31/03/2024
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.
If someone forwarded you this email you can sign up for your own free copy here delivered directly to your inbox.
|
|
If someone forwarded you this email you can sign up for your own free monthly copy here delivered directly to your inbox.
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.
The Role of Genetics in Medico-Legal Cases Tuesday 23 April 2024 | 12:30 - 13:30 |
Case Law Update – Mental Capacity Act 2005 Friday 26 April 2024 | 12:30 - 13:30 |
Pet Owners, Protected Parties and Patients - Thursday 2 May 2024 | 12:30 - 13:30|
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
Care in Emergency Departments: A Quality Statement. The Quality Statement for Care in Emergency Departments (EDs) sets out the outcomes and standards people should expect to receive when accessing care in high-quality, EDs throughout Wales. Shaped around new Health and Care Quality Standards, the statement provides health boards with clear direction on what good looks like for care in EDs, focusing on timeliness of access and effective communication, and the delivery of care. A national tool developed by the GIRFT (Getting it Right First Time) programme will be launched alongside to bring together ED demand, capacity, outcomes and flow information. Additionally, a new national "Green ED" scheme is being funded by Welsh Government, in collaboration with the Royal College of Emergency Medicine, to embed sustainable working practices, reduce emissions, waste and costs in EDs.
A vision for the NHS ambulance sector in co-designing urgent and emergency care provision. This report, produced in collaboration with the Association of Ambulance Chief Executives and the NHS Confederation, highlights the pivotal role ambulance trusts play in delivering urgent and emergency care and sets out a long-term vision for an enhanced role they could take in co-designing this care. It sets out the case for change and includes several case studies that demonstrate the benefits of ambulance services taking this broader approach.
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
Child mental health services. The Children’s Commissioner for England has published a report on children’s access to mental health services from 2022 to 2023. An analysis of NHS England data shows: 949,200 children in England had active referrals to Children and Young People’s Mental Health Services (CYPMHS) at any point within the 2022-23 financial year; of these children and young people, 28% were still waiting at the end of the year. Reasons for referral included anxiety, depression and self-harm.
Reform of children's social care in England: Research briefing. A House of Commons Library briefing provides a summary of the Government's proposals for reform of children's social care in England, including its implementation strategy and consultation "Stable Homes, Built on Love".
Social care common inspection framework (SCCIF): supported accommodation for looked after children and care leavers aged 16 and 17 - guidance. Following consultations on proposals for inspecting supported accommodation, OFSTED guidance details the Social Care Common Inspection Framework (SCCIF) under which supported accommodation for looked after children and care leavers aged 16 and 17 will be inspected from September 2024. Published alongside the guidance and consultation outcomes, a rapid review of evidence provides insight into what constitutes a positive experience and a good life for children in supported accommodation.
Children and Young People’s Health Equity Collaborative: framework for the drivers of health inequalities. The Children and Young People’s Health Equity Collaborative (CHEC) is a partnership between the UCL Institute of Health Equity, Barnardo’s, and three integrated care systems (ICSs): Birmingham and Solihull, Cheshire and Merseyside, and South Yorkshire. The CHEC sees action on the social determinants of health as essential in improving health outcomes among children and young people and reducing inequalities in health. The framework’s main purpose is to underpin action for achieving greater equity in children and young people’s health and wellbeing. It will be used to support the development of pilot interventions in the three partner ICS areas.
Clinical commissioning policy: prescribing of gender affirming hormones (masculinising or feminising hormones) as part of the children and young people's gender service. An NHS England paper confirms it will commission gender affirming hormone therapy for young people who meet the eligibility and readiness criteria described in the policy document from around their 16th birthday, and stipulates that young people should be aged around 16 years to receive a prescription for these medicines.
Accessing special educational needs and disabilities (SEND) provision for Black and mixed Black heritage children: lived experiences from parents and professionals living in south London. Global Black Maternal Health was commissioned to lead a research project to better understand the experiences of Black and mixed heritage children and families (including the impact on mental health) when a child has special educational needs or disabilities (SEND). This research provides clear recommendations for policy-makers to improve families’ experiences of navigating the support system for children with special educational needs or disabilities.
