Health and Social Care Update - June 2020

The growing impact of the Coronavirus (COVID-19) is having an unprecedented generational impact on the health and wellbeing of society across the UK and around the world. The impact is being felt in our everyday lives and is now having far reaching consequences for everyone. If you or your organisation needs advice relating to Coronavirus, Bevan Brittan has set up a COVID-19 Advisory Service which draws upon the expertise of a range of Bevan Brittan legal and regulatory teams. Please feel free to contact us.

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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Training Events	Inquests
Acute and emergency care	Mental Health
Children/young people	Primary Care
Clinical Risk/Patient Safety	Providers
Commissioning	Public Health
Digital Health	Regulation
Employment/HR	Social Care
Finance	General

 

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 

Clinical Risk Webinars
Bevan Brittan Clinical Risk/Health, Care and Regulatory Law Team Training - These are internal hour long lunch time training sessions that are attended by our team of solicitors. If your employer organisation is a Bevan Brittan client you can sign up to watch the training sessions remotely via our webinar facility.

Webinars coming up in July are as follows:-

Thinking Resolution – 9 July 1pm- 1.30pm. This webinar will be presented by Paul Balen of Trust mediation. He will cover the following:-

• Preparing for mediation
• Mediating in the virtual world
• Involving the non legal participants
• Removing the barriers to settlement

If you would like to attend this webinar, please email Claire Bentley and ask for the link.

Pitfalls in Prison Medicine – 14 July 1pm - 1.30pm. This webinar session will be presented by Dr Jake Hard. Dr Hard is a GP who has over 13 years’ experience in his special interests in substance misuse and prison medicine. He is the Chair of the Royal College of GP’s Secure Environments Group and the Clinical Lead for the Health and Justice Information System (HJIS). He is a Clinical Reviewer and has assisted the Prison and Probation Ombudsman investigating Deaths in Custody in the investigation of over 15 deaths. As an Expert Witness he has provided nearly 400 reports pertaining to Clinical Negligence. He will cover the following:-

• Background and context of prison healthcare - how did we get here?
• Equivalence of care - what does this mean?
• The medico-legal consequences - complaints, inspections, investigations and inquests
• Case examples: Delays, Drugs and Death
• Questions

If you would like to attend this webinar, please email Claire Bentley and ask for the link.

Human Rights Act Claims – an update for clinical negligence practitioners. - 21 July 12.30pm - 1.30pm. Ed Bishop QC will give a brief summary of the background law relevant to clinical negligence claims and an update on recent case law/ other developments you need to know. If you would like to attend this webinar, please email Claire Bentley and ask for the link.

If you would like to receive the Education Lunch Programme for 2020 just ask Claire Bentley.  

Knowledge Transfer

Training. In addition to our free training programme for 2020, 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.  All these sessions are available remotely via our webinar facility.

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Acute and emergency care

Publications/Guidance 

Recovery position: what next for the NHS? This report, based on the first full survey of NHS trust leaders since Covid-19 started, sets out the scale of increased demand and the dramatic loss of capacity many trusts are now facing as the NHS juggles treating Covid-19 patients with restarting the full range of services. The report shows that, while trusts are restoring services as fast as they can, some trusts – particularly acute hospitals – believe this restoration will take more than six months.

Psychological first aid in emergencies training for frontline staff and volunteers Staff and volunteers at the forefront of the national coronavirus response across England will be able to access a new psychological first aid training course.

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

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Children and young people 

Publications/Guidance 

Coronavirus (COVID-19): guidance for children's social care services Advice about coronavirus (COVID-19) for local authorities and their partners to help support and protect vulnerable children.

COVID-19: guidance on supporting children and young people’s mental health and wellbeing Advice for parents and carers on looking after the mental health and wellbeing of children or young people during the coronavirus (COVID-19) outbreak.

Human Rights and the Government's response to COVID-19: The detention of young people who are autistic and/or have learning disabilities: Fifth Report of Session 2019-21 The Joint Committee on Human Rights finds that the coronavirus (COVID-19) crisis has resulted in human rights abuses for young people with autism or learning disabilities who have been detained. It argues their rights are at risk through unlawful blanket bans on visits, the suspension of routine inspections, increased use of restraint and solitary confinement, and the vulnerability of those in detention to infection with COVID-19. It concludes that protecting these young people is urgent and makes recommendations including ensuring parental visits are permitted, discharging as many young people as possible into the community, and a telephone hotline for reporting abuse.

Cancer x coronavirus: the impact on young people Young people with cancer are feeling further isolated. This report reveals that they are having difficulties accessing emotional and psychological support and are finding the isolation from friends and family, school or work hardest to manage.

