Care

Publications/Guidance

High Quality Care for All: NHS Next Stage Review final report. This is the final report of Lord Darzi's NHS Next Stage Review. It sets out a vision for an NHS with quality at its heart.

Shifting the balance of care to local settings. The See Saw report is based on the findings of a simulation exercise led by The King’s Fund in partnership with Loop2 and commissioned by the Department of Health. It identifies the barriers that are currently standing in the way of change and explores what would need to happen to encourage a faster and more consistent shift of care to community settings and patients homes.

Commission for Social Care and Inspection: See me, not just the dementia: Understanding people’s experiences of living in a care home. This report looks at the experiences of people with dementia living in care homes in England, with a particular focus on whether their care offers dignity and respect. Most similar studies have relied on the views of carers, care staff and people in the early stages of dementia, but this study examines directly the experiences of people including those with advanced dementia.

DH: Carers at the heart of 21st century families and communities. This document outlines the Government's strategy for the future care and support of carers. Its vision is that by 2018, carers will be recognised and valued as being fundamental to strong families and stable communities. Support will be tailored to meet the individuals’ needs, enabling carers to maintain a balance between their caring responsibilities and a life outside caring, whilst enabling the person they support to be a full and equal citizen. The Carers' Strategy is underpinned by a £255m investment to implement some immediate steps alongside medium and long-term plans, including:

		£150m towards planned short breaks for carers;
		£38m towards supporting carers to enter or re-enter the job market; and
		£6m towards improving support for young carers.

Other schemes include the piloting of annual health checks for carers to help them stay well and training for GPs to recognise and support carers. A more integrated and personalised support service for carers will be offered through easily accessible information, targeted training for key professionals to support carers, and pilots to examine how the NHS can better support carers.

IDeA: Lessons from outsourcing adult social care - the workforce issues. This report presents the findings of a study that examined how outsourcing within adult social care has affected the workforce and the lessons for the rest of local government. It offers a set of messages for other parts of local government on how they might manage workforce issues positively if and when they consider outsourcing.

Self care: a national view in 2007 compared to 2004-5. DH commissioned Ipsos MORI to undertake a longitudinal study, exploring attitudes of the public towards self care. The study was carried out through a national omnibus, and face to face in-home interviews were conducted with a representative sample of the population. A further study will be carried out in 2009. The study is in three parts: views of the general public; views of people with long term conditions; and attachments. An executive summary is also available.

Consultations
CSCI: A consultation on changes for the performance assessment of adult social care in 2008-09. Seeks views from Directors of Adult Social Services, providers of social care services and those who work in adult social care performance assessment, on proposed changes to the Commission's performance assessment process. It focuses on changes to the grade descriptors under the outcomes framework, and the self-assessment survey. Comments are required by 8 August 2008. (10 June 2008)

Cases

Sandford (Executors of the Estate of Lydia Sandford, Deceased) v Waltham Forest LBC [2008] EWHC 1106 (QB) (QBD): S's executors claimed damages against the local authority for breach of the authority's statutory duty of care and its duty at common law. S, who was 91, was injured in a fall in her bedroom. She was admitted to hospital and then discharged to a nursing home where she remained until her death three years later. Prior to the fall, the authority had carried out an assessment of S's needs which recommended that it provide S with cot-sides for her bed; however, no cot-sides had been provided by the time of her fall. The claimants contended that she would not have fallen if the authority had provided cot-sides. They claimed the cost of contributions by S towards her accommodation fees in the nursing home together with damages for her pain and suffering and loss of amenity from the injury. The claimants submitted that the local authority, once it had assessed what equipment or aids S needed, owed to a duty of care at common law to supply that equipment or those aids within a reasonable time.
The court held, dismissing S's claim, that the local authority did not owe to S the duty of care alleged. A public body when performing its statutory duties had no common law duty of care as to the manner or timing of those duties because it was not voluntarily assuming responsibility for an affected person. The authority had a duty of care under s.2 of the Chronically Sick and Disabled Persons Act 1970 to supply necessary aids and equipment to S, which was not actionable by a private individual. The complaint against the local authority was not a failure to provide the cot-sides within a reasonable time but rather a failure to supply them at all before L's fall; time was immaterial. The claimants had failed to prove that S would not have sustained the injury if cot-sides had been fitted prior to her fall, and it was not accepted that, but for the fall, S would have been able to continue to live in her house until her health deteriorated three years later. (21 May 2008).

News

DH: Old age is the new middle age. The Secretary of State for Health, Alan Johnson, has outlined measures to improve healthcare for older people including: a new focus on telecare which helps older people manage their conditions in their own homes; improved services for falls, fractures and osteoporosis; and a review of podiatry services.

Bevan Brittan Training

Regulated Care Sector Seminar. Dramatic changes are taking place in the way that health and social care are provided, regulated and commissioned. In September Bevan Brittan is holding its annual Regulated Care Sector Seminar 2008. These seminars which are free of charge will provide you with valuable information to enable your business to prepare for the changes that are afoot. The seminars will take place in our London office (11 September), Bristol office (24 September) and Birmingham office (25 September). Click here if you would like more information on these sessions.

If you wish to discuss any of the items raised in this section please contact Neil Grant.

Children

Cases

Re B (Children) [2008] UKHL 35 (11 June 2008, HL). The standard of proof in finding the facts necessary to establish that a child "is likely to suffer significant harm" under the Children Act 1989 s.31(2), or the welfare considerations in s.1, was the balance of probabilities. Neither the seriousness of the allegation nor the seriousness of the consequences should make any difference to the standard of proof to be applied in determining the facts.

News

Legal Services Commission and DH: Reforming the delivery of health expert evidence. Gives details of a pilot designed to use cross-disciplinary teams of health professionals to provide expert witness services in public law childcare proceedings. Interested NHS Trusts and other suitable voluntary organisations are invited to apply by 23 July 2008.

If you wish to discuss any of the items raised in this section please contact Deborah Jeremiah.

