17/10/2018
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
Court of Protections Seminars
Key topics at the Annual Court of Protection Seminars include:
- Safeguarding – Care Act vs. CoP;
- Case law update;
- Liberty Protection Safeguards and DoLS update;
- What to do when someone is not acting in best interests; and
- Mediation in the CoP.
Please register your interest in attending by clicking on the following links:
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. You can sign up to watch the training sessions remotely via our webinar facility. Webinars coming up are set out below. If you want to attend by webinar just ask Claire Bentley.
1. Mental Health Act and Mental Capacity Act update - 30 October
2. Medico-legal aspects of vestibular disorders - 13 November
Knowledge Transfer
Training. 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.
Early Intervention Scheme and Triage. Our EIS allows us to help commissioners, providers and care co-ordinators identify packages of care and treatment interventions, for people who lack capacity, that need an appropriate legal framework. If you would like more information click here.
Acute and emergency care
Publications/guidance
Suspicion of sepsis insights dashboard. Imperial College Health Partners, NHS Improvement and NHS England have launched a suspicion of sepsis (SOS) dashboard. This provides clinicians and managers with a reliable and consistent tool to identify and analyse the impact of local improvement on deteriorating patients with SOS. It uses hospital episode statistics to provides an overall picture of hospital patients in the SoS category, allowing clinicians and managers to understand the impact of sepsis and target interventions accordingly.
Acute medical care in England: findings from a survey of smaller acute hospitals This profile of smaller hospitals in England finds trusts struggling to recruit and retain acute medical staff. Services across the country are configured in a wide variety of ways, with little evidence of an 'ideal' model for acute medical care emerging from the research.
Be the change: ensuring an effective response to all in psychiatric emergency equal to medical care Care for people in mental health crisis does not adequately address the needs of the community it is intended to serve, according to this report. It outlines ten recommendations that would make urgent and emergency psychiatric health care ‘minimally adequate’, and calls on governmental agencies, policy makers and health and social services to take radical action to address inequalities and improve mental health crisis care.
Bevan Brittan Updates
Healthcare receptionists and claims for misleading information: Keeping an eye on the threshold.
If you wish to discuss any queries you may have around acute and emergency care please contact Claire Bentley.
Children
Publications/Guidance
Improving children and young people’s mental health services This report examines whether the government is on track to meet its ambitions for children and young people’s services. It focuses on how the government decided to implement the policies set out in Future in Mind; whether it is on track to deliver improved mental health services to young people; and accountability for spending and outcomes.
Access to children and young people’s mental health services A report from Education Policy Institute examines access to specialist services, waiting times for treatment, and provision for those children that are not able to receive treatment, using information from child and adolescent mental health services (CAMHS) and local authorities in England.
Record high levels of severe obesity found in year 6 children. New national child measurement programme (NCMP) data provides the most comprehensive picture of the state of childhood obesity in England. New data published shows the rate of severe obesity among year 6 children (aged 10 to 11) has increased by more than a third since 2006 to 2007 to 4.2%. The latest data from the national child measurement programme also shows stubborn inequalities persist, with obesity in the poorest areas more than double that of the richest areas.
Child death reviews: forms for reporting child deaths. Forms to help child death overview panels (CDOPs) assess the causes of a child’s death as part of the child death review process.
Multi-agency statutory guidance on female genital mutilation Multi-agency guidelines on FGM for those with statutory duties to safeguard children and vulnerable adults.
What price safe motherhood? Charging for NHS maternity care in England and its impact on migrant women This study explores the experiences of women who faced charges for NHS maternity care. Most of the participants were socially and economically vulnerable but faced debts for bills which they were sent from the NHS. The study shows how NHS charging gives rise to stress and anxiety among migrant women who are pregnant and new mothers, with possible long-term consequences for their own and their children’s health.
