Health and Social Care Update - July 2016

Policy and law relevant for health and social care professionals.

27/07/2016

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

Children

Mental Health

Clinical Risk/Patient Safety

Primary Care

Commissioning

Procurement

Employment/HR

Public Health

Finance

Regulation

Foundation Trusts

General

Health and Safety 

 

 

Care

Publications/guidance

Our commitment to you for end of life care. This report is a response to an independent review on choice in end of life care. It details the six commitments that the Government has made to the public to end variation in end of life care across the health system by 2020. The commitments include: honest discussions between care professionals and dying people; greater choice and personalisation for dying people; greater involvement of family and carers; and a named contact for dying people and their families.

Discharging older people from acute hospitals. This report from the Commons Public Accounts Committee challenges the government to address the scale and cost of delays in discharging older patients from hospital. It highlights the need for urgent measures to tackle discharge delays, which are bad for both patients' health and the financial sustainability of the NHS and local government. The committee finds there is a poor understanding of the scale of discharge problems, with official data substantially under-estimating the range of delays and the number of older patients affected.

The Care Act - one year on. A year on from the introduction of the Care Act 2014, this review by the Carers Trust, the UK’s largest charity for unpaid carers, finds that the Act has made little or no difference to the 5.4m carers in England. Carers Trust surveyed and spoke to unpaid carers looking after their sick or disabled family and friends, and to health and social care professionals to find out how well they thought the new Act, which entitles carers to an assessment of their needs, was working. The review, led by former Care Minister Paul Burstow, found a ‘mixed picture’ with examples of good practice, but in many cases found that the Act had made no difference to carers. In some instances, carers hadn’t heard about the measures that had been introduced, which could support their needs and well-being as a carer.

Integration: delivering better outcomes for citizens and communities; the 2016/17 Care and Health Improvement (CHIP) offer. The integration of health and social care has been a policy ambition for many years, and systems across the country are already bringing together services and doing things differently. For some, integrated care is 'business as usual', while for others progress has been frustrated by local system pressures, which can make it harder to reach agreement. This document sets out how the LGA is and intends to continue working with councils and partners. It seeks comment and feedback on how to achieve improved outcomes for local citizens and communities.

NICE Pathway - Home care for older people. This quality standard covers home care given to older people in their own homes to meet their assessed social care needs. An age threshold is not specified for older people. Although almost 80% of people using home care services are over 65, the quality standard may also be relevant to some people under 65 with complex needs. The quality standard does not cover intermediate care, short-term reablement, home care for younger adults or children using home care services.

Oral health for adults in care homes. More than half of older adults in care homes have tooth decay compared to 40 per cent of over 75s and 33 per cent of over 85s who do not live in care homes. This NICE guidance calls for oral health and access to dental treatments to be given the same priority as general health for all adults in care homes. Recommendations in the guidance focus on improving and maintaining residents’ day-to-day oral healthcare, ensuring staff are properly trained to confidently look after the oral health needs of residents, and there is adequate access to dental services when needed. It also recommends all residents have an oral health assessment when they enter a care home with the results - including any treatment needs - being entered into their personal care plan.

Putting children first: delivering our vision for excellent children’s social care. Sets out the Government’s reform programme for children’s social care in England over the next five years. It sets out a strategy to deliver a system: staffed and led by the best trained professionals; dynamic and free to innovate in the interests of children; with less bureaucracy; new checks and balances designed to hold the system to account in the right ways; and new ways to intervene more quickly where services consistently fail the most vulnerable children.

Not seen, not heard – A review of the arrangements for child safeguarding and health care for looked after children in England. This CQC report looks at how effectively health services provide early help to children in need, and how they identify and protect children at risk of harm and looked-after children’s health and wellbeing. It reviews findings from 50 inspections across England as well as specific focus groups. The report concludes that health professionals have improved how they assess risk and recognise safeguarding concerns, but services are not protecting and promoting children’s health and welfare consistently. More needs to be done to listen to and involve children in need in their care.

Supporting integration through new roles and working across boundaries. This King's Fund report, commissioned by NHS Employers and the LGA, looks at the evidence on new roles and ways of spanning organisational workforce boundaries to deliver integrated health and social care. It finds increasing focus on roles which facilitate co-ordination and management of care, development of existing roles to increase the skill-mix and enable the provision of more holistic care, and a limited number of truly innovative roles, the most notable being care navigators and community facilitators, enablers or link workers. Given that many of the skills required for integrated care already exist within the workforce, it suggests the central question is how to use those skills more effectively to support boundary-spanning activities.