Clinical Management

Cases

Peters (by her Litigation Friend Miles) v (1) East Midlands SHA (2) Halstead; Nottingham City Council (Part 20 Defendant) [2008] EWHC 778 (QB). Where a patient had been left gravely handicapped as a result of the negligence of a health authority, but the local authority also had a statutory obligation under the National Assistance Act 1948 s.21 to provide for the costs of her care in a private care home, both the health authority and the local authority were liable to the patient for the future costs of her care. See the commentary by 1 Chancery Lane.

K v (1) Central & North West London Mental Health NHS Trust (2) Kensington & Chelsea RLBC [2008] EWHC 1217 (QB). A master had been wrong to strike out a mental patient's claim in damages for negligence against a mental health trust and local authority on the basis that such bodies were exempt from common law liability under the Mental Health Act 1983 s.117.

SF v Merton LBC (Out of Court Settlement, 16 January 2008): the claimant, a 21-year-old male, received £42,500 for the psychiatric injuries suffered when the local authority failed to intervene to protect him from the significant emotional, physical and sexual harm he suffered as a child whilst living with his mother from 1997 until 1999. He suffered from a serious personality disorder and was expected to continue to pose a risk to himself and other people.

Bevan Brittan Training

Managing the clinical and medico-legal risks of obesity. Julie Chappell can provide training on the issues around this increasingly high profile area including manual handling, risk management, equipment needs and clinical care. She has also recently published a journal article on the topic. If you would like more information on training or a copy/summary of the journal article please click here.

Bevan Brittan Updates

June Claims online - Important new regulations on collection of cord blood samples. Jackie Linehan and Richard Annandale on the need for a Human Tissue Authority licence for collection of cord blood for human application at birth.

June Claims online - Blood sample saves £5million. Continuing with the bloody theme of this issue, Tim Hodgetts illustrates the medico-legal value of fetal blood samples with a Bevan Brittan success in the Court of Appeal that will have saved £5million.

June Claims online - Case updates. The end of the party: A round-up of recent cases by Julie Charlton including new wording on Part 36, disregarding payments payable on death ... and bouncy castles.

If you wish to discuss any of the items raised in this section please contact Jackie Linehan.

Clinical Research

Publications/Guidance

60 years of research in the NHS benefiting patients. The Department of Health has published a report to commemorate 60 years of NHS research. The report outlines some of the major advances in medical knowledge, research, treatment and patient care that have marked the first 60 years of the NHS.
The Health Secretary has also announced that patients will be given the right to be informed of clinical trials which may be beneficial to them as part of measures to boost medical research and innovation. Other initiatives include the creation of up to 10 academic health science centres which combine university medical research departments with teaching hospitals.

News

£10 million per year for public health research: announces the Public Health Research (PHR) Programme, established by the National Institute for Health Research (NIHR), that will evaluate a wide range of public health interventions such as social marketing for the promotion of safe sex, the prevention of obesity in children, and speed bumps for the prevention of road traffic accidents. The funding will rise over each of the next three years to reach £10m a year. It will have two modes of operation: most funding will be in response to applicants' proposals, but there will also be commissioning capacity to advertise prioritised topics, themed calls and linked research projects. The programme will be managed by the NIHR Evaluation, Trials and Studies Coordinating Centres (NETS-CC), based at the University of Southampton alongside other NIHR Programmes including the world-class NIHR Health Technology Assessment Programme.

The DH has also announced new research collaborations for health: seven new NIHR Collaborations for Leadership in Applied Health Research and Care (NIHR CLAHRCs) will receive a total of £64m to conduct research and improve care in major conditions including heart disease, stroke, diabetes and obesity. Each Collaboration will bring together universities and their surrounding NHS organisations to test new treatments and new ways of working in specific clinical areas, to see if they are effective and appropriate for everyday use in the health service. The press release gives details of the seven CLAHRCs.

Medical research centre proposed: announces the University of Bristol's and United Bristol Healthcare NHS Trust's plans for a new £6.6m Clinical Research and Imaging Centre (CRIC) at St Michael's Hospital in Bristol that will house a highly advanced MRI scanner, sleep laboratory and clinical investigation suite. The scanner will be used to examine brain activity in patients with mood disorders, such as depression, and drug and alcohol addictions, while the sleep laboratories will house studies into the links between sleep disorders and obesity in children.

If you wish to discuss any of the items raised in this section please contact Deborah Jeremiah.

Commissioning

Publications/Guidance

Commissioning to Make a Bigger Difference: A guide for NHS and social care commissioners on promoting service innovation. This publication looks at innovation in commissioning, with a special focus on world-class commissioning. It is designed to help health and social care commissioners fulfil their roles in stimulating innovative ideas in the areas of promotional, preventive and care interventions, along with innovative service and marketplace development overall.

Buy and make a difference: How to address social issues in public procurement. OGC has published this practical guide to show public procurers how they can help address social concerns in what they buy and in their expectations of suppliers.

Pre registration education and funding for paramedics: guidance for SHAs, PCTs and ambulance services. This document provides information on the transition to higher education for paramedic pre registration education. It describes the recommended education model and provides guidance on commissioning and funding education programmes. It is designed for use by SHAs, PCTs and ambulance trusts.

PCT survey: provision of IVF in England 2007. This survey was carried out in autumn 2007 and will be used as a basis for monitoring IVF provision. Overall, there is a move towards the implementation of the NICE guideline, though there remain variations in access criteria. To help move to more equitable provision, the Government has established an expert group on commissioning NHS infertility provision, which will:-

		identify the barriers to the NHS progressing to the implementation of the NICE fertility guideline, taking account of the current variation in provision of IVF and ICSI between PCTs, the current variation in access criteria and the intermittent suspension of services in some locations
		identify and bring about the tools which will help PCT commissioners in making decisions on fertility provision and encourage stepwise progress towards the full implementation of the NICE fertility guideline

The expert group will support the work being carried out by Infertility Network UK, which will identify and disseminate good practice in the provision of fertility services

Supporting world class commissioning. The NHS Information Centre for health and social care has produced a short film and a booklet on how its products and services can help to support world class commissioning.

