31/08/2023
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
There is no charge for any of the events listed below
Webinars
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.
When might mediation be helpful in the Court of Protection context? 7th September 12.30pm
Recent developments in breach and causation for clinical negligence lawyers. 12th September 12.30pm
PSIRF and the Coronial Process 21st September 12.30pm
A Dance to the Music of Time – Mediation or Evaluation? 26th September 12.30pm
Please note that registration for each webinar will close one hour before the webinar starts, so please do ensure you have booked your place in advance to guarantee attendance.
Acute and emergency care
Publications/guidance
CQC publishes urgent and emergency care survey 2022 results and analysis. The Care Quality Commission has published the 'Urgent and emergency care survey 2022'. The national survey into patients’ experiences of major consultant-led A&E departments, urgent treatment centres and minor injury units in September 2022 has shown that many people had a worse experience than in previous years. The survey focused on experiences of 122 acute hospital trusts in England. Responses to questions about fundamental issues such as waiting times, availability of staff and pain management showed a significant decline, with 32% of patients at A&E departments waiting more than an hour to first speak to a doctor or nurse, compared to 15% in 2020. Further, respondents to the survey were more likely to report a negative experience of care if they identified as frail or if they were disabled. The CQC’s Chief Inspector of Healthcare, Dr Sean O’Kelly, has encouraged NHS trusts to ‘reflect on their individual results to identify what changes they might be able to make to help drive improvements’, but has also highlighted the ‘very urgent need for Integrated Care Systems to ensure that local services are set up in a way that is designed around the needs of the population they serve’.
Ambulance services and integrated care system collaboration. This report aims to examine the key themes and principles that should underpin effective and practical collaboration between ambulance services and integrated care boards. It sets out the findings of research involving a range of NHS leaders from both integrated care boards (ICBs) and ambulance services, and makes recommendations to the array of partners, national and local, that can affect change.
Harm caused by delays in transferring patients to the right place of care. A Healthcare Safety Investigation Branch (HSIB) report sets out the findings of its investigation into the systems in place to manage the flow of patients through and out of hospitals, the interactions between the health and social care systems and how patient flow issues affect ambulance crews' ability to hand over patient care to emergency department staff. Recommendations include that the Department of Health and Social Care should: lead an immediate strategic national response to address patient safety issues across health and social care arising from flow through and out of hospitals to the right place of care; conduct an integrated review of the health and social care system to identify risks to patient safety spanning the system arising from challenges in constraints, demand, capacity and flow of patients in and out of hospital and implement any changes as necessary; and develop and implement a patient safety accountability framework that spans the health and social care system.
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
Factors shaping gender incongruence and gender dysphoria, and impact on health services: Research briefing. A UK Parliament POSTnote outlines what is known about the factors that shape gender incongruence and gender dysphoria and discusses the impact on the NHS from increased referrals for gender identity care.
Supported accommodation: Ofsted's enforcement policy. Ofsted's interim policy on how they regulate providers of supported accommodation explains what they may do if a provider is not following the regulations.
Prevention in health and social care: vaccination. This report calls for urgent action to tackle declining vaccination rates among children, citing concern that England did not meet the 95 per cent target for any routine childhood immunisations in 2021/22. It also states that the United Kingdom lags behind international competitors on support for clinical research, in particular in the clinical trials system, and calls for urgent reform. The report also calls for immediate action to ensure the readiness of NHS England, the Medicines and Healthcare products Regulation Agency (MHRA) and the Joint Committee on Vaccination and Immunisation (JCVI) to support innovations around preventive health care, such as personalised cancer vaccine, given an uncertain time frame.
Support for children and young people’s mental health (England). House of Commons Library briefing on children and young people’s mental health policy.
Deprivation of liberty. Ofsted has created new guidance on placing children subject to a deprivation of liberty order (DoL) in unregistered settings in England and Wales. The guidance is aimed at providers, social workers and placement commissioners. Ofsted reiterates the legal registration requirement for settings offering children’s home services for children subject to DoL orders.
