09/05/2017
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.
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Bevan Brittan Free Training Events
Mental Health Seminars SAVE THE DATE.
Please register your interest in attending by clicking here
- 13 June – Birmingham
- 20 June – Leeds
- 21 June – Bristol
- 22 June - London
The Mental Health seminars will be from 9:30am (registration) until 13:00pm followed by a networking lunch.
Clinical Risk Webinars
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. The lunchtime training session coming up this month is:-
- An overview of spinal and epidural anaesthesia. - 16th May. Dr Chris Harber, Consultant Anaesthetist at Nottingham University Hospitals NHS Trust will be giving an overview of spinal and epidural anaesthesia which is an area that is a regular subject of claims and in which damages are often high. The session will look at what can go wrong and what to look out for. The session will also look at neuraxial anaesthesia and peripheral blocks. If you would like to attend this free webinar just ask Claire Bentley.
Employment Seminars
The future is now: dealing with modern workforce issues.
This free training session will look at the key legal issues surrounding the growing trend of utilising atypical working arrangements, and employers' obligations towards such workers. The second part of the session will focus on key practical steps to assist with managing employees' misuse of social media and reducing litigation risk.
- London - Wednesday 24 May 09:30
- Birmingham - Tuesday 6 June 09:30
- Bristol - Wednesday 7 June 09:30
- Leeds - Thursday 8 June 09:30
Procurement Seminars
Procurement Update. Our Procurement team will cover legislative and policy developments as well as looking at recent EU and UK court cases and how these affect procurement in practice.
If you wish to discuss any queries you may have around training or webinars please contact Claire Bentley
Acute and emergency care
Publications/guidance
Organising care at the NHS front line: who is responsible? This report looks at the reality of caring for acutely ill medical patients at the NHS front line and asks how care in hospitals can be improved. It comprises a series of essays by frontline clinicians, managers, quality improvement champions and patients, and provides vivid and frank detail about how clinical care is currently provided and how it could be improved. The essays are introduced and summarised by Chris Ham and Don Berwick and the report serves as the starting point of an ongoing appreciative inquiry into improving care processes, particularly for acutely ill medical patients.
Emergency hospital care for children and young people. A report from QualityWatch finds that the number of babies and young children admitted to hospital in an emergency has grown by almost a third over the past decade. The analysis reveals that many children are being admitted with conditions like asthma and tonsillitis that could potentially have been avoided if alternatives to hospital care were available.
NHS ambulance services. A report by the Commons Public Accounts Committee finds that since it last examined ambulance services in 2011, funding increases for the urgent and emergency services provided by ambulance trusts have not kept up with increasing demand; ambulance trusts increasingly struggle to meet response-time targets; and significant variations between trusts, in both operational and financial performance, persist or have got worse as insufficient work has been done to understand and reduce variation. Action is being taken by NHS England, NHS Improvement and ambulance trusts to address the performance and long-term sustainability of the ambulance services but it has taken too long to begin addressing the issues identified in 2011.
Ultimate guide for pharmacists working in urgent and emergency care. The Royal Pharmaceutical Society has published a guide to support pharmacists working in or with Urgent and Emergency Care. It will be for those thinking of a career in U&E care or for those already working in this area. The guide is relevant to pharmacists working in a number of urgent and emergency care settings. The RPS has also collected Good practice examples of pharmacists being utilised to support the Urgent and Emergency Care agenda.
Ambulatory emergency care: Reimbursement under the national tariff. Ambulatory emergency care is defined as a service that allows a patient to be seen, diagnosed and treated and discharged in the same day, doing away with the need for a bed. This briefing aims to create a better understanding of the current approaches taken to the recording and reimbursement of ambulatory care. HFMA surveyed its members to establish some basic benchmarking information to see how the guidance is currently applied.
Winter insight: The ambulance service. This briefing from the Nuffield Trust looks at growing pressures on a critical NHS service. It focuses on the ambulance service, which has come to be a totemic symbol of the NHS in England, free at the point of use and available to all. It represents the fundamental duty of care at the heart of the health service and is an expression of the dedication of NHS staff.
Remote health management: reducing bed blocking in the NHS. This report highlights the potential for remote monitoring technology to ease delayed discharges in the NHS and estimates that the widespread implementation of digital health could have already saved the NHS over £1 billion over the last five years. The report calls for the Department of Health to create a standardised remote health management network by 2020 which would enable acute and social care providers to have access to patient data and remote monitoring.
News
A&E departments to get more funding. Announces the allocation of £55.98m of the £100m A&E capital funding, outlined in the spring Budget by the Chancellor, to ease pressure on emergency departments in time for next winter. This funding is being awarded to 70 NHS hospitals. The funding will be used by hospitals to meet the 95% standard of admitting, transferring, or discharging patients within four hours by ensuring patients are treated in the most appropriate setting.