If you wish to discuss any of the items raised in this section please contact David Owens.

Embryology

Legislation

The Bill provides for revised and updated legislation on assisted reproduction and for changes to the regulation and licensing of embryo use in research and therapy. Progress of the Bill.

News

Women win the right to children without fathers: key ruling for single women and lesbians: MPs vote for new laws on IVF treatment. Members of Parliament have agreed to remove the requirement placed on fertility clinics to consider a child's need for a father. The Human Fertilisation and Embryology Bill will replace the requirement for a father with "supportive parenting" giving lesbians and single women the right to fertility treatment without requiring a father or similar male role model, ending a perceived discrimination against single women and lesbians.

If you wish to discuss any of the items raised in this section please contact Jackie Linehan.

Employment/Human Resources

Legislation

On 18 June 2008, the NHS Bodies Employment Contracts (Notice Periods) Directions 2008 came into force. The Directions, which have been introduced following a Department of Health consultation, set a notice period of 6 months for all new employment contracts for senior NHS managers, including Chief Executives and Executive Directors. The Directions apply to strategic health authorities, primary care trusts, NHS trusts (including ambulance trusts), and special health authorities. Foundation trusts are excluded, but will be expected to use the Directions as guidance on best practice. Longer notice periods may be acceptable in specific or specialist circumstances, but the employing organisation will have to present their case to the relevant, accountable authority for approval.

Publications/Guidance

Career planning in a changing landscape: do nurses need support? This briefing from the National Nursing Research Unit at King's College London, considers challenges in developing career planning support programmes. It draws on evidence from the Unit's cohort studies of nurses' careers.

Research on eliminating age discrimination in social services and mental health services. The DH commissioned two literature reviews and two research studies on the costs and benefits of eliminating age discrimination in the provision of health and social care. This was to inform decisions on whether to pursue legislation to outlaw discrimination in the provision of health and social services.

What matters to staff in the NHS? This research study, conducted for the Department of Health by Ipsos MORI, identifies the major emotional and behaviour drivers contributing to staff engagement and motivation to provide high quality patient care. The work has informed the Next Stage Review and the development of the draft NHS.

A new pay circular has been issued by NHS Employers outlining changes in the pay and terms and conditions for staff on Agenda for Change contracts.

DH: Pay framework for Very Senior Managers in Strategic and Special Health Authorities, Primary Care Trusts and Ambulance Trusts 2008-09: sets out the pay awards framework for very senior managers (VSMs) for 2008-09, defined as: chief executives, executive directors, with the exception of those who are eligible to be on the Consultant Contract by virtue of their qualification and the requirements of the post, and other senior managers with Board level responsibility who report directly to the chief executive - 'other second level very senior managers'. See also the letter from David Nicholson to Chairs and Chief Executives of NHS organisations that sets out the remuneration increases for chairs and non-executive directors, increases in pay for very senior managers, and the approval process for awards to those covered by the VSMs' Pay Framework.

Developing the NHS performance regime. Guidance intended to afford greater transparency and consistency across the NHS in relation to identifying underperformance, managing failure and considering interventions to address turnaround has been issued by the Department of Health. The Government is proposing new plans to drive up standards of care and tackle underperformance in hospitals and PCTs, that will identify failing trusts, remove poor managers and bring in new management, including from other hospitals or from the private sector. A further programme of work will be carried out to develop the detail of the vision and will be implemented as part of the 2008/09 Operating Framework. The Secretary of State for Health, Alan Johnson, suggested that if trusts fail to improve, a "turnaround plan" will be drawn up for a new management team. He added that the new managers could come from private health companies as well as from nearby NHS trusts. See also the Healthcare Commission's response to these plans.

News

DH: 'Creating a Healthier NHS' - NHS pilots well being assessments for staff: announces the launch of a new approach to supporting the health and well-being programmes for staff delivering NHS services. Rotherham PCT is the first of 10 sites across the country to pilot this programme. The pilot is being delivered by Vielife, and will start with an on-line health and well-being assessment drive to help to identify health issues in the pilot workforce. Throughout the pilot employees will receive on-line and off-line information on a wide range of health and well-being issues. It will also introduce a Healthy Eating programme and a Strength and Resilience programme to help staff identify and manage pressure in the workplace and everyday life. At the end of the first year, staff will be able to reassess themselves to see what improvements they have made. If there is still work left to do, then they will be able to undertake two additional lifestyle management programmes.

Bevan Brittan Updates

Have you got to have faith? Employment tribunal decisions on the Religious Discrimination Regulations 2003 are now starting to be reported, and John Moore reports on two recent developments.

TUPE: objecting and rejecting. How do the Transfer of Undertakings (Protection of Employment) Regulations operate if an employee objects to a transfer but then goes on 'secondment' with the transferee for a short period? And is a dismissal by a transferor automatically unfair if it is at the behest of a transferee - because the employee had brought employment tribunal proceedings against the transferee? Sarah Lamont looks at two cases which consider these questions.

News round-up. The latest news and developments in employment law, reported this month by Beth Cobner.

If you wish to discuss any of the items raised in this section please contact Sarah Michael.

Estates and Facilities

Publications/Guidance

Guidance on display energy certificates published. From 1 October 2008, occupiers of certain buildings (including hospitals) are required to show a display energy certificate (DEC) in a prominent place. The aims of this requirement are to enable the public to compare the energy performance of public buildings and to promote improved energy use. The requirement to display a DEC only applies to "buildings with a total useful floor area over 1,000 square metres occupied by public authorities and by institutions providing public services to a large number of persons and therefore frequently visited by those persons".

Bevan Brittan Services

Click here to view Bevan Brittan Asbestos flyer.

If you wish to discuss any of the items raised in this section please contact Mark Calverley.

Foundation Trusts

Publications/Guidance

Monitor has published a report on Developing the role of NHS foundation trust governors that summarises the results of research into how governors are performing in their new role, carried out by Ipsos MORI in October 2007. It reveals that the majority of governors are clear about their role, have good relationships with their executive board, and are using their statutory powers to make a difference. The report identifies where opportunities exist for further improvements, including one area - undertaking statutory duties - where Monitor has committed to playing a leading role. Monitor has also published the full results of the survey of Foundation Trusts governors.

