11/01/2017
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.
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If you have been forwarded this update by a colleague and would like to receive it directly, please email Claire Bentley.
Training Events
Bevan Brittan Clinical Risk/Medical Law Training - These are internal hour long lunch time training sessions that are attended by our team of solicitors. If you are a client and would like to come along and join our team at these sessions just ask Claire Bentley. You can attend in our London, Bristol or Birmingham office. If you are unable to get to one of our offices you can also sign up to watch the training sessions remotely via our webinar facility.
Acute and emergency care
Publications/guidance
Quick guides: transforming urgent and emergency care services in England. NHS England and partners have published a series of quick guides to support local health and care systems. The guides provide practical tips, case studies and links to useful documents, which can be used to implement solutions to commonly experienced issues.
How hospital activity and funding in England have changed over time. This King's Fund paper analyses hospital activity data over the past 13 years. It finds that the number of admissions to hospital are rising steeply and are outstripping increases in the NHS budget. The analysis also finds that rising hospital admissions could jeopardise the plans set out in the NHS Five Year Forward View. It highlights the importance of finding ways to moderate demand for hospital care, arguing that the best hope for this lies in strengthening community services by building on the new ways of delivering care being developed under the Forward View. It also suggests that sustainability and transformation plans could provide the means to deliver the changes needed, as long as they are accompanied by sufficient investment.
Updated key performance indicators for integrated urgent care. NHS England has published a new set of updated key performance indicators (KPIs) for integrated urgent care.
How nurses support families of intensive care patients towards the end of life. This systematic review finds that families of people dying in intensive care need to receive personalised communication and ongoing support, and be involved in the dying process. The findings support current NICE recommendations for health professionals to deliver care that meets the needs and preferences of the dying person and their family, wherever they are.
Nuffield winter insight: winter bed pressures. This briefing is the first in a series looking closely at some of the big issues behind pressure on the NHS in winter months. This briefing focuses on the findings of a new analysis of bed occupancy levels from NHS England situation reports for last winter.
Consultations
Safe staffing improvement resources: adult inpatients in acute care. The National Quality Board’s Safe Sustainable Productive Staffing paper (July 2016) set out expectations for nursing and midwifery staffing to help NHS provider boards make local decisions that will deliver high quality care for patients within the available staffing resource. NHS Improvement is now seeking views on a draft improvement resource to support nurse staffing in adult inpatient wards in acute hospitals which is aligned to Commitment 9 of Leading Change, Adding Value: a framework for nursing, midwifery and care staff. The consultation closes on 3 February 2017.
News
New pay deal for paramedics. Announces that the DH, NHS Employers and ambulance unions have agreed paramedics will be re-banded nationally from band 5 to band 6. The new deal for paramedics in England will see them move up the pay scale from band 5 to band 6 where appropriate. This is in recognition of the increasing responsibilities of being a modern paramedic. It also means paramedics will be able to earn more as they progress through the Agenda for Change pay scale.
Transformation funding for Urgent and Emergency Liaison Mental Health Services. NHS England is inviting bids for new transformation funding for urgent and emergency liaison mental health services in acute hospitals. Funding is being made available in two phases from 2017/18 in support of the national commitment to delivering a 'core 24' standard of liaison mental health services for adults and older adults in emergency departments and general inpatient wards in at least 50% of acute hospitals by 2020/21. The closing date for bids for Wave 1 is 18 January 2017.
If you wish to discuss any queries you may have around acute and emergency care please contact Claire Bentley.
Children
Publications/guidance
End of life care for infants, children and young people with life-limiting conditions: planning and management (NICE guideline NG61). This guideline covers the planning and management of end of life and palliative care in for infants, children and young people (aged 0–17 years) with life-limiting conditions. It aims to involve children, young people and their families in decisions about their care, and improve the support that is available to them throughout their lives. The guideline does not cover children and young people without a life-limiting condition who die unexpectedly (for example, accidental death).
News
End of life care must be for the whole family not just the dying child.
If you wish to discuss any queries you may have around children please contact Deborah Jeremiah.
