03/12/2021
Bevan Brittan provides high quality, comprehensive advice to the NHS, independent healthcare sector and local authorities. 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, independent sector and local authorities which have been published in the last month.
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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. You can sign up to watch the training sessions remotely via our webinar facility. Please contact Claire Bentley.
Employment Law Update 8 December 2021
HSIB and its role in patient safety in England. Kathryn Whitehill (Principal National Investigator at HSIB) will give a broad overview of the HSIB including their investigations, reports/recommendations and maternity programme. 14 December 2021
Clinical Negligence and the Emergency Department A review of some major issues relating to Emergency Medicine practice and clinical negligence law.25 January 2022
Please note that registration for each webinar will close when the webinar starts, so please do ensure you have booked your place in advance to guarantee attendance
If someone forwarded you this email, you can sign up for your own free monthly copy here delivered directly to your inbox.
Acute and emergency care
Publications/guidance
Nowhere else to turn: exploring high intensity use of accident and emergency services. People who frequently attend accident and emergency make up less than 1 per cent of the population, but account for a significant proportion of all A&E attendances, ambulance journeys and hospital admissions. It is estimated they cost the NHS at least £2.5 billion per year. This report explores the profile and experiences of people who frequently attend A&E and considers what needs to be done to ensure that more people can be supported in the community, before they reach a crisis that leads to the door of the emergency department. It shows the clear link between high intensity use and wider inequalities.
Crowding and its consequences Against the backdrop of long ambulance delays experienced across the United Kingdom, high levels of crowding in emergency departments, and record-breaking numbers of patients experiencing the longest waits, this report examines crowding and its consequences. It finds that at least 4,519 patients have died as a result of crowding and 12 hour stays in EDs in England in 2020-2021. The report urges governments, NHS England and devolved equivalents, integrated care systems, and trusts to take a system-wide approach to tackling the problem.
Have integrated care programmes reduced emergency admissions? Understanding evidence from earlier integrated health and social care policy initiatives can provide important lessons to inform the development of integrated care systems in this latest round of NHS reform – including expectations for what they can deliver, and by when. The Improvement Analytics Unit examined four of its own long-term evaluations of the impact of the recent vanguard programmes on emergency hospital use, looking at impacts over 4.5–6 years. This long read summarises the key findings from these evaluations and the implications for newly established ICSs.
Delayed hospital handovers: impact assessment of patient harm This report, based on a structured clinical review of handover delays at hospital emergency departments across England, finds that the proportion of patients who could be experiencing unacceptable levels of preventable harm is significant. More than eight in 10 of those whose ‘handover’ (from ambulance clinician to hospital clinician) was delayed beyond 60 minutes were assessed as having potentially experienced some level of harm; 53 per cent low harm, 23 per cent moderate harm and 9 per cent (one patient in 10) could have been said to have experienced severe harm.
No-one's listening. This inquiry, led by Rt Hon Pat McFadden MP, Chair of the APPG on Sickle Cell and Thalassaemia, has found “serious care failings” in acute services and evidence of attitudes underpinned by racism.
Bevan Brittan Events
Clinical Negligence and the Emergency Department A review of some major issues relating to Emergency Medicine practice and clinical negligence law. 25 January 2022
If you wish to discuss any queries you may have around acute and emergency issues please contact Claire Bentley.
Children and young people
Publications/Guidance
Transfer guidance under Mental Health Act 1983 for children detained on youth justice and welfare grounds. These good practice guidance documents set out the procedure in the children and young people secure estate for the referral for assessment, and transfer to and from mental health inpatient services under the Mental Health Act 1983. These documents are for all practitioners working in the children and young people secure estate who have a role in ensuring a smooth referral for assessment and transfer to and from mental health inpatient services.
The state of the world's children 2021.This report finds that children and young people could feel the impact of Covid-19 on their mental health and wellbeing for many years to come.
Bevan Brittan Updates
Unaccompanied Asylum Seeking Children: Local Authority Care and Support Jane Bennett
High Court upholds strikeout of allegations that social services should have removed children from harm Adrian Neale
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 or Ruth Shedlow
Clinical Risk / Patient Safety
Publications/Guidance
Child and maternal health data and intelligence: guide for health professionals Information to help healthcare professionals make decisions about the planning and provision of services using child and maternal health data and intelligence.
2021 Scorecards launch. The scorecards play a pivotal role in allowing NHS trusts and independent sector providers to review their up-to-date claims record. Such reviews can then be used to target interventions to improve patient safety. As an interactive tool in an excel format, the scorecards are easily accessible.
