Health and Social Care Update - September

  

Legal intelligence for professionals in health and social care

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

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

Care	Foundation Trusts
Children	Information and Data Sharing
Clinical Risk	Mental Health
Commissioning	Primary Care
Complaints	Public Health
Employment/HR	Regulation
Finance	General

 

Care

Publications/Guidance
Winterbourne View Hospital - a serious case review. This review by independent adult safeguarding expert Margaret Flynn was commissioned following the BBC's Panorama programme in May 2011 that disclosed the abuse of adults with learning disabilities and autism at Winterbourne View, a private hospital owned and operated by Castlebeck Ltd. The report shows that the abuse at the hospital resulted from serious and sustained failings in the management procedures of Castlebeck Ltd. It also identifies where other organisations’ systems and procedures fell short in commissioning patient care, and in reviewing and safeguarding the wellbeing of patients before and during their stay at Winterbourne View. It makes a number of recommendations, including a call for greater investment in community-based care in order to reduce the need for in-patient admissions at such assessment, treatment and rehabilitation units. It also calls for notifications of concern, including safeguarding alerts, hospital admissions and police attendances, to be better coordinated and shared amongst safeguarding organisations to allow earlier identification of potential problems and earlier action to be taken.
CQC has published its Internal management review of the regulation of Winterbourne View that sets out the results of its own investigation into its role as regulator.

Regulated activity (adults): The definition of ‘regulated activity’ (adults) as defined by the Safeguarding Vulnerable Groups Act 2006 from 10 September 2012. Provides information on the scope of regulated activity in relation to adults, as defined in the Safeguarding Vulnerable Groups Act 2006 (SGVA) as amended by the Protection of Freedoms Act 2012. Regulated activities are the activities that the Independent Safeguarding Authority and, from December 2012, the Disclosure and Barring Service can bar people from engaging in. The definition of regulated activity for adults from 10 September 2012 identifies the activities provided to any adult which, if any adult requires them, mean that the adult is considered vulnerable at that particular time. The SVGA will no longer label adults as ‘vulnerable’ because of the setting in which the activity is received, nor because of the personal characteristics or circumstances of the adult receiving the activities. There is no longer a requirement for a person to carry out the activities a certain number of times before they are engaging in regulated activity - any time a person engages in the activities set out in this document, they are engaging in regulated activity.

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

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Children

Publications/Guidance
Looked-after children and young people: consultation on draft quality standard. NICE is seeking views on a draft quality standard for social care on the health and wellbeing of looked after children and young people, for use in England. Around 60% of children being looked after in England have been reported to have emotional and mental health problems. The standard consists of a number of statements describing high quality care, to help improve the quality of care of looked-after children and young people. The consultation closes on 16 October 2012.

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

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Clinical Risk     

Publications/Guidance
The Social Cost of Litigation. New research by Professor Frank Furedi highlights the high financial and social cost of today’s ‘culture of litigation’ on health and education services. The report, by Professor Furedi and Jennie Bristow of the University of Kent’s School of Social Policy, Sociology and Social Research, is published by the Centre for Policy Studies.

Older people and emergency bed use: Exploring variation. This paper from The King's Fund explores factors that might be driving the significant variation in use of hospital beds by patients over 65 admitted as an emergency. It considers the contribution made by patient-based (demand-side) factors, hospital (supply-side) factors, the availability of community services and resources, and broader system relationships (how care systems and staff work together and relate to each other) in driving the observed variation in length of stay and rate of admission. It concludes that PCTs with the highest acute bed use should develop strategies across the care system and align ways of working to identify ways to reduce usage. All clinical commissioning groups would benefit from benchmarking the relative use of acute beds in their area, and the related rates of admission and length of stay. It is clear that organisational integration alone does not deliver improved performance. The key to reducing use of emergency beds lies in changing ways of working across the care system rather than implementing piecemeal initiatives. Organisations need to prioritise whole systems approaches if they are to deliver a real shift from hospital to community-based care.

Antibiotics for early-onset neonatal infection. This clinical guideline offers evidence-based advice on the use of antibiotics to prevent and treat early-onset neonatal infection (infection within 72 hours of birth). It recommends that the NHS needs to prioritise the treatment of sick babies, using antibiotics appropriately to avoid the development of bacterial resistance to antibiotics. It also recommends the introduction of a framework based on risk factors and clinical indicators to identify and treat babies with an increased likelihood of having an early-onset neonatal infection.