Clinical Risk/Patient Safety
Bevan Brittan Clinical Risk/Medical Law Training - These are internal hour long lunch time training sessions that are attended by our team of solicitors. If you are a client and would like to come along and join our team at these sessions just ask Claire Bentley. You can attend in our London, Bristol or Birmingham office. If you are unable to get to one of our offices you can also sign up to watch the training sessions remotely via our webinar facility.
Publications/Guidance
Working together to investigate health and social care complaints This report outlines how adopting an integrated approach to investigating complaints about health and social care can lead to significant benefits. It discovered that many of the problems experienced have been caused by the complex way in which health and social care is provided at a local level.
Development of learning from radiotherapy errors: supplementary guidance series. This document presents the causative factor taxonomy; presents the refinement to the radiotherapy pathway coding which includes the introduction of the safety barrier taxonomy; and provides guidance on the application of the taxonomy. It also shares submission procedures for coding with radiotherapy staff and risk managers for inclusion in national analysis and encourages local application of the taxonomies to improve local learning from radiotherapy error and near miss events.
Saving Lives, Improving Mothers’ Care. This is the third report of the Confidential Enquiry into Maternal Deaths. It details the findings of maternal mortality surveillance 2012 to 2014 in the UK and the lessons learned from the confidential enquiries into maternal deaths from cardiovascular causes, blood pressure disorders of pregnancy, early pregnancy causes together with messages for critical care. It also contains messages for the future care of women with early pregnancy conditions including ectopic pregnancy and those women in pregnancy or soon after who require critical care.
Quality at a cost. The Nuffield Trust's and Health Foundation's latest annual QualityWatch statement warns that ongoing pressures on the NHS risk making the health service more vulnerable to serious lapses in care in future, despite impressive achievements in maintaining and improving care quality in important areas. The report looks at a range of care quality measures across the NHS in England and highlights several areas of healthcare where standards have improved, but the authors point to slowing improvement in other areas, growing waiting times and continuing financial pressures as evidence that the NHS could face serious challenges in maintaining standards in care.
Midwifery staffing is the focus of two new publications from the RCM. The reports are: Getting the midwifery workforce right and RCM guidance on implementing the NICE safe staffing guideline on midwifery staffing in maternity settings.
Consent for anaesthesia 2017. The AAGBI has published new guidelines on consent for anaesthesia.
Learning, candour and accountability: A review of the way NHS trusts review and investigate the deaths of patients in England. A year after a review commissioned by NHS England uncovered failings at Southern Health Foundation Trust, the CQC has published a report that looks at how acute, community and mental health trusts across the country investigate and learn from deaths of people who have been in their care. The report concludes that many carers and families do not experience the NHS as being open and transparent and that opportunities are missed to learn across the system from deaths that may have been prevented. CQC found that the level of acceptance and sense of inevitability when people with a learning disability or mental illness die early is too common. This may often be due to unidentified or unsupported health needs that, in many cases, will offer even greater opportunity for learning. There can be no tolerance of their deaths being treated with any less importance than other patients. The report recommends improvements that need to be made if the NHS is to be more open about these events, and improves how it learns and acts on them. The recommendations consider the contribution made by the whole of the system. They address the culture of the NHS, national policy and guidance, information flows, the capability and capacity of staff to review deaths and how quality assurance and regulation can promote good practice.
NHSLA Neonatal Hypoglycaemia Guidance - The NHS LA has published guidance on neonatal hypoglycaemia.
Cases
Obstetric case - Baynham (A Child & Protected party by her litigation friend, Sarah Jane Baynham) v Royal Wolverhampton Hospitals NHS Trust [2016] EWCA Civ 1249. The Court of Appeal has rejected an appeal from a teenager, whose birth was delayed. The appeal related to an earlier ruling that the delay had not been the cause of the claimant’s subsequent brain damage and severe disabilities. The judge had not erred in his findings on complex issues in dispute between the parties' expert witnesses.
Obstetric case - Welds (and the child's mother and litigation friend Walrond) v Yorkshire Ambulance Service NHS Trust and another [2016] EWHC 3325 (QB). The High Court held that there has been no breach of duty in relation to a claim from a teenager who was left severely disabled due to oxygen starvation at birth. The court ruled that the ambulance service and the hospital could not be held liable for the claimant's injuries and that there was no culpable delay.
