Health and Social Care Update - November 2015

Publications, legislation, cases and other developments relevant to those involved in health and social care work.

30/11/2015

Claire Bentley

Claire Bentley

Associate

Bevan Brittan provides high quality, comprehensive advice to the NHS and independent healthcare sector. This update contains brief details of recent Government publications, legislation, cases and other developments relevant to those involved in health and social care work, both in the NHS and independent sector which have been published in the last month.

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

 

Care Information Sharing
Clinical Risk/Health and Safety Mental Health
Commissioning Primary Care
Employment/HR Public Health
Finance  General
Foundation Trusts  

Care

Publications/guidance
Life to the full. This report by think tank Demos and grant-giving body the True Colours Trust, focuses on the lived experiences of disabled children and children living with life-threatening and life-limiting conditions, two groups with especially complex health and care needs. While underlining the significant progress that has been made over recent years, the report explores how the structure, design and capacity of services to support them can be shaky or non-existent, and are struggling to keep pace with the medical advances improving life expectancy. The primary aim of this research is to provide recommendations about where the voluntary sector can add the greatest value and contribute to the greatest impact. Life to the Full sets out how improvements can be built on, and how gaps can be filled, to provide a more dignified, enjoyable and less stressful life for these children and their families.

Together for Health: End of Life Care annual report 2015. The Welsh Government's End of Life Delivery Plan sets out its expectations of NHS Wales to work with partners, in particular the hospice and social care sector, to reduce inequalities in end of life care. This second all-Wales annual report on end of life care highlights the progress that has been made in delivering services for those people who are approaching the end of their lives, and identifies areas for future improvement.

Older people with social care needs and multiple long-term conditions: NICE guidelines NG22. This guideline covers planning and delivering social care and support for older people who have multiple long-term conditions. It promotes an integrated and person-centred approach to delivering effective health and social care services.

Quick guide: better use of care at home. This NHS England guide has been developed to help people home from hospital. It contains practical tips, case studies and ideas to improve processes, relationships and the use of care at home.

Glossary of health and social care terms. The Welsh NHS Confederation has produced a briefing for Assembly Members and other stakeholders that provides a summary of general terms used within the health and social care sector in Wales. The document is not all-encompassing but provides some of the most common words and definitions used.

Legislation
Care and Support (Review of Charging Decisions and Determinations) (Wales) Regulations 2015 (SI 2015/1842 (W.270)). Section 59 of the Social Services and Well-being (Wales) Act 2014 gives local authorities in Wales a discretionary power to impose a reasonable charge where care and support are being provided under the Act. These regulations, which come into force in Wales on 6 April 2016, provide for the review of charging decisions and determinations made by a local authority under the 2014 Act.

Care and Support (Financial Assessment) (Wales) Regulations 2015 (SI 2015/1844 (W.272)). These regulations, which come into force in Wales on 6 April 2016, set out the way in which a local authority must carry out a financial assessment of a person’s financial resources under the Social Services and Well-being (Wales) Act
2014.  

If you wish to discuss any queries you may have around care please contact Stuart Marchant.

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Clinical Risk/Health and Safety

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

Publications/Guidance
How sharp are we on safety? An assessment of safer sharps adoption in UK hospitals. This report finds that not all NHS trusts are not complying with ‘safer sharps’ rules and, as a result, are continuing to put NHS employees at risk of needle stick injuries and possible blood-borne infections such as hepatitis and HIV.

Research into 'the weekend effect' on patient outcomes and mortality. In the last ten years an increasing number of research studies have examined the association between weekend hospital admissions and poorer patient outcomes including higher rates of mortality. There is significant evidence demonstrating this ‘weekend effect’. This document describes the main research, reports and reviews into this area.

State of maternity services report 2015. This report finds that record numbers of births to older mothers are putting maternity units under pressure. The shortage is made worse, the report says, by the ageing of the midwifery workforce.

MBRRACE-UK 2015 perinatal confidential enquiry: term, singleton, normally-formed, antepartum stillbirth. This report reveals key steps for hospitals to improve care for pregnant mums and babies. It follows an investigation by a team of experts into 133 cases of stillbirth in 2013 - and found that national guidance was not followed by hospitals in the majority of cases and identified ‘missed opportunities’ which could have potentially saved babies lives.

