09/10/2017
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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If someone forwarded you this email you can sign up for your own free copy here delivered directly to your inbox.
Bevan Brittan Free Training Events
Disclosure of medical records, protocols and other documents such as SUI reports and statements in the context of clinical negligence disputes can be complex, administratively burdensome and hugely time consuming. Patients will frequently have been treated by numerous clinicians in a variety of specialties across different sites, each of whom might have different systems and practices for storing and recording patient data. For more information click here.
Court of Protection Seminars - SAVE THE DATE
In October and November, Bevan Brittan's specialist Court of Protection team is hosting practical update sessions in Bristol, Birmingham, London and Leeds. These sessions will focus on practical issues that practitioners, commissioners and providers encounter in matters engaging the Court of Protection; covering relevant legislation, guidance and case law and their impact on managing incapable patients. They will offer guidance on the sort of problems that are faced by front-line practitioners and service planners. The sessions are aimed at all those working in organisations responsible for the care of vulnerable or incapable people both as care providers or commissioners. The sessions will run from 10:00 – 15.30. Registration for all sessions will open at 09:30 and lunch will be available.
- 31 October – Bristol
- 7 November – London
- 8 November – Birmingham
- 9 November – Leeds
If you would like to register your interest in one of the above seminars click on this link.
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 sessions coming up are:-
-
Front-line triage – a review of cases and what can go wrong. 10 October 12.30 -2pm. If you would like to attend this free lunchtime webinar just ask Claire Bentley.
-
Mental Health and Mental Capacity Acts Update. 24 October 12.30 - 2pm. If you would like to attend this free lunchtime webinar just ask Claire Bentley.
Bevan Brittan training packages
In addition to our free training programme, we also provide bespoke knowledge transfer sessions on a range of healthcare law topics. If you wish to discuss any queries you may have around training or webinars please contact Claire Bentley
Acute and emergency care
Publications/guidance
Home from hospital: how housing services are relieving pressure on the NHS. The National Housing Federation has published a report that looks at the increase in delays in discharging people from hospital, and shows how housing services are offering solutions that are relieving pressure on the NHS. With delayed transfers of care a growing problem in the context of an ageing population, housing associations are providing the link needed to ensure people are supported out of hospital into a suitable home with the right support. The report sets out the impact of delayed transfers of care, the implications for the NHS and the solutions that are offered by housing providers, including the cost benefits these solutions provide to the NHS. The report features a number of case studies that demonstrate how housing services are successfully reducing delays in discharging people from hospital and preventing unnecessary hospital admissions. It also considers the impact and additional savings that could be made by housing providers if this work were to be scaled up.
Integrated Urgent Care service specification. Provides a national service specification for the provision of a functionally integrated 24/7 urgent care access, clinical advice and treatment service (incorporating NHS 111 and OOH services), referred to here as an IUC Clinical Assessment Service. It outlines the steps that commissioners must take in delivering an essential part of this transformation – and to move from an 'assess and refer' to a 'consult and complete' model of service delivery.
NHS England has also written to CCG Accountable Officers and Clinical Leaders, setting out the key actions required from commissioners of an integrated urgent care service. It also describes the Clinical Assessment Service, outlines the key measures and details the underpinning technology for integrated urgent care services. There is an attached appendix describing in more detail some of the other key requirements.
Addendum to the NHS Constitution. The Handbook to the NHS Constitution for England is intended to be used by anyone who wishes to have more detail about the rights and pledges in the Constitution. This addendum contains updates about ambulance response times. It should be read in conjunction with the waiting times pledge in the Handbook.
Safety and quality of emergency care. Chief Inspector of Hospitals Prof Ted Baker has written to England’s NHS trusts to highlight good practice from successful emergency care departments.
NHS hospital bed numbers: past, present, future. This new report published by the King's Fund puts the debate around hospital bed capacity into context and takes a look at trends both here and abroad.
News
New £13 million funding to help hospital A&Es prepare for winter. Announces that 19 hospitals are to share £13m funding to improve patient flow through A&E. The funding will be used to help hospitals finalise preparations ahead of winter, particularly to handle the large volumes of patients attending A&E.
If you wish to discuss any queries you may have around acute and emergency care please contact Claire Bentley.
Children
Publications/guidance
Depression in children and young people: identification and management. This guideline covers identifying and managing depression in children and young people aged between 5 and 18 years. Based on the stepped care model, it aims to improve recognition and assessment and promote effective treatments for mild, moderate and severe depression. The guidance has been updated to clarify the training needed for therapists.
End of life care for infants, children and young people. This quality standard covers end of life care for infants, children and young people (from birth to 18 years) who have a life-limiting condition. Life-limiting conditions are those that are expected to result in an early death for the person. It also covers support for family members and carers. It describes high-quality care in priority areas for improvement.
Access and waiting times in children and young people's mental health services. This report examines new data on access to specialist treatment for children and young people with mental health problems, and the waiting times they face. It finds that children face barriers when seeking access to mental health services. It also finds that, over the last year, overall waiting times (including both assessment and treatment) have fallen – yet there remains substantial variation across England.
News
NHS commits to better care for expectant and new mums with mental health.
If you wish to discuss any queries you may have around children please contact Deborah Jeremiah.
Clinical Risk/Patient Safety
Publications/Guidance
Under pressure? NHS maternity services in England . This briefing finds that NHS maternity units are more likely to close towards the end of the week and during holiday periods due to low staffing levels. It reviews the evidence on the long-run pressures faced by maternity units from changes in the number of maternity admissions and the case mix. While the number of maternity cases has remained largely constant since 2010, the case mix continues to change, with women giving birth later in life and with more complex health conditions. There are implications for maternity units if this evolving case mix of mothers requires more care in terms of staffing or other resources.
