Health and Social Care Update - January 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	Foundation Trusts
Children	Information and Data Sharing
Clinical Risk	Mental Health
Commissioning	Obesity
Complaints	Primary Care
Employment/HR	Public Health
Estates and facilities	Regulation
Finance	General

 

Care

Publications/Guidance
Seven day Consultant Present care. This report from the Academy of Medical Royal Colleges, which brings together 20 colleges and faculties, outlines its commitment to delivering high quality care to patients seven days a week. The publication recommends three key standards to ensure all patients receive high quality care led by a consultant regardless of the day of the week:
 hospital inpatients should be reviewed by an on-site consultant at least once every 24 hours, seven days a week, unless it has been determined that this is not necessary for the patient;
 consultant-supervised interventions and investigations along with reports should be provided daily if the results will change the outcome or status of the patient’s overall care before the next ‘normal’ working day. This should include interventions which will enable immediate discharge or a shortened length of stay; and
 setting should be available daily to ensure that the next steps in the patient’s treatment, as determined by the daily consultant review, can be taken. It also acknowledges that it is outside its scope to look in detail at community services.
It raises a series of areas for improvement and highlights that it is unacceptable to not provide consultant-led care at weekends if evidence suggests that this is best for patients.

Delivering Dilnot: paying for elderly care. This report includes comments from a wide range of contributors, including: Paul Burstow, former Care Services Minister under the Coalition; Lord Sutherland, former chair of the Royal Commission on Long Term Care under Labour; as well as carers and elderly patients. It emphasises that tough political decisions must be made to deliver reform, and proposes how this can be funded a way that is fair and sustainable. It also looks at the private sector contribution to delivering the necessary insurance products.

Cases
R (Chatting) v (1) Viridian Housing (2) Wandsworth LBC [2012] EWHC 3595 (Admin) (Admin Ct). The court held that on the proper construction of a compromise agreement, a charity's transfer to another organisation of the provision of accommodation and care to an elderly woman, paid for by the local authority under s.26 of the National Assistance Act 1948, was lawful and compliant with Art.8 ECHR, so long as those services were provided until nursing care was needed. There was no requirement that the legal identity of the organisation providing or managing that care and accommodation had to be maintained.

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

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Children

Publications/guidance
Health visitors leading the way in transforming services for children and families. These case studies highlight innovations developed as part of the Health Visiting Programme. They focus on improvements in service quality and innovation, specifically along the strands of the ‘health visiting service vision and family offer’. They are intended as a resource for sharing and learning amongst NHS public health professionals and early years staff.

News
New child abuse alert system for hospitals announced . Announces that hospital emergency departments and urgent care centres will have a new Child Protection Information System to help doctors and nurses spot children suffering from abuse and neglect. Doctors and nurses will be able to see if the children they treat are subject to a child protection plan or being looked after by the local authority, or have frequently attended emergency departments or urgent care centres over a period of time. Work on the system will begin in early 2013 and it will start to be introduced to NHS hospitals in 2015.

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
Using safety cases in industry and healthcare. This report presents the results of a study that reviewed the use of safety cases in six safety-critical industries, as well as the emerging use of safety cases in healthcare. The aims of the study were to describe safety case use in other industries, to make pragmatic recommendations for the adoption of safety cases in healthcare and to outline possible healthcare application scenarios.

Zero tolerance - making ambulance delays a thing of the past. This report by the NHS Confederation is intended to support healthcare leaders in their efforts to make handover delays a never event in their local health economies.

The code: standards of conduct, performance and ethics for nurses and midwives. This code sets out a foundation for good nursing and midwifery practice, and will act as a key tool in safeguarding the health and well-being of the public.

Hepatitis B and C: ways to promote and offer testing to people at increased risk of infection. This advice tool considers implementation issues that are specific to the published guidance. It provides practical suggestions for action to help those responsible for planning and implementing staff training. It is aimed at commissioners, service leads and others providing training for professionals working with people at increased risk of infection. The latest pathway on hepatitis B and C aims to ensure more people who are at increased risk of infection are tested, and says GPs and practice nurses should offer testing for hepatitis B and C to adults and children at increased risk of infection. 

Review of the regulations of cosmetic interventions: summary of the responses to the call for evidence. This report summarises responses to a call for evidence issued as part of NHS Medical Director Sir Bruce Keogh’s review of the regulation of cosmetic interventions. Many respondents felt that: training requirements were disproportionately weak; there is a lack of data being collected on implants, procedures, adverse incidents and outcomes; and there are some procedures where legislation is insufficient to protect the public. Suggestions welcomed by respondents included: the banning of free consultations for cosmetic surgery; tighter restrictions on advertising, including the banning of offers on procedures; and better patient information on the potential risks and side-effects of cosmetic procedures.  

News
One year on since PiP breast implant scare. One year on since the serious problems with PiP breast implants emerged, almost 8,000 women, who had their implants put in privately, have turned to the NHS for help. The latest figures show that, up to 30 November a total of 7,917 referrals have been received from women who had their implants put in privately. The NHS stepped in when it became apparent that some private clinics wouldn’t support their patients or had collapsed so women had no way of getting help. Worried women were offered the opportunity to have a consultation, a scan and, if agreed it would be the best thing for their health, the NHS would remove the implants.

