Health and Social Care Update - June 2013

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	Governance
Children	Information and Data Sharing
Clinical Risk/Health and Safety	Inquests
Commissioning	Mental Health
Complaints	Obesity
Employment/HR	Primary Care
Estates and facilities	Public Health
Finance	Regulation
Foundation Trusts	General

Care

Publications/Guidance
Moving care to the community: an international perspective. Moving care out of hospitals and into the community has been a UK wide priority for over a decade; however despite the government’s commitment to invest in the community, there is a mismatch between reality and rhetoric. This report sets out the current policies and initiative in the above-mentioned countries to move care closer to home; outlines the impact of these reforms on the nursing workforce; and offers recommendations for key stakeholders in the UK.

Delivering high quality, effective, compassionate care: developing the right people with the right skills and the right values. This mandate to HEE includes a comprehensive and wide-ranging series of measures and is intended as a blueprint for NHS staff training. It emphasises the importance of training for support staff providing community care, and preventing patients with long term conditions for example needing to go into hospital.

Integrated care and support – Our shared commitment. This framework document on integration, signed by 12 national partners, sets out how local areas can use existing structures such as Health and Wellbeing Boards to bring together local authorities, the NHS, care and support providers, education, housing services, public health and others to make further steps towards integration.
See also National Voices's Narrative for Person-Centred Coordinated Care that sets out an agreed definition of what ‘integrated’ care means. It provides a guide to the sort of things that integrated care will achieve, such as better planning, more personal involvement of the person using services, and free access to good information. It also provides some clarity over what local areas should be aiming to achieve practically, in their efforts to integrate services.
The DH has also written to local areas inviting them to express an interest in becoming ‘integration pioneers’, demonstrating the use of ambitious and innovative approaches to delivering integrated care. The pioneers will work across the whole of their local health, public health and care and support systems, and alongside other local authority departments as necessary, to achieve and demonstrate the scale of change that is required. The closing date for Expressions of Interest is 28 June 2013.

Adult social care – Choice framework. Choice frameworks are part of the Cabinet Office’s Open Public Services agenda, and are designed to raise awareness of the choices available in a number of individual public services, such as health and education. This framework sets out the different choices people are able to make in relation to their care and support as at April 2013, including:
the right for people, including carers, to control the services they use;
the right to choose residential care accommodation that suits them; and
the right to access and receive information to inform choice.
It also sets out where people can access further information, and how to complain if they are not offered choice. It will be updated when the new policies in the Care Bill take effect. (15 May 2013)

Learning from the LINks – Resources for Healthwatch. A consortium of partners, including Regional Voices, the Race Equality Foundation, Disability Rights UK and NAVCA, was asked to research into good practice in the LINks, to share as a legacy for developing local Healthwatch. This has led to resources being produced on four themes: Leadership and Governance; Representation; Engagement; and Influencing. The resources ensure that examples of good practice are not lost and that learning is accessible and easy to use. These resources stand as a legacy to the work of LINKs and are also intended to help volunteers and staff feel supported in the transition to local Healthwatch. We hope they will help local Healthwatch deliver a stronger voice for communities in the improvement of local health and social care services.

Statement of government policy on adult safeguarding. Provides an update on the Government’s policy on safeguarding adults vulnerable to abuse and neglect. It includes the statement of principles for Local Authority Social Services and housing, health, the police and other agencies to use, for both developing and assessing the effectiveness of their local safeguarding arrangements. It also describes the outcomes for adult safeguarding, for both individuals and organisations and outlines the next steps that Government is taking.

Legislation
Care Bill 2013-14.this Bill has been introduced into the Lords and received its 1st Reading. The Bill is in three parts:-
 Reform of care and support: implements the recommendations of the Dilnot Commission and the Law Commission on consolidating and modernising existing care and support law. It sets out new rights for carers, emphasises the need to prevent and reduce care and support needs, and introduces a national eligibility threshold for care and support. It also introduces a cap on the costs that people will have to pay for care and sets out a universal deferred payment scheme so that people will not have to sell their home in their lifetime to pay for residential care.
 Response to the Francis Inquiry on Mid-Staffordshire Hospital: helps deliver the Government’s commitment to ensure patients are the first and foremost consideration of the system and everyone who works in it. It sets out Ofsted-style ratings for hospitals and care homes so that patients and the public can compare organisations or services in a fair and balanced way and make informed choices about where to go. The new Chief Inspector of Hospitals, appointed by the Care Quality Commission, will be able to trigger a process to deal with unresolved problems with the quality of care more effectively. It also makes it a criminal offence for health and care providers to supply or publish false or misleading information. 
 Health Education England and the Health Research Authority: establishes Health Education England (HEE) and the Health Research Authority (HRA) as statutory non-departmental public bodies and provides for their roles in improving education and training for healthcare professionals, and protecting the interests of people in health and social care research. 