Managing the costs of clinical negligence in trusts - National Audit Office. This National Audit Office Report published on managing the costs of clinical negligence in NHS trusts states that the costs are significant and rising fast. It argues that the Government needs to take a stronger and more integrated approach to managing and reigning in costs across the health and justice systems. It also suggests that NHS Resolution should work more closely with the Solicitors Regulation Authority over firms found to be overcharging.
Winter warning: Managing risk in health and care this winter - update. As the NHS faces up to another tough winter, NHS Providers is calling for an immediate emergency cash injection of between £200m and £350m to enable the NHS to manage patient safety risk this winter. it warns that failure to make this investment will lead to lengthening waiting times for patients in A&E and other services and will also put the safety of patients at risk as local trusts have insufficient capacity to meet extra expected demand. The extra funding is needed to complement other work currently being undertaken to improve the NHS’ state of readiness for this winter.
Average of two patients a month die after ambulance and 999 call handler failures. A review of coroners' reports has revealed that almost two patients die a month after failings by ambulance services and emergency call handlers, including delays or a failure to recognise the severity of symptoms. Minh Alexander, a patient safety campaigner, stated that action is needed to rectify underfunding, workforce issues and pressures on the NHS that "spill on to ambulance services". A number of the reports highlight delays caused by slow A&E handovers, echoing warnings from the National Audit Office earlier in 2017.
Five years of cerebral palsy claims – A thematic review of NHS Resolution data September 2017. This thematic review presents a detailed analysis of cerebral palsy claims, identifies the common problems and provides recommendations for improvement to reduce the incidence of avoidable cerebral palsy.
Learning from post-accident investigations to ensure patient safety. Health Secretary Jeremy Hunt explains the thinking behind the Health Service Safety Investigations Bill, and recent steps to improve patient safety.
Prevention in action This report finds that local authorities in England must do more in their areas to provide services that prevent, reduce or delay the need for care and support. It also identifies shortcomings in plans for integrating health and social care.
Safe and effective staffing: nursing against the odds. The Royal College of Nursing has launched the results of a survey of nursing and midwifery staff in the UK.
The personal injury discount rate: how it should be set in future. The documents published comprise the government response to the consultation on how the personal injury discount rate should be set in future, which sets out the responses received to the questions raised and the government’s conclusions on the way forward in the light of those responses.
Safety and quality of emergency care. Chief Inspector of Hospitals Prof Ted Baker has written to England’s NHS trusts to highlight good practice from successful emergency care departments.
Legislation
Draft Health Service Safety Investigations Bill. This draft Bill proposes setting up the Health Service Safety Investigations Body (HSSIB). The HSSIB will conduct investigations which focus on learning from patient safety incidents in the NHS, to reduce health care harm and improve patient care. The draft Bill allows the HSSIB to conduct investigations using ‘safe space’. ‘Safe space’ is a set of legal powers that prevent the HSSIB from disclosing the information it gathers during an investigation.
News
Southern Health NHS Trust admits guilt over Connor Sparrowhawk's death. The NHS Trust has pleaded guilty at Banbury Magistrates' Court to breaching health and safety law in the case of Connor Sparrowhawk, 18, who drowned in the bath while in its care.
Ian Paterson: Victims of disgraced surgeon get £37m.
Claimant lawyers to blame for soaring clinical negligence bill, watchdog concludes.
Infected blood scheme reform. The government announced reforms to payments supporting people who received infected blood during NHS treatment in the 1970s and 1980s.
Bevan Brittan Updates
New report from NHS Resolution: “Five years of cerebral palsy claims” - Jo Lloyd
Bevan Brittan Free Training Events
Disclosure of medical records, protocols and other documents such as SUI reports and statements in the context of clinical negligence disputes can be complex, administratively burdensome and hugely time consuming. Patients will frequently have been treated by numerous clinicians in a variety of specialties across different sites, each of whom might have different systems and practices for storing and recording patient data. For more information click here.
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 sessions coming up are:-
-
Front-line triage – a review of cases and what can go wrong. 10 October 12.30 -2pm. If you would like to attend this free lunchtime webinar just ask Claire Bentley.
-
Mental Health and Mental Capacity Acts Update. 24 October 12.30 - 2pm. If you would like to attend this free lunchtime 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
Steering towards strategic commissioning: Transforming the system. This publication from NHS Clinical Commissioners sets out CCGs’ vision for the future and what they need to get there at pace so they can deliver more for patients. The analysis, which was informed by a survey and interviews with CCG leaders, shows that CCGs are embracing change, with 77 per cent of those surveyed intending to contract for a new care model in 2017/18, and 72 per cent planning on increasing their collaborative commissioning.
Commissioning framework for biological medicines. This document from NHS England supports commissioners to act promptly to make the most of the opportunity presented by increased competition amongst biological medicines, including biosimilar medicines. In particular, the framework seeks to set out the importance of taking a collaborative approach to the commissioning of biological medicines, including biosimilar medicines, from the outset, as well as setting out how this can be achieved.
NHS England Specialised Commissioning Service development policy. Sets out NHS England’s approach for making decisions about which new treatments and interventions to routinely commission, and the approach used for updating existing service specifications, or creating new ones.
Sustainability and transformation plans in London: an independent analysis of the October 2016 STPs. This report, commissioned by the Mayor of London and based on work completed in March 2017, looks at the five STPs in London, their contents and common themes. The authors, from the King’s Fund and the Nuffield Trust, assess the main issues and risks to be addressed across the five plans. They make a small number of recommendations for the future of the STP process in London, focusing specifically on the role of London-wide action in taking forward the plans. It includes a brief update on progress since March 2017.
Next steps on the NHS Five Year Forward View - A national service specification for Integrated Urgent Care services. NHS England has written to CCG Accountable Officers and Clinical Leaders, setting out the key actions required from commissioners of an integrated urgent care service. The letter also describes the Clinical Assessment Service, outlines the key measures and details the underpinning technology for integrated urgent care services. There is an attached appendix describing in more detail some of the other key requirements.
