issues relating to the establishment of a new body which will be responsible for supporting the development of foundation trusts in the NHS.

Model core constitution. This document has been updated to reflect legislative changes to be implemented by the Health and Social Care Act 2012. It has been published to help FTs and aspirant FTs prepare for the new legal arrangements. Therefore, it should be noted that it is being issued for guidance purposes only and trusts should not send Monitor their revised constitutions for approval.

Bevan Brittan Updates
Health and Social Care Act: Stakeholder feedback on Monitor's Licensing Regime. Now that The Health and Social Care Act has received Royal Assent.  The provisions remain to be brought into force by commencement orders (except for a limited few which are not relevant to this briefing note) but we now have clarity on the framework of the restructuring of the NHS.

Health and Social Care Act: The new Foundation Trust failure regime. The Health and Social Care Act has led to an overhaul in the failure regime for NHS Foundation Trusts. The Act repeals the de-authorisation provisions in the NHS Act and establishes a Trust Special Administration regime for FTs. The proposal during the passage of the Bill for insolvency law to apply to FTs has been dropped and the role of Monitor in the administration process has been enhanced. This article explores the key features of the new regime and its implications for NHS FTs.

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

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Governance

Publications/Guidance
Leadership and engagement for improvement in the NHS: together we can. This report makes the case for engaging staff, patients and boards and for building relationships across systems of care. The final report builds on the work of The King's Fund's 2011 Leadership Commission, as well as evidence from a number of national and international experts.

How to maintain quality during the transition - preparing for handover. This guide, produced by the National Quality Board, sets out the steps to be taken to ensure that any risk to quality is reduced during transition and that business continuity is maintained is published. It ensures that information about quality is not lost as organisations change.

A glossary for NHS finance and governance. This briefing covers a variety of terms regularly used by both commissioners and healthcare providers when discussing the key areas of NHS finance and governance.

Clinicians in management: does it make a difference? This research has found that the boards remain dominated by non-clinicians, such as accountants and managers and that clinicians make up an average of just 26% of board members in English hospital trusts, with major variations around the country. It looks at the relationship between having doctors on the boards of trusts and patient satisfaction rates, patient morbidity rates and how highly the hospital’s management is regarded.

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

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Health and Safety

    

Publications/Guidance
Series of thought papers on patient safety. The Health Foundation is urging healthcare organisations and leaders to ensure patient safety remains their top priority at a time when many are faced with unprecedented financial pressures and increasing demand on their services. As part of this drive, a series of thought papers has been launched, giving healthcare experts within their respective fields the opportunity to share their ideas and experiences in patient safety.

Snapshot: patient safety. This briefing looks at the fundamental priorities for clinicians, managers, boards and policy makers to improve patient safety.

Delivering the NHS Safety Thermometer CQUIN 2012/13: a preliminary guide to measuring ‘harm free’ care. This guidance is intended to support the NHS in implementing the NHS Safety Thermometer. The NHS Safety Thermometer gives nurses a template to check basic levels of care, identify where things are going wrong and take action. It is being used by frontline healthcare workers to measure and track the proportion of patients in their care. NHS organisations are being encouraged to use the NHS Safety Thermometer in 2012/13 using a CQUIN incentive payment that rewards them if they collect data on the safety of the care they provide.

NHS safety thermometer equality analysis. This report examines the likely impact of the national roll-out of the NHS Safety Thermometer on those people who share a protected characteristic.

Back pain management: occupational health practice in the NHS in England - a national clinical audit – round 2. This report highlights the need for all NHS staff to be given good advice about back pain. It finds that musculoskeletal problems such as back pain account for 40% of sickness absence amongst NHS staff and costs approximately £400 million per year. It looks at how occupational health professionals cared for NHS staff who are experiencing back pain and found that the care and management occupational health professionals give to staff suffering with back problems has improved in the three years since the previous audit in 2008.

Falls prevention: new approaches to integrated falls prevention services. This briefing shares the learning and recommendations from a workshop for members held by the NHS Confederation and the Ambulance Service Network on falls prevention strategies for the older population. It intends to help the NHS and local government think about new approaches to the commissioning and provision of comprehensive, integrated falls prevention services. It shows that a focus on prevention and early intervention through joint working has benefits for the whole health and social care system, and that not taking action may soon become unaffordable.