General hospital care for children with learning disabilities has scope for improvement. Less than half of NHS staff surveyed said they were routinely informed that a child has learning disabilities through a dedicated flagging system on admission. Many general hospital staff lack confidence and organisational support in providing care for children and young people with learning disabilities. In an NIHR national hospital staff-awareness survey, staff were uncertain or unaware of local policy and practice. Only half of the children’s hospitals had a learning disability nurse, and where they did exist, there was disparity in the status and importance attributed to the role. This is likely to prevent the needs of these children being fully met. This research shows the frequent lack of well-embedded local policies to support children with learning disabilities in general hospitals and the current variation in practice.
Situation of child and adolescent health in Europe This report focuses on several areas where there are concerns about health outcomes for children and adolescents, and provides insight into ways in which countries can improve the situation. Areas in focus include mental health, obesity and adolescent risk-taking behaviour.
News
Families of over 300 children avoid driving 30,000 miles for appointments thanks to new hospital alliance Children and young people Integrated care Mental health Patient care Sustainability and transformation partnerships The families of over 300 children with epilepsy and other neurological diagnoses have avoided having to travel nearly 30,000 miles of hospital trips after two hospitals joined forces to provide care closer to home.
If you wish to discuss any queries you may have around children please contact Deborah Jeremiah.
Clinical Risk/Patient Safety
Publications/Guidance
Learning from safety incidents. New learning resource on caring for people at risk of choking. Earlier this year CQC launched 'Learning from safety incidents', a series of resources that describe a critical safety issue - what happened, what CQC and the provider have done about it, and the steps you can take to avoid it happening in your service. A new issue of these resources has been published, focusing on caring for people at risk of choking.
Reflective Practice New guidance has been published to support doctors to be ‘reflective practitioners’.
Data on written complaints in the NHS - 2017-18. Written complaints statistics Written complaints to GPs and dental services were up by 4.5% last year according to recent report by NHS Digital.
The spread challenge. A report from the Health Foundation outlines the challenges facing the NHS in improving the uptake of new ideas and practices. The report includes recommendations for those involved in spreading health care improvement.
Association of Anaesthetists: anaesthesia and perioperative care for Jehovah's Witnesses and patients who refuse blood. This is a consensus document produced by expert members of a Working Party established by the Association of Anaesthetists. It has been seen and approved by the Board of Directors of the Association of Anaesthetists. It has been endorsed by the Royal College of Anaesthetists, the Royal College of Surgeons and the Association of Paediatric Anaesthetists of Great Britain and Ireland.
The Meningitis Research Foundation (MRF) has launched a resource highlighting the importance of information for patients at risk of serious infections such as meningitis and sepsis. MRF has launched a newly updated GP handbook which includes a section on safety netting and can be downloaded or ordered free from the website. Doctors can direct patients to this, or download documents for patients to take home so that they know what to do if symptoms progress.
National mortality case record review: annual report 2018. The Royal College of Physicians reports on the effectiveness of the standardised review approach used by hospitals to learn from adult acute deaths and improve patient care.
Making hospitals safe for people with diabetes Diabetes UK has published a report that highlights the challenges facing diabetes inpatient services and shows what should be in place in all hospitals.
Regulating the duty of candour: requires improvement This research shows that the Care Quality Commission “requires improvement” in how it regulates the statutory duty of candour, despite significant improvements since a previous report published in 2016.
Cases
Darnley v Croydon Health Services NHS Trust. 2018 UKSC 50 Trusts had a duty to take reasonable care not to cause physical injury to those who presented themselves at accident and emergency departments complaining of illness or injury. The scope of that duty extended to taking reasonable care not to provide misleading information, whether given by medical or non-medical staff, about how long patients might have to wait before seeing a clinician. Where the standard practice was for patients to be triaged within a certain time of arrival, it was not unreasonable to require that they be given that information, either orally by the receptionist, in a leaflet, or by a prominent notice.
Simmons v City Hospitals Sunderland NHS Foundation Trust (2018) The court allowed a claimant to reamend her particulars of claim six months before trial in her medical negligence action against a hospital following the mismanaged treatment of her caesarean wound. The amendments did not introduce new material or substantially recast her case, and while the hospital would be under pressure to respond within a tight time frame, the trial date was still achievable and the balance was in favour of allowing the claimant to put her case fully.