Cases
Mahima Begum Tasmin (by her father & litigation friend Almas Ali) v Barts Health NHS Trust [2015] EWHC 3135 (QB). The parents of a baby who sustained an acute profound hypoxic/ischaemic insult just before she was delivered by emergency Caesarean section should, given the cardiotocograph readings, have been advised that a foetal blood sample test be done. However, if that test had been performed, it would probably have given a normal result and the labour would have proceeded in the same way, so the NHS Trust was not liable for its admitted negligence. 

News
NHS could be banned from prescribing homeopathy. The Department of Health has launched a consultation on proposals to ban general practitioners in England from prescribing homeopathy. The consultation has been issued following the Good Thinking Society's threat to launch judicial review proceedings against the Department of Health's refusal to add homeopathic products to the NHS's "schedule 1" blacklist, which details the products NHS doctors cannot prescribe, effectively blocking taxpayer funds from being used for them.

Reduce waste by carrying out blood transfusions only when necessary. Blood transfusions should only be carried out when necessary to help avoid waste in the NHS and prevent risk to patients, says NICE.

If you wish to discuss any clinical risk or health and safety issues please contact Joanna Lloyd or Stuart Marchant 

 

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Commissioning

Publications/Guidance
NHS patient, visitor and staff car parking principles. These car parking principles set out rules for managing car parking in the NHS. They have been updated to include carers as an additional explicit group that are eligible for the provision of concessions. See also the Hospital Parking Charges (Exemption for Carers) Bill, a Private Member's Bill introduced into the Commons by Julie Cooper MP. The Bill makes provision for exempting "qualifying" carers from hospital car parking charges. It would place a duty on health authorities to exempt carers who are currently in receipt of, or have an underlying entitlement for, Carer’s Allowance from paying car parking charges at healthcare facilities in England. The Bill also provides for exempting "eligible" carers from hospital car parking charges. These duties would apply to NHS hospitals, walk-in centres and GP practices, as well as private hospitals. The Bill's 2nd Reading debate has started but has been adjourned to March 2016.

Making choice work well in NHS adult hearing services: resources for commissioners. Following its research project into how choice is working for patients in NHS adult hearing services, Monitor has published a set of resources that set out key principles of well implemented choice in adult hearing services, help commissioners who are thinking about using patient choice and support decision-making. These resources may also be useful for NHS commissioners considering implementing choice in other types of services.

How much should be paid for Prescribed Specialised Services? English hospitals are paid according to the number and type of patients they treat. Different types of patients are described using a system called Healthcare Resource Groups (HRGs). Prices (or tariffs) are higher for patients in HRGs that require more resources during their hospital treatment. These prices are based on the average costs of all hospitals providing these treatments. But HRGs are not perfect. In particular it is possible that the costs of providing specialised care are not properly accounted for in the way that HRGs are designed. If so, hospitals that provide specialised care may be under-funded. This work from the Centre for Health Economics assesses whether this is the case and, if so, what might be done about it.

Transparency in supply chains – A practical guide. Section 54 of the Modern Slavery Act 2015 requires certain organisations to develop a slavery and human trafficking statement each year. The slavery and human trafficking statement should set out what steps organisations have taken to ensure modern slavery is not taking place in their business or supply chains. This document provides guidance on who is required to publish a statement, how to write a slavery and human trafficking statement and how to approve and publish the statement.

Hospital trusts' productivity in the English NHS: Uncovering possible drivers of productivity variations. In 2009, the NHS Chief Executive warned that there was a potential shortfall of £20bn in funding for the NHS. To address that shortfall priority was given to increasing efficiency and preventing waste. This study by the University of York's Centre for Health Economics looks at how NHS Trusts perform in terms of how much they produce given the resources (doctors, nurses, medicines and premises) they use. It finds that on these criteria – which economists call productivity measures – there is a lot of variation between Trusts and that the best and worst performers stay the same over time. It is not possible to explain away the variation in terms of the kinds of patients that are treated. These results suggest that there may be scope for making substantial savings by ensuring that all Trusts perform as well as the best ones.