Hospital Episode Statistics as a source of information on safety and quality in gynaecology to support revalidation. This report was a response to the introduction of revalidation by the GMC as a means of regulating UK doctors. The project outlined in the report aimed to assess whether routinely collected administrative data could be used as part of the evaluation of gynaecologists’ practice and as a way to compare measures of activity and outcome derived from administrative data, with measures derived from data in two specialist societies’ clinical databases.

An outcomes strategy for COPD and asthma: NHS companion document. A new action plan for treatment of respiratory problems is set out in this guidance for the NHS. The guidance contains 45 best practice actions for the treatment of COPD and asthma. A key part of the new strategy is reducing the variation in COPD diagnosis and care around the country. The guidelines estimate that 7,800 lives could be saved annually and that these improved diagnosis rates could also deliver significant cost savings.

The management of adult diabetes services in the NHS. This report examines whether the NHS in England is providing recommended standards of care to people with diabetes. The report finds that, despite some improvements since 2006-07, there is poor performance against expected levels of care, low achievement of treatment standards and high numbers of avoidable deaths.

Transition programme risks: review of November 2010 risk register. The purpose of this document is to describe and explain the areas of risk contained in the transition risk register of November 2010. Its release follows a review of the material contained in the risk register, carried out by the Department of Health in April 2012, following the passage of the Health and Social Care Act. There are nine areas in total, covering subjects such as legislation, communications, people transition, finance and the management of the organisational changes.

Ministerial veto on disclosure of the Department of Health’s transition risk register. This report to Parliament from the Information Commissioner outlines the ministerial decision to veto the publication of the NHS risk register.

Poly Implant Prothèse (PIP) silicone breast implants: review of the actions of the Medicines and Healthcare products Regulatory Agency (MHRA) and Department of Health. A review into PIP breast implants has found that, although the MHRA acted appropriately and followed scientific and clinical advice, there is room for improvement and lessons to be learned.

Time to intervene? A review of patients who underwent cardiopulmonary resuscitation as a result of an in-hospital cardiorespiratory arrest. This report highlights the process of care for patients aged 16 and over, who received cardiopulmonary resuscitation in an in-hospital setting. The report takes a critical look at areas where the care of patients might have been improved, and factors which may have affected the decision to initiate a resuscitation attempt. Remediable factors have also been identified in the clinical and the organisational care of these patients.

Legislation
The National Patient Safety Agency (Amendment) Directions 2012. This an amendment to local authority directions which came into force on 1 April 2012. The Directions to the National Patient Safety Agency (NPSA) have been amended to reflect the transfer of the operational delivery of the National Reporting and Learning System from NPSA to Imperial College Healthcare NHS Trust with NPSA retaining an oversight role.

News
The European Parliament has approved amendments to the pharmacovigilance legislation which will improve the detection system for identifying unsafe medicines and removing them as quickly as possible from the market. This is due to the selling of a once legal diabetes drug which was believed to have caused the deaths of 500 people in France.

On 1 June 2012 the key functions and expertise for patient safety transferred to the NHS Commissioning Board from the National Patient Safety Agency (NPSA).

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

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  Information and Data Sharing

Publications/Guidance
How to maintain quality during the transition - preparing for handover. This guide, produced by the National Quality Board, sets out the steps to be taken to ensure that any risk to quality is reduced during transition and that business continuity is maintained is published. It ensures that information about quality is not lost as organisations change.

Briefing on upcoming changes to the community pharmacy Medicines Use Review (MUR) service. From 1st July 2012, new data capture requirements for the community pharmacy MUR service will be implemented. There are also planned changes to the requirement to inform the patient's GP that an MUR has taken place but the implementation of these changes is subject to the amendment of the relevant Directions.

Medicines use review (MUR). New data capturing and reporting arrangements, published today are to be used from the 1st July for MUR. A MUR takes place between a pharmacist and a patient, and covers the patient’s medication and the support they need to get the most from their medicines. These changes are being published now to give pharmacy contractors preparatory time before the changes come into effect. Pharmacists will no longer need to complete the current medicines use review form for each patient if they do not wish. They will need to capture the data for each patient as sent out in ‘dataset to be retained by pharmacy contractors’.