Cartwright –v- Venduct 2018 EWCA Civ 1654 In the case of Cartwright v Venduct Engineering Limited [2018] EWCA Civ 1654, the Court of Appeal upheld the Costs Judge's decision that a successful Defendant in a multi-defendant claim may recover its costs under CPR 44.14(1) where the Claimant receives a sum of money from an unsuccessful Defendant. The Defendant, however, was precluded from recovering its costs from the Claimant on this occasion because the claim was compromised by way of Tomlin Order, which is not a Court Order for the purpose of CPR 44.14(1). See Bevan Brittan Update
Amanda Jayne Welsh v Walsall Healthcare NHS Trust [2018] EWHC 2491 The court departed from the general rule under CPR r.44.2(a) and ordered the defendant to pay 85% of the successful claimant's costs in a clinical negligence claim where it had not been reasonable for the claimant to have maintained the issue of consent through to trial. The judgment contains a summary of the rules relating to issue based costs orders.
News
Gender-balanced boards at NHS organisations result in “better care and safer care”
NHS pays out record £20m compensation for brain-injured teenager. The NHS has paid a record £19.8 million in compensation to a woman who suffered serious brain injuries when she was deprived of oxygen as a five-month old. The payment reflects the severity of her injuries and the lifetime costs of care at home. In September 2018 a judge agreed that hospital employees had failed to properly ventilate her before and after she went into respiratory arrest when in hospital being treated for reflux.
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. You can sign up to watch the training sessions remotely via our webinar facility. Just ask Claire Bentley.
Bevan Brittan Updates
Healthcare receptionists and claims for misleading information: Keeping an eye on the threshold
If you wish to discuss any clinical risk or patient safety issues please contact Joanna Lloyd, Catherine Radford or Penelope Radcliffe.
Commissioning
Publications/Guidance
Towards commissioning for workplace compassion: a support guide. This interactive guide will assist you with commissioning for compassion, helping you with case study examples from healthcare organisations who have good practice to share
NHS funding: clinical commissioning groups This paper gives details of funding allocations for each CCG in England from 2013/14 to 2020/21. It also describes the process used to allocate the funds.
Guide to 2018/19 screening specifications. NHS England has published the 2018 to 2019 service specifications – important reading for those involved in the commissioning and provision of screening services in England.
Guidance for Commissioners: Interpreting and Translation Services in Primary Care. This guidance aims to provide practical advice to commissioners including details of the legal position, principles for high quality interpreting and translation services, and commissioning and contracting considerations.
Mental Health, Dementia and Neurology. A mental health network and Public Health England have issued a guide for commissioners and others interested in depression in older people.
Guidance on the NHS Standard Contract requirements on discharge summaries and clinic letters and on interoperability of clinical IT systems. NHS England is reminding trusts and other NHS bodies of their obligations under the NHS standard contract to publish specifications that will allow their information systems to work with other NHS systems.
Guidance on the NHS Standard Contract requirements on discharge summaries and clinic letters and on interoperability of clinical IT systems. NHS England is reminding trusts and other NHS bodies of their obligations under the NHS standard contract to publish specifications that will allow their information systems to work with other NHS systems.
A new CCG model constitution NHS England has published an updated model constitution for CCGs.
News
NHS beats drug companies in sight loss drug battle.. The High Court has ruled in favour of 12 NHS clinical commissioning groups who sought to give people suffering from age-related macular degeneration (AMD) the drug Avastin, which is 30 times cheaper than the two existing treatments for AMD, Lucentis and Eylea. The arguments made by the drug companies Novartis and Bayer, which make the more expensive drugs, were rejected. Avastin is used as the main treatment for AMD in private hospitals, however, it has only been previously licensed in the UK to treat cancer.