New rules will force hospitals to publish operation survival rates by individual surgeons. Hospitals will be required to publish survival rates for operations by individual surgeons under rules to be announced on December 18, 2012 by the independent NHS Commissioning Board.

GMC launches confidential helpline for doctors to raise concerns about patient safety. The General Medical Council has launched a new confidential helpline for doctors to voice concerns about patient safety. The new service is part of the GMC's commitment to try and support doctors who raise concerns around patient safety and to promote a more open and transparent working culture. The Confidential Helpline number is: 0161 923 6399.

Thalidomide survivors given ten-year settlement. The Government has announced a new settlement for the survivors of the thalidomide scandal to help with increasing health costs. The Department of Health will disburse about GBP 80 million over the next decade to 325 surviving victims in England, whilst survivors in Scotland will share GBP 14.2 million.

Failure to diagnose leads to accountability test. This report in the Guardian notes that a nurse and one of the UK's largest out-of-hours providers of GPs are being sued for £250,000 by the family of a young woman who died because of their failure to diagnose her fatal condition. Neither the firm, originally part of Harmoni before being acquired by Care UK in November 2012, nor the nurse involved are willing to accept liability for the error. This is a test case for where culpability will lie in a service that is increasingly provided by private providers.

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

Publications/Guidance
The Public Services (Social Value) Act 2012 - Advice for commissioners and procurers(Procurement Policy Note 10/12). This Cabinet Office PPN advises commissioners and procurers on how they must follow the 2012 Act and take it into account when considering procurements on how they must follow the 2012 Act and take it into account when considering procurements of certain types of services contracts and framework agreements.

The social value guide. This guide is designed to help with embedding social value in commissioning and procurement practices. It aims to help those public bodies who are affected by the Social Value Act prepare for its implementation in January 2013.

Consultations
Consultation on service specifications and clinical policies. The NHS Commissioning Board is seeking views on 120 draft service specifications and 43 underpinning clinical commissioning policies for specialised services commissioning that have been developed by Clinical Reference Groups, which define what the NHS CB expects to be in place for providers to offer evidence-based, safe and effective services. They are grouped into five Programmes of Care: Internal medicine (digestion, renal, hepatobiliary, and circulatory system); Cancer and blood (infection, cancer, immunity and haematology); Mental health; Trauma (traumatic injury, orthopaedics, head and neck, and rehabilitation); and Women and children (women and children, and congenital and inherited diseases). The NHS CB now wants to test them further with more stakeholders to ensure that there are safe and effective services in place from 1 April 2013. The consultation closes on 18 January 2013.

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

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Complaints

 

News
Doctor under fire for alleged errors prescribing sex-change hormones. The Guardian reports that a woman who alleges that she was inappropriately prescribed sex-changing hormones and then wrongly underwent a double mastectomy is one of several complaints being investigated by the General Medical Council about the doctor who oversaw her aborted gender reassignment.

If you wish to discuss the item raised in this section please contact Julie Chappell. 

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Employment/HR

 

Publications/Guidance
Review Body on Doctors’ and Dentists’ Remuneration: Review of compensation levels, incentives and the Clinical Excellence and Distinction Award schemes for NHS consultants. This report by the independent expert pay review body recommends changes to consultant contracts and clinical excellence awards so that they better recognise current excellence in providing high quality patient care, medical teaching and research. The Government has accepted the main recommendations and observations expressed in the independent report as a basis for discussion, and will now begin active engagement with the medical profession and NHS Employers about how to take things forward.

Scoping report on the contract for doctors in training. NHS Employers carried out a scoping exercise in response to a request from the Review Body on Doctors’ and Dentists’ Remuneration (DDRB). The current contract was introduced 12 years ago and the report concludes that it no longer works effectively for junior doctors or their employers. Particularly problematic elements of the current contract include: the effect it has on the employment relationship; the rigidity of shift patterns; pay protection (both banding and career grade salary protection); monitoring; and the re-banding process. This report highlights the need for: more flexible working patterns and better training; a single contract for trainees; and more support for doctors’ work/life balance.

NHS lone worker services framework agreement. This letter provides information in relation to concerns which have arisen regarding early terminations of NHS lone worker services framework agreements.

NHS Employers scoping report on the contract for doctors in training. The NHS Employers scoping report on the contract for doctors in training provides a basis for discussions with the medical profession about how it can ensure national medical contracts that are affordable and fit for purpose for staff, employers and patients.

Letter on pensions for public health staff transferring to local authorities. This letter provides an update on the treatment of pensions after 1st April 2013 in relation to the transfer of public health staff to local authorities. 

Supplementary evidence for the review body on doctors' and dentists' remuneration: review for 2013. This scoping report on the contract for doctors in training and command paper provides a basis for discussions with the medical profession about how we can ensure national medical contracts that are affordable and fit for purpose for staff, employers and especially patients. The report outlines a case for the need to provide doctors who are completing specialist training a clearer career path; to reward excellence and promote high quality care; and to support the move towards more consultant-delivered care.