Social care annual report 2016. This third Ofsted Social Care Annual Report presents a mixed picture: while performance is inadequate in too many local authorities, several demonstrate that improvement is possible – often from a low base – and are now leading the way in providing good and outstanding services for children. It shows that a quarter of children’s services departments, 21 in total, are currently rated ‘inadequate’ while 43 require improvement.

Introduction to residential family centres – A children’s social care guide to registration. Updated guide to registration that explains in detail what a residential family centre is and what the law says it must do. Residential family centre providers and managers must meet a range of legal requirements, including a requirement to register with Ofsted, which expects providers and managers to show how they have taken account of the national minimum standards for residential family centres.
See also Introduction to residential holiday schemes for disabled children – A children’s social care guide to registration.

Building bridges, breaking barriers: Integrated care for older people. This CQC report looks at how well care for older people is integrated across health and social care, as well as the impact on older people who use services and their families and carers. The review seeks to improve CQC's understanding of how services work together to meet the needs of older people.

Delayed discharges and hospital type: evidence from the English NHS. This study investigated how delayed discharges vary by hospital type (acute, specialist, mental health, teaching), and the extent to which such differences can be explained by demography, case-mix, the availability of long-term care and hospital governance as reflected in whether the hospital has foundation trust status, which gives greater financial autonomy and flexibility in staffing and pay.

Keep on caring: supporting young people from care to independence. This cross-government strategy looks at how to improve services, support and advice for care leavers. It makes recommendations for local and national government, and wider sectors of society.

Consultations

End of life care for infants, children and young people: consultation. This draft guidance outlines what the best palliative care for children and young people should look like. It emphasises the need for children and young people to be treated as individuals and highlights the importance of children and their families being involved in decisions about their care. The consultation for this draft guidance is now open and will run until 12 August 2016.

Future of social care inspection. Ofsted is seeking views on proposed changes across its inspections of children's social care. It covers: principles for children’s social care inspections; a new approach to inspections of local authority children’s services from 2018; a new common inspection framework for social care establishments, agencies, boarding schools and residential special schools from April 2017; and changes to inspections of independent fostering agencies. The consultation closes on 9 September 2016. 

News

NHS-funded nursing care rate for 2016 to 2017. Announces that the NHS contribution towards the costs of a place in a care home with nursing is being increased on an interim basis to £156.25 - an increase of 40%, as recommended by the Mazars review. The increase will be backdated to 1 April 2016 for individuals who were in receipt of NHS-funded nursing care from that time.

Bevan Brittan Articles

CQC Enforcement Update. Financial penalties on the increase. A recent prosecution by CQC of a care home provider represents the 'final piece of the jigsaw' in terms of CQC's enforcement powers for the health and social care sector. The case provides a severe warning to providers of the sorts of financial penalties which can flow from non-compliance in the new enforcement environment.  

Claims against Care Homes. In a turbulent market insurers need the right legal team.

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

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Children

Publications/guidance

Wood Report – Review of the role and functions of Local Safeguarding Children Boards. Local Safeguarding Children Boards (LSCBs) are responsible for improving the overall wellbeing of children in their local-authority area. They include representatives from children’s services, police, district councils and NHS trusts. This review, which was chaired by Alan Wood, sets out a new framework for improving the organisation and delivery of multi-agency arrangements to protect and safeguard children. It makes recommendations for making LSCBs more effective, suggesting that appropriate steps should be taken to recast the statutory framework that underpins the model of LSCBs, Serious Case Reviews (SCRs) and Child Death Overview Panels (CDOPs). See also the Government's Response to the review, which outlines the recommendations that the Government has accepted.

Confronting mental illness in children before birth. Mental illness in children can begin through mental health problems suffered by their expectant mothers before their birth, a report from the Local Government Association (LGA) finds, so intervention should therefore be made at this stage. The report includes research which shows that if a baby's development falls behind during its first years, they are more at risk of falling behind later on in life, and more likely to develop mental illness. It also includes case studies of how some councils are finding innovative ways of providing support to families.  

Putting children first: delivering our vision for excellent children’s social care. Sets out the Government’s reform programme for children’s social care in England over the next five years. It sets out a strategy to deliver a system: staffed and led by the best trained professionals; dynamic and free to innovate in the interests of children; with less bureaucracy; new checks and balances designed to hold the system to account in the right ways; and new ways to intervene more quickly where services consistently fail the most vulnerable children.

Not seen, not heard – A review of the arrangements for child safeguarding and health care for looked after children in England. This CQC report looks at how effectively health services provide early help to children in need, and how they identify and protect children at risk of harm and looked-after children’s health and wellbeing. It reviews findings from 50 inspections across England as well as specific focus groups. The report concludes that health professionals have improved how they assess risk and recognise safeguarding concerns, but services are not protecting and promoting children’s health and welfare consistently. More needs to be done to listen to and involve children in need in their care.