Maternity Incentive Scheme. The Maternity Safety Strategy set out the Department of Health and Social Care’s ambition to reward those who have taken action to improve maternity safety. NHS Resolution want to support this work through the Maternity Incentive Scheme.
Mind the gap: an investigation into maternity training for frontline professionals across the UK 2020/21 This report, compiled from data received from freedom of information requests submitted to NHS trusts, examines the ongoing training actually delivered to maternity professionals. It once again shows there is not sufficient ongoing training and that NHS trusts are delivering less training today – and are spending less on it – than they were in 2017/18. Baby Lifeline is urging the government to commit funding to address the issues that this report highlights, in particular to ensure the correct level of training is delivered and that the staffing is in place to allow for that training.
Surgical care of NHS patients in independent hospitals This report shows that successful collaborations between NHS hospitals and independent hospitals help to protect patients when providing shared care. It is HSIB's first investigation into NHS-funded care in the independent sector and focuses on surgical care of patients.
Saving lives, improving mothers’ care: lessons learned to inform maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2017-19 This report finds that pregnancy remains safe in the UK, with the overall maternal death rate showing a slight decrease. Among 2,173,810 women who gave birth in 2017-2019, 191 died during or up to six weeks after pregnancy, and 495 during or up to one year after their pregnancy. However, the findings show a continued inequality in the mortality rates for women of different ethnic backgrounds, ages and socio-economic circumstances.
New Information Standard aims to reduce medication errors and improve patient safety NHS Digital has published a new Information Standard to support improved medication and allergy/intolerance information sharing across healthcare services in England. It will enable the transfer of prescription information across health and care settings to help reduce medicines related errors and improve patient safety. NHS and social care organisations will need to be compliant with the standard by 31 March 2023.
Health and Social Care Select Committee inquiry into NHS litigation reform - Evidence from the Association of Personal Injury Lawyers. The response of the Association of Personal Injury Lawyers (APIL) to the Health and Social Care Select Committee inquiry into NHS litigation reform states that clear leadership and a coherent strategy are needed urgently if the patient safety crisis is to be resolved.
News
NHS Resolution sat down with Nicole Mottolini, their Safety & Learning Clinical Fellow for patients with diabetes & lower limb complications, to talk about her work & commitment to improving outcomes for patients.
£5k NHS compensation fraud lands claimant with 7 month custodial sentence.
CQC prosecutes the Dudley Group NHS Foundation Trust following two patient deaths. The Dudley Group NHS Foundation Trust has been fined over £2.5 million by the Care Quality Commission (CQC) after pleading guilty to failing to provide safe care and treatment to two patients, causing them avoidable harm, following a sentencing hearing on 19 November 2021 at Wolverhampton Magistrates' Court, the highest fine handed to such a body after prosecution by the health watchdog. The trust admitted two breaches of the Health and Social Care Act 2001 for failings that included its management of patients at risk of developing sepsis, which was not diagnosed and treated in accordance with national standards.
Spina bifida showjumper Evie Toombes sues mother’s GP over her birth.
£3 million more to reduce brain injuries at birth.
Court makes £50,000 costs order against medical expert for “flagrant disregard” of duties.
Bevan Brittan Updates
Fundamental dishonesty in Elgamal v Westminster City Council - Adrian Neale
Bevan Brittan Events
HSIB and its role in patient safety in England. 14 December 2021 Kathryn Whitehill (Principal National Investigator at HSIB) will give a broad overview of the HSIB including their investigations, reports/recommendations and maternity programme. To register for this session click here.
Clinical Negligence and the Emergency Department A review of some major issues relating to Emergency Medicine practice and clinical negligence law. 25 January 2022
Bevan Brittan Updates
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 Joanne Easterbrook, Tim Hodgetts or Joanna Lloyd.
Digital Health
Publications/guidance
Fit for the future: what can the NHS learn about digital health care from other European countries? The rapid increase in the use of technology during the Covid-19 pandemic has shown that digital health technology will be a fundamental part of health system recovery and for preparing for the future. This report examines the approach that five European countries have taken to implementing digital technology and draws out learnings for the NHS.
Putting data, digital and tech at the heart of transforming the NHS This review sets out nine recommendations, which the Secretary of State has confirmed he will accept in full. It argues for a shift in culture, operating model, skills, capabilities and processes to put data, digital and technology at the heart of how we transform health services. It recognises progress made by NHS Digital and NHSX during the past two years of the pandemic.