Reporting child abuse and neglect. NSPCC Learning has published a Helplines insight briefing on barriers for professionals when reporting child abuse and neglect. It is based on contacts to the NSPCC Helpline and NSPCC Whistleblowing Advice Line in 2022/23 by people working or volunteering with children and young people. The briefing identified gaps in knowledge and confidence for some professionals including believing they needed to wait for permission to report concerns. There were also fears around sharing concerns, including worries about disrupting or breaking up families and fears for personal safety. Some professionals described organisational issues such as a lack of safeguarding processes and concealing of abuse.
Child neglect statistics. NSPCC Learning has published a new statistics briefing on child neglect. It looks at data and statistics about child neglect in the UK to help professionals make evidence-based decisions, covering the scale of the issue and what data tells us about children who have been neglected.
Children sharing nude images. The UK Council for Internet Safety (UKCIS) and Department for Science, Innovation and Technology have updated their non-statutory guidance for schools in England on responding to incidents involving the sharing of nude and semi-nude images. It is aimed at Designated safeguarding leads (DSLs) and senior leaders in educational settings in England. The document includes guidance on: risk assessing incidents; safeguarding and supporting children and young people; handling devices and imagery; recording incidents; and providing education on the sharing of nudes and semi-nudes.
Online harms. Ofcom have published three new research reports on online harms as part of their series on the protection of children online. The reports cover: understanding pathways to online violent content amongst children; experiences of children encountering online content promoting eating disorders, self harm and suicide; and key attributes and experiences of cyberbullying among children in the UK.
"No Wrong Doors for Young Carers" is a template Memorandum of Understanding (MoU) designed to improve joint working between adult and children's social care services, integrated care boards and other key organisations in respect of identification and support for young carers and their families. It covers a range of areas such as identification, whole-family approaches to support and transitions from children's to adult services.
The prevalence of sexually transmitted infections in young people and other high risk groups: Fifth Report of Session 2023-24. A Women and Equalities Committee report argues that the Government has "failed to heed" warnings over adequately funding sexual health services amid deeply concerning data on sexually transmitted infections (STI) in young people. It calls for the provision of face-to-face consultations to those who need them, within 48 hours, universal access to free postal STI testing, and greater priority on the teaching of relationship and sex education in schools. It also urges the Government to improve efforts to increase take up of the HPV (human papillomavirus) vaccine, including as a first step, by targeting the children who may have missed out due to the COVID-19 pandemic.
Consultations
Consultation report for the clinical policy on puberty suppressing hormones for children and adolescents who have gender incongruence / gender dysphoria. Following its consultation proposing an interim clinical policy on puberty suppressing hormones (PSH) (sometimes referred to as "puberty blockers" or "hormone blockers") for children and adolescents who have gender incongruence or dysphoria, NHS England has concluded that there is not enough evidence to support the safety or clinical effectiveness of PSH to make the treatment routinely available at this time. The decision means that the new regional services caring for under-18s with gender dysphoria, which open in April 2024, will not use them as part of treatment. From now on children and young people will only be able to get them if they are taking part in a clinical trial.
Consultation response - Gender Questioning Children: Non-statutory guidance for schools and colleges in England. Responding to a Department for Education consultation on non-statutory guidance for schools and colleges in England on gender questioning children, the Equality and Human Rights Commission suggests that the guidance: could provide better support to schools and colleges by explaining relevant provisions in the Equality Act 2010 and explicitly referring to them where relevant in each chapter; should make reference to other general legal concepts including Gillick competence, capacity for over 16 year olds, and safeguarding where relevant; could provide further detailed consideration of bullying as a particular risk to children with the protected characteristic of gender reassignment; and should highlight the need for schools to consider whether sharing information with parents in circumstances which do not meet the significant risk of harm threshold, for example, where there is some chance but not a significant risk of harm, is compatible with their safeguarding duties.
If you wish to discuss any queries you may have around children please contact Deborah Jeremiah.
Clinical Risk / Patient Safety
Publications/Guidance .