Checklist for induction and training of CCG lay members. This checklist aims to support CCGs with the induction and training of lay members. It focuses on induction, mentoring and buddying, networking, and ongoing or further training.
Vacant Space Handback Scheme: A guide for commissioners. Guide to NHS Property Services' new scheme that allows commissioners to pass the liability for eligible vacant space back to NHSPS. The company will then use its expertise to re-use the space via re-letting, disposal or development to generate much-needed funds for reinvestment in the NHS. To qualify for the scheme, space identified by commissioners must have been transferred to NHS Property Services as part of the 2013 health reforms and meet other criteria. Handing back the vacant space also needs to be in line with the commissioner’s ongoing strategic estate plans. If a property is eligible for handback, NHS Property Services takes on its future costs, following a one-off final payment.
Service specification & PGD for national Flu Vaccination Service 2017/18. The Pharmaceutical Services Negotiating Committee (PSNC) has published the service specification and Patient Group Direction (PGD) for the community pharmacy Flu Vaccination Advanced Service 2017. These documents explain what community pharmacy contractors need to do to offer the service, including how to confirm that their premises are appropriate, pharmacist training and Declaration of Competence requirements, data capture and sharing of information, vaccine storage, gaining patient consent, GP notification and claiming payments.
Sexual health, reproductive health and HIV: a review of commissioning. This report outlines the findings of a 2016 survey, carried out jointly with the Association of Directors of Public Health, which aimed to gain a clear picture of the commissioning arrangements for sexual health, reproductive health and HIV services. The survey found that whilst there has been progress in improving services and the development of collaborative approaches there is also evidence of structural concerns which have the potential to impede effective commissioning. Key findings from the survey highlight the fragmentation of commissioning, barriers to access for those at greatest risk, increasing financial pressures and patient demand, and workforce concerns.
Consultations
Accountable care models contract: proposed changes to regulations. Seeks views on changes to the GMS and PMS Regulations to support the introduction of Accountable Care Organisations (ACOs) in the NHS. The paper also proposes changes to a number of other regulations. The consultation closes on 2 November 2017.
If you wish to discuss the issue of commissioning please contact David Owens.
Employment/HR
Publications/guidance
Getting into shape: delivering a workforce for integrated care. The priority for the NHS is to increase its speed of innovation. To do this, the NHS is rightly seeking to devolve decision-making and to deregulate. For the workforce, however, policy remains highly centralised and tightly regulated. This paper from the thinktank Reform shows how to bring the same reform ideas to the workforce as the NHS is applying to other areas. It focuses on the structural barriers to delivering integrated care.
Improving staff retention: A guide for employers. The guide was developed from work which took place during 2016-17 where NHS Employers engaged a large number of NHS organisations to help equip them with tools and resources to shape and implement effective workforce retention plans. It highlights a number of case studies that illustrate the breadth of great work already taking place across the NHS, as well as resources to help employers think about improving turnover and managing staff effectively
From the frontline: Workforce pressures in the NHS. This report from Macmillan Cancer Support warns that bigger workloads, increasingly complex patient needs, and vacancies in key roles are creating 'unrelenting pressure' on cancer care workforce. The survey of over 250 GPs and nurses working in primary care across the UK, undertaken by nfpSynergy for Macmillan, has found that over half (52%) are not confident the NHS workforce is able to provide adequate care to cancer patients, given the current pressures it faces. Additional research looked at issues that were putting pressure on the NHS workforce. The issues most commonly reported by Macmillan GPs were increasing numbers of patients, gaps and vacancies in key roles, and the increasing complexity of cancer.
National Engagement Service. This infographic outlines the work of the National Engagement Service which supports leaders on workforce issues in the NHS.
Safe and effective staffing: nursing against the odds. Following on from the publication of Safe and effective staffing: the real picture in May 2017, the RCN launched a survey of nursing and midwifery staff in the UK. The survey asked people about their last shift or day worked in health or social care. More than 30,000 responses were received in just two weeks, providing insight into staff experiences and staffing levels across the UK. The findings provide a strong voice from nursing staff, clearly describing the impact that poor staffing has on both patient care and their own wellbeing. Some of the experiences and stories shared via the survey have been included throughout the report.
Public sector pay: still time for restraint? The government is considering easing the current restraint on the pay of public sector workers. It had previously announced in 2015 that public sector pay scales would only increase by an average of one per cent per year up to and including 2019–20. This briefing note describes the trade-offs faced by the government when deciding how to set public sector pay.
The state of pre and post-graduate medical recruitment in England, September 2017. This briefing examines the current state of medical recruitment in England, with additional UK-wide data for the foundation programme. Looking at data from 2013 onward, it identifies some of the ongoing issues facing medical recruitment, and recommends how some of these key concerns can be addressed.
News
Health Secretary announces nursing workforce reforms. Announces a 25% increase in training posts for nurses and improvements to working conditions.
Bevan Brittan Updates
Employment Eye September 2017 including:-
1. Holiday pay & employee monitoring: two important post-scripts
2. Proposed increase to State Pension Age – what does it mean for employers?
3. News round up
If you wish to discuss any employment issues please contact Julian Hoskins or James Gutteridge.
Finance
Publications and Guidance
Health economics: evidence resource tool This health economic evidence resource tool shows the key cost-effectiveness and return on investment evidence on activities in the public health grant. Each piece of evidence is summarised across over 20 criteria to provide details on how the results were created and to highlight the inputs and assumptions used in the original studies. It aims to help users to understand the relevance and apply the evidence to their local setting.
Funding for healthcare in England in support of the United Kingdom's resettlement programmes 2017/18. This suite of guidance provides information on funding reimbursement on UK resettlement programmes for refugees from Syria and the Middle East and North Africa region. The government is making funding available to allow local authorities, health care providers and third party sponsors to support refugees for the duration of the programme.