Principia vanguard reduces A&E attendances by 29 per cent for care home residents.
If you wish to discuss any queries you may have around acute and emergency care please contact Claire Bentley.
Children
Publications/guidance
Emergency hospital care for children and young people. A report from QualityWatch finds that the number of babies and young children admitted to hospital in an emergency has grown by almost a third over the past decade. The analysis reveals that many children are being admitted with conditions like asthma and tonsillitis that could potentially have been avoided if alternatives to hospital care were available.
The state of child health: The paediatric workforce. This RCPCH report sets out key findings from the biennial paediatric workforce census. It reveals that in the year to September 2015, shortages of nurses and/or doctors led to periods of closure to new admissions by 31% of paediatric inpatient units and 41% of neonatal units across the UK. It highlights substantial vacancies at both consultant and trainee levels, the low number of academic consultants and the fact that General Practitioners and Practice Nurses have limited training in child health. The report makes recommendations for immediate action on a number of fronts to address workforce pressures and to ensure care for UK children remains the best in the world.
Working together to safeguard children. Statutory guidance on inter-agency working to safeguard and promote the welfare of children.
Children and young people’s mental health — The role of education. As part of a joint inquiry into children and young people's mental health, the Commons Health and Education Committees have examined schools' and colleges' front line role in promoting and protecting children and young people’s mental health and well-being. The committees found that strong partnerships between the education sector and mental health services improve the provision for children’s mental health and well-being. There is significant variation in the quality of the links between schools and colleges and Child and Adolescent Mental Health Services (CAMHS) and in the level of financial support. The Government should commit sufficient resource and build on the CAMHS link pilot to ensure that effective services can be established in all parts of the country. With half of all mental illness starting before the age of 15, it is a false economy to cut services for children and young people that could help to improve well-being, build resilience and provide early intervention. The report adds that the next Government must review the effect of the budget reductions in the education sector.
Legislation
Children and Social Work Act 2017 given royal assent. This Act makes provision about looked-after children, provision in relation to the welfare of children and provision about the regulation of social workers.
Consultations
End of life care for infants, children and young people. NICE has published a draft standard aiming to improve end of life care for children in England. It says families who are caring for terminally ill children at home should have 24-hour access to specialist medical support and advice. The consultation closes on 16 May 2017.
News
Munby advises judges to limit involvement in serious case reviews.
If you wish to discuss any queries you may have around children please contact Deborah Jeremiah.
Clinical Risk/Patient Safety
Publications/Guidance
Confidentiality: good practice in handling patient information. This GMC guidance came into force on 25 April. It sets out the principles of confidentiality and respect for patients’ privacy that all doctors are expected to understand and follow, along with the responsibilities of doctors for managing and protecting patient information. It should be read alongside the core guidance, Good medical practice, which makes clear that patients have a right to expect that their personal information will be held in confidence by their doctors.
A-EQUIP a model of clinical midwifery supervision. Describes the new model of midwifery supervision, A-EQUIP (Advocating and Educating for Quality Improvement), and provides guidance for implementation. The A-EQUIP model is made up of four distinct functions: normative, restorative, personal action for quality improvement and education and development. It supports a continuous improvement process that builds personal and professional resilience, enhances quality of care and supports preparedness for appraisal and professional revalidation
Breast screening: imaging women with breast implants. This document explains how to screen women with breast implants in the NHS Breast Screening Programme.
NHS Resolution document 'Royal College of Obstetricians and Gynaecologists - letters to Each Baby Counts Lead Reporters.
NHS Resolution document 'Royal College of Obstetricians and Gynaecologists - letters to RCOG members.
NHS Resolution Business Plan
Maternity choice and personalisation pioneers: frequently asked questions. This updated set of FAQs provides guidance and information on the pioneers who are testing ways of improving choice and personalisation for women accessing maternity services.
NHS complaints procedures in England. This briefing paper provides information on the standard NHS complaints procedures and also the other options available to patients.
Consultations
Providing a 'safe space' in healthcare safety investigations: Summary of consultation responses and next steps. Summarises the results of the October 2016 consultation on creating a balanced 'safe space' to allow NHS staff to speak up about incidents without the fear of being punished. The main conclusion of the review is that the 'safe space' proposal would be of most use for the Healthcare Safety Investigation Branch (HSIB), which became fully operational from 1 April. The Government intends that HSIB will conduct its investigations using 'safe space' principles, but will consult further on any extension of the 'safe space' principle to local investigations by NHS Trusts and NHS Foundation Trusts.
News
Launch of NHS Resolution web site.
NHS research finds 'direct link' between staffing levels and death risk. New research at an NHS hospital has shown a “direct link” between the care individual patients receive from nurses and their risk of death due to low staffing levels.