Consultations
Interim Clinical Policy: Puberty suppressing hormones for children and adolescents who have gender incongruence/dysphoria. NHS England proposes an interim clinical policy on puberty suppressing hormones (sometimes referred to as "puberty blockers" or "hormone blockers") for children and adolescents who have gender incongruence or dysphoria. The policy proposition is that puberty suppressing hormones are not recommended to be available as a routine commissioning option for the treatment of children and adolescents who have gender incongruence or dysphoria. Comments by 1 November 2023.
Cases
R. (on the application of AA) v National Health Service Commissioning Board [2023] EWCA Civ 902. The duty imposed on NHS England by the National Health Service Commissioning Board and Clinical Commissioning Groups (Responsibilities and Standing Rules) Regulations 2012 Pt 9 reg.45(3) to make arrangements to ensure that not less than 92% of a cohort of patients being referred for non-acute treatment had to wait less than 18 weeks was a target duty, not an absolute duty to achieve that waiting time standard. The cohort to whom that duty was owed was limited to those being referred to consultant-led services.
News
Child mental health. Young Minds has conducted an analysis of NHS data reporting on urgent referrals of children under 18 to mental health crisis teams. Findings from the analysis show that the number of children in mental health crisis in England reached more than 3,500 in May 2023, three times higher than in May 2019.
Ofsted warns against use of unregistered children’s homes. Ofsted has issued a fresh warning against the placement of vulnerable children, including those subject to deprivation of liberty orders, in unregistered children’s homes.
Child deaths in care. The Times has published a news story reporting that 450 children looked after by local authorities died in care between 2011 and 2021 in the UK. Findings from a Freedom of Information (FOI) request show 400 looked after children died in regulated care placements and 50 children died in unregulated accommodation.
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
Best practice timed diagnostic cancer pathways: practical guidance for clinicians to maximise use of NHS Cancer pathways for the benefit of patients. GIRFT and the NHS England Cancer Programme have co-produced this guide, outlining how cancer alliances and constituent organisations can implement NHSE’s best practice timed pathways for cancer, with insights from the relevant GIRFT national clinical leads. The guide summarises the key guidance documents available to NHS colleagues, with links provided.
Government responds to review of maternity and neonatal services. The Department of Health and Social Care (DHSC) has published its response to the ‘Reading the signals’ report from the independent investigation into maternity and neonatal services in East Kent. The report made five recommendations for the healthcare system, which the government has been working to implement. In the response the government has confirmed that it will be undertaking further national action to improve safety in maternity and neonatal care, and announced that the Minister for Women’s Health, Maria Caulfield, will be overseeing a new group dedicated to this. Caulfield will also be chairing a local forum in East Kent made up of local NHS representatives, the Care Quality Commission and local MPs to share information and updates on the improvements being made to maternity services. Dr Kirkup, who led the original investigation, has also been appointed to help implement his recommendations. Royal Colleges, professional regulators and employers have further been instructed to conduct internal investigations to assess how they can improve workplace culture.
Strengthening perinatal mental health: a roadmap to the right support at the right time. This roadmap aims to ensure women receive the support they need and to improve perinatal mental health care in the UK. It finds that one in five women will experience mental health issues during pregnancy and up to a year after birth, ranging from anxiety and depression to more significant illness. Furthermore, suicide remains one of the leading causes of death in new mothers up to the first year after giving birth. It highlights how few of the women who died as a result of poor perinatal mental health actually received a formal mental health diagnosis despite reported symptoms.
Interim bulletin 1: Harm caused by delays in transferring patients to the right place of care. A first interim report by the Healthcare Safety Investigation Branch (HSIB) on its investigation exploring the impact of staff wellbeing on patient safety across the urgent and emergency care systems concludes that demand on services, the availability of beds and patient flow through acute hospitals (including the discharge of patients to social and community care) have affected the ability of ambulances to hand over patients to emergency care. It recommends immediate focus on: hospital discharge processes (planning and execution); interconnectivity and a "whole system" approach across health and social care; and demand, capacity and flow modelling across the health and social care system to understand where best to focus resource to achieve greatest impact.
Interim bulletin 2: Harm caused by delays in transferring patients to the right place of care. A second interim report by the Healthcare Safety Investigation Branch (HSIB) on its investigation exploring the impact of staff wellbeing on patient safety across the urgent and emergency care systems, which focuses on patient safety risk accountability, concludes that it may be beneficial for there to be a whole-system patient safety accountability and responsibility framework that spans health and social care.