Spotlight on adolescent health and well-being: findings from the 2017/2018 Health Behaviour in School-aged Children (HBSC) survey in Europe and Canada. Health Behaviour in School-aged Children (HBSC), a WHO collaborative cross-national study, has provided information about the health, wellbeing, social environment and health behaviour of 11-, 13- and 15-year-old boys and girls for more than 30 years. The 2017/2018 survey report presents data from more than 220,000 young people in 45 countries and regions in Europe and Canada. The data focuses on social context, health outcomes, and health and risk behaviours relevant to young people’s health and wellbeing. This report includes new items on electronic media communication and cyberbullying, and a revised measure on family meals. Additionally, measures of individual health complaints and underweight are also included for the first time in this international report. Volume one (key findings) Volume two (key data) World Health Organization.

Sexual and reproductive health return on investment tool This tool quantifies the costs and benefits associated with a range of sexual and reproductive health interventions. It focuses on young people (aged 15 to 24). It allows users to estimate the impact commissioning different services would have on population health and cost savings for local authorities, the NHS and wider government. The tool can be set to focus on the national level or in users’ local area (region, local authority or CCG).

NHS England has written to providers and commissioners regarding restoration of community health services for children and young people

Study launched to monitor prevalence of COVID-19 in schools The new voluntary coronavirus (COVID-19) study will assess and monitor the prevalence of COVID-19 among pre-school, primary and secondary school pupils and teachers.

Extended powers SEND tribunal: national trial Guidance for local authorities, health commissioners, parents and young people on a 2-year trial to extend powers of the SEND Tribunal. The trial was due to end on 31 August 2020. However, given the pressures local areas are under as a result of coronavirus (COVID-19), the trial was extended until 31 August 2021.    

Changes to the law on education, health and care needs assessments and plans due to coronavirus (COVID-19) Guidance on temporary changes to special educational needs and disability legislation during the coronavirus (COVID-19) outbreak.

Cases

[2020] EWCA Civ 763 RE S (VULNERABLE PARENT: INTERMEDIARY) (2020) A judge had erred in refusing an application in care proceedings concerning a child for an intermediary assessment and the appointment of an intermediary to support the child's mother, who had learning disabilities. The final hearing was to be conducted as a semi-remote, or hybrid, hearing because of the COVID-19 pandemic and the judge had failed to sufficiently address the additional factors to which such a hearing would give rise.

Bevan Brittan Updates

The safeguarding of children during the Covid-19 pandemic

How we can help

We can assist in relation to the statutory responsibilities for children under the Coronavirus Act 2020 including decisions around:-

• commissioning and the provision of healthcare and social care;
• isolation and duties toward children in the care and those classed as vulnerable under the Coronavirus ( COVID19 );
• guidance on vulnerable children and young people;
• the delivery of EHCP plans; 
• safeguarding; and,
• all aspects of educational provision including for key workers.

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

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Clinical Risk

Publications/Guidance 

Clinical Negligence Scheme for Coronavirus frequently asked questions. A useful page on the NHS Resolution website with Frequently Asked Questions.

NHS injury cost recovery scheme: April 2020 to March 2021 Data on the funds collected by the Compensation Recovery Unit and funds paid to the NHS.

Healthcare associated COVID-19 infections – further action. Letter to all NHS Trusts from NHS England regarding further action to reduce healthcare associated infections.

Coronavirus: health and social care key issues and sources. This Commons Library briefing paper provides an overview of key issues facing the NHS and social care services during the coronavirus (Covid-19) outbreak, and links to official UK and international guidance and data. It also lists other reliable sources of information in the health and social care sector, including comment from organisations representing patients, staff and service providers. First published on 7 April 2020, this briefing paper was last updated on 30 June 2020.

Cases

RS v MID YORKSHIRE HOSPITALS NHS TRUST (2020) The claimant, a 38-year old woman received £92,500 total damages following a ruptured appendix during pregnancy. She required emergency surgery and lost her baby and suffered a number of complications.

RH v JAMES PAGET UNIVERSITY HOSPITALS NHS FOUNDATION TRUST (2020) The claimant, a 27-year-old woman received £50,000 total damages following the stillbirth of her daughter in October 2016. The claimant suffered a persistent complex bereavement disorder resulting in low moods and anxiety and that disorder persisted until 2018.

DR v DONCASTER AND BASSETLAW TEACHING HOSPITALS NHS FOUNDATION TRUST (2020)  The claimant, a 38-year-old old woman, received £52,500 total damages for the failure to identify intrauterine growth restriction leading to the still birth of her child in December 2015. She suffered fatty liver disease, sepsis and multi-organ failure and a moderate recurrent depressive episode.

FR v BARTS HEALTH NHS TRUST (2020) The claimant, a 60-year-old old woman, received £217,000 total damages for the injuries she sustained as a result of a delay in carrying out emergency surgery in October 2013. She suffered an irreversible ischaemia of the small bowel, multi-organ failure, renal impairment, significant scarring and a psychiatric disorder.