NHS Resolution plans to create Faculty of Learning as it looks to move away from litigation. NHS Resolution, formerly the NHS Litigation Authority (NHSLA), plans to establish a Faculty of Learning to bring all its internal and external training schemes together, it has emerged. The organisation is also considering how to extend its new early notification process for high-cost maternity claims to cover other high-cost claims, according to its business plan for 2017-18.
Personal injury lawyers to be banned from hospitals from 2018. Changes to the NHS Standard Contract mean that law firms will be banned from operating at healthcare premises from 2018. The NHS paid out £1.5 billion in clinical negligence costs in 2015-16, with legal costs accounting for 34% of that bill, where in lower value claims, it was not unusual to see lawyers' costs exceed the compensation awarded to claimants
Ban on NHS nurses working agency shifts is dropped after protests. A ban on NHS nurses moonlighting for staffing agencies, that was due to come into effect on 1 April 2017, has been dropped in a last-minute reversal following protests by nurses who said that they could not make ends meet without topping up NHS pay with agency work, and fears that the ban might have led to a shortage of staff on wards. About half of nurses who work for agencies are thought to be taking extra shifts on top of NHS jobs.
Investigation launched into cluster of baby deaths at Shrewsbury and Telford NHS Trust. Jeremy Hunt has ordered an investigation by the regulator NHS England into a series of baby deaths at Shrewsbury and Telford Hospital NHS Trust, where there has been at least seven avoidable deaths in less than two years, many of which involved a failure to monitor the baby's heart rate correctly.
Bevan Brittan Training
Webinars
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. The lunchtime training session coming up this month is:-
- An overview of spinal and epidural anaesthesia. - 16th May. Dr Chris Harber, Consultant Anaesthetist at Nottingham University Hospitals NHS Trust will be giving an overview of spinal and epidural anaesthesia which is an area that is a regular subject of claims and in which damages are often high. The session will look at what can go wrong and what to look out for. The session will also look at neuraxial anaesthesia and peripheral blocks. If you would like to attend this free webinar just ask Claire Bentley.
If you wish to discuss any clinical risk or patient safety issues please contact Joanna Lloyd, Catherine Radford or Penelope Radcliffe.
Commissioning
Publications/Guidance
Excellence in commissioning diabetes care. NHS Clinical Commissioners has launched a new publication that showcases examples of where clinically led commissioning is changing the way diabetes care is commissioned and improving people’s lives. The document draws out lessons from those involved in the projects to share and embed for the future. it features a range of programmes from CCGs across the country with case studies.
Patient and public participation in commissioning health and care: statutory guidance for CCGs and NHS England. This guidance aims to support staff to involve patients and the public in their work in a meaningful way to improve services, including giving clear advice on the legal duty to involve. The guidance is accompanied by an equality and health inequalities analysis and associated resources.
Involving people in their own health and care: statutory guidance for clinical commissioning groups and NHS England. Guidance to help CCGs and NHS England to involve people in their own health and care in a meaningful way. It demonstrates the importance of involving people, their carers and families, to improve individuals’ health and wellbeing outcomes and the efficiency and effectiveness of health services. It also explains how CCGs and NHS England can meet their legal duties.
Consultations
End of life care for infants, children and young people. NICE has published a draft standard aiming to improve end of life care for children in England. It says families who are caring for terminally ill children at home should have 24-hour access to specialist medical support and advice. The consultation closes on 16 May 2017.
If you wish to discuss the issue of commissioning please contact David Owens.
Employment/HR
Publications/Guidance
Report shows change in NHS workforce over time The number of full time staff working for the NHS in England has increased by 2.2% (26,000) since 2015, NHS Digital figures show.
GMC unveils blueprint for better medical training Rigid training that adapts too slowly needs radical overhaul to provide trainees with more flexibility. Patients would also benefit from doctors who can care for multiple health conditions, the GMC’s plan for training tells health leaders.
A best practice guide for consultant job planning. Advice for trusts to ensure that their approach to consultant job planning is consistent with best practice.
Workforce Race Equality Standard 2016 report. This report publishes data from providers of NHS-funded care, including the voluntary and private sector, to demonstrate how they are addressing equality issues. For the first time, the report contains data covering nine WRES indicators including four relating to the workplace covering recruitment, promotion, career progression and staff development alongside BME board representation. The remaining four indicators are based on data from the NHS staff survey 2016, covering harassment, bullying or abuse from patients, relatives or the public. It shows a positive change in a range of areas including the number of nurses and midwives who have progressed from lower grades into senior positions; in BME representation at very senior management (VSM) and executive board level; and a slight reduction in the reported experience of discrimination of BME staff from colleagues and managers.