Supporting clinical decisions with health information technology. This summary guide for digital and clinical leaders at local and regional level highlights the implementation of clinical decision support (CDS) across NHS England to improve the quality of care and patient safety.
Fixed recoverable costs judicial review. The Association of Personal Injury Lawyers (APIL) has issued judicial review (JR) proceedings against the Lord Chancellor challenging aspects of new rules to extend fixed recoverable costs in personal injury cases. There are four key grounds to APIL's challenge, all of which represent impediments to access to justice for injured people: clinical negligence claims; vulnerable people; the unlawful exclusion of fixed recoverable costs for representation at inquests, and for restoring companies to the Companies Register; and an apparent reversal of Court of Appeal case law, without consultation, which allows parties to contract out of fixed costs when there is a dispute in settlement agreements, in favour of agreeing that costs will be subject to detailed assessment. The JR has been issued within three months of the date on which the rules were published, as required by limitation rules. Given that the Government later published a consultation which relates in part to APIL's claim, APIL has requested, and the Government has agreed, that the JR will be stayed until three weeks after the Government responds to the consultation. After the consultation response, APIL can apply to amend its grounds for issuing proceedings.
MoJ announces increased interest rates for Court Funds Office accounts. The Ministry of Justice (MoJ) has announced that the Lord Chancellor has reviewed the Court Funds Office (CFO) interest rates following the increase in the Bank of England base rate on 3 August 2023. The interest rates changed as of 23 August 2023 for both special and basic accounts. The special account interest rate has increased to 6% from 4.5% and for the basic account it has increased to 5% from 3.375%.
Research
Inappropriate hospital admission as a risk factor for the subsequent development of adverse events: a cross-sectional study. It found that patients with inappropriate hospital admission (IHA) have a higher risk of subsequent occurrence of adverse events (AEs). Due to the multifactorial nature of AEs, IHA is a possible contributing factor. AEs developed after IHA are associated with scheduled admissions, prolonged ICU stays, and resulted in significant cost overruns.
Cases
R. (on the application of JJ) v Spectrum Community Health CIC. Court of Appeal (Civil Division) [2023] EWCA Civ 885. The Court of Appeal upheld the dismissal of a claim for judicial review of a healthcare provider's refusal to provide a prisoner, who was quadriplegic and could not feed himself, with certain foods which it believed were contra-indicated and adverse to his clinical needs as they posed an increased risk of death or serious injury by choking or aspiration. There was no common law right of autonomy which allowed a patient to demand, and obliged a clinician to provide, medical treatment that was not offered to that patient by their doctors.
News
Government orders independent inquiry following Lucy Letby verdict. The Government has announced an independent inquiry into circumstances behind murders and attempted murders of babies at Countess of Chester Hospital, following the guilty verdict in the trial of former neonatal nurse Lucy Letby. The inquiry will look at the circumstances surrounding the deaths and incidents, including how concerns raised by clinicians were dealt with. Victims' families will be invited to both engage with and shape the inquiry, ensuring their views are heard throughout the process. A chair will be appointed, and the Government will publish the inquiry's proposed terms of reference in due course.
NHS to look at senior manager regulation following Letby conviction. Following the conviction of nurse Lucy Letby for the murder of seven babies and attempted murder of six others, Amanda Pritchard, chief executive of NHS England, has said she is considering regulating senior health service managers. She said it is "the right time to look again" at a system that could investigate and strike off managers responsible for serious failings. She is to hold a meeting with health chiefs to consider whether formal regulation is the right response, whilst also considering options that improve safety with less bureaucracy. Her intervention will increase pressure on ministers to revive plans for a body to investigate claims against senior hospital managers.
The mythbuster: Many healthcare interventions are wasteful, we just don’t know which ones
Bevan Brittan Events
Recent developments in breach and causation for clinical negligence lawyers. 12th September 12.30pm
PSIRF and the Coronial Process 21st September 12.30pm
A Dance to the Music of Time – Mediation or Evaluation? 26th September 12.30pm
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 or Tim Hodgetts.
Covid
Publications/Guidance
Not by choice: the unequal impact of the Covid-19 pandemic on disempowered ethnic minority and migrant communities. This report argues that too many of the policy decisions that were made during the Covid-19 health emergency either did not understand the evidence on inequality or ignored it, and that this was particularly true for ethnic minorities and migrants.