Cyber and data security services and resources In order to help health care service staff better understand the extent of current security threats, NHS Digital has relaunched a new cyber security awareness toolkit. This toolkit is free and aims to help NHS trusts and health care organisations to easily adopt new and safer ways of working.
New Information Standard aims to reduce medication errors and improve patient safety A new Information Standard has been published by NHS Digital to support improved medication and allergy/intolerance information sharing across healthcare services in England.
News
Practitioner Performance Advice launches a range of digital resources.
Major reforms to NHS workforce planning and tech agenda Recruitment, training and retention of NHS staff and digital transformation will be put at the heart of the NHS in England, under new reforms announced by the Secretary of State for Health and Social Care. The plans will aim to see more patients benefit from the best possible care, with the right staff in place to meet patients' needs. The changes will better support the recovery of NHS services, address waiting list backlogs, and support hardworking staff, all while driving forwards an ambitious agenda of digital transformation and progress.
If you wish to discuss any queries you may have around Digital Health please contact Daniel Morris.
Employment/HR
Publications/guidance
Vaccination as a condition of deployment (VCOD) for healthcare workers: Phase 1 - Planning and preparation. The purpose of this letter and guidance is to support providers in preparing and planning for when the regulations (which are subject to parliamentary passage) are introduced. These documents include supporting material to provide further clarity and confirmation of which individuals are in scope of the regulations and those which are exempt, and guidance on increasing vaccination uptake; including among groups where uptake is lower.
Attracting, supporting and retaining a diverse NHS workforce This report, commissioned by NHS Employers, examines the representation of under-served groups and provide a set of recommendations for change as the NHS strives to become an exemplar of equality, diversity and inclusion.
Winter 2021 preparedness: nursing and midwifery safer staffing Trust board members are collectively responsible for workforce planning, practice and safeguards. The following actions focus on preparedness, decision making and escalation processes to support safer nursing and midwifery staffing as the winter period approaches.
Team reviews retrospective. This publication looks at key themes and data from the reviews completed between November 2016 and March 2021. It is intended to share information about team dysfunction and the adverse consequences that can arise from it, as well as the experience of NHS Resolution of what helps to enact positive change.
Mind the gap: an investigation into maternity training for frontline professionals across the UK 2020/21 This report, compiled from data received from freedom of information requests submitted to NHS trusts, examines the ongoing training actually delivered to maternity professionals. It once again shows there is not sufficient ongoing training and that NHS trusts are delivering less training today – and are spending less on it – than they were in 2017/18. Baby Lifeline is urging the government to commit funding to address the issues that this report highlights, in particular to ensure the correct level of training is delivered and that the staffing is in place to allow for that training.
Raising concerns. The GOC have produced this guidance to help our registrants in situations where they need to consider the professional requirement to speak up when patient or public safety may be at risk.
Working harder than ever to support patients and communities: examples from across the NHS Amid unrelenting pressures, staff are working harder than ever to support patients, serve local communities and support each other. This case study spotlights some of the ways health care organisations are stepping up to the challenge.
Life in the time of Covid-19: the 2020 UK consultant census The most recent census of the consultant physician workforce in the United Kingdom shows that the number of doctors needed to meet patient demand continues to significantly outnumber the supply. It found that the proportion of unfilled medical consultant posts across the United Kingdom is at its highest level in almost a decade. Nearly half (48 per cent) of advertised consultant posts across the United Kingdom were unfilled last year – up from 36 per cent in 2013. Most posts were not filled because there were no applicants. The three Royal Colleges of Physicians believe a lack of long-term workforce planning is the primary factor behind the 33 per cent increase in unfilled consultant posts across the United Kingdom since 2013.
The future of NHS human resources and organisational development This report outlines the 10-year strategy for the human resources (HR) and organisational development (OD) services in the NHS. It is aimed at HR and OD directors, chief people officers, HR and OD practitioners, managers, leaders and anyone with an interest in HR and OD.
Department of Health and Social Care Review of health and social care leadership in England: terms of reference The government announced a review of leadership in health and social care, to be led by former Vice Chief of the Defence Staff, General Sir Gordon Messenger, and supported by Dame Linda Pollard, Chair of Leeds Teaching Hospital Trust. The terms of reference outline the scope for the leadership review to consider what is needed to improve how health and social care is led and managed in England. The review will consider how to foster and replicate the best examples of leadership. It aims to reduce regional disparities in efficiency and health outcomes across the country.