Bevan Brittan Updates
CCGs successfully defeat challenge to cost-saving drug policy In September 2018, in the case of Bayer and Novartis Pharmaceuticals v NHS Darlington CCG and others, a group of CCGs from the North East of England successfully defended a challenge to the lawfulness of their policy to give the drug Avastin preferred status for the treatment of wet age-related macular degeneration (Wet AMD), potentially saving the NHS millions of pounds.
If you wish to discuss the issue of commissioning please contact David Owens.
Employment/HR
Publications/guidance
What could make a difference to the mental health of UK doctors? A review of the research evidence This report found that the incidence of mental health problems among doctors is increasing alongside the growing demands and diminishing resources experienced in the healthcare sector. GPs, trainee and junior doctors appear to be particularly vulnerable, experiencing distress and burnout early in their career. The stigma associated with disclosing mental health problems and ‘a failure to cope’ mean that many doctors are reluctant to seek help as they fear sanctions and even job loss, as revealed in the report.
The Home Office has announced plans to test the EU settlement scheme with all health and social care workers from 26 November 2018. This means EU citizens working in the health or care sector will have early access to the scheme before it is rolled out more widely in 2019. NHS Employers will be working with the Department of Health and Social Care and the Home Office to get relevant information to those who need to register for the scheme. While the scheme does not open until 26 November, the government is urging NHS bodies to start preparing now by identifying those staff who need to register.
Clinical radiology: UK workforce census 2017 report The annual radiologist workforce report highlights the UK’s current and predicted future shortage of imaging doctors and urgently calls for more funding for trainees and better NHS retention and recruitment.
NHS directors to be dismissed if they fail to tackle staff bullying. NHS directors face being dismissed under a "fit and proper person" test, which imposes on them a legal duty to ensure patient safety and the wellbeing of health workers, as the Government takes action on harassment in the health service, where almost 30% of NHS staff have reported that they had been bullied by patients or their families in the past year and 25% reported abuse by colleagues.
Bevan Brittan Training
Combatting sexual harassment training
Bevan Brittan provides organisations with essential training at a range of levels including:-
Full coverage, workforce-wide training for all grades of employee
Focussed training for your HR/management teams and
Board level updates on the key issues and risks.
For more information click here.
If you wish to discuss any employment issues generally please contact Julian Hoskins or James Gutteridge.
Finance
Publications/Guidance
What price safe motherhood? Charging for NHS maternity care in England and its impact on migrant women This study explores the experiences of women who faced charges for NHS maternity care. Most of the participants were socially and economically vulnerable but faced debts for bills which they were sent from the NHS. The study shows how NHS charging gives rise to stress and anxiety among migrant women who are pregnant and new mothers, with possible long-term consequences for their own and their children’s health.
Social care funding in England: call for evidence A parliamentary inquiry is underway to address the funding challenges faced by the social care system in England.
Approaches to better value in the NHS - Improving quality and cost. The NHS is increasingly focusing on how it can improve the value of its services, to deliver the highest quality health outcomes for patients at the lowest possible cost. This new report shares learning and insight from three NHS hospital trusts that have developed organisation-wide strategies for value improvement.
If you wish to discuss any queries you may have around finance please contact Claire Bentley.
Independent Healthcare
News
Spire profits plunge amidst NHS squeeze. Profits at Spire Healthcare dropped sharply in the six months to June 30 following an “unprecedented decline” in patient admissions, with the group reiterating its profit warning for the full year.
Bupa fined £175,000 for systemic data protection failures. Bupa Insurance Services Limited (Bupa) has been fined £175,000 by the Information Commissioner’s Office (ICO) for failing to have effective security measures in place to protect customers’ personal information.
If you wish to discuss any queries you may have around independent healthcare please contact Vincent Buscemi or Debbie Rookes.
Information sharing/data
Publications/Guidance
Guidance on the NHS Standard Contract requirements on discharge summaries and clinic letters and on interoperability of clinical IT systems. NHS England is reminding trusts and other NHS bodies of their obligations under the NHS standard contract to publish specifications that will allow their information systems to work with other NHS systems.