Consultations
Safe and Effective Staffing in Health and Social Care: Consultation on proposals to enshrine safe staffing in law, starting with the nursing and midwifery workload and workforce planning tools. A Scottish Government consultation seeks views on proposals to introduce legislation that would require organisations providing health and social care to: apply nationally agreed, evidence based workload and workforce planning methodologies and tools; ensure that key principles underpin workload and workforce planning and inform staffing decisions; and monitor and report on how they have done this and provide assurance regarding safe and effective staffing. Comments by 4 July 2017.
News
Ban on NHS nurses working agency shifts is dropped after protests. A ban on NHS nurses moonlighting for staffing agencies, that was due to come into effect on 1 April 2017, has been dropped in a last-minute reversal following protests by nurses who said that they could not make ends meet without topping up NHS pay with agency work, and fears that the ban might have led to a shortage of staff on wards. About half of nurses who work for agencies are thought to be taking extra shifts on top of NHS jobs
Bevan Brittan Updates
Bevan Brittan Events
The future is now: dealing with modern workforce issues.
This free training session will look at the key legal issues surrounding the growing trend of utilising atypical working arrangements, and employers' obligations towards such workers. The second part of the session will focus on key practical steps to assist with managing employees' misuse of social media and reducing litigation risk.
- London - Wednesday 24 May 09:30
- Birmingham - Tuesday 6 June 09:30
- Bristol - Wednesday 7 June 09:30
- Leeds - Thursday 8 June 09:30
If you wish to discuss any employment issues please contact Julian Hoskins or James Gutteridge.
Finance
Publications and Guidance
NHS England funding and resource 2017-19: supporting Next Steps for the NHS Five Year Forward View. This document forms an annex to Next Steps on the NHS Five Year Forward View and contains important information about NHS England’s funding in 2017/18. It sets out how NHS England will, through the distribution of funding and its people, support Next Steps on the NHS Five Year Forward View to transform local health and care systems.
Integration and better care fund policy framework 2017 to 2019 The government has published a “policy framework” explaining the better care fund related to other policy initiatives.
UK health spending This briefing note analyses how UK public spending on health has changed over time, and both the short- and long-run pressures faced by the health service.
Health care costs in the English NHS This paper describes how to calculate average health care costs broken down by age, sex and neighbourhood deprivation quintile group using the distribution of health care spending by the English NHS in the financial year 2011/12.
If you wish to discuss any issues raised in this section please contact Claire Bentley.
Information sharing/data
Publications and Guidance
New resources launched to help health sector The ICO has launched a new set of resources aimed at improving records management in the health sector.
Confidentiality: good practice in handling patient information. This GMC guidance came into force on 25 April. It sets out the principles of confidentiality and respect for patients’ privacy that all doctors are expected to understand and follow, along with the responsibilities of doctors for managing and protecting patient information. It should be read alongside the core guidance, Good medical practice, which makes clear that patients have a right to expect that their personal information will be held in confidence by their doctors.
Bevan Brittan Updates
An overview of the upcoming General Data Protection Regulation (GDPR) - Emma Godding
If you wish to discuss any issues raised in this section please contact Jane Bennett.
Mental Health
Publications/Guidance
Management of epilepsy in adults with intellectual disability. This Royal College of Psychiatrists long-awaited report offers an important step towards clarifying the role of the psychiatrist in ID in the management of epilepsy. The proposed tiered system of professional competency gives psychiatrists the option to identify their role in care provision and ensures a framework for training. It provides a structure from which a competency evaluation can be developed. The vision should be for all psychiatrists working with people with ID to have training and certification to one of the three levels of competency (Bronze, Silver and Gold).
Local support for people with a learning disability. This Public Accounts Committee report says that greater focus is needed on measuring outcomes and improvements to quality of life. Two years ago, the previous Committee reported on the DH's efforts to move people with a learning disability out of mental health hospitals and into the community. At that time, the Committee found that progress had been poor but was promised improvements. This report finds that the DH and NHS England have since made progress. They have developed the Transforming Care programme and moved some people out of hospital. However, more needs to be done to address known barriers: money is not moving with the patient to pay for support in the community, too many people are not having care and treatment reviews and the uncertainty caused by the proposed changes to local housing allowance risks hampering the provision of accommodation in the community. It is also concerned that support for people with a learning disability who live in the community is patchy, with significant local variations. There needs to be a greater focus on measuring outcomes and improvements to the quality of life from the £8bn that central and local government spend each year on this support.
Children and young people’s mental health — The role of education. As part of a joint inquiry into children and young people's mental health, the Commons Health and Education Committees have examined schools' and colleges' front line role in promoting and protecting children and young people’s mental health and well-being. The committees found that strong partnerships between the education sector and mental health services improve the provision for children’s mental health and well-being. There is significant variation in the quality of the links between schools and colleges and Child and Adolescent Mental Health Services (CAMHS) and in the level of financial support. The Government should commit sufficient resource and build on the CAMHS link pilot to ensure that effective services can be established in all parts of the country. With half of all mental illness starting before the age of 15, it is a false economy to cut services for children and young people that could help to improve well-being, build resilience and provide early intervention. The report adds that the next Government must review the effect of the budget reductions in the education sector.