Health security from the ground up: 5 lessons for the future of the UKHSA. This paper explores the shortcomings in the English response to Covid-19 and presents five policy ideas that would help strengthen the UK Health Security Agency (UKHSA) and improve the UK’s resilience in the face of future health crises.
Covid-19 Committee report: "Beyond digital: Planning for a hybrid world": In Focus. A House of Lords Library publication discusses the findings of the House of Lords Covid-19 Committee's inquiry in 2020 and 2021 on the long-term impact of people living more of their lives online as a result of the pandemic. It also summarises the Government's response to its report "Beyond Digital: Planning for a Hybrid World" ahead of a House of Lords debate on the subject on 6 September 2023.
COVID-19: examining the effectiveness of non-pharmaceutical interventions. Non-pharmaceutical interventions (NPIs), when applied in packages that combine measures with complementary effects, were unequivocally effective in reducing the spread of infections during the COVID-19 pandemic, a Royal Society report has found. It reviewed the scientific evidence for six groups of NPIs and their effectiveness in reducing transmission of the SARS-CoV-2 virus: masks and face coverings; social distancing and lockdowns; test, trace and isolate; travel restrictions and controls across international borders; environmental controls; and communications. It found, when assessed individually, there was positive, if limited, evidence of transmission reduction from many of the NPIs used in the pandemic. However, the evidence of an effect was clear when countries used combinations of NPIs.
If you wish to discuss any queries you may have around Covid and Claims please contact Daniel Morris.
Digital Health
Publications/guidance
Scaling innovation within healthcare systems: practical considerations. This report outlines practical guidance to support the implementation and scaling of proven innovations in health care systems.
Can AI help put people firmly at the centre of their care? Pritesh Mistry (Fellow, Digital Technologies at The King's Fund) explores the potential for AI to transform health literacy with personalised health information.
News
Artificial intelligence technologies to speed up contouring in radiotherapy treatment planning. Nine artificial intelligence technologies can be used to help plan the treatment of those undergoing external beam radiotherapy for cancers such as lung, prostate or colorectal, NICE has said in draft guidance.
Experts to lead AI Safety Summit preparations as new funding announced to modernise healthcare. Two leading experts appointed to spearhead preparations for UK to host AI Safety Summit as £13 million unveiled to revolutionise healthcare research
If you wish to discuss any queries you may have around Digital Health please contact Daniel Morris.
Employment/HR
Publications/guidance
NHS England Fit and Proper Person Test Framework for board members. NHS England has developed a Fit and Proper Person Test (FPPT) Framework in response to recommendations made by Tom Kark KC in his 2019 review of the FPPT (the Kark Review). This also takes into account the requirements of the Care Quality Commission (CQC) in relation to directors being fit and proper for their roles. See Bevan Brittan Update.
Good medical practice 2024. The General Medical Council's updated Good Medical Practice includes, for the first time, zero tolerance of sexual harassment towards colleagues, including clear definitions of what constitutes it and an expectation that doctors who see such behaviour will act. The guidance says doctors "must not act in a sexual way towards colleagues with the effect or purpose of causing offence, embarrassment, humiliation or distress". The standards make clear this includes verbal or written comments and displaying or sharing images, as well as physical contact. It is the first major update to the guidance, which details the principles, values and standards expected of doctors working in the UK, in 10 years. The updated practice comes into effect on 30 January 2024.
A guide to supporting your internationally educated workforce. This guide provides practical advice and examples of how to support the internationally educated workforce (IEW) as an essential part of promoting a more inclusive and diverse NHS. It focuses on how trusts can support the IEW by looking at the following topics: recruitment, onboarding, and induction; creating a sense of belonging; tools to address bullying and harassment; high-quality training and inclusive talent management; and leadership and accountability.
Six steps methodology to integrated workforce planning checklist. This checklist provides a quick reference guide of the key considerations of each of the steps in integrated workforce planning. This document can be used to help with planning, ensuring that leaders reflect on and incorporate the level of detail needed to effectively plan their workforce needs.
Wellbeing and inclusion: how ambulance trusts are seeking improvements for staff. This long read explores how ambulance trusts are seeking to support and improve the wellbeing of their workforce.