Sally Harris v Francis Johnston [2016] EWHC 3193 (QB) The standard of care of a neurosurgeon had not fallen far below that reasonably expected when a patient sustained injury after a Cobb dissector came into contact with her spinal cord during decompression surgery. The court disregarded the claimant's expert evidence in reaching its decision on the basis that he had failed to engage with the defence pleading and referred throughout to a different instrument having caused the injury.
Tracy Holdsworth v Luton & Dunstable University Hospital NHS Foundation Trust [2016] EWHC 3347 (QB). A surgeon had not been negligent in performing a unicompartment knee replacement on a patient whose long-standing knee problems derived no benefit from it, and where expert opinion was agreed that only a minority of orthopaedic surgeons would have performed it in such circumstances. The mode of treatment was always a clinical decision, and the fact that the patient had been intent upon surgery could not, alone, justify the decision to perform it. However, the patient had been warned of the risks and the decision had been reasonable.
News
NHSLA faces new probe into £1.5bn clin neg costs. In light of clinical negligence claims against NHS hospitals costing a "significant and rising" amount, with the Department of Health spending £1.5 billion in this area in 2015/16, the National Audit Office is planning to investigate the NHS Litigation Authority's (NHSLA) main scheme for defending claims, whereby NHS trusts pay into a risk pool and receive indemnity cover. The study will examine what is causing the increase in clinical negligence costs, and evaluate their efforts to manage and reduce the costs associated with resulting claims.
Health secretary Jeremy Hunt is lobbying the Prime Minister for legislation on new reforms to the health service to be included in next year’s Queen’s speech.
Reducing infections in the NHS. Plans to prevent hospital infections include more money for hospitals who reduce infection rates and publishing E. coli rates by local area.
Barcode technology helping to improve patient safety. Barcodes are being used to trace NHS patients and their treatments, manage medical supplies and monitor the effectiveness of equipment.
If you wish to discuss any clinical risk or patient safety issues please contact Joanna Lloyd, Catherine Radford or Penelope Radcliffe.
Commissioning
Publications/Guidance
IPC Programme expands to improve services for millions with complex needs. Announces that Birmingham and Solihull, Nottingham City, Hertfordshire, Islington, Sheffield and Nottinghamshire will become early adopters in NHS England's Integrated Personal Commissioning (IPC) programme that helps to transform care for millions of disabled people and people those with long term conditions. The programme is aimed at joining up health, social care and other services, including the voluntary and charity sectors, to help people, carers and families have more control over their care needs. A key part of the IPC programme is increasing the number of people with a personal health budget (PHB). NHS England has set a target of at least 50,000 PHBs in place by 2020/21.
Independent review of community pharmacy clinical services. NHS England has published the independent review report of Richard Murray, director of policy at The King's Fund. The report was commissioned by the Chief Pharmaceutical Officer of NHS England in April 2016 to help inform him about the future provision of clinical pharmacy services. The report highlights a more clinical future for community pharmacists and pharmacy technicians which will help patients to benefit from their expertise as clinical healthcare professionals. NHS England intends to use the recommendations of the independent review to inform its approach to the commissioning of NHS community pharmacy services once the review recommendations have been considered.
CCG datapacks: NHS RightCare Long Term Conditions Pack. These packs contains data on a number of disease areas and elements of care. The pack is split by stages along a long term conditions pathway and enables a local health economy to look at an element, for example disease detection or prescribing, across multiple disease areas. The pack contains a number of new indicators not included in previous packs. It also includes case studies, tools and guidance to support CCGs to make improvements to long term conditions care in their local health economy.
Missing the wood for the trees. In this King's Fund blog, Ben Collins reflects on the reasons behind the failure of the UnitingCare contract, and lessons that have been learnt for commissioning in the NHS.
Shaping healthy cities and economies: the role of clinical commissioning. This report showcases how clinical leaders in England’s core cities - the eight largest cities outside of London - are looking at how the services they commission can improve not only the health but social and economic wellbeing of their populations. The report finds that in these areas, clinical commissioners are working with a wide range of partners to go beyond traditional boundaries to combat health inequalities and social exclusion, increase skills and employment and to attract inward investment to help realise the potential of their local economies.