AM v LEEDS TEACHING HOSPITALS NHS FOUNDATION TRUST (2019) The claimant, a 46-year-old old man, received £225,000 total damages for the failure to diagnose an Achilles tendon rupture in December 2013. He underwent tendon reconstruction, muscle and skin grafts, and suffered a severe adjustment disorder.

JF v NUFFIELD HEALTH (2020) The claimant, a 73-year-old old woman, received £27,000 total damages for the grade 4 pressure sore she sustained in November 2017 although liability was denied. She had undergone a knee replacement and as a result of the pressure sore her recovery was prolonged and she experienced altered sensation in her foot which might be permanent. Clinical Negligence: C, female, aged 71 at the date of the accident and 73 at the date of settlement developed a grade 4 pressure sore whilst attending the defendant private health company (D) for a knee replacement on 10 November 2017.

JH v ROYAL FREE LONDON HOSPITALS NHS FOUNDATION TRUST (2020) The claimant, a 33-year-old old man, received £175,000 total damages for the right facial palsy he suffered as a result of a reconstruction operation on his ear in February 2015, although liability was denied. He underwent a lateral tarsorrhaphy but remained unable to close his eye fully or raise his eyebrows or blink spontaneously and he experienced impaired visual performance.

KP v TAUNTON & SOMERSET NHS FOUNDATION TRUST (2020) The claimant, a 37-year-old old woman, received £200,000 total damages net of CRU for the failure to suspect impending/developing cauda equina syndrome in January 2016. She was left with foot weakness causing balance difficulties and permanent mild urinary incontinence.

News

Clinicians and GPs will soon be able to better identify patients who are at a higher risk of serious illness from SARS-CoV-2 infection based on a new data-driven risk prediction model, NHS Digital has announced. Led by Oxford University this new model could be applied in a variety of health and care settings, including supporting GPs and specialists in consultations with their patients to provide more targeted advice based on individual levels of risk.

Health expert advocates face masks in court Trish Greenhalgh, Professor of primary care health sciences at the University of Oxford has recommended that face coverings be worn in court - an environment she said was "risky" for transmitting the coronavirus (COVID-19). She was responding to Temple Garden Chambers barrister Ben Seifert, who contacted the Oxford Covid-19 Evidence Service. 

Women launch group action over mesh implants. More than 250 women left permanently injured by mesh implant surgery are to launch a group action against a group of pharmaceutical companies claiming negligence based on the lack of information given to patients prior to surgery. In 40 cases, the claimants are pursuing product liability claims over allegedly defective mesh products.

Royal Colleges appeal to select committee for 'urgent action' to make hospitals safe

Bevan Brittan Updates

Whittington Hospital NHS Trust v XX [2020] UKSC 14 – Progression over coherence?      

Bevan Brittan Webinars   

Bevan Brittan Clinical Risk/Health, Care and Regulatory Law Team Training - These are internal hour long lunch time training sessions that are attended by our team of solicitors. If your organisation is a Bevan Brittan client, you can sign up to watch the training sessions remotely via our webinar facility. If you would like to receive more information about our webinar programme just ask Claire Bentley. Sessions coming up in July are as follows:-

Thinking Resolution – 9 July 1pm- 1.30pm. This webinar will be presented by Paul Balen of Trust mediation. He will cover the following:-

• Preparing for mediation
• Mediating in the virtual world
• Involving the non legal participants
• Removing the barriers to settlement

If you would like to attend this webinar, please email Claire Bentley and ask for the link.

Pitfalls in Prison Medicine – 14 July 1pm - 1.30pm. This FREE webinar session will be presented by Dr Jake Hard. Dr Hard is a GP who has over 13 years’ experience in his special interests in substance misuse and prison medicine. He is the Chair of the Royal College of GP’s Secure Environments Group and the Clinical Lead for the Health and Justice Information System (HJIS). He is a Clinical Reviewer and has assisted the Prison and Probation Ombudsman investigating Deaths in Custody in the investigation of over 15 deaths. As an Expert Witness he has provided nearly 400 reports pertaining to Clinical Negligence. He will cover the following:-

• Background and context of prison healthcare - how did we get here?
• Equivalence of care - what does this mean?
• The medico-legal consequences - complaints, inspections, investigations and inquests
• Case examples: Delays, Drugs and Death
• Questions

If you would like to attend this webinar, please email Claire Bentley  and ask for the link.

Human Rights Act Claims – an update for clinical negligence practitioners. - 21 July 12.30pm - 1.30pm. Ed Bishop QC will give a brief summary of the background law relevant to clinical negligence claims and an update on recent case law/ other developments you need to know. If you would like to attend this webinar, please email Claire Bentley and ask for the link.

If you would like to receive the Education Lunch Programme for 2020 just ask Claire Bentley. 