Mental Health and Deaths in Prison: Interim Report Seventh Report of Session 2016-17. A Joint Committee on Human Rights report calls on the Government to bring forward legislation in the next Parliament to address the rise in self-harm and suicide in prisons. It recommends: a legal duty on the Secretary of State to specify and maintain a minimum ratio of prison officers to prisoners in each establishment; a prescribed legal maximum time that a prisoner can be kept in their cell; and a mechanism to ensure the Secretary of State's accountability to Parliament for overcrowding.
Depression self-assessment tool. One in four of us will have problems with our mental health.
House of Commons Health Select Committee Children and young people’s mental health — the role of education As part of a joint inquiry into children and young people's mental health, the Health and Education Committees found that financial pressures are restricting the provision of mental health services in schools and colleges. The report suggests that the next Government review the effects of the budget reductions in the education sector.
Dementia: Best practice repository for clinical commissioning. In March 2016, NHS England introduced a new CCG Improvement and Assessment Framework (CCG IAF) that brings together a range of key indicators, enabling NHS England and CCGs to work together to drive improvement for patients. The dementia indicators are: Estimated diagnosis rate for people with dementia; and Dementia care planning and post-diagnostic support. The NHS England Dementia Team has developed the Best Practice Repository on the NHS England Learning Environment website. It aims to showcase a wide variety of high quality dementia care across the Well Pathway for dementia, inspire primary and secondary care thinking and to help facilitate work towards meeting the CCG IAF indicators.
Health and care of people with learning disabilities: 2015-16. NHS Digital has published a report that includes information on people with and without learning disabilities, collected from over half of GP practices in England, in 2014-15 and 2015-16. The report identifies potential differences in the treatment, health status, and outcomes of people with learning disabilities compared with the rest of the population.
Online support: investigating the role of public online forums in mental health This report was written by the Centre for the Analysis of Social Media at Demos in partnership with The King’s Fund. It looks at the large amounts of mental health related discussion taking place on public online forums, and explores whether computational techniques can provide robust, actionable insight from these conversations. It describes the collection and analysis of one million publicly available forum posts and addresses the technical and ethical challenges posed by the collection and analysis of online forum data.
Cases
Lincolnshire County Council v J K [2016] EWCOP 59. Hearing to determine whether the Patient had capacity in respect of four areas. The Patient was deemed to lack capacity in all areas. The Patient is 73 and has suffered from depression in the past. She is also suffering from the early stages of Alzheimer's dementia. Her home conditions had deteriorated rapidly to the point where it was considered she was not coping so she moved into respite care in AB care home where she has remained. She also had financial problems and one of her two properties had been repossessed (the other one is her family home). The court had to decide if the P had capacity to 1) decide her place of residence; 2) decide her medical treatment and care; 3) deal with her financial affairs; and 4) conduct proceedings. The Court of Protection considered the question of capacity strictly in accordance with the evidence and the statutory test and met the P on three occasions. The court determined that the P lacked capacity in all four areas.
Re SL [2017] EWCOP 5. Hearing to determine whether the Patient, who lacked capacity in areas such as where she should live, also lacked litigation capacity. The Patient has been diagnosed as having schizophrenia and obsessive compulsive disorder. She was moved to supported living accommodation where she remains after concerns were raised about self-neglect. The Patient wants to return home but the LA made an application to authorise her deprivation of liberty. The issue in this hearing was to determine whether or not the Patient had litigation capacity after an expert report, whilst concluding that she did not have capacity to decide where she lived or to make a decision about her care and treatment amongst others, did not definitively conclude that the Patient does not have capacity to conduct the proceedings. The court was satisfied that the Patient understands in broad terms what the subject-matter of the litigation is but not satisfied that she is able to use and weigh the relevant information to make decisions and give instructions in relation to matters which are integral to the process of this litigation. On that basis, the court ruled that the Patient lacks capacity to conduct these proceedings.
McCann v State Hospitals Board for Scotland [2017] UKSC 31 SC 2017 A decision by the State Hospitals Board for Scotland to ban smoking in the buildings and grounds of the state hospital was lawful and did not violate the human rights of detained patients. However, its related policy of searching patients and visitors for tobacco and confiscating any that was found was illegal and fell to be annulled.
Re MM (A Patient) sub nom Teresa Kirk v (1) Devon County Council (2) MM (By his litigation friend the Official Solicitor) [2017] EWCA Civ 260 (Sir James Munby PFD) 12/04/2017. Following successful appeals against an order for committal and a welfare order, in a case where the appellant had refused to comply with Court of Protection orders to return a man lacking capacity to the jurisdiction, the Court of Appeal ordered costs in the appellant's favour on the committal appeal and made no order for costs on the welfare appeal.