Consolidated charging policy 2017-18. NHS Property Services (NHSPS) has published a refreshed charging policy for 2017-18. The policy clarifies their core charging principles and outlines charges payable for occupation of NHSPS properties. This includes regular charges (such as rent service charges), invoicing disputes, VAT, capital expenditure recovery and dilapidations. It is most relevant for customers without a formal lease in place; however, there are areas which apply to all customers such as the vacant space hand back scheme and sessional space.
The bottom line: understanding the NHS deficit and why it won’t go away. This briefing assesses the financial health of the NHS provider sector by unpicking the headline figures presented in the official accounts to reveal the true underlying state of the NHS’s finances today, and to outline prospects for the next three to four years. The analysis finds that NHS trusts ended last year with an underlying overspend almost £3 billion more than was reported in their official accounts. It warns that even if trusts continue to make savings, underlying deficits will remain until 2020/21.
Making the economic case for investing in actions to prevent and/or tackle loneliness: a systematic review. This research, carried out by the London School of Economics, reviews the evidence on the economic impact of loneliness interventions. It finds that up to £3 of health care costs can be saved for every £1 spent on an effective intervention on loneliness.
If you wish to discuss any issues raised in this section please contact Claire Bentley.
Independent Healthcare
Publications/Guidance
Private healthcare order 2014: directions issued to seven hospitals. Following the CMA's 2014 investigation of the private health care sector, private hospitals are now required to submit information on their quality of care to the Private Healthcare Information Network (PHIN) for publication. Seven hospitals have been directed to publish information on the quality of their private healthcare services after failing to meet the deadline. These directions have been issued to the hospitals and they demand that this information is provided by the end of October 2017.
HCA and University Hospitals Birmingham: PPU arrangements. The CMA’s decision on whether to review the private patient unit (PPU) arrangements between a private hospital operator and an NHS trust.
Expanding CQC ratings to include independent healthcare providers. This document summarises responses to the consultation on extending performance and assessment ratings to other providers.
Scope of performance assessments of providers regulated by the Care Quality Commission: Response to the consultation. In August 2016, the DH consulted on proposals to amend the CQC performance assessment regulations so as to extend performance assessments and the publication of ratings to certain other registered service providers and regulated activities. This document announces that all sectors identified as part of the consultation, with the exception of non-hospital independent community healthcare providers, will be included in a new set of regulations, in force before November 2017, which will impose a duty on the CQC to conduct performance assessment reviews for any other provider in the identified sectors who carry out specific regulated activities, and assign a rating for the quality and safety of the service provided.
News
Spire cools on private London hospital as health tourism slows. Plans for a new £500m private London hospital have been halted amid a slowdown in health tourism and spiralling property prices. Spire Healthcare has put plans to take on arch hospital rivals HCA and Bupa on their home turf with a new medical facility in the heart of the capital on hold after hitting a rough patch
Private hospital agrees £27m compensation deal over rogue surgeon.
If you wish to discuss any issues raised in this section please contact Vincent Buscemi.
Mental Health
Publications/Guidance
People with learning disabilities: making reasonable adjustments. Public Health England has updated its guidance on access to services for people with learning disabilities.
Quality checking health checks for people with learning disabilities. This audit tool consists of six questions and is designed to support practices, primary care liaison staff and health facilitators to improve the uptake and quality of annual health checks, and reduce the health inequalities experienced by people with learning disabilities.
Cervical screening: supporting women with learning disabilities. This information, originally developed in North Tyneside, is to support women with learning disabilities to access cervical screening.
Transition between inpatient mental health settings and community or care home settings. This quality standard covers transitions for children, young people and adults between mental health hospitals and their own homes, care homes or other community settings. It includes the period before, during and after a person is admitted to, and discharged from, a mental health hospital. It describes high-quality care in priority areas for improvement.
Adult and older adult mental health services 2012-2016. The NHS Benchmarking Network has made their mental health data available to the Centre for Mental Health to provide an independent commentary on what the data suggests about mental health provision in England and Wales between 2012 and 2016.
A review of new psychoactive substances in secure mental health settings: Summary document. Reviews the impact of new psychoactive substances (NPS) in secure mental health settings, and makes recommendations for the management of NPS use in these settings.
Access and waiting times in children and young people's mental health services. This report examines new data on access to specialist treatment for children and young people with mental health problems, and the waiting times they face. It finds that children face barriers when seeking access to mental health services. It also finds that, over the last year, overall waiting times (including both assessment and treatment) have fallen – yet there remains substantial variation across England.
Depression in children and young people: identification and management. This guideline covers identifying and managing depression in children and young people aged between 5 and 18 years. Based on the stepped care model, it aims to improve recognition and assessment and promote effective treatments for mild, moderate and severe depression. The guidance has been updated to clarify the training needed for therapists.
The future of the mental health workforce. This report calls for reform of mental health services in order to develop a workforce that is able to meet people's needs in the future. The report describes commissioning of mental health services as in crisis with a diminishing workforce, growing expectations and increasing demand putting pressure on staff across the country. It recommends that all GPs should have significant and wide-ranging mental health training, and that mental health professionals should be given the time and training to consult with GPs and other public service staff to help them to respond to more people’s mental health needs.
Not by degrees: improving student mental health in the UK's universities. This report finds that levels of mental illness, mental distress and low wellbeing among students in higher education in the UK are increasing, and are high relative to other sections of the population. It calls for universities to make mental health a strategic priority and adopt a whole-university approach to prevention, promotion and support.
Mental health at work: the business costs ten years on. This report finds that mental health problems in the UK workforce cost employers almost £35 billion last year. The largest part of this business cost is in the form of reduced productivity among people who are at work but unwell: or ‘presenteeism’. This costs businesses twice as much as sickness absence relating to poor mental health.