How we can help

We are working with clients on formulating policies and making it easier to balance treatment with finite resources. We are helping with social care policies and day to day activities such as contact and isolation, human rights issues and life/death decisions. We are working on notifications of harm and death, RIDDOR, CQC compliance, judicial review, infection control law and grappling with the new regulations and guidance. For more information click here.

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

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Commissioning

Publications / guidance

Sexual and reproductive health return on investment tool This tool quantifies the costs and benefits associated with a range of sexual and reproductive health interventions. It focuses on young people (aged 15 to 24). It allows users to estimate the impact commissioning different services would have on population health and cost savings for local authorities, the NHS and wider government. The tool can be set to focus on the national level or in users’ local area (region, local authority or CCG).

NHS England has written to providers and commissioners regarding restoration of community health services for children and young people.

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

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Digital Health

News

Landmark IT deal will provide access to digital tools and save hundreds of millions of pounds for the NHS An agreement struck between NHSX, NHS Digital and Microsoft will save the NHS hundreds of millions of pounds and enable all eligible organisations in England to access Microsoft 365 digital tools.

How we can help

Our Digital Health legal and regulatory team are experts in supporting clients in the delivery of new technology within health and social care. We understand the need to work in partnerships and across health and social care systems and are able to provide a one-stop, integrated Digital Health advice service drawing upon expertise across the firm’s Corporate, Commercial, Employment, Regulatory and Clinical Risk teams. Whether you want to ‘move fast and break things’ or ‘do no harm’, our lawyers have the agility to look at problems from different perspectives and offer expert commercial and regulatory support to help you succeed in your ventures.

If you wish to discuss any queries you may have around Digital Health please contact Daniel Morris.

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Employment/HR  

Publications/guidance

Psychological first aid in emergencies training for frontline staff and volunteers Staff and volunteers at the forefront of the national coronavirus response across England will be able to access a new psychological first aid training course.

Coronavirus (COVID-19): looking after people who lack mental capacity Guidance for health and social care staff who are caring for, or treating, a person who lacks the relevant mental capacity.

Health and care video library available free As part of the response to COVID-19, NHSX has secured a 6 month national licence for NHS clinicians to access a health and care video library of over 600 patient information videos free of charge.

What has Covid-19 taught us about supporting workforce mental health and wellbeing? The Covid-19 outbreak has exposed gaps in psychosocial support for health care workers. Mary Docherty, Consultant Liaison Psychiatrist at King’s College Hospital NHS Foundation Trust London, considers the action needed to address those gaps and meet the needs of the workforce in future.

Resource pack to help doctors in Foundation training Health Education England has worked with partners to produce a pack of new resources aimed at easing student doctors into Foundation training and supporting them during the programme. The pack, launched on June 25, contains information and guidance which will help new doctors as they start their training in August, as well as those currently in the Foundation Training programme.

Briefing Paper - Coronavirus: Overseas health and social care workforce.  A House of Commons Library briefing paper considers the impact of the coronavirus (COVID-19) pandemic on the overseas health and social care workforce. It discusses the measures used to increase numbers of overseas staff during the pandemic, the immigration measures introduced for health and social care workers, and the potential implications for overseas recruitment.

COVID-19: management of staff and exposed patients and residents in health and social care settings Guidance on the management of staff, patients and residents who have been exposed to COVID-19.

News

Incoming HEE chief: ‘White leaders under pressure’ to prove black lives matter.

COVID 19 – GMC confirms revalidation date changes   

Survey of doctors reveals high levels of exhaustion, stress and little confidence to manage the huge backlog of missed patient care.

BAME doctors being placed at risk due to lack of Covid-19 risk assessments, BMA survey reveals.

BMA survey reveals GPs are taking on overflowing secondary care work during pandemic

Bevan Brittan Updates

Coronavirus Job Retention Scheme - Changes from 1 July 2020 and Flexible Furlough

How we can help

We can offer support and advice on managing many workforce issues including furlough leave, managing bank staff, vulnerable groups, sick pay, leave options, supporting staff well-being, presenteeism, remote and home working, lay-offs/short term working through FAQs, helpline or policy guidance and practical day to day advice. 

If you wish to discuss any employment issues generally please contact Jodie Sinclair, Alastair Currie or James Gutteridge.

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Finance 

Publications/Guidance

Coronavirus and the economic value of human life or ... Is the lockdown worth it? This briefing examines the ongoing argument about easing or ending the lockdown restrictions and considers numerous factors that will affect government decisions. It emphasises the importance of putting a monetary value on life as a tool to make cost-benefit analyses about the effectiveness of lockdown and makes clear that while people may feel squeamish about looking at human life in financial terms, such calculations are necessary to make the most of limited resources in the fairest and most effective way.

E-guide for financing health promoting services Covid-19, as well as other diseases, require serious investments in prevention and health promotion. This e-guide illustrates a spectrum of approaches to mobilise resources to finance the delivery of such health-promoting services that benefit health and wellbeing for all.