Bevan Brittan Events
Workforce Forum: Your Medical Workforce - Improving Performance Management and Minimising Legal Challenges. 07 February 2013 : 6pm - 7.30pm (Registration at 5.30pm). Location: Birmingham. We are delighted to announce our first Workforce Forum in the Birmingham office of Bevan Brittan LLP.  Our forums involve the combination of brief presentations from high-level speakers, from both the private and public sectors, within an informal environment, where everyone is able to ask questions and make their own contributions. The sessions provide an excellent opportunity to exchange views, share knowledge and network with peers and other senior individuals within the NHS workforce landscape.

Bevan Brittan Updates
Employment Eye: News Round-up. This month, the plums in our Christmas employment news pudding are: ‘law in a cold climate’ (dealing with severe weather related absence); next year’s statutory payment rates and limits; DH guidance on staff transfers; and an update on the review of the Public Sector Equality Duties.  And Stop Press - Government announces reduced collective redundancy consultation period. Sarah Maddock reports.

If I’ve told you once, I’ve told you twice…a misconduct update. John Moore reports on two recent decisions which provide useful, practical points on dealing with misconduct dismissals.

Lessons from Mid Staffordshire – What does the board of a health organisation need to know? Robert Francis QC’s report into the Mid Staffordshire Inquiry is due to be issued to the Secretary of State in January 2013. Whilst the Inquiry’s detailed findings and recommendations are awaited, an examination of the evidence identifies a range of themes to which the sector should have regard in anticipation of the final report and beyond.  In this alert, we focus on the theme of the effectiveness of provider boards.

The law of unintended consequences: TUPE service provision changes. What happens if an outsourced contract expires and is brought back in-house to be run as a skeleton service, pending a new contractor being appointed to take over the outsourced contract? Would this amount to a ‘service provision change’ under TUPE, despite the fact that the client had never intended to run the service itself?  Sarah Lamont considers this question in the light of a recent decision from the Employment Appeal Tribunal.

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
Review of NHS structure critical infrastructure risk. This letter was sent to NHS organisations who have been invited to participate in the review of the NHS's recurrent report for of a need for significant investment in maintenance of its facilities. This is intended to eliminate 'critical risks' to the safety of patients, visitors and staff; and the resilience of its services.

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

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Finance

Publications/guidance
Progress in making NHS efficiency savings. This report finds that the NHS made a substantial amount of efficiency savings in 2011-12. It argues that these savings will need to be sustained and built on in future years if the NHS is to generate up to £20 billion of savings in the next four years.

Adults' personal social services: specific revenue grant and capital grant allocations for 2013/14 & 2014/15. This letter sets out the provisional adults’ personal social services specific revenue and capital grant funding for local authorities for the periods 2013/14 and 2014/15. Details of individual funding stream allocation formulae (where these are available), and a brief description of each area, appear in the relevant annexes.

Funding transfer from the NHS to social care in 2013/14 - what to expect. This letter provides provisional information on the transfer of £859m in 2013/14 to from the NHS to local authorities. 

Accountable officer and director of finance roles for the financial closedown of PCTs. This letter from Janet Perry, NHS Chief Financial Controller, provides an update for NHS Commissioning Board Local Area Team Directors regarding the financial closedown of PCTs. It outlines the accountability arrangements for the 2012/13 financial accounts, and their role in managing the discharge of balances transferred to the department in early 2013/14. 

Bevan Brittan Events
Project Finance 2. 17 January 2013 : 3:00pm to 5:00pm (Registration from 2:30pm). Location: Bevan Brittan, Fleet Place House, 2 Fleet Place, Holborn Viaduct, London, EC4M 7RF. Bevan Brittan invites you to a seminar on 'Private Finance 2' (PF2).  The Government wants PF2 to become an enduring part of public service and infrastructure provision for years to come and has recognised the benefits of PFI while seeking to address some of the issues that have generated negative publicity.  The new published Standardisation of PF2 Contracts therefore places great weight on enhancing transparency of arrangements between the public and private sectors and driving value for money, in part to attract new funding streams, through adjustments to the risk profile. 

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

Back to topFoundation Trusts 

Publications/guidance
Amendments to 'Applying for NHS Foundation Trust status - Guide for Applicants' (January 2013) The updates made to the Guide have been made to take account of Monitor's recent consultation on changes to the Guide for Applicants and  changes resulting from the Health and Social Care Act (2012), e.g. the removal of the private patient income cap; and to provide a range of updates and clarifications to Monitor's process. A further update to the guide will be made in spring 2013 to reflect additional changes resulting from the legislation and Monitor's consultation on the Risk Assessment Framework, which will replace the Compliance Framework later in 2013/14. Any changes which may result from the Mid Staffordshire NHS Foundation Trust Public Inquiry will be incorporated into guidance as necessary.

Consultation
Consultation on proposed changes to Quality Report requirements for 2012/13. This consultation sets out Monitors proposals to make changes to the Detailed Guidance for External Assurance on Quality Reports. The  proposals include changing the mandated indicators for acute foundation trusts and standardising and mandating the local indicator for all foundation trusts. Closing date : 31/01/2013.