How feasible are the NHS Long Term Workforce Plan commitments on training? The NHS Long Term Workforce Plan (LTWP) makes important commitments to increase training intakes across several NHS clinical staff groups in England by 2031/32. This short analysis looks at the implications of these commitments for the health care education system and wider workforce planning in England.
Spotlight on nursing and midwifery: report 2023. This annual report aims to share insights that can further improve learning and practice in nursing and midwifery, supporting professionals to uphold high standards. The data in the report shows that growth of the UK nursing and midwifery workforce has been increasingly reliant on international recruitment over recent years. However, some new international recruits have reported: not feeling respected or treated the same as colleagues; racist and derogatory language; and feeling misled during recruitment processes. It also finds that preceptorship programmes, which are designed to support new professionals into their workplaces, are not being delivered consistently, with wide variation in the way they're organised and supervised by different employers.
Code of practice for the international recruitment of health and social care personnel. Sets out the principles and best practice benchmarks health and social care employers and recruitment agencies must follow to ensure effective, ethical international recruitment.
Interim bulletin 1: Harm caused by delays in transferring patients to the right place of care. A first interim report by the Healthcare Safety Investigation Branch (HSIB) on its investigation exploring the impact of staff wellbeing on patient safety across the urgent and emergency care systems concludes that demand on services, the availability of beds and patient flow through acute hospitals (including the discharge of patients to social and community care) have affected the ability of ambulances to hand over patients to emergency care. It recommends immediate focus on: hospital discharge processes (planning and execution); interconnectivity and a "whole system" approach across health and social care; and demand, capacity and flow modelling across the health and social care system to understand where best to focus resource to achieve greatest impact.
Interim bulletin 2: Harm caused by delays in transferring patients to the right place of care. A second interim report by the Healthcare Safety Investigation Branch (HSIB) on its investigation exploring the impact of staff wellbeing on patient safety across the urgent and emergency care systems, which focuses on patient safety risk accountability, concludes that it may be beneficial for there to be a whole-system patient safety accountability and responsibility framework that spans health and social care.
Exploring the earnings of NHS doctors in England. This briefing looks at how doctors’ pay in England has changed over time, how it compares to other salaries in the wider economy, and how it compares with what doctors in other countries are paid.
News
NHS England publishes data on latest junior doctors strike
Bevan Brittan Updates
NHS Fit and Proper Person Test Framework for Board Members
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, James Gutteridge or Andrew Uttley.
Finance
Publications/guidance
How much public spending does each area receive? Local authority level estimates of health, police, school and local government spending. This report estimates the level of funding for five key public services (the NHS, schools, local government, the police and public health) in each local authority area in England in 2022-23 and compares the relative levels of funding different areas receive to estimates of their relative spending needs. It finds substantial differences between the share of funding areas receive, and the share they would receive if funding was allocated in line with their different levels of need.
Reciprocal healthcare policy framework for the funding of healthcare abroad in exceptional circumstances. From 18 August 2023, the Secretary of State will have the power to authorise payments for health care outside the scope of a health care arrangement in countries with which we have a reciprocal health care arrangement in place. This is subject to the condition that the payment is justified by ‘exceptional circumstances’. The framework sets out the factors the Secretary of State will take into account when making discretionary funding decisions in exceptional circumstances. This framework ensures discretionary funding powers are implemented consistently and fairly for patients across the UK, and supports transparency and accountability in the use of public funding for public services.
Health Inequalities
Publications/Guidance
Back to basics – understanding lived experience and intersectionality in health and care. There is a well-established case for involving communities and people with lived experience in health and care policy, service design and delivery. NHS England guidance on working in partnership with communities highlights the financial benefits and improvements to quality and health outcomes that working with local communities brings.
Beyond ‘bad admin’ exploring what great admin looks like and how it can be achieved. Julia Cream, introduces a new project that focuses on the value of co-produced administration in health and care and its potential to improve patient experience and reduce inequalities.