Comparative analysis of silicone implant samples. The MHRA and the Department of Health have published an interim-report of this year’s ongoing testing of PIP breast implants. The results from this interim-report were used by the expert group, chaired by NHS Medical Director Sir Bruce Keogh, that published its final report into the safety of PIP breast implants on the 18th June. 

Quality in the new health system – maintaining and improving quality from April 2013. This draft report by the National Quality Board sets out how the new health system will work together to identify, respond to and prevent serious failures in quality. The report describes how improving quality is the responsibility of everyone working in the health service, both individually and collectively. The different organisations in the new health system have distinct roles and responsibilities to ensure quality and promote a culture that places the patients at the heart of the health system. Collectively these organisations must collaborate where appropriate and work closely together in order to effectively maintain and improve the quality of care that the health service delivers for its patients. A network of local and regional Quality Surveillance Groups (QSG), which will be in action from 1 April 2013, will bring together commissioners, regulators and other bodies, in a virtual team, to share information and intelligence about quality across the system. The report is published in draft form so that it can be updated in the light of findings or recommendations from the Mid Staffordshire NHS Foundation Trust Public Inquiry, which is due to be published this Autumn. Comments on the draft should be sent to the NQB by 30 September 2012. 

Transforming the delivery of health and social care: the case for fundamental change. The UK has the second highest rate of mortality amenable to health care among 16 high-income countries, and evidence shows that variations in health outcomes between social groups are widening. This paper explores how the current health and social care delivery system has failed to keep pace with the population's needs and expectations. It argues that incremental changes to existing models of care will not be sufficient in addressing these challenges and that a much bolder approach is needed to bring about innovative models that are appropriate to the needs of the population and are high quality, sustainable and offer value for money. 

Getting it right first time: improving the quality of orthopaedic care within the National Health Service in England. This report looks into the issues facing orthopaedic care in England based on the views of a leading surgeon. It warns that the provision of orthopaedic care could soon suffer from falling quality and rising waiting lists unless fundamental changes are made to the way the service is delivered. It proposes a series of reforms for a joined up approach across the NHS to improve orthopaedic treatment. It also warns that this decline in quality could spread across services if not addressed, resulting in increased waiting times and widespread rationing. 

Consultations
Consultation on proposed regulations to implement Council Directive 2010/32/EU on preventing sharps injuries in the hospital and healthcare sector. The HSE is seeking views on proposals to introduce new Health and Safety (Sharp Instruments in Healthcare) Regulations 2013, which are are required under the Sharps Directive 2010/32. The new regulations will require employers in the healthcare sector to introduce arrangements for the safe use and disposal of medical sharps, to provide information and training to employees, and to record, investigate and take action following a sharps injury. The regulations will also introduce a duty on healthcare workers to promptly report any sharps injury to their employer. The consultation closes on 8 November 2012.

Review of the regulation of cosmetic interventions - Call for evidence. The DH has asked Sir Bruce Keogh to convene a group of experts to look at how the safety of patients considering cosmetic interventions can be better ensured in future, in response to concerns raised about the industry following the Poly Implant Prothèse (PIP) controversy. The review is expected to cover surgical cosmetic interventions such as breast augmentation, and non-surgical cosmetic interventions such as injectable dermal fillers. It will consider issues such as regulation and clinical governance, information and consent and outcomes based registers, and will provide recommendations to Government on the appropriate arrangements required to ensure patients receive the protection they need when accessing cosmetic services and interventions. This call for evidence enables all interested parties to feed in their views for Sir Bruce Keogh’s Review Committee to consider. The closing date for comments is 15 October 2012. See Article in Telegraph

Consultation on recommendations for no-fault compensation in Scotland for injuries resulting from clinical treatment. This consultation is for anyone who would be affected in anyway by a change in compensation arrangements for injuries resulting from clinical treatment. We are seeking views on the recommendations of the No-fault Compensation Review Group established in 2009 to consider the potential benefits for patients in Scotland of a no-fault compensation scheme.

National Quality Board sets out how quality will be maintained and improved in new health system - A consultation
Date of publication: 16 August 2012
Deadline date: 30 September 2012
The National Quality Board seeks views on a draft report setting out how quality will be maintained and improved in the new health system.

News
GMC gives green light to plans to boost standards of medical trainers. The General Medical Council (GMC) is set to strengthen the role of doctors who train medical students and doctors in training by formally recognising the contribution they make to patient safety.

Doctors blame 'no win, no fee' for rise in legal actions. Doctors are facing unprecedented increases in claims for compensation for clinical negligence, according to the head of the Medical Defence Union.