News
Mid-Staffordshire NHS Foundation Trust 'unsustainable.' A hospital trust accused of appalling standards of care three years ago is unsustainable in its current form, say independent experts.

Bevan Brittan Articles
The Mid-Staffordshire NHS Foundation Trust Public Inquiry - Organisational Culture and Quality Governance. In this alert, we focus on the related quality governance themes of organisational culture and the structures for quality governance and learning to enable organisations to consider these and possible future developments in advance of the Inquiry’s report.

Lessons from Mid Staffordshire – What does the board of a health organisation need to know? Robert Francis QC’s report into the Mid Staffordshire Inquiry is due to be issued to the Secretary of State in January 2013. Whilst the Inquiry’s detailed findings and recommendations are awaited, an examination of the evidence identifies a range of themes to which the sector should have regard in anticipation of the final report and beyond.  In this alert, we focus on the theme of the effectiveness of provider boards.

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

Back to topInformation and Data Sharing

Publications/Guidance
Number of GPs calling for advice on parental requests for children's medical records rises. GPs are increasingly getting caught in the crossfire between divorced or separated parents who want access to their children's medical records, experts have revealed. The Medical Protection Society, one of the world's leading medical defence organisations, says there has been a steep increase in calls from GPs concerned about requests for access to children's medical information from separated parents. The MPS has had 800 calls over the past five years, with 179 of them in the last year alone – equivalent to a phone call every other day. The numbers will be just a fraction of the total, since not all GPs belong to the MPS and many doctors will not ask for advice on what to do.

Bevan Brittan Events
Disclosure: A refresher considering the Access to Health Records Act 1990, Data Protection Act 1998 & Freedom of Information Act 2000. 16 January 2013 : 9.30am - 11.30am (Registration at 9.15am). Location: Bevan Brittan LLP, Fleet Place House, 2 Fleet Place, Holborn Viaduct, London, EC4M 7RF. We are delighted to welcome Gerard Boyle, barrister from 3 Sergeants Inn to host a seminar on disclosure. We will consider the disclosure issues that you face every day in relation to requests for medical records and information. We will look at the key provisions in the Access to Health Records Act and Data Protection Act. The latest case law in relation to the Freedom of Information Act will be examined along with the key principles and obligations in respect of the disclosure of information. We will finish the seminar with some case studies.

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.
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.

The extranet also contains a forum for use by members to share knowledge and information. 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 ask Claire Bentley.  You can attend in our London, Bristol or Birmingham office.

Publications/Guidance
Safer mental health services: a toolkit. Suicide and homicide by mentally ill people are major concerns for mental health care providers. The National Confidential Inquiry has made recommendations for clinical services over a number of years. In this toolkit these recommendations have been formulated into quality and safety statements regarding clinical, organisational and training aspects of care. This toolkit is intended to be used as a basis for self-assessment by mental health care providers and responses should ideally be based on recent local audit data or equivalent evidence.

Mental health PbR road test package for 2013/14 The Department of Health has published the components of the mental health PbR 2013/14 “road test” package. The mental health PbR road test package for 2013/14 includes draft guidance and support tools.

Government publishes final report on Winterbourne View Hospital. The Department of Health (DH) has published the report setting out the government's final response to the events at Winterbourne View hospital, including a programme of action to transform services for people with learning disabilities or autism and mental health conditions or behaviours described as challenging. The final report into the events at Winterbourne View Hospital states that staff routinely mistreated and abused patients, and management allowed a culture of abuse to grow. 

Transforming care: A national response to Winterbourne View Hospital. The government has published its final report into the events at Winterbourne View Hospital and has set out a programme of action to transform services so that vulnerable people no longer live inappropriately in hospitals and are cared for in line with best practice.
The programme of action includes:
 by Spring 2013, the DH will set out proposals to strengthen accountability of boards of directors and senior managers for the safety and quality of care which their organisations provide;
 by June 2013, all current placements will be reviewed, everyone in hospital inappropriately will move to community-based support as quickly as possible, and no later than June 2014;
 by April 2014, each area will have a joint plan to ensure high quality care and support services for all people with learning disabilities or autism and mental health conditions or behaviour described as challenging, in line with best practice as a consequence, there will be a dramatic reduction in hospital placements for this group of people;
 the Care Quality Commission will strengthen inspections and regulation of hospitals and care homes for this group of people, including unannounced inspections involving people who use services and their families; and
 a new NHS and local government-led joint improvement team will be created to lead and support this transformation. 
This programme is backed by a concordat signed by more than 50 partners, setting out what changes they will deliver and by when. The Government will publish a progress report on these actions by December 2013.
The final report into the events at Winterbourne View Hospital states that staff routinely mistreated and abused patients, and management allowed a culture of abuse to flourish. The warning signs were not picked up, and concerns raised by a whistleblower went unheeded. The report also reveals weaknesses in the system’s ability to hold the leaders of care organisations to account. In addition, it finds that many people are in hospital who don’t need to be. People with learning disabilities or autism, who also have mental health conditions or challenging behaviour can be, and have a right to be, given the support and care they need in the community, near to family and friends.
The Care and Support Minister Norman Lamb has made a commitment to move out of long stay hospital every person with a learning disability or autism who does not need to be there. He has pledged to set out plans for holding Boards of Directors to account for poor care and failing standards, saying that there is a national imperative to act decisively and end the scandal of poor care. A comprehensive, timetabled programme of action to drive forward improvement in services has been agreed. 50 groups, covering a wide range of organisations involved in the care and support of people with learning disabilities and autism, have signed up to a Concordat that will set out these goals. Norman Lamb will personally chair a board to oversee progress. The DH will report on progress by December 2013.