Early Notification Scheme process update: Improving communications with families. NHS Resolution is committed to improving engagement with families who are potentially impacted by the Early Notification (EN) Scheme. This update outlines changes to how the process is initiated, and families’ experience of the scheme. Seeking family permission to start legal investigations. In cases where the scheme criteria for entry is met, NHS Resolution will now seek permission from the family before commencing a legal investigation under the EN Scheme. This applies to babies born on or after 1 October 2023.
Safe scope of practice for Medical Associate Professionals (MAPs). A British Medical Association publication outlines the level of responsibility those in medical associate professions (MAPs), such as physician associates (PAs) and anaesthesia associates (AAs), should have. It uses a traffic light-style system to illustrate what clinical duties MAPs should be able to carry out, as well as those responsibilities from which they should be prohibited. It also sets out six general principles for how MAPs should be deployed in primary and secondary-care settings.
Written Statement: Clinical Indemnities Reform. A written statement from the Department of Health and Social Care reports on further progress on Recommendation 10 of the inquiry into the surgeon Ian Paterson, which identified shortcomings in the clinical negligence cover system. It announces that medical defence organisations propose to implement, by the end of 2024, a sector-led Code of Practice for medical defence organisations who provide a particular type of clinical negligence cover called discretionary indemnity that many healthcare professionals purchase.
Black maternal health care and community groups: building trust and bridging gaps. How are community groups bridging some of the gaps between Black mothers and health and care services? What can the health and care system learn in response?
Life or death medical mistakes happen due to bad translation. An Equality and Social Justice Committee report has concluded that language barriers in healthcare can cause serious medical harm. It highlights its concerns by evidence that people from ethnic minority backgrounds continue to face worse outcomes from public sector services in Wales. It calls on the Welsh Government to end the reliance on family members for translation as a matter of urgency, as part of the Anti-Racist Wales Action Plan.
AvMA's Response to Health and Social Care Committee NHS Leadership, performance and patient safety - Call for evidence. A response from Action Against Medical Accidents (AvMA), to the Health and Social Care Committee inquiry's call for evidence on leadership, performance and patient safety in the NHS, states that: in its experience, the NHS complaint process is not robust enough to head off many issues that subsequently become clinical negligence claims; and that, in general, complaints staff do not appear to have the skills, experience, training and gravitas to investigate complaints properly within their own trust. It suggests that the complaints process, in relation to low value claims only, would be more efficient and effective if trusts were able to make small awards in recognition of poor care provided.
Complaints about the NHS in England. PHSO
News
Maternity delays spark thousands of safety alerts each year
£35 million investment to boost maternity safety. The investment will be provided over the next 3 years to ensure maternity services listen to and act on women’s experiences.
Bevan Brittan Events
The Role of Genetics in Medico-Legal Cases Tuesday 23 April 2024 | 12:30 - 13:30 |
Learning from coroners Prevention of Future Death reports – A vigilance platform to learn lessons following inquests - Tuesday 7 May 2024 | 12:30 - 13:30 |
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.
Digital Health
Publications/guidance
Making the future a reality: harnessing the potential of patient-facing tech in health care. This guide, produced in collaboration with Google Health, is intended for NHS leaders and those leading on the technology and transformation agenda within their organisation. It aims to support them to: review transformation plans against five key components for unlocking the future of patient-facing technology in health care; stimulate conversations with team and board members, using the actions framework; and bring external stakeholders and partners together to assess priorities for patient-facing technology.
What the NHS can and cannot learn from the Singaporean health care system. Singapore spends less on health care than the UK, and achieves remarkable health outcomes. Yet it is often unclear how far these lower costs are due to the design of its health care system as opposed to wider societal and cultural factors. This paper focuses specifically on primary care, and argues that Singaporean-style polyclinics and telemedicine could help drive efficiency in the UK, as they have done in Singapore.
Equity in medical devices: independent review. Evidence has emerged about the potential for racial and ethnic bias in the design and use of some medical devices commonly used in the NHS, and that some ethnic groups may receive sub-optimal treatment as a result. The purpose of the review, chaired by Professor Dame Margaret Whitehead, was to establish the extent and impact of potential racial, ethnic and other factors leading to unfair biases in the design and use of medical devices, and to make recommendations for improvements.