Lessons in leadership from women clinical commissioners: Practical guidance to support the next generation of women clinical leaders. NHS Clinical Commissioners has launched a guide that provides practical advice based on the experience of women CCG leaders at the top of their careers. It contains practical examples from women clinical commissioning leaders on the skills, values, and behaviours that helped them to succeed in their own roles. The publication also includes advice on supporting future women clinical commissioning leaders, including actively encouraging women colleagues to apply for leadership roles and making sure that wording in job adverts attracts rather than discourages female applicants.
End of life care for infants, children and young people with life-limiting conditions: planning and management (NICE guideline NG61). This guideline covers the planning and management of end of life and palliative care in for infants, children and young people (aged 0–17 years) with life-limiting conditions. It aims to involve children, young people and their families in decisions about their care, and improve the support that is available to them throughout their lives. The guideline does not cover children and young people without a life-limiting condition who die unexpectedly (for example, accidental death).
Guidelines for responding to requests from practices to temporarily suspend patient registration. These guidelines have been published to assist commissioners in responding to practices wanting to suspend patient registration on a temporary basis. It recognises the duty on commissioners to secure services for patients as well as the pressure on practices in providing services linking with support arrangements described in the General Practice Forward View.
If you wish to discuss the issue of commissioning please contact David Owens.
Employment/HR
Publications/Guidance
RCM guidance on implementing the NICE safe staffing guideline on midwifery staffing in maternity settings This guidance is aimed at senior midwives and NHS managers and aims to support them in implementing NICE safe staffing guidance in maternity services.
Getting the midwifery workforce right. This report outlines how maternity services should be organised, funded and staffed. It discusses the role of the midwife and approaches for services to enable them to make safe and effective staffing decisions.
Beyond Brexit: assessing key risks to the nursing workforce in England. This paper analyses data at national and trust level to map the regions and NHS trusts in England who may be most vulnerable to the associated risks of Brexit and population growth. The analysis forecasts that areas with a high projected rate of population growth of over-85s and above average employment of nurses from the European Economic Area are most at risk of facing greater pressures in those health economies.
Updated pay circular for doctors and dentists in training. NHS Employers has issued an updated Pay and Conditions Circular (M&D) 2/2016 that replaces the version previously published on 25 July 2016. This circular details arrangements for those on the 2016 terms and conditions of service for NHS doctors and dentists in training. There are two main updates in the re-published circular: Section 1 on basic pay has been amended to clarify arrangements for those in dental core training and dental speciality training by providing these arrangements in a separate table; and Section 4 on flexible pay premia has been clarified to give further detail on the payment of this premium to those in psychiatry training programmes.
Medical professionalism matters: report and recommendations This report is the culmination of 18 months of events and conversations with the medical profession, from GPs, consultants and trainees who work on the ground, to royal colleges, training providers and employers. Among the most frequently raised issues were the lack of time and support to make a reality of reflective practice – at every stage of a doctor’s career. Doctors also cited problems around professional isolation, fragmentation of care for patients and poor communication.
News
New pay deal for paramedics. Announces that the DH, NHS Employers and ambulance unions have agreed paramedics will be re-banded nationally from band 5 to band 6. The new deal for paramedics in England will see them move up the pay scale from band 5 to band 6 where appropriate. This is in recognition of the increasing responsibilities of being a modern paramedic. It also means paramedics will be able to earn more as they progress through the Agenda for Change pay scale.
Bevan Brittan Updates
Employment news round-up, December 2016. Our last round-up of the key employment news in brief for 2016 covers: an update on industrial action reform; further ET reform; an interesting new report on working in local government; the latest Brexit news and details of next year's statutory payment increases.
Mind the [gender pay] gap. The final gender pay gap regulations have been published – whilst gender pay regulations for the public sector are awaited, they are expected to follow the same timescales and requirements as the recently published private sector regulations. You will, therefore, need to get to grips with the current draft regulations.
If you wish to discuss any employment issues please contact Julian Hoskins or James Gutteridge.