Social care annual report 2016. This third Ofsted Social Care Annual Report presents a mixed picture: while performance is inadequate in too many local authorities, several demonstrate that improvement is possible – often from a low base – and are now leading the way in providing good and outstanding services for children. It shows that a quarter of children’s services departments, 21 in total, are currently rated ‘inadequate’ while 43 require improvement.

Introduction to residential family centres – A children’s social care guide to registration. Updated guide to registration that explains in detail what a residential family centre is and what the law says it must do. Residential family centre providers and managers must meet a range of legal requirements, including a requirement to register with Ofsted, which expects providers and managers to show how they have taken account of the national minimum standards for residential family centres.
See also Introduction to residential holiday schemes for disabled children – A children’s social care guide to registration.

Consultations

End of life care for infants, children and young people: consultation. This draft guidance outlines what the best palliative care for children and young people should look like. It emphasises the need for children and young people to be treated as individuals and highlights the importance of children and their families being involved in decisions about their care. The consultation for this draft guidance is now open and will run until 12 August 2016.

News

First ever annual statistical publication for FGM shows 5,700 newly recorded cases during 2015-16. There were 5,700 (2) newly recorded (3) cases of Female Genital Mutilation (FGM) reported in England during 2015-16, according to the first ever publication of annual statistics.

Child abuse inquiry to begin preliminary hearings. The public inquiry into child sex abuse, chaired by Dame Justice Lowell Goddard, is to begin preliminary hearings in the week commencing 25 July 2016 which will focus on Lord Janner of Braunstone, the late Cyril Smith, the Anglican Church, the Roman Catholic Church, Lambeth council, children sent overseas and the conduct of the insurance industry.

Public call to ensure children with short lives aren't short changed. A survey carried out by YouGov for Together for Short Lives which looked at public understanding of children’s hospice funding in England, reveals that 81% of the public think that children’s hospices receive too little funding from statutory sources. It shows the public holds children’s hospices in very high esteem but in fact children’s hospices receive much less funding from the state than they had assumed.

If you wish to discuss any queries you may have around children please contact Deborah Jeremiah

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Clinical Risk/Patient 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

Care Quality Commission reviews how NHS acute trusts are learning from serious incidents. CQC has published the findings of its review of how acute NHS trusts report on investigations into serious incidents, and the extent to which they identify learning that can be used to improve practice when things go wrong.

Identifying and managing clinical risks in newborn babies and providing care for infants in the community who need respiratory support. This thematic review explains how newborn babies and infants with complex health conditions are cared for in hospitals and in the community. The review focused on three areas of care; the detection of health problems during pregnancy through screening; the diagnosis and management of newborn babies with deteriorating medical conditions, (with a particular focus on high blood pressure) and the management of infants requiring respiratory support in the community.

Patient safety collaboratives: making care safer for all Patient Safety Collaboratives are led by Academic Health Science Networks and are made up of NHS, academic and health care experts. The aim of the collaboratives is to improve patient safety, spread examples of success and influence system leaderships. This report highlights the work of 15 teams of Patient Safety Collaboratives that aimed to improve patient safety and reduce avoidable harm in the NHS.

MHRA guidance on re-manufacture of single use devices. Following a review, the Medicines and Healthcare products Regulation Authority (MHRA) has produced guidance on the re-manufacture of single use devices, and expectations around their use for healthcare professionals and manufacturers.

Ombudsman issues first dual jurisdiction report following complaint of neglect at Oxfordshire care home. The LGO has issued its first joint investigation report covering the actions of both a private care provider and a council’s subsequent safeguarding investigation into that provider’s quality of care. The investigation was prompted by a complaint from a man who said his wife was left severely dehydrated and suffering from oral thrush after a week-long respite stay at the Huntercombe Hall Care Home, operated by Caring Homes Healthcare Group Ltd. The LGO’s investigation found that the Council did not act in accordance with the law and relevant government guidance, it did not adhere to DH statutory guidance on safeguarding adults and failed to follow its own policy and procedure relating to safeguarding investigation. The investigation also upheld the man’s complaint against the care provider.

Beyond maternal death: improving the quality of maternal care through national studies of 'near-miss' maternal morbidity. Studies of maternal mortality have been shown to result in important improvements to women’s health. It is now recognised that in countries such as the UK, where maternal deaths are rare, the study of near-miss severe maternal morbidity provides additional information to aid disease prevention, treatment and service provision. The study aimed to estimate the incidence of near-miss morbidities; describe different interventions and their impact on outcomes and costs; and compare an external confidential enquiry or a local review approach for investigating the quality of care for affected women.