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

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Commissioning

Consultations
A consultation on guidance for commissioners: Ensuring continuity of health services and designating Commissioner Requested Services and Protected Services. Monitor's future role includes powers to protect patient services and enable them to continue should a provider become financially unviable. Through the licence, it will monitor the financial health of providers and take appropriate action if there are warning signs of a provider getting into difficulty; however, commissioners will have the main responsibility for ensuring the continuity of services in their local area. This includes identifying the types of services which may need to be protected if a provider should have financial problems. Monitor is seeking views on draft guidance that sets out an end-to-end process that will guide commissioners from initiating the process of designating services as Commissioner Requested Services under Monitor's provider licence, through to finalising their decision about which services to protect in the rare event of provider failure. Commissioners are required under the Act to pay regard to Monitor’s guidance. The deadline for responses is 8 November 2012.

Securing best value for NHS patients: Requirements for commissioners to adhere to good procurement practice and protect patient choice. Seeks views on proposals for regulations for the NHS Commissioning Board and CCGs under s.75 HSCA 2012 on procurement, patient choice, competition and managing conflicts of interest, that aim to protect patients’ interests by establishing minimum requirements for good commissioning so that commissioners always deliver best value. The consultation covers requirements to ensure good procurement practice and that commissioners enable patients to exercise their rights to choose as set out in the NHS Constitution; prohibiting commissioners from taking actions which restrict competition where this is against patients’ interests; conflicts of interest; and Monitor’s proposed investigative and enforcement powers. The closing date for comments is 26 October 2012. DH plans that the draft regulations based on these proposals will be laid in Parliament in January 2013 and come into force in April 2013.

A guide to commissioning for equality. This guide from the Royal College of Nursing analyses how needs are assessed and how services are introduced to meet these needs, emphasising the importance of knowledge, timeliness, consideration and review. It provides an overview of the Equality Act 2010 and the legislation’s implication for the public sector. The guide also provides advice for service providers on commissioning a framework through which they can measure equality outcomes.

Clinical commissioning factsheets. These factsheets are part of a series which aim to help outline the architecture of the new NHS commissioning system.

Clinical Advisory Group for Prescribed Services Final Recommendations. A report by the Clinical Advisory Group for Prescribed Services (CAG) has been published, recommending which specialised services for people with rare conditions should be commissioned nationally in England. The services listed in the report will be commissioned by the NHS Commissioning Board from April 2013, rather than by Clinical Commissioning Groups. The list will be agreed by Ministers and the Commissioning Board in the autumn. The CAG was established to advise the government on which specialised services should be commissioned nationally. The group is chaired by Dr Kathy McLean and includes clinical specialists, health professionals and GPs.

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

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Complaints

Publications/Guidance
Data on written complaints in the NHS 2011-12. The Health and Social Care Information Centre’s report, Data on Written Complaints in the NHS 2011-12, shows there were more than 162,000 written complaints against NHS services in England last year. That represents a rise of around 1% on the previous year, after allowing for the inclusion of data from 23 foundation trusts for the first time. The figures suggest an average of around 3,100 written complaints per week. The report is separated into two sections: one covering hospital and community health services and the second family health services covering GP practices and dental services. It also provides a breakdown by service area (who was complained about) or subject area (what was complained about).

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Employment/HR

 

Publications/Guidance
2012 national NHS staff survey. This letter from NHS Chief Executive, David Nicholson, encourages NHS chief executives to strongly support the 2012 NHS staff survey and to encourage their staff to take part. It provides information on the survey, including the key dates of activity for NHS organisations.

A guide to commissioning for equality. This guide from the Royal College of Nursing analyses how needs are assessed and how services are introduced to meet these needs, emphasising the importance of knowledge, timeliness, consideration and review. It provides an overview of the Equality Act 2010 and the legislation’s implication for the public sector. The guide also provides advice for service providers on commissioning a framework through which they can measure equality outcomes.

Process for making severance payments to very senior managers in Strategic Health Authorities and Primary Care Trusts. This letter from Sir David Nicholson sets out the new approval process to be followed when making a termination payment to very senior managers (VSMs) employed by primary care trusts (PCTs). It clarifies the process for all VSMs employed by strategic health authorities and PCTs.

2013/14 pay review body survey. NHS Employers will be submitting evidence to the NHS Pay Review Body, about the 2013/14 pay award for Agenda for Change staff, in October. Employer feedback is being sought to inform the submission. This survey is anonymous and will close on 21st September 2012.