Monitor: NHS foundation trusts - review of twelve months to 31 March 2008. This report details how the FT sector has performed over the fourth quarter for 2007/08. Overall, NHS FTs have performed well: their financial performance has been strong with a combined net surplus (pre-exceptional costs) for 89 NHS FTs for the 12 months to 31 March 2008 at £514m. Total revenues for the year were £16.3bn (£566m ahead of plan). Aggregate cash balances at 31 March 2008 amounted to £2.3bn.

Consultations

Monitor consultation on the interpretation and application of the Private Patient Income Cap. Monitor, the Independent Regulator of NHS Foundation Trusts, is seeking views on the rules that NHS foundation trusts should follow in relation to the legal ‘cap’ on the income they may earn from charges for services to patients. Comments by 9 September 2008.

Monitor consultation paper on updates to the NHS Foundation Trust Financial Reporting Manual 2008-09. Monitor issues the NHS Foundation Trust Financial Reporting Manual each year. This consultation covers the proposed changes for the 2008-09 manual. The consultation closes on 21 August 2008.

News

Monitor has announced that four more NHS Foundation Trusts have been authorised as from 1 June 2008:

		Cambridgeshire and Peterborough NHS Foundation Trust;
		North East London NHS Foundation Trust;
		University Hospitals Bristol NHS Foundation Trust.

and four new mental health NHS foundation trusts will be authorised from 1 July 2008:

		Pennine Care NHS Foundation Trust
		Tees, Esk and Wear Valleys NHS Foundation Trust
		Birmingham and Solihull Mental Health NHS Foundation Trust
		Sheffield Health and Social Care NHS Foundation Trust

Pennine Care NHS Foundation Trust will become the 100th NHS trust to achieve foundation trust status. The announcement means there are 103 NHS foundation trusts in total, of which 30 are mental health NHS foundation trusts.

If you wish to discuss any of the items raised in this section please contact Vincent Buscemi.

Governance

Publications/Guidance

Presentation to the NHS foundation trusts’ Chairmen’s conference - Is the Chair the Boss of the Board? Published 12 June 2008. Presentation by Professor Bob Garrett at the NHS foundation trusts’ Chairmen’s conference held in January 2008.

Information governance assurance programme. This letter from NHS Chief Executive David Nicholson draws attention to actions needed on information governance policies and processes.

Monitor has published two new reports on the role of NHS foundation trust governors. Developing the role of NHS foundation trust governors offers a summary of both the survey and the feedback from foundation trust governors. The report also identifies areas requiring further research and highlights the work that Monitor is planning on taking forward. Survey of foundation trust governors documents in full the results of the Ipsos MORI research carried out in October 2007 that formed the basis of Developing the role of NHS foundation trust governors. It is Monitor’s intention that these two reports act together as a useful reference for those with an interest in good governance and local accountability in health.

Specification for PCT board development. A board development specification has now been produced which PCTs can use locally to procure a board development programme. PCT board development has been identified as a key priority as part of the DH's world class commissioning programme. Following discussion with the ten strategic health authorities, DH has committed to leading this work at a national level.

If you wish to discuss any of the items raised in this section please contact David Owens.

Health and Safety

Publications/Guidance

Foresight Training Resource Pack. The National Patient Safety Agency (NPSA) has developed this resource to support nurses and midwives, working in all care settings to improve awareness of the factors that combine to increase the likelihood of patient safety incidents. It has been specifically designed to be flexible, so that it can be used in team meetings, handovers, mandatory training sessions and stand alone sessions, facilitated by members of staff.

Evaluation of disproportionate decisions on risk assessment and management. This report summarises a study of the scale and causes of disproportionate decisions. It is one of a number of sources that informed HSE’s sensible risk campaign.

Bevan Brittan Training

Corporate Manslaughter. The Bevan Brittan corporate manslaughter team provides a 2 hour training course on the issues raised by the Act as well as bespoke packages tailored to specific needs. If you would like more information please click here.

Managing the clinical and medico-legal risks of obesity. Julie Chappell can provide training on the issues around this increasingly high profile area including manual handling, risk management, equipment needs and clinical care. She has also recently published a journal article on the topic. If you would like more information on training or a copy/summary of the journal article please click here.

If you wish to discuss any of the items raised in this section please contact Duncan Astill.

Healthcare Associated Infection

News

DH: Matron numbers doubled to 5,000 - more powers to ensure highest standard of cleanliness and care: figures released by the DH show that there are 5,538 modern matrons in post. This follows a commitment the Prime Minister made in September 2007 to double the number of modern matrons to more than 5,000 by the end of May 2008. Matrons are responsible for improving standards of care, ensuring wards are clean and patients properly fed. They help set and monitor standards for cleaning and catering and have authority to take action where these are not met. In particular, they have strong powers that help in the fight against hospital infections.

Bevan Brittan Services

Infection prevention and control is a highly regulated area. The Healthcare Commission has warned all NHS Trusts in England that they must improve hygiene standards or face the risk of closure. A failure to meet the standard of care required can expose a healthcare provider to the risk of litigation, regulatory sanction and adverse publicity. If you are interested in the Bevan Brittan Healthcare Associated Infection Prevention and Control Training and Services please click here.

If you wish to discuss any of the items raised in this section please contact Simon Lindsay.

Human Organs and Tissue

Bevan Brittan Updates

June Claims online - Important new regulations on collection of cord blood samples. Jackie Linehan and Richard Annandale on the need for a Human Tissue Authority licence for collection of cord blood for human application at birth.

June Claims online - Blood sample saves £5million. Continuing with the bloody theme of this issue, Tim Hodgetts illustrates the medico-legal value of foetal blood samples with a Bevan Brittan success in the Court of Appeal that will have saved £5million.

If you wish to discuss any of the items raised in this section please contact Jackie Linehan.