Finance
Publications and Guidance
NHS trust FMA guidance: 2016 to 2017. Financial monitoring and accounts and management information forms (FMA) for NHS trusts to complete the 2016 to 2017 quarter 3 and year-end finance returns have been published by the Department of Health (DH). A guidance document has also been published by DH.
NHS machines: the utilisation of high-value capital equipment at NHS trusts. This report examines the utilisation of five different types of machines in NHS trusts in England to assess how greater and more efficient use of existing resources can be encouraged.
NHS reference costs 2015 to 2016. This document provides the most up-to-date information about how NHS expenditure was used to provide health care by NHS trusts and NHS foundation trusts. Reference costs are the unit costs to the NHS for providing defined services in a given financial year to NHS patients in England.
How hospital activity and funding in England have changed over time. This new analysis finds that the number of admissions to hospital are rising steeply and are outstripping increases in the NHS budget. It highlights the potential for rising hospital admissions to jeopardise the plans set out in the NHS five year forward view, which is based on an assumption that growth in hospital activity would be reduced to 1.3 per cent a year rather than the current rate of a 3.6 per cent increase per year. The paper argues that finding ways of moderating demand for hospital care should be prioritised and that the best hope for this lies in strengthening community services.
News
Spring Budget to take place on 8 March 2017. The Government has announced that the 2017 Spring Budget will be published on Wednesday 8 March 2017. This will be the last Budget to take place in the Spring, as confirmed by the Chancellor of the Exchequer in the 2016 Autumn Statement.
If you wish to discuss any issues raised in this section please contact Claire Bentley.
Inquests
Cases
Catherine McDonnell v HM Assistant Coroner for West London [2016] EWHC 3078 (Admin). It was not in the interests of justice to order a new inquest under the Coroners Act 1988 s.13(1)(b) where the coroner's initial verdict could not be validly criticised. The cause of death was complex and there had been a range of medical opinion given in evidence. A different coroner might take a different view but that was not sufficient to grant the order.
If you wish to discuss any issues raised in this section please contact Annette Parker.
Mental Health
Would you like to access the Bevan Brittan Mental Health Extranet? - It is a secure online resource containing a discussion forum, knowledge bank and information about training events. If you would like access please contact Claire Bentley.
Bevan Brittan Clinical Risk/Medical Law Training - These are internal hour long lunch time training sessions that are attended by our team of solicitors. If you are a client and would like to come along and join our team at these sessions just ask Claire Bentley. You can attend in our London, Bristol or Birmingham office. If you are unable to get to one of our offices you can also sign up to watch the training sessions remotely via our webinar facility.
Publications/Guidance
Looked after children: mental health and emotional wellbeing – call for evidence and stakeholder events. The DH and DfE have established an Expert Working Group – supported by the Social Care Institute for Excellence - to develop models of care and care pathways to support the mental health and wellbeing of looked after children and care leavers.
What is truth? An inquiry about truth and lying in dementia care. This is the report of the major Inquiry about Truth and Lying in Dementia Care, commissioned and funded by the Joseph Rowntree Foundation
Improving the mental health of children and young people. These reports describe the importance of mental health and wellbeing among children and young people and the case for investment in mental health. They also summarise the evidence of what works to improve mental health among children and young people in order to inform local transformation of services.
Suicide prevention: interim report. This report presents interim findings from an inquiry that will go on to inform the updated suicide prevention strategy. It argues that the government should prioritise a clear implementation strategy and increase support for public mental health and early intervention services if it is to bring down the suicide rate. Ahead of the final report, the interim report highlights areas for action: a clear implementation strategy; improving services for those who are vulnerable to suicide; developing a consensus statement on sharing information with families; the need for more timely and consistent data to help prevent suicides; and greater adherence to media guidelines for the reporting of suicides.
Consultations
Safe staffing improvement resources: learning disability services. NHS England is seeking views on a draft improvement resource for community and inpatient learning disability services. It is designed to help commissioners and providers of NHS commissioned services to create, review and sustain safe and effective specialist health services within the resources available for people with a learning disability, who have a wide range of needs and varying levels of disability. The consultation closes on 3 February 2017.