Government response to the House of Commons Health Select Committee first report of session 2012-13: education, training and workforce planning. The Health Select Committee's report stated that Government plans to reform education, training and workforce planning in the NHS are unclear and lack crucial detail. It made 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. This publication outlines the Government's response to this report and aims to clarify some of the issues which were identified as unclear in the original report.  

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

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Publications/Guidance
Reforming payment for health care in Europe to achieve better value. This report compares different payment systems for health care used across Europe and examines their role in improving the efficiency and quality of care. Findings are based on discussions at the Nuffield Trust and KPMG summit for European health leaders, held in January 2012.

Right data, right payment: Annual report on the Payment by Results (PbR) data assurance programme 2011/12. This report by the Audit Commission presents the key findings from the 2011/12 programme. It includes reviews of commissioner arrangements to secure good data quality on the information that underpins PbR and audits of inpatient clinical coding and the key data set that supports payment under PbR at acute NHS trusts and foundation trusts. It also follows up on recommendations made in previous audits to see how well NHS trusts and foundation trusts have delivered. The report finds that, when considering all trusts as a whole, performance on clinical coding has improved since the PbR assurance framework started, with lower average error rates each year and a smaller gap between the top and bottom of the error range. It names the ten trusts in the best performing category and the ten in the worst performing category, and highlights five organisations that have not demonstrated the adequate resolution of issues referred to in the 2010/11 annual report and therefore may still have an incorrect 2010/11 reference costs submission.

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

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Foundation Trusts 

Guidance /Publications
Review of NHS foundation trust plans (2012/13). This report sets out the main challenges facing foundation trusts based on a review of the sector’s annual plans, which shows that the sector still faces challenges in meeting greater demand and more stretching health care targets while delivering significant savings each year.

Consultations
Protecting and promoting patients’ interests – licensing providers of NHS services. Seeks views on proposals for implementing a new licensing regime for providers of NHS services, covering: who is required to be licensed, the objection threshold for providers to object changes to the standard conditions, and the fines Monitor will be able to impose if a provider fails to comply with the licensing regime. The consultation closes on 22 October 2012. Monitor and DH are working to enable Monitor to bring the licensing regime into force for NHS foundation trusts from April 2013 and for other providers of NHS services from April 2014.

Bevan Brittan Events
Health & Social Care Bill Seminar: Provider regulatory issues for Foundation Trusts - Exeter. 20 September 2012 : 10.00am - 12.30pm (Registration 9.30am). Location: The Rougemont Hotel By Thistle, Queen Street, Exeter, EX4 3SP.
The health and social care act 2012 is becoming  reality as more provisions come into force and  while much attention is currently on the commissioner changes the provision of services will also change significantly as the new regime comes in. This seminar enables you to get on top of the changes and gives you the keys to understanding the future. 

Health and Social Care Act Seminar: Provider regulatory issues for Foundation Trusts - London. 26 September 2012 : 10.00am - 12.30pm (Registration 9.30am). Location: Bevan Brittan, Fleet Place House, 2 Fleet Place, Holborn Viaduct, London, EC4M 7RF. The Health and Social Care Act 2012 is becoming reality as more provisions come into force and while much attention is currently on the commissioner changes the provision of services will also change significantly as the new regime come in. This seminar enables you to get on top of the changes and gives you the keys to understanding the future.

Health and Social Care Act Seminar: Provider regulatory issues for Foundation Trusts - Birmingham.

27 September 2012 : 10.00am - 12.30pm (Registration 9.30am). Location: Bevan Brittan, Interchange Place, Edmund Street, Birmingham, B3 2TA. The Health and Social Care Act 2012 is becoming reality as more provisions come into force and while much attention is currently on the commissioner changes the provision of services will also change significantly as the new regime come in. This seminar enables you to get on top of the changes and gives you the keys to understanding the future.

Bevan Brittan Updates
Monitor launches consultation on new NHS provider licence. Monitor has published a consultation on the proposed NHS provider licence which all NHS services providers will be required to hold, save for any applicable exemptions. The exemptions are currently subject to a separate consultation process (published 15 August 2012) for which responses are required by 22 October 2012.  The new licensing regime will be Monitor’s key mechanism for regulating both NHS and private providers of NHS services. 

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

Back to top Information and Data Sharing

Publications/Guidance
Information sharing challenge fund (ISCF). This dear colleague letter announces newly available funding to develop digital services that improve patient care and can be used to share information more easily across the NHS. Funded projects are expected to lead to a successful deployment and use of solutions based on the NHS interoperability toolkit. The ISCF is open to eligible NHS organisations.