4D tech to prevent falls to be rolled out in social care settings. 4D mapping technology that detects falls using sensors and alerts carers is piloted in care homes.
AI-Enabled faster diagnostics: How the NHS can build for the future
NHS England to extend use of AI to prevent missed appointments. NHS England has plans to extend the use of AI technology to help reduce the number of missed appointments and to allow staff more free time in elective care.
If you wish to discuss any queries you may have around Digital Health please contact Daniel Morris.
Employment/HR
Publications/guidance
Recent trends in public sector pay. Average pay in the public and private sectors has performed very differently since the election in 2019. These recent trends come on top of poor earnings performance in both sectors since 2007. Within the public sector, some high-profile professions (nurses, and particularly teachers and hospital doctors) have seen considerably worse pay growth than the average public sector worker. Looking at trends in the English NHS, nurses saw a significant reduction in real pay over the 2010s (falling 7% between 2010 and 2019), with only a modest recovery since. Doctors and teachers, as higher-paid public sector workers, have felt the consequences of compression of public sector pay, with pay deals consistently benefiting lower-paid workers more than higher-paid workers, both within and across professions.
Information sharing in mental health emergencies at work. Data protection law allows organisations to share personal information in an urgent or emergency situation, including to help them prevent loss of life or serious physical, emotional or mental harm. This guidance is aimed at giving employers greater certainty about sharing information about their workers in the event of a mental health emergency. It provides advice on when and how it is appropriate to share workers’ information in such an emergency, even if you haven’t thought about this before. It is good practice to plan ahead, as this will help you make timely and better informed decisions if you need to. So this guidance also provides advice on how to think in advance about sharing workers’ information in a mental health emergency.
Coronavirus: Long Covid. Information about long covid, including guidance and services for long covid patients, statistics and the impact of long covid on healthcare, employment and education.
The NHS workforce in England. This briefing covers the NHS workforce in England, including key targets, recruitment and retention issues, workforce planning and Government policy.
Counting the cost of NHS strikes. NHS strikes have become a familiar feature of our lives over the past two years, but is there a risk we become accustomed to their impact?
Safe scope of practice for Medical Associate Professionals (MAPs). A British Medical Association publication outlines the level of responsibility those in medical associate professions (MAPs), such as physician associates (PAs) and anaesthesia associates (AAs), should have. It uses a traffic light-style system to illustrate what clinical duties MAPs should be able to carry out, as well as those responsibilities from which they should be prohibited. It also sets out six general principles for how MAPs should be deployed in primary and secondary-care settings.
High-level principles concerning physician associates (PAs): Academy consensus statement. This document outlines some practical and high-level principles that doctors and health care teams should use to determine whether and how to integrate physician associates (PAs) into existing teams. Given that PAs will join more varied and diverse teams than anaesthesia associates (AAs), these principles are directed at the PA workforce.
The National Health Service Pension Schemes (Amendment) Regulations 2024: report on changes to member contribution rates and the earning thresholds at which rates become payable. This report sets out the reasons for changing the amount that members contribute to the NHS Pension Scheme. It takes into account the desirability of not making any changes at this point in time. The report is a statutory report and has been laid before parliament.
NHS Staff Survey 2023. The statistical results of the 2023 NHS Staff Survey give an insight into the experiences of more than 600,000 people working in the NHS in autumn 2023. It covers subjects such as bullying and discrimination, morale, rewards, learning, staff engagement and more.
Nursing locally, thinking globally: UK-registered nurses and their intentions to leave. This long read looks at the number of overseas-trained nurses registered in the UK, and how many are considering leaving to work elsewhere.
The Department of Health and Social Care's written evidence to the Senior Salaries Pay Review Body for the 2024 to 2025 pay round. The Senior Salaries Review Body (SSRB) has been asked to make a pay recommendation on the current levels of pay for very senior managers (VSMs) in the NHS and executive and senior managers (ESMs) in DHSC’s arm’s length bodies. The written evidence seeks to enable the SSRB to make independent observations on the levels of pay of VSMs and ESMs to form part of the wider SSRB report, which will include observations on the levels of pay for other senior public sector workers.