Cases
Henderson v Dorset Healthcare University NHS Foundation Trust [2016] EWHC 3275 (QB), [2016] MHLO 56. On public policy grounds the court was bound by Clunis v Camden and Islington HA [1998] Q.B. 978 and Gray v Thames Trains Ltd [2009] UKHL 33 to reject a damages claim brought by an individual who had pleaded guilty to manslaughter by reason of diminished responsibility when, owing to the defendant's negligence, she suffered a psychotic episode and killed her mother.
SSJ v Staffordshire County Council and SRK [2016] EWCA Civ 1317, [2016] MHLO 55. Where an incapacitated person was cared for and accommodated under a purely private care regime, there were insufficient procedural safeguards against arbitrary detention to satisfy the State's positive obligation under Article 5(1) ECHR to prevent the unlawful deprivation of liberty.
Briggs v Briggs [2016] EWCOP 53. The court determined that it was in the best interests of a patient in a minimally conscious state to refuse consent for the continuation of his clinically assisted nutrition and hydration. He would be moved to a hospice where he would receive palliative care and die. The strong presumption in favour of continuing life-sustaining treatment for a life that had value was not absolute and had to be weighed against the principle of self-determination.
News
Transformation funding for Urgent and Emergency Liaison Mental Health Services. NHS England is inviting bids for new transformation funding for urgent and emergency liaison mental health services in acute hospitals. Funding is being made available in two phases from 2017/18 in support of the national commitment to delivering a 'core 24' standard of liaison mental health services for adults and older adults in emergency departments and general inpatient wards in at least 50% of acute hospitals by 2020/21. The closing date for bids for Wave 1 is 18 January 2017.
Funds to improve housing for people with learning disabilities. Announces the successful local authorities that have been awarded a share of the £25m Housing and Technology Fund for people with learning disabilities. The fund aims to improve their quality of life by giving them independence, and helping them feel more included in their local community. The local authority projects will focus on adapting existing housing, creating new accommodation and giving people support so they have more independence and choice.
Bevan Brittan Updates
If you wish to discuss any of the items raised in the above section please contact Simon Lindsay or Stuart Marchant.
Primary Care
Publications/guidance
Guidelines for responding to requests from practices to temporarily suspend patient registration. These guidelines have been published to assist commissioners in responding to practices wanting to suspend patient registration on a temporary basis. It recognises the duty on commissioners to secure services for patients as well as the pressure on practices in providing services linking with support arrangements described in the General Practice Forward View.
General Practice Forward View (GPFV): Clinical Pharmacists in General Practice Phase 2 – Guidance for applicants. Helps potential providers who wish to apply for funding through the Clinical Pharmacists in General Practice scheme. It acts as a guide to the implementation of the scheme and aids completion of the application form.
Consultations
Draft multispecialty community provider (MCP) contract. NHS England has published a draft version of the Multispecialty Community Provider (MCP) contract and supporting documents, for consultation. This follows the publication in July 2016 of an MCP framework which described the care model and introduced the emerging contract and business model that underpins it. The package includes a document addressing GP participation in an MCP, which is potentially the most complex aspect of the MCP model. The consultation closes on 20 January 2017. A revised version of the contract will be published in early 2017 for initial use by vanguards, informing subsequent revision and a formal consultation during 2017.
News
Top GP and Sandwell CCG boss admit £153k fraud. The BBC reports that a leading GP and a senior NHS manager at Sandwell & West Birmingham CCG have been convicted of defrauding the NHS by raising a false invoice for GP training from a charity on whose board they both sat. They have since each been sentenced to two years' imprisonment, suspended for two years.
GPs seek support for collaborative working. The BMA reports that its latest GP survey demonstrates a strong desire among GPs for greater collaboration, but that the onus was on the Government to back these ambitions with adequate investment. Half of all doctors responding to the survey backed the independent contractor model coupled with resources for collaboration in the form of federations and networks, as the prime arrangement for individual practices. Half of those surveyed added that such practices should be supported by increasing levels of collaboration with other practices.
If you wish to discuss any queries you may have around primary care please contact David Owens.