Staff psychological support response to Covid-19 This case study describes how Lancashire Teaching Hospitals NHS Trust has implemented a psychological support service for its staff.
10 unsustainable pressures on the health and care system in England Members of the RCN working across health and social care in England dispute statements that the current situation in health and care is sustainable. Action needs to be taken to retain as many nursing staff as possible in light of serious staffing vacancies, as well as high levels of exhaustion and burnout. On top of this, the system is currently dealing with the immediate challenge of rising Covid-19 cases, intensified pressures as winter approaches and clearing the growing backlog of undelivered care to people in need. The RCN has identified 10 areas that currently demonstrate unsustainable, untenable conditions within the health and care system across England. All of these are reliant on nursing.
NHS health and wellbeing strategic overview This framework is a high-level culture change toolkit aimed at health and wellbeing staff, human resources and organisational development staff and directors, wellbeing guardians, managers and leaders, and anyone with an interest in health and wellbeing. It is made up of four documents: strategic overview; elements of health and wellbeing; diagnostic tool; and implementation guide.
Consultations
Workforce: recruitment, training and retention in health and social care: Inquiry. The Health and Social Care Committee calls for evidence to inform its inquiry into recruitment, training and retention in health and social care. Comments by 19 January 2022.
News
Major reforms to NHS workforce planning and tech agenda Recruitment, training and retention of NHS staff and digital transformation will be put at the heart of the NHS in England, under new reforms announced by the Secretary of State for Health and Social Care. The plans will aim to see more patients benefit from the best possible care, with the right staff in place to meet patients' needs. The changes will better support the recovery of NHS services, address waiting list backlogs, and support hardworking staff, all while driving forwards an ambitious agenda of digital transformation and progress.
Bullying and harassment reported in our advice cases: an overview
Continuing to support the Covid-19 response and NHS staff during the pandemic
Government to introduce COVID-19 vaccination as a condition of deployment for all frontline health and social care workers. The Health and Social Care Secretary has announced plans to ensure that health and social care workers, including volunteers who have face to face contact with service users, are fully vaccinated against COVID-19. The requirements will come into force in the spring, subject to the passage of the regulations through Parliament. There will be a 12-week grace period between the regulations being made and coming into force to allow those who have not yet been vaccinated to have both doses. Enforcement would begin from 1 April 2022, subject to parliamentary approval.
Evidence is insufficient to back mandatory NHS staff vaccination says House of Lords committee. BMJ 2021; 375 (Published 03 December 2021)
Bevan Brittan Updates
Mandatory vaccination for health and social care workers:Updated FAQs. Jodie Sinclair
MHPS investigations and the disclosure of documents James Gutteridge
Bevan Brittan Events
Employment Law Update 8 December 2021
Mandatory vaccinations for your workforce 14 December 2021
How we can help
We can offer support and advice on managing many workforce issues including flexing your workforce to respond to the pandemic, managing bank staff, redeployment, vulnerable groups, sick pay, leave options, supporting staff well-being, presenteeism, remote and home 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.
Finance
Publications/Guidance
Towards true universal care: reforming the NHS charging system The system of charging migrants for health care in England has become increasingly stringent in recent years. Since the introduction of the new rules, there is a growing body of evidence highlighting their adverse impacts. Through interviews with people with direct experience of NHS charging, health care workers and policy professionals, this study found further evidence of systemic problems with the current charging system. Other countries in Europe operate fairer systems to provide health care for residents without immigration status. Drawing on these examples, alternatives to the current system were tested out with the expert interviewees. Based on these interviews, a shortlist was drawn up of five alternatives to the current charging system.
Investigation into supply chain finance in the NHS. The failure of Greensill Capital in March 2021 has triggered several reviews and investigations. This investigation examines Greensill Capital’s involvement in the provision of two schemes to the NHS – firstly, supply chain finance – with particular focus on the Pharmacy Earlier Payment Scheme to pharmacy contractors; and secondly, the Employer Salary Advance Scheme, which allowed NHS employees to access their earned salaries in advance of payday. Supply chain finance is a financial transaction whereby a lender finances a supplier on behalf of the customer. The investigation also considers the impact of the failure of Greensill Capital in March 2021 on the government, taxpayers, and NHS organisations to which it provided its services.
If you wish to discuss any queries you may have around finance please contact Claire Bentley.