News
MIND says that thousands are being left to cope alone after leaving mental health hospital - putting their lives at risk.
£9m more for service veterans’ mental health. NHS England is set to launch a mental health service for ex-armed forces veterans and service personnel who are approaching discharge.
Bevan Brittan Events
Mental Health Seminars SAVE THE DATE.
Please register your interest in attending by clicking here
- 13 June – Birmingham
- 20 June – Leeds
- 21 June – Bristol
- 22 June - London
The Mental Health seminars will be from 9:30am (registration) until 13:00pm followed by a networking lunch.
Bevan Brittan Updates
- Accommodation. Section 117 Aftercare Services - Article 3 - Ruth Atkinson-Wilks
- Understanding Responsibility - Section 117 Aftercare Services - Article 2. - Ruth Atkinson-Wilks
- What constitutes s117 Aftercare services. Section 117 Aftercare Services - Article 1 - Ruth Atkinson Wilks
- Case Summary: Re MM (A Patient) [2017] EWCA Civ 34 (Court of Appeal) following Re Martins [2016] EWCOP 45 (First Instance). Court of Protection case summary - Hannah Taylor and Jane de Zonie
Bevan Brittan Mental Health Extranet
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.
Issues that are currently being discussed on our forum are:-
- Use of CTO and professionals beliefs and attitudes
- S117 Aftercare
- Statutory advocacy
- Restricted patients, CTOs and Deprivation of liberty.
- New Court of Appeal Judgment PJ and YZ
If you wish to discuss any mental health issues please contact Simon Lindsay or Stuart Marchant.
Primary Care
Publications/guidance
The impact of housing problems on mental health. This report, conducted with ComRes, reveals that over the last five years one in five adults suffer mental health problems due to housing pressures. The research also surveyed the experiences of 20 GPs who highlighted the number of patients diagnosed with anxiety or depression directly due to housing issues and that GPs required greater help to support patients with housing problems.
Access to General Practice: Progress review. In March 2016 the Commons Public Accounts Committee raised concerns that patients' experience of contacting and accessing their general practices varied significantly between different groups of patients and between different practices. One year on, these concerns persist. The DH and NHS England have objectives to improve and extend access, and have made some effort to understand the demand for this extended access; but they are moving ahead in rolling out extended hours without really understanding the level of access currently being provided or how to get the best from existing resources. Also, NHS England and Health Education England have several initiatives in place to boost recruitment further, to make better use of other staff groups, and to ease workload and encourage staff to stay, but they are pursuing these discrete initiatives without a credible plan for how to develop a cost-effective, sustainable workforce.
GPFV - One year on. The BMA has published its evaluation of the progress so far of the GP Forward View in England a year on from its launch. It calls for the urgent implementation of its promised extra funding after a patchy first 12 months of delivery. This progress report looks at what was promised in the first year of the GPFV and what has been delivered so far.
Framework for managing performer concerns. This document provides the framework through which NHS England will oversee and manage GPs, dentists and optometrists who are registered as a performer on the NHS England national performers list. This framework is designed to be used in conjunction with the toolkit for managing performance concerns in primary care.
News
Up to six million people set to benefit from more clinical pharmacists in GP surgeries. Announces that over 700 more practices in England will benefit from having a pharmacist located in their GP surgery covering up to 6m patients and helping to free up GP time. Clinical pharmacists work as part of the general practice team by providing expertise on day-to-day medicine issues and providing consultations with patients directly.
RCGP calls for urgent action to stop GPs leaving the profession.
If you wish to discuss any queries you may have around primary care please contact David Owens.
Procurement
Publications
Social value policy. The Crown Commercial Service has issued a statement that outlines how it will do more to help public sector bodies deliver additional social benefits in line with legislation, including the Public Services (Social Value) Act 2012.
Bevan Brittan Updates
Complete set of procurement and contract documents to help you deliver Value for Money and minimise risk of challenge - Emily Heard
If you wish to discuss any queries you may have around procurement please contact Emily Heard.
Providers
Publications/Guidance
The role of the independent sector in the NHS: Busting the myths. Throughout its history, the health service has relied on independent and voluntary organisations to provide care and support the NHS in a host of different ways. This publication from NHS Confederation takes a look at the independent sector and dispels four myths on its role in the NHS. It forms part of a series of myth busters on common misconceptions, produced to enrich debate on topical, sometimes controversial, issues regarding health and care.
Referral-to-treatment waiting times and forecasts. This NHS Confederation briefing shows that since the current waiting time policy was introduced in June 2015, the rate of growth in waiting times and the totals number of people waiting has notably increased.
Organising care at the NHS front line. This report looks at the reality of caring for acutely ill medical patients at the NHS front line and asks how care in hospitals can be improved.