The power of information: Putting all of us in control of the health and care information we need. This DH information strategy sets a ten-year framework for transforming information for the NHS, public health and social care. One of the key commitments is that patients will be able to view their GP record online by 2015. Other ambitions are for test results to be available electronically and that people will be able to book or re-arrange their medical appointments online. See also responses to the strategy:-
Alzheimer's Society
Beating Bowel Cancer
British Medical Association
Dr Foster Intelligence
The King's Fund
KPMG
Macmillan Cancer Support
National Voices
NHS Confederation
Nuffield Trust
Pharmacy Voice
Royal College of Nursing
Royal College of Physicians
Royal Pharmaceutical Society

Alive and clicking: information that benefits all. This paper explores the potential for using and sharing information in the NHS. It looks at the costs and benefits of informing and communicating with patients through web and social media platforms versus the costs of not doing so effectively.

Freedom Of Information (FOI) releases to requests made from 1 July to 30 September 2011. The Department of Health has made the details of all FOI requests made between 1st July and 30th September 2011.

News
London NHS Trust fined £90,000 for serious data breach. The ICO has fined Central London Community Healthcare NHS Trust £90,000 following a serious breach of the Data Protection Act 1998. The breach occurred in March 2011, after patient lists from the Pembridge Palliative Care Unit, intended for St John’s Hospice, were faxed to the wrong recipient. The individual informed the Trust in June that they had been receiving the patient lists – around 45 faxes over a three month period – but had shredded them. The patient lists contained sensitive personal data relating to 59 individuals, including medical diagnoses and information relating to their domestic situations and resuscitation instructions. See also the Monetary Penalty Notice.
This is the second fine issued to an NHS organisation. In April a monetary penalty of £70,000 was issued to the Aneurin Bevan Health Board following an incident where a sensitive report, containing explicit details relating to a patient's health, was sent to the wrong person.

Information technologies in the NHS : an observational study of three acute hospitals. This study examines the implementation and impact of electronic health records and electronic prescribing services across diabetes care in Yorkshire and the Humber.

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

Back to top  Inquests 

Publications/Guidance
Summary of reports and responses under Rule 43 of the Coroners' Rules. This publication gives details of coroners’ reports and responses received from organisations asked to consider action to prevent future deaths between 1 April and 30 September 2011. It includes trends and reports with wider implications and annexes giving details of the numbers of reports issued by each coroner district, organisations who have neither responded to the coroner nor been granted an extension and all reports issued in this period. This is the sixth report issued by the Ministry of Justice containing this information.

News
A Ministry of Justice written statement announces the appointment of His Honour Judge (HHJ) Peter Thornton QC as Chief Coroner, with effect from September 2012. HHJ Thornton was originally appointed to the post in May 2010 but did not formally take up his duties while the Government was reviewing the position.  

Discussion of coroners' courts and open justice, suggesting that court reporting is difficult due to coroners having the freedom to organise and run their own courts which leads to different policies in different jurisdictions. Suggests the appointment of Peter Thornton QC as the first chief coroner may introduce structure to the system.

If you require further information about any of the items raised in this section please contact  Joanna Lloyd or Nadia Persaud. 

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Mental Health

 

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

The extranet also contains a forum for use by members to share knowledge and information. Forum issues currently being discussed are:-
 Consent to treatment provisions
 New CTO treatment arrangements
 In house produced forms - not meeting working in regulations.

Training 
We had an interesting lunch time talk from Paul Barber this month who updated us on recent cases relevant to the Mental Health and Mental Capacity Acts. If you would like to come along to any of our lunch time training sessions just let me know. You can attend in London , Bristol or Birmingham.

If you would like information about how to access the Bevan Brittan Mental Health Extranet please email Claire Bentley by clicking here.

Publications/guidance
Unsung heroes: developing a better understanding of the emotional support needs of Service families. Armed Forces families must be better supported to deal with the emotional and psychological impact of deployment, according to this report. It calls for urgent research into alcohol misuse, domestic violence and the impact of mental health problems on the partners and children of Service personnel and veterans. It argues that while progress is being made to address the psychological needs of Service personnel and veterans themselves, the practical and emotional impact on their partners and children must also be taken into consideration. It also examines the services already in place for families and identifies areas where more evidence, about both the need for services to support families and the effectiveness of these services, is needed.

Race equality in mental health. This briefing summarises the findings and recommendations from a recent report into race equality in mental health commissioned by the Department of Health . The report is based on a series of interviews with NHS and local authority leaders. The briefing outlined findings such as black and minority ethnic groups, particularly people from black African and black Caribbean backgrounds, historically experiencing poorer outcomes than the rest of the population. It was also found that some groups continue to have higher rates of admission to inpatient units and greater rates of detention than the rest of the population.