Providers
Publications
Shared commitment to quality from the National Quality Board. The NQB has published a new framework that will promote improved quality criteria across all national health organisations for the first time. The new publication provides a nationally agreed definition of quality and guide for clinical and managerial leaders wanting to improve quality. The approach has been agreed across NHS and social care organisations to provide more consistency and to enable the system to work together more effectively.
Healthcare – Provision of clinical services – Specification (PAS 1616:2016). BSI, the business standards company, has published a new standard to help clinical services providers deliver efficient services which are good value for money. PAS 1616:2016 covers the full range of services from preventative care through all aspects of care that clinical service users and their carer(s) encounter on their journey, from first contact with a primary care health professional through to their exit from the clinical service, including home care. It includes requirements for clinical users with complex needs and for clinical services to seek and adopt innovation when that is considered appropriate.
End of life care for infants, children and young people with life-limiting conditions: planning and management (NICE guideline NG61). This guideline covers the planning and management of end of life and palliative care in for infants, children and young people (aged 0–17 years) with life-limiting conditions. It aims to involve children, young people and their families in decisions about their care, and improve the support that is available to them throughout their lives. The guideline does not cover children and young people without a life-limiting condition who die unexpectedly (for example, accidental death).
Consultations
Draft framework: use of resources and well-led assessments. NHS Improvement is seeking views on how NHS trusts and foundation trusts can make effective use of resources, leadership and governance enabling them to provide sustainable high quality services for patients. The consultation closes on 14 February 2017.
News
NHS England announces £101 million of new funding for new care model vanguards. NHS England has announced £101m of new funding to support and spread the work of the new care model vanguards. In addition to the funding, the vanguards will continue to receive support from NHS England and other national bodies to implement their plans, including how they harness new technology including apps and shared computer systems. They are also receiving help to develop their workforce so that it is organised around patients and their local populations. The press release gives examples of how each of the different care model vanguards are making a difference and how the latest round of funding will be used.
If you wish to discuss any queries you may have around providers please contact Vincent Buscemi.
Public Health
Publications/Guidance
Combating loneliness: a guide for local authorities. This report warns that the impact of loneliness and isolation on health and social care means that it must be recognised as a major public health issue
Professional appraisal and revalidation: ensuring a high-quality professional public health workforce This concordat describes the legal requirements for organisations who employ doctors, how PHE through the Office of the Responsible Officer delivers annual professional appraisal and medical revalidation and supports local authorities. It also outlines the expectations of support from local authorities in contributing to this process so that PHE can deliver its statutory Responsible Officer obligations.
Public health grants to local authorities 2017 to 2018. The public health allocations to local Combating loneliness: a guide for local authorities. This report warns that the impact of loneliness and isolation on health and social care means that it must be recognised as a major public health issue
Professional appraisal and revalidation: ensuring a high-quality professional public health workforce This concordat describes the legal requirements for organisations who employ doctors, how PHE through the Office of the Responsible Officer delivers annual professional appraisal and medical revalidation and supports local authorities. It also outlines the expectations of support from local authorities in contributing to this process so that PHE can deliver its statutory Responsible Officer obligations. ending 2018, local authorities will receive £3.3 billion public health grant for their public health duties for all ages. This local authority circular sets out the allocations and conditions for using the grant. Greater Manchester local authorities piloting the business rates retention will not receive the grant and therefore they are not governed by the grant conditions.
Oral health promotion in the community: Quality standard [QS139].. This NICE quality standard covers activities undertaken by local authorities and general dental practices to improve oral health. It particularly focuses on people at high risk of poor oral health or who find it difficult to use dental services. It describes high-quality care in priority areas for improvement. It says councils could introduce toothbrushing, fluoride varnishing schemes or programmes providing healthy eating advice. NICE also asks those providing emergency dental care to advise patients of the importance of regularly seeing a dentist
What if we eradicated obesity? Looking back from 2050. This latest essay in the King's Fund's "What if...?" series looks at the impact of the "obesity epidemic".