Supplementary evidence to pay review bodies: hospital and community health sector, 2024. This report and associated data tables give granular estimates of basic pay, total earnings and paybill for the hospital and community health sector workforce in England in 2022 to 2023 and 2023 to 2024.
What health and care need from the next government: #1 – NHS staffing. With a general election approaching, the Nuffield Trust is publishing a series of briefings that challenge the NHS and social care manifesto commitments of UK political parties ahead of the electorate heading to the polls. The first in our series looks at NHS staffing, setting out a series of policy ‘tests’ that the next government must meet to address some of the longstanding issues to attracting, training and retaining the mix of staff needed to meet the needs of the population.
Moving from not racist to anti-racist. What does anti-racism mean in practice? In this blog, Simon Newitt and Professor Joy Warmington look at the principles behind bringing anti-racism work to life and the role we can all play in our organisations in promoting an anti-racist approach.
Bevan Brittan Articles
Menopause – EHRC Guidance. How the EHRC’s guidance on the menopause will help employers
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, Oonagh Sharma, James Gutteridge or Andrew Uttley.
Finance
Publications/guidance
Commissioning to reduce health inequalities: the role of finance. This briefing explores how NHS finance staff can contribute to commissioning approaches that help reduce health inequalities. It sets out the direction of travel, explains the importance of population health management, and looks at the skills and expertise that finance staff can bring to this space.
Unlocking reform and financial sustainability: NHS payment mechanisms for the integrated care age.
Following the Hewitt review recommendation to consider alternative payment mechanisms within the health system, this discussion paper explores examples of international and domestic payment mechanisms. The paper is intended to support further discussion and debate and to inform future policy-making to support integration.
Introduction to the NHS payment scheme. This briefing focuses on the commissioning of secondary and tertiary health care from NHS providers by integrated care boards (ICBs) and NHS England. The briefing is aimed at finance staff in all sectors who may not be directly involved in the contracting and commissioning of services, or who have recently moved into roles in this field. It may also be of interest to non-finance staff supporting the strategic design of services and pathways in their organisations and wider integrated care systems.
NHS Supply Chain and efficiencies in procurement: Twenty-Fourth Report of Session 2023-24. A Committee of Public Accounts report warns that NHS Supply Chain, which was created to save the NHS money through pooling hospitals' purchasing power, has failed to persuade NHS trusts to use it to make billions in purchases. Finding that clinicians are not convinced that NHS England and NHS Supply Chain value quality over price, the report calls for clinicians to be involved in purchasing choices to ensure that better patient care is considered alongside value and cost.
The past and future of NHS waiting lists in England.This report discusses the past and future of NHS waiting lists. It outlines five key facts about past NHS waiting list performance, including pre-pandemic trends, changes during the pandemic and regional variation. It also describes a range of scenarios for what could happen to NHS waiting lists over the next four years under different assumptions.
Health Inequalities
Publications/Guidance
Reducing health inequalities: a guide for NHS trust board members. This is a practical guide to support NHS trust board members to address health inequalities as part of their core business. It outlines why trusts should act on health inequalities, includes a vision for what good looks like, a self-assessment tool for trusts to use to determine where they are in their journey, and a list of suggested objectives for board members. It covers a wide range of trust work, from operational and clinical delivery of services, to the trust’s role as an anchor institution and employer of NHS staff.
Commissioning to reduce health inequalities: the role of finance. This briefing explores how NHS finance staff can contribute to commissioning approaches that help reduce health inequalities. It sets out the direction of travel, explains the importance of population health management, and looks at the skills and expertise that finance staff can bring to this space.
How to embed action on health inequalities into integrated care systems. This toolkit is a practical guide for system leaders that will help to inform future spending on health inequalities (HI) and support implementation of high-impact changes within integrated care boards to address HI. It aims to build system leaders’ confidence in their ability to tackle inequalities in their organisations and is accompanied by a research report that looks at the approaches systems took to spending health inequalities money.
Commissioning to reduce health inequalities: the role of finance. This briefing explores how NHS finance staff can contribute to commissioning approaches that help reduce health inequalities. It sets out the direction of travel, explains the importance of population health management, and looks at the skills and expertise that finance staff can bring to this space.