Proposed reforms to top-up payments for specialised services. Monitor is considering changing the mechanism for reimbursing planned specialised care, so that it achieves better value for patients and the NHS. This document explains the reasons why it has reviewed the policy on specialised top-ups and gives options for how it may implement them. Monitor and NHS England will make a final proposal on top-ups for specialised services in the statutory consultation notice on the 2016/17 National Tariff.

Guidance for commissioners of financially, environmentally, and socially sustainable mental health services. Guide from the Joint Commissioning Panel for Mental Health (JCPMH) to support commissioners, local health authorities and providers to think broadly, but practically, about building sustainable, resilient communities that have the potential, over time, to reduce mental ill health.  

Consultations
Fair and transparent pricing for NHS services: Government response to consultation on proposals for revising the objection mechanism to the pricing method. Sets out the Government's response to the August 2015 consultation on proposals to revise the objection process for setting a pricing system for NHS services in England. Having considered the views expressed during consultation, the DH intends to lay draft amending regulations by November 2015.

2016/17 national tariff proposals: how you can get involved. Monitor and NHS England are seeking feedback to help shape the final proposals for the 2016/17 national tariff statutory consultation. This guidance sets out information for all commissioners and providers delivering nationally priced NHS services. These organisations need to nominate a representative to respond to the statutory consultation on the national tariff.

NHS Bodies and Local Authorities Partnership Arrangements (Amendment) Regulations 2015 - Government response to consultation. Following an analysis of the consultation launched last February, the Government has decided to proceed to amend the NHS Bodies and Local Authorities Partnership Regulations 2000. The Government has decided to proceed to amend the 2000 Regulations so as to provide a route for NHS England, CCGs and local authorities to use a pooled fund to jointly commission additional primary medical services for areas. A statutory instrument making provision to amend the NHS Bodies and Local Authorities Partnership Arrangements Regulations 2000 as set out will be laid before Parliament for consideration in due course.

Legislation
Draft National Health Service (Licensing and Pricing) (Amendment) Regulations 2015. These draft regulations amend SI 2013/2214 by increasing the prescribed objection percentages for CCGs and relevant providers of NHS health care services, and removing the prescribed objection percentage for providers weighted according to their share of the supply in England of such services as may be prescribed. Where any objection percentage is met, Monitor may not publish the National Tariff and must follow the procedure specified in s.120 of the Health and Social Care Act 2012. 

If you wish to discuss the issue of commissioning please contact David Owens. 

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Employment/HR

Publications and Guidance
George Eliot Hospital NHS Trust - journey to continuous improvement. This NHS Employers case study looks at the Trust's staff engagement programme which empowered staff and improved engagement, after it was placed into special measures following the Keogh Review. Its approach focused on empowering staff to create their own vision and values - a vision that could unite staff irrespective of grade.

Nurse and midwife revalidation: letter from Chief Nursing Officer. The Chief Nursing Officer Jane Cummings has responded to the decision of the NMC on 8 October 2015 to introduce nurses’ and midwives’ revalidation. She states that she is now content for revalidation to proceed in England from April 2016. She would expect the NMC to introduce robust and thorough monitoring from the point of introduction, to evaluate the revised guidance, the impact of revalidation and to ensure that it delivers the intended benefits and does not have a negative impact on front-line care.  

Junior doctors' contract offer: main points. The Government has published a firm contract offer for junior doctors that builds on the cast-iron guarantees that the Government has already set out on pay, working hours and patient safety. The Health Secretary Jeremy Hunt has written directly to all junior doctors in England confirming that no junior doctor will receive a pay cut compared to their current contract. Around three quarters of junior doctors moving to the new contract will see an increase in pay with the remainder getting pay protection. This policy paper sets out the main points included in the new junior doctor contract offer. For full details of the offer, see the NHS Employers' web page.

Rules for all agency staff working in the NHS. This collection of guidance and resources aims to provide support on the new cap on the amount of money that trusts can pay per hour for agency staff within the NHS which was implemented with effect from 23 November 2015. 