Pathways to harm, pathways to protection analyses 293 Serious Case Reviews (SCRs) relating to incidents which occurred between 1 April 2011-31 March 2014. This is the fifth consecutive analysis of SCRs by this research team; together these reports cover 11 years from 2003-14. This ‘long view’ has allowed the team to build a picture of the nature and circumstances of serious and fatal maltreatment.

News 

Optician faces jail for gross negligence. In a landmark case, an optician faces jail for gross negligence after an eight-year old boy died due to her failure to spot a life-threatening brain condition. In February 2012, Honey Rose, a locum optometrist, examined the boy at a branch of Boots Opticians. The boy died five months later from a build-up of fluid on his brain. Ipswich Crown Court was told the optician should have spotted the symptoms. The boy complained of headaches and collapsed. He then died at Ipswich Hospital. The cause of death was undiagnosed hydrocephalus. Retinal images taken during his eye test showed the optic disc at the back of each eye was swollen, a result of raised pressure in the skull.

Maternity Transformation Programme early adopters. NHS England are seeking expressions of interest from local areas that are willing to test out new models of care as outlined by the Maternity Transformation Programme. The experiences of the early adopters will pave the way for national roll-out of initiatives that deliver safer, more personalised care for all women and every baby, improve outcomes, and reduce inequalities. The closing date for applications is 19 September 2016.

NHS LA annual report and accounts 2015/2016 .

Bevan Brittan Events

Dealing with Complaints - This practical training day will focus on best practice and guidance for front-line staff of the NHS and healthcare organisations to investigate and manage claims, complex complaints and adverse incidents.
London. Tuesday 18 October 2016, 09:30 
Bristol Wednesday 19 October 2016, 09:30 
Birmingham. Tuesday 01 November 2016, 09:30

If you wish to discuss any clinical risk or patient safety issues please contact Joanna Lloyd, Catherine Radford or Penelope Radcliffe

Follow us! Bevan Brittan's patient safety team is regularly tweeting the latest patient safety news @BBPatientSafety.

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Commissioning

Publications/Guidance

Commissioning services for people with hearing loss: a framework for clinical commissioning groups. This guidance aims to support organisations responsible for planning and commissioning local hearing services for deaf people and those with diminishing hearing. It has been produced with patient groups, service users, hearing loss charities and healthcare providers and hopes to establish what effective commissioning looks like for CCGs. In addition, it features a range of local commissioning model case studies.

Clinical commissioning: GPs in charge? This King's Fund report considers progress made by CCGs in implementing their clinically led model and what more needs to be done. It looks at what has been learnt – including strategies to overcome challenges and identification of the main barriers to effective involvement – and makes recommendations for the future. The report warns that CCGs’ clinically led model of commissioning is at risk if barriers to effective clinical involvement are not addressed. The research found that CCGs feel they need more autonomy to involve GPs in decisions about service design. There are also concerns that inadequate resourcing of CCGs is undermining efforts to develop high-quality, clinically led commissioning and that there is a lack political support when making tough decisions about priorities.  

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

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Employment/HR

Publications/Guidance

Statement: the status of EU nationals in the UK. The Cabinet Office has issued a statement confirming that there has been no change to the rights and status of EU nationals in the UK, and UK nationals in the EU, as a result of the referendum.

Five big issues for the NHS after the Brexit vote. Health is not an area of significant EU competence; its role is by and large limited to supporting member states in their health endeavours. Nevertheless, the impact of the UK’s vote to leave the EU could have major implications for health and social care, not least because it has ushered in a period of significant economic and political uncertainty at a time when these services are facing huge operational and financial pressures. While the impact on the NHS of leaving the EU is impossible to forecast, it is clear that a number of important issues will need to be resolved, five of which are set out in this article.

Fair training pathways for all – Understanding experiences of progression. Research from the General Medical Council (GMC) has found that white UK medical graduates remain more likely to pass specialty exams than their black and minority ethnic (BME) counterparts. It was also found that doctors whose primary qualification was gained outside the UK or European Economic Area (EEA) are even less likely to do well in exams or recruitment. The chief executive of the GMC said the issues was complex and not unique to medical training and for which there are 'no quick fixes'. He continued: 'Differences in the way doctors progress through training may be influenced by a range of factors, such as individual characteristics and approaches to learning, institutions' support systems and wider socio-cultural factors.'