The DH has published a number of factsheets that explain different areas of the Bill.
See also The Care Bill explained that describes the changes that have been made in response to the public consultation and the recommendations of the Joint Committee that carried out pre-legislative scrutiny on the draft Care and Support Bill.   

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

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Children

Publications/guidance
Growing up in the UK - Ensuring a healthy future for our children. The BMA's latest major report Growing up in the UK builds on a report they published in 1999 called Growing Up in Britain. As they launch an updated edition, the BMA acknowledges that some progress has been made but they are concerned these improvements are likely to be reversed.

Opening the door to better healthcare: ensuring general practice is working for children and young peopleThis report examines the available evidence on how well general practice is delivering for children and young people, including the evidence on their experiences of the services and the particular challenges they face in accessing them. It emerges that some of these challenges are related to major flaws in the framework in which GP services are commissioned and delivered. These flaws lie in the approach to commissioning primary care, the concept of out of hours services, and very limited mandatory training in paediatrics. It argues that as a result, action is needed not just from individual GPs and their practices but right up to the highest levels of NHS leadership and government.

A core care pathway for children with life-limiting and life-threatening conditions. This is the third edition of this care pathway for children with palliative care needs. It reflects the latest developments in care as well as responding to family feedback about difficulties encountered in their palliative care journey. It aims to provides a blueprint for the integration of care by setting out a framework for care delivery across the sector; encompassing health, education and social care.

Updated guidance on safeguarding children has been produced by the Royal College of Paediatrics and Child Health (RCPCH). The second edition of The Child Protection Companion provides guidance for paediatricians on examination and identification of children presenting with non-accidental injuries, through to referral and court proceedings.  Dr Ian Maconochie, registrar at RCPCH, said: “Safeguarding continues to be one of the most challenging aspects of a paediatrician’s job and we have to make surethey are fully competent and feel confident to approach child protection work. “

News
Serious case review panel established. An independent national panel of experts has been established to help ensure that lessons are learnedwhen a child dies or is seriously harmed and there are signs of abuse or neglect. Panel members are Peter Wanless, NSPCC chief executive, Nicholas Dann, of the Air Accidents Investigation Branch, Elizabeth Clarke, a family law barrister, and broadcaster and columnist Jenni Russell. They will advise and challenge Local Safeguarding Children Boards to initiate and publish high quality serious case reviews in order that lessons can be learned to improve child protection services nationally. 

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/Health and Safety

Publications/Guidance
The drive for quality: how to achieve safe, sustainable care in our emergency departments. This report calls for fundamental change in the way emergency care systems are designed, funded and run. Ten recommendations are made across four domains, based on the results of a survey of 131 emergency departments in the UK between 2011 and 2012. These domains cover: system redesign; expansion and sustainable working practices; radical funding change; and a better system to measure success.

Improving A&E performance. This document outlines plans to strengthen performance in urgent and emergency care and to meet demand and tackle waiting time pressures.

The medical patient at risk: recognition and care of the seriously ill or deteriorating medical patient. This toolkit recommends that patients admitted as emergencies should only transfer out of the acute medical unit to a ward area that has facilities to meet their clinical needs. It makes recommendations for the use of the National Early Warning Score (NEWS), launched by the RCP in 2012, in order to rapidly identify patients who are severely ill or at risk of sudden deterioration.

Protecting healthcare workers from sharps injuries. This briefing outlines information regarding the new Health and Safety (Sharp Instruments in Healthcare) Regulations 2013 (SI 2013/645) that implement EU law (the Sharps Directive) which comes into force across the UK on 11 May 2013. The regulations aim to minimise the risk of sharps-related injuries and potential contamination for healthcare practitioners. It discusses key changes and implications for the NHS.

Keogh mortality review data. Detailed data about the first four of the 14 hospitals involved in the review has been published. The review is reviewing data from hospitals with higher than expected mortality rates for more than two years.

Remuneration of clinical negligence experts. Guidance on the level of fees which will be acceptable for specified expert types providing reports on cerebral palsy clinical negligence cases has been published by the Ministry of Justice.