Supplying the demand for nurses: the need to end the rationing of nurse training places. This paper proposes reforming the present financing of nurse education, under which tuition fees and living bursaries are paid up front, and replacing it with a system whereby nursing undergraduates would take out student loans as with any other course. The NHS would then pay back the loan for nursing graduates if they work for the organisation after qualification. The paper argues that this reform would remove the need for a limit on nurse numbers. Nurses who work in the private sector are likely to similarly have their student debt repaid as companies compete with the NHS to recruit nurses. 

The state of medical education and practice in the UK report: 2015. This report sets out what is happening in the education and practice of doctors, and considers some of the current challenges facing the profession and the systems in which it works. An online resource containing the GMC’s registration, education and fitness to practise data is published alongside the report.

Making the difference: diversity and inclusion in the NHS. This report uses data from the NHS Staff Survey to assess the scale of the problem before drawing on wider work on climates of inclusion to suggest comprehensive strategies to bring about lasting and pervasive change. It showed that discrimination within the NHS was experienced between managers and staff, between colleagues, but also from patients and members of the public.

Cap imposed on pay for agency workers in the NHS. From 23 November 2015, a cap will apply to the amount of money NHS Trusts can pay per hour for agency staff working for the NHS. New nursing agency rules will also set ceilings on the amount individual NHS Trusts and NHS Foundation Trusts can spend on nursing agency staff. The new rules have been implemented by the regulator Monitor and the NHS Trust Development Authority (TDA), and will apply to all NHS Trusts and NHS Foundation Trusts. 

Consultations
Freedom to speak up: whistleblowing policy for the NHS - Draft for consultation A joint Monitor, Trust Development Authority and NHS England consultation seeks views on a proposed single national whistleblowing policy. The policy sets out: who can raise a concern; the process for raising a concern; how the concern will be investigated; and what will be done with the findings of the investigation. Comments by 8 January 2016.

News
GMC calls for greater powers to regulate European doctors' skills. The General Medical Council (GMC) has called for greater powers to check the competence and skills of European doctors in the same way as it already does for medics from the rest of the world. The medical regulator also criticised plans to introduce digital passports to practice for EU doctors saying that language checks would serve as the last line of defence.

Bevan Brittan Articles
Employment Eye - TUPE & groups of employers. This month, the Employment Appeal Tribunal has provided new guidance on the application of the TUPE Regulations to group structures, specifically where there is more than one transferee, one of which is also the transferor. Sarah Lamont reports on this development and its practical implications.

Employment news round-up, November 2015. Our monthly edit of key employment law developments features: NHS strike action; new NHS whistleblowing policy; revised DBS guidance; gender pay gap reporting; nurse revalidation; new Acas guidance on investigations; and a reminder about requirements for engaging independent contractors in the NHS. Jodie Sinclair reports. 

The 'right to know' and the 'right to be forgotten' – information law overhaul - Employment Eye. It's not often that Hollywood actor Michael Sheen and the Data Protection Act are mentioned in the same report, but our Information Law team brings together these two apparently disparate topics in our update on forthcoming reform of information law.

At a glance guide: preparing for strike action. The British Medical Association (BMA) is currently balloting junior doctors about a potential strike on 1, 8 and 16 December 2015.  With the results of the ballot set to be announced on Thursday, what can Trusts do to best prepare for potential strike action?

If you wish to discuss any employment issues please contact Julian Hoskins or James Gutteridge  

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Finance

Publications and Guidance
Alcohol’s impact on emergency services. The Institute of Alcohol Studies has published a report that reveals the full extent of the toll alcohol takes on emergency services in England. It presents an extensive survey of police officers, ambulance and paramedic staff, accident and emergency department consultants and fire officers. It outlines both the financial burden on the emergency services and the human cost to frontline staff. The report also recommends a set of evidence-based policy measures to address this issue.

Guidance for commissioners of financially, environmentally, and socially sustainable mental health services. Guide from the Joint Commissioning Panel for Mental Health (JCPMH) to support commissioners, local health authorities and providers to think broadly, but practically, about building sustainable, resilient communities that have the potential, over time, to reduce mental ill health.

Place-based systems of care: A way forward for the NHS in England. This paper from the King's Fund proposes a new approach to tackling the NHS's challenges of growing financial and service pressures at a time of rising demand. It argues that NHS organisations need to move away from a 'fortress mentality' whereby they act to secure their own individual interests and future, and instead establish place-based 'systems of care' in which they collaborate with other NHS organisations and services to address the challenges and improve the health of the populations they serve. The paper argues that this will require the backing and support of national bodies and policy-makers, and fundamental changes to the role of commissioning in the NHS.