Inquests

Legislation

Coroners (Amendment) Rules 2008. Justice Minister Bridget Prentice has made a written ministerial statement on new rules regarding coroners' powers to make reports to prevent future deaths. From July 17 2008, a new statutory duty will be placed on organisations to help prevent avoidable deaths. The new rules, which are being introduced ahead of the Coroners and Death Certification Bill, will ensure that organisations receiving reports from coroners respond within 56 days. The rules also stipulate that coroners must share reports and responses with those, including bereaved families, to whom they have assigned "interested persons" status. The Government will collate reports and responses centrally for the first time so that any trends can be identified. The proposed changes will amend Coroners Rules 1984 r.43 and add a new r.57A.

Publications/Guidance

Draft Charter for Bereaved People. This document brings together many of the services bereaved people will receive from coroners in a reformed system. A Ministry of Justice draft charter details the level of service that bereaved people should expect from the coroner service and sets out the rights of redress if services are not delivered. The main improvements include: a new requirement for coroners to contact families at least every three months to explain the status of the case and the reason for any delay; provision to ensure that any disclosure of documents made to families should be free of charge; provisions to ensure that families will receive copies of any "lessons learned" reports and responses; a new provision to ensure that families are aware they can report a death to the coroner's office personally if they believe that a professional agency has failed to do so; an extension of the time limit for appeals against a final decision to 60 working days; and a new "purpose of the coroner service" section.
See also the press release Coroner reform: Bereaved families' needs are central, says Bridget Prentice.

Summary of responses to the consultation on improving the process of death certification. This document provides an overview of respondents' comments on the proposals to address weaknesses identified by the Shipman Inquiry in the process of death certification in England and Wales.

News

Children's minister Beverley Hughes has said that the review of restraint in youth custody has been completed but signalled that it would not be published until the autumn. In a written parliamentary statement, Hughes said that the review's chairs, Andrew Williamson and Paul Smallridge, have submitted their recommendations to her and prisons minister David Hanson. However she said the review report would not be published until the government had formulated its response, with both issued together by the end of October. The review was announced last July after the monitoring of restraint in custody was questioned during the inquests into the deaths of Gareth Myatt and Adam Rickwood, both of whom died in secure training centres in 2004.

If you wish to discuss any of the items raised in this section please contact Joanna Lloyd.

Mental Health

Publications/Guidance

The Mental Capacity Act. A DH circular setting out the resources available for the year 2008-2009 for the Mental Capacity Act 2005 and provisional figures for 2009-2010 and 2010-2011 is now available.

Mental Capacity Act 2005: Deprivation of liberty safeguards code of practice. This is a written ministerial statement to Parliament by Justice Minister Bridget Prentice on 13 June 2008. She announces a new code of practice for deprivation of liberty safeguards.

Mental Capacity Act 2005: Deprivation of liberty safeguards - Code of Practice to supplement the main Mental Capacity Act 2005 Code of Practice. The Code contains guidance on the Mental Capacity Act Deprivation of Liberty Safeguards. The Code is particularly intended to provide guidance for professionals involved in administering and delivering the safeguards who are under a duty to have regard to the Code. The Code is also intended to provide information for people who are, or could become, subject to the deprivation of liberty safeguards, and for their families, friends and carers, as well as for anyone who believes that someone is being deprived of their liberty unlawfully.

Mental Capacity Act 2005 deprivation of liberty safeguards code of practice and regulations: report on consultation. This report is of a consultation exercise that took place between September 2007 and December 2007 relating to draft code of practice guidance and two sets of draft regulations concerning the deprivation of liberty safeguards introduced into the Mental Capacity Act 2005 by the Mental Health Act 2007.

Paying the price: the cost of mental health care in England. This report from the King's Fund, the results of a year-long study into the costs of meeting the mental health needs of the nation over the next two decades, reveals that mental illness in England cost £50 billion in 2007. Almost half, £22.5 billion represents money spent on direct NHS and social care services to support people with mental disorders. The rest, £26.1 billion, represents the estimated cost to the economy of earnings lost because of the thousands of people unable to work due to their mental illness. Although it finds that the prevalence of most mental disorders, including schizophrenia, is likely to remain stable over the next 20 years, it predicts a huge increase in dementia - up by almost two-thirds (61 per cent) from 582,827 to 937,636 due to an ageing population. As a result of this, and above inflation rises in health care costs, the bill for mental health services is expected to grow from £22.5 billion to £47 billion. The report contains chapters on eight different specific disorders: depression, anxiety disorders, schizophrenic disorders, bipolar and related conditions, eating disorders, personality disorder, disorders affecting children and adolescents, and dementia.

Smokefree mental health units from 1 July 2008. This letter highlights legislation that requires all mental health facilities to be smokefree from 1 July 2008.

The Mental Capacity Act: Local authority circular. This circular sets out the resources available for the Mental Capacity Act 2005 for the year 2008-09 and provisional figures for 2009-10 and 2010-11.

Looking at my genes: what can they tell me? Genetic testing FAQs, National Institute of Mental Health.

Consultations
Welsh Assembly
Government: Iechyd Meddwl Cymru - a well being and mental health service fit for Wales: seeks views on a recommendation that a statutory body responsible for mental health and well being in Wales be established, that would provide a comprehensive integrated mental health and well being service for Wales, including teaching and research. Its proposed structure would be unique to Wales but in line with the Government of Wales' health policies and strategies. The consultation closes on 2 September 2008.

NICE Consultation: Personality disorders - Borderline. This consultation seeks views on draft guidance for treating borderline personality disorders.

Transforming the quality of dementia care - consultation on a National Dementia Strategy. A DH consultation on a national dementia strategy and a review of the use of anti-psychotic drugs seeks views on proposals to improve the quality of dementia care and provide more help for people with dementia. The strategy, to be launched in autumn 2008, aims to increase awareness of dementia and remove the stigma associated with it, ensure early diagnosis and intervention and improve the quality of care. The Government will also consult on the appointment of a named dementia care advisor and the establishment of more memory clinics.