Private lives, public health: The changing shape of contraceptive services in England post-2013. The expert Advisory Group on Contraception (AGC) has conducted an audit of the impact of funding cuts and commissioning reforms on contraceptive services in England by analysing the results of an FOI request sent to all 152 upper tier and unitary councils. The findings show a mixed but worrying picture. While some areas have so far managed to sustain current service provision, there are clear signs that full, open access contraceptive care and services are under increasing strain in many places.
The role of public health in the prevention of violence. This position statement sets out the public health approach to violence prevention and argues that health professionals can help to break the cycle of violence in families and communities. It outlines a series of actions that can be taken such as measuring violence-related health needs; identification of root causes and solutions; and it makes the case for effective interventions on a partnership basis.
Guidelines for the public health management of pertussis. These guidelines for health professionals update the 2012 Health Protection Agency (HPA) guidelines for the public health management of pertussis (whooping cough). They are based on a recent review of all currently available scientific evidence and consultation with experts where required.
If you wish to discuss any queries you may have around public health please contact Claire Bentley.
Regulation
Consultations
Our next phase of regulation: A more targeted, responsive and collaborative approach – Cross-sector and NHS trusts. CQC is seeking views on changes to the way it regulates health and adult social care services. It covers: principles for regulating new models of care and complex providers; changes to its assessment frameworks across all sectors to reduce complexity and create more consistency; how it will register services for people with learning disabilities; and the way it will regulate NHS trusts and foundation trusts from April 2017 – including changes to the approach to rating them. The consultation closes on 14 February 2017.
Cases
Khan v General Pharmaceutical Council (Scotland) [2016] UKSC 64. The Supreme Court has ruled that the powers of the General Pharmaceutical Society's Professional Conduct Review Committee to direct suspension of a pharmacist's right to practise beyond the 12-month period originally imposed under art.54(2)(d) of the Pharmacy Order 2010 could not be exercised so as to reflect a conclusion by the original Fitness to Practise Committee that the gravity of the misconduct demanded a longer period of suspension.
DP v General Dental Council [2016] EWHC 3181 (Admin). The court held that s.27A(11) of the Dentists Act 1984 conferred a right upon registrants, from 13 April 2016, to seek review by the investigating committee of the General Dental Council of an earlier decision to issue a warning, provided only that registrants applied within two years of the decision. The Act contained no wording which limited the right to seek a review to decisions made after 13 April 2016.
If you wish to discuss any queries you may have around regulation please contact Stuart Marchant.
Social Care
Publications/Guidance
Care Act statutory guidance. Chapter 19 of the statutory guidance has been updated regarding the determination of questions of ordinary residence referred to the Secretary of State under s.40 of the Care Act 2014, following the Supreme Court judgment in the case of R (Cornwall Council) v Secretary of State for Health last year.
Priorities for the NHS and social care in 2017. 2017 promises to be another challenging year for the health and care system, with demand for care increasing faster than the supply of resources. A system already stretched to its limits will have to work even harder to maintain current standards of care and to balance budgets. Against this background, we have identified five main priorities for 2017 in our new briefing.
If you wish to discuss any queries you may have around social care please contact Stuart Marchant.
General
Publications/Guidance
Universal healthcare without the NHS: towards a patient-centred health system. This report recommends that the NHS emulates the best elements of various European health care systems, whilst retaining universal health care access, in order to improve the quality of care and performance. Proposals include opening the market to both non-profit and for-profit insurers, and the introduction of tax rebates for patients wishing to opt out of NHS care.
Cases
Wilkes v Deputy International [2016] EWHC 3096 (QB). The court held that the manufacturer of an artificial hip made from metal, which fractured after surgery and caused metal debris to be shed around the patient's hip joint, was not liable to the patient under s.3 of the Consumer Protection Act 1987. The court examined the aim of the Act and Directive 85/374, which it implemented, and commented upon the proper approach to determining "defects".
News
NHS England to fund ground-breaking new mitochondrial donation clinical trial. NHS England has announced that it will make up to £8m available over five years to fund the treatment costs of a five year clinical trial of mitochondrial donation – a form of IVF in which the future baby’s mitochondrial DNA comes from a donor egg, to avoid passing on inherited mitochondrial diseases.
If you wish to discuss any issues raised in this section please contact Claire Bentley.