MHRA and DH response to the recommendations of the Howe Review into Poly Implant Prothèse (PIP) Breast Implants – One year on. In January 2012, Earl Howe commissioned a review of the activities of the MHRA into its involvement and handling of the PIP breast implant investigations. This review was published in May 2012, and made fifteen specific recommendations for the MHRA and DH to act on. This report outlines the substantial progress achieved by the MHRA and DH in addressing the recommendations of the Howe Review, as of the end March 2013.

News
Expert group to consider regulation of cosmetic surgery. The Welsh Government is to set up an expert group that will consider whether tighter regulation of cosmetic surgery in Wales is necessary. The group will comprise membership from the National Specialist Advisory Group for Plastic Surgery, the Academy of Medical Royal Colleges in Wales, Healthcare Inspectorate Wales, the Welsh Healthcare Specialised Services Commission and the Welsh Independent Healthcare Association. It will report back to the Health Minister by July. 

Woman in Northern Ireland who brought "unjustified" medical negligence case "must pay hospital's legal costs". Alison Campbell, who brought "unjustified" medical negligence proceedings against a private hospital, must pay its legal costs, a High Court judge has ruled. Ms Campbell sued the Ulster Independent Clinic as part of a wider action over care she received. The judge struck out the case for failure to disclose a reasonable cause of action and said "the principle of costs exists to protect ... all in society from unjustified litigation".

Bevan Brittan Events
South West claims seminar. 04 July 2013 : 10am - 3:45pm (Registration from 9:30am). Location: Thistle Exeter City Centre, The Rougemont, Queen Street, Exeter, EX4 3SP. An inter-active and practical seminar for anyone who handles complaints and claims arising from clinical care in a Trust setting.

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

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Commissioning

Publications/Guidance
Evidence submission: Health Select Committee's inquiry into the Health and Social Care Act 2012. This written submission considers the readiness of the NHS to move to the new system of commissioning and implement the other major health reforms introduced by the act. It argues that good progress has been made in establishing the new commissioning model, but highlights ongoing concerns about uncertainty and confusion, not helped by a lack of guidance in the system. It also highlights a risk of confused accountability and warns of the dangers of fragmentation, calling for the government to strengthen its commitment to integrated care.

High quality healthcare commissioning: obstacles and opportunities for progress on race equalityThis paper draws on findings from the Evidence and Ethnicity in Commissioning (EEiC) project, together with practice experience and other research, to highlight obstacles and opportunities for healthcare commissioning to enhance access, experiences and outcomes for minority ethnic people. The aim of the paper is to describe typical elements of commissioning work and to point out a range of actions that clinical commissioners, commissioning managers and other stakeholders can and should take to improve healthcare commissioning for multi-ethnic populations.

National surgical commissioning centre. This online resource aims to help commissioners and healthcare professionals find clear, consistent and evidence-based guidelines for a variety of surgical procedures. As well as bringing together commissioning guidance, it also provides access to an online tool which is designed to help commissioners understand local clinical variation for the surgical procedures covered by the commissioning guidance.

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

NHS governance of complaints handling. This publication reports the results of a survey of NHS trusts across England and found that the majority of leaders of NHS hospital trusts believe that they are failing to use information from complaints as well as they should because the data boards receive lacks the right quality and detail. It also found that only 20% review learning from complaints and take resulting action to improve services and that less than half measure patient satisfaction with the way that complaints are handled. The research will inform the Health Service Ombudsman’s recommendations to the Clwyd/Hart review of NHS hospital complaints system and its on-going work with boards to develop and embed good practice.

Bevan Brittan Events
South West claims seminar. 04 July 2013 : 10am - 3:45pm (Registration from 9:30am). Location: Thistle Exeter City Centre, The Rougemont, Queen Street, Exeter, EX4 3SP. An inter-active and practical seminar for anyone who handles complaints and claims arising from clinical care in a Trust setting.

If you wish to discuss the issue of complaints more generally please contact Julie Chappell.

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Employment/HR

Publications/Guidance
Discrimination by appointment: how black and minority ethnic applicants are disadvantaged in NHS recruitmentThis publication reports the results of research which looked a cross-section of 30 NHS trusts and found that black and minority ethnic applicants are less likely to be appointed than white applicants. It argues that there has been little improvement in recent years despite the introduction of various initiatives designed to combat discrimination in recruitment.