Bupa fined £175,000 for systemic data protection failures. Bupa Insurance Services Limited (Bupa) has been fined £175,000 by the Information Commissioner’s Office (ICO) for failing to have effective security measures in place to protect customers’ personal information.
Nurse prosecuted for inappropriately accessing patient records. A former nurse at Southport and Ormskirk Hospital NHS Trust has been prosecuted for accessing patients’ medical records without authorisation.
If you wish to discuss any queries you may have around information sharing please contact Jane Bennett.
Inquests
News
Calls for emergency legal aid for families at inquests. Dame Eilish Angiolini QC the author of "Report of the Independent Review of Deaths and Serious Incidents in Police Custody" and other campaigners have argued emergency legal aid must be provided for bereaved relatives required to attend inquests. Dame Angiolini has called for interim measures to speed up the official response to her report which recommended automatic funding of legal representation for families in cases in which state agencies have been involved in a death. The problem has been highlighted by the experience of the family of PC Keith Palmer, who was killed in the March 2017 Westminster Bridge terrorist attack.
If you wish to discuss any queries you may have around inquests please contact Clementine Robertshaw or Will Pickles
Mental Health
Publications/Guidance
Mental Capacity Act 2005, Deprivation of Liberty Safeguards England, 2017-18 [PAS]. The report looks at aspects of DoLS activity, including the profile of people for whom a DoLS application was received, applications completed and their outcome, and applications not completed. The data tables and interactive business intelligence tool published alongside the report present further analyses and breakdowns of the data, including breakdowns by local authority.
Advance care planning in general practice: does policy match reality? This report by an end of life care charity reveals the mismatch between clinical commissioning group policies concerning advance care planning and the reality faced by patients.
Improving children and young people’s mental health services This report examines whether the government is on track to meet its ambitions for children and young people’s services. It focuses on how the government decided to implement the policies set out in Future in Mind; whether it is on track to deliver improved mental health services to young people; and accountability for spending and outcomes.
Access to children and young people’s mental health services A report from Education Policy Institute examines access to specialist services, waiting times for treatment, and provision for those children that are not able to receive treatment, using information from child and adolescent mental health services (CAMHS) and local authorities in England.
GP access to new prescribing indicators for adults with a learning disability and/or autism GP practices have an opportunity to gain useful feedback for improving patient care - such as a report, due later this year, about the impact of prescribing certain medications to adults with a learning disability - by joining Clinical Practice Research Datalink (CPRD). More than 1,100 practices already take part, contributing data which can be used to prove the safety of drugs/vaccines. They can earn extra money by completing questionnaires and taking part in clinical trials. A key benefit is receiving quality improvement reports, which help GPs to review patient care.
Mental Health, Dementia and Neurology. A mental health network and Public Health England have issued a guide for commissioners and others interested in depression in older people.
Guidance on physical care of those with serious mental illness NHS Digital is to start collecting data on physical health assessments for people with severe mental illness (SMI) in primary care.
People with severe mental illness experience worse physical health A new Public Health England report shows people with severe mental illness (SMI) suffer worse physical health compared to the general population.
Decision-making and mental capacity. This guideline covers decision-making in people 16 years and over who may lack capacity now or in the future. It aims to help health and social care practitioners support people to make their own decisions where they have the capacity to do so. It also helps practitioners to keep people who lack capacity at the centre of the decision-making process. There is some useful commentary available here.
Sexual safety on mental health wards. A CQC report calls for new national guidance to improve the sexual safety of people on mental health wards, following analysis of how mental health trusts in England report sexual incidents. The report shares findings from a review of patient safety incidents, which found that more than a third of incidents could be categorised as sexual assault or harassment of patients or staff.
Law Society: Mental Capacity (Amendment) Bill 2018 ‘not fit for purpose’ The Law Society has issued a damning briefing on the Mental Capacity (Amendment) Bill 2018 that this week moved to a Lords committee stage.