Doing good? Altruism and wellbeing in an age of austerity. This report highlights the impact that helping others has on people’s mental health and wellbeing, following a public attitude survey which showed that people believe society has become more selfish. It makes various recommendations including that commissioners of services aiming to support vulnerable groups should invest in volunteering and peer support services for socially isolated groups.

Stuck at home: the impact of day service cuts on people with a learning disability. This report finds that nearly a third of local authorities have closed day services in the last three years which results in one in four adults with a learning disability now spending less than one hour a day outside of their home due to these cuts.

Supporting dementia workers: a case study-based manager’s guide to good practice in learning and development for social care workers supporting people with dementia. This guide supports leaders and managers in developing their workforces to enable them to provide the highest quality of care for people with dementia. It considers how workforce planning and development can best improve the outcomes for people with dementia, supporting managers to work in the most effective way with training providers to deliver service outcomes and implement the Common Core Principles to Support People with Dementia.

General Social Care Council targeted inspections of Approved Mental Health Professionals courses in England (2011-12). This report presents the findings of inspections of approved courses in England offering the training for the Approved Mental Heath Professional role as defined by the Mental Health Act 2007.

Cases
MS v United Kingdom (App. No. 24527/08) [2012] ECHR 804 (ECtHR). The European Court of Human Rights has ruled that the detention of a mentally-ill man without appropriate psychiatric treatment  for more than three days in police custody had diminished his human dignity and amounted to degrading treatment.

DC v Nottinghamshire Healthcare NHS Trust and the Secretary of State for Justice [2012] UKUT 92 (AAC) 1. This case considers at "what point in considering the possible discharge of a restricted patient is the tribunal no longer allowed to adjourn but obliged to defer a direction for a conditional discharge." The response to this question is set out in paragraph 26 " In summary, the tribunal cannot exercise the power in section 73(7) unless it finds that the patient should not be detained but should be subject to recall and it formulates a direction, including conditions for discharge, that can take effect if the necessary arrangements can be made. Until then, it is free to adjourn."

News
Kidney failure patient forced to have dialysis.

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

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Obesity

  

Publications/Guidance
A report by the All-Party Parliamentary Group on Body Image calls on the Government to investigate putting "appearance-based discrimination" on the same legal basis as race and sexual discrimination under the Equality Act 2010. The report, "Reflections on Body Image", recommends a review into the scale of the problem after finding that one in five people had been victimised because of their weight.

If you would like more information please contact Julie Chappell. 

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Primary Care

Publications/Guidance
QMAS underpayments: action for PCTs to correct payments made in respect of 2010/11 financial year. This letter gives guidance on how to make the necessary payment adjustments for GP contractors regarding the 2010/11 Quality and Outcomes Framework (QOF) achievement payments. The guidance includes an action to make the necessary adjustments by the end of June 2012. It follows on from the DH's letter to PCTs in February 2011 that advised of an error found in QMAS, which error meant that GP contractors may have been underpaid for achievements under the QOF additional services indicators since 2004/05.

Primary care: today and tomorrow - improving general practice by working differently. This report finds that rising life expectancy, accompanied by increasingly complex long-term health conditions, a stretched primary care workforce and unprecedented financial and healthcare reform are amongst the greatest challenges facing primary care in the UK.

Care Quality Commission (CQC) registration - what you need to know. From July 2012, most primary medical services providers will be invited to apply for registration with the CQC, and all providers will need to be registered by April 2013. The purpose of this guidance is to aid GPs by providing a straightforward explanation of the registration process, to help providers determine whether they are compliant with the CQC’s essential standards, and to explain what will happen once providers are registered.

Failing the frail: a chaotic approach to commissioning healthcare services for care homes. This report is an analysis of data collected by the Care Quality Commission about PCT support for the healthcare of older people living within nursing and residential care homes. Overall the report outlines concerns about the standard of and access to healthcare of older people in England who live in care homes, who typically have greater and more complex health needs than their peers who live in the community. The report suggests that improvements in access to healthcare will benefit this population and reduce unplanned and costly demands on the NHS.

Responding to domestic abuse: guidance for general practices. This document provides guidance to general practices to help them respond effectively to patients experiencing domestic abuse, which is a Department of Health strategic priority. Targeted at practice managers and clinicians, this guidance supports practices to respond appropriately and safely to women and men experiencing abuse. The guidance includes key principles to help GPs and healthcare staff respond quickly and effectively to patients who disclose domestic abuse as well as resources to help the practice team, including a process map for responding to domestic abuse and a services directory.