Code of Practice on the English language requirement for public sector workers. Part 7 of the Immigration Act 2016 imposes a new duty on public authorities to ensure that each person who works for the public authority in a customer-facing role speaks fluent English. This Code of Practice help public authorities to comply with this new "fluency" legal duty. It sets out considerations that public authorities will need to take into account when deciding how to determine the necessary standard of spoken English (or English or Welsh in Wales) to be met by their customer-facing staff, the appropriate complaints procedure to follow should a member of the public consider that the required standard has not been met and the appropriate forms of remedial action which may be taken if a member of staff falls below the standard required.

Staffing matters; funding counts: an analysis of workforce profile and trends in the English NHS. This report examines the profile and features of the NHS workforce in England, including; health labour market trends; relevant international data and comparisons from other countries; and a series of specific ‘pressure points’. The report concludes that the greatest threats to the delivery of the NHS five year forward view are funding constraints and workforce shortages. It argues that policymakers need to look at how targeted and aligned policies covering the effective use of temporary staff, retention of existing employees and international recruitment can be used to address current shortages in staffing and skills in order to buy time, while a more long-term sustainable approach is introduced.

Making staff experts in delivering end-of-life care. This case study outlines the benefits of empowering staff to deliver end of life care through greater education and training. The case study outlines outcomes that were achieved by Salford Royal NHS Foundation Trust including being awarded an outstanding rating by CQC for end of life care services; improved patient care and staff communication; and excellent feedback from patient families.

News

Junior doctors and medical students in England have voted to reject the contract that has been offered to them by the government. British Medical Association members voted 58% to 42% against accepting the deal. BMA leaders had urged members to accept the terms, which were announced in May after talks with the government resumed following six strikes. BMA junior doctor leader Johann Malawana has resigned.

Bevan Brittan Articles

Bevan Brittan's top five tips on taking charge of employee investigations. Anne Palmer runs through our top five 'need to know' tips on running an investigation, without the investigation running away from you. 

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

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Finance

Publications and Guidance

Sustainability and Transformation Fund 2016/17: Criteria to access the Fund. NHS Improvement has sent a letter to all Trust finance directors setting out the conditions for Trusts to access the £1.8bn Sustainability and Transformation Fund (STF) in 2016-17. If a Trust achieves its quarterly year-to-date target, or "control total", it will receive 70 per cent of its STF allocation, while the other 30 per cent will depend on performance against the headline waiting time targets for emergency, elective and cancer services.  

Impact of the Spending Review on health and social care. This report reviews the impact of the government spending review on health and social care and it finds that the scale of the funding challenge in health is colossal and whilst spending on health is increasing, the service is under unprecedented strain and struggling to keep pace with relentlessly rising demand. It also highlights the change in definition of health spending in the 2015 Spending Review and argues that using the original definitions, the total health spending will increase by £4.5bn in real terms by 2021, rather than £8.4bn as stated in the 2015 Spending Review.

NHS specialised services. This report warns that the disproportionate growth in spending on specialised services poses a risk to the financial sustainability of the wider NHS. It highlights the need for urgent action to be taken to ensure that services are affordable and recommends that NHS England take action to ensure that new drugs and medical equipment are affordable; that services are delivered cost-effectively; and that demand for specialised services is better managed. The report also argues for more consistent, transparent and equitable decision-making on the part of NHS England.

Deficits in the NHS 2016. This King's Fund briefing draws on data from its quarterly monitoring reports, secondary research and interviews with health care leaders to consider commissioner and provider finances in the round and to provide an overview of the factors that have led to the NHS going into deficit. It goes on to outline some of the strategies being employed to restore financial balance, before drawing together its thoughts on the implications of these strategies for the NHS this year and in the longer term. It calls on the Government to review its priorities for the NHS and be honest with the public about what the health service can deliver with its budget. The think tank suggests that key waiting time targets may need to be reviewed and the commitment to deliver seven-day services revisited, if the Government’s priority is to restore financial balance in the NHS.

NHS finances outside the EU. This briefing explores what the UK leaving the EU might mean for funding of the NHS in England. In light of economists warning that leaving the EU will have a negative effect on the UK economy the report concludes that it is difficult to see how the NHS can avoid the impact on public spending. In a long term analysis of NHS finances, the report estimates that the funding shortfall could be at least £19bn by 2030/31 assuming that the UK is able to join the European Economic Area; if this is not the case the shortfall is estimated at £28bn.

Strengthening financial performance and accountability in 2016/17. NHS Improvement, in partnership with NHS England, has set out a suite of new measures for providers and commissioners to restore financial discipline and help ensure ongoing financial sustainability for the NHS. This document sets out action to stabilise NHS finances in 2016/17, provides further detail on access to the Sustainability and Transformation Fund, outlines the proposed basis for assessing the financial performance of provider organisations and introduces new programmes of financial special measures for providers and commissioners that are unable to ensure sufficient financial discipline.