General hospital care for children with learning disabilities has scope for improvement. Less than half of NHS staff surveyed said they were routinely informed that a child has learning disabilities through a dedicated flagging system on admission. Many general hospital staff lack confidence and organisational support in providing care for children and young people with learning disabilities. In an NIHR national hospital staff-awareness survey, staff were uncertain or unaware of local policy and practice. Only half of the children’s hospitals had a learning disability nurse, and where they did exist, there was disparity in the status and importance attributed to the role. This is likely to prevent the needs of these children being fully met. This research shows the frequent lack of well-embedded local policies to support children with learning disabilities in general hospitals and the current variation in practice.
Be the change: ensuring an effective response to all in psychiatric emergency equal to medical care Care for people in mental health crisis does not adequately address the needs of the community it is intended to serve, according to this report. It outlines ten recommendations that would make urgent and emergency psychiatric health care ‘minimally adequate’, and calls on governmental agencies, policy makers and health and social services to take radical action to address inequalities and improve mental health crisis care.
What could make a difference to the mental health of UK doctors? A review of the research evidence This report found that the incidence of mental health problems among doctors is increasing alongside the growing demands and diminishing resources experienced in the healthcare sector. GPs, trainee and junior doctors appear to be particularly vulnerable, experiencing distress and burnout early in their career. The stigma associated with disclosing mental health problems and ‘a failure to cope’ mean that many doctors are reluctant to seek help as they fear sanctions and even job loss, as revealed in the report.
Preventing suicide in community and custodial settings This guideline covers ways to reduce suicide and help people bereaved or affected by suicides. It aims to: help local services work more effectively together to prevent suicide; identify and help people at risk; prevent suicide in places where it is currently more likely.
News
New interactive online data tool provides easier access to mental health statistics. National mental health statistics that shed new light on care and treatment for patients are now available at the click of a mouse thanks to the latest interactive data hub created by NHS Digital.
£2 million investment to help NHS achieve zero inpatient suicide ambition. The funding for the Zero Suicide Alliance will help to improve suicide awareness and training in the NHS.
Bevan Brittan Updates
Case Summary: RW v Chelsea and Westminster Hospital NHS Foundation Trust [2018] EWCA Civ 1067. This case will be of interest to commissioners, providers and care co-ordinators because it confirms the scope for appealing a best interests decision or a transparency order made in the Court of Protection is limited to situations where a Judge has erred in applying the law or where the decision is wrong. The Court of Appeal is likely to be "very slow" to conclude that a Judge is wrong in sensitive and difficult cases.
Supporting women and girls in crisis Over the last 10 years, there has been an unprecedented rise in reported mental health problems among women and girls.
How can we help?
Fixed fee training packages. We have devised a two-part fixed fee training package to ensure mental health professionals are up to speed with their duties and to enable key managers to proactively manage caseloads. We regularly deliver these sessions to provider and commissioner organisations, including their partner agencies. If you would like more information click here.
Early Intervention Scheme and Triage. Our EIS allows us to help commissioners, providers and care co-ordinators identify packages of care and treatment interventions, for people who lack capacity, that need an appropriate legal framework. If you would like more information click here.
Bevan Brittan Events
Court of Protections Seminars - SAVE THE DATE
Key topics at the Annual Court of Protection Seminars include:
- Safeguarding – Care Act vs. CoP;
- Case law update;;
- Liberty Protection Safeguards and DoLS update;
- What to do when someone is not acting in best interests; and
- Mediation in the CoP.
Please register your interest in attending by clicking on the following links:
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.
If you wish to discuss any mental health issues please contact Hannah Taylor, Simon Lindsay or Stuart Marchant.
Primary Care
Publications/Guidance
Mental Health, Dementia and Neurology. A mental health network and Public Health England have issued a guide for commissioners and others interested in depression in older people.
Framework for responding to CQC inspections of GP practices New guidance promotes a consistent approach for CCGs, area teams and CQC to work together before, during and after GP practice inspections and for responding to instances where practices are rated inadequate.
Guidance on physical care of those with serious mental illness NHS Digital is to start collecting data on physical health assessments for people with severe mental illness (SMI) in primary care.