Power of attorney applications lead MoJ's digital dash. The Ministry of Justice has announced that applications for lasting power of attorney will be available on the internet from April 2013 as one of a batch of digital services that will also involve the introduction of the following: an online process for making civil claims; online payments of the new fees for employment tribunals; and online bookings for prison visits by pre-approved members of the public.

Drugs and alcohol Payment by Results (PbR) pilot evaluation: scoping and feasibility report. This report, commissioned by the Department of Health, looks at a pilot project which took a new approach to commissioning and delivering drug and alcohol misuse treatment.

A future state of mind: facing up to the dementia challenge. This report draws on in-depth interviews with people with Alzheimer's and their carers and a wealth of research to identify the barriers to early diagnosis, from a patient and professional perspective. New policies are proposed to better incentivise the health system to diagnose dementia earlier.

Consultations
Liberating the NHS: No decision about me without me – Government response. This response to the consultation on proposals for greater patient involvement and more choice outlines how patients will be able to choose from any provider in England when they are first referred to see a specialist in secondary care. In addition, the response outlines plans more broadly to increase patient involvement in decisions about their care and treatment and to increase patient choice. For the first time, people who use mental health services will get more choice about where and how they get their condition treated by the NHS.
The DH has also published a digital map and list of organisations that will be providing NHS community services locally and what services they will offer to local patients.

Department announces pilot projects to improve severe mental illness services. Care and Support Minister Norman Lamb has announced that 6 local projects have begun work to help improve access to psychological therapies for those with severe mental illnesses. The 6 NHS demonstration sites are already leaders in the mental health field and have been chosen to implement the National Institute of Clinical Excellence’s recommended psychological therapies.

Cases
J Council v GU (by his litigation friend, the Official Solicitor) [2012] EWHC 3531 (COP). The Court of Protection approved an agreed final order requiring the patient to live at a care home. The court held that in the circumstances, the interferences with G's private life, which included monitoring his correspondence and telephone calls, were in compliance with Art.8 ECHR.

An NHS Trust v DJ (by his litigation friend, the Official Solicitor) [2012] EWHC 3524 (COP). The Court of Protection held that it would not be appropriate to make the declaration sought by the application NHS trust and that the withholding of the stated treatments would not be in the patient's best interests.

News
Department of Health and NHS investigations into Jimmy Savile. The DH has outlined the terms of reference for the investigations into the alleged abuse by Jimmy Savile at Broadmoor Hospital, Stoke Mandeville Hospital and the Leeds General Infirmary. Former barrister Kate Lampard is to provide independent assurance of the existing investigation process. The investigations are expected to be completed towards the second half of 2013.

Government backs businesses with £5 million funding boost. Announces £5m of funding for businesses to come up with new products or services that will help improve the experience of people with mental health illnesses and people at the end of their life. This funding is part of the Government’s commitment to help improve care for patients with long-term conditions and ensure high quality care and support offered to dying people in their final days and hours. The application process for both of the two new competitions is being run through Health Enterprise East, the NHS Innovation Hub for the East of England. All applications should be made using the application forms, which can be downloaded from the Health Enterprise East website. The closing date for applications is 28 February 2013.

More choice in mental health. For the first time, people who use mental health services will get more choice about where and how they get their condition treated in the NHS.

Jail sentence for mentally ill man quashed A man with a mental illness who set fire to a hospital door in an attempt to escape his psychiatric ward has had his sentence reduced from an indefinite prison sentence on the grounds of public protection to a hospital order.

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

Back to topObesity 

Publications/Guidance
Action on obesity: comprehensive care for all. This report from the RCP outlines the issues around obesity in the UK, including the variations in treatment across the country, the related health issues, and the wider impact on public health.

News
Overweight people who refuse to complete exercise prescribed by doctors could have their benefits reduced under proposals by Westminster City Council. Responsibility for "community wellbeing and public health" is being transferred to local authorities under reform of the benefits system.

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

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Primary Care

Publications/Guidance
First GP groups given green light to take control of NHS budgets. The NHS Commissioning Board has announced the authorisation of the first wave of 34 new Clinical Commissioning Groups (CCGs) that will take control of the NHS budget in their area to commission healthcare services for their communities.

Determining arrangements for supporting research in primary and community care: discussion paper. This paper aims to support local organisations, in collaboration with local networks, to consider how to achieve a smooth transfer of capability within the changing NHS for supporting primary and community care research.