Regional review of medical education and training in London: 2012-13. This report on standards of medical training and education in London finds that doctors in training and medical students are being well educated and trained. Despite this, it highlights concerns over the quality of clinical supervision at some sites in the capital. As a result of the findings, the GMC will work with Health Education England and all those involved in delivering medical education to help them make any improvements that are necessary.

Delivering high quality, effective, compassionate care: Developing the right people with the right skills and the right values – A mandate from the Government to Health Education England. The Secretary of State for Health has a statutory duty to ensure that an effective education and training system is in place for the NHS and public health system. Health Education England has been established to support that duty. Health Education England, with the networks of employers working through Local Education and Training Boards, will ensure a nationally coherent system is in place to develop the right people with the right skills and the right values. This mandate provides details of the strategic objectives in the areas of: workforce planning; health education; and training and development. It aligns with the mandate for NHS England and the Government’s response to the Francis report. The mandate is set out under six broad themes: support for service priorities; NHS values and behaviours; excellent education; competent and capable staff; working in partnership; and value for money. It covers the two years from April 2013 to March 2015 and will be reviewed in autumn 2013.

Bevan Brittan Updates
Employment Eye Alert: Collective redundancy consultation – major change announced In what looks very likely to be a significant change to the rules on collective redundancy consultation, it has been reported that a decision of the Employment Appeal Tribunal overhauls the current approach to deciding whether 20 or more employees at an 'establishment' are risk of redundancy.

Acas and SOSR dismissals. James Gutteridge reports on an EAT decision which looked at whether the Acas Code applies to dismissals for ‘some other substantial reason’, where the working relationship had broken down between the parties.

Employment news round-up May 2013. Sarah Michael introduces our new Francis Report knowledge sharing website, and reports on this month’s employment law developments: it seems that it is possible to bring a post-termination victimisation claim after all, and we provide new dates for your diary in June in respect of the next tranche of employment law reform.  

TUPE: information and consultation. Following a recent run of seemingly odd outcomes in TUPE cases, we are pleased to report that this month the Employment Appeal Tribunal has handed down a refreshingly clear and useful decision on how the consultation requirements under TUPE operate. Specifically, the EAT looked at whether an employer is required to undertake consultation if a proposed transfer does not go ahead; and also whether employees in a part of an organisation which does not transfer are ‘affected’ by the transfer and are, therefore, entitled to be included in the consultation. Sarah Lamont unpicks the detail. 

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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Estates and facilities

Publications/guidance

NHS Premises Assurance Model (NHS PAM): April 2013 Update. The NHS PAM is a management tool that provides NHS organisations with a way of measuring how well they run their estate. It provides a nationally consistent approach to evaluating NHS premises performance against a set of common indicators. It is a basis for assurance on the premises where NHS healthcare is provided, improvements in premises-related performance throughout the health and care system and providing greater understanding of the vital role that NHS premises play in improved clinical and social outcomes. NHS PAM supports clinical leaders and Directors of Finance and Estates to make more informed decisions on the development of their estates and facilities. It also provides important information to commissioners for use during the commissioning process and regulators in identifying risks.

Transfer of assets to NHS Property Services Limited. This letter sets out details of the responsibilities of the Secretary of State in relation to NHS Property Services (NHSPS). It is addressed to landlords, sponsors and/or funders of NHS property schemes where the NHS counter-party after 1 April 2013 is NHS Property Services Ltd. It includes how NHSPS will receive its funding from the NHS Commissioning Board (now NHS England). There is also a deed of indemnity from the Secretary of State to NHSPS which is referred to in the letter and is a copy of the signed indemnity. 

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

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Finance

Publications/Guidance
Public payment and private provision: the changing landscape of health care in the 2000sThis report examines the changing relationship between the public and private sector in the provision of NHS funded care in the past decade. It looks specifically at the funding and provision of two elective inpatient procedures: hip and knee replacements. It finds that the economic crisis has had a greater impact on private spending; that the role of non-NHS providers in delivering NHS-funded care increased markedly from 2006 onwards; the single largest share of secondary care spending on non-NHS providers went to independent sector providers; and that PCT spending on independent sector providers increased across England between 2006 and 2011.

Counting the cuts: the impact of spending cuts on the UK voluntary and community sector - 2013 update. This update to the 2011 report looks at the scale of cuts so far and those still to come. It considers the impact of this on several areas, including the changing commissioning structure of the NHS, and the increased involvement of the private and voluntary sector in the delivery of public services.