Preventing people with a learning disability from dying too young. Around 1.3 million people in England have a learning disability and may need more support to stay in good health. But are they able to get access to the services they are entitled to in order to prevent illness? This report looks at a set of five key preventive health care services and functions to understand whether they are working as they should for people with a learning disability.
Equity in medical devices: independent review. Evidence has emerged about the potential for racial and ethnic bias in the design and use of some medical devices commonly used in the NHS, and that some ethnic groups may receive sub-optimal treatment as a result. The purpose of the review, chaired by Professor Dame Margaret Whitehead, was to establish the extent and impact of potential racial, ethnic and other factors leading to unfair biases in the design and use of medical devices, and to make recommendations for improvements.
Government response to the report of the equity in medical devices: independent review
The government recognises the report’s main argument that unless appropriate actions are taken, biases can occur throughout the entire medical device life cycle. The government response provides: a summary of the government’s response to each of the 18 recommendations and calls to action; and a detailed discussion of the steps required to address the core sentiment of the recommendations and sub-recommendations.
Illustrating the relationship between poverty and NHS services. This long read argues that while the NHS can, and should, do more to make timely care accessible to deprived communities, wider government and societal action is needed to address the root causes of poverty.
End of life care: improving "do not attempt CPR" conversations for everyone. A Parliamentary and Health Service Ombudsman (PHSO) report warns that a change in how British people and health professionals talk about death is needed to avoid delays in crucial conversations about end-of-life care, resulting in traumatic consequences for patients and their families, and has called for urgent improvements to the process and communication surrounding do not attempt cardiopulmonary resuscitation (DNACPR). The majority of complaints received about the communication of DNACPR notices by PHSO during the COVID-19 pandemic were either from older people or disabled people, or on their behalf. The report also uncovers fears about ableist and ageist attitudes and behaviours within the NHS. Other key findings included: issues with record-keeping and documenting decisions, with up-to-date information not following a patient through the medical system; and a lack of public awareness about cardiopulmonary resuscitation and who is responsible for making a DNACPR decision.
Adverse weather and health plan equity review and impact assessment 2024. This review covers evidence on inequalities in risks to health from adverse weather events. It also describes how the Adverse Weather and Health Plan addresses these risks for different populations and makes recommendations for strengthening action to help reduce inequalities in risk across populations, now and in future.
Illustrating the relationship between poverty and NHS services. Currently, it is estimated that more than one in five people in the UK are living in poverty. Living in poverty has a profound impact on people’s health and how they use NHS services. From greater prevalence of a wide range of diseases and difficulties in accessing health care to later treatment and worse health outcomes, poverty affects every stage of the patient journey.
Children and Young People’s Health Equity Collaborative: framework for the drivers of health inequalities. The Children and Young People’s Health Equity Collaborative (CHEC) is a partnership between the UCL Institute of Health Equity, Barnardo’s, and three integrated care systems (ICSs): Birmingham and Solihull, Cheshire and Merseyside, and South Yorkshire. The CHEC sees action on the social determinants of health as essential in improving health outcomes among children and young people and reducing inequalities in health. The framework’s main purpose is to underpin action for achieving greater equity in children and young people’s health and wellbeing. It will be used to support the development of pilot interventions in the three partner ICS areas.
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.
Housing
Publications and guidance
'Always at the bottom of the pile': the Homeless and Inclusion Health Barometer 2024. This report, the first of its kind from the homelessness charities Pathway and Crisis, reveals how the national crisis facing both England's health and housing systems leads to worsening health for people in inclusion health groups. Drawing on 85 pieces of published literature from the past two years, and a survey of frontline medical and health care professionals, the findings reveal how those who are most excluded in our society struggle to access health services due to inflexibility, discrimination and stigma.
For more information contact Julia Jones.