If you wish to discuss any queries you may have around providers please contact Vincent Buscemi.
Public Health
Publications/Guidance
The future of HIV services in England: Shaping the response to changing needs. This King's Fund report explores the challenges and opportunities facing HIV services in four areas in England, and makes recommendations on future development to those in national and local leadership roles.
Public health ethics in practice. This section of the UK Public Health Skills and Knowledge Framework (PHSKF) provides an introduction to public health ethics both as a philosophical field of enquiry and as an applied area that guides practice and policy. it is a background paper supporting the public health workforce in their practice.
What does improving population health really mean? This briefing from the King's Fund looks at how everybody in NHS policy seems to be talking about population health. It discusses what this really means and how we can improve it.
Physical health of people in prison. NICE has published a draft standard aiming to address the variation in health checks offered by prisons in England. The draft quality standard says healthcare staff working in prisons should offer testing for blood-borne viruses like hepatitis B and C, and HIV to people upon entry to prison. And they should also assess inmates for their risk of having a sexually transmitted infection (STI).
Tailored review of Public Health England. Reports on the outcome of DH's tailored review that looked at PHE’s performance and effectiveness, efficiency, and governance. The main conclusion of the review was that PHE performs necessary functions and should continue to operate as an executive agency. The review report also contains recommendations to improve performance, governance and efficiency.
Breast screening: consolidated programme standards. This document sets out the national standards for the NHS Breast Screening Programme which provide a defined set of measures that screening providers must meet to make sure local services are safe and effective. These revised programme standards have an implementation date of April 2017 and replace all previous versions.
If you wish to discuss any queries you may have around public health please contact Claire Bentley.
Regulation
Publications/Guidance
Framework for managing performer concerns. This document provides the framework through which NHS England will oversee and manage GPs, dentists and optometrists who are registered as a performer on the NHS England national performers list. This framework is designed to be used in conjunction with the toolkit for managing performance concerns in primary care.
The progress and outcomes of black and minority ethnic (BME) nurses and midwives through the Nursing and Midwifery Council's fitness to practise process This research, carried out by the University of Greenwich, explores the progress and outcomes of BME nurses and midwives going through the NMC's fitness to practise process. The findings highlight that BME staff are more likely to be referred to the NMC than their white counterparts but that BME staff are less likely to be struck off or suspended.
Consultations
Consultation on revalidation for pharmacy professionals. Seeks views on proposals to introduce revalidation for pharmacy professionals. The changes make the requirements placed on pharmacy professionals more meaningful, proportionate and effective and reflect what members of the public, pharmacists and pharmacy technicians said they wanted. The consultation closes on 17 July 2017.
If you wish to discuss any queries you may have around public health please contact Stuart Marchant.
Social Care
Publications/Guidance
Integrating health and social care. Two years ago, the Commons Public Accounts Committee expressed serious doubt that the Government's latest integration initiative, the Better Care Fund, would save money, reduce emergency admissions to hospitals and reduce the number of days people remain stuck in hospital unnecessarily. This report finds that since then, the BCF has failed to achieve any of these objectives and witnesses displayed an appallingly casual attitude to the targets that had been set for reducing emergency admissions and delayed transfers of care, both of which have actually increased. The committee concludes that in practice, the BCF was little more than a complicated ruse to transfer money from health to local government to paper over the funding pressures on adult social care. Integration must now be delivered in the context of the sustainability and transformation planning process. Place-based planning will be critical to the future of health and social care. However, to succeed, the NHS must find better ways to engage more genuinely with local government and local populations.
Assessing the credibility of election manifesto promises on health and social care. This King's Fund briefing sets out five tests for assessing the credibility of the parties' commitments on health and social care. It also highlights the importance of choices the next government makes on tax and public spending, and its willingness to lead a grown-up debate about the balance between public and private responsibilities.
Public spending on adult social care in England. This briefing note describes how local authority spending on adult social care has evolved since 2000-01, what could happen to spending under current plans, and the challenges faced by social care in the long run.
Care home performance across England. New analysis by Independent Age, the older people’s charity, reveals a stark variation in the quality of care homes at a regional and local authority level across England. The North West is the worst performing region in England when it comes to the proportion of satisfactory care homes, whilst London is the best performing region. In some areas such as Stockport or Salford, older people and their families face little choice of quality care, with 3 in 5 homes rated not good enough.
National standards, local risks: the geography of local authority funded social care, 2009–10 to 2015–16. Research by the Institute for Fiscal Studies, that was funded by the Health Foundation, has found that one in ten councils have cut spending on adult social care by more than a quarter. The report examines the extent to which the level of local authority social care spending per adult varied around England in 2015–16, and the extent to which these spending differences correlated with local demographic and socio-economic characteristics, and assessed local relative spending needs for adult social care as of the last official assessment in 2013–14. It also considers how social care spending has changed between 2009–10 and 2015–16.