NHS Premises Assurance Model (NHS PAM): April 2013 Update. The NHS PAM is a management tool that provides NHS organisations with a way of measuring how well they run their estate. It provides a nationally consistent approach to evaluating NHS premises performance against a set of common indicators. It is a basis for assurance on the premises where NHS healthcare is provided, improvements in premises-related performance throughout the health and care system and providing greater understanding of the vital role that NHS premises play in improved clinical and social outcomes. NHS PAM supports clinical leaders and Directors of Finance and Estates to make more informed decisions on the development of their estates and facilities. It also provides important information to commissioners for use during the commissioning process and regulators in identifying risks.

Transfer of assets to NHS Property Services Limited. This letter sets out details of the responsibilities of the Secretary of State in relation to NHS Property Services (NHSPS). It is addressed to landlords, sponsors and/or funders of NHS property schemes where the NHS counter-party after 1 April 2013 is NHS Property Services Ltd. It includes how NHSPS will receive its funding from the NHS Commissioning Board (now NHS England). There is also a deed of indemnity from the Secretary of State to NHSPS which is referred to in the letter and is a copy of the signed indemnity.

Consultations
Discussion paper - How can the NHS payment system do more for patients? Monitor and NHS England are seeking views on the future of the payment system. The discussion paper also sets out possible improvements and presents early thinking on setting objectives and designing the NHS payment system. They have also issued a call for evidence on the way that hospitals are reimbursed for some emergency admissions. The closing date for comments is 19 July 2013.  

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
Model Core Constitution. Monitor has published the latest version of the Model Core Constitution for foundation trusts (April 2013) in Word and PDF formats. It reflects provisions of the Health and Social Care Act 2012 which are relevant to NHS FTs' constitutions and which are now in force. Aspirant FTs should use this version. Existing FTs wishing to update their constitutions for the Health and Social Care Act 2012 should continue to refer to the June 2012 version of the Model Core Constitution. There is also a version showing, in tracked changes, the Health and Social Care Act 2012 updates to the September 2008 version of the Model Core Constitution.

Emergency care and emergency services 2013. This report details the results of a survey of Foundation Trust Network members who operate on the frontline of urgent and emergency care services. It shows that six out of ten trusts expect the coming winter to be worse than 2012-13 and that seven out of ten trusts believe that the A&E system is at tipping point. It highlights concerns facing A&E systems for the upcoming winter and emphasises the need for effective planning within each local health economy.

NHS foundation trusts: review of 2012/13 performanceThese presentation slides provide an overview of the key trends drawn from the individual reports of NHS foundation trusts in England. It provides topline information on governance risk ratings; A&E performance; financial performance; and hospital acquired infection control.

Performance of the NHS Foundation Trust sector – year ended 31 March 2013. This report argues that foundation trusts must ensure they are investing adequately in health services in order to protect patients interests. The findings of the report demonstrate a sharp increase in the number of foundation trusts failing to meet the national four hour A&E waiting times target in the last quarter. Between January and March 2013, 47 foundation trusts failed to meet the A&E target, an increase on 32 in the previous quarter; meaning that over half (58%) of all FTs with A&E units breached their target. The number of foundation trusts failing national targets on cancer referral treatment waiting times also increased.

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

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Governance

Publications/Guidance
The drive for quality: how to achieve safe, sustainable care in our emergency departments. This report calls for fundamental change in the way emergency care systems are designed, funded and run. Ten recommendations are made across four domains, based on the results of a survey of 131 emergency departments in the UK between 2011 and 2012. These domains cover: system redesign; expansion and sustainable working practices; radical funding change; and a better system to measure success.

Improving A&E performance. This document outlines plans to strengthen performance in urgent and emergency care and to meet demand and tackle waiting time pressures.

The medical patient at risk: recognition and care of the seriously ill or deteriorating medical patient. This toolkit recommends that patients admitted as emergencies should only transfer out of the acute medical unit to a ward area that has facilities to meet their clinical needs. It makes recommendations for the use of the National Early Warning Score (NEWS), launched by the RCP in 2012, in order to rapidly identify patients who are severely ill or at risk of sudden deterioration.

The non-executive directors’ guide to hospital data part two: elective hospital admissions, waiting times and patient experience. Understanding your organisation’s data is an essential part of providing effective oversight. But data may not always give you the complete picture and it is important to first understand what data is available, how it is recorded and what these records are used for. This briefing will help non-executive directors (NEDs) better understand NHS data and how it can be used to determine what is going on in their hospital. It looks at elective hospital admissions, waiting times and patient experience. 