Securing Excellence in IT Services. The NHS Commissioning Board has published frequently asked questions and a factsheet to accompany the recently published primary care IT operating model.

Hepatitis B and C: ways to promote and offer testing to people at increased risk of infection. This advice tool considers implementation issues that are specific to the published guidance. It provides practical suggestions for action to help those responsible for planning and implementing staff training. It is aimed at commissioners, service leads and others providing training for professionals working with people at increased risk of infection. The latest pathway on hepatitis B and C aims to ensure more people who are at increased risk of infection are tested, and says GPs and practice nurses should offer testing for hepatitis B and C to adults and children at increased risk of infection.

Consultations
General Medical Services - Contractual changes 2013/2014. Seeks views on proposed changes to the GP contract, which will see: GPs rewarded for earlier diagnosis and better care of dementia patients and patents with long term conditions; and a new vaccination and immunisation programme for rotavirus and shingles from 1 September 2013. The closing date for comments is 26 February 2013.

News
A new telehealth video from the Royal College of General Practitioners (RCGP) highlights some of the key reasons why clinicians are recommending telehealth for their patients. 

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
A dose of localism – The role of councils in public health. This joint report from the LGiU and Westminster City Council examines the role of councils in promoting public health. It discusses how local government is receiving responsibility for public health at a challenging time, when it is facing both a significant increase in demand and a significant reduction in resource. It makes five recommendations as to how local authorities can integrate public health across all service areas, help communities to provide services for themselves and invest in prevention. In particular, it highlights the need for councils to incentivise people to exercise.

Public Health England: code of conduct for staff. This code of conduct, announced by Chief Executive Designate Duncan Selbie, has been agreed for staff of Public Health England.

Local Healthwatch regulations: a summary report of engagement - addendum. This addendum covers issues around the local Healthwatch regulations and provides information on the Department’s approach to the drafting of regulations in response to the views received from the six week consultation.

News
More control given to councils to scrutinise changes to local healthcare. The Health and Social Care Act 2012 will come into force in April 2013 extending the scope of health scrutiny to include all NHS and public health services. New regulations on local authority health scrutiny are being prepared to ensue that any changes to local healthcare are more transparent and overseen and considered locally.

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
Government response to the Science and Technology Select Committee report on the regulation of medical implants. The Medicines and Healthcare Products Regulatory Agency has published the government's response to the Science and Technology Select Committee report on the regulation of medical implants. The government believes there should be tighter controls on notified bodies, better post-market surveillance of medical devices and more collaboration between national regulators. Broadly, the government agrees the best way to improve the safety of medical implants is to build on the current regulatory framework.

Consultation
Draft enforcement guidance: consultation document. Seeks views on draft guidance that sets out Monitor's general approach to exercising its enforcement powers in relation to potential and actual breaches of the licence and other regulatory obligations. The consultation closes on 11 February 2013.

Cases
Houshian v General Medical Council [2012] EWHC 3458 (QB) (QBD). The court held that the GMC's Interim Orders Panel had erred in suspending a doctor's registration for 18 months pending the determination of his fitness to practise after an employment tribunal had found that he had fabricated evidence in an unfair dismissal claim. The suspension was not a proportionate response since the Panel had failed to identify a serious risk to the public if the doctor was allowed to continue to work with patients.

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

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General

Publications/Guidance

Seven day Consultant Present care. This report from the Academy of Medical Royal Colleges, which brings together 20 colleges and faculties, outlines its commitment to delivering high quality care to patients seven days a week. The publication recommends three key standards to ensure all patients receive high quality care led by a consultant regardless of the day of the week:
 hospital inpatients should be reviewed by an on-site consultant at least once every 24 hours, seven days a week, unless it has been determined that this is not necessary for the patient;
 consultant-supervised interventions and investigations along with reports should be provided daily if the results will change the outcome or status of the patient’s overall care before the next ‘normal’ working day. This should include interventions which will enable immediate discharge or a shortened length of stay; and
 setting should be available daily to ensure that the next steps in the patient’s treatment, as determined by the daily consultant review, can be taken. It also acknowledges that it is outside its scope to look in detail at community services.

Securing sustainable NHS services - The Trust Special Administrator’s report on South London Healthcare NHS Trust and the NHS in south east London. The Trust Special Administrator Matthew Kershaw was appointed in July 2012 under the Regime for Unsustainable NHS Providers – the first time the regime has been used since it was introduced in 2009. The Administrator was appointed to develop recommendations under a time-limited framework for addressing the Trust’s significant financial problems and ensuring high-quality care for the people of SE London in the long term. This final report makes recommendations in relation to the South London Healthcare NHS Trust to secure sustainable provision of health services to those patients served by the trust and in the south east London health economy. The Secretary of State will now consider the final recommendations made to him and make his decision by early February that can secure sustainable services for the people of SE London.

Accident and emergency 2012. This report outlines the results of a survey on people's experiences of treatment on A&E departments. The results of this survey can be used by members of the public to help them find out how well A&E departments in the NHS are performing. NHS trusts can also use them to improve their own performance. The results will also feed into the CQC quality and risk profiles which contribute to inspections of health services.