Prevention concordat for better mental health: planning resource. The Prevention Concordat for Better Mental Health is underpinned by an understanding that taking a prevention-focused approach to improving the public’s mental health is shown to make a valuable contribution to achieving a fairer and more equitable society. This resource has been developed to help local areas put in place effective arrangements to promote good mental health and prevent mental health problems. It does so by offering a five-part framework of focus for effective planning for better mental health.
Better mental health: JSNA toolkit. This toolkit aims to support the joint strategic needs assessment (JSNA) process in relation to mental health needs. It links mental health data, policy and knowledge to help planners understand needs within the local population and assess local services.
Stocktake of local mental health prevention planning arrangements. This report, commissioned by PHE and written by The King's Fund, provides a high-level summary of how local areas are currently incorporating mental health promotion and prevention of mental ill-health in their planning processes. The findings are based primarily on a content analysis of key planning documents in 35 local areas. This included a random sample of 16 areas across England and 19 areas selected as possible examples of transferable effective practice.
Mental health services: cost-effective commissioning. This toolkit, commissioned by PHE and written by the Personal Social Services Research Unit (PSSRU), summarises the evidence on promoting good mental health and reducing the impact of poor mental health, generated through a rapid evidence review. The accompanying return on investment tool and user guide aims to support economic evaluation of mental health interventions and prevention of mental ill health.
News
NHS commits to better care for expectant and new mums with mental health.
Judge reprimanded for allowing a student to sit in on a mental health tribunal. Judge Viney Jung who allowed a student to sit in on a private mental health tribunal hearing without the required consent has been reprimanded and issued with formal advice by the Judicial Conduct Investigations Office, which concluded that his actions had amounted to misconduct.
NHS England urged to improve physical healthcare in mental health units.
PHE highlights 8 ways for local areas to prevent mental ill health.
Bevan Brittan Updates
Case Summary: CH v A Metropolitan Council [2017] EWCOP 12 - Toby de Mellow. This case will be of interest to commissioners, providers and care co-ordinators because it was a highly unusual case in which the court was asked to approve a settlement by the Local Authority to the Claimant, who had Downs Syndrome. The claim for damages arose after the Local Authority assessed the Claimant as lacking capacity to consent to sexual relations with his wife and that such relations could only be continued once he had undertaken a course of sex education.
Bevan Brittan Events
Court of Protection Seminars - SAVE THE DATE
In October and November, Bevan Brittan's specialist Court of Protection team is hosting practical update sessions in Bristol, Birmingham, London and Leeds. These sessions will focus on practical issues that practitioners, commissioners and providers encounter in matters engaging the Court of Protection; covering relevant legislation, guidance and case law and their impact on managing incapable patients. They will offer guidance on the sort of problems that are faced by front-line practitioners and service planners. The sessions are aimed at all those working in organisations responsible for the care of vulnerable or incapable people both as care providers or commissioners. The sessions will run from 10:00 – 15.30. Registration for all sessions will open at 09:30 and lunch will be available.
- 31 October – Bristol
- 7 November – London
- 8 November – Birmingham
- 9 November – Leeds
If you would like to register your interest in one of the above seminars click on this link.
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 sessions coming up are:-
-
Front-line triage – a review of cases and what can go wrong. 10 October 12.30 -2pm. If you would like to attend this free lunchtime webinar just ask Claire Bentley.
-
Mental Health and Mental Capacity Acts Update. 24 October 12.30 - 2pm. If you would like to attend this free lunchtime webinar just ask Claire Bentley.
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:-
Nomination of deputies for S5
Disclosure in clinical negligence disputes: know your duty, know the cost of getting it wrong
If you wish to discuss any mental health issues please contact Simon Lindsay or Stuart Marchant.
Primary Care
Publications/Guidance
Guides to help staff support people with access needs. NHS England has published four practical guides to help patients with sight loss, hearing loss, autism or learning disabilities to access GP services online such as book appointments, repeat their prescriptions and view medical records.
Investing in primary care is cost effective for the NHS and good for patient care says College. The Royal College of General Practitioners has welcomed new research by King's College London, published in the British Journal of General Practice, which shows that stronger investment in primary care in England would lead to significant savings for secondary care - and reduce pressure on emergency departments.
Communications guide and resource pack. The Improving Access to General Practice communications guide and resources are designed to support commissioners and general practice providers to meet this core requirement and inform and signpost patients to ways they can access general practice appointments.
The state of care in general practice 2014 to 2017. The Care Quality Commission has published the most detailed analysis yet of the quality and safety of general medical practice in England.
Legislation
National Health Service (General Medical Services Contracts and Personal Medical Services Agreements) (Amendment) Regulations 2017 (SI 2017/908). These regulations, which come into force on 6 October 2017, amend the GMS Contracts Regulations 2015 (SI 2015/1862) and the PMS Agreements Regulations 2015 (SI 2015/1879) so as to implement the agreement between the NHS Commissioning Board and the BMA General Practitioners Committee on changes to primary medical services contracts from 2 October 2017.
News
Health Secretary challenges NHS to deliver digital services nationwide. The Health Secretary Jeremy Hunt has said that every patient in England should be able access their medical records and book an appointment with a GP via an app by the end of 2018. Speaking at the Health and Care Innovation Expo in Manchester, he set seven challenges which would make the NHS a world-beater in the care of people with long term conditions. These include people being able to access their own medical records 24/7, show their full medical history to anyone they choose and book basic services like GP appointments or repeat prescriptions online.
NHS England to help tackle rising costs of GP indemnity with £10 million boost. NHS England has announced at its Public Board meeting plans to help strengthen out-of-hours GP services during the winter period by making £10m available for indemnity costs.
If you wish to discuss any queries you may have around providers please contact Vincent Buscemi.