Health Inequalities
Publications/Guidance
Saving lives, improving mothers’ care: lessons learned to inform maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2017-19 This report finds that pregnancy remains safe in the UK, with the overall maternal death rate showing a slight decrease. Among 2,173,810 women who gave birth in 2017-2019, 191 died during or up to six weeks after pregnancy, and 495 during or up to one year after their pregnancy. However, the findings show a continued inequality in the mortality rates for women of different ethnic backgrounds, ages and socio-economic circumstances.
Review launched into the health impact of potential bias in medical devices. Independent review will look at potential bias in items like oxygen measuring devices and the impact on patients from different ethnic groups.
Tackling health inequalities must be a fundamental priority for the NHS This briefing highlights the leading role trusts can play in creating lasting change in how inequalities in care are understood and dealt with across the NHS.
Spotlight on the early years: using national clinical audit reports to harness cross-cutting lessons This report calls for changes to audit reporting to enable better understanding of health care, specifically in relation to health inequalities. The report, which is based on data spanning four years, aims to improve health outcomes for all, in light of an increased focus on a variation in care as a result of the Covid-19 pandemic.
Integrating gender data in health information systems: challenges, opportunities and good practices This paper explains the importance of gender data and statistics and how health information systems contribute. It explores the common challenges in producing and using gender and health data and suggests opportunities and examples of good practices. Recommendations to support national health systems in improving data quality are provided.
If you wish to discuss any queries you may have around health inequalities please contact Claire Bentley.
Information sharing/data
Publications/Guidance
New Information Standard aims to reduce medication errors and improve patient safety NHS Digital has published a new Information Standard to support improved medication and allergy/intolerance information sharing across healthcare services in England. It will enable the transfer of prescription information across health and care settings to help reduce medicines related errors and improve patient safety. NHS and social care organisations will need to be compliant with the standard by 31 March 2023.
How we can help
We have a dedicated Information Law & Privacy team who advise clients on:-
- all aspects of the UK GDPR and Data Protection Act 2018 including commercial GDPR issues and information sharing
- managing and completing Subject Access Requests
- rights of access under Freedom of Information and the Environmental Information Regulations, alongside issues relating to access to records, confidentiality, cyber risks and data breaches.
For more information contact James Cassidy or Jane Bennett
Inquests
Publications/guidance
Death certification and medical examiners This Commons Library briefing paper deals with the introduction of a medical examiner system in England and Wales to provide greater scrutiny of deaths that do not require investigation by a coroner.
Bevan Brittan events
On demand - Introduction to Inquests: Housing Providers.
How we can help
We have a vast experience in representing a range of organisations for inquests, including NHS and other health bodies, regulators, schools and individual medical practitioners. For more information click here.
If you wish to discuss any queries you may have around inquests, please contact Toby De Mellow, Samantha Minchin or Claire Leonard.
Mental Health
Publications/guidance
Transfer guidance under Mental Health Act 1983 for children detained on youth justice and welfare grounds. These good practice guidance documents set out the procedure in the children and young people secure estate for the referral for assessment, and transfer to and from mental health inpatient services under the Mental Health Act 1983. These documents are for all practitioners working in the children and young people secure estate who have a role in ensuring a smooth referral for assessment and transfer to and from mental health inpatient services.
Medical disclosure information to attorneys and deputies Office of the Public Guardian guidance on issues surrounding the disclosure of medical and care information to individuals holding either a lasting power of attorney or a deputyship under the Mental Capacity Act 2005 to enable them to make best interest decisions on behalf of the donor.
Supporting people with dementia and their carers. This report into dementia care criticises the government plans for the health and care levy. In the committee’s view, the levy provides insufficient funding for social care over the next three years and fails to spell out how the sector will benefit from the levy after that.
Cases
North West London Clinical Commissioning Group v GU Case [2021] EWCOP 59 The Court of Protection considered whether the dignity of a patient was properly protected during the time he spent at the Royal Hospital for Neuro-disability.
Hull City Council v A & Ors [2021] EWCOP 60. Application by the LA to authorise the P's removal from her home and her transfer to a residential care home, at least for an interim period. The application was granted.
A Local Authority v JB [2021] UKSC 52. Appeal concerning when an individual lacks capacity to consent to sexual relations and whether that assessment should also take into account their capacity to understand whether the other person has given consent. Appeal dismissed.
Re AH [2021] EWCA Civ 1768 A judge had erred in determining that it was not in the best interests of a hospital patient to continue to receive ventilatory treatment. It seemed that the judge might have used a hospital visit to ascertain the patient's views, but there had been a lack of procedural fairness because there had been no clarity about the purpose of the visit and the patient's children had not been given an opportunity to make submissions. There was an urgent need for Court of Protection guidance on judicial visits to patients, pending which the court outlined the issues to be considered prior to any such visit. See article in Law Society Gazette.