The outlook for the public finances under the long shadow of Covid-19 This report outlines how the Covid-19 outbreak – and the public health response to it – will dramatically reduce economic activity in the second quarter of 2020. This in turn will depress tax receipts and add to government spending, increasing government borrowing and in turn adding to government debt. This report sets out three scenarios for the outlook for growth over the next five years and describes what in turn these might mean for government borrowing and government debt.

The financial risk and resilience of English local authorities in the coronavirus crisis The government has provided an additional £3.2 billion of general-purpose funding to English councils to help support them through the coronavirus (Covid-19) crisis. This will increase their budgets by just over five per cent on average. But councils have warned a further £6 billion could be required. This report examines how financial risks and resilience vary across councils, and which types of councils and regions are most exposed. It is published alongside a spreadsheet dashboard that collates for each local authority in England a series of indicators of coronavirus-related risks.

NHS entitlements: migrant health guide. Advice and guidance for healthcare practitioners on the health needs of migrant patients.

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

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Inquests  

Publications/guidance

CQC publishes data on deaths in care settings broken down by ethnicity. The information that care homes submit to CQC about the deaths of people in their care is published on a weekly basis as part of the Office for National Statistics (ONS) reporting on deaths. The ONS data is not routinely broken down by ethnicity.

Steps to take following the death of a person who worked in adult social care in England. Department of Health and Social Care guidance sets out actions for local authorities and social care providers following a coronavirus (COVID-19) related death of an employee or volunteer in adult social care. It includes advice on: informing the family and others at work; reporting to the Health and Safety Executive (HSE); informing the Department of Health and Social Care (DHSC), informing the Care Quality Commission (CQC) if applicable; and supporting the family's coronavirus life assurance scheme application.

Guidance from the Chief Coroner No 38. Remote participation in coronial proceedings via video and audio broadcast. This note is to give guidance to coroners about conducting hearings with participants accessing the hearing remotely whilst the coroner is physically present in court.

Guidance from the Chief Coroner No 39 Recovery from the COVID-19 pandemic. This note seeks to assist all coroners in addressing the process of concluding those inquests required to be held that were in train as of 23 March 2020 as well as managing all new cases that have come in since.

Cases

Re Rushbrooke's Death Inquest. [2020] EWHC 1612 (Admin) 2020 WL 03439117 The court quashed a determination made at an inquest into the death of a woman with dementia. There had been a number of procedural irregularities in relation to the inquest and a number of investigations conducted by the coroner had been insufficient. It was clearly necessary and desirable in the interests of justice for a fresh inquest and investigation to take place. 

R. (on the application of Maguire) v HM Senior Coroner for Blackpool and Fylde. [2020] EWCA Civ 738. ECHR art.2 was not engaged in a case concerning the death of a woman who had Down's syndrome and learning disabilities and had been living in a care home pursuant to a standard authorisation granted under the Mental Capacity Act 2005 Sch.A1. The state's obligations under art.2 were not triggered by the mere fact of her vulnerability and deprivation of liberty.

Bevan Brittan Updates

Case Summary: R (Maguire) v HM Senior Coroner for Blackpool Fylde [2020] EWCA Civ 738 

If you  wish to discuss any queries you may have around inquests please contact Toby De Mellow.

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Mental Health 

Publications/guidance 

Coronavirus (COVID-19): looking after people who lack mental capacity. Guidance for health and social care staff who are caring for, or treating, a person who lacks the relevant mental capacity.

COVID-19 Insight: Issue 2 - This CQC report highlights the coronavirus-related pressures faced by the services they regulate. It looks at:
• how providers are working together across systems in response to coronavirus
• how care for people from different groups is being managed, including people with a learning disability, people detained under the Mental Health Act (MHA) and people from black and minority ethnic groups within social care settings
• the changing face of GP and online primary care services
Finally, the report contains updated graphs and maps, as well as additional key pieces of data. The data in the report includes numbers of outbreaks in care homes, availability of personal protective equipment (PPE) in homecare services, numbers of deaths of people in care homes, people detained under the MHA and people with a learning disability, and the proportion of deaths in social care services due to coronavirus by ethnic group.

COVID-19: guidance on supporting children and young people’s mental health and wellbeing Advice for parents and carers on looking after the mental health and wellbeing of children or young people during the coronavirus (COVID-19) outbreak.

Covid-19: understanding inequalities in mental health during the pandemic This briefing paper, supported by 13 other national mental health charities, explores the mental health inequalities that are associated with the pandemic in the UK. It finds that the virus and the lockdown are putting greater pressure on groups and communities whose mental health was already poorer and more precarious.

The mental health effects of the first two months of lockdown and social distancing during the Covid-19 pandemic in the UK This report discusses the impact of Covid-19 on mental health. It finds that mental health in the UK has worsened substantially as a result of the Covid-19 pandemic, particularly for groups that already had lower levels of mental health before Covid-19, such as young adults and women.