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

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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:-
 Capacity to enter into marriage

 Vicarious liability and s13

 Recall of CTO but recall no longer needed. 

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

Training - If you would like to know about our lunch time training sessions just let Claire Bentley know. You can attend in our London, Bristol or Birmingham office.

Publications/Guidance
Winterbourne View Hospital - a serious case review. This review by independent adult safeguarding expert Margaret Flynn was commissioned following the BBC's Panorama programme in May 2011 that disclosed the abuse of adults with learning disabilities and autism at Winterbourne View, a private hospital owned and operated by Castlebeck Ltd. The report shows that the abuse at the hospital resulted from serious and sustained failings in the management procedures of Castlebeck Ltd. It also identifies where other organisations’ systems and procedures fell short in commissioning patient care, and in reviewing and safeguarding the wellbeing of patients before and during their stay at Winterbourne View. It makes a number of recommendations, including a call for greater investment in community-based care in order to reduce the need for in-patient admissions at such assessment, treatment and rehabilitation units. It also calls for notifications of concern, including safeguarding alerts, hospital admissions and police attendances, to be better coordinated and shared amongst safeguarding organisations to allow earlier identification of potential problems and earlier action to be taken.
CQC has published its Internal management review of the regulation of Winterbourne View that sets out the results of its own investigation into its role as regulator.

Regulated activity (adults): The definition of ‘regulated activity’ (adults) as defined by the Safeguarding Vulnerable Groups Act 2006 from 10 September 2012. Provides information on the scope of regulated activity in relation to adults, as defined in the Safeguarding Vulnerable Groups Act 2006 (SGVA) as amended by the Protection of Freedoms Act 2012. Regulated activities are the activities that the Independent Safeguarding Authority and, from December 2012, the Disclosure and Barring Service can bar people from engaging in. The definition of regulated activity for adults from 10 September 2012 identifies the activities provided to any adult which, if any adult requires them, mean that the adult is considered vulnerable at that particular time. The SVGA will no longer label adults as ‘vulnerable’ because of the setting in which the activity is received, nor because of the personal characteristics or circumstances of the adult receiving the activities. There is no longer a requirement for a person to carry out the activities a certain number of times before they are engaging in regulated activity - any time a person engages in the activities set out in this document, they are engaging in regulated activity.

Peer support in mental health and learning disability. This briefing paper provides an overview of peer support in mental health (including dementia) and learning disabilities, based on some of the recent literature. It looks at how peer support can help people to recover, or get more control over their condition, and to live fulfilling lives in their communities.

Command Paper: Post-legislative assessment of the Mental Health Act 2007 (Cm 8408). The Department of Health (DoH) has published a Memorandum to the Health Committee of the House of Commons providing a preliminary assessment of the Mental Health Act 2007 (MHA 2007). It looks at the main amendments to the Mental Health Act 1983 made by the MHA 2007 in areas where it was generally agreed reform was needed. The 2007 Act also introduced 'deprivation of liberty safeguards', and extended the rights of victims.

Making every contact count: a joint approach to preventing homelessness. This report thinks about how local services and agencies can be managed in a way that prevents all households, regardless of whether they are families, couples, or single people, from reaching a crisis point where they are faced with homelessness. It calls for an improvement in health outcomes for homeless people with dual substance abuse and mental health needs and support for professionals discharging patients with knowledge of who to approach for help in meeting housing needs. 

Maternal mental health pathway aims to provide a structured approach. This guidance provides a structured approach on common issues associated with maternal mental health and well being, from pregnancy through the early months after the birth.

Mental Capacity and the Mental Capacity Act 2005 - A literature review. This literature review prepared by the Mental Health Foundation was carried out to collate academic literature relating to mental capacity issues and to the implementation of the Mental Capacity Act 2005. 

Suicide prevention strategy launched. The Department of Health has launched a new cross-government strategy ‘Preventing suicide in England.’ The strategy aims to: reduce the risk of suicide in high-risk groups; tailor approaches to improve mental health in specific groups; reduce access to the means of suicide; and support the media in delivering sensitive approaches.

Care Quality Commission: Your rights under the Mental Health Act. This documents outlines people's rights under the Mental Health Act following recent changes to giving consent to treatment. The information has been produced for people who are detained in hospital, on a community treatment order, and those who have been recommended electro-convulsive therapy.

Consultations
Dementia - supporting people to live well with dementia: consultation on draft quality standard. NICE is seeking views on a draft quality standard for social care on supporting people to live well with dementia, for use in England. To help improve the care of people with dementia, the draft quality standard features a number of statements which together set out a vision of high quality care. The consultation closes on 16 October 2012.