We deserve better: ethnic minorities with a learning disability and access to healthcare. This five-part review examines two decades of research looking into discriminatory barriers preventing equitable health care treatment. It finds that people with a learning disability from Black, South Asian (Indian, Pakistani or Bangladeshi heritage) and minority ethnic backgrounds face shorter life expectancy triggered by poorer health care access, experience and outcomes. It also captures the lack of reasonable adjustments and failure to recognise individual needs. Other obstacles identified include language barriers, cultural and religious insensitivity, a lack of information in easy-read format, and a lack of information during transitional care in hospital and home.
Not by choice – the unequal impact of the Covid-19 pandemic on disempowered ethnic minority and migrant communities. The Covid-19 pandemic exposed significant inequalities in the UK, particularly among ethnic minority communities and migrants. Data revealed higher infection rates, up to 88 per cent, in these groups. Additionally, Black men were twice as likely to die from the virus compared with White British men. Lack of access to sick pay and support schemes disproportionately affected minority workers and migrants, forcing them to work despite risks. The vaccination programme also failed to reach and protect these communities adequately. The findings of this report argue that better, evidence-based and responsive policy and practice at the time could have changed these outcomes.
Back to basics – understanding lived experience and intersectionality in health and care. Loreen Chikwira (researcher at The King's Fund) explains what lived experience and intersectionality mean when it comes to designing health and care services.
We deserve better: ethnic minorities with a learning disability and access to healthcare. This five-part review examines two decades of research looking into discriminatory barriers preventing equitable health care treatment. It finds that people with a learning disability from Black, South Asian (Indian, Pakistani or Bangladeshi heritage) and minority ethnic backgrounds face shorter life expectancy triggered by poorer health care access, experience and outcomes. It also captures the lack of reasonable adjustments and failure to recognise individual needs. Other obstacles identified include language barriers, cultural and religious insensitivity, a lack of information in easy-read format, and a lack of information during transitional care in hospital and home.
Not by choice – the unequal impact of the Covid-19 pandemic on disempowered ethnic minority and migrant communities. The Covid-19 pandemic exposed significant inequalities in the UK, particularly among ethnic minority communities and migrants. Data revealed higher infection rates, up to 88 per cent, in these groups. Additionally, Black men were twice as likely to die from the virus compared with White British men. Lack of access to sick pay and support schemes disproportionately affected minority workers and migrants, forcing them to work despite risks. The vaccination programme also failed to reach and protect these communities adequately. The findings of this report argue that better, evidence-based and responsive policy and practice at the time could have changed these outcomes.
Building equitable primary care – a practical toolkit. Two academic groups have independently looked at what works to address inequalities in and through primary care. This document brings together these two studies to describe what equitable primary care looks like and provides practical steps to help local decision-makers address inequalities in health and health care.
How we can help
We have a multidisciplinary team advising NHS commissioners and providers on all aspects of tackling health inequalities, ranging from:
- advising on the new legal framework and compliance with the relevant statutory duties, particularly in the context of service reconfiguration;
- addressing workforce inequalities;
- taking action on patient safety to reduce health inequalities;
- the role of the Care Quality Commission in tackling health inequalities; and
- lessons to be learnt from the Covid-19 pandemic.
If you wish to discuss any queries you may have around health inequalities please contact Julia Jones.
Independent Health
Publications/guidance
Guidance: Elective recovery taskforce: implementation plan. A Department of Health and Social Care implementation plan aims to assist in the recovery of the COVID-19 backlog in elective care by leveraging the capacity across the whole system and empowering patients to choose where they are treated. The plan sets out action to: empower patients to exercise their right to choice, overcoming data, technological, information and knowledge barriers to patients, harnessing their right to choose where they receive their care; deliver a post-pandemic recovery by overcoming obstacles to providers entering the market, ensuring payment mechanisms promote the right incentives, overcoming barriers to effectively working with the independent sector; and enable longer-term system sustainability, ensuring the NHS and independent sector work together to develop a sustainable workforce and access to facilities, for additional capacity, both now and in the future.
Consultations
Licensing of non-surgical cosmetic procedures. The government brought forward an amendment to the Health and Care Act 2022 which gives the Secretary of State for Health and Social Care the power to bring into force a licensing scheme in England for non-surgical cosmetic procedures. The purpose of the scheme is to ensure that consumers who choose to undergo a non-surgical cosmetic procedure can be confident that the treatment they receive is safe and of a high standard. Under the proposed scheme, practitioners will need to be licensed to perform specific procedures and the premises from which they operate will also need to be licensed. The Government is seeking views on what procedures should be in scope of the licensing scheme for non-surgical cosmetic procedures in England. The JCCP has prepared a public guide to the Government consultation, with a clear explanation of what it means and how to respond to it. The consultation is open until 28 October 2023.