If you wish to discuss any issues raised in this section please contact Claire Bentley.  

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Foundation Trusts

Publications and Guidance
Cap imposed on pay for agency workers in the NHS. From 23 November 2015, a cap will apply to the amount of money NHS Trusts can pay per hour for agency staff working for the NHS. New nursing agency rules will also set ceilings on the amount individual NHS Trusts and NHS Foundation Trusts can spend on nursing agency staff. The new rules have been implemented by the regulator Monitor and the NHS Trust Development Authority (TDA), and will apply to all NHS Trusts and NHS Foundation Trusts.

News
NHS trust found guilty of four patient deaths. Mid Staffordshire NHS Foundation Trust has pleaded guilty to very significant health and safety breaches connected to the deaths of four elderly patients. Three of the deaths took place after falls at Stafford Hospital, while another death occurred after a patient was incorrectly given penicillin that she was allergic to.

If you wish to discuss any issues relating to foundation trusts please contact Vincent Buscemi.

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Information Sharing

Consultations
GMC reviews of its confidentiality guidance for doctors. A review of the General Medical Council’s confidentiality guidance for doctors aims to ensure it is clear, helpful, relevant to doctors’ needs and compatible with UK law. The GMC will also review explanatory statements which give more detailed advice on how to apply the principles in the confidentiality guidance to certain situations a doctor may face. The GMC is seeking comments on the reviews from individuals and organisations through a consultation which runs until 10 February 2016.

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

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Mental Health

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

Publications/Guidance
Government response to No voice unheard, no right ignored - a consultation for people with learning disabilities, autism and mental health conditions. Following responses to its March 2015 consultation on strengthening rights of people with learning disabilities, autism and mental health issues, a Department of Health Command Paper outlines measures to be taken, including early actions that seek to sustain momentum generated, chiefly through the use of existing powers; and further changes, including proposed legislative changes that cannot be achieved via existing powers.

What can I expect from good quality services if I have dementia? The London Dementia Strategic Clinical Network has issued online guidance for carers and people with dementia to explain what good quality services should look like. The expectations listed apply to all of the different types of health and social care services a person with dementia might need to use, including services provided at home, in the community and in hospitals.

Article 2 of the European Convention on Human Rights and the investigation of serious incidents in mental health services. This guidance is for NHS organisations deciding whether to carry out an independent investigation to satisfy the state’s obligations under Article 2 of the European Convention on Human Rights. NHS bodies implicated in serious incidents may be considered ‘state agents’ for the purposes of Article 2.

Guidance for commissioners of financially, environmentally, and socially sustainable mental health services. Guide from the Joint Commissioning Panel for Mental Health (JCPMH) to support commissioners, local health authorities and providers to think broadly, but practically, about building sustainable, resilient communities that have the potential, over time, to reduce mental ill health.

Children and mental health - In focus. A House of Commons Library In Focus Briefing examines mental health in children and young people in the UK.

Powers of attorney and making decisions for another person - Briefing Paper. A House of Commons Library Briefing Paper deals with powers of attorney and other ways of authorising someone to make a decision for another person in England and Wales.

Cases
Re AB (A Child: Deprivation of liberty) [2015] EWHC 3125 (Fam). The Family Division held that, in all of the circumstances, the applicant local authority would be granted permission to invoke the court's inherent jurisdiction and a 14-year-old child's deprivation of liberty at a children's home would be authorised. The court also made observations in respect of children in need or looked after children who might be living in circumstances which amounted to a deprivation of liberty.

M v (1) N (By Her Litigation friend the Official Solicitor) (2) Bury Clinical Commissioning Group (3) Care Provider [2015] EWCOP 76.  It was not in the best interests of a 68-year-old woman who, due to the progressive and degenerative impact of multiple sclerosis, was impaired both physically and cognitively and in a minimally conscious state, to continue to receive life-sustaining treatment. Her wishes, coupled with the intrusive nature of the treatment and its minimal potential to achieve any medical objective, rebutted any presumption of continuing to promote life. It would be disrespectful to her to preserve her further in a manner that she would regard as grotesque, and the respect for her dignity and human freedom overwhelmed further prolongation of life.