Cases

RP v Nottingham City Council [2008] EWCA Civ 462 (CA). This Court of Appeal decision contains important guidance as to the approach the OS will take when acting on behalf of incapacitated individuals (‘protected party’) as litigation friend. Notably, the role of the OS will be to advance the views of the protected party where ‘reasonably arguable’ on the law or facts and, if not reasonably arguable, not to make submissions that actively oppose the protected party’s views. The OS has adopted this position on the advice of Peter Jackson QC, appended to the judgment as Appendix B, who considers such a stance is necessary to comply with Article 6(1).

R (G) v Nottinghamshire Healthcare Trust [2008] EWHC 1096 (Admin) (Admin Ct): the court has ruled that patients at Rampton Hospital, a high-security psychiatric hospital, will not be allowed to smoke in their rooms as they could not be permitted to risk the health of others or themselves. The patients applied to quash Reg.10(3) of the Smoke-free (Exemption & Vehicles) Regulations 2007 (SI 2007/765) on the grounds that it breached their right to respect for family life under Art.8 ECHR as it prevented them from smoking in "the privacy of their own home". The court held that preventing a person smoking does not generally involve such adverse effect upon the person's 'physical or moral integrity' as would amount to an interference with the right to respect for private or home life within the meaning of Art.8. It did not accept the notion of an absolute right to smoke wherever one is living. There was powerful evidence that, in the interests of public health, strict limitations upon smoking, and a complete ban in appropriate circumstances, were justified. Given the harm which smoking may cause, the measures taken by the Secretary of Health and the Trust were proportionate.

News

Minister hails mental health service success. Care Services Minister Ivan Lewis congratulated the NHS on major improvements in key mental health services

Bevan Brittan Training

Mental Health Act Training. The changes to the Mental Health Act 1983 will be in place by October 2008.The Mental Health Law Team at Bevan Brittan offers a 3 hour course covering issues raised by the Act as well as bespoke packages tailored to specific needs. Click here for details of the Bevan Brittan Mental Health Act Training.

Regulated Care Sector Seminar. Dramatic changes are taking place in the way that health and social care are provided, regulated and commissioned. In September Bevan Brittan is holding its annual Regulated Care Sector Seminar 2008. These seminars which are free of charge will provide you with valuable information to enable your business to prepare for the changes that are afoot. The seminars will take place in our London office (11 September), Bristol office (24 September) and Birmingham office (25 September). Click here if you would like more information on these sessions.

Bevan Brittan Booklets/Updates

Supervised Community Treatment flowchart. Simon Lindsay has produced a Supervised Community Treatment flowchart card which sets out the key points in relation to Supervised Community Treatment. If you would like a copy please contact Lisa Selby.

Mental Capacity Act booklet.  We have produced a credit card size booklet that sets out the Mental Capacity Act 2005 key points. If you would like a copy please email Lisa Selby with your name and address and you will receive a copy through the post.

If you would like a copy of the Bevan Brittan update on the recent case brought by patients at Rampton relating to smoking please contact Claire Bentley.

If you wish to discuss any of the items raised in this section please contact Simon Lindsay.

Obesity

Publications/Guidance

NICE Guidance: Rimonabant for the treatment of overweight and obese patients. This guidance covers the use of the drug Rimonabant in treating obese and overweight patients. The recommendations include that the drug should be used if patients also have other risk factors such as type-two diabetes or high levels of cholesterol and that the drug should be used at the same time as a calorie-controlled diet and exercise.

Department of Health: Obesity. This page gives information on obesity, which is associated with many illnesses and is directly related to increased mortality and lower life expectancy.

Obesity: The challenges we face - Speech by Deirdre Hutton. This is a transcript of the speech by Chair of the Food Standards Agency Deirdre Hutton at the faculty of public health annual conference on 5 June 2008. She talks about practical ways to tackle the obesity problem.

News

DH: Bidding begins for healthy towns. The DH is inviting towns in England to bid to be a Healthy Town by coming up with innovative new ways to improve the health of their inhabitants, as part of the Government's obesity strategy. Successful localities will receive additional resources from the £30m Healthy Community Challenge Fund to build on existing work in their communities and test out their ideas on what further action needs to happen to make regular physical activity and healthy food choices easier for people. In each case the local areas will be expected to match any resources they receive from Government. The selection process is in two stages: PCTs and local authorities should submit their joint expression of interest by 11 July 2008, whilst the deadline for the detailed proposal and delivery plan is September 2008.

Study links slimming drug to depression.

Bevan Brittan Training

Managing the clinical and medico-legal risks of obesity. Julie Chappell can provide training on the issues around this increasingly high profile area including manual handling, risk management, equipment needs and clinical care. She has also recently published a journal article on the topic. If you would like more information on training or a copy/summary of the journal article please contact Julie Chappell.

If you wish to discuss any of the items raised in this section please contact Julie Chappell.

Patient

Publications/Guidance

An Accreditation Scheme for Health and Social Care Information: Next steps and testing phase. This letter sets out the next steps for the information accreditation scheme, which will improve patients' experiences by making it easier for them to judge the quality of information and make decisions about their health, health care and social care.

No patient left behind: How can we ensure world-class primary care for black and ethnic minority people? The 2007 GP Patient Survey highlighted significant variations between GP practices in levels of patient satisfaction, together with lower satisfaction rates for people from some BME groups. In response, the Secretary of State announced in July 2007 that he was asking Professor David Colin-Thomé, National Clinical Director for Primary Care, and Professor Mayur Lakhani (former Chair of the RCGP) to lead two reviews into access and responsiveness of primary care services. In this report, Professor Lakhani looks specifically at the reasons for lower satisfaction among patients from some BME communities.

Report and analysis of the experience of patients in black and minority ethnic groups. This publication examines variations in the self-reported views of NHS patients from different ethnic groups across a range of healthcare settings. The work was undertaken jointly by the Department of Health and the Healthcare Commission. Results include data from the national surveys of patients published by the Healthcare Commission up to and including 2006-07. See also the press release that announces the creation of a national support programme, led by Dr Michael Warburton, to work with the NHS and with GP practices to drive forward improvements in GP services. The programme brings together existing work to extend GP opening hours and to invest £250m in establishing additional primary care services that increase access and patient choice, together with fresh action to ensure that these additional services create more responsive and accessible primary care for BME groups.