Human Rights and the Government's response to COVID-19: The detention of young people who are autistic and/or have learning disabilities: Fifth Report of Session 2019-21 The Joint Committee on Human Rights finds that the coronavirus (COVID-19) crisis has resulted in human rights abuses for young people with autism or learning disabilities who have been detained. It argues their rights are at risk through unlawful blanket bans on visits, the suspension of routine inspections, increased use of restraint and solitary confinement, and the vulnerability of those in detention to infection with COVID-19. It concludes that protecting these young people is urgent and makes recommendations including ensuring parental visits are permitted, discharging as many young people as possible into the community, and a telephone hotline for reporting abuse.

Coronavirus (COVID-19): looking after people who lack mental capacity Guidance for health and social care staff who are caring for, or treating, a person who lacks the relevant mental capacity.

Learning Disability House of Commons Library briefing on policies and services for people with a learning disability in England.

The mental health effects of the first two months of lockdown and social distancing during the Covid-19 pandemic in the UK. This report discusses the impact of Covid-19 on mental health. It finds that mental health in the UK has worsened substantially as a result of the Covid-19 pandemic, particularly for groups that already had lower levels of mental health before Covid-19, such as young adults and women.

Premature discharge from hospital This is a report of a qualitative survey that explored unsafe, premature discharge from hospital. It shows how serious the consequences can be of discharging someone from hospital who is not ready to go home. Particular themes emerge around pressures on beds, and how premature discharge of people from mental health settings can quickly lead them to harm. 

News

Councils told not to prioritise preparations for Liberty Protection Safeguards 

Bevan Brittan Updates

Case Summary: Barnsley Hospital NHS Foundation Trust v MSP [2020] EWCOP 26

Case Summary: R (Maguire) v HM Senior Coroner for Blackpool Fylde [2020] EWCA Civ 738 

NHS Guidance: mental health, learning disability, autism and specialised commissioning services under the MHA and ‘supporting systems’ in COVID-19

Bevan Brittan Education Lunches 

These are internal hour long lunch time training sessions that are attended by our team of solicitors. If your organisation is a Bevan Brittan client you can sign up to watch the training sessions remotely via our webinar facility. Please contact Claire Bentley if you would like to attend any of our webinars remotely/would like to receive our education lunch programme for 2020. 

If you wish to discuss any mental health issues please contact Hannah Taylor, Simon Lindsay or Stuart Marchant. 

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Primary Care  

Publications/guidance

COVID-19 Insight: Issue 2 - This CQC report highlights the coronavirus-related pressures faced by the services they regulate. It looks at:
• how providers are working together across systems in response to coronavirus
• how care for people from different groups is being managed, including people with a learning disability, people detained under the Mental Health Act (MHA) and people from black and minority ethnic groups within social care settings
• the changing face of GP and online primary care services
Finally, the report contains updated graphs and maps, as well as additional key pieces of data. The data in the report includes numbers of outbreaks in care homes, availability of personal protective equipment (PPE) in homecare services, numbers of deaths of people in care homes, people detained under the MHA and people with a learning disability, and the proportion of deaths in social care services due to coronavirus by ethnic group.

GP Standard Operating Procedure. NHS England has added two new sections to the GP Standard Operating Procedure. The updated sections are on:
1. Outbreak management in the context of COVID-19 – with a recommendation to review business continuity plans. 2. Suspected or diagnosed cancers, including ongoing cancer treatment – information on referral into secondary care.

Pulse oximetry to detect early deterioration of patients with COVID-19 in primary and community care settings. This document sets out principles to support the remote monitoring, using pulse oximetry, of patients with confirmed or possible COVID-19.

News

Clinicians and GPs will soon be able to better identify patients who are at a higher risk of serious illness from SARS-CoV-2 infection based on a new data-driven risk prediction model, NHS Digital has announced. Led by Oxford University this new model could be applied in a variety of health and care settings, including supporting GPs and specialists in consultations with their patients to provide more targeted advice based on individual levels of risk.

BMA statement on remote working and consultations for GPs saying this should be the default. 

Bevan Brittan Updates

Remote consultations and assessments in the time of Covid-19

Bevan Brittan Events

Pitfalls in Prison Medicine – 14 July 1pm - 1.30pm. This FREE webinar session will be presented by Dr Jake Hard. Dr Hard is a GP who has over 13 years’ experience in his special interests in substance misuse and prison medicine. He is the Chair of the Royal College of GP’s Secure Environments Group and the Clinical Lead for the Health and Justice Information System (HJIS). He is a Clinical Reviewer and has assisted the Prison and Probation Ombudsman investigating Deaths in Custody in the investigation of over 15 deaths. As an Expert Witness he has provided nearly 400 reports pertaining to Clinical Negligence. He will cover the following:-

• Background and context of prison healthcare - how did we get here?
• Equivalence of care - what does this mean?
• The medico-legal consequences - complaints, inspections, investigations and inquests
• Case examples: Delays, Drugs and Death
• Questions

If you would like to attend this webinar, please email Claire Bentley and ask for the link.