Patterns of maternity care in English NHS hospitals. A study of hospital episode statistics has found wide variation in practice and outcomes across maternity units in England. The report makes a number of recommendations including calls for units to use the indicators as a basis for reflection upon current practice and recommends that units should audit themselves against existing clinical guidelines to help identify causes of variation. It also highlights the need for clinicians to take ownership of their own data in order to drive up data quality.

Patient-centred leadership: rediscovering our purpose. This report is based on a survey of NHS professionals and took place after the publication of the report of the Francis Inquiry. It found that 73% of respondents do not think that quality of care in the NHS is given enough priority and 40% think that the quality of leadership throughout the NHS as a whole was poor or very poor. The report concludes that nothing less than a transformation of systems, leadership and culture is needed throughout the NHS if the lessons of the Francis Inquiry are to be learnt and acted on. Alignment of leadership in clinical teams, NHS boards and national organisations around the needs of patients and quality and safety of care is also essential.

The non-executive directors' (NEDs) guide to hospital data This series of briefings by the NHS confederation have been developed to increase the NEDs understanding of NHS data and give them the confidence to ask the right questions about it.
Activity, pathways and datasets
Elective hospital admissions, waiting times and patient experience
A&E, non-elective admissions, readmissions and diagnostics
How to make good use of data - quality and safety, including mortality, activity data, contracting and finance
NHS Confederation - briefings

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

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Information and Data Sharing

Publications/guidance
Dealing with vexatious requests (section 14): Freedom of Information Act. The ICO has published revised guidance on when an FOI request can be refused as vexatious under s.14(1) FOIA 2000, bringing greater clarity to one of the three circumstances under which an entire request can be rejected. Earlier this year, the Upper Tribunal took the view that the ordinary dictionary definition of the word "vexatious" was of limited use in the context of FOI requests, prompting their alternative suggestion of “a manifestly unjustified, inappropriate or improper use of a formal procedure”. Much of the guidance focuses on what is meant by the term, and more specifically, what a public authority should do to satisfy itself that a request is vexatious. It includes a list of typical key features of a vexatious request. 

Online medical records and the doctor-patient relationship. This report draws on surveys commissioned by MPS which asked patients and doctors' views on online medical records. One of the issues highlighted is the disparity between the services that patients expect they will receive through online access to their records and what doctors think is realistic in the immediate term. The report also highlights issues around security; purpose of record; vulnerable people; and sensitive information.

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

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Inquests

Legislation
Draft Coroners and Justice Act 2009 (Consequential Provisions) Order 2013. This draft Order, once in force, makes consequential amendments to provisions of the Coroners Act 1988 to make the language consistent with the Coroners and Justice Act 2009. See also the Explanatory memorandum.

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

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Mental Health

Bevan Brittan Mental Health Extranet. - This is a 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.

If you would like information about how to access the Bevan Brittan Mental Health Extranet please email Claire Bentley by clicking here. Current topics being discussed are:-
 Mental Health Act Forum - South West. For more information contact Claire Bentley. here
 Police frustrated by mental health professionals
 Francis and mental health - what are you doing about it?
 s117 and accommodation for homeless persons 
 CTOs : Do the ends justify the means?
 Impact of the Health and Social Care Act 2012 on the MHA

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

Publications/Guidance
Independent Commission on Mental Health and Policing report. The commission was tasked to look into how the Metropolitan Police Service deals with incidents involving people with mental health problems. This report outlines findings including: a lack of mental health awareness amongst staff and officers; problems with interagency working; lack of training and policy guidance in suicide prevention; and the failure of procedures to provide adequate care to vulnerable people in custody.

The NHS mandate and its implications for mental health. This briefing examines what the NHS Mandate means for mental health services and the people who use them. It identifies areas for improvements in mental health services and argues that a stronger focus on mental health support can improve people's physical health. It also outlines key actions for NHS England and CCGs, including expanding IAPT services, addressing access and waiting times for mental health care and commissioning integrated support for people with co-existing physical and mental health conditions.

Mental health advocacy and human rights: your guide. This guide has been produced with Mind Brighton and Hove, Wish and NSUN. It aims to explain how the Human Rights Act can be used in mental health settings to secure better treatment and care. It draws on real life stories of how laws and legal cases can be used in everyday advocacy practice, providing helpful flow-charts, worked through examples and top tips. It is directed both at advocates, and those who use services.