Hospital Pathways programme: lessons learned. This article tells the story of the Hospital Pathways programme, a collaborative programme in which five acute trusts worked with The King's Fund and the Health Foundation to apply techniques, not widely used in the NHS, to improve both processes of care and interactions between staff and patients. It describes the programme; the method used to evaluate it; what was learned about the approach, and how the lessons have influenced the next programme called Patient and Family-Centred Care.

Making integrated out of hospital care a reality This report discusses the foundations for integrated care for adults, children and young people, with a focus on implementing out of hospital care, and connecting primary, community and social care. It highlights key evidence and draws on learning from partners across health and social care.

Improving outcomes: a strategy for cancer - second annual report 2012. This report demonstrates that cancer survival rates are improving. It is published alongside a report of the first pilot survey of cancer survivors, in which people with specific cancers were asked about their quality of life after diagnosis. This report is aimed at commissioners, commissioning support units and providers to help them understand how to continuously improve after-care for cancer survivors.

Everyone counts: planning for patients 2013/14. This planning guidance aims to help local clinicians deliver more responsive health services, focused on improving outcomes for patients, addressing local priorities and meeting the rights people have under the NHS Constitution. It outlines the incentives and levers that will be used to improve services from April 2013, the first year of the new NHS where improvement is driven by clinical commissioners.

'Friends and family' test to expose poor care in NHS. The Prime Minister has announced that a new ‘friends and family’ test – where patients and staff are asked whether they would recommend the service to a loved one – will be introduced into every hospital in England from April 2013. He wants that to go further, with GP surgeries, district nursing and community hospitals all adopting the measure. The announcement builds on the recently published ‘Compassion in Practice’ vision for nursing, midwives and care staff, which sets a blueprint for respectful and dignified care across the NHS.

Care in local communities: A new vision and model for district nursing. This document sets out the strong foundations of district nursing services, and outlines the developments and innovations that ensure services can meet current and future needs.

The Coalition – Together in the national interest. The Coalition Government has published its Mid Term Review that takes stock of progress made in implementing the Coalition Agreement signed in May 2010. The Review mainly lists what the Government has done so far to implement its policies to build a stronger, more balanced economy and a fair society. It also highlights what it claims are a "new set of reforms" to secure the country’s future and help people realise their ambitions. These include:
 setting an ambition for the NHS to put mental health on a par with physical health, significantly improving access and waiting times for all mental health services, and  reducing the incidence and impact of post-natal depression through earlier diagnosis and better intervention and support;
 implementing a strategy aimed at building a culture of compassionate care for nursing, midwifery and care staff;
 consulting on further measures to protect people who rely on care services where the provider fails in England;
 threshold to make access to care more consistent across England;
 introducing a Universal Deferred Payments scheme so that nobody will need to sell their home to pay for the costs of residential care in England;
 providing £100m for NHS nurses and midwives to spend on new technology to free up time for patient care and make essential patient details instantly available on the ward;
 continued support for the creation of mutuals and co-operatives, and continued development of Right to Provide policies that will enable mutual and co-operative organisations to deliver a wider range of public services;
 legislating to give people with eligible needs for care an entitlement to a personal budget and a care and support plan in England; and
 each public body will be reviewed once every three years to ensure that it can justify to Ministers its existence and structure.
Detailed plans for public spending for the 2015/16 fiscal year will be set out before Summer 2013, in line with the overall path of deficit reduction which has already been set out to 2017/18.

Liberating the NHS: no decision about me without me - Government response. This publication outlines the Government's response to a consultation on proposals for greater patient involvement and choice. It outlines how patients will have a choice in provider when they are first referred to see a specialist in secondary care. It also outlines broader plans to increase patient involvement and patient choice.

Getting started: prospects for health and wellbeing boards. This report suggests that the new health and wellbeing boards could improve integrated care, provide a more democratic approach and help develop a shared plan for their local populations. It emphasises that building good relationships and adequate resources will be required if they are to be effective.

Developing and updating local formularies. This guidance provides advice and guides good practice for those involved in handling, prescribing, commissioning and decision-making about medicines. It has been designed to help organisations develop and update local formularies that reflect local needs, reduce variation in prescribing, and allow rapid uptake of innovative medicines and treatments, in accordance with statutory requirements.

Digital strategy: leading the culture change in health and care published. This strategy sets out plans for the Department of Health to become a Digital First department of state, with digital tools and techniques embedded throughout its work. It outlines the department's commitments to increase the effectiveness of engagement with stakeholders; improve the development of policymaking; and steward the health and social care system towards a health information revolution.

Cancer services coming of age: learning from the improving cancer treatment assessment and support for older people project. This report summarises a series of pilots that tested whether appropriate assessment of older cancer patients would result in improved access to appropriate cancer treatment, based on need and not age. It also tested whether action, as a result of an age appropriate assessment, improved the scope for older people to benefit from treatment.

Francis: the story so far. This interactive presentation gives a brief overview of the background to the upcoming Francis Report and the key areas which may be covered.