Myth busting questions on partnerships for GP trainees This document, aimed at GP trainees and others thinking about becoming a partner, contains common questions and issues raised about partnerships including risk, tax implications, earnings and the future of the partnership model.
Guidance for Commissioners: Interpreting and Translation Services in Primary Care. This guidance aims to provide practical advice to commissioners including details of the legal position, principles for high quality interpreting and translation services, and commissioning and contracting considerations.
GP Partnership Review: interim report The interim report describes progress so far and outlines the challenges facing the partnership model.
Framework for responding to CQC inspections of GP practices New guidance promotes a consistent approach for CCGs, area teams and CQC to work together before, during and after GP practice inspections and for responding to instances where practices are rated inadequate.
Signing up students: a guide for universities, GP practices and CCGs NHS England has published a guide to help GP practices register more students to use GP online services.
Advance care planning in general practice: does policy match reality? This report by an end of life care charity reveals the mismatch between clinical commissioning group policies concerning advance care planning and the reality faced by patients.
Quality improvement reports for GPs Confidential reports designed to help GPs improve the quality of their prescribing and patient safety are available for practices that contribute to CPRD.
Using the NHS standard contract in primary and secondary care. NHS England has published a “toolkit” with advice on how to use the NHS standard contract to manage referrals and other processes where collaboration between primary and secondary care could improve the experience for patients.
The IMMDS Review is investigating three medical interventions where patients have reported problems and suffered serious harm. The Review wishes to ensure that any individual or family affected by these three interventions is aware of its work and has the opportunity to make contact or provide evidence. It is therefore asking GP practices and community pharmacies to display the poster prominently for members of the public to see. The poster is available in two forms – a print-sized version and an e-version. Posters were sent out to community pharmacies registered as member of the Medication Safety Officer Network and to all the multiple high street pharmacies in September. For further information, please contact the IMMDS Review communications team at reviewcomms@luther.co.uk or on 0207 618 9189.
If you wish to discuss any issues involving primary care please contact Vincent Buscemi.
Prison Health
Publications/Guidance
Preventing suicide in community and custodial settings This guideline covers ways to reduce suicide and help people bereaved or affected by suicides. It aims to: help local services work more effectively together to prevent suicide; identify and help people at risk; prevent suicide in places where it is currently more likely.
News
Appointment of the Prisons and Probation Ombudsman. The Secretary of State for Justice has appointed Sue McAllister as the Prisons and Probation Ombudsman from 15 October 2018 for three years. The role involves conducting independent investigations into deaths and complaints in custody.
If you wish to discuss any prison health issues please contact Will Pickles.
Providers
Publications/guidance
Making the most of the money: efficiency and the long-term plan This report says trusts recognise their responsibility to maximise efficiency but a different approach is now needed as the current method of driving efficiency in the health service is no longer sustainable. The report says the forthcoming NHS long-term plan, backed by the new funding settlement, can provide a vision for a transformed and sustainable NHS. It concludes that the success of that plan will depend on the ability of the health service to deliver stretching levels of efficiency.
Quarterly performance of the NHS provider sector: quarter 1 2018/19. The start of the financial year saw frontline staff cope with record A&E attendances, high bed occupancy levels and improved discharge rates. The sector ended the quarter £814 million in deficit – £22m better than planned at the beginning of the year but £78m worse than the same quarter last year.
Criminal investigation launched into NHS supplier The Environment Agency is taking enforcement action against a major NHS supplier, Healthcare Environmental Services (HES), after finding that it has breached its permits at five sites in England that deal with clinical waste. A criminal investigation has also been launched into how large amounts of various forms of human waste, including amputated limbs, and dangerous pharmaceutical waste, built up at HES disposal sites.
Consultations
Directions for integrated care providers (ICPs). Seeks views on draft directions about the mandatory requirements of GP services providers who choose to participate in a new ICP contract.
Bevan Brittan Updates
NHS Subsidiaries - Next steps?
Bevan Brittan successfully defends provider from prosecution. Bevan Brittan LLP recently acted for a private care home provider in relation to enforcement action taken by the Care Quality Commission ("CQC").