Best and worst areas for care home quality in England revealed in new research. A stark variation in the quality of care homes at a regional and local authority level across England has been highlighted by new research. The North West is the worst performing region in England when it comes to the proportion of satisfactory care homes, whilst London is the best performing region. In some areas such as Stockport or Salford, older people and their families face little choice of quality care, with 3 in 5 homes rated not good enough. That’s according to new analysis by Independent Age, the older people’s charity.
News
Principia vanguard reduces A&E attendances by 29 per cent for care home residents.
Social care system 'beginning to collapse' as 900 carers quit every day.
If you wish to discuss any queries you may have around public health please contact Stuart Marchant.
General
Publications/Guidance
No regrets: how talking more openly about death could help people die well. This report finds that more than 62,000 people die of cancer in hospitals each year in the UK despite a significant majority stating that they would like to die at home. It reveals the challenging obstacles that people face when discussing death and highlights the need for better communication to help people plan for their final days.
Brexit and health and social care — People & process. This Commons Health Committee report examines the effect of Brexit on health and social care and the process and preparations being made by the DH in advance of the Brexit negotiations. It urges the DH to produce a comprehensive list of those issues that will require contingency planning and to ensure that it has sufficient staff working on the process of Brexit. The Government's plan for the UK's post-Brexit future should both ensure that health and social care providers can retain and recruit the brightest and best from all parts of the globe and that the value of the contribution of lower paid health and social workers is recognised. It welcomes the Government's signal that they wish to prioritise and resolve the existing rights of all EU nationals resident in the UK and UK nationals resident in the EU. It calls on both sides of the negotiation to prioritise and resolve this matter at the earliest opportunity.
Brexit negotiations and the NHS. With the UK preparing for a general election on 8 June, Brexit is expected to dominate both political party manifestos and public debate in the lead up to polling day. Preparations for Brexit negotiations are well underway in Brussels, with the three European institutions involved – the European Council, the European Commission and the European Parliament – working on ‘red lines’ for the talks. This NHS Confederation briefing note considers what the emerging EU positions mean from an NHS perspective.
Health technical memorandum 06-01: electrical services supply and distribution. DH guidance on the design, installation and testing of all fixed wiring and integral electrical equipment used for electrical services within healthcare premises.
Referral-to-treatment waiting times and forecasts This report estimates that the number of people waiting longer than 18 weeks for planned operations could exceed 800,000 by 2020. The analysis finds that demand for elective operations is rising, with the number of people waiting for treatment forecast to hit 5 million in 2020. The report recommends that patients be made aware of their right to choose where they receive NHS treatment in order to help patients access care as quickly as possible.
NHS property and estates: Naylor review Sir Robert Naylor’s review of NHS property and estates examines how to make best use of the buildings and land to support NHS England’s Five Year Forward View.
The future of HIV services in England: shaping the response to changing needs This report argues that the complexity of the health system in England is holding back progress in meeting the needs of people with HIV. The report highlights how improvements in treatment mean that, 30 years on from being seen as a death sentence, people with HIV are able to live longer, healthier lives. It argues that because of this, health services need to focus on quality of life rather than just on suppressing the virus, and also need to co-ordinate care with that for other long-term conditions common in older people.
News
Personal injury lawyers to be banned from hospitals from 2018. Changes to the NHS Standard Contract mean that law firms will be banned from operating at healthcare premises from 2018. The NHS paid out £1.5 billion in clinical negligence costs in 2015-16, with legal costs accounting for 34% of that bill, where in lower value claims, it was not unusual to see lawyers' costs exceed the compensation awarded to claimants
Pharmaceutical companies threaten to leave the UK. Lisa Anson, who takes over as president of the Association of the British Pharmaceutical Industry on 27 April 2017, has warned that pharmaceutical companies would delay launching medicines in the UK as they were unlikely to be approved, and would leave the UK, unless the NHS receives an extra £20 billion a year. She added that the increased rationing of treatments is causing the NHS to fall out of the top tier of world health systems.
Changes to NICE drug appraisals: what you need to know The NHS is under unprecedented financial pressure, so it’s more important than ever for it to use the money it has effectively and fairly.
Appeal judges allow assisted-dying campaigner's case to proceed. Campaigner Noel Conway has been granted permission by the Court of Appeal to apply for a declaration that the ban on assisted suicide is incompatible with his ECHR-determined right to life. In March 2017 the High Court rejected his case based on the 2014 decision in R. (on the application of Nicklinson) v Ministry of Justice, but the Court of Appeal ruled that Conway's circumstances were sufficiently different for him to be allowed to proceed with his case.
If you wish to discuss any issues raised in this section please contact Claire Bentley.
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