News
Hillingdon council has been ordered to pay £35,000 to Steven Neary who was unlawfully detained in a care unit. 

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
Guidance published alongside the NHS (Pharmaceutical Services) Regulations 2012. This guidance helps PCTs in the assessment and determination of applications to provide NHS pharmaceutical services under the new market entry test and the new performance sanctions regime. Also, an addendum has been produced to the transitional provisions guidance published on 23 July 2012 with regard to applications which do not have an equivalent provision in the 2012 Regulations but have been notified.

The austerity Britain report: the impact of the recession on the UK's health, according to GPs. This report is the result of a GP opinion survey which aimed to better understand the impact that the economic downturn of the last four years has had on the nation’s health, and how this may have impacted on GPs’ practices. It questioned GPs broadly at the impact of the recession on family planning, alcohol abuse, wellbeing, mental health and the impact on GPs themselves.

Working with local government: a guide for GP commissioners. This short guide aims to help GP commissioners understand some of the structural and cultural differences between the NHS and local government and suggest ways of bridging these to build strong, productive Health and Well-being Boards. It includes a summary of local authorities' responsibilities for public health.
There is also an equivalent guide for councillors on working with GP commissioners.

News
PCTs to be added to the EPS authorisation directions from 1 December 2012. The national electronic prescriptions service (EPS) directions evaluation panel have approved 33 primary care trusts to be added to the EPS Directions.

Bevan Brittan Updates
Benefit or burden? Transfer of PCT-owned PFI property to NHS providers. The Department of Health has published its guidance relating to the treatment of PCT- owned PFI property which confirms that providers may ask for these assets to be transferred. If you have agreed to take on a community PFI, or are considering doing so, how should you approach the acquisition?

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

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Public Health

Publications/Guidance
Public Health England people transition policy – FAQs for Module 1. This document sets out a series of frequently asked questions about the agreed HR processes for handling the transfer, appointment and redeployment of staff from sender organisations to Public Health England. It has been developed to support module 1 of the Public Health England People Transition Policy that sets out the agreed HR policies and processes for transferring staff from existing senders to the new organisation.

Clustering of unhealthy behaviours over time: Implications for policy and practice. This report from The King's Fund considers how people's lifestyle behaviours, such as smoking, drinking, eating and exercise, co-occur or cluster in the population. It looks at how these patterns of multiple lifestyle risk have been evolving over time, in the context of the English population, and sets out the implications for public health policy and practice. The findings suggest that public health initiatives have been important in improving health among the population as a whole; however, they have failed to have an impact among lower socio-economic groups during this period. While noting the successes of public health initiatives, the report suggests that they have focused too much on tackling individual behaviours. It recommends public health policy should focus more on tackling multiple behaviours and targeting those in lower socio-economic and educational groups.

Implementing NICE public health guidance for the workplace: staff health improvement project interim report. This project aims to facilitate faster implementation of NICE public health guidance for the workplace by NHS trusts. Telephone interviews were conducted with 22 acute and mental health trusts around the country that have made progress in implementing the NICE guidance for the workplace. The second phase of the project will involve meeting with 40 trusts that have made less progress, and offering action planning support to help further this implementation. The experience of the 22 trusts interviewed will be shared and examples of good practice will continue to be collected from the trusts to be visited. An updated report will be produced in November 2012.

Health protection and local government. This provisional guidance describes the arrangements for preventing, planning for and responding to health protection incidents and outbreaks within the new system, focusing on those which do not require mobilisation of a multi-agency response under the Civil Contingencies Act 2004. It also gives further details about the nature of local authorities’ planned new duty to protect the health of the population.

Transforming Public Health bulletin: Issue 11, July/August 2012. This issue includes an update on Public Health England, puts the spotlight on quality assurance reference centres for cancer screening, and provides an update on the work of the Concordat Steering Group.

Suicide prevention strategy launched. The Department of Health has launched a new cross-government strategy ‘Preventing suicide in England.’ The strategy aims to: reduce the risk of suicide in high-risk groups; tailor approaches to improve mental health in specific groups; reduce access to the means of suicide; and support the media in delivering sensitive approaches.