If you wish to discuss any queries you may have around providers please contact Vincent Buscemi.
Public Health
Publications/Guidance
Guide to 2018/19 screening specifications. NHS England has published the 2018 to 2019 service specifications – important reading for those involved in the commissioning and provision of screening services in England.
Alcohol, drugs and tobacco: commissioning support packs This guidance on smoking, drinking and drug misuse has been produced for commissioners of tobacco control and drug and alcohol services for adults and young people. It aims to help commissioners and local authorities develop joint strategic needs assessment and health and wellbeing strategies to reduce the harm caused by smoking, drinking, substance use and misuse.
Improving people’s health: applying behavioural and social sciences to improve population health and wellbeing in England Academics, public health professionals, and representatives from funders and learned bodies have collaborated to produce this strategy. It aims to enable the broad public health system to use behavioural and social sciences more effectively and efficiently to reduce inequalities and improve the health and wellbeing of the population.
Updates from the Healthy New Towns programme. The Kings Fund is working with NHS England and other partners to support the Healthy New Towns programme which brings together the health sector, housing developers and local authority planning teams to design and build healthier communities. This interim report explores emerging lessons from the programme so far. It highlights the importance of involving and empowering communities as one of the first steps to creating a healthy place, as well as the key role that NHS professionals have to play.
If you wish to discuss any queries you may have around public health please contact Claire Bentley.
Regulation
Publications/Guidance
Framework for responding to CQC inspections of GP practices New guidance promotes a consistent approach for CCGs, area teams and CQC to work together before, during and after GP practice inspections and for responding to instances where practices are rated inadequate.
Regulating the Duty of Candour Action Against Medical Accidents. Independent research carried out by Action Against Medical Accidents (AvMA) concludes that, despite significant improvements since the 2016 report, the Care Quality Commission (CQC) "requires improvement" with respect to how it regulates the statutory duty of candour. Recommendations include the development of a more robust framework for inspections, improving how the CQC deals with reports received alleging breaches of the duty, a more proactive approach to publicising the taking of regulatory action with regard to the duty, and collaboration with other statutory bodies and stakeholders.
The state of health care and adult social care in England: 2017/18 This report looks at the trends, shares examples of good and outstanding care, and highlights where care needs to improve. Ratings show that quality overall has been largely maintained from last year, and in some cases improved, despite the continuing challenges providers face. However, it found that it was harder for people to access services in the community in places where services failed to work well together, putting extra pressure on acute and mental health services. The report also considers the factors that affect the sustainability of good care for people.
If you wish to discuss any queries you may have around regulation please contact Stuart Marchant or Ben Lambert.
Social Care
Publications/Guidance
The state of health care and adult social care in England: 2017/18 This report looks at the trends, shares examples of good and outstanding care, and highlights where care needs to improve. Ratings show that quality overall has been largely maintained from last year, and in some cases improved, despite the continuing challenges providers face. However, it found that it was harder for people to access services in the community in places where services failed to work well together, putting extra pressure on acute and mental health services. The report also considers the factors that affect the sustainability of good care for people.
Carers action plan 2018 to 2020. The plan sets out how the government will improve support for carers in England over the next 2 years.
Social care funding in England: call for evidence A parliamentary inquiry is underway to address the funding challenges faced by the social care system in England.
NHS Continuing Healthcare in England. This House of Commons Library briefing paper is intended to help Members respond to queries from constituents about eligibility to NHS continuing healthcare in England. Equivalent provision in Scotland, Wales, and Northern Ireland is covered in the sixth section.
1.4 percentage point increase in people paying for some of their social care. The proportion of people receiving council funded or managed care1, who report that they or their family pay for some of their care and support has risen from 35.3 per cent in 2016/17 to 36.7 per cent in 2017/18, according to figures released by NHS Digital2.
£1.4m to fund digital projects for social care NHS Digital has awarded 18 councils a share of £1.4m to develop digital projects that support social care.
If you wish to discuss any queries you may have around social care please contact Stuart Marchant.
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