News

NHS action to strengthen trusts’ and CCGs’ financial and operational performance for 2016/17. NHS England and NHS Improvement have announced a seven-point set of actions to cut dramatically the annual trust deficit, and sharpen the direct accountability of trusts and CCGs to live within the public resources made available by Parliament and the Government in 2016/17.

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

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Foundation Trusts

Publications/Guidance

NHS foundation trusts: consolidated accounts 2015/16. This report presents a consolidation of the audited accounts of the 153 individual NHS foundation trusts for the financial year 1 April 2015 to 31 March 2016. It finds that in 2015/16 the foundation trust sector has delivered a deficit of £1,088 million for as a result of sustained financial pressures. The report reflects that newly introduced measures have started to have a positive impact but the overall performance of the sector has been affected by high usage of agency staff, financial sanctions, a shortfall of cost savings and a reduction in non-recurrent income.

Consultations

Single Oversight Framework consultation. NHS Improvement is seeking views on its proposed approach to overseeing and supporting NHS trusts and foundation trusts. It aims to identify where providers may benefit from improvement support across five areas: quality of care; finance and use of resources; operational performance; strategic change; and leadership and improvement capability. The consultation closes on 4 August 2016.

If you wish to discuss any issues raised in this section please contact Vincent Buscemi

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Health and Safety

News

Sydenham hospice fined and charged for Legionella breaches. A Sydenham-based hospice has been sentenced and fined for health and safety violations in relation to a patient and employee who have suffered life-changing effects after contracting Legionnaires' disease.

Support worker sentenced after severely disabled woman choked and died. A senior support worker from Leeds was sentenced after a severely disabled woman choked and later died while in her care.

Bevan Brittan Events

Health & Safety Update. A number of recent developments mean that the potential impact of health and safety breaches is greater than ever before. Bevan Brittan is at the forefront of advising organisations in the UK to minimise your exposure from a financial, commercial and reputational perspective. This seminar provides a fantastic opportunity to ensure you are up to date with the law, to receive practical tips to help you achieve compliance, an interesting selection of break-out sessions to opt-in to, and a chance to share experiences with other colleagues.
Bristol. Wednesday 02 November 2016, 09:30
London. Tuesday 15 November 2016, 09:30
Birmingham - Wednesday 16 November 2016, 09:30

If you wish to discuss any issues raised in this section please contact Sarah Knight or Debbie Rookes

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Information Sharing

Publications/Guidance

Safe data, safe care: Report into how data is safely and securely managed in the NHS. A Care Quality Commission review examines whether personal health and care information is being used safely and is appropriately protected in the NHS. It found that there was evident widespread commitment to data security, but staff at all levels faced significant challenges in translating their commitment into reliable practice. It sets out six recommendations to improve data security. The Government responded to the report in a written statement (HCWS62).

New safeguards and a public conversation about health and care information proposed. Two reports commissioned by the Secretary of State for Health make a number of recommendations to strengthen the security of health and care information and to help people make informed choices about how their data is used. While both reports found a strong commitment among staff and organisations to keep data secure and a high level of public trust in the NHS to do so, they also identified areas for improvement.

Consultations

National Data Guardian for Health and Care’s review of data security, consent and opt-outs. This consultation seeks views on the proposed data security standards and the consent/opt-outs model from health and care professionals and organisations and the public. The review includes: ten new data security standards; a method of testing compliance with these standards; and a new consent model for data sharing in health and social care. The consultation closes on 7 September 2016.

News

Government scraps scheme to pool patients’ records.

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

Perinatal mental health toolkit. This resource is aimed at family doctors and other healthcare professionals, as a go-to collation of resources that could support them to deliver the care their patients with perinatal mental health need. It includes a variety of resources to offer patients from information leaflets, links to supporting charities and social media peer support groups amongst many others. Health professionals may face additional challenges in seeking help for perinatal mental health problems and there is a specific section of the toolkit to address this need.

Best start in life: promoting good emotional wellbeing and mental health for children and young people. Tackling mental illness in children should begin before they are born, at a time when expectant mothers can suffer mental health problems, this report suggests. It says that early interactions and experiences directly affect how a child's brain develops and concludes it is vital that intervention is made at this critical stage to reduce the chances of mental illness developing in children.

Implementing the Five Year Forward View for mental health. This plan outlines the changes people will see on the ground over the coming years in response to the Mental Health Taskforce’s recommendations to improve care. It is intended as a blueprint for the changes that NHS staff, organisations and other parts of the system can make to improve mental health. The plan also gives a clear indication to the public and people who use services what they can expect from the NHS, and when. The plan also outlines further details on key commitments to greater funding for mental health services.