Independent Health
News
Investors eye opportunities in Labour pledge to boost private health sector
For more information contact Tim Hodgetts or Julie Charlton
Information sharing/data
Publications/Guidance
Information sharing in mental health emergencies at work. Data protection law allows organisations to share personal information in an urgent or emergency situation, including to help them prevent loss of life or serious physical, emotional or mental harm. This guidance is aimed at giving employers greater certainty about sharing information about their workers in the event of a mental health emergency. It provides advice on when and how it is appropriate to share workers’ information in such an emergency, even if you haven’t thought about this before. It is good practice to plan ahead, as this will help you make timely and better informed decisions if you need to. So this guidance also provides advice on how to think in advance about sharing workers’ information in a mental health emergency.
Government response to the rapid review into data on mental health inpatient settings. Following the recommendations in the independent "rapid review" into mental health patient safety, the Government, with support from NHS England and the Care Quality Commission, will: take forward a programme of work to agree how to make sure that providers, commissioners and national bodies are "measuring what matters" for mental health inpatient services, and can access the information they need to provide safe, therapeutic care; work with integrated care systems (ICSs) leaders to highlight the importance of ICSs taking a leadership role in ensuring the quality of data, to improve patient safety and therapeutic care in inpatient settings and reduce the time needed for frontline staff to input data; and publish, in due course, updated NHS England guidance on delivering same sex accommodation in mental health inpatient units.
Bevan Brittan Articles
For more information contact Jane Bennett.
Inquests and Inquiries
Publications/Guidance
Guidance No 46 Obtaining information regarding social media use. The purpose of this guidance is to help coroners understand their options when it comes to obtaining evidence relating to the use of social media, should such information fall within the scope of an investigation.
Bevan Brittan Events
Learning from coroners Prevention of Future Death reports – A vigilance platform to learn lessons following inquests - Tuesday 7 May 2024 | 12:30 - 13:30 |
If you wish to discuss any queries you may have around inquests, please contact Amanda Wright- Kluger or Claire Leonard.
Mental Health
Publications/Guidance
A hidden crisis: Older people and deprivation of liberty in care homes. A report from Age UK calls for urgent action to resolve what it describes as an "ongoing human rights crisis" around deprivation of liberty safeguards (DoLS), to ensure that the rights of older people who lack mental capacity are not ignored. In what is part of a "wider story of policy neglect and underfunding" impacting social care, it states that almost 50,000 older people have died without the proper legal safeguards being in place, and that in 2022/23, it took an average of 156 days for a standard authorisation, vastly longer than the statutory timeframe of 21 days. A number of recommendations are put forward, including: supporting local authorities to recruit sufficient staff to ensure that adequate time can be given to DoLS assessments; the need to fully fund Liberty Protection Safeguard to ensure that local authorities and the NHS are able to meet their legal obligations; and the requirement for a cultural shift within social care to ensure that older and disabled people's rights are recognised and protected, via the progressive values and aims of the Mental Capacity Act 2005.
Identifying a deprivation of liberty: a practical guide. A Law Society publication provides guidance to help solicitors and people working in health and social care to identify when a deprivation of liberty may be taking place. It has been updated to take account of important developments in the law relating to deprivation of liberty, including clarification of the position of: those under 18; and those in receipt of life-sustaining medical treatment.
Child mental health services. The Children’s Commissioner for England has published a report on children’s access to mental health services from 2022 to 2023. An analysis of NHS England data shows: 949,200 children in England had active referrals to Children and Young People’s Mental Health Services (CYPMHS) at any point within the 2022-23 financial year; of these children and young people, 28% were still waiting at the end of the year. Reasons for referral included anxiety, depression and self-harm.
Cases
Wareham v Betsi Cadwaladar University Health Board & Ors [2024] EWCOP 15. Capacity decision concerning Laura Wareham, an adult woman, and where there is disagreement between her and the treating clinicians over her treatment.
CLF, Re (Capacity: Sexual Relations and Contraception) [2024] EWCOP 11. Judgment concerning capacity of CLF to make decisions relation to residence, care, contact, use of social media, engagement in sexual relations and use of contraception.
Bevan Brittan Articles
Interim declarations in the Court of Protection: a new approach - Shiva Krishnan
Bevan Brittan Events
Case Law Update – Mental Capacity Act 2005 Friday 26 April 2024 | 12:30 - 13:30 |
Pet Owners, Protected Parties and Patients - Thursday 2 May 2024 | 12:30 - 13:30|
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 or Hannah Taylor.