News
Government boosts use of independent sector capacity to cut NHS waits. Thirteen new community diagnostic centres are opening across the country to deliver more than 742,000 additional scans, tests and checks a year.
For more information contact Tim Hodgetts, Julie Charlton or Amanda Wright- Kluger
Information sharing
Publications/guidance
Towards a healthier, wealthier UK: unlocking the value of health care data. This report on health care data shows public support for unlocking the value of the UK’s data, and sets out how the opportunity for leveraging health care data can be grasped.
CMA provisionally clears NHS healthcare tech deal. The CMA has provisionally found no competition concerns in the deal between specialist health care tech and software companies which provide services to the NHS.
For more information contact Jane Bennett.
Inquests
News
Events
PSIRF and the Coronial Process 21st September 12.30pm
If you wish to discuss any queries you may have around inquests, please contact Amanda Wright- Kluger, Toby De Mellow or Claire Leonard.
Mental Health
Publications/Guidance
Maternal mental health: a briefing for integrated care systems. This briefing aims to help integrated care systems (ICSs) understand the role they have in ensuring every new and expectant mother receives the right mental health support at the right time, close to home. It finds that, if untreated, maternal mental health problems can cost an average-sized ICS the equivalent of £190 million per year. The briefing outlines why maternal mental health is important and explains the steps ICSs can take to provide the right support.
Deprivation of liberty. Ofsted has created new guidance on placing children subject to a deprivation of liberty order (DoL) in unregistered settings in England and Wales. The guidance is aimed at providers, social workers and placement commissioners. Ofsted reiterates the legal registration requirement for settings offering children’s home services for children subject to DoL orders.
Strengthening perinatal mental health: A roadmap to the right support at the right time. A Royal College of Midwives (RCM) roadmap on strengthening perinatal mental health aims to ensure women receive the support they need and to improve perinatal mental health care in the UK. The RCM warns that one in five women will experience mental health issues during pregnancy and up to a year after birth, ranging from anxiety and depression to more significant illness and that suicide remains one of the leading causes of death in new mothers up to the first year after giving birth. Demonstrating the economic and social case for more mental health resources, the RCM calls for: all professionals working with women in the perinatal period to have the necessary knowledge and understanding of perinatal mental health; every maternity service to have a minimum whole-time equivalent Band 7 perinatal specialist midwife; and all maternity professionals to be equally concerned with mental as well as physical health in pregnancy, childbirth, and the postnatal period.
News
(R (Worcestershire County Council) v Secretary of State for Health and Social Care [2023] UKSC 31. Duty to provide after-care services under section 117 of Mental Health Act 1983 ceases upon second section 3 detention. The Supreme Court has held that where an after-care service user had been detained for a second time under section 3 of the Mental Health Act 1983 (MHA 1983), and moved to a different local authority's area after their first detention, the section 117(2) duty on the first local authority ended upon the second detention.
Bevan Brittan Updates
New CoP3 Form - Assessment of Capacity
Bevan Brittan Events
When might mediation be helpful in the Court of Protection context? 7th September 12.30pm
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
Supporting digital inclusion in general practice: 10 top tips. This guide is for health care staff in general practices, primary care networks (PCNs), integrated care systems (ICSs) and anyone else who is seeking to reduce digital exclusion in general practice, particularly among underserved and marginalised communities.
All GP surgeries in England to have digital phonelines by March. In support of the Government's Primary Care Recovery Plan to improve patient access to care, and modernise and reform primary care, all general practices across England will benefit from new digital phonelines designed to make booking GP appointments easier by March 2024. To better utilise community pharmacies, a consultation will also be launched to enable registered pharmacy technicians to supply and administer medicines. Ahead of the dental recovery plan, which is due to be announced shortly, a second consultation will consider how dental hygienists and therapists can be better supported to provide additional care to patients.
All GP surgeries in England to have digital phonelines by March. Government plans to modernise and reform primary care progress as more than one thousand general practices sign up for digital upgrades.