A spectrum of obstacles: an inquiry into access to healthcare for autistic people. Following a seven-month inquiry and a consultation of over 900 people, the Westminster Commission on Autism launches its inquiry report and calls for improved access to healthcare for all autistic people. It calls for greater training of health professionals to increase awareness of the health care needs of autistic people; the implementation of annual health checks for autistic people; and also that CQC should establish autism-specific inspection questions into their inspection framework.  

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

Clinical commissioning: GPs in charge? This King's Fund report considers progress made by CCGs in implementing their clinically led model and what more needs to be done. It looks at what has been learnt – including strategies to overcome challenges and identification of the main barriers to effective involvement – and makes recommendations for the future. The report warns that CCGs’ clinically led model of commissioning is at risk if barriers to effective clinical involvement are not addressed. The research found that CCGs feel they need more autonomy to involve GPs in decisions about service design. There are also concerns that inadequate resourcing of CCGs is undermining efforts to develop high-quality, clinically led commissioning and that there is a lack political support when making tough decisions about priorities. 

Is bigger better? Lessons for large-scale general practice. The Nuffield Trust has published a report which shows that three quarters of English practices have now joined large-scale GP organisations, formed to help cope with rising pressure and policies demanding longer hours and new services. It finds these organisations can help to sustain general practice in the face of intense financial pressure and shortages of doctors and nurses. However, they have so far made limited progress in expanding into new services, and taking on a strategic role in redesigning care.

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

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Procurement

Guidance

NHS Procurement & Commercial Standards. Sets out the standards for NHS healthcare provider organisations to assess and benchmark procurement performance and identify areas for improvements. The guidance provides an outline for a moderation process to ensure consistency of application and sharing of good practice. It also provides information on how to use the standards, process for the peer reviews, and templates for completion with examples of the types of evidence which are required.

Procurement Policy Note 07/16 Legal requirement to publish on Contracts Finder. This PPN reminds contracting authorities to ensure that any procurement opportunities and contract awards above certain low thresholds are published on Contracts Finder. It should be read alongside the guidance on transparency requirements for publishing on Contracts Finder. The PPN provides additional guidance to assist contracting authorities to meet the requirements.

If you wish to discuss any queries you may have around procurement please contact Emily Heard.  

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Public Health

Publications/Guidance 

Future of an ageing population. This report by the Government Office for Science brings together evidence about today’s older population, with future trends and projections, to identify the implications for the UK. This evidence will help government to develop the policies needed to adapt to an ageing population. Section 6 considers health and care systems. It finds that ageing will increase the total amount of ill-health and disability in the population. There will be an accompanying change in the nature of ill-health, with a relative shift away from acute illness towards chronic conditions, multi-morbidities, cognitive impairments and long-term frailty. In parallel, families and communities will play an increasing role in providing care services.

Public health's role in local government and NHS integration. This LGA report makes the case for greater engagement of public health in supporting integration, with a view to promoting comprehensive involvement across the country.

Commissioning local infant feeding services. PHE and Unicef UK have developed guidance to support the commissioning of evidence-based interventions to improve breastfeeding rates across England. Presented as a toolkit, the guidance is divided into three parts: infographics which highlight the key issues; good practice guidance for commissioners; and guidance on effective data collection, monitoring and reporting.

Use of e-cigarettes in public places and workplaces: advice to inform evidence-based policy making. This guide aims to help organisations develop their own policies on e-cigarette use in public places and workplaces. It sets out five principles to guide the development of evidence-based policies that maximise the potential for e-cigarettes to improve public health while managing the risks in any particular setting. It is recommended that policies are kept under regular review to take account of developments in the evidence base and changes in the regulatory environment. There is also a five point summary.

If you wish to discuss any queries you may have around public health please contact Claire Bentley.  

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Regulation

Publications/guidance

Care Quality Commission reviews how NHS acute trusts are learning from serious incidents. CQC has published the findings of its review of how acute NHS trusts report on investigations into serious incidents, and the extent to which they identify learning that can be used to improve practice when things go wrong.

Ombudsman issues first dual jurisdiction report following complaint of neglect at Oxfordshire care home. The LGO has issued its first joint investigation report covering the actions of both a private care provider and a council’s subsequent safeguarding investigation into that provider’s quality of care. The investigation was prompted by a complaint from a man who said his wife was left severely dehydrated and suffering from oral thrush after a week-long respite stay at the Huntercombe Hall Care Home, operated by Caring Homes Healthcare Group Ltd. The LGO’s investigation found that the Council did not act in accordance with the law and relevant government guidance, it did not adhere to DH statutory guidance on safeguarding adults and failed to follow its own policy and procedure relating to safeguarding investigation. The investigation also upheld the man’s complaint against the care provider.