How we can help   

We can offer support and advice on managing contractual and operational issues affecting the delivery of primary care services, including emerging legislative changes, updated guidance and policy arrangements, workforce issues and any transactional – related matters relating to vertical integrations, STPs, PCNs, etc. If you wish to discuss any commercial, corporate or regulatory issues in primary care then please contact Vincent Buscemi.

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Providers 

Publications/Guidance  

Innovation and inspiration: examples of how providers are responding to coronavirus (COVID-19). The CQC asked providers to send through examples of changes they made.  The response was overwhelming, particularly from adult social care services.

Adult social care data and cyber security programme report 2019-20 This report summarises learning from the programme, identifies the key risks faced by provider services, and the extent to which recommendations in the 2018/19 programme report have been implemented.    

PPE portal: how to order emergency personal protective equipment Healthcare providers can order additional personal protective equipment (PPE) through the portal to top up their existing supplies for COVID-19 in an emergency.    

NHS England has written to providers and commissioners regarding restoration of community health services for children and young people.

Bevan Brittan Updates

Uncertainty ahead for care providers

If you wish to discuss any queries you may have around providers please contact Vincent Buscemi.  

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Public Health 

Publications/guidance

COVID-19: background information. Information on COVID-19 including epidemiology, virology and clinical features.

COVID-19: guidance for the public on mental health and wellbeing Advice and information on how to look after your mental health and wellbeing during the coronavirus (COVID-19) outbreak.

Life after lockdown: tackling loneliness The Covid-19 crisis has made loneliness worse, with some people more affected than others. This report shows that although social distancing and lockdown measures will continue to be eased, loneliness will remain and for those most left behind, it may continue to grow.

Public health on the frontline: responding to Covid-19 In this series of interviews, directors of public health from across the country talk about the local response to Covid-19.

COVID-19: Guidance on use of face masks Public Health England has published recommendations, based on evidence presented to the Scientific Advisory Group for Emergencies, for hospital settings including use of face coverings for those visiting hospitals and face masks for staff when in non-clinical areas.

The geography of the Covid-19 crisis in England This report analyses how the health, economic and social impacts of Covid-19 vary around England. It explores which local authorities (LAs) have residents who are more vulnerable to severe Covid-19 symptoms because of their age or pre-existing conditions; which LAs have a greater share of workers in shut-down sectors such as retail or hospitality; and which LAs have a greater share of children either eligible for free school meals or receiving children’s social services, who might be at particular educational or social risk from the crisis.

Beyond the data: understanding the impact of Covid-19 on BAME groups This report is a descriptive summary of stakeholder insights into the factors that may be influencing the impact of Covid-19 on BAME communities and strategies for addressing inequalities. The report summarises requests for action, which have been used to inform a number of recommendations. It also includes a rapid literature review. These insights will form the basis of the next steps being taken forward by the Equalities Minister.

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

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Regulation  

Publications/Guidance 

COVID-19 Insight: Issue 2 - This CQC report highlights the coronavirus-related pressures faced by the services they regulate. It looks at:
• how providers are working together across systems in response to coronavirus
• how care for people from different groups is being managed, including people with a learning disability, people detained under the Mental Health Act (MHA) and people from black and minority ethnic groups within social care settings
• the changing face of GP and online primary care services
Finally, the report contains updated graphs and maps, as well as additional key pieces of data. The data in the report includes numbers of outbreaks in care homes, availability of personal protective equipment (PPE) in homecare services, numbers of deaths of people in care homes, people detained under the MHA and people with a learning disability, and the proportion of deaths in social care services due to coronavirus by ethnic group.

Innovation and inspiration: examples of how providers are responding to coronavirus (COVID-19). The CQC asked providers to send through examples of changes they made.  The response was overwhelming, particularly from adult social care services.

CQC publishes data on deaths in care settings broken down by ethnicity. The information that care homes submit to CQC about the deaths of people in their care is published on a weekly basis as part of the Office for National Statistics (ONS) reporting on deaths. The ONS data is not routinely broken down by ethnicity.          

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

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Social Care  

Publications/Guidance 

Innovation and inspiration: examples of how providers are responding to coronavirus (COVID-19). The CQC asked providers to send through examples of changes they made.  The response was overwhelming, particularly from adult social care services. 

Adult social care data and cyber security programme report 2019-20 This report summarises learning from the programme, identifies the key risks faced by provider services, and the extent to which recommendations in the 2018/19 programme report have been implemented.    

Ordinary residence: anonymised determinations 2020. How the department resolves disputes in the health and social care sector when 2 or more local authorities cannot agree responsibility for meeting a person’s eligible needs.