Primary Care
Publications/Guidance
Continuity of Care Increases Physician Productivity in Primary Care. This study suggest that if all GP practices moved to a model where patients saw the same doctor at each visit, it could significantly reduce doctor workload while improving patient health.
The gap between need and supply of GP practice consultations
This paper finds that the use of GP practice consultations increases with age and with levels of morbidity. Since 2008, the population has aged, and age-specific morbidity levels have increased. This suggests that need for GP practice consultations has grown, while the average number of consultations per person has reduced. It is estimated that in 2019, a patient was 12.2% less likely to receive a consultation than a patient with similar needs in 2012. An additional 36.6 million consultations (+13.9%) would have been required to meet needs in 2019 as they were in 2012.
GP practice productivity, efficiency, and continuity of care
This report explores the issue of GP practice productivity and efficiency — how it might be measured, how it has changed over time, the degree of geographic variation, and the relationship between productivity, efficiency, and continuity of care for patients.
Rethinking access to general practice: it’s not all about supply. This briefing finds that, in recent years, public satisfaction with access to general practice has plummeted. People are finding it harder to make appointments, and feeling increasingly dissatisfied with waiting times and the types of appointment offered. However, despite having fewer GPs in England than there were in 2015, general practice is now delivering record numbers of appointments. The briefing looks at ways of improving access to general practice, beyond increasing the supply of appointments.
Government response to the House of Lords committee report on integrating primary and community care. This report provides a response to the House of Lords committee report, Patients at the centre: integrating primary and community care, published on 15 December 2023. This is the government’s response to the committee’s recommendations contained in the report, which explored how integrating services could address the challenges facing primary and community care.
If you wish to discuss any issues in primary care then please contact Joanne Easterbrook or Ben Lambert.
Prison Health
Journal Articles
Prison healthcare in England and Wales is in perpetual crisis.
If you wish to discuss any issues in prison health then please contact Joanne Easterbrook or Julie Charlton
Social Care
Publications/Guidance
Reforming adult social care in England. This report looks at adult social care in England and finds understaffing, rising waiting lists and patchwork funding that places sustained financial pressure on local authorities. It calls for stronger leadership, long-term financial support, and a clear workforce strategy to address key shortfalls in the sector.
Who cares wins: Unfair to Care 2024 – understanding the social care pay gap and how to close it. This report analyses the social care pay gap and its impact on people, communities, the care sector and the economy. It reveals an opportunity to end the workforce challenges in social care, with public and MP polling finding consensus that the social care pay gap must be addressed. Highlighting the importance of a 2.6 million-strong ‘social care vote’, it indicates that the challenges of social care may influence the course of the 2024 election.
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
Public satisfaction with the NHS and social care in 2023. Results from the British Social Attitudes Survey. Only 24% of the public are satisfied with the NHS, and only 13% are satisfied with social care. The public largely agree on the way forward for the health service, however, with a large majority still supportive of the NHS’s principles.
What do virtual wards look like in England? This working paper analyses aggregate national data on virtual wards to describe what virtual wards currently look like across England and discuss the effects of virtual wards on patients, staff and hospital capacity, as well as the gaps in the evidence.
Assisted dying/assisted suicide. This report covers: parliament and the current law; the government's role in the debate; international examples of jurisdictions where assisted dying/assisted suicide is available in some form; the involvement of physicians and assessments of eligibility and capacity to give informed consent; and palliative and end-of-life care. It identifies the pursuit of high-quality compassionate end-of-life care as a common theme in the evidence received, as well as agency and control for the person dying.
If you would like to sign up for any of our Bevan Brittan publications click here.
Related Insights
Civil Procedure Rules, Part 36 offers and recent decisions in 2024
Jul 9 2024
Bevan Brittan Education Lunchtime Training Webinars 2024
Read More
Perplexing Presentations and Fabricated and Induced Illness in...
Jul 4 2024
Bevan Brittan Education Lunchtime Training Webinars 2024
Read MoreScientific Developments in the causation of birth injuries. Is...
Jun 25 2024
Bevan Brittan Education Lunchtime Training Webinars 2024
Read More