NHS progress against 18 week target. The NHS has met its commitment to reduce the time patients wait from referral from their GP to starting their treatment. By 31 March 2008, 85% of patients who require admission to hospital and 90% of patients not needing admission started treatment within 18 weeks of referral from their GP. Also, the NHS is on track to meet the Government's target that by December 2008 every patient, for whom it is clinically appropriate and who wants it, will start their treatment within 18 weeks. Many trusts have already delivered this target 9 months early.

18-week Patient Experience Survey and National Patient Choice Survey. This is a letter from the director general of NHS finance, performance and operations to inform strategic health authority, primary care trust and NHS trust chief executives of the intention to use primary care trust-level surveys to measure local patient experiences of 18-week pathways. Patient experiences of choice will continue to be measured through the national patient choice survey.

Report of the national patient choice survey, England - January 2008. This report gives the final results of around 72,000 responses to the eleventh national patient choice survey commissioned to assess the implementation of choice at PCT level. The series of surveys, conducted by Ipsos MORI on behalf of DH, monitors patient awareness of choice and recall of having been offered a choice of hospital for their first outpatient appointment. They were designed to provide a national overview of choice and summary results at PCT level and generally have an effective response rate around 30%.

A vision for emergency and urgent care: the role of ambulance services. This report from the NHS Confederation's Ambulance Service Network sets out the Ambulance Service Network’s vision for emergency and urgent care, and explains how ambulance services can help transform patients’ experiences and outcomes, and deliver better value for money for taxpayers.

If you wish to discuss any of the items raised in this section please contact Duncan Astill.

Primary Care Trust

Publications/Guidance

Progress with FESC. This Dear colleague letter is to inform PCT chief executives of revised FESC (Framework for procuring external support for commissioners) governance requirements for PCTs to follow, giving a streamlined procurement timetable. The commercial and technical support role will increasingly move from the DH to the SHA. To assist this, FESC awareness sessions and workshops are being arranged through SHAs.

DH: More GP surgeries open longer. Reports on new statistics for May 2008, published for the first time, which show that 20% of family doctor practices are already offering extended opening for their patients, and in 21 PCTs more than half the local family doctor services are offering extended opening.

DH: 32 PCTs to spearhead surge in talking therapies. Announces the 32 sites who will begin to roll out talking therapies around the country. Each of the 32 PCTs will receive a share of the £33m first instalment of new money announced for the purpose by Health Secretary Alan Johnson on 10 October 2007. The funds will help the NHS create a new workforce that can offer properly supervised low intensity and high intensity therapy, slashing waiting times for this kind of treatment and helping patients achieve a level of recovery that they can clearly see and which is in line with the evidence from clinical trials that has been independently reviewed by NICE.

PCT survey: provision of IVF in England 2007. This survey was carried out in autumn 2007 and will be used as a basis for monitoring IVF provision. Overall, there is a move towards the implementation of the NICE guideline, though there remain variations in access criteria. To help move to more equitable provision, the Government has established an expert group on commissioning NHS infertility provision, which will:-

		identify the barriers to the NHS progressing to the implementation of the NICE fertility guideline, taking account of the current variation in provision of IVF and ICSI between PCTs, the current variation in access criteria and the intermittent suspension of services in some locations
		identify and bring about the tools which will help PCT commissioners in making decisions on fertility provision and encourage stepwise progress towards the full implementation of the NICE fertility guideline

The expert group will support the work being carried out by Infertility Network UK, which will identify and disseminate good practice in the provision of fertility services.

If you wish to discuss any of the items raised in this section please contact David Owens.

Prison Health

Publications/Guidance

Common Themes from Analysis of 120 Prisons and Probation Ombudsman Reports. This letter, written by Richard Bradshaw, Director of Offender Health, deals with best practice issues on learning from Prisons and Probation Ombudsman reports on death in custody.

Short-changed - Spending on prison mental health care. This report, published by the Sainsbury Centre for Mental Health (SCMH) , states that prison mental health services in England face a postcode lottery in funding and get only one-third of the money they need.

Bevan Brittan Training

In September Bevan Brittan is holding its Prison Health Seminar 2008. The topics that will be covered are:-

		Mental Health in Prison
		Prison Health Care Models
		Corporate Manslaughter
		Mental Capacity
		Information Sharing

This seminar is free of charge and will take place in our London Office. If you would like more information please click here.

If you wish to discuss any of the items raised in this section please contact Nadia Persaud.

Regulation

Publications/Guidance

Implementing the White Paper Trust, Assurance and Safety: Enhancing confidence in healthcare professional regulators - Final report and the Department of Health's response to recommendations. This document presents the recommendations of a working group on enhancing public confidence in the regulators of healthcare professionals and the Department's response to its recommendations.

Healthcare Commission: The annual health check 2008/09 - assessing and rating the NHS. This document sets out the design of the Healthcare Commission's NHS assessment framework for 2008-09 that measures basic standards across the NHS as well as performance on indicators that matter to patients, including safety, clinical effectiveness and waiting times. The overall structure of the health check is largely unchanged for 2008/09. Each NHS trust will again receive an overall performance rating in two parts – one rating for the quality of services and one for quality of financial management. The Healthcare Commission will carry out the 2008/09 health check until the end of the assessment year in April 2009; after then it is replaced by the new regulator for health and social care, the Care Quality Commission, which is expected to publish the results in autumn 2009.

Healthcare Commission: Corporate plan 2008/2009. Outlines the activities that the Healthcare Commission plans to undertake this year. The Commission's regulatory role is being taken over by the Care Quality Commission from April 2009 so this document details its specific plans to March 2009 in the context of the vision for the new regulator. It includes the roles of the new regulator in registering and assessing providers of healthcare in the NHS as well as the independent sector, in assessing commissioners and in promoting the efficiency and effectiveness of regulation. However, the Commission's first priority is the delivery of its statutory functions through the programme of work set out in this plan for 2008/2009.