How CQC is supporting the development of new care models. CQC has published a "statement of intent", which explains how it will support providers of health and care services to find new and innovative ways to provide care for people. The supportive approach outlined in this document is designed to ensure regulation is not an unnecessary barrier to innovation, but continues to protect people and supports those who want to provide effective and creative solutions to meeting people’s needs. The offer is built on the principles of: Listening and learning; Supporting innovation; and Working with national regulators and system partners

A Public Service Ombudsman for the UK. This House of Commons Library briefing paper looks at the Government's proposal to bring forward a draft Bill for a Public Service Ombudsman which will provide a unified ombudsman service for UK reserved matters and public services delivered solely in England. It also looks at the existing ombudsman landscape for public services across the UK.

News

GMC to reduce the stress on doctors by piloting fitness to practise changes. Announces that the General Medical Council has launched two pilot schemes to speed up fitness to practise cases and reduce their impact on doctors. The first scheme will involve cases where doctors are alleged to have made a one off mistake involving poor clinical care. Instead of opening a full investigation the GMC will first gather a few pieces of key information about the case, such as medical records and incident reports. Only after reviewing this evidence will the GMC decide whether to open a full investigation, refer the matter to the doctor’s Responsible Officer, or close it with no further action. The second pilot takes forward one of the recommendations of Sir Anthony Hooper’s review of whistle-blowers. It will require designated bodies, such as NHS organisations and independent healthcare providers, to disclose whether the doctor being complained about to the GMC has previously raised any patient safety issues. The person referring the concerns will also have to make a declaration that the complaint is being made in good faith, and that steps have been taken to make sure it is fair and accurate.

Bevan Brittan Updates

CQC Enforcement Update. Financial penalties on the increase. 

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

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General

Publications/Guidance

Brexit FAQs. The NHS European Office has produced a set of frequently asked questions which relate to the potential implications of leaving the EU on the NHS. It covers the facts around issues such as compliance with EU laws and regulations, recruiting and retaining EU staff and accessing EU funding.

Decisions relating to cardiopulmonary resuscitation. The British Medical Association (BMA), the Resuscitation Council (UK), and the Royal College of Nursing (RCN) have issued updated guidance regarding anticipatory decisions about whether or not to attempt resuscitation in a person when their heart stops or they stop breathing. 

Stepping up to the place: integration self-assessment tool. This toolkit was developed to help local health and care leaders move further and faster on achieving their vision of integration. It aims to enable local areas to assess their own readiness to bring about integration, and identify what action they need to take.

The future of pathology services. Pathology, the branch of medicine involving the examination of organs, tissues and whole bodies, is involved in 70 to 80 per cent of diagnosis and treatment decisions. It also faces some of the fastest and most radical technological changes in health care. The Nuffield Trust has looked at the important opportunities to deliver better care and save money in this field, what could hold them back, and how they can be realised. The report finds that there are clear opportunities in pathology services for the NHS to save up to £200m and step up the improvement of quality; however, progress has been patchy, and an emerging squeeze on staffing risks holding back change.

The NHS if ... . The King's Fund has published a collection of essays that explores hypothetical scenarios and their impact on the future of health and care. The aim is to encourage new thinking and debate about possible future scenarios that could fundamentally change health and care. The essays cover three themes: the NHS and society; medicine, data and technology; and how the NHS works.

News

Department of Health ministerial responsibilities. Details new ministers joining DH and changes in responsibilities following the change in government.

New findings reveal NHS initiative to get vulnerable people online has dramatically improved their health and well being and reduced demand for front line services. A report published by the Tinder Foundation, Health & digital - Reducing inequalities, improving society, shows that an NHS programme to train vulnerable people to use the internet has led to over half feeling more confident to manage their health, 21% making fewer calls or visits to their GP and 6% making fewer trips to A&E. This behaviour change is estimated to have saved the NHS £6m in avoided GP and A&E visits in just 12 months. As a result of the Widening Digital Participation programme, run by NHS England and Tinder Foundation, 59% of learners report feeling more confident to use online tools to manage their health, 65% feel more informed and 52% say they feel less lonely with 62% saying they feel happier as a result of social contact, an important indicator for overall well being.

Chief coroner calls for legal aid provision in state-involved inquests.  

Bevan Brittan News

Lifting the automatic suspension: when will damages be adequate for non-profit organisations? Over the past 18 months a quintet of cases beginning with Solent NHS Trust v Hampshire County Council have explored the circumstances in which the court will lift the automatic suspension on contract-making triggered by the issue of proceedings under Public Contracts Regulations 2006/2015. 

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

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