SM (A Patient), Re Court of Protection | [2021] 11 WLUK 66 It was in the best interests of a mother with schizoaffective disorder, who was 37 weeks pregnant and currently lacked capacity, to undergo a planned caesarean section where the baby was in the breech position and likely to remain so. Prior to that discovery, her expressed wish had been for a vaginal delivery, which carried an increased risk of a scar rupture as she had previously had a caesarean delivery for her first child.
Consultation
Depression in adults: treatment and management (update) A National Institute for Health and Care Excellence (NICE) consultation seeks comments on draft guidance on the treatment and management of depression in adults. NICE has created a menu of treatment options to allow patients to pick the one which is right for them, in a shared decision-making discussion between them and their healthcare practitioner. Under the guideline those with mild depression should be offered therapy, exercise, mindfulness and meditation before antidepressants. It also contains new recommendations for those stopping antidepressant medication. Comments by 17.00 on 12 January 2022.
News/Articles
£5 million launched to support suicide prevention services The government has launched a £5 million fund to support the voluntary, community and social enterprise (VCSE) sector on suicide prevention services.
BBC finds people with learning difficulties or autism are being unfairly detained. A BBC investigation has revealed that more than 2,000 people with learning difficulties or autism are detained in specialist secure unit hospitals in England, and 100 have been held for more than 20 years. It claims that the Government failed to fulfil a pledge to cut the numbers significantly by March 2020.
Policing mental illness: Police use of section 136 - Perspectives from police and mental-health nurses. This study examines how police in five English counties respond to crisis calls when employing the powers afforded in section 136 of the Mental Health Act 1983, and the effectiveness of the national Street Triage pilot scheme. Qualitative interviews with 30 police officers and mental-health nurses were collected as data sources. The analysis shows that police have previously struggled with the significant number of crisis calls, whilst also finding mental-health services inadequately sourced, leading to some detentions in police cells as alternatives to health-based places of safety. However, the scheme has made positive changes in alleviating these issues when mental-health nurses are co-located with police, highlighting the need to strengthen their partnership by facilitating the sharing of information, responsibilities and decision making in order to ensure police cells continue to be avoided as alternative places of safety.
Bevan Brittan Events
Liberty Protection Safeguards- where are we now? - Recorded webinar.
How we can help
We are experts in advising commissioners, providers and care co-ordinators on the relevant legal frameworks. We deal with complex issues such as deprivation of liberty, state involvement, use of CCTV monitoring, seclusion, physical restraint and covert medication. We can help providers with queries about admission and detention, consent to treatment, forensic service users, transfers, leave, discharge planning and hearings. We can advise commissioners on all matters concerning commissioning responsibility, liability and disputes. For more information click here
If you wish to discuss any mental health issues facing your organisation please contact Simon Lindsay, Hannah Taylor,or Stuart Marchant.
Primary Care
Publications/guidance
A healthier future: how to make general practice work better for everyone This is a collection of essays about general practice in England and its future. The authors offer analysis and prescriptions based on expertise developed working in fields including medicine, NHS management, economics and the civil service.
Appointments in General Practice - September 2021. The aim of the publication is to inform users about activity and usage of GP appointments historically and how primary care is impacted by seasonal pressures, such as winter.
Addressing complex needs in the community: a GP trainee’s perspective. As demand for primary care services continues to grow, Martha Martin, GP trainee, explores how investment in improving the social determinants of health and time to develop relationships in multidisciplinary teams would help her to better support her patients.
Consultation
The future of General Practice. A Health and Social Care Committee inquiry seeks views to explore the future of NHS general practice (GP), examining the key challenges facing GP over the next five years as well as the biggest existing and ongoing barriers to access to GP. Key areas of focus include regional variation in GP, the GP workload, and the partnership model of GP. Comments by 14 December 2021.
News
Record number of 4,000 GPs accepted on training placements.
NHS chief announces next steps for local health systems. The NHS will set out the next steps for how primary care networks will work with partners across newly formed integrated care systems to meet the health needs of people in their local areas.