Personal health budgets in England - making them work in mental health. This report is the result of research conducted with people with mental health problems to find out what they want from the services and support that they use to manage their mental health, and what role personal health budgets might play in improving their experience of care and their health and wellbeing outcomes. The key issues identified included access to a choice of treatments and being involved in joint-care planning.

Social anxiety disorder: recognition, assessment and treatment of social anxiety disorder Clinical guidelines, CG159 - Issued: May 2013. This clinical guideline offers evidence-based advice on the recognition, assessment and treatment of social anxiety disorder in children and young people (from school age to 17 years) and adults (aged 18 years and older). It includes a recommendation on the treatment of specific phobias that updates and replaces the section of NICE technology appraisal guidance 97 that deals with phobia.

Launch of Making the Difference: The role of adult social care services for vulnerable offenders.

Peer support in mental health care. This report argues that using peer support workers to support the recovery of people with mental illness can add significant value to mental health services, sometimes at no extra cost. The research, which is published in two separate papers, examines the value of peer support workers in supporting recovery. Peer support workers draw on their own experiences of mental illness and support others using services in their own recovery journeys. The research examines evidence relating to outcomes, financial cost and effectiveness both in England and internationally.

Statement of government policy on adult safeguarding. Provides an update on the Government’s policy on safeguarding adults vulnerable to abuse and neglect. It includes the statement of principles for Local Authority Social Services and housing, health, the police and other agencies to use, for both developing and assessing the effectiveness of their local safeguarding arrangements. It also describes the outcomes for adult safeguarding, for both individuals and organisations and outlines the next steps that Government is taking.

News
A three-judge panel has ruled that the Government's work capability assessment, which determines whether disabled people are fit for work, "substantially disadvantages" people with mental illnesses. The Department for Work and Pensions is appealing against the decision to cease testing mentally ill people before changes are implemented.

Emergency mental health admissions delayed up to 3 weeks due to beds crisis, social workers warn. Shortage of mental health beds at time of rising demand leading to delays that damage patients and placing AMHPs in “intolerable” positions, warns College

Partners issue joint statement 2 years after Winterbourne View. The DH, NHS England, LGA, ADASS, CQC and the National Forum of People with Learning Disabilities have issued a statement that emphasises these organisations’ commitment to making the lives of people with learning disabilities better and safer, and improving their health and care. It states that the safety and wellbeing of former Winterbourne View patients is a prime concern and gives details of funding provided by the Department of Health during 2013 to 2014, to support former Winterbourne View patients and their families.

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

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Obesity

Publications/Guidance
Preventing obesity and helping people to manage their weight. This public health briefing summarises NICE's recommendations for local authorities and partner organisations on preventing people becoming overweight and obese and helping them to manage their weight.  

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

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Primary Care

Publications/Guidance
Quality imaging services for primary care: a good practice guide. This guide sets out what needs to change to make a difference to the care of patients requiring an NHS scan, and aims to reinforce the links between local NHS clinical imaging departments and CCGs. It aims to significantly improve patient care, increase efficiency and shorten waiting times, as well as cut NHS costs.

Care.data guide for GP practices. This guidance for GP practices explains how better use of anonymised patient information from general practice will help commissioners improve the quality, efficiency, and equity of health care services. It explains how data from general practice will be collected, anonymised and used to improve patient care.

Physical activity: brief advice for adults in primary care. This guidance aims to support routine provision of brief advice on physical activity in primary care practice. The recommendations include: identifying adults who are inactive; delivering and following up on brief advice; and incorporating advice in commissioning. It is aimed at commissioners of health services and anyone working in primary care whose remit includes offering lifestyle advice.

Consultations
Review by Monitor of the provision of walk-in centre services in England. This review aims to review the extent to which closure of walk-in centres has limited people's ability to choose when or where they access routine or emergency primary care services without appointment. It will examine three issues: the changes to arrangements of walk-in centre services over the past two to three years; assessment of the impact of these changes on patient choice and competition; and developing a greater understanding of current commissioning practices in relation to walk-in centres and possible future developments. Monitor are seeking views on this review from patients, past and present providers of walk-in centres, GPs, commissioners and other stakeholders. The closing date for responses is 28 June 2013.

Bevan Brittan Updates
Transition Scheme Rectifications. On 1 April 2013 the assets and liabilities of PCTs and SHAs were transferred to the relevant receivers. However, there will be circumstances where the receiver identified in the Transfer Scheme may not be appropriate. This may be where PCTs were told that changes requested prior to 1 April would not be included and would need to be dealt with through rectification process. Alternatively it may be that the need to change the receiver has come to light since receipt of the final Transfer Scheme.