Procurement
Cases
Sysmex (UK) Ltd v Imperial College Healthcare NHS Trust [2017] EWHC 1824 (TCC). S participated as a specialist sub-contractor in an unsuccessful bid for a managed services contract in respect of pathology services. S challenged the Trust's decision to award the contract to another bidder, triggering the automatic suspension of the award under the Public Contracts Regulations 2015. The NHS Trust applied to lift the automatic suspension. The court held, granting the application, that the balance of convenience overwhelmingly favoured lifting the suspension. Damages were an adequate remedy for S, and the potential effect on patient care, and the cost saving which could be made, provided an overwhelming case on the balance of convenience for lifting the suspension.
If you wish to discuss any queries you may have around providers please contact Vincent Buscemi.
Providers
Publications/Guidance
Quality Payments reminder: Urgent action required by contractors who appear to have not met the gateway criteria for the April review point. The Pharmaceutical Services Negotiating Committee has warned that if a contractor does not show that it has met the gateway criteria by the deadline of 8 October 2017, NHS BSA will not be able to confirm to NHS England that the contractor has met the gateway criteria, which will result in NHS England taking further action; this could include NHS England reclaiming the Quality Payment paid to the contractor in June 2017 for the April review point.
Equally outstanding: equality and human rights – good practice resource. This guidance aims to help providers put equality and human rights at the heart of their improvement work so that the quality of care gets better for everyone. It contains case studies and identifies nine common success factors.
NHS Improvement operational productivity: Proposed Pathology Consolidation Networks. NHS Improvement has identified 29 potential pathology networks, allowing for the transformation of pathology services into a series of networks across the country. Providers have been put in to one of 29 proposed pathology networks and must now work with their local communities, and clinical staff to implement this better way of delivering services for patients.
Managing risk in health and care this winter: update. This report assesses NHS planning for the upcoming winter season and finds whilst the level of planning and support is more developed than last year, the system still requires emergency funding to ensure patient safety. NHS Providers warns that a failure to make an emergency investment of £200-£350 million will lead to longer patient waiting times and increased patient safety risks.
Legislation
Velindre National Health Service Trust (Establishment) (Amendment) Order 2017 (SI 2017/912 (W.223). This Order, which comes into force on 5 October 2017, amends the Trust's Establishment Order to give the Trust the function of managing and administering an Infected Blood Support Scheme (in accordance with directions given by the Welsh Ministers) to provide financial support and advisory services to, or in respect of, persons infected with hepatitis C and/or HIV as a result of receiving infected blood or blood products during the course of national health service treatment in Wales.
News
New quality of life measure for recovering cancer patients. NHS England has developed a new 'quality of life metric' that will use questionnaires to measure how effectively cancer patients are supported after treatment. The data will be made available on My NHS, helping patients, the public, clinicians and health service providers see how well their local after cancer care support is doing.
Quality Payments reminder: Urgent action required by contractors who appear to have not met the gateway criteria for the April review point. The Pharmaceutical Services Negotiating Committee has warned that if a contractor does not show that it has met the gateway criteria by the deadline of 8 October 2017, NHS BSA will not be able to confirm to NHS England that the contractor has met the gateway criteria, which will result in NHS England taking further action; this could include NHS England reclaiming the Quality Payment paid to the contractor in June 2017 for the April review point.
If you wish to discuss any queries you may have around providers please contact Vincent Buscemi.
Public Health
Publications/Guidance
Flu immunisation leaflet for social care staff. Information for social care providers with details on the benefits of providing staff flu vaccination and options for providing the service to increase uptake of the vaccine.
Public Health England Health and Justice Annual Review 2016/17. PHE has published its latest annual report on health trends in prisons and other prescribed places of detention, as well as those in contact with the criminal justice system in the community. It highlights some of the sources of robust health and justice data used to inform healthcare decision making in prisons and provides details of related work programmes undertaken by the Health and Justice team consequent to the implementation of the prison reform agenda. The report also provides some current data and evidence in relation to key public health concerns in the prison population including the high prevalence of infectious diseases, high levels of substance misuse and prisoners’ mental health needs.
A vision for the public health system in England. This project aims to consolidate and build on the King's Fund's previous work programme by setting out a vision for the public health system and population health. It will use this vision to inform and influence the debate about the future of public health and to shape its own work programme. Its considerations include: how to define the 'public health system'; key trends likely to affect public health over the next 10–15 years; strengths and weakness of the current system; changes needed to realise our vision, including understanding the role of policy levers such as regulation, taxation, and information; and the implications for the workforce and system leaders, including accountability.
Reducing health inequalities: system, scale and sustainability. This document identifies steps to support local action on health inequalities to improve outcomes. It is aimed at local authority leaders, chief executives, other senior officers and councillors, directors of public health, public health specialists, and commissioners.
Size matters: the impact of upselling on weight gain. This research that the average person consumes an additional 330 calories each week – 17,000 per year – because of businesses upselling high calorie food and drink. Over the course of the year that could result in an estimated weight gain of 5lbs (2.3kg). The report, which includes a survey of 2,055 UK adults, shows that consumers face an average of 106 verbal pushes towards unhealthy choices each year as they are asked whether they would like to upgrade to larger meals and drinks, add high calorie toppings or sides to their order or take advantage of special offers on unhealthy food and drink.
Seasonal flu in prisons and detention centres in England: Guidance for prison staff and healthcare professionals. PHE guidance on preventing and responding to seasonal flu cases or outbreaks.
Reasonable adjustments: a legal duty. Updated guide from Public Health England explaining why reasonable adjustments must be made to health services and what adjustments help people with learning disabilities access services.
There is also a guide to Blood tests for people with learning disabilities: making reasonable adjustments.
Models of delivery for stop smoking services: options and evidence. This document supports directors of public health and local healthcare commissioners in rapidly appraising the evidence, to enable informed decisions on the provision of local smoking cessation.
News
New approach to preventing heart attacks and strokes. The NHS and Public Health England have announced a new drive to save thousands of lives by preventing heart attacks and strokes brought on by cardiovascular disease.