News
Court of Protection to begin pilot scheme for greater access. The Court of Protection, which makes decisions on issues affecting vulnerable people and those lacking mental capacity, is to trial a new 'open-door' policy for the public and the media. The new pilot scheme will start in January and give journalists and the public greater access to court hearings.

Leicester doctor guilty of manslaughter of Jack Adcock, 6. A doctor has been found guilty of the manslaughter of a six-year-old boy who was "seriously neglected" in hospital. 

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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Primary Care

Publications/Guidance
Weekend opening in primary care: analysis of the General Practice Patient Survey. This paper from the British Journal of General Practice looks at the Government's key policy of seven-day opening in primary care. It shows a lack of demand for routine weekend opening of GP practices and concludes that it is unclear if weekend opening will meet patients' needs or lead to additional demand. 

If you wish to discuss any queries you may have around primary care please contact David Owens.   

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Public Health

Publications/Guidance
Mandatory reporting of FGM: A new professional duty - Training package for NHS organisations. From 31 October 2015, healthcare professionals must report to the police any cases of female genital mutilation (FGM) in girls under 18 that they come across in their work. This training package introduces the duty to healthcare professionals. There is also a flowchart with guidance on what healthcare professionals should do if they think a child has had or is at risk of FGM.

Healthy beginnings: Giving our children the best start in life. This LGA publication discusses how the transfer of public health commissioning responsibilities for under-fives to local government marks a tremendous opportunity. It brings a new momentum for developing and driving forward a shared vision for local children, young people and families.

Registered vs residency: Approaches to managing and resolving registered and resident population issues. This DH fact sheet clarifies issues relating to registered and resident populations which may be preventing progress from being made on the transfer of commissioning arrangements for 0-5 year old children's public health services. 

If you wish to discuss any queries you may have around public health please contact Olwen Dutton 

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General

Publications/Guidance
Key facts and trends in acute care. The NHS Confederation has published a factsheet giving an overview of major trends and challenges facing the acute sector. The information has been compiled on NHS trusts and FTs that provide secondary care services, including A&E and major surgical procedures. These trusts include teaching hospitals, smaller district and general hospitals and specialist hospitals.

Alcohol’s impact on emergency services. The Institute of Alcohol Studies has published a report that reveals the full extent of the toll alcohol takes on emergency services in England. It presents an extensive survey of police officers, ambulance and paramedic staff, accident and emergency department consultants and fire officers. It outlines both the financial burden on the emergency services and the human cost to frontline staff. The report also recommends a set of evidence-based policy measures to address this issue.

Quick guide: Extending the role of community pharmacy in urgent care. NHS England has published a 'quick guide' to making use of community pharmacy in urgent care, aimed at system resilience groups and commissioners. It provides practical tips and case studies for System Resilience Groups and local commissioners showing how to extend the role of community pharmacy to relieve pressure on urgent care and how to make best use of the tools such as the Directory of Services, NHS Choices and the Summary Care Record to support this. 

Jimmy Savile NHS investigations: update on the themes and lessons learnt from NHS investigations into matters relating to Jimmy Savile. In February 2015, the government accepted in principle 13 of the 14 recommendations in Kate Lampard’s lessons learnt report following the investigations into the activities of Jimmy Savile relating to the NHS. This report provides a summary of actions taken in response to the 13 recommendations for the NHS, DH and wider government.  

Place-based systems of care: A way forward for the NHS in England. This paper from the King's Fund proposes a new approach to tackling the NHS's challenges of growing financial and service pressures at a time of rising demand. It argues that NHS organisations need to move away from a 'fortress mentality' whereby they act to secure their own individual interests and future, and instead establish place-based 'systems of care' in which they collaborate with other NHS organisations and services to address the challenges and improve the health of the populations they serve. The paper argues that this will require the backing and support of national bodies and policy-makers, and fundamental changes to the role of commissioning in the NHS.