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
Longer livesThis interactive map shows how local areas perform on early deaths from the major four killers, like heart disease and cancer, and how this varies across the country. It contains a range of data which allows comparison of an area’s mortality performance against those with similar populations, incomes and levels of health. It aims to provide local areas with information to help them understand their own position and better target efforts to improve the public’s health.

MMR action plan. Public Health England has published a comprehensive set of local and national actions to significantly increase MMR (measles, mumps and rubella) vaccine coverage among those most at risk.

Mandatory surveillance of MRSA bacteraemia, Clostridium difficile infection and MSSA bacteraemia. Public Health England has published mandatory HCAI data for for April 2012 to April 2013.

The lesbian, gay, bisexual and trans (LGB&T) public health outcomes framework companion document. This document aims to be a resource for all those commissioning and delivering healthcare services in order to support the delivery of an equitable public health system. It has been developed by a group of volunteer experts from across the LGB&T community working with the Department of Health, to increase understanding of LGB&T health, to make sure that the public health system tackles inequality related to sexual orientation and gender identity, and to promote equality.

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
The regulation and oversight of NHS trusts and NHS foundation trusts. This joint policy statement provides further detail on the changes to the regulation and oversight of NHS trusts and NHS foundations trusts proposed in the Government’s initial response to the Mid Staffordshire NHS Foundation Trust Public Inquiry and related clauses in Part 2 of the Care Bill. 

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

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General

Publications/Guidance
The new NHS in 2013 - poster. NHS Employers have produced a poster that aims to explain in a simplified way to both patients and staff how the new NHS is structured

Social media for chief executives: the essential guideThis briefing explores how using social media platforms can help NHS chief executives develop a collaborative leadership style that helps get results in the complex system of health and social care.

An introduction to: using social media during your career. This guide is written specifically for care makers and focuses on the benefits of using social media as part of professional development but also highlights the potentially adverse impact that use of social media could bring about.

The NHS Friends and Family Test (FFT): guidance for maternity services. This guidance outlines the background and requirements for implementing, reporting and publishing the national FFT within NHS-funded maternity services from 1 October 2013. It aims to support those who will be establishing and implementing the test, and is relevant to NHS trusts, foundation trusts and independent sector organisations that provide NHS-funded maternity services.

Asthma data tool. This tool has been launched by PHE’s INHALE, a website set up to provide data on lung conditions in England. It aims to provide clinicians and commissioners with a one-stop portal for accessing reliable data on asthma outcomes in England as well as helping clinical commissioning groups to understand the outcomes of asthma care in their area.

Heatwave Plan for England 2013. PHE has published its Heatwave Plan for England that aims to prepare for, alert people to, and prevent, the major avoidable effects on health during periods of severe heat in England. It recommends a series of steps to reduce the risks to health from prolonged exposure to severe heat for: the NHS, local authorities, social care, and other public agencies; professionals working with people at risk; and individuals, local communities and voluntary groups.

Homeless hospital discharge fund 2013 to 2014. This application form, guidance and criteria is for voluntary sector organisations working in partnership with the NHS and local authorities to apply for funding to improve hospital discharge arrangements for the homeless. 

Emergency services and emergency care inquiry. This briefing outlines Carers UK's response to the inquiry on emergency care. It states that the role of families, and the need to support carers through community and primary care services, have a key part to play in the prevention of critical healthcare needs and in easing the strain on emergency services.

Review of the final benefits statement for programmes previously managed under the National Programme for IT in the NHSThis report details the results of a review into the Department of Health's costs and benefits of the programmes previously managed under the National Programme for IT in the NHS. The Department of Health forecasts that benefits will slightly exceed costs over the whole life of the systems, £10.7 billion compared with £9.8 billion. However, there is uncertainty around whether these forecast benefits will be realised and the report outlines the range of risks to the realisation of future benefits. It argues that experience over the last decade suggests that it will be challenging to achieve these benefits, particularly in the case of the local care records system.

Department of Health corporate plan 2013-14. Sets out departmental priorities for the year ahead. The plan focuses on how the Department will support the Secretary of State to deliver his strategic objectives.

DH's arm's length bodies: business priorities 2013 to 2014. Provides information about the DH’s ALBs including: the role of each organisation; what they achieved in 2012 to 2013; and their business priorities for 2013 to 2014.

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

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