Coronavirus (COVID-19): providing home care. Information for those providing personal care to people living in their own home during the coronavirus outbreak

ADASS budget survey 2020 The annual ADASS budget survey has been split into two reports this year. The first report considered the impact upon those who are older or disabled, who have care and support needs, and their families. This second report reveals the scale of the financial impact of the pandemic and its very real consequences on the care and support of millions of people, the ability of local authorities to fund adult care, and the very viability of thousands of caring organisations that provide vital support.

Coronavirus (COVID-19): reducing risk in adult social care A framework for how adult social care employers should assess and reduce risk to their workforce during the coronavirus pandemic.

Coronavirus (COVID-19): admission and care of people in care homes How to protect care home residents and staff during the coronavirus outbreak. This document has been updated throughout in line with the care homes support package announced on 15 May and the latest advice on testing, and infection prevention and control. The changes are set out in full in the document.

Steps to take following the death of a person who worked in adult social care in England. Department of Health and Social Care guidance sets out actions for local authorities and social care providers following a coronavirus (COVID-19) related death of an employee or volunteer in adult social care. It includes advice on: informing the family and others at work; reporting to the Health and Safety Executive (HSE); informing the Department of Health and Social Care (DHSC), informing the Care Quality Commission (CQC) if applicable; and supporting the family's coronavirus life assurance scheme application.

Readying the NHS and adult social care in England for COVID-19 This report is the second in a programme of work by the National Audit Office to support Parliament’s scrutiny of the UK government’s response to COVID-19. It sets out the facts about government’s progress in preparing the NHS and social care for the COVID-19 outbreak, discussing: a.actions set out in the 17 March letter to the NHS, and the 15 April action plan for adult social care. It also describes what is currently known about additional funding for health and adult social care; b.actions taken at a national level by those responsible for coordinating health, adult social care and local government in England; and c.the period from the start of the outbreak to at least the end of April, when the government announced that the UK was “past the peak”. Depending on the data available at the time of writing, we have provided information up to mid-May.

Carers Week 2020 research report: the rise in the number of unpaid carers during the coronavirus (Covid-19) outbreak The six Carers Week charities – Carers UK, Age UK, Carers Trust, Motor Neurone Disease Association, Oxfam GB and Rethink Mental Illness – have published research based on polling carried out by YouGov in May 2020 of 4,557 people over the age of 18 living in the UK. The figures show an estimated 4.5 million people in the UK have become unpaid carers as a result of the Covid-19 pandemic. This is on top of the 9.1 million unpaid carers who were already caring before the outbreak, bringing the total to 13.6 million. 2.7 million women (59 per cent) and 1.8 million men (41 per cent) have started caring for relatives who are older, disabled or living with a physical or mental illness.

Readying the NHS and adult social care in England for Covid-19 This report is the second in a programme of work by the National Audit Office to support parliament’s scrutiny of the UK government’s response to Covid-19. It sets out the facts about the government’s progress in preparing the NHS and social care for the Covid-19 outbreak. 

Coronavirus (COVID-19): reducing risk in adult social care A framework for how adult social care employers should assess and reduce risk to their workforce during the coronavirus pandemic.

News

Thousands to be offered repeat testing in care homes Approximately 10,000 people in care homes will be given repeat testing as part of a new government study into coronavirus to understand more about its spread in these settings. 

'Lessons must be learnt' as ONS reveal tragic death toll among care staff Suzie Bailey, Director of Leadership and Organisational Development at The King’s Fund, comments on the latest ONS figures on Covid-19 deaths by occupation.

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

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General 

Publications/Guidance  

Rebuilding the NHS – RCP priorities for the resetting of services The RCP has set out its nine key priorities for the resetting and rebuilding of NHS services, now that the initial COVID-19 peak has passed.

Coronavirus (Covid-19): Information and advice

Tackling UK's mortality problem: Covid-19 and other causes The number of UK deaths from Covid-19 is among the highest reported internationally, second only to the United States. This comes on the heels of the historical legacy of stalling improvements in life expectancy in the United Kingdom. Veena Raleigh argues that if the United Kingdom’s mortality problem is to improve, then we need to understand the driving factors.

COVID-19 and the NHS Customer Environment. A report examining how covid-19 has changed the NHS, what aspects of treatment are challenging, what plans remain in place, what developments are likely, and which aspects of transformation are accelerating.      

‘Independent review of NHS’ ahead of second wave. There should be independent reviews of the NHS’ readiness for a potential second major outbreak of coronavirus in the UK, senior doctors are arguing.

Health Secretary calls on country to get tested as access is expanded even further.  Six new "walk through" local testing sites are now offering appointments for coronavirus tests to people in England, with the capacity to test hundreds of people without cars each day. These sites will continue to be expanded where there is demand from local communities. 

If you wish to discuss any queries around this general topic please contact Claire Bentley.

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