If you wish to discuss any queries you may have around public health please contact Claire Bentley.
Regulation
Consultations
Expanding CQC ratings to include independent healthcare providers. This document summarises responses to the consultation on extending performance and assessment ratings to other providers.
Scope of performance assessments of providers regulated by the Care Quality Commission: Response to the consultation. In August 2016, the DH consulted on proposals to amend the CQC performance assessment regulations so as to extend performance assessments and the publication of ratings to certain other registered service providers and regulated activities. This document announces that all sectors identified as part of the consultation, with the exception of non-hospital independent community healthcare providers, will be included in a new set of regulations, in force before November 2017, which will impose a duty on the CQC to conduct performance assessment reviews for any other provider in the identified sectors who carry out specific regulated activities, and assign a rating for the quality and safety of the service provided.
New proposal to expand the scope of performance assessments of providers regulated by the Care Quality Commission. Seeks views on proposals to amend the Care Quality Commission (Reviews and Performance Assessments) Regulations 2014 so that the CQC has a duty to rate all providers of regulated activities, except for some specific registered service providers or regulated activities. The consultation closes on 7 November 2017.
Proposed changes to the statutory scheme to control the cost of branded health service medicines. Seeks views on on proposals to amend the statutory scheme that controls the prices of branded health service medicines. This builds on a previous consultation run in 2015. The aim is to achieve alignment with the current voluntary pharmaceutical price regulation scheme (PPRS), agreed in 2014. The consultation closes on 17 October 2017.
Regulating clinical trials. This briefing describes the new EU Clinical Trial Regulation and the timetable for its implementation and examines its likely impact on the regulation of clinical trials in the UK post-Brexit.
Professional regulation in health and social care. This House of Commons Library briefing describes the main functions of the UK’s health and social care professional regulators and outlines some of the prominent debates surrounding this area of policy and the case for reform.
Legislation
Care Quality Commission (Reviews and Performance Assessments) (Amendment) Regulations 2017 (SI 2017/914). These regulations, which come into force on 31 October 2017, substitute the table in the Schedule to SI 2014/1788 to expand the scope of the rating regime to include providers undertaking certain regulated activities relating to cosmetic surgery services, transport services, dialysis services, refractive eye surgery services, substance misuse services and termination of pregnancy services.
Health Education and Improvement Wales (Establishment and Constitution) Order 2017 (SI 2017/913 (W.224). This Order, which comes into force on 5 October 2017, establishes a new Special Health Authority, Health Education and Improvement Wales (HEIW) and makes provision about its functions and constitution. HEIW's principal functions relate to the planning, commissioning and delivery of education and training for persons who are employed, or are considering becoming employed, in an activity relating to the health service in Wales.
NHS Counter Fraud Authority (Establishment, Constitution, and Staff and Other Transfer Provisions) Order 2017 (SI 2017/958). This Order, which comes into force on 1 November 2017, establishes a new special health authority, the NHS Counter Fraud Authority (NHSCFA), to carry out the Secretary of State’s counter fraud functions in respect of the health service in England. It provides for the constitution of the NHSCFA and appointment of its members, and for the transfer from the NHS Business Services Authority of staff and property concerned in delivering the Secretary of State’s counter fraud functions prior to 1 November 2017. It also makes provision for abolition of the NHSCFA in three years’ time as required by s.28A NHS 2006.
NHS Business Services Authority (Awdurdod Gwasanaethau Busnes y GIG) (Establishment and Constitution) (Amendment) Order 2017 (SI 2017/959). This Order, which comes into force on 1 November 2017, amends the NHS BSA Order 2005 (SI 2005/2414) in relation to England and Wales to remove counter fraud and security functions from the statutory remit of the NHS BSA in relation to the health service in England, and counter fraud functions of the BSA in relation to the health service in Wales.
NHS Counter Fraud Authority (Investigatory Powers and Other Miscellaneous Amendments) Order 2017 (SI 2017/960). This Order, which comes into force on 1 November 2017, amends a number of instruments to reflect the establishment of the NHSCFA under s.28 NHS Act 2006. It principally puts the new special health authority in the same position as the BSA was, in particular so that the NHSCFA may use those powers which have previously been made available to carry out the Secretary of State’s health service counter fraud functions. The amendments largely substitute references to the new special health authority or its officers for references to the BSA or the division within it or its officers.
Health and Social Care (National Data Guardian) Bill. This Private Member's Bill has been introduced into the Commons by Mr Peter Bone MP and received its 1st Reading. It establishes, and makes provision about, the National Data Guardian for Health and Social Care.
News
Trusts left waiting months for late CQC inspection results.
If you wish to discuss any queries you may have around regulation please contact Stuart Marchant.
Social Care
Publications/Guidance
VCSE Health and Wellbeing Fund 2017-18: Social prescribing. Information pack for voluntary, community and social enterprise (VCSE) sector organisations. Provides VCSE organisations with information about the Health and Wellbeing Fund for 2017-18, to help them decide whether to submit an application for funding. The Fund component of the VCSE Health and Wellbeing Programme is themed around a specific topic for each round - for 2017-18 this is social prescribing, i.e. "Enabling healthcare professionals to refer patients to a link worker, to co-design a nonclinical social prescription to improve their health and wellbeing". The guide details the outcomes that the system partners are seeking from the Fund and the criteria that will be used for assessing applications. The closing date for applications is 21 November 2017.
Government extends suspension of minimum wage enforcement in the social care sector. Announces a further one-month suspension of minimum wage enforcement concerning sleep-in shifts in the social care sector to minimise disruption to the sector and seek to ensure workers receive the wages they are owed. This follows July’s decision to waive all historic penalties in the sector where employers incorrectly paid workers a flat-rate for sleep-in shifts instead of hourly rates. During this temporary pause, the Government will develop a new enforcement scheme for the sector to encourage and support social care providers to identify back pay owed to their staff.