Bevan Brittan Videos
Bevan Brittan has collaborated with NHS Resolution to produce a series of videos outlining key areas in general practice that frequently give rise to claims. Members of our clinical negligence team draw on their wealth of experience in dealing with claims to highlight the common areas of risk, provide guidance on how to mitigate or avoid these issues, and what steps to take if a complaint or a claim is received. The first five videos in this series are available to watch now. See below:-
Consent - Daniel Morris
Medical record keeping - Ben Lambert
Administrative errors - Susan Trigg
What to do if you receive a complaint or claim - Joanne Easterbrook
Common pitfalls - Helen Carrington
Other useful resources from NHS Resolution for primary care are set out below:-
1. General Practice Indemnity schemes
2. Understanding the Clinical Negligence Scheme for General Practice
3. Handling claims under the Clinical Negligence Scheme for General Practice
4. Covid-19 guidance for general practice
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. For more information click here.
If you wish to discuss any issues in primary care then please contact Joanne Easterbrook, Susan Trigg, Vincent Buscemi or Ben Lambert.
Public Health
Publications/Guidance
Identifying the gap: understanding the drivers of inequality in public health This report aims to provide insights into the historical challenges and approaches taken to tackle the problems affecting public health. Key findings include the need for: longer-term funding and commissioning cycles; investment in the public health workforce; and for public health to be recognised and valued as an integral part of the integrated care system.
Narrowing the gap: a fairer and sustainable future for public health This report examines the current challenges and future requirements for a resilient public health system in the UK. It finds that the pandemic has exposed the impact of health inequalities and a lack of progress in addressing the social determinants of health as well as shortcomings in public health funding. It supports action to improve public health and narrow the inequalities gap and optimise the link between health and productivity.
Public Health Protection and Health Security Framework: outline agreement This framework has been jointly developed and agreed between the UK Government, the Welsh Government, the Scottish Government, the Northern Ireland Executive and each of the UK’s national public health agencies. It provides a formal basis and governance structure for collaboration between all parts of the UK on health security and health protection policy. It supports co-operation on issues that require UK-wide approaches, as well as on devolved issues where the sharing of knowledge and expertise is beneficial.
How we can help
If you wish to discuss any queries you may have around public health please contact Claire Bentley.
Regulation
Publications/Guidance
Five key principles for regulation and oversight in a systems world This briefing explains how within this new context the national bodies that regulate the quality and performance of NHS services, including the Care Quality Commission and NHS England and Improvement, are adapting their approaches to more closely align with these changes.
How we can help
If you wish to discuss any queries you may have around regulation please contact Stuart Marchant.
Social Care
Publications/Guidance
Workforce: recruitment, training and retention in health and social care: Inquiry. The Health and Social Care Committee calls for evidence to inform its inquiry into recruitment, training and retention in health and social care. Comments by 19 January 2022.
Proposed reforms to adult social care (including cap on care costs). This briefing provides information on the Government's proposals for adult social care reform, including the cap on care costs.
Government response on social care changes - letter. Publication of the Government's response to a request for an impact assessment on proposed changes to adult social care. In the response, the Government acknowledges that it is unable to provide regional or individual assessments, as the funding at a local authority level has not yet been agreed. It outlines that a full impact assessment will be published in 2022.
Briefing on the Health and Care Bill: House of Commons report stage and third reading The Health and Care Bill introduces new measures to promote and enable collaboration in health and care, building on earlier recommendations made by NHS England and NHS Improvement in 2019. The Bill also contains new powers for the Secretary of State to intervene in the health and care system, and targeted changes to public health, social care, and the oversight of quality and safety. This briefing focuses on Parts 1, 2, and 3 of the Bill, which deal with the NHS and its relationships to other parts of the system, including the powers of the Secretary of State, plus proposed changes to information sharing across the health and care system.
Adult social care charging reform: further details. This document sets out further detail on the workings of the new charging reform framework and confirms key outstanding policy details, including the standard level at which ‘daily living costs’, will initially be set.
The state of health care and adult social care in England 2020/21 This annual report looks at trends and shares examples of good and outstanding care as well as highlighting where care needs to improve. This year it highlights that the pandemic has taken a toll on the health and wellbeing of older people and calls for increased stability in the social care system to meet the needs of a post-pandemic, ageing population living with more complex co-morbidities.