QMAS underpayments: action for PCTs to correct payments made in respect of 2010/11 financial year. PCTs have been issued with guidance on how to make the necessary adjustments regarding the 2010/11 Quality and Outcomes Framework achievement payments. The guidance includes an action to make the necessary adjustments by the end of June 2012.

Use of non-geographic telephone numbers (e.g. 0845) by the NHS and GPs’ practices. This briefing provides an overview of current Department of Health guidance on NHS and general practice use of non-geographic phone numbers.

Planning for contract transfer: stabilisation phase. This guidance letter sets out activities and information required within the stabilisation phase. The stabilisation phase will use the risk assessment, produced during stock take, and address actions in the deficiency of documentation and management controls, so that agreements can be transferred to the new contracting bodies. 

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

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Regulation

  

Publications/Guidance
The new Medical Practitioners Tribunal Service (MPTS), which is to adjudicate on complaints made against doctors and impose sanctions where appropriate, launches on June 8, 2012. The service, which will operate separately from the General Medical Council, is expected to handle an estimated 340 doctors' fitness to practise hearings a year.

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

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General

Publications/Guidance
Liberating the NHS - Greater choice and control - A summary of responses. This publication collates the responses received to the government’s consultation document 'Liberating the NHS: Greater Choice and Control'.

Technical amendment to the category A8 ambulance response time standard. This letter outlines changes to ambulance response time categories. These changes prioritise the most critically ill patients, increase the number of vehicles available to reach patients most in need and reduce the number of cancelled ambulances.

Briefing on upcoming changes to the community pharmacy Medicines Use Review (MUR) service. From 1st July 2012, new data capture requirements for the community pharmacy MUR service will be implemented. There are also planned changes to the requirement to inform the patient's GP that an MUR has taken place but the implementation of these changes is subject to the amendment of the relevant Directions.

Medicines use review (MUR). New data capturing and reporting arrangements, published today are to be used from the 1st July for MUR. A MUR takes place between a pharmacist and a patient, and covers the patient’s medication and the support they need to get the most from their medicines. These changes are being published now to give pharmacy contractors preparatory time before the changes come into effect. Pharmacists will no longer need to complete the current medicines use review form for each patient if they do not wish. They will need to capture the data for each patient as sent out in ‘dataset to be retained by pharmacy contractors’.

Joint working – a quick start reference guide for NHS and pharmaceutical industry partners. This guide aims to address the challenges that can arise when initiating joint working projects. It includes a simple seven step flow chart that maps the journey of a joint working project from the idea generation stage to the development of a joint working agreement.

Heatwave Plan for England 2012. This Plan and accompanying guidance is intended to raise public and professional awareness on how to prepare in case of severe hot weather and potential heatwaves this summer. The Plan has been developed in partnership with the Health Protection Agency, and is supported by the Met Office. It sets out the risks to health of exposure from severe heat, and the steps people can take to protect their own health, and to reduce the risks of illness and death in the most vulnerable people.

Citizens Council report on discounting: for public comment. In 2002 NICE established the Citizens Council to ensure the perspective of the public is reflected in the methodology and processes that NICE uses to develop it's guidance. The Council discusses a topic set by the Citizens Council Committee. The Citizens Council last met in early November 2011 and discussed the question "How should NICE assess future costs and health benefits?". The report from that meeting is now available for public comment. The comments on the report will be collated and submitted with the report to NICE's Board. Please note that as this not a consultation, NICE does not respond to any comments that are submitted. The document will be available for comment until 8th June 2012.

Department of Health corporate plan 2012-13. The Department of Health corporate plan sets out the six priorities for the year ahead: better health, better care, better value, successful change, partnering and improvement within the Department of Health itself.

Payment by Results questions and answers for 2012-13. This question and answers document is provided in response to feedback received and where questions could not be addressed in the Payment by Results (PbR) guidance. The guidance for 2012-13 and supporting materials will enable organisations to operate PbR and the national tariff in 2012-13.