Building equitable primary care – a practical toolkit. Two academic groups have independently looked at what works to address inequalities in and through primary care. This document brings together these two studies to describe what equitable primary care looks like and provides practical steps to help local decision-makers address inequalities in health and health care.
If you wish to discuss any issues in primary care then please contact Joanne Easterbrook or Ben Lambert.
Public Health
Publications/Guidance
Carrots and sticks: can governments do without public health regulation? This is the first of three papers from the Social Market Foundation exploring tobacco, alcohol, obesity and gambling policy. It compares different types of policy approach, and concludes that more ‘interventionist’ and apparently politically challenging measures, such as strict regulations on availability and taxes, tend to be more effective.
Prevention, integration and implementation: healthcare leaders’ views on the major conditions strategy. The major conditions strategy is a national framework being developed by the Department of Health and Social Care (DHSC) and the Office for Health Improvement and Disparities (OHID). This briefing considers how the strategy can set the conditions to prevent, treat and manage multimorbidity in England.
Treating causes not symptoms: Basic Income as a public health measure. This report summarises research carried out by the Universities of Northumbria, York, Bath and Strathclyde, in collaboration with Compass and Autonomy. It highlights the potential of Basic Income as a public health measure. The study suggests that between 125,000 and 1 million cases of depressive disorders and 120,000 to 1.04 million cases of physical health symptoms could be prevented or postponed. Quality-adjusted life years gained could be valued at £3.9 billion to £19.7 billion, leading to significant cost savings for the NHS.
If you wish to discuss any issues in primary care then please contact Joanne Easterbrook or Ben Lambert.
Social Care
Publications/Guidance
The government's response to the Adult Social Care Committee report. The government’s formal response to the House of Lords Adult Social Care Committee report, ‘A “gloriously ordinary life”: spotlight on adult social care’.
The enhancing clinical care framework for adults living in care homes. A Department of health publications sets out its enhancing clinical care framework, which aims to ensure that people who live in care homes are supported to lead the best life possible and that their right to access timely, integrated, equitable healthcare provision is observed. The framework describes what "good" looks like when someone in a care home accesses multi-disciplinary clinical care and support, in line with their needs and wishes, to support their health and wellbeing. The framework is relevant and equitable for adults living in both residential and nursing homes and across the full range of categories registered by the Regulation and Quality Improvement Authority.
How we can help
For ways in which we can help with Social Care issues click here.
If you wish to discuss any queries you may have around social care please contact Siwan Griffiths.
General
Publications/Guidance
Growing numbers of delayed discharges from community hospitals. Community hospitals play a very important role in supporting patients but, unlike with larger hospitals, little has been known until now about how they struggle with delayed discharges. Following a freedom of information request, this chart of the week from Emma Dodsworth reveals the number of patients experiencing delays leaving community hospitals, and highlights the capacity challenges such hospitals face.
How do the public and NHS staff feel about virtual wards? This report commissioned in March 2023 surveyed the perspectives of members of the public and NHS staff towards the use of virtual wards in the NHS.
Reciprocal healthcare policy framework for the funding of healthcare abroad in exceptional circumstances. This reciprocal healthcare policy outlines the factors the Secretary of State will consider when making funding decisions for care abroad where exceptional circumstances may apply.Reciprocal healthcare policy framework for the funding of healthcare abroad in exceptional circumstances. Published alongside the Department of Health and Social Care's response to the consultation on a reciprocal healthcare policy framework for the funding of healthcare abroad in exceptional circumstances, the final version of the policy framework incorporates minor drafting amendments and comes into effect from 18 August 2023. The framework outlines the factors the Secretary of State will consider when making funding decisions for care abroad where exceptional circumstances may apply.
Health in 2040: projected patterns of illness in England. Produced by The Health Foundation’s REAL Centre in partnership with the University of Liverpool, this report aims to support policy-makers prepare for the future by looking at patterns of illness over the next two decades. The analysis lays out the potential scale and impact of the growth in the number of people living with major illness as the population ages, assigning scores to 20 conditions based on how likely the illness is to affect people’s use of primary care and emergency health services and likelihood of death. The report projects that 9.1 million people will be living with major illness by 2040, 2.5 million more than in 2019.
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