News
Government extends suspension of minimum wage enforcement in the social care sector. Announces a further one-month suspension of minimum wage enforcement concerning sleep-in shifts in the social care sector to minimise disruption to the sector and seek to ensure workers receive the wages they are owed. This follows July’s decision to waive all historic penalties in the sector where employers incorrectly paid workers a flat-rate for sleep-in shifts instead of hourly rates. During this temporary pause, the Government will develop a new enforcement scheme for the sector to encourage and support social care providers to identify back pay owed to their staff.
If you wish to discuss any queries you may have around social care please contact Stuart Marchant.
General
Publications/Guidance
What does the public think about the NHS? This report, based on polling data carried out by Ipsos MORI, explores public attitudes towards the health service. It finds that despite the significant challenges it faces, the NHS still holds strong support amongst the majority of the general public with 66 per cent of respondents stating that they would be willing to pay more taxes in order to fund the NHS.
Person-centred care in 2017: Evidence from service users. This report from National Voices attempts to create a snapshot of the extent of person-centred care in the English health and care system, based on how people report their experience of treatment, care and support. It finds that, from the patchy data available, it appears some aspects of person-centred care are being consistently achieved in mainstream services. Others are not, or aren’t even being measured. People’s experiences can be highly variable depending which services they use, what their needs are, and who they are.
Guidance on supporting end of life care patients while flying. New guidance for care professionals supporting seriously ill patients who wish to travel overseas.
One year on: the Government response to the review of choice in end of life care. This report sets out how the National End of Life Care Programme Board performing against the commitments identified in the government's vision of high-quality end of life care.
Physical health of people in prisons This quality standard covers the assessment, diagnosing and management of physical health problems of adults aged 18 years and older in prisons or young offender institutes.
Prison health: health and justice annual report. Public Health England (PHE) annual report on health trends in prisons and other prescribed places of detention (PPDs).
Test Beds: the story so far. This report describes the progress on the Test Beds Programme so far and how they are tackling clinical challenges such as dementia, diabetes and mental health through technology including algorithms, sensors and the Internet of Things.
Brexit FAQs. This set of frequently asked questions addresses issues relating to Brexit and the NHS workforce.
Brexit: reciprocal healthcare inquiry launched. The House of Lords EU Committee and its six sub-committees are conducting a coordinated series of inquiries looking at the key issues that will arise in the negotiations on Brexit. The Home Affairs Sub-Committee has now launched one of these, focusing on the reciprocal healthcare implications of Brexit for UK citizens travelling, living and/or working in the rest of the EU, and for EU citizens travelling, living and/or working in the UK, in both the short and medium term.
New care models: harnessing technology. This report explores how digital tools can help to address rising demand, constrained funding and workforce challenges, and it demonstrates how technology has the potential to revolutionise the way health and care is delivered. It focuses on how five vanguards are implementing innovative digital technology solutions at the heart of a new approach to care.
A short guide to the Department of Health and NHS England. The NAO is publishing a suite of short guides for the new Parliament, one for each government department and a selection of cross-government issues, to assist House of Commons select committees and members of Parliament. This guide summarises what the DH and NHS England do, how much they spend, recent and planned changes and what to look out for across their main business areas and services.
New help for acid attack victims from the NHS. The NHS and leading burns surgeons are issuing new first aid guidance to help ensure victims of acid attacks get the right help fast.
Brexit: reciprocal healthcare inquiry: call for evidence The House of Lords EU Committee and its six sub-committees are conducting a coordinated series of short inquiries looking at the key issues that will arise in the negotiations on Brexit. This inquiry will focus on the reciprocal healthcare implications of Brexit for UK citizens travelling, living and/or working in the rest of the EU, and for EU citizens travelling, living and/or working in the UK, in both the short and medium term. The public call for written evidence is now open and evidence will be accepted up until 24 November 2017.
Sustainability and transformation plans and partnerships. This House of Commons Library briefing covers the context in which sustainability and transformation partnerships have been developed, their funding and accountability arrangements as well as their progress so far. A key role of these partnerships was the creation of local blueprints for delivering the NHS five year forward view, known as sustainability and transformation plans (STPs). This briefing therefore explores how these plans were developed, as well as research and debate surrounding the content and implementation of these plans.
Resilience and recovery: What the NHS can learn from the criminal justice and education sectors. Summary of Health Foundation research into wh some public sector organisations overcome and recover from disruptive events and failures and others languish in failure regimes or special measures, and what enables these organisations to adapt and recover from these events. The Health Foundation has used the findings to develop a tool for leaders of NHS organisations, to help them deploy limited resources in the most effective way to build organisational resilience. The research and that of others suggests that organisational resilience theory can provide a useful framework to aid rapid recovery from failure across a range of public sector organisations.
News
More than 100 charities claim they are being damaged by anti-lobbying rules. An open letter signed by 122 organisations including Save the Children, Greenpeace and Christian Aid, has claimed that the Transparency of Lobbying, Non-Party Campaigning and Trade Union Administration Act 2014, which dictates what charities can do publicly in the 12-month run-up to elections in order to ensure individuals or organisations cannot have an undue influence over the vote, is having a "chilling" effect on their sector.
Government announces consultation on organ donation opt-out system. The Prime Minister has announced the intention to launch a public consultation on increasing rates of organ donation, by the end of 2017. The proposals will include a new opt-out system for organ donation for England. The consultation will seek views on how Government can increase rates of organ donation, particularly from black and minority ethnic communities; how the issue of consent should be managed within the NHS; and what role technology could play in helping people to discuss their preferences with family.
Home-testing kits that detect bowel cancer could almost halve invasive examinations by 2020. A major NHS England funded study is expected to almost halve the number of invasive procedures by 2020 by improving the accuracy of home-testing kits that detect bowel cancer from invisible amounts of blood.
If you wish to discuss any issues raised in this section please contact Claire Bentley.
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