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

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Regulation

  

Publications/Guidance
Regulated activity (adults): The definition of ‘regulated activity’ (adults) as defined by the Safeguarding Vulnerable Groups Act 2006 from 10 September 2012. Provides information on the scope of regulated activity in relation to adults, as defined in the Safeguarding Vulnerable Groups Act 2006 (SGVA) as amended by the Protection of Freedoms Act 2012. Regulated activities are the activities that the Independent Safeguarding Authority and, from December 2012, the Disclosure and Barring Service can bar people from engaging in. The definition of regulated activity for adults from 10 September 2012 identifies the activities provided to any adult which, if any adult requires them, mean that the adult is considered vulnerable at that particular time. The SVGA will no longer label adults as ‘vulnerable’ because of the setting in which the activity is received, nor because of the personal characteristics or circumstances of the adult receiving the activities. There is no longer a requirement for a person to carry out the activities a certain number of times before they are engaging in regulated activity - any time a person engages in the activities set out in this document, they are engaging in regulated activity.

Making revalidation recommendations: the GMC responsible officer (ROs) protocol. This guide for ROs describes what the revalidation recommendations are; clarifies the roles and responsibilities of ROs and their delegates in making and sending recommendations; sets out the GMC’s expectations of what will underpin RO recommendations; and provides ROs with statements and criteria for the three recommendation categories. The GMC licence to practise and revalidation regulations are expected to commence in December 2012.

Consultations
The next phase: our consultation on our strategy for 2013 to 2016. The CQC are developing their strategy for the next three years. Comments are invited until the 6th December 2012.

Bevan Brittan Updates
Monitor launches consultation on new NHS provider licence. Monitor has published a consultation on the proposed NHS provider licence which all NHS services providers will be required to hold, save for any applicable exemptions. The exemptions are currently subject to a separate consultation process (published 15 August 2012) for which responses are required by 22 October 2012.  The new licensing regime will be Monitor’s key mechanism for regulating both NHS and private providers of NHS services. 

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

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General

Publications/Guidance

Adaptation to climate change for health and social care organisations. This guidance, written in collaboration with partners including the DH, the Environment Agency, DEFRA and Climate UK, aims to summarise the current knowledge on adapting to climate change in NHS organisations. It describes what climate change adaptation is, why it is a priority for the NHS and how organisations can include adaptation in their Sustainable Development Management Plans (SDMPs).

Health care quality for an active later life. The Peninsula College of Medicine and Dentistry Ageing Research Group has been funded by Age UK to collate recent scientific data from diverse sources to report on the current state of health of the older population, as well as to examine the evidence on how the NHS is meeting the needs of the older population. It also looks at whether the current healthcare reforms will improve health outcomes for older people.

HIV outpatient pathway factsheets. These factsheets provide guidance on the HIV outpatients pathway for clinicians, commissioners and finance personnel.

Working with older lesbian, gay and bisexual (LGB) people: a guide for care and support services. The CQC are working with Stonewall as part of their Health Champions Scheme (which supports NHS organisations to improve services for LGB people) to develop the way services’ compliance with equality standards are monitored. This guide provides information on: the law, supporting older LGB people, tips and case studies for care homes, domiciliary services, health care services, housing providers and councils, and involving LGB people in service provision.

Revising the clinical trials directive. The EU Clinical Trials Directive, which was implemented in the UK in 2004, has been highly criticised for contributing to a significant drop in the number of clinical trials conducted in the UK. The EC, having recognised the need to remedy the unintended consequences of this EU law, has published legal proposals to amend the existing EU directive. This briefing outlines the key changes proposed and what they mean for the NHS. The proposals will be subject to negotiations at EU level and the NHS European Office will continue to brief EU decision-makers on NHS views.

Impact assessment: the new NHS provider licence. This independent report analyses the costs and benefits of each of the proposed licence conditions which set out various obligations on providers of NHS services. The conditions fall into six broad groups: general, pricing, choice and competition, integrated care, continuity of services, and NHS foundation trusts.

Cases
Nicklinson v Ministry of Justice [2012] EWHC 2381 (Admin) (Admin Ct). The High Court of England and Wales has declined to change the law concerning assisted suicide and euthanasia, holding that it was for Parliament to decide whether to change the law. Tony Nicklinson died on 22 August six days after the High Court decision. See also GMC statement.

Consultations
The people's NHS. The Welsh Government is seeking views on proposals to create a 'Compact' with the people of Wales in relation to their health and health services. The Compact will be in two parts: first, an evolving agreement about what are the responsibilities of the Government, the NHS and people across Wales; and second, an ongoing discussion about how people can play a greater part in managing their own health and improving health services in Wales, and how the Government and NHS can help that happen. The consultation closes on 24 October 2012.