Cases

General Medical Council v George (Unreported, 6 June 2008) (QBD). An extension of an interim order of suspension against a doctor was granted where further investigation of his fitness to practise was necessary for the protection of patients and the public, and outweighed any prejudice suffered by the doctor and concerns about the considerable delays that had occurred in the proceedings.

P v Nursing and Midwifery Council (Unreported, 11 June 2008) (Admin Ct, Lloyd-Jones J). A decision of a professional conduct committee to remove a psychiatric nurse's name from the register of nurses after he had spent a weekend away with a mental health patient was appropriate as the nurse's behaviour amounted to serious professional misconduct.

News

Healthcare Commission to cross-check NHS performance. More trusts have declared that they are compliant with more of the standards compared to last year in the first stage of annual performance assessment (NHS trust declarations on standards for 2007/8). The Healthcare Commission has said it will carry out a thorough check of these public declarations on whether they meet the government’s standards for healthcare.

Bevan Brittan Training

Regulated Care Sector Seminar. Dramatic changes are taking place in the way that health and social care are provided, regulated and commissioned. In September Bevan Brittan is holding its annual Regulated Care Sector Seminar 2008. These seminars which are free of charge will provide you with valuable information to enable your business to prepare for the changes that are afoot. The seminars will take place in our London office (11 September), Bristol office (24 September) and Birmingham office (25 September). Click here if you would like more information on these sessions.

If you wish to discuss any of the items raised in this section please contact Neil Grant.

Third Sector

Publications/Guidance

Cabinet Office: Criminal Records Bureau checks - guidance for volunteering: advises organisations that use volunteers about when they do and don't need to carry out CRB checks on volunteers. People volunteering or working with children or vulnerable adults are sometimes legally required to have a CRB check. Where contact with vulnerable people will be limited or perhaps the person has recently been CRB checked for a different role, a decision about clearance must be made. The guidance clearly explains how the check works as part of a proper risk management process.

Third sector strategy - Improving policies and securing better public services through effective partnerships 2008-2011. A Ministry of Justice document outlines a strategy for engaging with the third sector to deliver better public services and improve policy through effective partnerships.

Consultations

Towards a strategy to support volunteering in health and social care - consultation: the DH has launched a consultation on a proposed volunteering strategy for health and social care that will articulate the key actions needed to address the perceived obstacles to volunteering. The proposed Strategy aims to: raise the esteem and profile of volunteering; help improve management and support for volunteers; support more robust evaluation of the outcomes and benefits of volunteering; and allow more coherent investment to support their involvement. The consultation closes on 30 September 2008, and the Government hopes to publish the final Strategy and implementation plan in early 2009.

If you wish to discuss any of the items raised in this section please contact John Chapman.

General

Publications/Guidance

Commission for Rural Communities: Our NHS, Our Future - a rural response. The CRC has submitted a dossier of evidence to the NHS Next State Review to help provide the NHS, central government and regional and local service providers with a greater understanding and delivery of better healthcare services in rural areas. The summary and recommendations paper highlights the key issues together with the CRC's recommendations. The dossier includes a short film follows the Rural Advocate, Stuart Burgess, as he investigates healthcare provision in rural areas. There are also a number of factsheets on issues regarding the delivery of healthcare in rural areas.

Strategic Health Authorities' visions for better healthcare. Each of the nine Strategic Health Authorities (SHAs) involved in the Our NHS our future: NHS next stage review has published its vision for better healthcare. These vision documents will be the basis of Lord Darzi's final Our NHS, Our Future report, which will enable and support their delivery. The documents cover: East of England; East Midlands; South Central; South East Coast; South West; North East; North West; West Midlands; Yorkshire and Humber.

DH: Health inequalities: progress and next steps. Sets out the Government's commitment to tackling health inequalities and helping the most deprived communities. It also identifies how the challenging PSA target for Health Inequalities (by 2010 to reduce inequalities in health outcomes by 10%) can be met. Record spending in the NHS in England will increase from just over £90bn in 2007-08 to almost £110bn in 2010-11. This takes account of inequalities so that sustainable action can be taken. The Government has also announced £34m funding for programmes to support local communities.

A profile of the nation's health - wake-up call on health inequalities. The DH and the Association of Public Health Observatories have published Health Profiles for every local authority and region across England. The Profiles use key health indicators to capture a picture of the nation's health down to local level, providing areas across England with valuable information to improve their population's health. This year's data also includes new information on child health inequalities. The Profiles follow the launch of the report Health inequalities: progress and next steps that sets out clear and achievable measures for the NHS and local authorities to implement, together with the Health Inequalities Intervention Tool that helps PCTs, practice-based commissioners and local authorities to implement simple, effective, evidence-based measures to affect the life expectancy gap of their local populations. It can be used as part of a comprehensive local strategy to reduce health inequalities.

DH: 'Creating a Healthier NHS' - NHS pilots well being assessments for staff: announces the launch of a new approach to supporting the health and well-being programmes for staff delivering NHS services. Rotherham PCT is the first of 10 sites across the country to pilot this programme. The pilot is being delivered by Vielife, and will start with an on-line health and well-being assessment drive to help to identify health issues in the pilot workforce. Throughout the pilot employees will receive on-line and off-line information on a wide range of health and well-being issues. It will also introduce a Healthy Eating programme and a Strength and Resilience programme to help staff identify and manage pressure in the workplace and everyday life. At the end of the first year, staff will be able to reassess themselves to see what improvements they have made. If there is still work left to do, then they will be able to undertake two additional lifestyle management programmes.

Bevan Brittan Services

Bevan Brittan has a comprehensive library service and a specialist team of Practice Support Lawyers who concentrate on effective knowledge management and professional support. We also provide training and advice at Trust offices in order to review and effectively manage knowledge. Click here to view our flyer on the Bevan Brittan Knowledge Management Services in Health.

If you wish to discuss any of the items raised in this section please contact Claire Bentley.