Adult social care: COVID-19 winter plan 2021 to 2022. A Department of Health and Social Care publication sets out the Government's ambitions for the sector and the challenges facing adult social care over winter 2021/22. It focuses on: elements of national support available for the social care sector during winter 2021 to 2022; and principal actions that local authorities, NHS organisations and social care providers across all settings (including those in the voluntary and community sector) in England should take. Alongside this plan, the Social Care Sector COVID-19 Support Taskforce's independent review of the Government's adult social care: winter plan 2020 to 2021 has been published
Submission from the Nursing and Midwifery Council to the Public Bill Committee regarding the Health and Care Bill The Nursing and Midwifery Council (NMC) welcomes the provisions in the Health and Care Bill 2021-22, including those around professional regulation. However, it raises a number of concerns requiring greater clarity from the Government, including: more information on the criteria that the Government will use for reviews of professional regulation in healthcare, and how it intends to engage and consult with the public and stakeholders before changes are made; assurance that the creation of a "safe space" for the Health Services Safety Investigations Body does not affect efforts by regulators to create a safety culture in healthcare; and assurance that regulators be able to operate independently of government and make their own decisions about the regulation of their respective professions.
Human Rights in Adult Social Care Care England has responded to the Joint Committee on Human Rights inquiry into protecting human rights in care settings.
Department of Health and Social Care Review of health and social care leadership in England: terms of reference The government announced a review of leadership in health and social care, to be led by former Vice Chief of the Defence Staff, General Sir Gordon Messenger, and supported by Dame Linda Pollard, Chair of Leeds Teaching Hospital Trust. The terms of reference outline the scope for the leadership review to consider what is needed to improve how health and social care is led and managed in England. The review will consider how to foster and replicate the best examples of leadership. It aims to reduce regional disparities in efficiency and health outcomes across the country.
A place we can call home: A vision and a roadmap for providing more options for housing with care and support for older people. This report for commissioners and managers in health and social care develops a vision and roadmap for providing more options for housing with care and support.
Cases
R. (on the application of Gardner) v Secretary of State for Health and Social Care Case [2021] EWHC 2946 (Admin): The court discussed the admissibility of expert evidence of opinion in judicial review proceedings brought against the Secretary of State for Health and Social Care, NHS England and Public Health England by two women whose fathers had died from coronavirus whilst living in care homes.
Bevan Brittan Update
Adult Social Care Report - Social Care Cap - Update. Sarah Clarke.
How we can help
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General
Publications/Guidance
PPE procurement in the early pandemic Information about the government's procurement exercise to secure critical personal protective equipment (PPE) during the early months of the COVID-19 pandemic.
Strict new rules for ads for cosmetic interventions Following consultation, the Committee of Advertising Practice and Broadcast Committee of Advertising Practice will introduce new targeting restrictions that prohibit cosmetic interventions advertising from being directed at under-18s. From 25 May 2022: advertisements for cosmetic interventions must not appear in non-broadcast media directed at under-18s; advertisements for cosmetic interventions must not appear in other non-broadcast media where under-18s make up over 25% of the audience; and broadcast advertisements for cosmetic interventions must not appear during or adjacent to programmes commissioned for, principally directed at or likely to appeal particularly to under-18s. A regulatory statement, an evaluation of responses and updated advertising guidance are also available.
COVID-19: migrant health guide Advice and guidance for healthcare practitioners on the health needs of migrant patients.
Understanding vaccine hesitancy through communities of place This UK–US collaborative study highlights the importance of tapping into local knowledge and leadership in efforts to improve Covid-19 vaccine take-up. Produced together with the Institute for Community Research and Boston University in the United States, the study explores levels of vaccine engagement in four locations: Oldham and Tower Hamlets in the United Kingdom, and the cities of Boston and Hartford in the US. In all four localities, the survey finds the authorities’ ‘top-down’ approach to vaccine distribution and education has been ineffective, and that applying a ‘community engagement approach’ instead –involving community groups and trusted leaders in vaccine distribution and education – can improve take-up rates.
A joint thematic inspection of the criminal justice journey for individuals with mental health needs and disorders Inspectors looked at more than 300 cases from 6 regions, interviewed 550 professionals, and heard from 67 people with mental health issues who had been through the criminal justice system, from first contact with the police to release from prison. The inspection found poor support for people with mental health issues and concludes that too little progress had been made since the last review in 2009.
Invisible women: understanding women’s experiences of long-term imprisonment This briefing highlights the far-reaching consequences of a lack of specialist, gender-specific, trauma informed provision for the the small minority of women serving very long determinate or indeterminate prison sentences. Most women serving long prison sentences will have extensive histories of trauma and are often victims as well as perpetrators. In a study of women serving life sentences, 60 per cent reported histories of sexual abuse, 80 per cent had experienced physical abuse and 54 per cent reported both sexual and physical abuse. Women lacking specialist support can feel isolated in their trauma; those serving long sentences are more exposed to repeat traumatisation.
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