RCN launches new technology guides. These guides are aimed at helping nursing staff utilise technology to complement their clinical practice. The guides cover: using technology to complement nursing practice, using telephone advice for patients with long-term conditions, using text messaging services, developing and using websites and using telehealth to monitor patients remotely.
Using technology to complement nursing practice
Using telephone advice for patients with long-term conditions
Using text messaging services
Developing and using websites
Using telehealth to monitor patients remotely
RCN - news

Eurobarometer qualitative study: patient involvement. This research aimed to explore views on patient involvement in healthcare across fifteen European member states. In-depth interviews were carried out with five healthcare practitioners and ten patients in each country. Practitioners and patients were asked their overall opinion of national healthcare, who they perceived to be responsible for healthcare, feeling on patient trust and control, their understanding of the concept of patient involvement, perceived benefits and risks of patient involvement and perceived barriers and improvements.

An introduction to the National Health Service. This guide is designed for use by both NHS and industry partners, and has been developed around a simple seven step flow chart which covers the history of the NHS, key statistics, primary and secondary care, devolved health services in Wales, Scotland and Northern Ireland, the current NHS structure and the implications of the reforms and the considerations for industry.

Abortion Statistics: England and Wales - 2011. This bulletin summarises information from the abortion notification forms returned to chief medical officers about abortions carried out in England and Wales in 2011.

World class procurement in the NHS: call for evidence and ideas. A call for evidence on how procurement in the NHS can be transformed has been issued. Views and contributions are being sought from the NHS, industry, other government departments, the academic, scientific and third sectors and social care. The call for evidence and ideas will close on 27th July 2012.

NHS procurement: raising our game. This guidance aims to improve procurement across the healthcare system. It sets out proposed actions for NHS trusts and the Department of Health and focuses on taking immediate action to start tackling key areas for improvements.

Implementing the overseas visitors hospital charging regulations 2011. This updated guidance incorporates some changes to advice given in December 2011 on when to share data with the UK Border Agency on overseas visitors with debts to the NHS. It also comments on what evidence will demonstrate that a member of the Olympic/Paralympic Games Family is entitled to free NHS hospital treatment. The guidance is for NHS bodies in carrying out their duties to make and recover charges for NHS hospital treatment from overseas visitors not exempt from charge. It also includes guidance to safeguard the health of those not entitled to free hospital treatment.

Preparations for Olympic and Paralympic Games planning and reporting 2012. Situation reporting (SITREP) will commence from Tuesday 3 July 2012 through to Monday 10 September 2012 (‘Gamestime’ reporting). The Olympic and Paralympic ‘Gamestime’ reporting 2012 points to revised guidance to help effective completion of daily SITREPs, which will be available via UNIFY2 (the system for reporting and sharing NHS and social care performance information).

NHS bursary scheme rules. This document outlines the new rules which are applicable for students who started courses on or after 1st September 2012. The rules for students who started their courses before this date are set out in the thirteenth edition of the NHS bursary scheme rules.

Consultations
Liberating the NHS: No decision about me, without me. Seeks view on detailed proposals to secure genuinely shared decision-making for patients. The consultation proposes a model of shared decision-making all along the patient pathway, which should be relevant irrespective of patients’ conditions, their clinical pathway or progress along it. The model indicates where patients would be expected to have more say in decisions about their care in primary care: before a diagnosis; at referral to secondary care; and after a diagnosis had been made. It asks a small number of focused questions. The consultation closes on 20 July 2012.

Public consultation on regulations to transpose organ directive 2010/53/EU into UK legislation: summary of consultation responses. This document brings together responses to the consultation on draft Quality and Safety of Organs for Transplantation Regulations 2012. The objective of the directive is to set standards across the European Union and the UK is required to be compliant from 27 August 2012. Respondents saw little or no benefits from the UK implementing the Organ Directive. Respondents were also concerned about cost burdens arising from implementation, and would prefer current arrangements under NHS Blood and Transplant (NHSBT) and commissioners to continue. 

Health and wellbeing boards: your chance to shape secondary legislation. Informal views are being sought to help develop proposals for the technical regulations that will apply to health and wellbeing boards from April 2013. The intention with the regulations is to give as much flexibility to local areas as possible and to build on how shadow boards are already running. Responses will be used to inform proposals and form the basis for recommendations to Ministers later in the summer. The deadline for feedback is Friday 29th June 2012. 

News
OFT calls for greater patient choice and competition in dentistry market.

Bevan Brittan Updates
Telecoms masts - legal issues for NHS landowners. The presence of telecommunications apparatus can be a major obstacle to a landowner’s ability to dispose of or redevelop its land. Most mobile operators enjoy statutory protection which makes it very difficult for them to be removed from sites. 

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

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