Public consultation (MLX 376): Proposal to introduce an early access to medicines scheme in the UK. The MHRA is undertaking a public consultation on proposals to introduce a scheme in the UK that will provide access to certain new medicines before they are formally licensed. The detail of the scheme, the types of medicines that may be made available and the stage in their development at which we expect that companies will apply are set out in this document.

Call for evidence to support HPV immunisation programme review - A consultation
Date of publication: 14 August 2012
Deadline date: 9 November 2012
This consultation calls for evidence to support a review of possible modifications to the Human Papillomavirus (HPV) immunisation programme. The programme currently provides the offer of immunisation routinely to girls aged 12 to 13 years.

Legislation
The Human Medicines Regulations 2012. These regulations simplify medicines legislation whilst maintaining strong and effective safeguards for public health. They replace much of the Medicines Act 1968 and around 200 statutory instruments and also introduce some small policy changes to help ensure that the legislation remains fit for purpose and reflects modern practice.

News
Health warning over army of NHS "temps". Concerns have been raised following an increase in NHS trusts employing key clinical staff on "zero-hours" contracts, which bind employees to on-call working without guaranteeing any specified number of hours or employment rights.

IT agreement to save the taxpayer over £1 billion. Announces that DH has entered into a new agreement with CSC, suppliers of the Lorenzo healthcare IT system, which will give local hospitals and NHS organisations the power to make their own decisions about which IT systems they use. Under the re-negotiated agreement, local NHS organisations will no longer be committed to using Lorenzo, and will have the freedom to decide what IT systems are most suitable for their needs. CSC will retain responsibility for rolling out their Lorenzo Electronic Patient Record system, currently being used by 10 NHS organisations in the North, Midlands and East of England, to the NHS. If eligible local NHS organisations wish to use Lorenzo they will be able to access centralised support and funding but will first need to develop a robust business case and demonstrate value for money in order to gain approval to do so.

OFT welcomes action by NHS trusts to ensure compliance with competition law. Eight NHS Hospital Trusts, which are members of the Southern Region Private Healthcare Association (SPHA), have given voluntary assurances to the OFT that they will no longer exchange commercially sensitive information about their Private Patient Unit (PPU) prices, to ensure they comply with competition law. They will also provide further training to their staff on the importance of complying with competition law where applicable. The OFT will also be writing to all NHS Trusts and Foundation Trusts which operate PPUs, enclosing guidance on competition law compliance.

Hospitals and patients urged to take action on missed appointments. The Health Minister Simon Burns is urging NHS hospitals to make more use of innovative solutions to tackle the number of people who miss their hospital appointments. In 2011/12 there were around 5.5m missed appointments in the NHS. Overall the NHS carried out nearly 53m outpatient appointments – meaning more than one in ten appointments were did-not-attends. This press release gives details of some successful initiatives, such as text messages, for preventing and dealing with missed appointments.

Government response to the Office of Fair Trading market study into dentistry. The OFT's market study of the private and NHS dental markets, published in May 2012, was prompted by a significant level of complaints reported to Consumer Direct, and by the OFT’s concerns regarding potentially high barriers to entry and expansion into the dentistry market and regarding the continuing restrictions on patients' ability to directly access dental care professionals. The evidence showed that dental patients have a high level of satisfaction with the services provided by their dentist. The OFT’s report highlighted a number of concerns with both the private and NHS dental markets, and made five recommendations to address these concerns. This response discusses the report and the recommendations.

Patients to get the latest drugs and treatments more quickly. Announces a new scheme under which the NHS will have to comply with NICE guidance on new drugs and treatments or explain to patients why there is a delay, in order to end the unfair practice where some parts of the NHS delay offering new treatment while other areas make them available straightaway. The new regime, which will be fully implemented in the Autumn, will ensure rapid and consistent adoption of NICE-approved drugs and treatments throughout the NHS.

"Hit squads" to take over seven NHS trusts. Government lawyers and accountants are to take over seven NHS hospital trusts found to be on the brink of bankruptcy after being saddled with private finance initiative contracts costing the NHS as a whole £79bn, of which only 8 per cent had been repaid by 2010.

Right-to-life case adjourned after man shows signs of consciousness.

Dame Jo Williams, the head of the Care Quality Commission (CQC), has resigned following criticism of the CQC's performance and the announcement that CQC has launched a consultation on how it should change its approach.

Doctors can expect to start receiving revalidation dates by the end of the year. The GMC told the Health Select Committee that revalidation was its number one concern and should begin at the end of the year.

New appointments in the Department of Health.

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

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