District Nursing and General Practice Nursing Service education and career framework. This Health Education England guide sets out the specialist knowledge and skills needed to deliver and advance in district nursing and general practice nursing. It contains frameworks for both district nursing and general practice nursing services within one framework and outlines the career pathways for both professions, while setting out clearly the key responsibilities and roles at each level of advancement.

Accelerated Access Review: interim report. This interim report from the review's independent Chair, Sir Hugh Taylor, describes the review’s progress in preparing proposals to improve the current system for developing, evaluating and adopting innovative medical technology for the benefit of patients, the health system and the life sciences industry. Building on extensive responses from stakeholders during an initial period of engagement, which is summarised in the supporting evidence documents, it sets out five main propositions which will form the basis of the review’s next phase of engagement. The review intends to publish its final report with more detailed recommendations by April 2016.

E-learning tool for health service staff on identifying and responding to Modern Slavery. This DH tool sets out situations in which health staff may encounter victims of trafficking, explains the legal situation regarding potential victims’ rights to medical care, and explores ways in which health staff can provide support. NHS staff who suspect that a patient may have been trafficked can contact the 24-hour confidential helpline, run by the Salvation Army, for professional advice and support on 0300 303 8151. Staff should follow child protection guidelines when child trafficking is suspected, and speak to their designated lead for child protection: out of hours staff should contact their local Children’s Social Services or Police, specifically highlighting their concerns about child trafficking.

Sexual health promotion for young people delivered via digital media: a scoping review This study aimed to summarise evidence on effectiveness, cost-effectiveness and mechanism of action of interactive digital interventions (IDIs) for sexual health; optimal practice for intervention development; contexts for successful implementation; research methods for digital intervention evaluation; and the future potential of sexual health promotion via digital media.

Improving the quality of orthotics services in England. This guidance issues a call for local commissioners to improve how vital ortheses are provided, alongside a suite of guidance and resources to help them do so. It finds that there are variations in the quality of services and waiting times to access them across the country and aims to help local CCGs address this variation. It has been produced in cooperation with local commissioners, providers and patient groups, and draws on the findings of a recent review of services by NHS Quality Observatory triggered by concerns raised by Healthwatch England.

Devolution: What it means for health and social care in England. Ahead of further devolution deals expected to be announced as part of the Spending Review 2015, this briefing describes the origins of the devolution agenda and charts its progress in relation to health and social care. Before drawing some broad conclusions, the penultimate section explores some of the key policy and implementation questions that remain unresolved.

Consultations
Cancer Drugs Fund consultation. The aim of the new Cancer Drugs Fund (CDF) is to help patients receive new treatments with genuine promise, while real world evidence is collected for up to two years on how well they work in practice. The original CDF was established in 2011 to fund cancer drugs in England that are not currently approved by NICE and will run until April 2016. The proposal for a new CDF has been issued for public consultation which outlines a new system, fully integrated into the NICE appraisal process, where the CDF becomes a transitional fund - with clear criteria for entry and exit. This is in line with the recommendation of the recently published independent Cancer Taskforce report, which proposed that the new CDF should operate with NHS England and NICE. The closing date for comments is 11 February 2016.

Cases
Re X (No 2: Application for contact by the biological father) [2015] EWFC 84 (Fam Ct). A father who had donated sperm to enable a couple to have a child was refused direct contact. His view of his role as a co-parent would risk the security of the child's placement with her legal parents, and the anxiety his stance caused the parents was not in the child's best interests. 

News
Guidance says GPs should report elderly unsafe drivers. New guidance from the General Medical Council (GMC) says GPs should put the protection of the public ahead of patient confidentiality and report elderly unsafe drivers. The watchdog has expressed concerns about an ageing population meaning rising numbers of drivers with poor eyesight or confusion.

Wales’ Health Minister says to junior doctors: “make your future part of our future here in Wales”. Wales’ Health Minister, Mark Drakeford, has released a video message explaining why Wales is a great place to be a junior doctor.

Bevan Brittan Articles
Update on the Independent Inquiry into Child Sexual Abuse. Judge Lowell Goddard, who chairs the Independent Inquiry into Child Sexual Abuse (IICSA) will be making a statement later today which promises to name some of the institutions IICSA will be examining in the first phase of its investigation.

If you wish to discuss any issues raised in this section please contact Claire Bentley.

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