Interim procedures for the approval of independent sector places for the termination of pregnancy (abortion). These procedures set out the required standard operating principles that approved organisations need to comply with in order to obtain Secretary of State approval under section 1(3) of the Abortion Act 1967. They have been updated to reflect the Care Quality Commission’s (CQC’s) regulatory framework, including other relevant professional guidance, and should be used by all independent sector providers of abortion services. Under the new arrangements, all providers of regulated activities must meet the relevant outcomes set out in the CQC’s guidance on essential standards of quality and safety.

Creating change: Innovation health and wealth one year on. Provides an update on the implementation of the NHS Chief Executive’s report "Innovation health and wealth, accelerating adoption and diffusion in the NHS" (December 2011). The first report set out delivery for spreading innovation quickly and at a scale throughout the NHS. This new report demonstrates the progress that is being made at a time of great change in the NHS. It highlights what more should be done to deliver the improvements needed to fully embrace and embed innovation in the NHS and improve outcomes and quality for patients and the NHS and drive growth for the UK.

Improving the use of medicines for better outcomes and reduced waste: an action plan. This report looks at ways of improving the use of medicines and tackling avoidable wastage in primary and community care, secondary care, and in care homes and end of life care. It also looks at how patients can be better engaged in decisions about their medicines as well as how information can be better provided to patients and health and care professionals. The action plan outlines how best practice could be shared across the NHS in the future.

Cases
R (Tracey) v (1) Cambridge University Hospital NHS Foundation Trust (2) Secretary of State for Health; Equality & Human Rights Commission (Interested Party) [2012] EWHC 3670 (Admin) (Admin Ct). Following a determination of disputed issues of fact in a claim for judicial review of a hospital's policy in respect of non-resuscitation orders, the court decided that a further substantive hearing would not be appropriate or proportionate. Although there was a wider public interest in such a hearing, public interest would not be served by a wide-ranging enquiry based on limited findings of fact.

Legislation
Common rules on medical prescriptions when travelling to another EU country. The European Commission has adopted EU-wide rules on a minimum list of elements to be included in medical prescriptions taken by a patient travelling from one EU member state to another. Member states must implement the provisions into national law by 25 October 2013. The rules are intended to allow for the easy identification of the patient, the prescriber and the prescribed product.

Consultations
Consultation on service specifications and clinical policies. The NHS Commissioning Board is seeking views on 120 draft service specifications and 43 underpinning clinical commissioning policies for specialised services commissioning that have been developed by Clinical Reference Groups, which define what the NHS CB expects to be in place for providers to offer evidence-based, safe and effective services. They are grouped into five Programmes of Care: Internal medicine (digestion, renal, hepatobiliary, and circulatory system); Cancer and blood (infection, cancer, immunity and haematology); Mental health; Trauma (traumatic injury, orthopaedics, head and neck, and rehabilitation); and Women and children (women and children, and congenital and inherited diseases). The NHS CB now wants to test them further with more stakeholders to ensure that there are safe and effective services in place from 1 April 2013. The consultation closes on 18 January 2013.

News
DNA tests to revolutionise fight against cancer and help 100,000 NHS patients. £100 million will be invested in sequencing the genome of 100,000 cancer patients within the NHS, the Prime Minister has announced. The patients' genomes will be sequenced over the next three to five years, beginning within the next 12 months. The research is intended to provide doctors with new and detailed understanding of a patient's genetic makeup and treatment needs.

A widow has been granted leave to continue her late husband’s challenge to the existing law on murder and assisted suicide. The family of Tony Nicklinson, the locked-in syndrome sufferer who died in August 2012, has gained permission to continue his right-to-die campaign and appeal against the High Court ruling which went against him. The Court of Appeal has made an order that Jane Nicklinson as the administrator of her late husband Tony’s estate, may take forward his case that the current law was incompatible with his rights under Article 8 of the European Convention on Human Rights.

Terminally ill woman not consulted on hospital resuscitation order: family of 63-year-old who received medical notice on Addenbrooke's ward want patient rights clarified. On December 21, 2012 the High Court will rule on whether the legal issues in the case of terminally ill Janet Tracey, who was not consulted before a notice instructing "do not resuscitate" was placed with her medical records, should be considered at a judicial review hearing in February 2013. Tracey's family want to clarify the law over the notices and make the Department of Health maintain a national policy on the issue.

Bevan Brittan events
Project Finance 2. 17 January 2013 : 3:00pm to 5:00pm (Registration from 2:30pm). Location: Bevan Brittan, Fleet Place House, 2 Fleet Place, Holborn Viaduct, London, EC4M 7RF. Bevan Brittan invites you to a seminar on 'Private Finance 2' (PF2).  The Government wants PF2 to become an enduring part of public service and infrastructure provision for years to come and has recognised the benefits of PFI while seeking to address some of the issues that have generated negative publicity.  The new published Standardisation of PF2 Contracts therefore places great weight on enhancing transparency of arrangements between the public and private sectors and driving value for money, in part to attract new funding streams, through adjustments to the risk profile.  

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

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